Background: Immunological factors play a unique role in the setting of preeclampsia; there is a rising debate about the performance of interleukin 17 (IL-17) as inflammatory mediator in its pathogenesis. The purpose of this paper was to evaluate the significance of IL-17 in the diagnosis and prognosis of preeclampsia and estimate a cutoff value for better prediction. Methods: A prospective case control study, 40 patient were enrolled in the study, two groups were designed: a normotensive (control) group (n=20) and preeclampsia group (n=20). Both groups were compared regarding serum IL-17 level to clarify its significance, then ROC curve analysis was done to establish the best cutoff level to predict preeclampsia, with further assessment of its relation to blood pressure to determine its prognostic value. Results: We noted a statistically significant difference in serum IL-17 (pg/mL) level between the preeclampsia and control group (P<0.05). The best cutoff value of serum IL-17 in preeclampsia was (8.2 pg/mL) with a sensitivity of 100%, specificity 80% and accuracy 89%. There was also significant variation in its concentrations before and after control of blood pressure and a significant positive correlation with systolic blood pressure level (r=0.9). Conclusion: IL-17 is a significant inflammatory biomarker in preeclampsia with useful prognostic power to predict severity of disease.

Background. Allergic rhinitis (AR) is an inflammatory state categorized by a disturbance of immunoregulatory mechanisms. MicroRNA-155 (miRNA-155) has an essential role in regulating gene expression and can mediate the allergic TH2 process. Objective. In this study, we aimed to evaluate the role of miR-155 as a biomarker in AR and correlate its level with the total nasal symptom score (TNSS) and the levels of serum interleukin-4 (IL-4). Methods. This study included 90 children: 45 with pollen-induced AR and 45 healthy controls. Serum miR-155 expression levels were measured using quantitative real-time PCR. Human IL-4 ELIZA kits were used for the semiquantitative detection of the serum levels of IL-4. Receiver operating characteristic (ROC) curves were used to determine the best cutoff values for the studied parameters for the diagnosis of AR. Results. The demographic characteristics of the two groups were matched with respect to age and sex. The AR case group included 23 (51.1%) males and 22 (48.9%) females, while the control group included 24 (53.3%) males and 21 (46.7%) females. The miR-155 level was increased in the serum of children with pollen-induced AR compared with controls (mean difference = 2.8, ). A significant positive correlation between the serum expression level of miR-155 and TNSS in children with AR was detected (r = 0.494, ). However, no significant correlation was identified between the expression of miR-155 and that of IL-4. At a cutoff value of 1.09, the sensitivity of miR-155 as a biomarker for AR was 100%, and the specificity was 71.1%. Conclusion. MiR-155 expression levels were elevated in the serum of AR children. Therefore, miR-155 could be used as a biomarker in AR diagnosis.

Activated Phospho-Inositide 3 (PI3) Kinases Delta syndrome (APDS) can underlie primary immune deficiency. The prevalence and phenotypic characterization of these patients are not well described in Egypt. To describe patients with APDS in hospitalized children with recurrent respiratory tract infections with suspected primary immune deficiency. 79 patients were included in the study. E1021K and E525K mutations of PI3K δ chain gene were screened by Sanger sequencing technique. one patient was heterozygous to E1021K mutation; a female child was diagnosed clinically as Combined Immune Deficiency with CD4 and B lymphopenia and markedly deficient IgG and increased IgM. The E525K mutation was not detected in our cohort. Screening for APDS in patients with recurrent respiratory tract infections with undefined antibody deficiency or combined immune deficiency with or without bronchiectasis is required. These patients need great attention to benefit from the available treatment. Further studies on the Egyptian population are recommended to increase the knowledge about the prevalence and phenotypic characterization of this disease in Egypt.

Background: Psoriasis has a global prevalence of 1–3%, with variations observed across different ethnic groups and geographical areas. Disease susceptibility and response to anti-tumor necrosis factor-α (TNFα) drugs suggest different genetic regulatory mechanisms which may include NLR family pyrin domain containing 3 (NLRP3) polymorphism. Evaluation of the NLRP3 gene polymorphism, the serum level of CRP and TNFα in psoriasis patients and assessment of the NLRP3 (rs10754558) gene polymorphism, CRP and TNFα with disease severity and their role as biomarkers for response to Methotrexate and Adalimumab in psoriasis. The study had a total of 75 patients diagnosed with psoriasis vulgaris, who were compared to a control group of 75 healthy individuals. Results: There was a highly significant difference in NLRP3 genotypes and alleles distribution between psoriasis patients and controls (P = 0.002,0.004). The heterozygote genotype GC (OR = 3.67,95%CI:1.75–7.68, P = 0.0006), was linked with increased risk of psoriasis. Additionally, The GC genotype was significantly associated with nonresponse to psoriasis therapy (OR = 11.7,95%CI:3.24–42.28, P = 0.0002). Regarding serum CRP and TNFα levels, there was a highly statistically significant difference between psoriasis patients and controls (P < 0.0001), and there was also a highly statistically significant difference between responders and non-responders in psoriasis patients regarding PASI 50 (P < 0.0001). Conclusions: The NLRP3 (rs10754558) genotypes GC was associated with the severe form of psoriasis and with nonresponse to psoriasis medication. Therefore, NLRP3 (rs10754558) gene polymorphism is an important prognostic biomarker in psoriasis patients. The serum TNFα can be used as a predictor for response to therapy in psoriasis patients. More research for evaluation of role of the NLRP3 gene polymorphism in the genetic risks and treatment outcomes associated with psoriasis is still required.

Background: Group B streptococcus (GBS) is one of the main causes of neonatal sepsis. Purpose: Evaluation of the diagnostic performance of direct latex agglutination test (DLA), post-enrichment latex agglutination (LA) test, and direct culture on chromogenic media in rapid identification of GBS carrier in pregnant women in comparison with the conventional post-enrichment CDC-recommended culture method and further to estimate GBS carriage prevalence and its antimicrobial susceptibility. Methods: Two hundred pregnant women at gestational age (35–37 weeks) were enrolled. Three low vaginal swabs were obtained from each participant. One swab was directly inoculated into Strep B Select (SBS) agar. The second swab was inoculated in enrichment Lim broth for immunological antigen detection by post-enrichment latex agglutination (5 h and 24 h) and subculture for bacteriological detection. The third swab was used for immunological detection of GBS antigen by direct latex agglutination. The isolated GBS was subjected to antimicrobial susceptibility testing. Results: Among 200 pregnant women, 47 (23.5%) were GBS carriers. Considering post-enrichment subculture on SBS medium as a gold standard, the sensitivities for post-enrichment 5 h and 24 h LA were 66% and 95.7%, respectively. However, direct cultivation of the vaginal swabs on SBS medium and DLA recorded 83% and 4.3%, respectively, for sensitivity. All GBS isolates (100%) were sensitive to penicillin G, ampicillin, ceftriaxone, and vancomycin. In contrast, 21.3% and 12.8% of isolated GBS were resistant to erythromycin and clindamycin, respectively. Conclusion: Group B streptococcal antigen detection by latex agglutination after 5 h enrichment is a reliable, easy, and relatively rapid method for screening of GBS carriage in pregnant woman not in labor. Latex agglutination after 18–24 h enrichment can be used alternative to standard subculture method for screening GBS carriage.

Background: The immune response of the mother against her embryo is supposed to be responsible for about 50 % of recurrent spontaneous abortion (RSA) case. Objectives: To assess the prevalence of HLA-G 14bp insertion/deletion (ins/del) polymorphism in females with RSA and normal pregnant females and compare the plasma levels of soluble HLA-G (sHLA-G) in the studying groups. Also, we intended to explore the association between HLA-G 14 bp polymorphism and sHLA-G plasma levels. Methodology: This case-control study involved 50 females with RSA and 50 control pregnant females. The genotype for HLA-G 14 bp (ins/del) polymorphism was performed by PCR and their sHLA-G plasma levels were measured. Results: The HLA-G del/del genotype and ins/ins genotype frequencies were significantly different in RSA group as compared to controls (P=0.002). Additionally, the incidence of the 14-bp ins allele was significantly raised in RSA group than in control (67 vs. 41%, respectively; P=0.0004). Consequently, the higher frequency of 14-bp ins allele in RSA group as compared to controls indicate that this allele is associated with an increased risk of RSA (OR 2.9, 95% CI: 1.6-5.2, P=0.0003). Conclusion: The plasma level of sHLA-G is a promising marker in the management of RSA and could be an early indicator of the fate of In Vitro Fertilization (IVF). The polymorphism in the HLA-G gene, specifically, in the 3′UTR region of exon 8 affects the plasma level of sHLA-G and subsequent pregnancy outcome.