Somaia Mohammed Mousa

The association between hepatitis C virus infection, genetic polymorphisms of oxidative stress genes and B-cell non-Hodgkin's lymphoma risk in Egypt.

Hepatitis C virus (HCV) has been postulated to be an etiological agent for lymphoid malignancies. Polymorphisms in oxidative stress genes as; superoxide dismutase (SOD2), glutathione peroxidase (GPX1), catalase (CAT), myeloperoxidase (MPO) and nitric oxide synthase (NOS2) may influence non-Hodgkins lymphoma (NHL) risk. HCV screening and polymorphisms in these five genes coding for antioxidant enzymes were studied in 100 Egyptian patients with B cell-NHL and 100 controls to clarify the association between HCV infection, oxidative stress genes polymorphisms and B cell-NHL risk. A significantly higher prevalence of HCV infection was detected among NHL patients relative to controls and this carried a 14-fold increased NHL risk (odds ratio (OR)=14.3, 95% confidence interval (CI)=5.4-38.3, p<0.0001). GPX1 and MPO genetic polymorphisms conveyed increase in B-NHL risk (OR=3.3, 95% CI=1.4-7.4, p=0.004 and OR=4.4, 95% CI=1.3-14.2, p=0.009 respectively). Further analyses stratified by HCV infection revealed that concomitant HCV infection and GPX1 gene polymorphism had a synergetic effect on NHL risk with an OR of 15 (95%CI=2.2-69.6, p<0.0001). In addition, combined HCV infection and MPO gene polymorphisms had a pronounced NHL risk (OR=9.2, 95%CI=2.5-33.9, p<0.0001). SOD2, CAT and NOS2 genetic polymorphisms were not found to confer increased NHL risk. This study revealed that HCV infection is a risk factor for NHL in Egypt. Polymorphisms in GPX1 and MPO genes may influence NHL risk in HCV infected Egyptian patients. Larger scale studies are warranted to establish this genetic susceptibility for NHL.

Glutathione S-Transferase Gene Polymorphisms (GSTM1, GSTT1, and GSTP1) in Egyptian Pediatric Patients with Sickle Cell Disease

Sickle cell disease (SCD) complications are associated with oxidative stress. Glutathione S-transferases (GSTs) are a group of enzymes that protect against oxidative stress. The aims of this study was to evaluate the prevalence of GSTM1, GSTT1, and GSTP1 gene polymorphisms among homozygous sickle cell anemia patients and to investigate the possible association between the presence of these polymorphisms and SCD severity and complications. Genotyping the polymorphisms in GSTT1 and GSTM1 genes was performed using the multiplex polymerase chain reaction (PCR) method. The GSTP1 ILe105Val polymorphism was determined using PCR–restriction fragment length polymorphism. GSTM1 null genotype was significantly associated with increased risk of severe vaso-occlusive crises (VOC) (odds ratio = 1.52, 95% confidence interval = 0.42–5.56, P = 0.005). We found no significant association between GST genotypes and frequency of sickle cell–related pain, transfusion frequency, disease severity, or hydroxyurea treatment. GSTM1 gene polymorphism may be associated with risk of severe VOC among Egyptian SCD patients.

Mesenchymal Stem Cells from Pediatric Patients with Aplastic Anemia: Isolation, Characterization, Adipogenic, and Osteogenic Differentiation

Aplastic anemia is a syndrome of bone marrow (BM) failure characterized by peripheral pancytopenia and marrow hypoplasia. Its exact pathophysiology is still not clear. Mesenchymal stem cells (MSCs) play an important role in providing the specialized BM microenvironment for hematopoietic stem cells survival and differentiation. MSCs were isolated from BM of five patients with aplastic anemia and five controls. MSCs were characterized by morphology and immunophenotyping. Their viability, proliferative capacity, and adipogenic as well as osteogenic differentiation potentials were assessed. MSCs from aplastic anemia patients and controls shared similar spindle-shaped morphology and surface marker expression. MSCs derived from patients with aplastic anemia showed lower viability (74.2 ± 4.44% vs. 97.0 ± 1.58, p < 0.0001) and slower expansion rate as indicated by smaller population doubling and smaller cumulative population doubling from passages 1 to 4 (0.70 ± 0.22 vs. 2.34 ± 0.84; p = 0.009). Besides, aplastic anemia MSCs had poor capacity to differentiate into adipocytic and osteocytic lineages.

The Development of FVIII Inhibitors in Relation to IL10 Gene Polymorphism in Hemophilia A Egyptian Pediatric Patients

ABSTRACT Background: Development of inhibitors against Factor VIII (FVIII) in hemophilia A patients is a serious complication of therapy. Many cytokines, including interleukin-10 (IL10), may affect inhibitor development; however, literature data are not sufficient to prove this association. The aim of this study was to investigate the relation between FVIII inhibitor formation and IL10-1082A/G polymorphism among Egyptian hemophiliacs. Methods: Patients were screened for FVIII inhibitors using the Bethesda method. IL10-1082A/G polymorphism was detected by polymerase chain reaction–restriction fragment length polymorphism. Results: Six patients (12%) developed inhibitors. No statistically significant difference was found between inhibitor positive and negative patients regarding IL10-1082A/G genotypes, disease severity, or treatment-related variables (type of FVIII received, treatment regimen, age at first exposure to FVIII, and frequency of replacement therapy). Conclusions: FVIII inhibitor formation in this group of Egyptian hemophiliacs was not correlated to IL10-1082A/G polymorphism, disease severity, or any of the treatment variables.

Palliative care: an unexplored aspect of schistosomiasis neglect?

The World Health Organization defines palliative care as ‘‘an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.’’ Although the palliative care needs of patients with lifethreatening noncancer diseases are comparable to those of patients with cancer, they are largely unmet. In higher income countries, noncancer palliative care is directed mainly to patients with life-threatening noncommunicable diseases like advanced neurological, chronic heart, chronic obstructive pulmonary, and end-stage renal diseases. Unlike higher-income countries, communicable diseases are a dominant cause of death in the low-income countries where 6 out of the top 10 causes of death are communicable diseases. In response to the needs in low-income countries, it is not surprising that the available noncancer palliative care there may be directed to patients with life-threatening communicable diseases like HIV/AIDS, tuberculosis, and malaria. Schistosomiasis is one of the neglected tropical diseases which are considered ‘‘a symptom of poverty and disadvantage.’’ Five of the Schistosoma species are known to infect humans. Schistosoma mansoni, S japonicum, S mekongi, and S intercalatum (and related S guineansis) cause intestinal schistosomiasis; and S haematobium causes urogenital schistosomiasis. Three of these species (S mansoni, S haematobium, and S intercalatum) are endemic in Africa, the most affected region worldwide. In addition to the intestinal and urogenital forms, schistosomiasis may be ectopic (pulmonary, genital, and neurological). Although effective prevention and treatment strategies against schistosomiasis are available, a significant number of schistosomiasis patients suffer due to advanced disease and eventually die. It is estimated that more than 207 million people are infected with schistosomiasis, and the majority (85%) are in Africa. Among those infected, more than 20 million would suffer due to serious illness if only 10% of them have severe clinical disease. In addition to the physical suffering that may be caused by different schistosomiasis forms, affected patients may experience psychological, spiritual, and social suffering. In one study, the impact of schistosomiasis on different aspects of the quality of life of infected workers was assessed. Compared to noninfected workers, infected workers had significantly lower scores in the physical, psychological, spiritual, and social domains of quality of life. The estimated number of deaths per year due to schistosomiasis is more than 200 000 in sub-Saharan Africa alone. The above-mentioned morbidity and mortality figures suggest that a significant proportion of advanced schistosomiasis patients may benefit from the palliative approach of care according to the World Health Organization definition. While prevention and treatment of schistosomiasis remain an ultimate goal, the provision of palliative care services for those with the late effects of schistosomiasis is an area that needs exploration. Research is warranted to identify patients with schistosomiasis, who are likely to benefit from palliative care, to assess their needs and to establish programs that can meet these needs.