Journal of African Christian Biography: v. 5, no. 2

A publication of the Dictionary of African Christian Biography with U.S. offices located at the Center for Global Christianity and Mission at Boston University. This issue focuses on: Women / Bilingual (French): 1. Biography of Émilienne Mboungou-Mouyabi (née Niangui Loubota), Congolese woman pastor, in ENGLISH and in FRENCH; 2. "Recovering the Lives of African Women Leaders in South Africa: The Case of Nokutela Dube" By Heather Hughes, chapter from African Christian Biography: Stories, Lives and Challenges, (D. L. Robert, editor); 3. "Notes on the Life History of the Reverend Canon Professor Emeritus John Samuel Pobee (1937 to 2020)"" by Casely Essamuah.; and, 4. "Theological Publishing and the Future of Christianity in Africa: African Theological Network Press" by Kyama Mugambi. 5. Book Notes, by Beth Restrick

Improving Early Diagnosis Of Cervical Cancer Lesions Using p16INK4a Biomarkers On Cellblocks From Cervical Smears

Globally, cervical cancer is the second most regular malignant growth in females after breast cancer. Timely recognition of premalignant lesions is an essential segment in the decrease of related morbidity and mortality. Though Pap -Smear test has been a helpful screening device despite hampered by high intra and interobserver changeability, false negatives at 20– 30% and false positives at 5– 70%. Objective: The study was to determine the role of p16INK4a biomarker in the identification of low grade Squamous Intraepithelial lesions in cellblocks prepared from Pap smears and subsequently compared with previous Pap smear results with Colposcopy and Cellblock results. Methodology:  This was a laboratory-based, prospective study with a parallel comparative arm at Kenyatta National Hospital Reproductive health clinic (66). All patients who had abnormal Pap smear reports and referred for Colposcopy, and consented for the study were enrolled. A smearwas taken just before taking a Colposcopy biopsy. The cytobrush was immediately put in Acid alcohol fixative centrifuged and deposits wrapped in a filter paper and processed histologically to form a cellblock. Colposcopy biopsies were then retrieved from KNH histology Lab and both samples subjected to Routine histological stain and eventually with biomarker p16. Total of 85 samples was collected. Results: There was a significant level of agreement between Pap smears and cellblock findings on the routine Histological stain. Of the 58 cases analyzed Colposcopy had (39%) 27 negatives and (45%) 31 positives while cellblock had (48%) 33 negative and (36%) 25 positive for pre and malignancy with a confidence interval of 0.016 as the margin of error. Biomarker Colposcopy had (43%) 30 negativity and (41%) 28 positivity while cellblock had negativity of (46%) 32 and positivity of (38 %) 26 Conclusion: Poor inter-rater agreement resulting to mortality and morbidity associated with false positives and false negatives, cellblock prepared from residues of cytobrush stained with Haematoxyline and Eosin and biomarker is likely to circumvent all the above, together with minimizing loss to follow up as patients only visit health facility once and they acquire all the results without resampling hence drastically reducing the cost of colposcopy, which require highly specialized equipment and experienced personnel who are very few and difficult to find

Prevalence of abnormal cervical cytology among women infected with HIV in Machakos County Hospital Kenya

Background: Cervical cancer is increasingly becoming a major threat to health among women in the world particularly in developing countries where screening programs are not well established. In Kenya, cervical cancer is the second most frequent cancer among women and the leading cause of cancer deaths in women of reproductive age.Studies have shown that women infected with HIV especially those with low CD4 counts or decreasing immunity are at a higher risk of developing pre cancerous cervical lesions and invasive cervical cancer than those in the general population without HIV infection.Objective: To determine the prevalence of abnormal Pap smears in HIV positive women attending Comprehensive care clinic at Machakos Level 5 Hospital.Design: Cross sectional descriptive studySetting: Machakos County hospital.Subjects: Women infected with HIV attending Machakos County Hospital Comprehensive care clinic.Results: 295 women infected with HIV were enrolled in this study and cervical smear taken for cytology screening. 22 were excluded from the analysis due to unsatisfactory smears. The prevalence of cervical cytology abnormalities was 14 out of 273 (5.1%) with HSIL being the most prevalent at 5 out of 273 (1.8%). Other lesions were ASC-H 4 (1.46%), LSIL 3 (1.05%), SCC and Adenocarcinoma both with 1(0.36%).In this study, age and Pap smear findings had no statistically significant association, X²=6.262, p=0.618.Conclusion: This prevalence of abnormal cervical cytology among HIV infected women in this study was 5.2%. There was no statistically significant association between age and Pap smear findings

HPV DNA testing and pap smear cytology co-testing as a‘test of cure’ in patients previously treated for cervical lesions by leep at Kenyatta National Hospital

Background: HPV infection is a pre-requisite for the development of the majority (99.7%) of precancerous cervical lesions. Treatment of cervical precancerous lesions reduces the risk of invasive cervical cancer by 90%; however, treated women still have five times risk of invasive cancer compared to women who have  always had a normal Pap smear, thus special follow-up measures are critical to reduce these risks.Objective: To determine the utility of co-testing by conventional Pap smear and HPV testing as a ‘test of cure’ in patients previously treated for cervical lesions by LEEP at KNH.Design: Cross sectional descriptive study.Setting: Kenyatta National Hospital and KAVI molecular laboratory.Subjects: Women on follow for cervical lesions post LEEP treatment.Results: Out of the 25 participants, 22(88%) had a report of NILM while 3(12%) had a report of ≥ASCUS). 16 (64%) were positive for HPV. HPV 56 was the commonest HPV subtype detected in 11 patients (41%). The Cohen’s Kappa correlation between Pap smear and HPV DNA test not statistically significant = 0.143, 95% CI: -0.17 to 0.46, p=0. 166.There was no statistically significant association between HIV status and pap smear findings post LEEP, X²=0.711, p=0.399Conclusions: Co-testing with HPV DNA testing and Pap smear is a useful approach to stratify women with no cytological abnormalities according to their risk of residual diseas

Potential involvement of the immune system in the development of endometriosis

This article presents an overview of immunological factors and their role in the development of endometriosis, with emphasis on inflammatory cytokines, growth and adhesion factors. Although retrograde menstruation is a common phenomenon among women of reproductive age, not all women who have retrograde menstruation develop endometriosis. The development of endometriosis is hypothesised to be a complex process, which may be facilitated by several factors, including the quantity and quality of endometrial cells in peritoneal fluid (PF), increased inflammatory activity in PF, increased endometrial-peritoneal adhesion and angiogenesis, reduced immune surveillance and clearance of endometrial cells, and increased production of autoantibodies against endometrial cells. Potential biomarkers like cytokines and autoantibodies upregulated during development of endometriosis may be useful in the development of a non-surgical diagnostic tool. Although endometriosis can be treated using hormonal suppression, there is need for non-hormonal drugs, which can inhibit the development of endometriosis and alleviate pain or infertility without inhibition of ovulation. New molecules that modulate immune function in endometriosis should be the targets for future research

DETERMINATION OF ANTIGEN LEVELS: T-PLASTIN, TRANSGELIN AND CA-125 IN BABOONS WITH INDUCED ENDOMETRIOSIS

Endometriosis is defined as the presence of endometrial-like tissue outside the uterine cavity and is associated with chronic intra-pelvic inflammation. Its symptoms, which are often severe, have a negative impact on a woman’s quality of life. They include chronic pelvic pain and infertility. It is estimated that about 10% women in their reproductive ages are affected by the disease globally. Currently, diagnostic methods are laparoscopy with histological confirmation and non-invasive such as ultrasound and the quantification of CA-125 biomarker in serum. CA-125 is known to be elevated in endometriosis, however it does not have sufficient diagnostic power as a single biomarker of endometriosis. Due to this, there is a need to determine other antigens that would act as potential biomarkers for endometriosis. It has been observed that Transgelin and T-Plastin are upregulated in endometriosis lesions and in secretory phase of endometrium respectively. There is insufficient data available showing the concentration of T-plastin in serum or plasma in the development of endometriosis. The main objective of this study was to identify whether T-plastin, Transgelin and CA-125 are potential biomarkers in early diagnosis of endometriosis using animal model for endometriosis. The baboon model represents clinically relevant research models for endometriosis. This study compared the levels of T-plastin, Transgelin and CA-125 in the peripheral blood and peritoneal fluid of baboons before and after induction of endometriosis. In this prospective, case-control study, ten female baboons (Papio anubis, 9-15 kg each) of proven fertility that have had at least one menstruation during captivity, were induced by intra-pelvic injection of menstrual endometrium on day 1 or 2 of menstruation followed by staging laparoscopy. Serum and peritoneal fluid samples were collected prior to induction to serve as controls.T-Plastin, Transgelin and CA-125 were measured using commercially available ELISA Kits. Data was analyzed using non-parametric test and level of significance at p<0.005. T-Plastin and Transgelin had insignificant p values in both peripheral blood and peritoneal fluid while CA-125 showed p=0.0003 in peripheral blood and p=0.0279 in peritoneal fluid. Diagnostic performance of individual biomarkers was determined by Receiver Operating Characteristic (ROC) with the Area under the curve (AUC) equal to 0.5 showing T-Plastin and Transgelin in both serum and peritoneal fluid unreliable for use as biomarkers in endometriosis. CA-125 levels in peritoneal fluid had an AUC of 0.7900 indicating it can be used as potential biomarkers for endometriosis. Key words: Endometriosis, biomarkers, T-Plastin, Transgelin, CA-125, ELISA, Olive Baboons. DOI: 10.7176/ALST/75-06 Publication date:August 31st 201

Diagnostic and Antivenom Immunotherapeutic Approaches in the Management of Snakebites

Snakebite envenoming normally occurs as a result of the injection of venom following the bite of a venomous snake or the spraying of venom into a person’s eyes by snake species that are capable of spitting venom as a defense mechanism. According to World Health Organization, snakebite is considered to have high mortality among the neglected tropical diseases. The administration of toxin-specific therapy in snake envenoming is predicated on improving diagnostic techniques capable of detecting specific venom toxins. Various serological tests have been used in detecting snakebite envenoming. Comparatively, enzyme-linked immunosorbent assay has been shown to offer a wider practical application. On the other hand, the unavailability of effective antivenoms to treat snake envenoming has created a critical health need at global level. It has been reported that antivenom immunotherapy is the treatment of choice for snakebites. The generation of toxin-specific antibodies would lead to an increase in the dose efficacy of antivenoms and consequently reduce the risk of early anaphylactoid and late serum reactions that typify the administration of large volumes of horse and sheep-derived antivenoms. The aim of this chapter is to explore and discuss diagnostic and antivenom immunotherapeutic approaches to the management of snakebite envenoming

TRIzol treatment of secretory phase endometrium allows combined proteomic and mRNA microarray analysis of the same sample in women with and without endometriosis

<p>Abstract</p> <p>Background</p> <p>According to mRNA microarray, proteomics and other studies, biological abnormalities of eutopic endometrium (EM) are involved in the pathogenesis of endometriosis, but the relationship between mRNA and protein expression in EM is not clear. We tested for the first time the hypothesis that EM TRIzol extraction allows proteomic Surface Enhanced Laser Desorption/Ionisation Time-of-Flight Mass Spectrometry (SELDI-TOF MS) analysis and that these proteomic data can be related to mRNA (microarray) data obtained from the same EM sample from women with and without endometriosis.</p> <p>Methods</p> <p>Proteomic analysis was performed using SELDI-TOF-MS of TRIzol-extracted EM obtained during secretory phase from patients without endometriosis (n = 6), patients with minimal-mild (n = 5) and with moderate-severe endometriosis (n = 5), classified according to the system of the American Society of Reproductive Medicine. Proteomic data were compared to mRNA microarray data obtained from the same EM samples.</p> <p>Results</p> <p>In our SELDI-TOF MS study 32 peaks were differentially expressed in endometrium of all women with endometriosis (stages I-IV) compared with all controls during the secretory phase. Comparison of proteomic results with those from microarray revealed no corresponding genes/proteins.</p> <p>Conclusion</p> <p>TRIzol treatment of secretory phase EM allows combined proteomic and mRNA microarray analysis of the same sample, but comparison between proteomic and microarray data was not evident, probably due to post-translational modifications.</p

MUC2 polymorphisms are associated with endometriosis development and infertility: a case-control study

<p>Abstract</p> <p>Background</p> <p>Mucins are highly glycosylated proteins protecting and lubricating epithelial surface of respiratory, gastrointestinal and reproductive tracts. Members of the mucin protein family have been suggested to play an important role in development of endometriosis and infertility. This study investigates genetic association of mucin2 (<it>MUC2</it>) with the risk of endometriosis and endometriosis-related infertility.</p> <p>Methods</p> <p>This case-control study was conducted at China Medical University Hospital, with 195 endometriosis patients and 196 healthy controls enrolled. Genotyping of six SNPs (rs2856111, rs11245936, rs10794288, rs10902088, rs7103978 and rs11245954) within <it>MUC2 </it>gene were performed by using <it>Taqman </it>genotyping assay; individual SNP and haplotype associations with endometriosis and endometriosis-related infertility were assessed by <it>χ</it>²test.</p> <p>Results</p> <p>Endometriosis patients exhibit significantly lower frequency of the rs10794288 C allele, the rs10902088 T allele and the rs7103978 G allele (<it>P </it>= 0.030, 0.013 and 0.040, respectively). In addition, the rs10794288 C allele and the rs10902088 T allele were also less abundant in patients with infertility versus fertile ones (<it>P </it>= 0.015 and 0.024, respectively). Haplotype analysis of the endometriosis associated SNPs in <it>MUC2 </it>also showed significantly association between the most common haplotypes and endometriosis or endometriosis-related infertility.</p> <p>Conclusions</p> <p><it>MUC2 </it>polymorphisms, especially rs10794288 and rs10902088, are associated with endometriosis as well as endometriosis-related infertility. Our data present MUC2 as a new candidate involved in development of endometriosis and related infertility in Taiwanese Han women.</p

Endometriosis: New insight in pathogenesis and search for biomarkers

Endometriose, een chronische gynaecologische aandoening die frequent res ulteert in chronische onderbuikpijn, ernstige dysmenorroe en subfertilit eit, wordt gekenmerkt door de aanwezigheid van fragmenten van endometriu m gerelateerd weefsel buiten de baarmoeder, zoals ter hoogte van het per itoneum en de ovaria. Het stellen van de diagnose vereist een laparoscop ische ingreep met biopsiename van de letsels, gevolgd door histologische confirmatie. De huidige behandelingsopties zijn beperkt tot hormonale t herapie en chirurgische ablatie van de letsels en worden gekarakteriseer d door hoge herval cijfers, significante nevenwerkingen en een beperkte toedieningsduur. De peritoneale micro-omgeving bestaande uit peritoneaal vocht, normaal p eritoneum en peritoneaal endometriale letsels, speelt een actieve rol in de pathogenese van endometriose. Menstrueel endometrium kan het periton eaal weefsel binden en invaderen. Verschillende adhesiemoleculen, pro-in flammatoire cytokines en chemo-attractieve cytokines kunnen een rol spel en als centrale coördinators van deze endometriale-peritoneale interacti es. Wij toonden aan dat gestegen endometriale en peritoneale cytokine mR NA expressie tijdens menstruatie in patiënten met endometriose aanleidin g kan geven tot een pelviene inflammatieve micro-omgeving die gunstig is voor endometrium-peritoneale adhesie en kan leiden tot de ontwikkeling van endometriose. We toonden ook aan dat de gestegen expressie van infla mmatoire cytokines, aromatasen en adhesiefactoren in endometrium en in m acroscopisch normaal peritoneum van vrouwen met endometriose, suggereert dat beide weefsels beïnvloed worden door vergaande biologische verander ingen afhankelijk van de fase in de menstruele cyclus en de aan- of afwe zigheid van endometriose. Intrapelviene injectie van menstrueel endometrium in bavianen laat toe d e vroege endometriale-peritoneale interactie te bestuderen in een in viv o micro-omgeving welke kan leiden tot een belangrijk inzicht in de vroeg e ontwikkeling van endometriose letsels. We toonden voor het eerst aan d at intrapelviene injectie van autoloog menstruele fragmenten binnen 24 u ur vasthechten aan het peritoneum en dat het proces gedreven wordt door endometrium gerelateerde stromale cellen. De bevestiging van invasie van typische endometriose letsels in de extracellulaire matrix van het peri toneum werd 6 dagen na inductie geobserveerd. Een dynamische dialoog kan bestaan tijdens vroege endometriale- peritoneale interacties, alhoewel factoren die betrokken zijn in deze cross-talk nog steeds niet gekend zi jn. Integrine eiwitten, gekend om hun capaciteit om cellen vast te hecht en aan hun buurcellen, kunnen een belangrijke rol spelen in dit adhesiep roces. De infiltratie van leukocyten in een geïsoleerd endometriose lets el, kan een gunstige inflammatoire pelviene micro-omgeving creëren voor endometrium-peritoneale adhesie en zo leiden tot de ontwikkeling van end ometriose. We verschaften experimenteel bewijs dat intrapelviene injectie van menst rueel endometriaal weefsel-pellet typische endometriose kan veroorzaken, terwijl intrapelviene injectie van acellulair menstrueel supernatans le idt tot de ontwikkeling van peritoneaal stromale endometriose. De huidig e data tonen voor het eerst in een klinisch relevant diermodel de induct ietheorie aan als een mogelijke verklaring voor de pathogenese van endom etriose. In deze studie vertoonde zowel de cellulaire fractie van het me nstrueel endometrium als het acellulaire endometrial supernatant, een ge dilateerd glandulaire structuur die verbonden werd door columnair epithe el, hetgeen een mulleriaans type epitheel suggereert. Desonda nks is het nog steeds moeilijk uit te maken of deze glandulaire structur en van endometriale origine zijn en is verder onderzoek nodig om deze ob servaties te bevestigen of ontkennen. Het doel van translationeel endometriose onderzoek is biomerkers te ontd ekken die kunnen gebruikt worden in de kliniek. We toonden een reeks pot entiële biomerkers met een hoge sensitiviteit en specificiteit en gaven aan dat een semi-invasieve diagnostische test kan worden ontwikkeld voor endometriose, met een verbeterde diagnostische kracht om vrouwen met en zonder endometriose te onderscheiden. We stellen voor dat de combinatie van SELDI-TOF-MS ProteinChip technology en bioinformatica analyse kan h elpen bij de ontwikkeling van een non-invasieve diagnostische test met e en hoge sensitiviteit voor minimale en milde endometriose. We toonden aan dat gedaalde mRNA expressie van TGF-beta in endometriose letsels van de r-hTBP-1 behandelde groep in vergelijking met de placebo groep het gevolg kan zijn van een verminderde angiogenese en een vermind erde endometriale celproliferatie. De ontwikkeling van nieuwe doel-moleculen moet erop gericht zijn de endo metriale-peritoneale interactie te verminderen door het minimaliseren va n het adhesieproces en de activiteit van degraderende ECM enzymen, het n eutraliseren van geïnduceerde peritoneale inflammatie en het inhiberen v an angiogenese. Ook nieuwe ontwikkelingen in het endometriose onderzoek zoals proteomics, genomics of transcriptomics kunnen leiden tot de ontdekking van biomerkers voor vroege diagnose, prognose of kunnen dien en als nieuwe therapeutische doelen.status: publishe