The pathogenesis of sickle vaso-occlusive crisis (VOC) in sickle cell disease (SCD) patients involves the accumulation of rigid sickle cells and the stimulation of an ongoing inflammatory response, as well as the stress of infections. The immune response, via cytokine imbalances and deregulated T-cell subsets, also has been proposed to contribute to the development of VOC. In this study, a panel of high-sensitivity cytokine kits was used to investigate cytokines in the sera of SCD patients in VOC. The results were compared primarily with those for stable SCD patients and secondarily with those for normal healthy people who served as controls. The cytokines studied included interleukin-2 (IL-2), IL-4, and IL-10. Lymphocyte subsets of patients with VOC were also studied and were compared with those of both control groups (20 stable patients without crisis [SCD group] and 20 normal healthy controls [NHC]). The VOC group was notable for remarkably elevated levels of IL-4, among the three cytokines tested, compared with those for the SCD and NHC groups. Patients with VOC also differed from stable SCD patients and NHC by having notably lower IL-10 levels, as well as the lowest ratio of CD4⁺to CD8⁺T cells (0.7). The patterns of the proinflammatory cytokine IL-2 did not differ between VOC and stable SCD patients, but NHC had significantly lower IL-2 levels than both the VOC and SCD groups. Our results demonstrate coexisting levels, both high and low, of TH1- and TH2-type cytokines, as well as diminished levels of T-cell subsets in VOC. These results are discussed in an effort to better understand the importance of the immune system profile in the pathogenesis of sickle cell VOC. Since the possibility that a cytokine imbalance is implicated in the pathogenesis of sickle cell crisis has been raised, our results should prompt further investigation of the host immune response in terms of TH1 and TH2 balance in sickle cell crisis.

----------- Introduction: Breast cancer is a traumatic and pathologically debilitating disease in northern Nigeria. Traditionally, diagnosis of breast cancer is done by clinical examination and histological confirmation. Immunological diagnosis of breast cancer using tumor molecular biomarkers is lacking. This pilot study was conducted to investigate and analyze the use of CA-15-3 marker in relation to disease in patients with breast cancer as a simpler, robust test which could have importance in clinical decision making. Methodology: All female patients sent to the Radiotherapy and Oncology center, between January 2009 and January 2013, were purposively and consecutively bled and tested for CA-15-3 in serum using a high sensitivity commercial enzyme immunoassay kit. Informed consent and ethical approval was obtained prior to testing. Levels of CA-15-3 were statistically compared with disease stage and tumor grade. Results: A total of 45 patients (33-75yrs) participated. Disease status of the patients included 40 invasive ductal Ca, 4 invasive lobular Ca and 1mixed Ca. There were 31 pre- and 14 post-menopausal women; 36 in non- metastatic and 9 in metastatic disease. There were no patients in disease stage I, 4 in stage II, 32 in stage III and 9 in stage IV (same 9 patients had primary disease and values of CA-15-3 above 35 units/mL). Values of CA-15-3 correlated positively with disease staging. Conclusion: CA-15-3 is clinically relevant in the staging and monitoring of patients with breast cancer. Introduction: --------------- Breast cancer represents a heterogeneous categorization of diseases which is on the increase in Zaria. Pathologic classification of breast cancers is traditionally via size of primary tumor, presence/absence of regional lymph node involvement, features of tumor aggressiveness and histologic grade and is of clinical importance in establishing the choice of informed treatment for affected clients. However, molecular classification of breast cancer via immunologic markers could help to integrate host and tumor patterns for optimal personalized therapy. CA 15 3 is a tumor associated antigen raised against breast carcinoma cell. It is a high molecular weight membrane glycoprotein shed from breast cancer cells into circulation, with a half-life of about 8 days. This study aimed to evaluate the role of CA -15-3 in monitoring breast cancer in ABU teaching hospital. Materials and Methods: --------------------------- This was a retrospective pilot study to assess CA – 15- 3 for monitoring breast cancer by correlating the results of the tumor marker with patients disease status as a means of integrating host and tumor factors for optimal patient care. Data from female patients sent to the Radiotherapy and Oncology center, between January 2009 and January 2012 with results of testing for CA-15-3 in serum using a high sensitivity commercial enzyme immunoassay kit (Diagnostic Automation Inc, USA) were utilized. Informed consent from the patients and ethical approval of the Ahmadu Bello University Teaching hospital had been obtained prior to testing. Levels of CA-15-3 were statistically compared with disease stage as well as tumor grade. Disease was staged based on whether the cancer was constrained to the breast alone (stage I), sparsely spread (stage II), fungated and spread (stage III) or diffuse and well spread (stage IV). The tumors were also graded as stages I (well differentiated), II (moderately differentiated), III (poorly differentiated and necrotic) or Not known. Results: --------- Between 2009 and 2012, 45 women positively identified via histology and clinical examination had been tested for CA 15 3 (Fig 2). The age range of the women was 33-75 yrs. (45.7± 8 yrs.). Thirty-one (31) of the women were pre- while 14 were post-menopausal. The extent of disease revealed no metastasis in 36 women (in disease stages II an III) and metastasis in 9 women (disease stage IV). No woman was in disease stage I. Of the women in disease stages II and III, no one had a value of CA 15 3 above the cut off for positivity of 35 u/mL. All the women in stage IV, had values of CA 15 3 well above 35 u/mL ( range 53-150 u/mL; 100 ± 35 u/mL) as well as extensive disease spread (Fig 1.). Disease spread was majorly to the lungs, liver and bone in patients in disease stage IV. Histologically the samples from affected breasts were described as Invasive ductal (IDC), invasive lobular (ILC) or mixed (papillary/ductal). There were four patients with ILC and only one (25%) of them had CA 15 3 values above 35 u/mL. ILC was associated with bilateral spread of the cancer.There were 40 patients with IDC and 8 (20%) of them had CA 15 3 values above 35 u/mL. IDC was associated with a more aggressive (worse prognosis) form of disease. Only one patient had a mixed papillary/ductal Ca and she had greater than 35 u/mL CA 15 3. Results of CA 15 3 did not correlate with tumor grades. Discussion: ------------- The absence of any woman positive for breast cancer in disease stage I, indicated the generally late presentation of our patients to hospital and negates the role of CA 15 3 for early diagnosis of cancer. However, the positive correlation of CA 15 3 with disease staging from stage II with sparse spread to stage IV with extensive spread, indicates CA 15 3 is associated with tumor mass and confirms other reports of CA 15 3 relating with tumor bulk as well as its suitability for disease monitoring. It remains to be seen whether serial testing of CA 15 3 levels in patients with Breast cancer would be indicative of patients in relapse or remission