Rasha H. Bassyouni

Plasma concentrations of growth arrest specific protein 6 and the soluble form of its tyrosine kinase receptor Axl in patients with Systemic lupus erythematosus and Behçets disease

PurposeThe aim of the present study was to investigate plasma concentrations of Gas6 and its soluble tyrosine kinase receptor sAxl in Systemic lupus erythematosus (SLE) and Behçets disease (BD) patients and to correlate those levels with clinical and laboratory manifestations of the diseases.MethodsThe study included 89 female SLE and 49 male BD patients. Twenty-seven age and sex matched healthy volunteers served as controls. All patients were subjected to full clinical examination, laboratory investigations and assessment of disease activity. Plasma concentrations of Gas6 and sAxl were quantified using ELISA technique.ResultsThe level of Gas6 and Axl were significantly altered in the SLE patients (p < 0.001) and in the BD patients (p 0.001 and 0.04 respectively) compared to those of the control. In SLE, the Gas6 was remarkably lower in those with class 1 lupus nephritis and in those with neuropsychiatric manifestations. In the BD patients, the level of Axl was significantly increased in those with neurological disease activity. The number of lymphocytes significantly negatively correlated with the gas6 and Axl levels significantly correlated with the number of neutrophils and negatively with the lymphocytic count in the BD patients.ConclusionThe plasma concentrations of Gas6 and Axl were significantly altered in SLE and BD patients, suggesting that the Axl receptor shedding is an active process affected by and influences Gas6-mediated Axl-signaling in both diseases. Special attention is required in SLE patients with early lupus nephritis and neuropsychiatric manifestations and BD patients presenting with neurological disease activity. The relation with lymphocytes and neutrophils in BD throws light on the role of gas6 and Axl on their known resistance to cell death. Although the mechanisms responsible for the initiation of BD remain to be clarified, the role of the apoptotic process seems critical throughout the disease.

Phospholipase and Aspartyl Proteinase Activities of Candida Species Causing Vulvovaginal Candidiasis in Patients with Type 2 Diabetes Mellitus.

Few research had investigated the secretion of phospholipase and aspartyl proteinase from Candida spp. causing infection in females with type 2 diabetes mellitus. This research aimed to investigate the prevalence of vulvovaginal candidiasis (VVC) in diabetic versus non-diabetic women and compare the ability of identified Candida isolates to secrete phospholipases and aspartyl proteinases with characterization of their genetic profile. The study included 80 females with type 2 diabetes mellitus and 100 non-diabetic females within the child-bearing period. Candida strains were isolated and identified by conventional microbiological methods and by API Candida. The isolates were screened for their extracellular phospholipase and proteinase activities by culturing them on egg yolk and bovine serum albumin media, respectively. Detection of aspartyl proteinase genes (SAP1 to SAP8) and phospholipase genes (PLB1, PLB2) were performed by multiplex polymerase chain reaction. Our results indicated that vaginal candidiasis was significantly higher among the diabetic group versus nondiabetic group (50% versus 20%, respectively) (p = 0.004). C. albicans was the most prevalent species followed by C. glabrata in both groups. No significant association between diabetes mellitus and phospholipase activities was detected (p = 0.262), whereas high significant proteinase activities exhibited by Candida isolated from diabetic females were found (82.5%) (p = 0.000). Non-significant associations between any of the tested proteinase or phospholipase genes and diabetes mellitus were detected (p > 0.05). In conclusion, it is noticed that the incidence of C. glabrata causing VVC is increased. The higher prevalence of vaginal candidiasis among diabetics could be related to the increased aspartyl proteinase production in this group of patients.

Diminished soluble levels of growth arrest specific protein 6 and tyrosine kinase receptor Axl in patients with rheumatoid arthritis

Growth arrest specific protein 6 (Gas‐6) and its tyrosine kinase receptor Axl plays an important role in apoptosis, and regulation of innate immune response, therefore, we investigated their plasma concentrations in Rheumatoid arthritis (RA) patients and correlated them to clinical, laboratory and radiological parameters of the disease.

Fecal carriage of extended-spectrum β-lactamase- and AmpC- producing Escherichia coli among healthcare workers

INTRODUCTION Commensal E. coli can be considered a reservoir of genes coding for antibiotic resistance that may be transmitted in hospitals by healthcare workers (HCWs). This study aimed to determine the fecal carriage rate of extended-spectrum β-lactamase (ESBL)-producing E. coli among HCWs. METHODOLOGY Stool samples were collected from 200 HCWs. Phenotypic screening for ESBL and AmpC β-lactamases was performed using disk diffusion and minimum inhibitory concentration methods followed by the combined disks test and double synergy differential test for confirmation. Multiplex polymerase chain reaction (PCR) was used to detect blaSHV, blaTEM, blaCTX-M, and CIT groups for AmpC genes. RESULTS Of 200 E. coli isolates, 100% were susceptible to imipenem, and 59 (29.5%) were resistant to one or more third-generation cephalosporins. By molecular analysis, 21% (42/200) were colonized by ESBL-producing E. coli, and 3% (6/200) were colonized by AmpC-producing E. coli. The blaSHV gene was the predominant ESBL gene, detected in 81.8% of the resistant E. coli isolates. CONCLUSIONS These findings highlight the increase in fecal carriage of E. coli carrying ESBL and AmpC genes among HCWs, which may be one of the causes of the spread of ESBL-producing bacteria in hospitals and requires sound infection control measures. This is the first study of the fecal carriage rate of E. coli carrying AmpC genes in HCWs.

Antimicrobial potential of licorice: Leaves versus roots

Medicinal plants play a vital role in covering the basic health needs. They may offer a new source of antibacterial agents. The aim of this study was to screen in-vitro the antimicrobial activity of some Egyptian medicinal plants against clinical methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from different hospitals in Egypt followed by studying the MIC and cytotoxicty of the most active one. Screening of antimicrobial activities of 70% ethanolic extracts obtained from 19 plants against 59 MRSA clinical isolates were tested by agar well diffusion method. Licorice showed the highest antimicrobial effect against all 59 MRSA isolates (leaves were more active than roots). Minimum inhibitory concentrations (MICs) of licorice leaves were 8 μg/ml, whereas that of Flucloxacillin range between 32 to <128 ug/ml when tested against five MRSA strains. Colorimetric cytotoxicity assay of licorice leaves extract was done on HEPG2 and HCTI16 cell lines and revealed that the IC50 were 19.5 and 15 µg/ml respectively. Separation of the components in licorice leaves using thin layer chromatography (TLC) results in two active fractions identified with the help of spectroscopic analysis as inflacoumarin A and Licochalcone A. Our results reveal that the Egyptian licorice leaves extract represent a new candidate for antimicrobial agent against MRSA more than that achieved by root. This is the first report which highlights the antimicrobial activity of licorice leaves.

Clinical Association of a Soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM-1) in Patients with Systemic Lupus Erythematosus.

ABSTRACT A triggering receptor expressed on myeloid cells-1 (TREM-1) is a member of the immunoglobulin superfamily with an established role in innate and adaptive immune response. We aimed to determine the plasma concentrations and clinical association of sTREM-1 in Systemic Lupus Erythematosus (SLE) patients. Plasma from 79 SLE patients and 35 normal healthy subjects were assayed for sTREM-1 and IL-6 levels using Enzyme Linked Immunosorbant Assay (ELISA). The clinical disease characteristics and serological data were prospectively assessed. Disease activity was scored using the SLE disease activity index. We detected significantly higher levels of sTREM-1 in plasma of SLE patients than the healthy control group. We also detected high sTREM-1 levels in subgroups of patients with neuropsychiatric manifestations (NPLE) and patients with the total high disease activity and NPLE activity. In addition, sTREM-l levels were significantly correlated with parameters of disease activity, i.e. SLEDAI score, IL-6, hypoalbuminemia. On the other hand, we did not find significant differences in sTREM-1 levels in relation to age, disease duration, medications, ESR, other organ system involvement, or the presence of anti-dsDNA. Our preliminary data indicated that sTREM-1 levels may be an additional useful marker of disease activity in SLE. It also highlights its importance in patients with NPLE. An additional prospective longitudinal study should be carried out to support these findings.

Detoxification of Patulin by Kombucha tea culture

Kombucha is a refreshing beverage, obtained by fermenting sugared tea with a symbiotic culture of acetic acid bacteria and yeast, consumed for its positive effects on human health. In this study, the potential of kombucha supernatant for reduction of patulin (PAT) of three toxigenic fungal strains (Penicillium expansum LC015096, Talaromyces purpureogenus LC015095, and Acremonium implicatum LC015097) in liquid medium and apple fruit was investigated. In liquid medium, kombucha up to 10% (v/v) significantly inhibited PAT production of P. expansum by 77.2% and that of T. purpureogenus and A. implicatum by 100%. In apple fruit, inhibition percent of PAT accumulation by the respective fungal strains was 49.8%, 100%, and 53%. In aqueous solution, kombucha cells showed a relative greater PAT uptake capacity than Sacchromyces cerevisiae. The maximum PAT uptake (64.67% and 60.69%) by viable and heat-treated kombucha cells was achieved at pH 3.0 throughout 48 h incubation, respectively.

Soluble levels of Osteopontin in Patients with Behcet's Disease: Association with Disease Activity and Vascular Involvement

AimOsteopontin (OPN) is a multifunctional molecule highly expressed in chronic inflammatory and autoimmune diseases. We aimed to assess the plasma OPN levels in Behcets disease (BD) patients and identify potential associations between these levels with disease activity, severity and clinical manifestations with special emphasis on vascular affection.MethodsWe studied 55 BD patients and 31 age- and gender-matched healthy controls. Demographic, clinical and serological data were prospectively assessed. Activity and severity of BD were assessed using clinical scores and laboratory parameters. Plasma OPN levels were measured using enzyme-linked immunosorbent assay (ELISA).ResultsPlasma OPN levels were significantly higher in patients with BD compared to healthy controls (p < 0.000). The means for plasma OPN levels in active and inactive BD patients were significantly higher than that for the normal controls (with p < 0.000 and p = 0.002 respectively). The mean OPN levels significantly associated with the BD clinical severity score from mild to severe (p = 0.011). BD patients with vascular involvement had significant elevation of plasma OPN levels than those without (P = 0.03). OPN levels positively correlated with severity score, IL6, hsCRP, ESR, leucocytes count and neutrophil count.ConclusionPlasma OPN levels were higher in BD patients than in healthy controls and were found to be associated with disease activity, severity and vascular involvement. To confirm our results we propose that larger scale, multicentre studies with longer evaluation periods are needed.

Elevated serum levels of a proliferation-inducing ligand in patients with systemic sclerosis: possible association with myositis?

OBJECTIVE A proliferation-inducing ligand (APRIL) is a new member of the tumour necrosis factor family which is intimately connected to the regulation of cellular pathways. The aim of this study was to assess serum concentrations of APRIL in systemic sclerosis patients, and to correlate them with the main clinical and serological features of the disease. METHODS Sera from 35 patients with systemic sclerosis, 25 had limited cutaneous and 10 had diffuse cutaneous subtypes, and 35 normal healthy subjects were assayed for APRIL by Enzyme Linked Immunosorbant Assay. Demographic, clinical, autoantibodies and serological data were prospectively assessed. RESULTS Serum APRIL concentrations were higher in patients with systemic sclerosis and in both its subtypes compared to the healthy controls (p<0.0001 in all). Patients with elevated APRIL levels had significantly higher incidences of myositis than those with normal levels (p=0.04). We did not find significant differences in other organ involvement prevalence between systemic sclerosis patients with elevated vs. normal APRIL levels. In addition, the frequencies of autoantibodies (i.e., anti-topoisomerase I, anti-centromere) were comparable between both groups. Serum APRIL levels were correlated with serum γ-globulins concentrations (r=0.404, p=0.016) but not with C-reactive protein, skin score, nor pulmonary functions. Serum APRIL was also correlated with creatine kinase levels only in systemic sclerosis patients with myositis (r=0.786, p=0.02). CONCLUSION Our preliminary results suggest increased serum APRIL levels in systemic sclerosis patients, particularly in those associated with myositis and hypergammaglobinemia. To confirm our results, we propose that larger scale, multicentre studies with longer evaluation periods are needed.

Conjunctival microbiota and Antibiotic Resistance Pattern in Patients Submitted to Cataract Surgery and Antibacterial Activity of Some Plant Essential Oils

Objective: The objective of this study was to identify the conjunctival microbiota of patients undergoing cataract surgery and evaluate its antibiotic resistance pattern. Also to in-vitro evaluate the antimicrobial effects of some essential oils against multidrug resistant isolates. Methodology: Ocular samples were collected using swabs and polymethyl-metaacrylate (PMMA) intraocular lenses from seventy patients submitted to cataract surgery. Isolation and identification of bacteria was performed using conventional microbiological methods. Antibiotic sensitivity was done by disc diffusion method. The sensitivity of 16 essential oils against isolated bacteria was tested using well diffusion method. Results: Thirty six strains were isolated from patients submitted to cataract surgery. Gram positive microorganisms represent 75% of the isolates with coagulase-negative Staphylococci (CoNS) the most common isolate (47.2%) followed by S.aureus (19.4%), whereas gram negative occurred in 25% of cases, with Moraxella spp. the most frequent Gram negative isolate. Antibiotic sensitivity test revealed that the highest antibiotic resistance was exhibited against ceftazidime (100%) followed by clindamycin (86%), ampicillin (80.5%), erythromycin (72.2%) and tetracycline (69.4%). Gentamycin displayed the best activity (55.5%) followed by chloramphenicol (44.4%) and vancomycin (38.88%). Fifteen essential oils showed antibacterial effect against one or more bacterial strains. The most potent oils were peppermint oil, dill oil, cinnamon oil which showed promising inhibitory activity against most tested bacterial species, whereas cotton, ginger, chamomile, blue green, cod liver and parsley oil were the least active against tested strains. Olive oil failed to inhibit any of the tested strains. In general, St. pneumoniae was the most susceptible organism as it inhibited by ten oils. Conclusion: Our results indicate a promising antibacterial effect of peppermint oil, dill oil and cinnamon oil against conjunctival microorganisms.