Essam Nada

Increased sperm nuclear DNA damage in normozoospermic infertile men: a prospective study

OBJECTIVE To evaluate levels of sperm nuclear DNA damage in infertile men with normal and abnormal standard semen parameters. DESIGN Prospective study. SETTING Male infertility clinic. PATIENT(S) Ninety-two men seeking infertility treatment and 16 fertile volunteers. INTERVENTION(S) Standard semen analysis was performed according to the World Health Organization guidelines. MAIN OUTCOME MEASURE(S) Sperm DNA damage was assessed by sperm chromatin structure assay and the results expressed as %DFI. RESULT(S) Of the 92 patients, 21 (23%) had normal standard sperm parameters (concentration, motility, and normal sperm forms), while 71 (77%) had an abnormality in one or more of these parameters. The %DFI [median (25th and 75th percentiles)] in infertile men with normal sperm parameters [23 (15, 32)] was significantly higher than fertile donors [15 (11, 20)] (P=.02), but not significantly different from infertile men with abnormal sperm parameters [28 (18, 41)] (P=.27). CONCLUSION(S) The results of this study indicate that a significant increase in SCSA-defined DNA damage can be found in sperm from infertile men with normal standard sperm parameters. Therefore, sperm DNA damage analysis may reveal a hidden abnormality of sperm DNA in infertile men classified as idiopathic based on apparently normal standard sperm parameters.

Leukocytospermia is associated with increased reactive oxygen species production by human spermatozoa

To investigate the role of increased seminal leukocytes in enhancing reactive oxygen species (ROS) production by human spermatozoa.A prospective study. Male infertility clinic.Forty-eight infertile men. Standard semen analysis. Assessment of sperm nuclear DNA damage by sperm chromatin structure assay. Incubation of spermatozoa from nonleukocytospermic samples with blood neutrophils. Spontaneous and phorbol 12-myristate 13-acetate (PMA)-induced ROS production in pure-sperm suspensions (after removal of leukocytes) as measured by a chemiluminescence assay. Levels of spontaneous and PMA-induced ROS production in pure-sperm suspensions from the infertile men with a diagnosis of leukocytospermia (n = 16) were significantly higher compared with the case of infertile men without leukocytospermia (n = 32) and with the case of a control group of healthy volunteers (n = 13). A similar pattern of increased ROS was observed when spermatozoa were incubated with blood neutrophils. Leukocytospermia was associated with a significant decrease in sperm motility and increase in DNA damage. Increased seminal leukocytes may play a role in stimulating ROS production by human spermatozoa. Such stimulation may be mediated via direct cell-cell contact or by soluble products released by leukocytes. Poor sperm quality in leukocytospermic samples may be due to leukocyte-mediated oxidative stress.

Platelets rich plasma versus minoxidil 5% in treatment of alopecia areata: A trichoscopic evaluation

Alopecia areata is a common cause of nonscarring alopecia that occurs in a patchy, confluent, or diffuse pattern. Dermoscopy is a noninvasive technique for the clinical diagnosis of many skin diseases. Topical minoxidil solution 5% and platelet rich plasma are important modalities used in treatment of alopecia areata. We aimed to evaluate the efficacy of PRP versus topical minoxidil 5% in the treatment of AA by clinical evaluation and trichoscopic examination. Ninety patients were allocated into three groups; the first was treated with topical minoxidil 5% solution, the second with platelets rich plasma injections, and the third with placebo. Diagnosis and follow up were done by serial digital camera photography of lesions and dermoscopic scan before and every 1 month after treatment for 3 months. Patients treated with minoxidil 5% and platelets rich plasma both have significant hair growth than placebo (p < .05). Patients treated with platelets rich plasma had an earlier response in the form of hair regrowth, reduction in short vellus hair and dystrophic hair unlike patients treated with minoxidil and control (p < .05). In conclusion, platelets rich plasma is more effective in the treatment of alopecia areata than topical minoxidil 5% as evaluated by clinical and trichoscopic examination.

Expression of nerve growth factor and its high-affinity receptor, tyrosine kinase A proteins, in the human scalp skin

Background:  Nerve growth factor (NGF) and its high‐affinity receptor, tyrosine kinase A (TrkA), are members of the neurotrophin family. NGF–TrkA are involved in murine hair morphogenesis and cycling. To date, their expression in human hair follicle (HF) is unknown. In this investigation, we hypothesize that NGF–TrkA proteins are expressed in the human scalp skin. Moreover, NGF–TrkA expression in HF changes with the transitions from anagen→catagen→telogen stages.

Human scalp skin and hair follicles express neurotrophin-3 and its high-affinity receptor tyrosine kinase C, and show hair cycle-dependent alterations in expression.

Background  Neurotrophin (NT)‐3 and its high‐affinity receptor tyrosine kinase C (Trk C) are essential for nervous system development. These members of the NT family are also involved in murine hair morphogenesis and cycling. However, their role in human hair follicle (HF) biology remains to be elucidated.

Phenotypical Characteristics of the Immune Cells in Allergic Contact Dermatitis, Atopic Dermatitis and Pityriasis Rosea

Allergic contact dermatitis (ACD) is a cell-mediated, delayed type IV immunologic reaction. Atopic dermatitis (AD) is a chronic inflammatory skin disease that results from a complex interaction between immunologic, genetic, and environmental factors. Pityriasis rosea (PR) is a self-limited eruption of unknown etiology. Immune cell infiltrate is a constant feature in the inflammatory skin diseases. Here, we performed phenotypical characterization of the immune cells in ACD, AD and PR (ten cases each). We performed immunohistochemical stains for B cells (CD20), T cells (CD3), histiocytes (CD68) and T cells with cytotoxic activity (granzyme-B). The data were compared with findings in 20 specimens of normal skin. The results were scored as mean values of positively stained immune cells. Immunohistochemistry showed significantly high counts of immune cells in lesional skin (ACD, AD and PR) compared to the normal one (p < 0.05). In the lesional skin, the immune cells were composed predominantly of CD3+ T lymphocytes and CD68+ cells (histiocytes). Some of the CD3+ cells were granzyme B+. The counts of some immune cells (CD3+ and CD68+) were high in ACD compared to AD and PR. The counts of CD20+ and granzyme B+ cells were high in PR compared to ACD and AD. However, these differences did not reach the level of statistical significance. The present data describe the profile of the immune cell infiltrate in AD, ACD and PR. The cell-mediated immunity seems to have critical role in the development of these lesions.

Negative effects of sperm nuclear DNA damage on the fertility potential of couples with idiopathic and male-factor infertility

FERTILITY POTENTIAL OF COUPLES WITH IDIOPATHIC AND MALE-FACTOR INFERTILITY Ramadan A Saleh, Ashok Agarwal, Cleveland Clinic Foundation, Essam A Nada, South Valley University, Mohamed H El-Tonsy, al-Minya University, Donald P Evenson, Kjersten Larson, South Dakota State University Objective: Rapidly accumulating data, in recent years, indicate that increased sperm DNA damage is detrimental to the fertility potential of men. The objectives of this study were to examine: i) levels of sperm DNA damage in infertile men with idiopathic and male-factor infertility, and ii) the effects of sperm DNA damage on the outcome of assisted reproductive techniques (ART).

Lesional and circulating levels of interleukin-17 and 25-hydroxycholecalciferol in active acne vulgaris: Correlation to disease severity

The immunological aspects of inflammatory acne are still incompletely understood, so this study aimed to investigate the possible role of IL‐17 and 25 hydroxycholecalciferol (25(OH)D3) in the disease pathogenesis and progression.

Serum interleukin-6 and interferon-γ in patients with leprosy

Background Leprosy is a chronic infectious disease caused by Mycobacterium leprae and manifested by an immunological and clinical outcome, ranging from borderline lepromatous and lepromatous infections to tuberculoid and borderline tuberculoid infections. Cytokines such as interleukin (IL)-6, IL-10, interferon-γ (IFN-γ), and tumor necrosis factor-α are associated with leprosy. Objective The aim was to assess IL-6 and IFN-γ in untreated patients with leprosy and compare these levels with those in healthy controls and with different parts of the disease spectrum. Patients and methods A case–control study was conducted on 90 untreated patients with leprosy and 30 healthy controls randomly selected from patients attending the Dermatology and Leprosy Hospital, Qena Governorate, Egypt. The patients were classified into tuberculoid, borderline tuberculoid, borderline-borderline, borderline lepromatous, and lepromatous (LL). IFN-γ and IL-6 were measured by enzyme-linked immunosorbent assay technique. Results IL-6 and INF-γ were significantly higher in the patients than in the control group, with P value of 0.001 and 0.002, respectively. Regarding the serum level of INF-γ in all types of leprosy, there was a statistically significantly increase in paucibacillary leprosy and a nonsignificant increase in multibacillary leprosy; on the contrary, the results showed that serum level of IL-6 was statistically significantly increased in multibacillary leprosy and nonsignificantly increased in paucibacillary leprosy. Conclusion This study concluded that INF-γ and IL-6 may have a significant role in classifying various forms of leprosy and can be used as leprosy disease markers to predict the course and the prognosis of the disease.

Possible role of interleukin-17 and macrophage migration inhibitory factor in cutaneous warts

Cutaneous warts (CW), or verrucae, are benign proliferation of skin that result from infection with human papilloma viruses. Cellular immune reactivity plays a significant role in wart regression. The aim of this study was to elucidate the cellular immune status of patients with CW through measurements of their serum levels of interleukin‐17 (IL‐17) and macrophage migration inhibitory factor (MIF,) and, identify the possible role of IL‐17 and MIF in CW. We assessed serum IL‐17 and MIF levels in patients with different forms of CW and compare the results with controls.