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
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
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
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
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
دراسة مناعية وجزيئية لخمج القرنية بحمة الحلا - 1 (حمة الهربس البسيط - 1) == Immunological And Molecular Study Of Herpes Simplex Virus - 1 Keratitis
تقييم دور مؤشرات حيوية مختارة لدى مرضى التصلب المتعدد == Assessment Of The Role Of Selected Biomarkers In Multiple Sclerosis Patients
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
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.
