Evaluation of regulatory T cells in obese asthmatic children

Background: Asthma is an airway inflammatory disorder with functional and structural changes. Regulatory T (T reg) cells are important in controlling immune responses. The study was aimed to investigate the frequency of Treg cells in obese asthmatic children, in comparison to non-obese asthmatics and healthy matched controls .Methods: In addition to anthropometric and body mass index (BMI) assessment, peripheral blood samples from healthy control subjects (n = 30) and asthmatic obese (n=30) and asthmatic non-obese children (n=30) were examined for serum IgE, eosinophils counts, and flowcytometric measurement of CD4+CD25+CD127 low/neg- T cells. Pulmonary function testing was performed for asthmatic children . Results: Obese asthmatics showed significantly higher levels of serum IgE and CD4+CD25+CD127 low/neg- T cells as compared to healthy controls (p<0.001, 0.001, respectively) while comparable numbers of T reg cells were found among obese and non-obese asthmatic children. Asthmatics receiving inhaled corticosteroids (ICS) showed higher percentages of CD4+CD25+CD127 low/neg- T cells than the non-receivers (median 11.8% vs 8.8%, p <0.001). No significant correlations were found between Treg and age, eosinophil percentage, total serum IgE, pulmonary functions, or BMI and its Z score . Conclusion: Our study demonstrates an increased frequency of Treg cells in asthmatic children compared to controls with possible association with the use of ICS but not with obesity. Small sample size and lack of obese non-asthmatic group are the main points of limitation in our study

Cytokine profile of obese asthma phenotype

Background: The incidence of asthma and obesity is increasing worldwide. Understanding the causal directions between asthma and obesity could have important therapeutic implications. However, the mechanism connecting the two is not well defined.Objective: This study was undertaken to compare pulmonary function tests (PFTs), C-reactive protein (CRP) and inflammatory cytokines in obesity and asthma in Egyptian adolescents and to investigate whether obese asthmatics have a specific inflammatory phenotype than lean asthmatics.Methods: Fifty asthmatic and 30 control subjects were enrolled in the study and divided into 2 sub-groups: obese and non-obese. Serum levels of CRP, leptin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), IL-5, body mass index (BMI) and PFTs were done for asthmatics and controls.Results: Serum levels of IL-6, TNF-α and leptin in obese individuals whether asthmatic or not showed significant increase compared to lean ones (P < 0.01). Body mass index (BMI) showed positive linear correlations with serum levels of IL-6, TNF-α, leptin and CRP. Serum IL-5 showed significantly higher levels in all asthmatics versus all controls (P < 0.01). Also serum IL-5 showed non-significant difference between lean and obese asthmatics and it showed significant negative correlations with FEV1/FVC % and PEF.Conclusion: Serum levels ofIL-6, TNF-α and leptin could be considered surrogate markers for obesity, whereas serum IL-5 is considered a marker of airway inflammation in bronchial asthma. Thus obesity and asthma have been shown to coexist together but systemic and airway inflammation appears to operate independent of each other.Keywords: Asthma, cytokines, obesity, phenotyp

Prevalence of bronchial asthma and correlation between the chemokine receptor 3 gene polymorphism and clinical asthma phenotypes among Egyptian asthmatic children

Abstract Background Asthma is a chronic inflammatory airway disease characterized by episodic reversible airway obstruction that variably presents with cough, wheezing, shortness of breath, or chest tightness. It is a multigenetic disease, where both genetic and environmental factors have significant roles in pathogenesis. As regard asthma pathogenesis, the chemokine/chemokine receptor system is considered a key point of the immune response in most allergic diseases. This study was done to estimate the prevalence of bronchial asthma among school age children and explore the association between the underlying gene polymorphisms in chemokine receptor 3 (CCR3) and symptom-based clinical asthma phenotypes among a cohort of Egyptian children. Results Prevalence of asthma is increasing (20.6%). There are male asthma predominance. Family history of bronchial asthma and allergic diseases are predominant risk factors for asthma development. Sixty asthmatic cases with different clinical phenotypes were compared to 100 healthy controls, results explored that eosinophilic percent and total serum IgE are significantly higher among asthmatic cases versus controls. There are no significant difference regarding eosinophilic percent, serum IgE, and CCR3 T51C gene polymorphism among different clinical asthma phenotypes. There is no significant difference as regards degree of severity of asthma and level of asthma control between CCR3 T51C gene polymorphism. Conclusion We conclude the prevalence of bronchial asthma is increasing. Also, eosinophilic percent and serum IgE are elevated in asthma patients, while CCR3 T51C gene polymorphism frequency seemed to be more prevalent among asthmatic subjects however without statistical significance. We recommend a prospective study on larger sample size to validate our results

Association between chemokine receptor 3T51C gene polymorphism and different clinical asthma phenotypes in Egyptian asthmatic children

Background Asthma is a heterogeneous disorder, which is affected by interaction between genes and the surrounding environment. Chemokine receptor 3 (CCR3) which is expressed over eosinophils and Th2 lymphocytes has a significant role in chemoattraction of those cells to inflammatory sites which symbolizes a key mechanism in asthma. Aim A trial to detect the association between CCR3 T51C gene polymorphism and different asthma phenotypes (allergic march phenotype, cough-predominant asthma phenotype, and wheeze-predominant asthma phenotype). Patients and methods A case–control study was conducted comprising 60 asthmatic patients and 100 healthy controls. Asthmatic children were divided into three groups of 20 patients each, group 1 allergic march phenotype (wheeze asthma phenotype with allergic rhinitis and/or atopic dermatitis), group 2 cough-predominant asthma phenotype, and group 3 wheeze-predominant asthma phenotype. The included cases and controls underwent total serum immunoglobulin E (IgE) using the enzyme-linked immunosorbent assay technique, peripheral eosinophilic percent, and PCR-restriction fragment length polymorphism for CCR3 T51C gene polymorphism. Results Asthmatic children showed significant increase in crowding index, family history of bronchial asthma, parental smoking, parental consanguinity, and total serum IgE than controls. Also, the CCR3 T51C gene polymorphism was found in Egyptian asthmatic children but no significant association concerning this polymorphism and different clinical asthma phenotypes was detected. Conclusion In conclusion, allergic march phenotype showed significant higher frequency with positive family history of asthma when compared with cough and wheezy asthma phenotypes. Also, parental consanguinity showed higher frequency in cough phenotype compared with allergic march phenotype. Furthermore, the CCR3 T51C gene polymorphism is found to be present in Egyptian asthmatic children, but there is no significant association between CCR3 T51C gene polymorphism and different asthma phenotypes. So, larger scale studies are needed. However, the TT genotype showed higher frequency in the studied phenotypes compared with CC and CT genotypes while asthmatic cases with the CC genotype showed higher total serum IgE compared with those with TT and CT genotypes

Schimke immune-osseous dysplasia: A case report

Schimke immune-osseous dysplasia (SIOD) is a rare autosomal recessive disorder characterized by spondylo-epiphyseal dysplasia (SED), progressive renal insufficiency beginning as steroid-resistant nephrotic syndrome (SRNS) and defective cellular immunity. This article reports a case from Egypt with a mild form of SIOD. A 14.5-year-old male patient presented with disproportionate short stature, SRNS (focal and segmental glomerulosclerosis), laboratory evidence of cellular immune deficiency and radiologic characteristics of SED. He died at the age of 16.5 years with bone marrow failure and severe pneumonia. To the best of our knowledge, this is the first case of SIOD to be reported from Egypt

Fifteen years of kidney biopsies in children: A single center in Egypt

This study retrospectively investigates the indications and results of renal biopsy in children to determine the patterns of childhood kidney disease in a single tertiary children′s hospital in Egypt. We included all the patients who underwent ultrasound-guided renal biopsy from 1998 to 2012. All the kidney biopsies were studied under light microscopy, while immunofluorescence and electron microscopy were performed when indicated. A total of 1246 renal biopsies were performed over 15 years, on 1096 patients. The mean age of the patients at the time of biopsy was 9.2 ± 3.7 years. The main indication for a biopsy was the steroid-resistant nephrotic syndrome (n = 354, 28.4%), followed by the atypical nephrotic syndrome (n = 250, 20.1%), and renal abnormalities in the systemic diseases (n = 228, 18.3 %). In the 1226 pathologically diagnosed specimens, primary glomerulonephritis was the most common finding (n = 826, 67.4%), followed by secondary glomerulonephritis (n = 238, 19.4%). The most common causes of primary glomerulonephritis were Minimal Change Disease (MCD) (n = 267, 21.8%), diffuse proliferative glomerulonephritis (n = 188, 15. 3%), and focal proliferative glomerulonephritis (n = 164, 13.3%). Lupus nephritis (n = 209, 17%) was the most common cause of secondary glomerulonephritis. We conclude that the steroid-resistant nephrotic syndrome was the most frequent indication for biopsy and minimal change disease was the most common histopathological finding in our population