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Steroid-refractory chronic graft versus host disease (cGVHD) remains a significant cause of morbidity and mortality following allogeneic transplantation. Abatacept is a selective co-stimulation modulator, used for the treatment of rheumatologic disease, and was recently the first drug to be approved by the FDA for the prophylaxis of acute graft versus host disease. We conducted a Phase II study to evaluate the efficacy of Abatacept in steroid-refractory cGVHD (clinicaltrials.gov #NCT01954979). The overall response rate was 58%, with all responders achieving a partial response. Abatacept was well-tolerated with few serious infectious complications. Immune correlative studies showed a decrease in IL-1-alpha, IL-21, and TNF-alpha as well as decreased PD-1 expression by CD4+ T cells in all patients after treatment with Abatacept, demonstrating the effect of this drug on the immune microenvironment. The results demonstrate that Abatacept is a promising therapeutic strategy for the treatment of cGVHD.

Background: Patients, their families and the community suffer a heavy burden when it comes to asthma because it is both common and possibly life-threatening. It has been postulated that arachidonic acid's most prevalent cyclooxygenase metabolite, prostaglandin D2 (PGD2), is a mast cell activation marker in asthma. Objective: To evaluate association between PGDR-441 polymorphism with risk factors, laboratory characteristics, and severity of asthma in children. Methods: In this cross-sectional study, Forty Egyptian children were genotyped using allele specific polymerase chain reaction (AS-PCR) to assess single nucleotide polymorphism of PTGDR2 receptors. Selected cases were classified according to GINA guidelines and spirometrically assessed to evaluate pulmonary functions. Results: There is significant difference between mild, moderate and severe asthma regarding total IgE level(P1

Background: Childhood asthma is a chronic inflammatory disorder of the airways in children characterized by interaction between many cells of the innate and adaptive immune systems that interact with epithelial cells to cause bronchial hyper-reactivity. Annexin A1 (ANXA1) is a glucocorticoid-induced protein with multiple functions in the regulation of inflammatory cell activation. ANXA1 has anti-inflammatory effects by stimulating inflammatory cell programmed cell death and prohibiting eicosanoid synthesis. Objectives: The aim of the current work was to evaluate Annexin A1 levels in the blood of asthmatic patients and to evaluate the relationship between Annexin A1 levels and clinical profiles in asthma.Patients and Methods: This case-control study included a total of 100 children, 80 of them were asthmatic and 20 were apparently healthy children, attending at Pediatric Department, Zagazig University Hospitals. Results: There is a statistically significant higher annexin A1 among cases than control group (3.3ng/ml & 2.6 ng/ml, respectively). There was a statistically significant difference between severity of bronchial asthma and serum Annexin A1 (higher annexin A1 values with increased severity of the disease). There was a statistically significant negative correlation between serum annexin A1 & FEV1, FVC and PEF (r = −0.27, p = 0.01, r = −0.31, p = 0.00 and r = −0.22, p = 0.05 respectively). Serum IgE had statistically significant positive correlation with serum annexin A1 among studied cases (r=0.254 p=0.023). ROC was done to detect a cutoff point, at which trying to detect asthma cases. We found that at a level of 2.65 we can diagnose asthmatic cases with sensitivity 70 %, specificity 65% with total accuracy 69%.Conclusion: It could be concluded that serum annexin A1 can be considered as a possible biomarker for diagnosis, grading of asthma severity.

Background: Patients, their families and the community suffer a heavy burden when it comes to asthma because it is both common and possibly life-threatening. It has been postulated that arachidonic acid's most prevalent cyclooxygenase metabolite, prostaglandin D2 (PGD2), is a mast cell activation marker in asthma. Objective: To evaluate association between PGDR-441 polymorphism with risk factors, laboratory characteristics, and severity of asthma in children. Methods: In this cross-sectional study, Forty Egyptian children were genotyped using allele specific polymerase chain reaction (AS-PCR) to assess single nucleotide polymorphism of PTGDR2 receptors. Selected cases were classified according to GINA guidelines and spirometrically assessed to evaluate pulmonary functions. Results: There is significant difference between mild, moderate and severe asthma regarding total IgE level(P1

Eye surgery is the most common surgery in the elderly. Many ophthalmic procedures, such as cataract extraction can be performed safely in an outpatient setting, using regional anesthesia and mild sedation. The number of outpatient ophthalmic procedures will increase as the population continues to age. Advantages of regional anesthesia over general anesthesia are numerous; it is generally safer with less incidence of complications and less bleeding. Aim: The purpose of this thesis is to evaluate the use of ultrasonography in the performance of local anesthesia for ophthalmic surgery. This assessment includes whether ultrasound will add to the safety of the technique and its success rate. Patients and methods: After approval of our institutional ethics committee and obtaining a written informed consent, 100 adult patients having routine cataract extraction were divided randomly into: Group A (peribulbar anesthesia) and Group B (retrobulbar anesthesia), with 50 patients in each group. Each group was subdivided into two subgroups: In one the anesthesia was administered blindly, in the second using B-scan ultasonography, with 25 patients in each one. Patients randomly allocated to one of these four subgroups until the required number is reached in each group. Results: Results of the current study demonstrated comparable degree of globe akinesia after 10 minutes (p = 0.342). The majority of cases showed no globe movement after 10 minutes. Similarly, lid akinesia showed no significant difference between 4 groups (p = 0.082). This was accompanied by partial satisfaction of the majority of surgeons with the procedure; comparable in the 4 subgroups (p = 0.270). Conclusion: Peribulbar and retrobulbar regional anesthesia of the orbit during cataract surgery are safe procedures if blindly applied. Ultrasonography-guided needle injection doesn’t add to the safety and/or efficacy of the procedure. Therefore, ultrasound guidance is not an advantage in orbital regional anesthesia; whether administered by the peribulbar or retrobulbar technique.

Allogeneic transplantation is uniquely curative for a subset of patients with acute myeloid leukemia (AML) however, post-transplant relapse and graft versus host disease remain significant concerns. We have developed a vaccine in which patient-derived AML cells are fused with donor-derived dendritic cells (DCs), thereby presenting a broad array of antigens. Previous work (Rosenblatt Sci Transl Med) has suggested that such vaccines given in the first complete remission setting after chemotherapy consolidation elicit specific immune responses and can possibly lessen the risk of relapse. We hypothesize that donor-derived DC/AML vaccination post-transplant would elicit the durable expansion of leukemia- specific T cells within the donor T cell repertoire to effectively protect against disease relapse. We report the results of a phase 1 clinical trial (NCT03679650) evaluating the use of DC/AML fusion vaccine in patients with acute myeloid leukemia (AML) following allogeneic transplant. DC/AML fusion vaccine is generated with autologous leukemia blasts, cryopreserved at the time of diagnosis with AML, and donor-derived dendritic cells. DCs are collected via leukapheresis in pts in CR 25-70 days after an allogenic matched related or unrelated donor transplant (cohort A) or a haplo-identical donor (Cohort B). In order to proceed with leukapheresis, patients must demonstrate donor hematopoietic recovery and the absence of ongoing grade 2 or higher GVHD. For DC generation, donor-derived adherent mononuclear cells are cultured with GM-CSF, IL-4 and TNFa. Vaccine is administered subcutaneously starting day 70-100 post-transplant. 2 vaccines are given at 3 week intervals, in conjunction with 100 mcg GMCSF daily at the vaccine site for 4 days. A booster vaccine is given 30-60 days following the taper of immune suppression, in the absence of GVHD. Profiling of the immune microenvironment using single cell RNA sequencing from samples obtained before and after vaccination is being carried out. 17 participants have been enrolled. The median age was 59 years (range 23-74). 15 patients were enrolled to cohort A: 8 were transplanted with a matched unrelated donor and 7 were transplanted with a matched sibling donor. 2 participants were enrolled to cohort B. The median yield of leukemia cells was 207x10 6 (range 80-818x10 6)and mean viability was 96.5%. The median yield of DCs was 133x10 6 (range 29-182x10 6) and mean viability 72%. Fusion vaccine was successfully generated in 14/16 patients. One patient had insufficient DC, one patient relapsed prior to leukapheresis and one vaccine is currently in process. Mean fusion efficiency was 52% with viability of 78.6%. Mean fusion vaccine dose was 4.36 x10 6 cells. 3 patients from whom vaccine was generated did not meet eligibility to initiate vaccination due to ongoing toxicity following transplant or GVHD. 11 participants have initiated vaccine administration and are evaluable for toxicity and response. The most common side effects have been vaccine site reactions (n=10 grade 1, n=2 grade 2). 7 patients developed GVHD that was determined to be possibly related to vaccination, at a median time of 19 days after vaccination (range 5-70 days). 2 of these patients developed grade 2 acute GVHD of the skin, and 5 developed chronic GVHD affecting one to up to four organ systems ranging from mild to severe. There were 5 additional GVHD events with a median time of 115 days post vaccination (range 91-126 days), assessed as unlikely related or unrelated to vaccine based on timing of onset. 10 of 11 evaluable patients remain in a CR at a median time of 21 months post-transplant (range 6-33 months). One patient died of relapsed disease 15 months post transplant and another died of GVHD and infection unrelated to vaccine 21 months post transplant. Vaccination using patient-derived autologous leukemia cells and donor derived DC isolated following engraftment of hematopoietic cells appears safe and feasible. Toxicity of vaccination has included injection site reactions as well as graft versus host disease, primarily mild to moderate severity. Outcomes to date demonstrate that vaccination post-transplant may be a promising strategy to reduce relapse as 10 of 11 vaccinated patients remain relapse free. However this approach is limited to patients who have not had early relapse or early GVHD post-transplant. Immune correlates, including single cell RNA sequencing of the immune milieu, are ongoing. Disclosures Stone: Abbvie: Consultancy; Actinium: Membership on an entity's Board of Directors or advisory committees; Agios: Consultancy, Research Funding; Amgen: Membership on an entity's Board of Directors or advisory committees; Aprea: Consultancy; Arog: Consultancy, Research Funding; Astellas: Membership on an entity's Board of Directors or advisory committees; BerGen Bio: Membership on an entity's Board of Directors or advisory committees; Boston Pharmaceuticals: Consultancy; Bristol Meyers Squibb: Consultancy; Celgene: Consultancy; Elevate Bio: Membership on an entity's Board of Directors or advisory committees; Foghorn Therapeutics: Consultancy; Gemoab: Membership on an entity's Board of Directors or advisory committees; Glaxo Smith Kline: Consultancy; Innate: Consultancy; Janssen: Consultancy; Jazz: Consultancy; Macrogenics: Consultancy; Novartis: Consultancy, Research Funding; OncoNova: Consultancy; Syndax: Membership on an entity's Board of Directors or advisory committees; Syntrix/ACI: Membership on an entity's Board of Directors or advisory committees; Syros: Membership on an entity's Board of Directors or advisory committees; Takeda: Consultancy. Soiffer: Takeda: Consultancy; Jasper: Consultancy; Jazz Pharmaceuticals, USA: Consultancy; Precision Biosciences, USA: Consultancy; Juno Therapeutics, USA: Other: Data Safety Monitoring Board; Kiadis, Netherlands: Membership on an entity's Board of Directors or advisory committees; Rheos Therapeutics, USA: Consultancy; Gilead, USA: Other: Career Development Award Committee; NMPD - Be the Match, USA: Membership on an entity's Board of Directors or advisory committees. Stroopinsky: The Blackstone Group: Consultancy. Romee: Glycostem: Membership on an entity's Board of Directors or advisory committees; Crispr Therapeutics: Research Funding. Neuberg: Madrigal Pharmaceuticals: Other: Stock ownership; Pharmacyclics: Research Funding. Kufe: Canbas: Consultancy; Hillstream BioPharma: Current equity holder in publicly-traded company; Genus Oncology: Current equity holder in publicly-traded company; REATA: Consultancy, Current equity holder in publicly-traded company. Avigan: Chugai: Membership on an entity's Board of Directors or advisory committees; Partner Tx: Membership on an entity's Board of Directors or advisory committees; Karyopharm: Membership on an entity's Board of Directors or advisory committees; Parexcel: Consultancy; Janssen: Consultancy; Legend Biotech: Membership on an entity's Board of Directors or advisory committees; Pharmacyclics: Research Funding; Bristol-Myers Squibb: Membership on an entity's Board of Directors or advisory committees; Kite Pharma: Consultancy, Research Funding; Takeda: Membership on an entity's Board of Directors or advisory committees; Juno: Membership on an entity's Board of Directors or advisory committees; Takeda: Consultancy; Sanofi: Consultancy; Aviv MedTech Ltd: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding. Rosenblatt: Wolters Kluwer Health: Consultancy, Patents & Royalties; Parexel: Consultancy; Karyopharm: Membership on an entity's Board of Directors or advisory committees; Imaging Endpoints: Consultancy; Bristol-Myers Squibb: Research Funding; Attivare Therapeutics: Consultancy.

Background: Chronic graft versus host disease (cGVHD) remains a significant cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation (HCT), with a cumulative incidence of 50% (Arora et al, Biol Blood Marrow Transplant 2016). Systemic corticosteroids are considered first-line therapy, and best approach to managing steroid-refractory cGVHD is lacking. Abatacept is a recombinant fusion protein consisting of the extracellular domain of human cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) linked to the modified Fc portion of human immunoglobulin G1 (IgG1) to prevent complement fixation and antibody-dependent cellular cytotoxicity. Abatacept is a selective costimulation modulator that binds specifically to CD80 and CD86 on antigen presenting cells, thus attenuating CD28-mediated T cell activation. We previously reported results from a Phase I clinical trial evaluating the safety and clinical efficacy of abatacept in patients with steroid-refractory cGVHD (Nahas et al, Blood 2018 #NCT01954979). Here we report results of the phase II study evaluating the overall clinical response rate of abatacept in patients with steroid-refractory cGVHD. Methods: Allogeneic bone marrow or stem cell transplantation recipients were eligible if they developed cGVHD as defined by NIH consensus criteria and were treated with prednisone ≥ 0.25 mg/kg/day for at least 4 weeks without complete resolution of signs and symptoms. Peripheral blood was drawn prior to each dose of abatacept and following completion of therapy to assess the effect of treatment on circulating T cells. Abatacept was administered at 10mg/kg for a total of 6 doses. Doses 1-3 were administered at two-week intervals. One month after administration of Dose 3, abatacept was given at four-week intervals for Doses 4-6. Patients who completed 6 doses of abatacept and continued to demonstrate response were eligible to receive extended duration therapy with monthly abatacept at a dose of 10mg/kg for up to a total of 12 additional doses. Primary study endpoint was overall response rate (ORR) of using abatacept in treating cGVHD. Complete response (CR) was defined as resolution of all manifestations in each organ or site, and partial response (PR) was defined as improvement in at least one organ or site without progression in any other organ or site as per the 2014 NIH Chronic GVHD Consensus Response Criteria (Lee et al Biol Blood Marrow Transplant 2015). Results: 39 subjects with median age of 62 years (range 25-77 years) had undergone HCT a median of 43 months (range 6-173 months) prior to study entry. Patients were treated with abatacept and received a median of 8 doses (range 2-18). 17 patients had moderate cGVHD and 22 patients had severe cGVHD at baseline. Baseline cGVHD assessment of the 39 evaluable patients showed involvement of the skin in 85% (n=33), mouth in 44% (n=17), eyes in 69% (n=27), gastrointestinal tract (GI) in 18% (n=7), liver in 23% (n=9), lung in 54% (n=21), joints in 82% (n=32), and genital tract in 8% (n=3). The ORR was 49% (19/39 patients) with CR 0% and PR 49%. The organ sites with greatest improvement included lung (33%), eyes (23%), mouth (21%), and joints (21%). Progression of disease occurred in 26% of patients (n=10), with sites of involvement including skin (8%), mouth (10%), eyes (5%), lung (3%), and joints (5%). Baseline median daily dose of prednisone was 20mg with a 27.5% reduction at 1-month follow-up to 14.5mg (p Conclusions: Abatacept is associated with a 49% ORR in steroid refractory cGVHD and leads to durable reduction in prednisone dosing over time. Severe infections are uncommon and the infusions are well tolerated. Abatacept represents a promising novel therapeutic agent for patients with steroid-refractory cGVHD. Disclosures Stroopinsky: The Blackstone Group: Consultancy. Arnason: Juno/BMS: Honoraria. Cutler: Cimeio: Consultancy; Editas: Consultancy; Kadmon: Consultancy; Pfizer: Consultancy; Mallinckrodt: Consultancy; CareDx: Consultancy; Incyte: Consultancy; Omeros: Consultancy; Syndax: Consultancy; Mesoblast: Consultancy; Deciphera: Consultancy; Jazz: Consultancy. Nikiforow: Kite/Gilead: Other: ad HOC Advisory Boards; Novartis: Other: ad Hoc Advisory Boards; Iovance: Other: ad Hoc Advisory Boards; Glaxo Smith Kline (GSK): Other: ad Hoc Advisory Boards. Avigan: Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; Pharmacyclics: Research Funding; Kite Pharma: Consultancy, Research Funding; Juno: Membership on an entity's Board of Directors or advisory committees; Partner Tx: Membership on an entity's Board of Directors or advisory committees; Karyopharm: Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb: Membership on an entity's Board of Directors or advisory committees; Aviv MedTech Ltd: Membership on an entity's Board of Directors or advisory committees; Takeda: Membership on an entity's Board of Directors or advisory committees; Legend Biotech: Membership on an entity's Board of Directors or advisory committees; Chugai: Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy; Parexcel: Consultancy; Takeda: Consultancy; Sanofi: Consultancy. Soiffer: Rheos Therapeutics, USA: Consultancy; Kiadis, Netherlands: Membership on an entity's Board of Directors or advisory committees; Juno Therapeutics, USA: Other: Data Safety Monitoring Board; Precision Biosciences, USA: Consultancy; Jazz Pharmaceuticals, USA: Consultancy; Takeda: Consultancy; Jasper: Consultancy; Gilead, USA: Other: Career Development Award Committee; NMPD - Be the Match, USA: Membership on an entity's Board of Directors or advisory committees. Rosenblatt: Attivare Therapeutics: Consultancy; Parexel: Consultancy; Karyopharm: Membership on an entity's Board of Directors or advisory committees; Imaging Endpoints: Consultancy; Wolters Kluwer Health: Consultancy, Patents & Royalties; Bristol-Myers Squibb: Research Funding.

Maternal and neonatal infections by Escherichia coli remain a challenging problem for obstetricians and pediatricians. This study aims to determine the prevalence of vaginal colonization by Escherichia coli among pregnant women attending the Antenatal Clinics at King Abdulaziz University Hospital in Jeddah- Saudi Arabia, and to investigate the susceptibility of isolated Escherichia coli to the most commonly used antimicrobials. In this study, 100 pregnant women in the last trimester and 25 non-pregnant women were screened for vaginal colonization of Escherichia coli. The suspected colonies were identified by conventional methods and were confirmed by automated technology "Vitek 2 System". Also, antimicrobial susceptibility tests were done by the same methods". Escherichia coli isolates were serotyped to detect the presence of K1 antigen. Out of 100 pregnant women in the last trimester; twenty-one (21%) were Escherichia coli positive. Also, out of 25 non-pregnant women; four (16%) were Escherichia coli-positive. All of the isolated Escherichia coli were susceptible to most antimicrobial agents. The percentage of vaginal Escherichia coli resistance to trimethoprim/sulfamethoxazole, ampicillin and piperacillin ranged from 38.1% to 42.9%. The virulence factor K1 antigen was demonstrated in 42.9% of Escherichia coli -positive pregnant women.

Inserting capacitors in distribution systems has a great role in the energy losses reduction and achieving money saving. Many researches defined the optimization problem for the optimal sizing and placing the capacitors. All previous researches defined the problem during normal operation periods only, faults periods weren't considered. In this paper, fault periods in loop distribution system are considered. Comparisons are held between results of optimal capacitor placement in normal operation only (OCPN), and results of optimal capacitor placement considering both normal period and fault periods (OCPNF). The main target of the proposed methodology is to minimize the total cost of the system concerning both normal and fault periods. A Genetic algorithm (GA) based optimization model is developed to solve the problem and is simulated on an actual practical loop distribution system. The results show the impact of considering the faults periods on the optimal places and sizes of the capacitors.

The acoustical properties of two rooms that are one-way connected electroacoustically, e.g., in a telephone/video conference, can be analyzed through the total impulse response from a source in one room to the receiver in the other room. The total impulse response is a convolution of the two involved room impulse responses, and such a model is analyzed in this paper. The room impulse response model used here facilitates convolution analysis as the model is quite simple and composed of two terms only, a direct sound term and an exponentially decaying random Gaussian noise term. Analytical expressions have been derived for the energy decay function, leading to estimates of room acoustical parameters like clarity and the modulation transfer functions for such convolved impulse responses. Background noise expressions are also introduced to allow signal-to-noise ratio studies. Estimates of acoustic parameter values have been compared with measurements to evaluate the model used and verify the results achieved.

Background Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease, with a worldwide prevalence of 0.5% to 1%. Anti-cyclic citrullinated peptide antibody (anti-CCP-2 Ab) is a marker of choice for diagnosing early and late RA. Anti-oxidant enzymes activity decreases in RA patients. Till now, the relationship between the rheumatoid factor (RF) and anti-CCP-2 Ab, anti-oxidant activity and polymorphism of paraoxenase-1 (PON-1) 192 Q/R in patients with RA has not been investigated. In this study, we aimed to determine the serum level of RF and anti-CCP-2 Ab, PON-1 activity and 192 Q/R polymorphism and arylesterase (ARE) activity in patients with RA. Also, we studied RA markers in different genotypes of PON-1 of RA patients. Methods A total of 120 RA patients and 90 healthy persons were subjected to full clinical examinations and routine laboratory tests. PON-1 and ARE activities were determined using an enzymatic spectrophotometric method. PON-1 192 gene polymorphism was determined using polymerase chain reaction based restriction fragment analysis. RF was measured by immunoturbidimetry method and anti-CCP-2 Ab was assayed by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using SPSS for windows 20.0. Results The sensitivity and specificity of anti-CCP-2 Ab for the diagnosis of RA were 76.2% and 100% respectively. PON-1 and ARE activities were statistically lower (P

Coronary artery disease (CAD) is the leading cause of death in many countries. The underlying mechanism of the chronic inflammatory process in atherosclerosis is still unknown. As a possible trigger, different viruses and bacteria may be associated with atherosclerotic diseases. The aim of this work was to investigate the association of chronic infection with C pneumoniae, H pylori and cytomegalovirus (CMV) infections and CAD. Fifty patients [20 with acute coronary artery disease (ACAD) and 30 with chronic coronary artery disease (CCAD)] in addition to 15 healthy individuals as a control group were involved in this study. The studied individuals were subjected to complete history taking, thorough physical examination, electrocardiography, echocardiography and coronary angiography (for patients). Assessment of blood glucose level, lipid profile and creatine kinase (CK) was performed. Determination of hsCRP was done by nephlemetry, while C pneumoniae-, H pylori- and CMV-specific IgG antibodies was done by enzyme immunoassay. Results showed that the levels of cholesterol, triglycerides, LDL-c and hsCRP were significantly higher, while HDL-c was significantly lower among patients compared to that of the controls. A significantly (P0.05) higher perecentage of patients had C pneumoniae and H pylori-specific IgG antibodies as compared to that of the controls. Higher percentage of patients had CMV-specific IgG antibody, however, there was no significant difference between the 2 groups. The levels of C pneumoniae and H pylori-specific IgG antibodies were significantly (P0.001) higher among patients with CAD when compared to that of the controls. CMV-specific IgG level in patients was higher compared to that of the controls, however, the difference was not statistically significant. Among acute CAD patients, C pneumoniae-specific IgG was positively correlated with hsCRP (P0.05), cholesterol (p0.01) and HDL-c (P0.05), while H pylori-specific IgG was positively correlated with triglyceride level (P0.05). Among patients with CCAD, hsCRP was negatively correlated with HDL-c (P0.05). There was no significant correlation between the levels of CMV-specific IgG and lipid profile or hsCRP. In conclusion, the level of C pneumoniae and H pylori-specific IgG antibodies are elevated among CAD patients and their presence was associated with development of the disease. They were significantly correlated to cholesterol level. Moreover, C pneumoniae-specific IgG was significantly correlated with hsCRP among ACAD patients, suggesting an important role of these organisms in the development of CAD by altering lipid profile and induction of inflammation.

This study was carried out to investigate that the effect of grape seed oil (GSO) on Hypercholesterolemia in rats. Thirty-five rats were divided into 5 groups, group 1 was given the basal diet as a negative control group (-ve), group 2 was given the basal diet with GSO instead of soybean oil as a negative control for GSO. Groups (3, 4 and 5) were fed on high cholesterol diet (HCD) (1% cholesterol powder and 0.5% bile salt for 8 weeks), Group 3 was +ve control, group 4 and 5 were treatment groups which received GSO 2% and 4% daily with HCD. The results of this study indicated that the GSO caused an improvement in the blood lipids especially 4% GSO. The 4% GSO decreased serum TC, TG, LDL-c and VLDL significantly (P ˂ 0.05), and caused a significant increase in HDL-C level. Also, 2% GSO decreased TG, LDL-C and VLDL significantly (P ˂ 0.05), whereas the level of HDL-C showed significant increases. Subsequently, GSO enhanced the lipid ratios: atherogenic coefficient (AC), cardiac risk ratio (CRR), LDL-c to HDL-c ratio and atherogenic index of plasma (AIP). Moreover, the serum, liver function (AST, ALT and ALP) levels also, enhanced in the GSO groups. However, 4% GSO led to significant decrease in serum MDA and elevated serum GST. Otherwise, histopathological examination showed enhanced in the heart and aorta of rats compared with the +ve control group. This study indicates that GSO effective in lowering total cholesterol, triglyceride and LDL-c and increasing HDL-c. Therefore, GSO have hypocholesterolemic effect and might be effective to protect against the risk of CVD.

One third of the world's population is infected with Mycobacterium tuberculosis (MTB). However, active disease can develop only in a small percentage, when the immunity is weakened. The acquired immune response to MTB is primarily mediated by T cells. Natural killer (NK) cells play a central role in innate immunity to microbial pathogens. Human NKT cells have characteristics of both T and NK cells and also exhibit antimycobacterial activity. This work aimed to enumerate T, NK and NKT cells in active pulmonary TB compared with healthy controls and to study the correlation between these cells with different factors affecting prognosis of pulmonary TB as disease severity, complications or associated diseases, antitubrculosis chemotherapy, and agegender. Of the 22 active tuberculosis patients examined, 17 were recent cases and 5 recurrent. Healthy controls were divided into 14 individuals with detectable reaction to purified protein derivative (PPD+) and 14 individuals without detectable reaction to PPD-. The percentages of T, NK and NKT cells in erythrocyte-lysed whole blood samples were determined using flowcytometry. The percentage of NKT cells was significantly higher among the recently diagnosed MTB cases as compared with both PPD+ (P0.01) and PPD- (P0.01) healthy controls, while no significant difference could be found in the percentages of T or NK cells among these groups. However, comparing recurrent cases with recently diagnosed cases showed a significant difference only in the percentage of T cells (P0.01). There was also a significant difference in the percentage of T cells according to severity of disease (P0.01) and in the association of diabetes mellitus (P0.01). Age, gender and treatment with antituberculosis chemotherapy had no effect on the percentages of T, NK or NKT cells. It is concluded that T and NKT cells play an important role in immunity against TB. In active pulmonary tuberculosis, increased T cell count points to severity of the disease, while their reduced count predicts bad prognosis. Human NKT cell count is a marker of disease activity. Enumeration of these cells in peripheral blood can be used as a non-invasive prognostic indicator for patients with active pulmonary TB.

Pulmonary tuberculosis remains a major health problem. It is caused by Mycobacterium tuberculosis, which elicits a T-cell dependent immune response, initiated by monocytes through a large number of cytokines of which interleukin-12 is thought to play a critical role in initiation and regulation of T-helper (Th-1) like responses. To better understand the role of IL-12 in pulmonary tuberculosis patients, intracellular IL-12 in peripheral blood-derived monocytes was examined by flowcytometery. The percentage of monocytes producing IL-12 was measured after invitro stimulation of heparinized whole blood with mycobacterial protein antigens (culture filtrate). Of the 22 active tuberculosis patients, 17 were recent cases and 5 recurrent cases. Healthy controls were 14 individuals with detectable reaction to purified protein derivative (PPD+) and 14 without detectable reaction to PPD. The role of different factors affecting disease outcome such as treatment, age, gender, smoking, severity of disease and presence of other complications on the percentage of monocytes producing IL-12 was studied. Recurrent TB patients had a higher number of monocytes producing IL-12 in unstimulated cultures compared to other groups (P0.001). However, after in vitro stimulation there was a significant decrease in the number of monocytes producing IL-12 in recurrent TB patients as compared to recently diagnosed TB patients and healthy PPD+ individuals (P0.001). Antituberculosis chemotherapy was the only factor that had significant effect on the percentage of monocytes producing IL-12 (p0.05) while other studied factors did not show significant effect (p0.05). It is concluded that IL-12 plays a prominent regulatory role in tuberculosis.