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دراسة بعض الجوانب المناعية لمرضى الالتهاب الجلدي المتماحل من العراقيين == Study of some immunological aspects of Iraqi patients with ATOPIC DERMATITIS

Author name: ميادة نوري اقبال الدوسكي
Supervisor name: رجوه حسن عيسى الربيعي | جاسم طعمه حسين الخفاجي
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Master
University: Mustansiriyah University - College Of Science
Language: English
University location: Baghdad
First pages:
Abstract: اجريت هذه الدراسة بهدف الحصول على المزيد من الايضاحات حول تاثير الاضطرابات المناعية على الحالة المرضية عند مرضى الالتهاب الجلدي المتماحل من العراقيين ،لقد تم خلال هذه الدراسة اخضاع 124 مريضا من كلا الجنسين (55مريضاﹰمن الذكور و69من الاناث ) تتراوح اعمارهم ما بين(6 - 55 ) سنة من الذين شخصوا كمرضى التهاب جلدي متماحل ،حيث كان بينهم 48 مريضاﹰ من المصابين بالتهاب الجلدي المتماحل البسيط و76 مريضاﹰ من المصابين بالتهاب الجلدي المتماحل الشديد ، اضافةﹰالى(50) شخصاﹰمن الاصحاء ظاهرياﹰ كمجموعة سيطرة ، تم اخضاعهم الى مختلف الاختبارات بضمنها الفحوصات المختبرية المالوفة للحساسيةوقياس المعلمات المناعية حديثة الاكتشاف بالاضافة الى عزل وتشخيص بكتريا الـ Staphylococcus spp. .اظهرت النتائج اختلاف انتشار مرض التهاب الجلدي المتماحل بين مختلف الفئات العمرية وكذلك بين الجنسين حيث كان نسبة انتشار المرض عند الاناث اكثرمن الذكور. من خلال فحص الجلد وباستخدام (13) نوع من المستارجات، تم التوصل الى انه المستارجات داخل المباني indoor allergens اعلى نسبة للتفاعل الموجب لفحص الجلد ضمن كل مرضى الالتهاب الجلدي المتماحل ،ومن بينها كان حلم الغبار المنزل HDM هو اكثر الانواع تكرارا فى الظهور بنسبة =5‚68 في حين كان لثيل البرمودا Bermuda grass وخليط انواع المختلفة النسبة الاعلى بين حبوب اللقاح =7‚ 13 % و1‚ 12 % على التوالي ، وكذلك لخليط الفطريات نوع MMI النسبة الاعلى بين الفطريات =9‚12%. باستخدام اختبار الامتزاز المناعي للانظيم المرتبط ELISA تم قياس مستوى الكلوبيولين المناعي(E) الكلي والنوعي في مصل الدم ، وكانت قيمة المتوسط الحسابي للكلوبيولين المناعي(E) الكلي لدى مرضى الالتهاب الجلدي المتماحل الشديد اعلى وذات فرق احصائي معنوي عنها في كل من مرضى الالتهاب الجلدي المتماحل البسيط ومجموعة السيطرة الاصحاء.وكذلك تم احتساب مستوى الكلوبيولين المناعي (E)النوعي في مصل الدم وذلك لـ 19 نوع المستارجات اظهرت نتائج الدراسة ان الكلوبيولين المناعي (E)النوعي الاكثر تكرارا في كل مجاميع الدراسة من المرضى كان للمستارج D2 بنسبة =7‚ 63 % يتبعه للمستارج H2بنسبة = 7‚ 59 % ،ثم للعشب G2 وبنسبة = 9‚ 58 % تبعهم الكلوبيولين النوعي للفطر M1 = 5‚ 57 % ، F29 =8‚ 54 % ، = F23‚ 54 %، W6 =6‚ 51 % ، M4 = 50 % ، G1 = 50 % ، G15 =2‚ 49 % ، W1 =5‚ 43 % ، M6 =8‚ 46 % ، D1 =46 % ، M2 =5‚ 43 % ، بينما كانت نسبة الكلوبيولين (E ) النوعي للـ F73 مساوي لـ T9 = 1‚ 37 % ،و 9‚ 33 % للمستارج W9 . في حين كانت اقل نسب للكلوبيولين النوعي ضد كل من T3 ، T5 وكانت تساوي 4‚ 23 % ،1، 16 % على التوالي .ان نسبة التطابق الاجمالية بين فحص الجلد ومستوى الكلوبيولينات المناعية النوعية لـخمسة من المستارجات كانت بمقدار9‚ 83 % كما كانت حساسية الاختبار بنسبة 100% لاشجار Mediterranean و19% لاعشاب Mugwort في حين كانت نسبة خصوصية الاختبار 98 % مساوية لكل من Plantain ,Betula واعقبتها المستارجات Fagac ,Bermuda =5‚97% ، 7‚96% على التوالي .اما المستارج HD اظهر اقل نسبة خصوصية وكانت2‚74% لم يلاحظ اي اختلاف معنوي في مستوى الكلوبيولينات المناعية (M , A ) واحدى مكونات المتمم C3 في المصل بين المجاميع الثلاثة قيد الدراسة بينما لوحظ ارتفاع معنوي في مستوى الكلوبيولين المناعي G واحدى مكونات المتمم C4 عند مرضى الالتهاب الجلدي المتماحل مقارنة بمجموعة السيطرة الاصحاء. وجد ان عدد خلايا اليفة الايوسين في الدم اعلى معنويا عند كل من مجموعتي المرضى بالمقارنة مع الاصحاء. لم تظهر النسبة المئوية للخلايا اللمفاوية التي تعبر المعلم السطحي CD3 اي فروقات معنوية ضمن مجاميع الدراسة ،بينما النسبة المئوية للخلايا اللمفاوية التي تعبر المعلم السطحي .CDميادة نوري اقبال الدوسكيكانت اعلى معنويا عند مجموعة مرضى الالتهاب الجلدي المتماحل الشديد عما هو عليه في كل من مجموعتي مرضى الالتهاب الجلدي المتماحل البسيط والاصحاء. المعلم المناعي الـ CD8 اظهر انخفاض معنوي عند مرضى الالتهاب الجلدي المتماحل مقارنة بمجموعة السيطرة الاصحاءولوحظ فروقات معنوية في نسبة الخلايا اللمفاوية الموجبة للـ CD4 ضمن مجاميع الدراسة مما ادى الى ارتفاع نسبة ((CD4/CD8 ارتفاعا ملحوظا ضمن مجموعتي مرضى الالتهاب الجلدي المتماحل ومقارنة بالاصحاء وخاصة عند مجموعة مرضى الالتهاب الجلدي المتماحل الشديد.كذلك لوحظت اضطرابات في الاستجابة المناعية الخلوية تجاه المشطر اللانوعي PHA ومستخلص البروتيني عند مجموعة مرضى الالتهاب الجلدي المتماحل الشديد.احد النتائج المهمة في هذه الدراسة هي ان متوسط مستوى الانترلوكين نوع IL - 4 يزداد بشكل معنوي لدى مرضى الالتهاب الجلدي المتماحل عن الاصحاء ،ان مجموعة مرضى الالتهاب الجلدي المتماحل البسيط اظهرت زيادة معنوية مقارنة بمرضى الالتهاب الجلدي المتماحل الشديد والاصحاء (1‚84، 9‚58،4 ‚15 بيكوغرام/مل ) في حين ان مستوى الانترلوكين نوع IL - 5 في المصل كان اعلى في مرضى الالتهاب الجلدي المتماحل الشديد عن مرضى الالتهاب الجلدي المتماحل البسيط والاصحاء(5‚95، 9‚75، 2 ‚23 بيكوغرام/مل ) ، بالاضافة الى ذلك ظهرت علاقة خطية موجبة بين IL - 5 واعداد خلايا اليفة الايوسين في مرضى الالتهاب الجلدي المتماحل اما فيما يتعلق بمجاميع الدم فلم تظهر اية علاقة معنوية موجبة بين مرضى الالتهاب الجلدي المتماحل ومجاميع فصائل الدم بالرغم من انتشار مرض الالتهاب الجلدي المتماحل ضمن الاشخاص ذوي فصائل الدم A, B .الجزء الاخير من الدراسة تضمن اخذ مسحات للجلد لكل من المرضى والاصحاء ، تم زرعها بشكل مناسب لعزل وتشخيص بكتريا المتواجدة فيه . لقد اوضحت النتائج ان بكتريا Staphylococcus aureus كانت الاكثر تكرارا لدى مرضى الالتهاب الجلد المتماحل بنسبة 7‚ 76 % وبالاخص مجموعة مرضى الالتهاب الجلدي المتماحل الشديد بينما Staphylococcus epidermidis كانت نسبتها3‚ 23 % .فيما يخص علاقة الكلوبيولين المناعي (E) الكلي في المصل مع مختلف المعلمات المناعية ،فقد لوحظ وجود علاقة خطية موجبة معنوية مع عدد من الفحوصات الموجبة للجلد والكلوبيولين المناعي (E) النوعي ،الى جانب ذلك فقد بينت النتائج وجود علاقة الكلوبيولين المناعي (E) الكلي مع عدد خلايا اليفة الايوسين عند كل مرضى الالتهاب الجلد المتماحل النسب المئوية للخلايا اللمفاوية الموجبة للـ CD4 وCD19ونسبة CD4/CD8 وIL - 4 ضمن مجاميع مرضى الالتهاب الجلدي المتماحل اظهرت علاقة موجبة معنوية مع مستوى الكلوبيولين المناعي (E) الكلي ،في حين علاقة الانترلوكين IL - 5 مع الكلوبيولين المناعي (E) الكلي هي علاقة سلبية واظهرت النتائج ايضا وجود الـ Staphylococcus aureus ضمن مجاميع مرضى الالتهاب الجلدي المتماحل هو مقترن مع زيادة او ارتفاع مستوى الكلوبيولين المناعي (E) الكلي في المصل مما ادى الى علاقة موجبة .فيما لم تظهر الكلوبيولينات المناعية ( M , A ) علاقة موجبة مع الكلوبيولين المناعي (E) الكلي عدا الكلوبيولين المناعي G حيث اظهر علاقة ضعيفة ،كذلك الحال بالنسبة لعلاقة شدة المرض مع مختلف المعلمات المناعية حيث اظهرت النتائج وجود علاقة موجبة ذات قيمة معنوية احصائيا مع كل من عدد الفحوصات الموجبة للجلد والكلوبيولين المناعي (E) وعدد خلايا اليفة الايوسين ،ونسبة CD4/CD8 ، مستوى الانترلوكين IL - 5 في المصل ، اضافة الى ذلك كانت نسبة انتشار بكتريا Staphylococcus aureus مقترنة مع شدة المرض. | The favor of this work, is first at all, and above all, is all Allah's. I would like to express my profound thanks and sincere gratitude to my supervisor Dr. Rajwa H.AL - Rubai’e for her valuable scientific guidance, encouragement and support that made it possible for me to accomplish this study. I extend my deep gratitude also to my supervisor Dr. Jassem T. AL - Khafaji for his scientific advice, clinical instructions, in addition to his provision of laboratory materials and equipment. I should express my gratitude to the head and all the employees of the Department of Biology in the College of Science, AL - Mustansiriya University.Deepest gratitude goes to consultant center for Allergy and Asthma especially, Dr. Arij AL - Ani and Dr. Omar AL - Janabi for preparing the diagnostic cases and the chemist Mrs. Aysar F.AL - Aumari and Alaa’s father, Hamssa’s mother for their generous help and their kind assistance in presenting the possible facilities in the lab work.Thanks are also dedicated for Fransois Tron for his cooperation in help me to complete our research in laboratories of Rouen University France. My sincere gratitude presented to Dr. Abdul Alkhaliq AL - Naqeb for their efforts and help in statistical analysis.From my deep hearts, I would express my thanks and respect to my colleagues for their encouragement during my study. Finally, I would like to express my deepest and warmest gratitude and indebtedness to my family, for their kind, love and help in one way or another, and to all those who have contributed to the completion and success of this project. Mayada N. AL - DoskiResearcher SummaryA Prospective study was conducted to obtain more clarification about the impact of immunological abnormalities on the clinical expression of atopic dermatitis (AD) among Iraqi patients. One hundred twenty four cases of AD (55 males and 69 females), ranging in age between (6 to 55) years, Patients were grouped as mild AD (48) and severe AD (76), according to severity, and (50) apparently healthy individuals used as a control group (24 males and 26 females). They were studied using different allergic, immunological and hematological tests; in addition to that Staphylococcus species were isolated and diagnosed, Atopic Dermatitis occurred in different ages and most frequently in females than males.Skin test analysis of 13 allergens revealed that AD patients had higher proportions of positive skin reactivity to indoor allergens, among them House dust mites HDM was the most frequent = 68.5%, Bermuda grass and grasses mixture had the highest frequency = 13.7%, and 12.1% respectively among pollens, whereas mould mixture I were the most frequent moulds = 12.9%. Enzyme linked immunosorbent assay ELISA was used to measure serum IgE levels. The mean total IgE was significantly higher in severe than in mild AD and healthy control groups. The quantitative of serum specific IgE was carried out for 19 allergens. Among all AD cases, the most frequent specific IgE was found to D2 = 63.7% followed by H2 = 59.7%, G2 = 58 .9%, M1=56.5%, F29= 54.8%, F2= 54.03%, W6= 51.6%, M4= 50%, G1=50%, G15= 49.2%, W1= 43.5%, M6 = 46.8%, D1 = 46%, M2 = 43.5% and F73 and T9 are equal = 37.1% and 33.9 % for W9. However the least rates were to T3 and T5=23.4% and 16.1% respectively, in contrast to that of healthy controls which showed negative results for most allergens with the exception of M1= 24% = followed by W9 = 16% . The relationship of skin test with serum specific IgE level for seven compatible allergens showed an overall agreement of (83.9%) sensitivity for Mediterranean trees=100%, Mugwort=99%, specificity for Plantain equal to Betula = 98%, followed by specificity for Bermuda and Fagac = 97.5%, 96.7% respectively while the least were to HD = 74.2%. No significant differences between all AD patients and healthy controls as well as between two types of AD patients could be detected in IgM, IgA and C3 serum levels, while serum IgG and C4 levels were significantly increased in both types of illness compared to healthy controls. Blood eosinophil counts were significantly higher in all AD patients than healthy controls. No significant differences between all AD patients and healthy subjects in CD3+ lymphocyte percentage while CD19+ lymphocyte percentage was significantly higher in severe AD group than mild and healthy control groups. CD8+ lymphocyte percentage was significantly lower in all AD patients than healthy control group . Statistically significant differences were observed between the study groups in CD4+ lymphocyte percentage, the mean CD4+ / CD8+ ratio was higher in severe AD group compared to mild AD and healthy control. On the other hand a disorder observed in cellular immunity response to PHA and proteins extract among patients with severe AD. One of the important findings of this study, was that the mean serum IL - 4 was significantly increasing among AD patients as compared to healthy controls, also it was significantly higher in mild AD than severe AD and healthy control groups = 84.1, 58.9 and 15.4 pg/ml respectively, whereas serum level of IL - 5 was obviously higher in cases with severe AD group than mild AD and healthy control groups= 95.5, 75.9 and 23.2 pg/ml respectively. More over a significant positive linear correlation was found between IL - 5 and peripheral eosinophil counts in atopic dermatitis. The relationship between AD and ABO system has shown no significant correlation in spite of the highest frequency of A and B blood groups among atopic dermatitis patients. The last part of this study included skin swabs which were taken from AD patients. Samples were cultured on suitable media for isolation then identification bacteria. The results showed that Staphylococcus aureus was the most common organism isolated from AD patients =76.7% while Staphylococcus epidermidis was =23.3%. In severe AD group; the incidence of Staphylococcus aureus was higher than in mild AD group =70 %, 60% respectively. Regarding the association between total serum IgE and different immunological markers, the mean serum total IgE concentration was significantly increased with number of positive skin tests as well as serum specific IgE scored by subjects with AD. Also, the eosinophil counts revealed a statistically significant positive linear correlation with total serum IgE level in all AD group.CD4+ and CD19+ lymphocyte percentage and CD4+/CD8+ ratio among all AD groups showed significant positive linear correlation with total serum IgE concentration.The relationship between total serum IgE levels and IL - 4 concentration gave positive linear correlation; whereas, between IL - 5 and total IgE levels the results showed negative correlation. The results revealed that persistence of Staphylococcus aureus colonization in AD patients was associated with higher levels of total serum IgE leading to positive correlations between serum total IgE and Staphylococcus aureus persistence. There were no significant differences in level concentration of IgM, IgA with the exception of the IgG which showed a weak correlation. In conclusion, the association between AD severity and different immunological markers were assessed. The severity of AD group was associated with higher total serum IgE levels and number of specific IgE scored by subjects, as well as, eosinophil counts, CD4+/CD8+ ratio, level of cytokine in serum (IL - 5), in addition, the persistence of Staphylococcus aureus were associated with severity of AD disease.

مقارنة تشخيصية جزيئية وبكتريولوجسة لبكتريا الزائفة الزنجارية المعزولة من مرضى السكري النوع الثاني وامراض اخرى == Comparison the Molecular and Conventional Identification of Pseudomonas aeruginosa isolated from Diabetes Type II and other Diseases

Author name: سناء محمد حبيب الشمري
Supervisor name: اسماء محمد صالح المهيدي
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Master
University: University of Baghdad
Language: English
University location: Baghdad
First pages:
Abstract: Fifty clinical samples suspected as Pseudomonas aeruginosa were collected from patients with different diseases, diabetic foot ulcers, U.T.I., wounds, burns, keratitis, external otitis from September 2015, till February 2016, from hospitalized patients in four different Baghdad hospitals (Al - Kindi General Teaching Hospital, Al - Yarmuk General Teaching Hospital, Alkadhmiya General Teaching Hospital, and AL - Shiakh Zaied Hospital).The study population targeted both gender from different ages groups.The collected samples were cultured on different selective and differential media and tested biochemically in order to identify P.aeruginosa, then the identification was ensured by using two molecular methods which are conventional PCR in the detection of ecfx gene and 16SrDNA gene and real time PCR with commercial kit from sacace (qualitative detection of P.aeruginosa) and with gyrB gene using specific primers to each gene.Sensitivity for each test was measured then compared with other tests to determine the test efficiency. The results showed that the sensitivity for API20NE test was (80%), the sensitivity for molecular tests as flows : ecfx test was (92%), 16SrDNA test was (96%), the commercial kit test was (98%) and for gyrB test was (92%).The present study shows that using more than one target gene is reducing the probability of misidentification of P.aeruginosa that may be caused by variation in primer or probe targets.According to the type of infection the comparison was done. The results of P.aeruginosa detection for diabetic foot isolates were compared with other isolates. The results showed that there is a remarkabledifference in the API20NE test; as well as, with the oxidase test (according to the time that oxidase test need it to give the dark purple color as a positive result), for the mucoid strains of this bacterium. The results of detection isolates by using gyrB gene were differed too.Then a comparison in simplicity, cost, accuracy and time of P.aeruginosa identification between molecular methods and API20NE test (biochemical test) and between molecular tests themselves were performed. The results of these comparisons show that the molecular methods are better than API test in all aspects of the comparison. Real time PCR is better than conventional PCR in simplicity, accuracy and time but not in cost.All isolates were tested for antibiotic sensitivity using nine antibiotics. The results showed that most isolates were sensitive to Levofloxacin (94%), Ticarcillin - clavulanic acid (Timinim) (88%), Gentamicin (82%) and (80%) to both Pipracillin and Imipenem, while the isolates appeared resistant to another antimicrobials represented by (72%) to Augmentin, (34%) to Ceftazidime, (38%) to Colistin, and (28%) to Ciprofloxacin. In the present study, Levofloxacin represents the most effective antibiotic against P. aeruginosa isolates with the all types of infection.The present study improves the importance of the rapid and accurate detection of the bacterial types and thus giving the right antibiotics to patients to obtain rapid recovery and prevent any complications that may lead to death.

عزل وتشخيص بكتريا Yersinia enterocolitica من بعض المصادر السريرية والبيئية

Author name: رعـد ناجي حسن الفلاحي الحسني
Supervisor name: هشام عطا شحاذة | ضحى سعد صالح
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: Mustansiriyah University - College Of Science
Language: English
University location: Baghdad
First pages:
Abstract: لغرض دراسة تواجد وانتشار بكتريا (Yersinia enterocolitica) في مناطق مختلفة من العراق ودراسة قابليتها على احداث المرض تم ولاول مرة في القطر التحري عن هذه الجرثومة في 422 عينة مختلفة المصادر شملت عينات الاسهال الدموي الحاد(Acute Bloody Diarrhea) (150) عينة , و(37 ) عينة من حالات الاصابة بالتهاب الزائدة الدودية الحاد(Acute Appendisitis) , و(60) عينة من مياه نهري دجلة والفرات, و(15) عينة من مزارع المواشي, و(100) عينة من محلات بيع لحوم الاغنام المحلية, و(60) عينة من معلبات اللحوم (المستوردة) من السوق المحلية.جمعت العينات السريرية من عشر مستشفيات متوزعة في مناطق مختلفة من العراق فيما يخص عينات الاطفال المصابين باسهال دموي حاد وحالات التهاب الزائدة الدودية الحاد ، وشملت العينات البيئية مياه من مناطق متفرقة من نهري دجلة والفرات، كما تمت دراسة لعينات لحوم اخذت من محلات بيع اللحوم الطازجة في ثلاث محافظات هي الانبار وبغداد وديالى . واخرى من لحوم المعلبات المستوردة.شمل البحث ايضا دراسة لعدد من العينات الماخوذة من مزارع المواشي في الاسحاقي والصويرة ومزرعة الجسامية في مدينة الفلوجة . لقد تم الحصول على عزلات عائدة لبكتريا Yersinia enterocolitica من 27 عينة شخصت هذه العزلات اعتمادا على الفحوصات الخاصة بالتشخيص الاولي والتي تضمنت الاغناء البارد(Cold Enrichment ) وتنمية العزلات على وسط (CIN agar )( Cefsulodin - Irgasan - Novobiocin agar ) ثم فحص اشكال المستعرات واشكال الخلايا وتفاعلاتها مع ملون غرام(Gram Stain) وفحص انظيمي الاوكسيديز ( Oxidase ) والكاتاليز ( Catalase ) واخضاع البكتريا للفحوصات الكيموحيوية المتضمنة لتخمر السكريات المختلفة وتم ايضا تنميط العزلات مصليا بالاعتماد على الطرائق العلمية المعروفة واظهر التنميط المصلي ان غالبية العزلات السريرية وعزلات اللحوم المعلبة تعود للنمط المصلي (O : 8) اما العزلات البيئية فتعود للنمط المصلي (O : 9) وتعود عزلات اللحوم العراقية للنمط ( O : 3).درست حساسية العزلات للمضادات الحيوية (Antibiotic Sensitivity ) واظهرت النتائج حساسية العزلات لمضادات Chloramphenecole ,Ciprofloxacin, Gentamycin ,Tetracycline ,Trimethoprim ,Sulphafurazole ومقاومتها لمضادات Clavulonic acid, Carbincillin, Ampicillin Ticarcillin,Amoxicillin ، ودرست ايضا قابلية هذه العزلات على انتاج انظيم البيتالاكتميز(β - lactamase ) بينما اظهرت بعض العزلات قابليتها على انتاج هذا الانظيم، ودرست قابلية البكتريا على احداث التهاب الامعاء والاسهال باستخدام الفئران التجريبية، كما اظهرت دراسة المحتوى البلازميدي احتواء اغلب العزلات على حزم بلازميدية باعداد متفاوتة تعتمد على مصدر العينة المعزولة منه البكتريا والمرض المسببة له، كما درست قابلية البكتريا على الحركة في درجتي حرارة 22مو37م واظهرت النتائج قدرتها على الحركة في درجة 22 درجة مئوية وعدم قدرتها على الحركة في درجة 37 درجة مئوية. | Serving the purpose of studying the presence and spreading of Yersinia enterocolitica in different areas in Iraq and to study its pathogenesis. The bacteria was detected in 422 different specimen comprising acute bloody diarrhea (150 specimen) cases of Acute Appendicitis (37 specimen), specimens were taken from Tigris and Euphrates water (60 specimen), from Cattle farms (15 specimen), from local sheep shopping (100 specimen), others taken from imported canned meat and other heat specimens taken from local market (60 specimen). The Clinical Specimens were taken from 10 different hospitals in various areas in Iraq concerning specimens from children infected with acute B.d. & acute Appendicitis. Whereas water specimens were taken from Tigris & Euphrates. Fresh meat samples were taken from the local butchers stores from three different districts; Anbar, Baghdad and Dyala. Other samples were taken from imported meat. The research comprised the study of several samples from cattle farms in Al - Eshaqi , Al - Sowera and Jassamiya in Falluja City. Bacteria Yersinia enterocolitica was isolated from 27 samples, these isolates were identified according to prelimary testing using Cold Enrichment, growing isolates in (CIN agar) (Cefsslodin - Irgsan - Novobiocin agar) and examination of colony and cell shapes and their interacting with Gram Stain and Oxidase testing Catalase and submitting Bacteria for Bio - chemic at test containing various sugar fermentation. In addition, isolates were sorted Plasmatic depending on the known scientific methods. This sorting showed that most tested isolates and canned meat isolates belong to serum type (O : 8). Whilst ambiance serum belongs to type (O : 9) and Iraqi meat isolates were of type (O : 3). Antibiotic sensitivity of the isolates are determined. The results showed isolates sensitivity for Chloramphenecole, Ciprofloxacin, Gentamycin, Tetracycline, Trimethoprim and Sulphafurazole and its resistance to Ampiciline, Carbinicillin, Clavulonic acid, Ticarcillin and Amoxicillin in the meanwhile ability of these isolates to produce β - lactamase was studied. The ability of Bacteria to produce bowl inflammation and diarrhea was studied by using experimental rats. Plasmids reveals the container of different numbers of plasmadic bands depending on the source of the isolate. Besides, the movement ability of the bacteria at 22C and at 37C were studied. The results explained its movement ability at 22C and its inability of movement at 37C.

بعض المظاهر المناعية للمرضى المصابين بفايروس التهاب الكـبد C في محافظة اربيل == Some Immunological Aspects of Patients Infected with Hepatitis C virus in Erbil Province

Author name: زاكروس كمال احمد البرزنجي
Supervisor name: احسان شفيق توفيق دميرداغ | ماجد محمد محمود
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: Mustansiriyah University - College Of Science
Language: English
University location: Baghdad
First pages:
Abstract: This study was designed to fined out the prevalence of anti - HCV in thalassemics and diabetic patients and HCV viremia in anti - HCV positive patients, to delineate the role of TH1 cytokines in HCV infection, and to fined out a possible diabetogenic role for HCV infectionThis study was carried out in Erbil province for the period Feb 2006 to March 2007. Different diagnostic test approaches are used like 3rd generation ELISA, RT - PCR to detect HCV infection and ELISA for cytokine determination. The screened patients and control group including : (347) β - thalassemics, (786) diabetic patient, and (465) as control population were subjected to above tests for the purpose of clarifying the sensitivity and specificity of ELISA vs PCR in risk and control groups moreover, to delineate the role of TH1 cytokines in HCV infection.The results can be briefly summarized as following : Anti - HCV anti body were detected among (28.24%) (5.97%), and (0.43). of thalassemics, diabetics, and control population. RT - PCR testing revealed (88.77%), (68%) positivity among anti - HCV positive thalassemics, and diabetics cases screened by ELISA test.Cytokine levels in thalassemics for TNF - α, IFN - γ, and IL - 2 were significantly higher in PCR - confirmed HCV cases than in HCV - negative thalassemics (P < 2.017E - 17), (P< 1.67E - 5), and (P< 6.048E - 8) respectively. A statistically higher significant levels of TNF - α, IFN - γ, and IL - 2 demonstrated also in thalassemic patients (PCR - confirmed HCV thalassemics and, HCV - negative thalassemics ) than in healthy controls In diabetic patients revealed only high significant association between PCR confirmed HCV infection and increased level of TNF - α (P < 1.19E - 10).Statistically significant high level of TNF - α only was detected among diabetic patients (PCR - confirmed HCV diabetics and, HCV - negative diabetics) than healthy control group (P < 1.19 E - 10).In PCR confirmed - HCV thalassemic patients (4.6%) were found to be diabetic in comparison with (0.9%) in HCV - negative thalassemic group.This study clearly demonstrates the highly prevalence of HCV - infection among thalassemic patients and to a lesser extent in diabetics.The elevation of TH1 cytokines (TNF - α, IFN - γ, and IL - 2) in thalassemics may contribute to cell mediated immunity and may be related to other infections not just HCV as a reason of frequent blood transfusion. The Study also confirm that the

دراسة جوانب من الاستجابة المناعية لاصابات الكلية عند الاطفال == A study of some immunological aspects in children with renal disease

Author name: ايمان عباس محسن
Supervisor name: رجوة حسن عيسى الربيعي | سيناء مهدي شاكر
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Master
University: Mustansiriyah University - College Of Science
Language: English
University location: Baghdad
First pages:
Abstract: نفذت هذه الدراسة بين 17 - 12 - 2008 و25 - 8 - 2009 وشملت 62 طفلا مريضا في المدى العمري (1 - 12) سنة ومن كلا الجنسين : 26 طفلا مصابا بالفشل الكلوي المزمن و36 طفلا مصابا بالمتلازمة الكلائية، وكان المرضى خارجيين وراقدين في وحدة غسل الكلية في كل من مستشفى المنصور التعليمي للاطفال ومستشفى الطفل التعليمي المركزي وشملت المجموعة الضابطة 26 طفلا. جمعت عينات الدم من المرضى والاصحاء واجريت الفحوص المناعية وهي قياس مستويات كلا من انترلوكين - 6 والاريثروبيوتين وفق تقنية مقايسة الممتز المناعي المرتبط بالانزيم ((ELISA. اما الاختبارات الكيميائية الحيوية فقد تضمنت قياس نسبة اليوريا والكرياتنين في المصل لتقييم الوظيفة الكلوية. شملت السمات الدموية قياس حجم الخلايا المرصوصة ونسبة خضاب الدم للتحري عن وجود فقر الدم. اظهرت النتائج زيادة معنوية في مستوى انترلوكين - 6 (0.001>P) ونقصانا معنويا في مستوى الاريثروبيوتين(0.001>P) وزيادة معنوية في يوريا وكرياتنين المصل(0.001>P) ونقصانا معنويا في كل من حجم الخلايا المرصوصة ونسبة خضاب الدم (0.001>P)في كلتا المجموعتين المرضيتين بالمقارنة مع المجموعة الضابطة. جمعت عينات الادرار من مجاميع المرضى والاصحاء واجري لها الفحص العام (بغض النظر عن نوع المرض الكلوي) بعد زرع النماذج على وسطي اغار ماكونكي واغار الدم . اظهرت نتائج الفحص العام للادرار ان وجود القوالب في ادرار المرضى لم يكن معنويا (الاحتمالية=0.056)، بينما كان وجود بروتين الالبومين في ادرار المرضى معنويا (الاحتمالية=0.049). وجدت نتائج زرع الادرار السالبة في 64.5% من كلتا المجموعتين المرضيتين٬ كذلك كانت نتائج زرع الادرار سالبة في المجموعة الضابطة. اما نتائج زرع الادرار الموجبة في المرضى (35.3%) فكانت تشير الى وجود التهاب السبيل البولي مع علاقة معنوية بنوع المرض الكلوي (الاحتمالية= 0.042). لقد اظهر التهاب السبيل البولي علاقة معنوية مع الجنس (الاحتمالية= 0.044). تضمن النمو الجرثومي الانواع التالية : E. coli (54.55%) وPseudomonas aeruginosa (22.73%) وKlebsiella pneumoniae (9.09%) وProteus mirabilis (9.09%) وعزلة واحدة فقط من Morganella morganii (4.55%). اختلفت العزلات البكتيرية في حساسيتها للمضادات الحياتية والتي اشتملت على السفترياكزون والسفتازديم والجنتامايسين وحامض الناليدكسك والتراي ميثوبريم والنايتروفيورانتين. | This study was carried out between December 17, 2008 and August 25, 2009. It included 62 pediatric patients at the age range (1 - 12) years of both genders : 26 with chronic renal failure (CRF) and 36 with nephrotic syndrome (NS), who were outpatients and in - patients in the dialysis unit in both Al - Mansour pediatric teaching hospital and Child's central teaching hospital. The control group consisted of 26 children. Blood samples were collected from patients and controls. Immunological tests of interleukin - 6 (IL - 6) and erythropoietin (Epo) measurement were done by using ELISA technique. Biochemical tests, including blood urea and serum creatinine, were applied to evaluate renal function. Hematological aspects referred to anemia presence or not; by measuring PCV and Hb. The results explained significant increase in serum IL - 6 levels (P<0.001), significant decrease in serum Epo levels (P<0.001), significant increase in both urea and creatinine concentrations (P<0.001) in serum and significant decrease in both PCV and Hb (P<0.001) in NS and CRF patients in comparison with the control group. Urine samples were collected from children with both renal diseases and healthy controls. After culturing the samples on both MacConkey agar medium and blood agar medium, general urine examination (GUE) was applied regardless the type of the renal disease. GUE of both CRF and NS patients showed that casts presence in urine was not significant (p=0.056), while albuminuria was significant (P=0.049). The negative urine cultures were present in 64.5% of both patients' groups. The control group showed no bacteria in urine. The positive cultures in patients (35.5%) were indicating UTIs with a significant relation with the type of renal disease (P=0.042). UTIs seemed to be related with gender (P=0.044). The bacterial growth included the following isolates : E. coli (54.55%), Pseudomonas aeruginosa (22.73%), Klebsiella pneumoniae (9.09%), Proteus mirabilis (9.09%) and Morganella morganii in one case only (4.55%). The bacterial isolates were different in their sensitivity to antibiotics, which included Ceftazidime, Cefteriaxone, Gentamycin, Nalidixic acid, Nitrofurantoin and Trimethoprime).

دراسة لمؤشرات مناعية وحيوية في مرضى تصلب الاعصاب المنتشر == Study of Certain Immuno and Biomarkers in Multiple Sclerosis Patients

Author name: سماح خليل يحيى
Supervisor name: طالب عبد الله حسين
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Master
University: University of Baghdad
Language: English
University location: Baghdad
First pages:
Abstract: تصلب الاعصاب المنتشر مرض التهابي مزمن مجهول السبب، يتصف بفقدان الميالين (النخاعين) مع الميل الى اصابة محور الليف العصبي، ويصيب الاشخاص في الاعمار المتوسطة من حياتهم مع ارجحية اصابة النساء اكثر من الرجال.جاءت هذه الدراسة بصورة رئيسية لبحث العلاقة بين تصلب الاعصاب المتعدد وتركيز كل من البين الابيضاضي - 2 و- 10 وعامل التنخر الورمي - الفا وكذلك المؤشرات الحيوية كمستوى الدهون في الدم (الكولسترول, لشحوم الثلاثية والشحوم عالية الكثافة) , حمض اليوريك وظائف الغدة الدرقية (ثالث يود الثيرونين , الثايروكسين وهرمون تنشيط الغدة الدرقية). الى جانب ذللك , قياس العد الكلي والتفريقي لكريات الدم البيض. كما تناولت العلاقة بين تركيز هذة الحركيات الخلوية والمؤشرات الحيوية وعلاقتها بالجنس ومراحل تقدم المرض.اجريت هذه الدراسة على 60 مريض عراقي شخصوا بتصلب الاعصاب المتعدد وفق لمعايرMcDonald criteria وتم تصنيف المرضى المختارين الى مجموعتين : 1. المجموعة الاولى : تضمنت 30 مريض (15 ذكور و15اناث) تتراوحت اعمرهم من (56 - 18) سنة وهم في المرحلة الاولى من التشخيص (اي حدث لهم انتكاسة) ولم ياخذوا اي علاج.2. المجموعة الثانية : تضمنت 30 مريض (15 ذكور و15 اناث) تراوحت اعمرهم من (53 - 18) سنة وهم مشخصين مندو فتره ومعالجين بانترفيرون بيتا مع مثل ابردزولون الى3 ايام او 5 ايام.الى جانب ذلك‚ مجاميع سيطرة باجناس وفئات عمرية مماثلة لاغراض المقارنة مكونة من 20 فردا (10 اناث و10 ذكور) تراوحت اعمارهم من (50 - 20) اصحاء ظاهريا والذين راجعوا الى (مستشفى بغداد التعليمي في مدينة الطب / عيادة للكشف المبكر عن تصلب الاعصاب المتعدد) في بغداد خلال الفترة من تشرين الثاني/ 2013 الى نهاية نيسان/ 2014 للتشخيص والعلاج. تم سحب عينة (8 - 6) ملليتر من الدم الوريدي من 80 من الحالات المتضمنة في الدراسة (المرضى والسيطرة) لغرض استخدامها في الدراسة المناعية والتي تشمل قياس الحركيات الخلوية المذكورة بواسطة استعمال تقنية الامتزاز المناعي مرتبط بالانزيم ELISA)) والمؤشرات الحيوية باستخدام جهاز ابت لقياس (مستوى الدهون في الدم وحمض اليوريك) ويستخدم جهاز توسوا لقياس (وظائف الغدة الدرقية). فضلا عن حساب العد الكلي والتفريقي لكريات الدم البيض باستخدام جهاز روبي. توصلت الدراسة للنتائج الاتية : 1. اظهرت النتائج ان متوسط العمر في مرضى تصلب الاعصاب هو (34.43) سنة وان الفئة العمرية (39 - 30) سنة هي اكثر عرضة للاصابة.2. اظهر معدل المستوى المصلي للبين الابيضاضي - 10 فروقا معنوية عند مستوى P<0.05 بين مجموعات مرضى التصلب المتعدد (قبل وبعد المعالجة) ومجموعة السيطرة (46.64 , 44.70 و50.95) بيكو غرام/مل , على التوالي.3. اظهر معدل المستوى المصلي لعامل التنخر الورمي - الفا فروقا معنوية عند مستوى P<0.05 ما بين مرضى بعد المعالجة (17.04) بيكو غرام/ مل ومجموعة المرضى قبل العلاج ومجموعة السيطرة (14.81 و14.28) بيكو غرام/ مل , على التوالي .4. لوحظ وجود ارتفاع معنوي في تركيز المستوى المصلي من الكولسترول , الشحوم الثلاثية, الشحوم قليلة الكثافة والشحوم قليلة الكثافة جدا عند مستوى P<0.05 في المرضى غير المعالجين والمعالجين مقارنة بمجموعة السيطرة .5. لوحظ وجود ارتفاع معنوي في تركيز المستوى المصلي من ثالث يود الثيرونين وهرمون الثايروكسين عند مستوى P<0.05 في المرضى الغير معالجين ) 1.08) نانوغرام / مل و(7.99) ميكروغرام / ديسيلتر، على التوالي والمرضى المعالجين (1.27) نانوغرام / مل و(8.68) ميكروغرام / ديسيلتر ,على التوالي مقارنة بمجموعة السيطرة (0.898) نانوغرام / مل و(6.95) ميكروغرام / ديسيلتر ,على التوالي. 6. اظهره نقصان معنوية في معدل الخلايا الحمضة في مجاميع المرضى (قبل وبعد المعالجة) مع انترفيرون - بيتا - 1ب مقارنة مع مجموعة السيطرة.7. لم تظهر اي علاقة بين معدل كريات الدم والمستويات المصلية من كل البين الابيضاضي - 2 ,هرمون تنشيط الغدة الدرقية , حمض اليوريك والشحوم عالية الكثافة والامراضية من تصلب الاعصاب المنتشر.8. ظهر تاثير الجنس في كلا من الشحوم الثلاثية وحمض اليوريك حيث وجود زيادة وبفارق معنوي في الذكور مقارنة بالاناث, بينما كانت هنالك زيادة معنويه في الشحوم عالية الكثافة في الاناث مقارنة بالذكور. | Multiple Sclerosis (MS) is an idiopathic chronic inflammatory disease characterized by demyelination that can be associated with axonal degeneration and is the leading cause of a non - traumatic neurological disability in young adults, with female affection more than male.This study is designated mainly to investigate the relationship between the MS patients and certain cytokines serum concentrations of Interleukin - 2 (IL - 2), interleukin - 10 (IL - 10), Tumor necrosis factor - alpha (TNF - α) and biomarkers; lipid profile (TC, TG, LDL, VLDL and HDL), Uric Acid (UA) and thyroid function (T3, T4 and TSH). Besides, measured total and differential WBC of the blood. Also it is trying to find out the relation between concentrations of these cytokines and biomarkers with the gender and disease course of Iraqi MS patients. The study involved 60 Iraqi who were diagnosed as MS patients. the selected patients were classified into two groups :  Pre - treated patients included 30 patients 15 male and 15 female whose age range between (18 - 56) years at the stage of the early diagnosis (RRMS).  Post - treated patients included 30 patients 15 male and 15 female whose age range between (18 - 53) years with treatment Interferon - β 1b (INF - β - 1b) intravenous immunoglobulin (Ig) pulse Methyl - Prednisolone MP (in acute relapses) for 3 days or 5 days. Besides, 20 healthy volunteers 10 males and 10 females matched the patients with age and gender were used as control subjects with age range between (20 - 50) years. They have attended to (Baghdad Teaching Hospital in the Medical City / Clinic for early detection of MS) in Baghdad during the period from November / 2013 to the end of April / 2014 for the diagnosis and treatment. The blood samples (6 - 8) ml were drown from all of studied cases in order to be used for immunological study by measuring their serum level of cytokines using Enzyme - linked Immunosorbent Assay (ELISA) and biomarkers; using Architect c4000 System (Abbott) for (TC, TG, LDL, VLDL, HDL and UA) and AIA - 360 system for (T3, T4 and TSH). Besides, measured total and differential WBC of the 2 ml of blood at using Cell - Dyn Ruby System.The Study has Reached the following Results : 1. The results showed that the average age in patients with MS is (34.43) years and age group (30 - 39) years are more susceptible to affected. 2. The study has showed the average serum level of IL - 10 were significant differences at the level of probability P<0.05 between the (pre - and post - treated) patients and the healthy control (35.54, 35.86 and 52.68) pg/ml, respectively. 3. The study furthermore, has showed the average serum level of TNF - α were significant differences at the level of probability P<0.05 between the post - treated patients (17.04) pg/ml and two group the pre - treated patients and the healthy control (14.81 and 14. 28) pg/ml, respectively.4. The result observed significant an increase in the concentration of serum level of TC, TG, LDL and VLDL at the level of probability P<0.05 in the pre - and post - treated patients as compared to the healthy control. 5. The result observed significant increase in the concentration of serum level of T3 and T4 at the level of probability P<0.05 in the pre - treated patients (1.08) ng/ml and (7.99) μg/dl, respectively and the post - treated patients (1.27) ng/ml and (8.68) μg/dl, respectively as compared to the healthy control (0.898) ng/ml and (6.95) μg/dl, respectively. 6. The study has showed a significant decrease in mean of the eosinophil for the pre - and post - treated patients (1.28 and 1.99) respectively as compared with the healthy controls (2.79).7. There is no relationship between the differential count of WBC and serum levels of (IL - 2, HDL, UA and TSH) and the pathogenicity of MS. 8. The research show significant increase in levels of TG and UA in male as compared with female, while level of HDL was significant increase in female as compared with male.

تقييم بعض المؤشرات المناعية لمرض بهجت في عينة من المرضى العراقيين == Evaluation of some Immunological Parameters of Behcet's disease in a sample of Iraqi patients

Author name: دنيا فريد سلوم
Supervisor name: ضحى سعد صالح | جاسم طعمة الخفاجي
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: University of Baghdad
Language: English
University location: Baghdad
First pages:
Abstract: اجريت الدراسة على 70 مريض عراقي من العرب بواقع 39 مريضا من الاناث و31 مريضا من الذكور خضعوا للصفات التشخيصية العالمية لمرض بهجت وهم من المراجعين لمختبر التطابق النسيجي في المختبرات التعليمية في مدينة بغداد الطبية للفترة من نيسان 2009 - ايار 2010، كان41 مريضا ( 58.6 %) ، منهم مشمولا بالتهاب العين بينما 29 منهم لم يكن لديهم شمول للعين . شملت الدراسة على مجموعة السيطرة والمتكونة من 20 شخص ظاهريا اصحاء ومطابقين لمجموعة المرضى من ناحية العمر والجنس ، وكانت نسبة الذكور الى الاناث 0.8 ومتوسط عمر المرضى (36.3 ± 1.4) سنة ومتوسط عمر حدوث المرض (32 ± 1.3) سنة وفترة المرض (4.7 ± 0.37) سنة وان معدل كتلة الجسم (24.8 ± 0.4 كغم/ملم2) وان اكثر الصفات السريرية تكرارا هي افات فموية وافات جلدية بتكرار 100 % وافات تناسلية 50 %، ، اما اختبار باثرجي فكان سالبا عند كل المرضى (لم يظهر انتفاخ جلدي التهابي ولم يحوي على قيح او يحوي على قيح بعد مرور 24 - 48 ساعة)، وكان متوسط عمر المرضى المشمولين باصابات العين (32 ± 1.6) سنة وفترة حدوثها (2.4 ± 0.32) سنة واحتلت النساء النسبة الاعلى 51.2 % مقارنة بالذكور 48.7 % .تم تقييم مستضدات HLA B51 وHLA B27لمجموعة المرضى والسيطرة ، اضداد الهربس نوع IgG ، اضداد الكلاميديا نوع IgG وIgM ، العامل البروتيني الانتكاسي ، معدل ترسيب كريات الدم الحمر ، انترليوكين 8 ، انترليوكين 10 ، بيتا - 2 - مايكروغلوبيولين ، اضداد المادة النووية ، اضداد سايتوبلازم الخلايا العدلة . اظهرت النتائج وجود زيادة احصائية معنوية للاليل HLA B51 في المرضى مقارنة بمجموعة السيطرة، وكان HLA B51 (+) في 39 مريض (55.7 %) ، وان 59 % من المرضى الذين يحملون الاليل HLA B51 (+) هم من الذكور، فقد يرتبط وجود هذا الاليل مع زيادة احتمالية حدوث المرض ، وعلى النقيض فان الاليل HLA B27 ينخفض في المرضى مقارنة بالاصحاء اي ليس له دورا في المرض ولم يصل الى حد الفرق المعنوي . كما وجد ان 65.9 % من مرضى مجموعة HLA B51 (+) كان لديهم شمول العين و24.3 % من المرضى حاملين HLA B51 (+) وB27 (+) ، وان الاليل HLA B27 (+) في المرضى ربما يفيد كمرتبة تصنيفية لالتهاب العين في مرضى بهجت .وكانت نسبة الافات الفموية والجلدية في المرضى الذين يحملون HLA B51 55.7 % بينما كانت نسبة الافات التناسلية 45.9 % .اظهرت النتائج وجود اضداد IgG لفيروس HSV - 1 في مصل 24 مريض (34.2 %) كما اظهرت اضداد الكلاميديا الرئوية IgG عند 15 مريض (21.4 %) اما شمول العين لدى المرضى فظهرت متلازمة مع اضداد الجرثومتين بنسبة 41.5 % و29.2 % على التوالي هذا يشير ربما ان للفيروس او البكتيريا دورا في استحثاث المرض . بينت النتائج وجود زيادة احصائية معنوية في تركيز اللبتين وال بيتا 2 مايكروغلوبيولين في المرضى مقارنة بمجموعة السيطرة الشيء الذي يؤشر الى دوره في الامراضية وعدم وجود فروق معنوية في تركيزهما في مجموعة المرضى المشمولين باصابات العين من الذين لم يكن لديهم شمول بتلك الاصابات من المرضى هذا يشير الى ان اللبتين يلعب دورا في امراضية المرض دورا طفيفا كعامل خطورة عند مجموعة المرضى الذين لديهم شمول العين . كما ان مستضدات التوافق النسيجي B51 لم يكن لها دور مع اللبتين والبيتا 2 مايكروغلوبيولينفي المرضى .ظهرت زيادة معنوية في تركيز IL - 8، IL - 10 في مصل المرضى مقارنة بمجموعة السيطرة، وان تركيز هذه المؤشرات كان منخفض في مرضى من كان لديهم شمول العين من المرضى الاخرين الذين لم يكن لديهم شمول للعين، ولم يكن لمستضدات التوافق النسيجي B51 على هذه االموشرات. ان هناك علاقة موجبة بين تركيز العامل البروتيني الانتكاسي وتركيز IL - 8 كذلك بين الاخير وتركيز اللبتين. ظهرت زيادة معنوية في تركيز العامل البروتيني الانتكاسي ومعدل ترسيب كريات الدم الحمر في مرضى بهجت وان العامل البروتيني الانتكاسي لم يزداد عند مجموعة مرضى شمول العين بينما لوحظت زيادة معنوية في معدل ترسيب كريات الدم الحمر عند تلك المجموعة .اظهر اختبار التالق المناعي غير المباشر سلبية اضداد الانوية وايجابية اضداد سايتوبلازم الخلايا العدلة النمط P عند 8.5 % من المرضى . | A total of 70 Iraqi Arab patients (39 females, 31 males), who fulfilled the international study group criteria for diagnosis of Behcet's disease (BD) were enrolled in this study. Forty one patients (58.6 %) had ocular involvement, while non - ocular involvement was found in 29 patients (41.4 %). The patients attended the HLA Typing Laboratory in Teaching Laboratories of Baghdad Medical City from April 2009 - May 2010.A control group of twenty subjects were also included, and they were matched patients for gender and age.The ratio of male to female was 0.8. The mean age was 36.3 ± 1.4 years and the mean age at onset was 32 ± 1.3 years. The duration of disease was 4.7 ± 0.37 years with body mass index of 24.8 ± 0.4 Kg / m2, and the high percentage (60 %) of patients was at the age range 31 - 60 years.The overall frequency of clinical manifestation was 100 % for oral lesion, 100 % for skin lesion, 50 % for genital lesion, 58.6 % for ocular lesion and Pathergy test was negative in all patients. The mean age of ocular lesion patients was 32 ± 1.6 years with duration of 2.4 ± 0.32 years. Ocular lesion involvement in females was higher (51.2 %) than males (48.7 %).The patients and control were evaluated for HLA - B51, HLA - B27, Anti herpes simplex virus - 1 (HSV - 1) IgG, Anti Chlamydia pneumoniae IgG and IgM, Leptin, C - reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), Interleukin - 8 (IL - 8), Interleukin - 10 (IL - 10), β2 Microglobulin (β2M), Antinuclear antibody (ANA) and Antineutrophil cytoplasmic antibody (ANCa).There was a statistically significant increase in HLA B51 in patients as compared with controls (55.7 % vs 10 %), 59 % in of HLA B51 (+) was found in males. This marker might play crucial role in pathogenesis of BD. In contrast HLA B27 was decreased in the patients as compared two controls, it may have no role in the disease but the differences did not reach a significant level. High percentage (65.9 %) of HLA B51 positive was found in ocular BD. (24.3 %) of patients had HLA B27 positive and B 51 positive, double positive B27 and B51 patients may be the benign subgroup of BD uveitis.The percentage of patients with oral lesion and skin lesion positive for HLA B51 were 55.7 %, while it was 45.7 % in patients with genital involvement.Anti Herpes simplex virus - 1 (HSV - 1) IgG was found in 24 patients (34.2%), while anti Chlamydia pneumoniae IgG antibodies were found in 15 patients (21.4%) . Eye involvement was found in association with antimicrobes antibodies (41.5% and 29.2%, respectively). This suggests that these microbes may be the trigger factor of BD.Results indicated statistically significant increase in the concentration of leptin and β2M as compared with control group, but no significant differences in leptin concentration between ocular and non - ocular BD This suggest that leptin plays a role in pathogenesis of disease but it has a slight risk factor in ocular involvement.There was statistically significant increase in the concentration of IL - 8 and IL - 10 in sera of patients as compared with the controls, and these parameters were lower in ocular BD patients than non - ocular BD. This suggests that these parameters might play a role in immunopathogensis of BD. There was positive correlation between CRP and IL - 8 as well as, between IL - 8 and leptin concentrations.There was statistical increase in C - reactive protein concentration and ESR in BD patients as compared with the controls. The CRP showed a non - significant increase in ocular BD patients, while ESR was significantly increased.Indirect immunofluorescent technique indicated a negative anti nuclear antibody (ANA) in all cases, while the anti neutrophile cytoplasmic antibody (AN

تعدد الاشكال الجيني للكالكتين - ? في مرضى التهاب المفاصل الروماتويدي == Galectin - 8 Gene Polymorphism In Rheumatoid Arthritis Patients

Author name: طارق قادر طلاب
Supervisor name: محمد عبد الاخوة الفحام | فائق ايشو كوريال
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: التهاب المفاصل الروماتويدي هو مرض التهاب المفاصل الالتهابي المزمن مع معدلات كبيرة للمراضة والوفيات .التشخيص المبكر مهم للمعالجة وتحقيق افضل النتائج . لقد اجريت هذه الدراسة في الفترة ما بين بداية تشرين الثاني عام 2016 وحتى نهاية تشرين الثاني عام 2017 على 90 شخصا تم تشخيص 50 منهم على انهم مصابين بالتهاب المفاصل الروماتويدي (مجموعة المرضى) الذين كانوا يحضرون للعيادة الخارجية للمفاصل بمستشفى بغداد التعليمي وكان هناك ايضا 40 اخرون من مجموعة الاصحاء. تم جمع عينات الدم من المرضى والاصحاء لاكتشاف تعدد الاشكال الجيني للكالكتين - 8 والذي تم اجراؤه بواسطة تفاعل سلسلة البوليميريز الخاص بتضخيم الطفرة (ARMS - PCR)كما تم تقييم مستوى الكالكتين - 8 والاجسام المضادة لل CCP في مصل الدم بواسطة مقايسة الممتز المناعي المرتبط بالانزيم ELISA)). تم قياس بروتين سي التفاعلي( CRP) بواسطة nephlometer كما تم فحص العامل الروماتويدي RF) ) بواسطة طريقة تراص اللاتكس . كان مجموع مرضى الدراسة الحالية 50 مريضا، كان متوسط اعمارهم (10.4±46.5) سنة ، وكانت نسبة الاناث سائدة اكثر من الذكور في نسبة (F : M 2.6 : 1). لقد اوضحت الدراسة الحالية انه لم يكن هناك اختلاف كبير بين المرضى والاصحاء في ما يتعلق بتعدد الاشكال الجيني للكالكتين - 8 وكشفت الدراسة الحالية ان مستوى الكالكتين - 8 كان اعلى في مجموعة الاصحاء (87.83 ± 182.93) من مجموعة المرضى ( 36.68± 25.79 ) وهذا الفرق ذو دلالة احصائية (P<0.001 ) ,في ما يتعلق بالاجسام المضادة للCCP فقد تم اكتشافها في 45 من المرضى بينما كانت سالب في جميع عناصر مجموعة الاصحاء والفرق كان ذو دلالة احصائية P <0.001 ) ) ,كما اظهرت الدراسة ان بروتين سي التفاعلي كان موجبا في 25 مريضا وفي 11 فردا من مجموعة الاصحاء وهذا الفرق ذو قيمة احصائية (p= 0.03), كما كشفت النتائج الحالية ان اختبار العامل الروماتويدي كان موجبا في 25 مريضا وكذلك 9 افراد من مجموعة الاصحاء وهذا الفرق ذو دلالة احصائية (p= 0.007) ,كما ان معدل ترسيب الدم لمجموعة المرضى اعلى من مجموعة الاصحاء وذو دلالة احصائية عالية (P <0.0001 ) . لقد اوضحت الدراسة انه لم يكن هناك اي اختلاف ملحوظ بين مجموعة المرضى ومجموعة الاصحاء فيما يتعلق بتعدد الاشكال الجيني للكالكتين - 8كما بينت الدراسة ان لمستوى الكالكتين - 8 في مصل الدم نتائج ممتازة للتمييز بين مجموعة المرضى ومجموعة الاصحاء.ان مستويات الكالكتين - 8 كانت اعلى في مجموعة الاصحاء من مجموعة المرضى , كان هناك ارتباط كبير سلبي بين مستويات الكالكتين - 8 والاجسام المضادة للCCPومعدل ترسيب الدم والعامل الروماتزمي وهذا يشير الى ان مستوى منخفض من الكالاكتين - 8 يرتبط بشكل كبير مع مستوى عال ( مستوى متزايد) من الاجسام المضادة للCCPومعدل ترسيب الدم والعامل الروماتويدي ، وبالتالي يمكن ان يشير الى نشاط المرض وشدته. | Rheumatoid arthritis is chronic inflammatory arthritis disease with significant morbidity and mortality .Early diagnosis is important for beter treatment and outcome. Galectins are potent immune regulators and modulate a range of pathological processes, such as inflammation, autoimmunity, and cancer, Accumulated evidence shows that several family members of galectins play positive or negative roles in the disease development of RA, through their effects on T and B lymphocytes, myeloid lineage cells, and fibroblast - like synoviocytes. This case controls study assess the association between serum galactin - 8 gene polymorphism in RA and controls .And also measure the serum level of Galectin - 8 in RA patient and controls and its validity in early diagnosis. Patients and Methods : This study was conducted in the period between November 2016 till the end of November 2017 on ninety (90) subjects, fifty (50) of them (patient group) were diagnosed as established RA patients, who were attending the Rheumatology Outpatient Clinic of Baghdad Teaching hospital, and other forty (40) were apparently healthy control group. Blood samples were collected from patients and controls to assess serum galectin - 8 and ACCP by enzyme linked immunosorbent assay (ELISA), the CRP was measured by nephlometer, and RF by latex agglutination method, Whereas Galectin - 8 gene Polymorphism done by Amplification - Refractory Mutation System - PCR (ARMS - PCR).Results : 50 case study group included in the current study, their mean age 46.5±10.4 years, the females were predominant than males in a ratio (F : M 2.6 : 1). The current study revealed that serum levels of galectin - 8) higher in control group (182.93±87.83) than patient group (36.68±25.79) and this difference is statistically significant (P - value < 0.001).At the optimum cut off value of serum gal - 8 ≤ 95.7 we found that maximum accuracy was 95.6 , sensitivity 98.0%, specifity 92.5% and AUC was 0.971 this indicate that the biomarker has excellent valid results to differentiate bet patient and control. In the present study there was negative significant correlation between serum galectin - 8 and ESR,ACCP,RF. there was no significant difference between patients and controls regarding galectin - 8 gene polymorphism. TT allele had the highest association with RA while AT allele had the weakest association with RA, however; all these alleles did not associated significantly with RA.Anti - CCP antibodies were detected in 45 (90.0%) patients and were not detected only in 5 (10.0%) patients. Out of 40 healthy controls; the anti - CCP was negative in all healthy controls (100.0%), , with extremely statistical difference (P <0.001) between the patients and healthy control group. The present study showed that CRP was positive in 25 patients (50.0 %), and in 11 subjects (27.5%) from control group and this difference is statistically significant p - value= 0.03The present findings revealed that RF test was positive in only 25 patients (50.0%), and was positive in nine subjects (22.5%) from control group and this difference was statistically significant (P - Value = 0.007 ), Mean level of ESR of patient group higher than control group and is highly statistically significant (P - Value < 0.0001).Conclusions : The study shown that there was no significant difference between patient and controls regarding galectin - 8 gene polymorphism, and there was significantly less serum galectin - 8 in patient compared to control, also there was negative significant correlation between serum galectin - 8 and ESR,ACCP,RF.At the optimum cut off value of serum gal - 8 ≤ 95.7 we found that maximum accuracy was 95.6 , sensitivity, specifity and AUC was 0.971 this indicate that the biomarker has excellent valid results to differentiate between patient and control

مستوى الكالبروتيكتين بروتين (S - 100) في مصل الدم للمرضى المصابين بالتهاب الفقار المقسط في العراق وعلاقته بالعلاج, نشاط المرض وتنميط.HLA == The Serum Level of Calprotectin (S - 100 protein) in Iraqi Patients with Ankylosing Spondylitis and its Relation with Treatment, Disease Activity and HLA Typing

Author name: خالد محمد عبد الواحد
Supervisor name: جاسم محمد كرحوت | محمد هادي العصامي
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: لقد اجريت هذه الدراسة في الفترة ما بين تشرين الاول عام 2016 وتشرين الاول عام 2017 على 90 شخصا تم تشخيص 60 منهم على انهم مصابين بالتهاب الفقار المقسط (مجموعة المرضى) وكان 30 منهم يتناولون العلاج التقليدي (الستيرويد و/او العقاقير السامة للخلايا) الذين كانوا يحضرون للعيادة الخارجية للمفاصل بمستشفى بغداد التعليمي في حين كان هناك 30 مريضا اخرين يتلقون العلاج البيولوجي Inliximab infusion)) وهم يحضرون ردهة العلاج البيولوجي وكان هناك ايضا 30 اخرون من مجموعة الاصحاء. تم جمع عينات الدم من المرضى والاصحاء لتقييم الكالبروتيكتين(Calprotectin) (Matrix(metalloproteinase - 3) في مصل الدم وتم الكشف عنها بواسطة مقايسة الممتز المناعي المرتبط بالانزيم ELISA)). تم قياس hs - CRP بواسطة nephlometer كما تم فحص HLA B - 27 بواسطة التفاعل المتسلسل للبوليميريز في الوقت الحقيقي RT - PCR)). كان مجموع مرضى الدراسة الحالية 60 مريضا، كان متوسط اعمارهم 40.05 ± 8.02 سنة ، وكانت نسبة الذكور سائدة اكثر من الاناث في نسبة (M : F 11 : 1). لقد اوضحت الدراسة الحالية ان مستويات الكالبروتيكتين في المصل كانت اعلى في مجموعة المرضى (89.23 ± 73.97) من مجموعة الاصحاء (54.94 ± 20.51) وكان هذا الفرق ذو دلالة احصائية (P= 0.0148) ، وكان اعلى ايضا في المرضى الذين عولجوا بالعلاج التقليدي مقارنة بالمرضى الذين عولجوا بالعلاج البيولوجي (infliximab infusion) وكان الفرق ذو دلالة احصائية (P = 0.0013) بينما لم يكن هناك فرقا احصائيا بين المرضى الذين كان BASDAI وBASFI < 4.0 وغيرهم من المرضى الذين كان BASDAI و4.0 ≤ BASFI ولا بين المرضى الذين HLA B - 27 ايجابية وغيرها سلبية. لقد كان متوسط مستوى المصل من مركب Metalloproteinase - 3 من المرضى اعلى من مجموعة الاصحاء وكان ذو دلالة احصائية عالية (P= 0.0093)وكان اعلى ايضا في المرضى الذين عولجوا بالعلاج التقليدي ، مقارنة بالمرضى في العلاج البيولوجي (infliximab infusion) والفرق كان ذو دلالة احصائية (P value = 0.0235). وفيما يتعلق باختبار hs - CRP الذي كشف ان متوسط مستوى hs - CRP في المصل للمرضى كان اعلى من مجموعة الاصحاء وكان ذو دلالة احصائية عالية (P= 0.0001) وكان اعلى ايضا في المرضى الذين عولجوا بالعلاج التقليدي ، مقارنة بالمرضى الذين كانوا يتلقون العلاج البيولوجي (infliximab infusion) وكان هذا الفرق ذو دلالة احصائية(P = 0.0235). لقد اظهرت الدراسة الحالية ان HLA B - 27 كان ايجابيا في 34 مريضا (56.7 ٪) ، ولم يكن موجبا في اي شخص من مجموعة الاصحاء وكان هذا الفرق ذو دلالة احصائية عالية (P < 0.0001) وكان هناك فرق كبير من hs - CRP بين مجموعات HLA B - 27 الايجابية والسلبية (P= 0.0437) ولم يتم الكشف عن اختلافات اخرى (ESR ، Calprotectin ، MMP - 3 ، BASDAI ، BASFI) بين مجموعة المرضى HLA B - 27 الايجابية والسلبية. فيما يتعلق بالعلاقة بين ESR وCalprotectin وMMP - 3 وhs - CRP في كلا المجموعتين من المرضى. كان هناك ارتباط مباشر كبير بين hs - CRP وESR (P value = 0.005) ولم يلاحظ اي ارتباط بين المعلمات الاخرى في كلتا المجموعتين من المرضى.لقد اوضحت الدراسة ان الكالبروتيكتين في المصل كان اعلى في مجموعة المرضى من مجموعة الاصحاء وكان اعلى في المرضى الذين يتلقون العلاج التقليدي مقارنة بالمرضى المعالجين بالعلاج البيولوجي ولم تكن هناك علاقة بين مستوى الكالبروتيكتين في المصل ونشاط المرض ولا بوجود HLA B - 27 . | patients were diagnosed as established ankylosing spondylitis patients, thirty (30) patients of them were on conventional treatment (steroid and/or cytotoxic drugs) who were attending the Rheumatology Outpatient Clinic of Baghdad Teaching Hospital, while the other thirty (30) patients were on biological treatment (infliximab infusion) attending biological therapy room and other thirty (30) were apparently healthy control group. Blood samples were collected from patients and controls to assess Serum calprotectin and matrix metalloproteinase - 3 which were detected by enzyme linked immunosorbent assay, the high sensitivity C - Reactive Protein was measured by nephelometer,, wherease Human Leucocyte Antigen B - 27 has been done by real time polymerase chain reaction. Out of 60 patients study group included in the current study, their mean age was 40.05 ± 8.02 years, the males were predominant than females in a ratio (M : F 11 : 1). The current study revealed that serum level of calprotectin is higher in patient group (89.23±73.97) than control group (54.94±20.51) and this difference is statistically significant (P - value =0.0148), and also is higher in patients treated with conventional treatment, than in patients treated with biological treatment (infliximab infusion) and the difference is statistically significant (P - value =0.0013) while the difference is not statistically significant between patients whose Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index < 4.0 and other patients whose Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index ≥ 4.0 nor between patients whose Human Leucocyte Antigen B - 27 positive and others negative. Mean serum level of matrix metalloproteinase - 3 of patients is higher than control group and is highly statistically significant (P - Value 0.0093) and also higher in patients treated with conventional treatment, than in patients on biological treatment (infliximab infusion) and the difference is statistically significant (P - value =0.0235). Regarding high sensitivity C - Reactive Protein test which revealed that mean serum level of high sensitivity C - Reactive Protein of patient higher than control group and is highly statistically significant (P - Value =0.0001) and also higher in patients treated with conventional treatment, than in patients on biological treatment (infliximab infusion) and this difference is statistically significant (P - value = 0.0235). The current study showed that Human Leucocyte Antigen B - 27 was positive in 34 (56.7 %) patients, and in no subject ( 0 %) from control group and this difference is highly statistically significant (P - Value < 0.0001) and there is a significant difference of high sensitivity C - Reactive Protein between positive and negative Human Leucocyte Antigen B - 27 groups (P - value =0.0437) and no other differences detected of (Erythrocyte Sedimentation Rate, Calprotectin, matrix metalloproteinase - 3, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index) between positive and negative Human Leucocyte Antigen B - 27 patients group. Regarding the correlation between Erythrocyte Sedimentation Rate, Calprotectin, matrix metalloproteinase - 3 and high sensitivity C - Reactive Protein in both patients groups; there is a significant direct correlation between high sensitivity C - Reactive Protein and Erythrocyte Sedimentation Rate (P - value=0.005) and no correlation is observed between the other parameters in both patients groups. The study had showed that serum Calprotectin is higher in patients group than control group and also higher in patients on conventional treatment than in patients on biological treatment, and there is no relation between serum calprotectin level and disease activity nor Human Leucocyte Antigen B - 27 typing

دور العلامات المصلية (CA - 125, CA19 - 9) وIL - 6 في بطانة الرحم المهاجره == The Role of Serological Markers (CA - 125,CA19 - 9) and IL - 6 in Endometriosis

Author name: ثروه هادي حسن الطائي
Supervisor name: هيفاء سلمان الحديثي | هند صباح عبد السلام
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Master
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
Key words:
  • بطانة الرحم المهاجرة
  • علامات ورم
  • CA - 125
First pages:
Abstract: بطانة الرحم المهاجرة هو خلل مزمن يصيب الجهاز التناسلي للمراة ويتصف بوجود وانتشار غدة وسدى خارج تجويف الرحم حيث يصيب 10% من النساء اللاتي في سن الانجاب، ويعد هذا المرض احد اكثر الامراض تعقيدا وارباكا ومن اعراضه المرهقة الم دوري في الحوض مما يجعل حياة المريضة لا تطاق ان تركت الحالة بدون علاج. النساء المصابات بمرض بطانة الرحم المهاجرة في مرحلته الاولى او الثانية (الخفيفة الى المعتدلة) قد يعانين من اعراض اكثر الما من اللاتي في المرحلة الثالثة او الرابعة، حيث توجد بعض الادلة التي تفيد بان مرض بطانة الرحم المهاجرة الخفيف الى المعتدل قد يكون اكثر اشكال المرض نشاطا.ان امكانية تشخيص مرض بطانة الرحم بسهولة، وذلك باستخدام وسائل اقل تداخلا (العلامات البيولوجية)، من شانه ان يعكس قيمة كبيرة، وعلى وجه الخصوص في حال استخدام العلامات البيولوجية ذاتها في رصد العلاج بفاعلية.الهدف : - لتشخيص فاعلية مصل CA - 125 وCA19 - 9 وIL - 6 في مجال التكهن في بطانة الرحم المهاجرة واستخداماتها في قياس مدى خطورة المرض. الاشخاص والمواد والعمل : - طبقت تلك الدراسة على 51 امراة ممن اصبن بمرض بطانة الرحم المهاجرة (20 حالة حديثة و31 حالة تمت معالجتها) و33 امراة سليمة. خضع جميع الافراد الى اختبار اخذ عينات الدم بهدف قياس مصل CA - 125 وCA19 - 9 وIL - 6 وذلك باستخدام تقنية ELISA. النتائج : - خلصت دراستنا الى ان مريضات بطانة الرحم المهاجرة يعانين بشكل كبير في عمر يتراوح بين 28 - 37 (54%)، و(61%) من المريضات يراجعون بسبب الم مزمن في الحوض في حين ما تبقى (39%) يراجعون بسبب العقم. ووجدت زيادة بشكل ملحوظ في مستويات مصل CA - 125 وCA19 - 9 لدى المصابات بالمرض وعلى وجه الخصوص في المرحلتين الثالثة والرابعة واقل منه لدى المريضات اللاتي تمت معالجتهن مقارنة بالمجاميع غير المعالجة. اما مستوى مصل IL - 6 فقد انخفض بنحو كبير لدى المصابات اللاتي في المرحلة الرابعة، حيث ان مصل IL - 6 كان 100% نوعية في حين CA - 125كان اكثر حساسية. الاستنتاج : - يرتبط كل من CA - 125 وCA19 - 9 ايجابا ببطانة الرحم المهاجرة، وعلى ما يبدو ان تركيز اختبار مصل IL - 6 اكثر نوعية والذي يعد علامة مبكرة للكشف عن مرض بطانة الرحم المهاجرة. | Endometriosis is a common chronic gynecologic disorder characterized by the presence and proliferation of functional endometrial gland and stroma outside the uterine cavity, affecting approximately 10% of reproductive age women. It is one of the most complicated and baffling disease with debilitating symptoms of cyclical pelvic pain, which may render the patients life unbearable if left untreated.Endometriotic women with stage I or II (mild to moderate) may have more painful symptoms than a women with stage III or IV. there is some evidence that mild to moderate endometriosis may be the more active forms of the disease. Therefore, the ability to diagnose endometriosis more easily, using less invasive means ( marker), would be of great value, particularly if the same biomarker could be used to monitor treatment efficacy.Aim of study : - To evaluate the efficacy of serum CA - 125, CA19 - 9 and IL - 6 levels in the diagnosis of endometriosis and their uses in measuring the severity of the disease.Materials and methods : - This study was applied on 51 women with endometriosis (20 newly diagnosed and 31 treated cases) and 33 apparently healthy women.All individuals were subjected to blood sampling for measuring their serum CA - 125, CA19 - 9 and IL - 6 by using ELISA technique.Results : - Our study shows that endometriosis patient mainly presented at age between 28 - 37 (54%), 61% of them presented with chronic pelvic pain while the other (39%) presented due to infertility.Serum levels of CA - 125 and CA19 - 9 were significantly elevated in patients with endometriosis mainly those at stage III and IV and that there were much less in treated patients when compared to non treated group.Serum IL - 6 level was significantly decrease in those with stage IV endometriosis. IL - 6 has 100% specificity while CA - 125 has a higher sensitivity.Conclusion : - Serum CA - 125 and CA19 - 9 were positively correlated with severity of endometriosis. Reduction in serum IL - 6 concentration seems to be the highly specific

تاثير الاجسام المضادة لل انفلياكسيمب وعلاقتها مع مستضدات الكريات البيض البشرية - النوع الثاني - DRB1 في المرضى العراقيين المصابين بالتهاب المفاصل الرثوي == Influence of Anti - infliximab Antibodies and its Association with HLA - class II - DRB1 alleles in Iraqi patients with Rheumatoid arthritis

Author name: محمد احمد الكرخي
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: التهاب المفاصل الرثوي هو مرض مزمن ذاتي المناعة يصيب عدة اعضاء من الجسم ومن ضمنها المفاصل ويمكن ان يؤدي الى تدمير المفاصل والعجز الشديد اذا لم يعالج في وقت مبكر. المضادات لعامل نخر الورم عامل الفا (TNFα) مثل اينفلياكسيمب (INF) وهو من الاجسام المضادة وحيدة النسيلة خيالية ادخلت في عام 2010 من قبل وزارة الصحة كعوامل فعالة للغاية لعلاج المرضى العراقيين المصابين بالتهاب المفاصل الرثوي الحاد متوسط الشدة او الشديد الذي لا يستجيب للعلاج التقليدي.اينفلياكسيمب يمكن ان يحفز على تكوين الاجسام المضادة لعقار اينفلياكسيمب (ATIS)، ولكن هذه الاجسام المضادة من الممكن ان تؤدي الى نقص فعالية الاينفلياكسيمب او تاثيرات جانبية سلبية.وفقا لمعلوماتنا المتاحة انه لا توجد اية معلومات عن هذه الاجسام المضادة لل انفلياكسيمب وارتباطها مع النتائج السريرية، العلامات المصلية ومستضدات HLA - classІІ - DRB1 في المرضى العراقيين المصابين بالتهاب المفاصل الرثوي.وقد اجريت هذه الدراسة لاعطاء فكرة واضحة عن تكون ودور هذه الاجسام المضادة في الاستجابة السريرية للمرضى لعقار الاينفلياكسيمب وكذلك توضيح تاثير مستضداتHLA - classІІ - DRB1 على القابلية المناعية لعقار الانفلياكسيمب في تكوين هذه المضادات.المرضى والطرق : شملت الدراسة 100 شخص. حيث تضمنت ما مجموعه 50 مريضا الذين توافقوا مع المعايير المنقحة لمرض التهاب المفاصل الرثوي (الكلية الامريكية لامراض الروماتيزم 1987 و2010) في المواءمة مع 50 مجموعة السيطرة (25 اشخاص اصحاء و25 مرضى مصابين بالتهاب المفاصل الرثوي لم يعالجوا بعقار اينفلياكسيمب). وقد اجريت هذه الدراسة خلال الفترة من بداية شهراذار 2014 حتى نهاية شهر ايلول 2014 في وحدة العلاج البيولوجي لقسم امراض الروماتيزم / مستشفى بغداد التعليمي، مختبر الدراسات العليا / فرع الاحياء المجهرية / كلية الطب - جامعة بغداد، المختبرات التعليمية / مدينة الطب، وحدة زرع الكلى / مستشفى الكرامة التعليمي ومركز التطابق النسيجي البحثي / كلية طب الكندي / جامعة بغداد. تم جمع عينات الدم من مجموعة السيطرة والمرضى الذين يعانون من التهاب المفاصل الرثوي في والذين تمت معالجتهم بعقار الانفلياكسيمب لاكثر من ثلاثة اشهر لغرض تقييم الاجسام المضادة لعقار الاينفلياكسيمب،مضادات - CCP، بروتين سي التفاعلي والتنميط الجيني HLA - DRB1.المرضى الذين لم تتكون لديهم الاجسام المضادة لل انفلياكسيمب فتمت متابعتهم لمدة 6 اشهر واعادة فحصهم للتحقق من وجود الاجسام المضادة لل انفلياكسيمب,anti - CCP وبروتين سي التفاعلي.تم الكشف عن الاجسام المضادة لل انفلياكسيمب والاجسام المضادة لل CCP بواسطة جهاز فحص الانزيم الرابط المناعي (ELISA) ,اما بروتين سي التفاعلي(CRP) فتمت قياسته بواسطة جهازNephelometer في حين تم اجراء تحليل التنميط الجيني النوع الثاني DRB1 بواسطة بادئات محددة تفاعل البلمرة المتسلسل (PCR - SSO) لكل من المرضى ومجموعة السيطرة الاصحاء.النتائج : من اصل 50 مريض في الدراسة الحالية، كان متوسط العمر (45.24 ± 9.15سنة) وكانت الاناث اكثر من الذكور (اناث : ذكور 3 : 1).تم اكتشاف الاجسام المضادة لل انفلياكسيمب في خمسة وثلاثون مريض(70٪) من مرضى التهاب المفاصل الرثوي بعد فترة ثلاثة اشهر من العلاج بهذا الدواء, بينما لم تتكون هذه المضادات للعقار في 15 (30٪) منهم.في حين لم يتم الكشف عن اية اجسام مضادة في مجموعة السيطرة (الاصحاء ووالسيطرة المرضية)، كان الفرق على درجة عالية وذات دلالة احصائية (قيمةp = 0.000001)، ومع حساسية وخصوصية (70٪، 100٪) على التوالي. في نفس المدة من العلاج تم الكشف عن الاجسام المضادة لل - CCP في 47 (94٪) من المرضى بينما لم يتم اكتشاف هذه الاجسام المضادة في في 3 (6.0٪)منهم، في حين تم الكشف عن هذه الاجسام المضادة في 22 (88٪) من مجموعة السيطرة ولم يتم اكتشافها في 3 (12٪) منهم.بينما لم يتم اكتشاف اية اجسام مضادة لل - CCPفي مجموعة الاصحاء ,وكان الفرق معتد للغاية وذات دلالة احصائية (قيمة p=0.0005) مع حساسية وخصوصية (94٪، 100٪) على التوالي.تم توثيق علاقة قوية بين نشوء الاجسام المضادة للانفلياكسيمب والاجسام المضادة لل - CCP (قيمة p = 0.006).وفيما يتعلق بفحص بروتين سي التفاعلي، تم الكشف عنه في 26 (52٪) من مجموعةالمرضى بينما لم يتم الكشف عنه في 24 (48٪) منهم، كما انه كان ايجابيا في كل مجموعة السيطرة المرضية, بينما في مجموعة السيطرة للاصحاء، كان ايجابيا في 10 (40٪) وسلبيا في 15 (60٪) وكان الفرق ذات دلالة احصائية عالية (قيمة p= 0.000014) مع تدني في الحساسية والخصوصية (52٪، 60٪) على التوالي.ولم تسجل الدراسة الحالية اي ارتباط ذو قيمة بين نتيجة بروتين سي التفاعلي وتكون اضداد اينفلياكسيمب (قيمةp = 0.084).بالنسبة لمجموع المرضى الذين لم يتم اكتشاف اضداد ال انفلياكسيمب لديهم والبالغ عددهم 15 مريض فتمت متابعتهم بعد 6 اشهر من فترة العلاج بال انفلياكسيمب لغرض التحقق من احتمالية تكون الاجسام المضادة لل انفلياكسيمب ,اضافة الى اعادة فحص اضداد - CCPو بروتين سي التفاعلي ,اظهرت النتائج عن عدم وجود فرق احصائي بين نتائج الفحص بعد 3 اشهر وونتائج الفحص بعد 6 اشهر وكانت قيمة - p((0.067، 0.067 و1.0) على التوالي.وعلاوة على ذلك، كشفت الدراسة وجود علاقة ايجابية بين HLA - DRB1 * 04 (DR4) اليل مع 35 مريض مصاب بالتهاب المفاصل الرثوي تمت علاجهم بال اينفلياكسيمب حيث تمت مقارنتهم مع 25شخص من مجموعة السيطرة للاصحاء وكان الفرق ذات دلالة احصائية (قيمة p = 0.001).واخيرا كشفت الدراسة الحالية عن عدم وجود اي ارتباط بين HLA - DRB1 وتكون الاجسام المضادة لل اينفلياكسيمب في المرضى الذين يعانون من التهاب المفاصل الرثوي (قيمة p = 0.0914).الاستنتاجات : اظهرت الدراسة الحالية على ان ما يقرب من ثلاثة ارباع المرضى العراقيين المصابين بمرض التهاب المفاصل الرثوي تتكون لديهم الاجسام المضادة لل ااينفلياكسيمب بعد ثلاثة اشهر من العلاج مع هذا العامل البيولوجي مع عدم وجود اي ارتباط للعامل الوراثي (اليل DRB1 - HLAالنوع الثاني) مع تكونها، كما اثبتت الدراسة وجود ارتباط وثيق بين العامل الجيني الاليل( HLA - DRB1 * 04 (DR4مع نشوء مرض التهاب المفاصل الرثوي في المرضى العراقيين. | Rheumatoid arthritis is a systemic chronic autoimmune inflammatory polyarthritis leads to joints destruction and severe disability if not treated early. Tumor necrosis factor alpha antagonists such as infliximabwhich is a chimeric monoclonal antibody have been introduced and approved in 2010 by Ministry of Health as highly effective agents for the treatment of Iraqi patients with moderate to severe Rheumatoid arthritis that not responds to conventional treatment.Infliximab can induce formation of anti - infliximab antibodies, however, these antibodies may lead to lack of efficacy to Infliximab or adverse reactions.According to our knowlege no information is available about these antibodies to infliximab and their association with clinical findings , serological markers and HLA - class ІІ - DRB1 antigens in iraqi patients with Rheumatoid arthritis.The present study was conducted to give a clear idea about the development and the role of these antibodies in clinical response of patients to infliximab and demonstration the effect of HLA - class ІІ - DRB1 antigens on the immungenicity of infliximab. Patients and Methods : The study covered 100 subjects. It included a total of 50 patients who met the revised criteria for RA (the American College of Rheumatology 1987 and 2010) in aligment with the 50 control group(25 healthy individuals and 25 RA patients not treated by infliximab). This study was carried out during the beginning of March 2014 till the end of September 2014 in the Biological Therapy Unit of the Deparment of Rheumatology/Baghdad Teaching Hospital, the laboratory for Higher Studies/Microbiology Deparment/Baghdad College of Medicine, the Teaching Laboratories/Medical City, the Kidney Transplant Unit/ Al - Karama Teaching Hospital and HLA Research Center /Al - kindy College of Medicine/Baghdad University. Blood samples were collected from control group and patients with RA on infliximab therapy for more than three months duration for assesment of antibodies to infliximab , anti - Cyclic Citrullinated Peptide(anti - CCP) ,C - reactive Protein(CRP) and for Human Leukocyte Antigen - DRB1(HLA - DRB1) genotyping.The patients with negative anti - infliximab antibodies were follow up and reinvestigated after 6 month of infliximab therapy for anti - infliximab antibodies, anti - cyclic citrullinated peptide and C - reactive Protein.Anti - bodies to infliximab and anti - Cyclic Citrullinated Peptide antibodies were detected by Enzyme Link Immunosorbent Assay (ELISA), the C - reactive protien (CRP) was measured by Nephlometer . whereas the genotyping analysis for HLA - class ІІ - DRB1 had been done by polymerase chain reaction - sequence specific primers (PCR - SSO) for both patients and healthy control group.Results : Out of 50 case study group included in the current study, their mean age was (45.24± 9.15) the females were predminance than males in a ratio (F : M 3 : 1).Thirty five (70%) of RA patients developed antibodies against infliximab after three months of treatment with this drug ,15 (30%) of them were negative for these antibodies, while no anti - inflixmab antibodies were detected in control groups( (healthy and case control) ,the difference was a highly statistically significant(P - value=0.000001), and with sensitivity and specificity (70 %,100%) respectively.At the same duration of treatment the anti - CCP was detected in 47 (94%) patients and negative in 3 (6.0%), while in case control was postive in 22 ( 88%) and negative in 3(12%), and was not detected in all healthy control group,the difference was highly satistically siginficant ( p - value =0.0005) with sensitivity and specificity (94%,100%) repectively.A strong correlation was reported between the development of anti - infliximab and anti - CCP antibodies (p - value=0.006).Regarding the CRP test ,it was positive in 26 (52%) patients and negative in 24 (48%), also it was positive in all case control group while in healthy control group ,it was reported positive in 10(40%) and negative in 15(60%) with highly statistically significance(p - value=0.000014) with low sensitivity and specificity (52%, 60%) respectively.No significant correlation was reported between CRP and development of anti - infliximab antibodies (p - value=.084).Fifteen patients group with negative anti - infliximab antibodies were follow up and re - investigated after six months of treatment with infliximab for anti - infliximab ,anti - CCP antibodies and CRP, the results showed no statistical difference of these test after three and six month of infliximab treatment with p - value (0.067, 0.067 and 1.0) respectively.The study revealed a positive association of HLA - DRB1*04(DR4) allele with 35 patients with RA on infliximab therapy whom compared with 25 healthy control and the difference was statistically significant (p - value=0.001).There was no association found between the HLA - DRB1 and development of antibodies to infliximab in patients with RA (p - value=0.0914).Conclusions : The current thesis showed that approximately three quarter of Iraqi patients with RA developed antibodies against infliximab after three months of treatment with this biological agent and without association of genetic factor( HLA - class ІІ - DRB1 alleles) with their development ,also the study suggested an association of susceptibility of RA in Iraqi patients with HLA - DRB1*04(DR4).

دور Foxp جين والاحماض النووية الرايبوية متناهية الصغر ,145 ,146a ,20aفي عينة من المرضى العراقيين المصابين بمرض تصلب الاعصاب المنتشر == The Role of Foxp3 and MicroRNAs (20a, 146a, 145, and 155) in a Sample of Iraqi patients with Multiple sclerosis

Author name: زينب عبد الاله عبد الجواد الجوادي
Supervisor name: عائدة رشيد منصور الدرزي | بان عباس عبد المجيد
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Multiple sclerosis is a devastating central nervous system autoimmune disorder that is characterized by a series of inflammations, demyelinations, and neurodegenerations that affect the brain and spinal cord. The epigenetic studies specially micro Ribonucleic acid expression represent an important field of researches that probably uncover the obscurities behind the multiple sclerosis pathogenesis. The aims of the present work were to study the expression of micro Ribonucleic acids (20a, 146a, 155, and 145) and forkhead box P3 genes by real time polymerase chain reaction relative quantification technique, to correlate their expression according to different clinical parameters, and to perform chromosomal analysis on the multiple sclerosis patients peripheral blood lymphocytes. A case - control study was performed on 25 newly diagnosed untreated multiple sclerosis patients during their attendance to Multiple Sclerosis clinic, or during their admission to the Neuromedical ward (10th floor) in Baghdad Teaching Hospital, and Special Nursing Home (5th floor) in Baghdad Medical City as well as from the Neuromedical Consultancy Unit in Al - Yarmouk Teaching Hospital in Baghdad city, in addition to 25 apparently healthy controls which were medical staff with no history of having any autoimmune disease or receiving any steroid or immunomodulatory therapy. Furthermore, chromosomal analysis was performed for multiple sclerosis patients. This work was conducted during the period from 1st of April 2015 to 31st of March 2016.From a total of 25 multiple sclerosis patients, 23 of them were females and 2 were males with a female to male ratio (F : M) of 11.5 : 1. The ages of these patients ranged between 18 - 55 years; mean age was 33.32 + 9.45 years. Studying of micro Ribonucleic acids expression revealed a significant down - regulation in micro Ribonucleic acid - 20a and forkhead box P3 gene while up - regulation of micro Ribonucleic acid - 155 expression in multiple sclerosis patients in comparison to controls. Micro Ribonucleic acid - 146a was directly associated with inflammation, and multiple sclerosis disease activity. On the other hand, micro Ribonucleic acid - 145 was not associated with significant changes in its expression in relation to multiple sclerosis disease. Chromosomal analysis was done for multiple sclerosis patients and it was normal.In conclusion, multiple sclerosis is associated with significant changes in micro Ribonucleic acids expression including micro Ribonucleic acid - 20a, micro Ribonucleic acid - 146a, and micro Ribonucleic acid - 155 but not micro Ribonucleic acid - 145 as well as to a significant change in forkhead box P3 gene expression that can be measured by real time polymerase chain reaction technique. Furthermore, multiple sclerosis is not associated withgross chromosomal abnormalities.

الكشف عن بعض عوامل البيئة الداخلية للخلايا السرطانية للنساء العراقيات المصابات بسرطان الثدي == Detection of Some Microenvironment Factors In Tissue Samples of Iraqi Women With Breast Cancer

Author name: فاطمة سمير عبد الرزاق الزبيدي
Supervisor name: اخلاص مشرف عيدان
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Master
University: University of Baghdad - College Of Science For Girls
Language: English
University location: Baghdad
First pages:
Abstract: Breast cancer (BC) is the most common cause of cancer - related deaths in women. It continues to rank as one of the top killer of women. This cancer increased in frequency in the last years in Iraq. The aim of this study was to shed light on the immunohistochemical for some factors that could be affect on development of microenvironment in breast cancer of Iraqi patients. And these factors include CD133 as a marker for breast cancer stem cells (BCSs), and also studying tumor necrosis factor alpha (TNF - ?) and transforming growth factor beta (TGF - ?). 53 samples Formalin - fixed, paraffin - embedded (FFPE) wax block appeared their ages were range from 29 - 70 year with a mean age of 48.45 years. 32 patients with breast carcinoma and 21 patients with benign breast lesions were included in this study for comparison. The results of this study show that the CD133 positive expression was found in (56.2%) of Iraqi breast cancer cases. Also the result of this study show that (62.5%) positive expression from both (TNF - ? &TGF - ?) of breast cancer cases, compared with sample of benign breast lesion. The results show (52.3%) positive expression of TNF - ? and (28.57%) positive expression of TGF - ? of samples with benign breast lesion, there is a significant different between studied samples, compared with (19.05%) samples positive expression of CD133 of sample with benign breast lesion so there is a significant different between the samples with breast cancer and benign breast lesion. Also the results show there is a positive relationship correlation between (TGF - ?) expression and (TNF - ?) expression, while there were no relationship correlation between (TGF - ?) and CD133 and no relationship correlation between TNF - ? and CD133. The results show there is a positive correlation between the grade and breast cancer with the three different expressions of marker but in different strongest correlations between (TNF - ?) and (TGF - ?) with the graded but this correlation becomes weak with CD133 marker the value of significant. According to the relationship in breast cancer case in this study between the studied markers and stage of case it shows (TNF - ?) has a strong positive correlation while the correlation appear week between the stage of this studies case and end each of TGF - ? and CD133. For this we concluded from the results there high expression of CD133 and TNF - ? indicators and TGF - ?. CD133 could use in diagnosis of the cancer cell and the high expression of TNF - ? & TGF - ? indicate that these factor play important roles in tumor microenvironment metastasis. And the strong correlation between the expression of these markers with grade and stage of breast cancer

دراسة مناعية وجزيئية لخمج القرنية بحمة الحلا - 1 (حمة الهربس البسيط - 1) == Immunological And Molecular Study Of Herpes Simplex Virus - 1 Keratitis

Author name: نهاية كاظم سالم
Supervisor name: عبد العظيم ياسين عبود البراك | فائز اسماعيل الشكرجي
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
First pages:
Abstract: يمثل التهاب القرنية (Keratitis) مشكلة كبيرة قد تؤدي الى فقدان البصر احيانا نتيجة لخدش القرنية او فقدان الوضوحية في القرنية بعد اختفاء الالتهاب, ويعتبر فايروس الحلا (الهربس) البسيط - 1Herpes Simplex Virus - 1(HSV - 1))) هو من اهم العوامل المسببة لمرض التهاب ال | Keratitis is a medical term referring to inflammation of the cornea. It is a serious problem, resulting in everlasting loss of vision as a secondary effect to corneal scarring or loss of clarity of the cornea after the inflammation has disappeared. Most common microbes causing viral corneal keratitis is Herpes Simplex Virus - 1 (HSV - 1). HSV - 1 is a double stranded DNA (dsDNA) virus belongs to the Herpesiviridae. It affects the majority of peoples and its infections have been frequently without clinical manifestation. Ocular HSV - 1 infections caused multiple pathologies with possibly the most damaging being herpetic stromal keratitis (HSK). This study aimed to evaluate the abilities of the immunological and molecular indicators to diagnose herpetic keratitis in the infected and contralateral eye of patients, as well as to assess the immune status of both eyes by using tears and corneal scraping. Fifty - two patients with herpetic keratitis involved in this study, they attended the outpatient clinics / Ibn - AL - Haithum Teaching Hospital from March 2014 until December 2014. For the purpose of comparison, thirty, apparently healthy age matched control subjects were also included. Tears were collected from infected eyes of the 52 patients and from 16 out of the 52 patients contralateral eyes as well as from 30 controls. Corneal scraping had been obtained from 16 patient's infected eyes with corneal ulcers (epithelial ulcers) out of the total patients (52) with herpetic keratitis. Indirect immunofluorescence assay technique (IFA) was applied to measure levels of immunoglobulins (sIgA and IgG) in tears specific to HSV - 1. Realtime - polymerase chain reaction RT - PCR test was used to diagnose HSV - 1 in corneal scraping and tears of patients and control subjects. Interlukin - 17 (IL - 17A), tumor necrosis factor - alpha (TNF - ?) and interferon - gamma (IFN - ?) were measured in tear samples from patients and control subjects by the ELISA sandwich method. In tear samples; results of RT - PCR showed that 39/52 (75%) of the total patient's infected eyes were positive, 12/16 contralateral eyes were positive (75%). Corneal scraping and tear samples were taken from 16 patients with corneal ulcer, tear samples 14/16 (87.5%) positive result, while the corneal scraping samples were 16/16 (100%) positive, this indicates clearly that the cornea scraping is more appropriate and sensitive sample to detect HSV - 1 than tear. All controls were RT - PCR negative. IFA results of IgA and IgG in tears of infected and contralateral eyes were found to be more than the concentration in tears of control eyes with a highly significant p - value (0.0001). Comparison between the infected and the contralateral eyes indicates that both patients' eyes expressed a significant humoral immune response against HSV - 1. Although there were high significant differences between both the mean value of tears IL - 17A in infected and contralateral eyes with control, while the comparison between patient both eyes gave non - significant difference. The mean of tears TNF - ? and IFN - ? concentration in infected eyes of patients as compared to control was found to be highly significant (p= 0.0001). In this study we compared between patients infected eye with control to evaluate the performance of different markers in tear as HSV - 1specific sIgA, HSV - 1 specific IgG, IL - 17, TNF - ? and IFN - ? by using statistical test called Receiver Operating Characteristic (ROC) curve, the sensitivity for all studied parameters ranged from 80% - 96%.At the same time the comparisons between patient contralateral eyes and controls also revealed a high sensitivity range for these parameters ranged from 81% - 100%.These findings proved the ability of these markers in confirming diagnosis of HSV - 1 keratitis. In conclusion, the high percentage of RT - PCR results for corneal scraping sample indicate that this sample and by using this technique is more appropriate and sensitive to detect HSV - 1 than tear samples and detect the shedding of virus in both eyes of the same patients. Both patient eyes indicated that they were a good source for HSV - 1 diagnosis. In spite of the high sensitivity of all studied markers and their diagnostic ability, TNF - ? showed a higher sensitivity. To assess the immunological status of Herpetic keratitis patients, the studied markers TNF - ?, IFN - ? and IL - 17 were evaluated and showed a highly significant differences which indicated there was an active inflammatory condition combined with HSV - 1 infection and finally it can be concluded that both humoral and cellular branches of immune responses were involved in this disease.

تقييم دور مؤشرات حيوية مختارة لدى مرضى التصلب المتعدد == Assessment Of The Role Of Selected Biomarkers In Multiple Sclerosis Patients

Author name: ميساء نجاح امين
Supervisor name: عبد العظيم ياسين عبود البراك | سرمد عبد الرسول الماشطة
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
First pages:
Abstract: التصلب المتعدد (MS) هو من امراض الجهاز العصبي المركزي الاكثر شيوعا الذي يسبب الاعاقه الدائمه لدى الشباب البالغين. بناء على ادلة غير مباشرة قوية، يعتبر مرض التصلب المتعدد اضطراب المناعة الذاتية لعضو محدد ولكن لا يزال هناك الكثير يجب ان يفهم عن كيفيه نشوء ا | Multiple sclerosis (MS) is the most common disease of the central nervous system that causes permanent disability in young adults. Based on strong circumstantial evidence, MS is considered to be an organ - specific autoimmune disorder, but much remains to be understood about the initiation of the disease. It seems unlikely that MS results from a single causative event, but rather the disease develop in a genetically susceptible population as a result of environmental exposures. The present study was planned to determine the serum levels of IL - 17A, IL - 21 and Myelin Oligodendrocyte Glycoprotein (MOG) in patients and control subjects by a sandwich ELISA test using commercially available kits. Vitamin D total was measured in a group of patients and control subjects by cobas e 411 analyzers which is an automated multichannel analyzer for immunological analysis by the use of electrochemiluminescence (ECL) technology.Forty Iraqi MS patients attending the Consultation Clinic for Multiple Sclerosis / Baghdad Teaching Hospital during the period January 2013 - July 2013 were recruited for this study. For the purpose of comparison, 40 control subjects matched by age and gender were also included.The mean serum level of MOG in patient and control (554.85 vs. 315.20pg/ml) and IL - 17A (11.42 vs. 8.33pg/ml) was significantly higher in MS patients as compared to controls, while the mean serum level of IL - 21 (176.164 vs. 75.714pg/ml) was not significantly higher in MS patients as compared to controls. The mean serum level of vitamin D (n=20) (10.38 vs. 13.06ng/ml) was not significantly lower in MS patients as compared to controls. There was a positive correlation between MOG with IL - 17A and between MOG with IL - 21. These results might illustrate the synergism of action between antibody and T cell response in MS patients. A positive correlation was also detected between IL - 17A and IL21 in MS patients.A significant negative correlation was detected between Vitamin D with MOG. A negative correlation was recorded between Vitamin D and IL - 17A in patients. Also negative correlation was recorded between vitamin D and IL - 21 in MS patients. In conclusion, higher level of IL - 17A and MOG in MS serum indicates an important role of this cytokine and MOG as an auto antigen in the pathogenesis of multiple sclerosis and demyelination process, so they could be considered as a good biomarkers for diagnosis and considered as a target for future therapy.

دراسة معظم السمات المناعية وتحديد البكتريا الابرز في مرض التهاب السحايا باستعمال تقنية البي سي ار == Study Some Immunological Aspects And Determination Of Most Prominent Bacteria In Meningitis Patients By Using Real Time Pcr

Author name: شيماء عبد الرضا حميد
Supervisor name: زينب فاضل عاشور | دريد قاسم الشريف
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
First pages:
Abstract: Meningitis, which is inflammation of the membranes that surround the brain and spinal cord and can occur at any age, it is caused by infectious microorganisms include (Bacteria, Viruses, Fungi, and Parasites) and non infectious include (Drugs, Carcinoma and Inflammatory disorder), also requires early treatment with aggressive use of potent antimicrobials; otherwise the outcome almost ends fatally.The predominant causes of bacterial meningitis are streptococcus pneumoniae, Haemophilus influenzae type b (Hib) and Neisseria meningitides.This prospective study includes 40 cases of meningitis which have been admitted to the Baghdad Teaching Hospital and Child Welfare Teaching Hospital during the period from May to November/ 2014.The detection of meningitis causative agent were specified by using the standard biochemical and microbiological methods such as : Determination of protein and sugar in Cerebrospinal fluid, Differential and cell count, growth on Culture media and morphological appearance on Gram's stain.Confirmative tests were also done for identification of meningitis causative agent; these tests included Procalcitonin, IL - 6, CRP, D. Dimer. These confirmative tests have been crowned by PCR technique, by employing the detection of the bacterial gene.The DNA of bacteria was extracted from CSF of meningitis patients and detection the type of bacteria gene by using multiplex PCR technique that using primers to amplify each ply, bexA and ctrA gene.Out of 40 samples, 28 (70%) were identified as bacterial meningitis and 12 (30%) as viral meningitis, the result of PCR reaction revealed unmistakably that 20 (71.4%) of 28 were detected the bacteria (S. pneumonia, H. influenzaetype b and N. meningitides) as a causative agent, while there were no detectable infectious agents in the (40) control group included in this study.Viral meningitis patients showed the number of lymphocytes (31.92 cell/ mm3) and neutrophils (1.00 cell/ mm3), while the highest number of lymphocytes and neutrophils in bacterial meningitis caused by S. pneumoniae (77.08 cell/ mm3) , (28.86 cell/ mm3) respectively, so that there was significant difference between cells (lymphocyte and neutrophil) with study group at P value = 0.010, P value = 0.013 respectively. In microbiological examination 22.5% of patients group (40) showed positive result of culture and 7.5% showed positive result of gram stain.In biochemical tests, the detection of Cerebrospinal fluid's protein and glucose level was done. The level of protein concentrations in bacterial meningitis with S. pneumoniae (103.08 mg/l), H. influenzae (65.14 mg/l) and in other bacteria was (124.44 mg/l) which is higher than the protein concentration in viral meningitis (42.25 mg/l), and these results showed highly significant difference at (P=0.010). Results of glucose's level determination showed that there were no significant difference among the studied groups (P =0.2). Results of glucose's level determination showed the presence of non significant difference among the studied groups, (60.92 mg/dl), (43, 57 mg/ dl), (51.00 mg/dl), (41.50 mg/dl) consecutively appeared in bacterial, viral.Interleukin - 6 and Procalcitonin levels were diagnosed by Enzyme Linked Immunosorbent Assay, while the plasma D. Dimer and erum C - Reactive protein was diagnosed by NaycoCard technique.The current results showed the presence of high concentration of IL - 6 among meningitis patients, high concentration of serum IL - 6 appeared in bacterial and viral meningitis (28.68 pg/ml) when compared with control group (2.194 pg/ml) (P =0.001), while CSF IL - 6 show high concentration in bothbacterial and viral meningitis but with no significant difference (579.24 pg/ml) (P =0.0001). The data of this study showed, there was correlation between IL - 6 levels and neutrophil in meningitis patients. Interleukin - 6 had significant correlation with neutrophil (P =0.009). While no significant correlation appeared between IL - 6 and Lymphocyte.Procalcitonin results showed high concentration in bacterial meningitis group compared with viral and control group with a highly significant differences (P =0.0001).The results of CRP shown no significant differences between bacterial and viral group, while the levels of D. Dimer appear significant differences in both groups when compared with control group.Current study indicated that PCR, Procalcitonin and D. Dimer played an important role in diagnosis of meningitis disease.

تقييم sFas ligand, sFas وcaspase - 3 في المرضى المصابين بمرض ابيضاض الدم النقياني المزمن == Assessment Of Soluble Fas, Soluble Fas Ligand And Caspase - 3 In Patients With Chronic Myeloid Leukemia

Author name: سحر راضي ياسر
Supervisor name: ميسون علي سليم | بسام فرنسيس متي
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
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Abstract: ابيضاض الدم النقياني المزمن هو اضطراب التكاثر النقي النسيلي للخلايا الجذعية ويتميز بواسطة فلادلفيا كروموسوم وهو انتقال متبادل بين كروموسوم 9 و22. الجين المسرطن المتحد الجديد المتولد على كروموسوم 22 كنتيجة للانتقال يسمى BCR - ABL gene. في اغلبية المرضى, هذ | Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of the haemopoietic stem cell, defined by the Philadelphia chromosome (Ph) - reciprocal translocation between chromosomes 9 and 22. The novel fusion oncogenes generated on chromosome 22 as a result of this translocation are called BCR - ABL gene. In the majority of patients, this oncogene transcribes a 210 - kDa constitutively active protein tyrosine kinase, often referred to as p210BCR - ABL, which is necessary for the transformation of the disease. The introduction of tyrosine kinase inhibitor (TKI) - imatinib mesylate (IM) - marked a major advance in CML treatment in terms of efficacy and tolerability and has now become the first line of therapy. In CML, besides genetic change during which a normal cell is transformed into a malignant one, evasion of apoptosis (programm cell death PCD) is one of the essential changes in a cell that cause malignant transformation. So ‘Evading apoptosis’ has been recognized as one of the six hallmarks of cancers, as reduced apoptosis or its resistance plays a vital role in carcinogenesis. Soluble receptors (sFas) that act as decoys, binding FasL and preventing association with transmembrane Fas. So production of sFas in tumor patients may be a key mechanism to inhibit Fas - mediated apoptosis. Soluble FasL competes with the membrane - bound counterpart; however, it can act even as an antagonist preventing apoptosis induction by the membrane integrated form of the ligand. Recently, caspase - 3 has been demonstrated to play an important role in determining the cellular sensitivity to diverse apoptotic stimuli, also it is involved in a number of non - apoptotic events. So the aims of the study were to estimate the level of serum sFas, sFas ligand & caspase - 3 in patients with chronic myeloid leukemia at time of diagnosis (newly diagnosed), then after receiving imatinib myselate treatment with optimal response and compare them with healthy control. It was a prospective study, included 56 Iraqi CML patients (25 were males and 31 were females with Age ranged from 15 - 78 years) attending to Baghdad teaching hospital/hematology department between November 2012 up to June 2013, were categorized by fluorescence in situ hybridization analysis (FISH) for Ph chromosome into two stages, newly diagnosed CML patients (FISH Ph cells result ? 90% ) not received any treatment and optimally treated (complete cytogenetic response (CCgR) = FISH Ph cells result < 1% or by major molecular response (MMoR) = BCR - ABL : ABL ?0.10% by International Scale, on RT - Q - PCR) with imatinib mesylate 400 mg/day at least 1 year. Then used an ELISA technique to assess serum level of sFas, sFas Ligand (sFasL) & Caspase - 3 for each patients of CML, and compared them with 28 apparently healthy volunteers used as control. The controls were age and sex matched with the patients, they were not taken medication and with no history of chronic illness and/or acute infection. As well as, they were nonsmoker and nondrinker. For patients the inclusion criteria including all patients were free of fever and other chronic illness such as diabetes mellitus, hypertension and infection; also they had no history of smoking and drinking of alcohol. And the exclusion criteria including patients suffering from any chronic, debilitating disease and other blood disorders were not taken.The observed results revealed the following : ? Patients were included in the study, male : female ratio was 0.8 : 1with mean age 42.6± 14.0.? The mean± SD serum of sFas levels (pg/ml) for the newly diagnosed and optimally responded of CML was 1163.6±231.5 and 1021.7±360.6 respectively.? The mean± SD serum of sFas Ligand levels (pg/ml) for the newly diagnosed and optimally responded of CML was 216.9±165.7 and 147.7±91 respectively. ? The median serum of Caspase - 3 (ng/ml) for the newly diagnosed and optimally treated cases was 0.421 and 0.361 respectively. ? The mean± SD serum of sFas and sFas Ligand levels (pg/ml) for the healthy group was 970.1±361.7, 152.5±98 consequently. The median serum of Caspase - 3 (ng/ml) for the healthy group was 0.314.? Serum sFas level was increased in newly diagnosed compare with optimal responder and healthy control group. Also serum sFas level in optimal responder group was increase when compared with healthy control group. The differences observed were no statistical significance (P=0.09).? Serum sFasL level was increased in newly diagnosed patients of CML when compared with optimal responder and healthy control group. But serum sFasL level in optimal responder group was decreased when compared with healthy control group. The differences observed were non statistical significance (P=0.07).? Serum Caspase - 3 level showed statistically significant (P ?0.001) increase in newly diagnosed when compared with healthy control group. While it was in optimal responder group was statistically increased (not significant P=0.13) when compared with healthy control group. And its level was increased in newly diagnosed compare with responder group which was statistically significant (P= 0.04).Finally, this study concluded that increase in sFas and sFas Ligand &Caspase - 3 in newly diagnosed CML patients compared with optimally and healthy control groups. Also concluded that Caspase - 3 was a good confirmed test to diagnose newly CML cases

توازن الحركيات الخلوية وعلاقة اليللات التطابق النسجي في كل من النوع الاول لمرضى السكري واشقائهم في دراسة مقارنة == Cytokine Balance (Th1/Th2) And Hla - Dr Association In Type I Diabetic Patients And Their Siblings In A Comparative Study A Thesis

Author name: محمد علي سلمان علیوي الكعبي
Supervisor name: كریم ثامر مشكور الكعبي | جعفر كاظم الموسوي
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: University of Kufa - Faculty Of Medicine - Department Of Microbiology
Language: English
University location: Najaf
First pages:
Abstract: It has been proposed that the balance of Th1 and Th2 cells is critical in the development of Type 1 diabetes and much of the genetic susceptibility to IDDM maps to the MHC class II region, thus one approach to investigate the immunopathogenesis of diabetes is to study first degree relatives of affected individuals.A case - control study was performed on 120 persons, they divided into three group which are diabetic, siblings and control (40 persons in each group), who attended to Al Zahraa Teaching Hospital /Diabetic Center in Al Kut between the period from April; 2012 till April; 2013. OGTT performed on both diabetic siblings and control, results have showed that the means of OGTT is highly Significant (P value = 0.000) in both siblings and control groups, whereas there were no Significant differences in the Means of differences of OGTT in both tested groups (Siblings and Control), P value = 0.288, although the mean of differences of OGTT is higher in siblings group (25.3250) than that in control group (22.0750). Cytokines levels (IFN - gamma, IL - 2, IL - 4 and IL - 10) were determined among the study groups (type 1 diabetes, siblings and control) by ELISA method, results showed that the means of IFN - gamma and IL - 2 levels were highly Significant (P value = 0.012, 0.037 respectively) in type 1 diabetic group , in comparison to their corresponds among both siblings and control groups, whereas the mean of IL - 4 levels was non - significant (P value = 0.738) among the study groups (type 1 diabetes, siblings and control), in spite it was higher in control group (0.81936) than that in both type 1 diabetic patients and their sibling (0.74387, 0.77593 respectively).While in case of IL - 10 results showed that the mean was highly significant among control group (P value = 0.030) in comparison to its corresponds among both type 1 diabetic patient and their siblings. Distribution of HLA - DRB1 loci among the study groups (type 1 diabetic patients, siblings and control group) were performed using MR.SPOT ROBOTING system, results showed that the frequencies of HLA - DRB1*3,*4 {25 (69.4%)} among diabetic group were Significant in differences (P value = 0.002), in comparison to the corresponding frequencies among control group {11 (30.6%)}, in comparison to the frequencies of other HLA - DRB1 loci in both diabetic group and control group { 15 (34.1%), 29 (65.9%)} respectively.Meanwhile results showed that there were no Significant differences (P value = 0.116), in the frequencies of HLA - DRB1*3,*4 {25 (58.1%)} among diabetic group in comparison to the frequencies of HLA - DRB1*3,*4 {18 (41.9%)} among siblings group, in compare to the frequencies of other HLA - DRB1 loci among diabetic group and sibling group {15 (40.5%), 22 (59.5%)} respectively, also results have showed that there were no Significant (P value = 0.104), in the frequencies of HLA - DRB1*3,*4 {18 (62.1%)} among sibling group in compare to the frequencies of HLA - DRB1*3,*4 {11 (37.9%)} among control group, in compare to the frequencies of other HLA - DRB1 loci among sibling group and control group {22 (43.1%), 29 (56.9%)} respectively. In another part of this study we estimate the relation between means of HbA1c and their corresponding HLADRB1 Loci among the study groups, result have showed that there was a significant relation (P value = 0.010) between the Means of HbA1c and their corresponding HLA - DRB1*03 Locus among the study groups. In conclusion the higher Mean of differences of OGTT among Siblings group might reflect the potential of them to develop diabetes, also T1D is Th1 mediated disorder, while Th2 cytokines profile might play a protective role against the development of T1D,in addition the genetic predisposition of diabetic Siblings for development of diabetes since, both diabetic group and sibling group showing the highest frequencies of HLA - DRB1 *3,*4, in compare to Control group and finally HbA1c might have an inheriting pattern. In conclusion diabetic siblings more prone for development of diabetes in future.

دراسة مناعية و بكتريولوجية لمرضى التهاب الجلد التاتبي == Immunological And Bacteriological Study On Patients With Atopic Dermatitis

Author name: غادة محمد صالح تركي القريشي
Supervisor name: رشيد محجوب مصلح | جاسم طعمة الخفاجي
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: University of Baghdad
Language: English
University location: Baghdad
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النسق المناعي لمرض الزهايمر في عينة من المرضى العراقيين == Immunological And Biochemical Profile Of Alzheimer'S Disease In A Sample Of Iraqi Patients

Author name: الاء عبد الحسن حمدان
Supervisor name: علي محسن ادحية
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: University of Baghdad
Language: English
University location: Baghdad
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دراسة جينية ومناعية وحالة الاضداد الذاتية في مرضى السكري النمط الاول واخوانهم == Immunogenetic Study And Autoantibody Status In Type 1 Diabetic Patients And Their Siblings

Author name: اسراء علي حسين الربيعي
Supervisor name: رغد السهيل | علي حسين ادحية
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Master
University: University of Baghdad
Language: English
University location: Baghdad
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الاجسام المضادة ضد بعض مستضدات كريات الدم البيضاء العدلة في المرضى المصابين بالسل الرئوي == Antineutrophil Cytoplasmic Antibodies In Patients With Tuberculosis

Author name: صاحب عبد الله حسين
Supervisor name: مي خليل اسماعيل | نهلة غانم عبد المجيد
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Master
University: University of Baghdad
Language: English
University location: Baghdad
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دراسة مناعية لمرضى الربو من العراقيين == Immunological Study On Iraqi Asthmatic Patients

Author name: مكارم عادل الطائي
Supervisor name: رجوة حسن الربيعي | عبد الوهاب عبد الرزاق الشيخلي
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: Mustansiriyah University - College Of Science
Language: English
University location: Baghdad
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التحري عن بكتيريا Salmonella typhi المعزولة من مرضى التيفوئيد : دراسة مناعية جزيئية == Identification Of Salmonella Typhi Isolated From Patients With Typhoid Fever (Immunomolecular Study)

Author name: انغام جاسم محمد علي الرماحي
Supervisor name: حوراء عبد الامير الدهان
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Doctorate
University: University of Kufa - College Of Science - Department Of Biology
Language: English
University location: Najaf
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دراسة علاقة الاصابة البكتيرية و الحركيات المناعية مع تكوين حصاة المرارة == Study Of Bacterial Infection And Immune Kinetics Relationship With Gallstone Formation

Author name: مثنى محمد مثنى
Supervisor name: عواطف حميد عيسى
General topic: Biology
Specific topic: Microbiology - Immunology
Degree: Master
University: University Of Basrah - College Of Science - Department Of Biology
Language: English
University location: Basrah
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