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Matrix Metalloproteinase-2 as Potential Marker of Early Nephropathy in Type 1 Diabetes
Mohamed Fouad,
Maher Boraie
Issue:
Volume 3, Issue 1, January 2015
Pages:
1-5
Received:
18 January 2015
Accepted:
29 January 2015
Published:
6 February 2015
Abstract: Background: Early detection of diabetic nephropathy (DN) is important. Matrix metalloproteinases-2 (MMP-2) regulates a variety of cellular functions including apoptosis and angiogenesis. Diabetic environment stimulates the secretion of MMP-2 that is considered to participate in DN. Objectives: We conducted this study to investigate the level of MMP-2 as a potential marker of early nephropathy in type 1 diabetes. Methods: The total number of the study was 300 participants, among them 100 participants, were healthy volunteers control group with comparable age and sex to other participants (Group 1). The remaining 200 participants were suffering from type 1 diabetes and were categorized according to duration of diabetes into 100 patients had disease duration less than 5 years and all of them non microalbuimnuric (Group 2) and the last 100 patients had disease duration more than 5 years (Group 3). All subjects were submitted to complete clinical examination; routine laboratory investigations, including; random blood sugar (RBS); glycosylated hemoglobin (HbA1C) and quantitative determination of microalbuminuria (MA) for DN. Specific laboratory investigation for MMP-2 by enzyme-linked immunosorbent assay. Results: RBS and HbA-1c were significantly higher in group 3 than group 2. MA significantly detected only in group 3. MMP-2 was significantly higher in group 3 than the other groups 1, 2 and in the meantime significantly higher in group 2 than 1. MMP-2 starts to rise early before the onset of MA in group 2. Eventually duration of diabetes, RBS, HbA1c and MA were positively correlated with the MMP-2 level. (r=0. 44; P<0.05), (r=0. 43; P<0.05), (r=0. 58; P<0.05) and (r=0. 71; P<0.001) respectively. MMP-2 cutoff level of ≥ 311 ng/ml had a greater sensitivity and specificity for identifying MA (P<0.001). Conclusion: MMP-2 level pre-date the clinical evidence of MA, may serve as an important predictor for early development of DN and a potential marker of severity.
Abstract: Background: Early detection of diabetic nephropathy (DN) is important. Matrix metalloproteinases-2 (MMP-2) regulates a variety of cellular functions including apoptosis and angiogenesis. Diabetic environment stimulates the secretion of MMP-2 that is considered to participate in DN. Objectives: We conducted this study to investigate the level of MMP...
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Adiponectin as a Predictor for the Severity of Sepsis in ICU Patients
Mohammed Amin Abd-Elghany,
Nahed Salah Eldin,
Sherif Wadie,
Mervat Mohammed El Damarawy,
Fady Adib Abd-El-malek,
Ashraf Abd El-Khalik Barakat
Issue:
Volume 3, Issue 1, January 2015
Pages:
6-14
Received:
25 January 2015
Accepted:
31 January 2015
Published:
6 February 2015
Abstract: Sepsis is widely diagnosed In ICU patients. The sepsis markers are numerous with variable sensitivity and specificity. Adiponectin is a protein hormone that is secreted from adipose tissue into the bloodstream. It is a key substance in metabolic syndrome and has an anti-inflammatory property. The relationship between adiponectin and sepsis is unclear. In the current study, we aim to demonstrate that low plasma adiponectin level could be an early predictor for morbidity and mortality of sepsis by its comparison with c-reactive protein, serum lactate and procalcitonine. Thirty patients admitted to the intensive care unit with picture clinically suggesting sepsis were enrolled in the study. Predisposition, insult/infection, response, and organ dysfunction (PIRO) score was used to follow the course of the septic process. Plasma adiponectin level, serum lactate level, procalcitonin level(PCT), c-reactive protein(CRP) were checked on day1 then day 4 then day 7 and so on until ICU discharge or demise for a total of 28 days . PIRO score was able to expect sepsis prognosis with high statistical significance. Procalcitonin, serum lactate and adiponectin were valuable in follow up the sepsis prognosis with P value (0, 0.01 & 0 respectively) on the contrary CRP had poor prognostic value in sepsis follow up (P value 0.16).We conclude that PIRO score is an effective model for staging of sepsis and predict mortality. Measuring serial procalcitonin levels may be the most useful in order to understand the trend, identify the peak, and be able to identify resolution of sepsis. Early high lactate level is a predictor for poor prognosis of sepsis. Adiponectin is similar to procalcitinin in early detection of sepsis & can be used as a prognostic indicator with considering that adiponectin level could be affected by other metabolic disorders.
Abstract: Sepsis is widely diagnosed In ICU patients. The sepsis markers are numerous with variable sensitivity and specificity. Adiponectin is a protein hormone that is secreted from adipose tissue into the bloodstream. It is a key substance in metabolic syndrome and has an anti-inflammatory property. The relationship between adiponectin and sepsis is uncle...
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Diversity within the Immunodominant Epitopes of Envelope gp41 HIV-1 in Kenya and Its Effects on Performance of the HIV-1 Antibody-Based Detection Kits
James Kimotho,
Zipporah N g’ang’a2,
Edna Nyairo,
Missiani Ochwoto,
Nicholas Nzioka,
Francis Ogolla,
Michael Kiptoo
Issue:
Volume 3, Issue 1, January 2015
Pages:
15-22
Received:
22 January 2015
Accepted:
2 February 2015
Published:
10 February 2015
Abstract: Background: Human Immunodeficiency Virus (HIV) is characterized by high rates of genetic variability in vivo that could affect the performance of the HIV-1 Antibody-Based Detection Kits in use in Kenya. Objective: This study aimed at establishing the diversity of Envelope gp41 Epitopes and its effects on performance of the currently used HIV diagnostic kits in Kenya. Methods: Two hundred (200) HIV positives and 200 HIV negatives samples were collected from the Regional Blood Transfusion Centers (RBTCs) in Kenya. Viral RNA was extracted from 96 HIV Positive samples and sequenced on gp41-immunodominant region (IDR).The sequences obtained were analyzed using various applications in the Los Alamos HIV Database. The HIV gp41-IDR consensus sequence generated was used to synthesize gp41 IDR peptide. The Global HIV gp41-IDR Consensus nucleotide sequence was obtained from literature and used also to synthesis corresponding gp41 IDR peptide. The two peptides were used to prepare HIV Testing ELISA kits. The400 plasma samples that had been collected from this study from RBTCs were tested using five HIV testing kits approved for use in Kenya. The same samples were tested using the two ELISA system developed. Results: The HIV Consensus gp41-IDR peptide from Kenya displays a similarity of 93.0% against HXB2 sequence and 95.3% against Global HIV Consensus gp41-IDR amino acid sequence. There were 331 (7.8%) substitutions in the Consensus gp41-IDR peptides (Kenya) out of which 151substitutions were due to the substitution in positions A96→N (n = 79) and A101→S (n = 75). Both Consensus gp41-IDR peptides (Kenya) and Consensus gp41-IDR peptides (Global) showed common substitutions rate of 4.2% (n = 151). All the kits that were used showed 100% agreement in results. Conclusion: Although the HIV Consensus gp41-IDR peptides (Kenya) showed marked substitutions in respect to Consensus gp41-IDR peptide (Global) there was no difference in effects on the performance of the HIV-1 Antibody-Based Detection Kits in use in Kenya.
Abstract: Background: Human Immunodeficiency Virus (HIV) is characterized by high rates of genetic variability in vivo that could affect the performance of the HIV-1 Antibody-Based Detection Kits in use in Kenya. Objective: This study aimed at establishing the diversity of Envelope gp41 Epitopes and its effects on performance of the currently used HIV diagno...
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Laboratory Evaluation of the Validity of the Current HIV Testing Algorithm in Kenya
James Kimotho,
Zipporah Ng’ang’a,
Edna Nyairo,
Missiani Ochwoto,
Nicholas Nzioka,
Francis Ogolla,
Michael Kiptoo
Issue:
Volume 3, Issue 1, January 2015
Pages:
23-27
Received:
30 January 2015
Accepted:
9 February 2015
Published:
15 February 2015
Abstract: Background: The HIV Lateral Flow Tests (LFTs) provide a good compromise between accuracy, cost, speed and overall effectiveness. Objective: This study assessed the laboratory performance of the LFTs in the current National HIV Testing Algorithm in Kenya. Methods: Four hundred blood samples, 145 HIV positives and 255 HIV negatives, were collected from the Regional Blood Transfusion Centers in Kenya. They were analyzed using five LFTs, three of which were in the HIV Testing Algorithm in Kenya. Samples were also tested using Vironostika™ Uni-Form II Ag/Ab ELISA as a Gold Standard. The decision on the HIV status of the samples was determined by consensus status of the five LFTs. Diagnostic sensitivity (D-SN), specificity (D-SP), Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were then computed together with relative Analytical sensitivity each LFT. Results: The three LFTs in the HIV Testing Algorithm in Kenya (KHB Colloidal Gold, First Response™ 1-2.0 and Uni-Gold™ HIV test) showed a D-SN of 100% (95% CI: 97.4-100.0), 96.4% (95% CI: 91.8 - 98.8) and 100% (95% CI: 97.4-100.0) respectively in relation to the Consensus status with LFTs. However, Determine™ HIV-1/2 showed the highest Analytical sensitivity when compared with two other kits in HIV Testing Algorithm in Kenya and Aware™ HIV-1/2 BSP kit. Conclusion: Though the LFTs in the current HIV Testing Algorithm in Kenya show high performance profiles, Determine™ HIV-1/2 showed higher Analytical sensitivity profile than the two HIV Screening and confirmation test kits. There is a need of reconsidering the financial savings (of 10-16%) vis-ȃ-vis the possibilities of missing HIV positive cases in the current HIV Testing Algorithm in Kenya.
Abstract: Background: The HIV Lateral Flow Tests (LFTs) provide a good compromise between accuracy, cost, speed and overall effectiveness. Objective: This study assessed the laboratory performance of the LFTs in the current National HIV Testing Algorithm in Kenya. Methods: Four hundred blood samples, 145 HIV positives and 255 HIV negatives, were collected fr...
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