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The Co-Existence of Rheumatoid Arthritis and Systemic Lupus Erythematosus Biomarkers: Is It Rhupus?
Get PDFBackground: Rhupus is a rare clinical condition where rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) overlap and is characterized by the presence of erosive arthritis with symptoms and signs of SLE. This study aims to investigate the prevalence of anti-CCP antibodies in SLE patients from CHU BLIDA (Immunology unit) and its association with anti-DNA and Anti Sm, in order to make a diagnosis of rhupus among our patients.
Methods: Our retrospective study included 96 patients fulfilling the American College of Rheumatology (ACR) classification criteria for lupus. anti-CCP antibodies, anti-Sm were analyzed by ELISA, anti-DNA antibodies were determined by both IFI on Crithidia luciliae substrate and ELISA. The FR by Laser Nephelemetry. Inclusion criteria are the presence of at least one immunological marker of LES with anti-CCP. The sex ratio F / H is equal to 13/1, where the average age is 37 years.
Results: Anti-CCP was found in 14 patients (14.6% ), 56.25% and 39.59% had positive anti-DNA and antiSm respectively; rheumatoid factors (RF) were positive in 27.08% of cases; anti-CCP / FR combination was found in 7.3% of cases. Besides, the combination of anti-CCP and anti-DNA was found in 12.5%. These two autoantibodies were simultaneously absent in 49.92% of cases. Arthritis was found in 80 patients. Our results concerning the prevalence of immunological and clinical markers of RA such as anti-CCP, RF and arthritis in our lupus patients corroborate with those of the literature.
Conclusion: Based on the presence of shared clinical features of RA and SLE along with the presence of anti-DNA and anti-CCP antibodies in our patients, our findings strongly support the contention that rhupus is a true overlap between RA and SLE. Despite being a rare entity, it is important to know the clinical and humoral elements that allow its early diagnosis, making it easier to start treatment in a timely manner and reduce its possible complications
The management of the colorectal cancer: Perspectives
Get PDFBackground: The progress of scientific research gives new tracks to be exploited for the management of the colorectal cancers whose the molecular profile study became fundamental. Aim: the aim of this study was to compare the management of the colorectal cancer in our patients to the current international recommendations.
Subjects and methods: In a retrospective study, we analysed 256 files between January, 2015 and September 2019. All the adenocarcinoma of colon and rectum were included.
Our patients were divided into two groups: 161 patients with colorectal cancer (63%) and 95 patients with rectum cancer (37%). We studied if the management of the disease was actually compliant to the international recommendations.
Results: Our study showed that the colorectal cancer occured most frequently in young population, with 45,5% in patients aged more than 60 years, 44% between 40 -60 years and 10 were under 40 years. The tumor was in T3 or more stage in 40,3% for colon cancer and 68,4% for rectum cancer. Elsewhere, none of the patients benefited from a molecular profile study of his tumor.
Discussion:The colorectal cancer is diagnosed in relatively young population with 54,5% of patients aged less than 60 years among whom 10% are less than 40, which explains the diagnostic delay. This delay is also due to the lack of a screening in general population and high risk subjects. Moreover, the absence of a molecular examination has a negative impact on the treatment and on the screening in the apparented, especially in case of tumor with micro satellite instability.
Conclusion: In order to improve the prognosis of the colorectal cancers in our patients, a screening adapted to the groups at risk has to be implemented and a molecular profil examination achived so that evolution and therapeutics perspectives could be set
Clinicopathological Characteristics of Breast Cancer in a Population of Eastern Algeria
Get PDFBackground: One of the most common cancers in female is the breast cancer. It is the most important cause of neoplasie deaths among women in both developed countries and developing countries. The incidence of breast cancer has increased more than 10000 new cases per year. The aim of our study is to determine the clinical characteristics of breast cancer in the Eastern Algeria.
Methods: This is a retrospective study made in public hospital EHS Abdallah Nouaouria El Bouni, Annaba gynecology and anatomy pathology services, which included 40 patients over a period of three months from July to September 2019.
Results: The mean age was 49.87 (SD = 9.2) years. The age group of 40–76 years represented the majority of the study population (85%). A total of 30 patients (75%) had invasive ductal carcinoma, while 3 (7,5%) had ductal carcinoma in situ, 3 (7,5%) had inflammatory breast cancer, 2 (5%) had mucinous carcinoma and 2 (5%) had phyllodes tumors .
The average size tumor was 3,7 cm. The rate of tumor grade with large size T2, T3 and T4b was 70%. 45% of patients had positive lymph nodes and 2,5 % had bilateral breast cancer. No metastatic cases were reported.
Results also show that the most affected women are between 35 and 55 years; 92,5% have an invasive breast cancer, and more than 80% are in advanced stage .
Conclusion: Histological diagnosis is important since it state the specific type of carcinoma. One of the best approaches to prevent this disease is early diagnosis
CcMP-II Metalloproteinase from Cerastes Cerastes Snake Venom Acts both on Blood Vessel ECM and Platelets
Get PDFBackground: Snake venoms contain various metalloproteinases that are highly toxic, inducing in severe bleeding by interfering with the blood coagulation and degrading the basement membrane or extracellular matrix (ECM) components. It has been suggested that hemorrhagic metalloproteinases interact in a specific way with platelet surface proteins resulting in an alteration of platelet function. Hemorrhage and tissue necrosis are common manifestations of viperid envenomations in humans, largely due to the actions of prominent metalloproteinases. CcMP-II a weakly hemorrhagic metalloproteinase purified from Cerastes cerastes venom, as already described it belongs to the class P-II snake venom metalloproteinase.
Methods: In this study, we characterized the biological effects of CcMP-II, including the ability of the enzyme to hydrolyze extracellular matrix components and plasma proteins, as well as its histopathological effects induced in capillaries. Then a study of the anti-aggregating activity was carried out and controlled for 10 min using a Chronolog aggregometer (ServiBIO) (USTHB, Faculty of Biological Sciences, BP 32, El-Alia Bab Ezzouar, 16111, Algiers, Algeria in 2019). The histopathological changes induced by CcMP-II were also analyzed and the 1 µm semi-thin sections are then stained with Toluidine Blue and the observation of these sections was realized using a photomicroscope. Toluidine Blue, magnification: 100x.
Results: Obtained results showed that CcMP-II metalloproteinase hydrolyzed selectively the A α-chain of fibrinogen. This enzyme hydrolyzed also laminin and type IV collagen in time- and dose-dependent manner. CcMP-II inhibits collagen-induced platelet aggregation of human PRP with an IC50 value of 0.11 nM. Pathological changes induced by CcMP-II after intramuscular injection in mice gastrocnemius were also studied. Histological study showed that the main morphological alterations in capillary vessels are characterized by a separation of endothelial cells from the surrounding basement membrane and reduction in the width of these cells, together with loss of basement membrane in some areas, through which erythrocytes and plasma are extravasated.
Conclusion: In conclusion, CcMP-II, as a member of the P-II class of SVMPs, presents a selective specificity toward fibrinogen, laminin and type IV collagen. It was an α- fibrinogenase metalloproteinase, which inhibits collagen-stimulated platelet aggregation. This study will contribute to understanding better the functional mechanisms of the metalloproteinases that may be useful in the development of therapeutic agents related to thrombotic disorders
Genotyping of MEFV and SAA1 Genes and Their Correlation to the AA-Amyloidosis Development
Get PDFBackground: Familial Mediterranean fever (FMF) is the most common autoinflammatory disease caused by recessive mutations in the MEFV gene. If not treated, FMF patients may develop renal AA-amyloidosis that leads to renal failure and death. Both mutations and polymorphisms in MEFV and SAA1 genes, respectively, have been associated with AA-amyloidosis in several populations. In Algeria, as FMF is still under-estimate and misdiagnosed, genetic data on renal complication are largely lacking. We thus explored the contribution of MEFV and SAA1 loci in the development of amyloidosis in Algerian patients with FMF.
Methods: This study included 64 unrelated FMF patients (21 without and 43 with renal amyloidosis) and 13 healthy controls. The entire exon 10 was sequenced after PCR amplification to detect MEFV mutations. Genotypes of SAA1 locus (SAA1.1, SAA1.5, and SAA1.3) were determined by PCR-RFLP (restriction fragment length polymorphism).
Results: Analyze of MEFV gene showed that the percentage of homozygous for p.M694I mutation was significantly higher in patients with amyloidosis compared to patients without amyloidosis (p=0.032). The SAA1.1/1.1 genotype was significantly predominant in patients with amyloidosis compared to those without AA-amyloidosis (p=0.001) and controls (0.001). The SAA1.5/1.5 genotype was identified only in patients without amyloidosis and controls. The most patients with renal complications were homozygous for p.M694I and SAA1.1 alleles.
Conclusion: Our data suggest a positive correlation between the p.M694I/M694I and SAA1.1/1.1 genotypes and the development of AA-amyloidosis secondary to FMF in Algerian patients
Apolipoprotein E Genotypes in Alzheimer\u27s Disease in Central Algerian Population
Get PDFBackground: Alzheimer\u27s disease (AD) is a progressive and fatal neurodegenerative disorder associated with cognitive decline and is the most common form of dementia in the elderly. Early-onset familial AD accounts for less than 1% of AD cases and develops before the age of 65 years because of mutations in either the APP gene or genes encoding presenilin 1 (PSEN1) or presenilin 2 (PSEN2). The majority of sporadic AD cases are referred to as late-onset AD (LOAD) because they occur late in life (>65 years). Apolipoprotein E (APOE) polymorphic alleles are the major genetic risk factor for AD. The human APOE gene exists as three polymorphic alleles, ε2, ε3, and ε4, with a worldwide frequency of 8%, 78%, and 13%, respectively, with ε4 reaching frequencies of 40% in AD patients. The purpose of this preliminary study was to determine ApoE genotype status since no previous association studies between LOAD and ApoE gene were available for the Central Algerian population.
Methods: The cohort of our study was composed of 47 AD patients recruited from the Neurology Department of Frantz Fanon Hospital of Blida. Forty-seven controls with no type of dementia were also included in the study. All samples were genotyped for the ApoE Polymorphisms by PCR-RFLP method. Statistical studies can use the Fisher exact test or Chi-2 using the GraphPad Prism 7.0 software.
Results: The results show that the genotype ɛ3/ɛ3 is most common in both groups followed by the heterozygous genotype ɛ3/ɛ4 which showed an increased frequency in patients compared to controls (27.66% vs. 12.77%, OR=3.66, IC=0.89-7.9, p=0,11). Although rare, all other possible genotypes have been observed in our cohort, namely ɛ2/ɛ2, ɛ2/ɛ3, ɛ2/ɛ4 and ɛ4/ɛ4. The ɛ2/ɛ4 genotype was observed only in AD patients, while the ɛ2/ɛ2 genotype was observed only in controls. As expected, the homozygous genotype ɛ4/ɛ4 was more frequent in AD patients, compared to controls (6.38% vs. 2.13%, respectively OR=2.64, IC=0.36-37.33; p=0,33). At the allelic level, ɛ4 allele was significantly associated with AD compared to controls (21,28% vs. 4,26% ; OR= 2.75, 95% CI= 1.109-6.35; p = 0.02, respectively), while the ɛ2 allele seems to be protective (4,26% vs. 9,57%, OR = 0.49 ; 95% CI=0.14-1.66 ; p=0,38, respectively), but without statistical significance. In population-based studies, the ApoEɛ4-AD association was weaker among African Americans (ε4/ε4, OR 5.7) and Hispanics (ε4/ε4, OR 2.2) and was stronger in the Japanese population (ε4/ε4, OR 33.1) compared with Caucasian cases (ε4/ε4, OR 12.5). The results obtained in our preliminary study indicate that the ApoEɛ4-AD association in the Central Algerian population is similar to that observed in the Mediterranean populations.
Conclusion: We have presented, for the first time in the North Central Algerian population, the association of the ɛ4 allele with AD, which could be of great use in the diagnosis but also the follow-up of patients with this disease
Autophagy Genes (ATG16L1/IRGM) and IBD: Involvement of the ATG16L1 Gene in Algerian Patients with Crohn\u27s Disease
Get PDFBackground: Chronic Inflammatory Bowel Diseases (IBD) including Crohn’s disease (CD) and ulcerative colitis (UC) are gastrointestinal disorders under the influence of a complex genetic basis. One hundred sixty-three predisposition loci were identified by genome-wide association (GWAS) studies, refocusing the pathogenesis of IBD on immunity genes. Autophagy is a fundamental mechanism in the maintenance of intestinal homeostasis. Failures of this mechanism appear to be a major risk factor in the setting up of chronic intestinal inflammation. Two single nucleotide polymorphisms (SNPs) within two genes, were selected namely (rs2241880 AàG) for ATG16L1 and (rs10065172 CàT) for IRGM.These two genes are both involved in the autophagy mechanism. We investigated these two SNP in an Algerian cohort for the first time since no previous association studies between IBD and the two studied genes were available for the Algerian population.
Methods: A case-control study was performed on a cohort including 95 Algerian patients with Crohn\u27s disease and ulcerative colitis versus 116 Controls. Genotyping of the cohort involved allelic discrimination by TaqMan SNP Genotyping Assay.
Results: A statistically significant association of the rs2241880 AàGmutation of the ATG16L1 gene was demonstrated in IBD (p = 0.04) and, more particularly in Crohn\u27s disease (p = 0.03).The presence of this mutation would increase the risk of Crohn\u27s disease by a factor of 2 in its GG homozygous mutated form (OR = 2.11 95% CI (1.07-4.16)). No significant associations were found for the rs10065172 CàT mutation of the IRGM gene.
Conclusion: Our data highlight the involvement of the ATG16L1 gene in the genesis and/or evolution of IBD cases, notably Crohn\u27s disease, indicating the impact that deregulation of the autophagy mechanism could have on the Algerian population. Nevertheless, it would be interesting to expand the sampling and carry out the functional studies to elucidate the impact of the deregulation of the ATG16L1 gene in IBD
Removal of Copper from Industrial Wastewater and its Relationship with Wilson\u27s Disease
Get PDFBackground:Wilson’s illness, or hepatolenticular degeneration, is an autosomal passive issue that outcomes from an accumulation of copper prevalently in the liver and brain. The aggregation is happen because of imperfect biliary discharge of copper. Current information demonstrates that grown-up people need to ingest about 0.75 mg of copper every day to continue a parity. Because of a hereditary imperfection, people with Wilson’s ailment can\u27t discharge the abundance copper, bringing about a progressive develop of copper in the body. Substantial metals are the most hurtful of the concoction toxins and are of specific worry because of their poison levels to people. From this poisonous metal copper, which has impacts in drinking water on the gastrointestinal tract, yet there is some with respect to the drawn out impacts of copper on delicate populaces, for example, bearers of the quality for Wilson’smalady and other metabolic issue of copper homeostasis.
Method:We picked as a characteristic adsorbent in this work the Moringa Oleifera Seeds (MOSs) from Mali assortment, which could be a practical and earth safe strategy for water sanitization. All examinations were directed at room temperature, andafter being permitted to represent two hours, the examples were broke down utilizing the Atomic Absorption Spectrophotometer (AAS). The seeds of Moringawere set up by taking around 1 g of the seed squashed and blending it in with around 20 cm3 of water to be decontaminated in three distinct measuring utensils.
Result:The different arrangements after filtration, indicated an expanded thickness in the amount of copper, which demonstrates the viability of the cleansing intensity of the seeds of MO. The best consequences of adsorption were for 30 min of contact time. We had half copper evacuation. The impact of contact time is significant in biosorption investigations to decide the harmony time required for the take-up of metal particles by the MOSs.
Conclusion:In this investigation, the MOS from Mali were demonstrated to be a proficient regular adsorbent material of copper from fluid arrangements. The limit of the MOS to evacuate copper relies upon numerous models as; plant assortment and states of examinations. Our examination is going on the investigation of evacuation parameters, for example, contact time, pH, temperature, molecule size, sorbent portion, and introductory metal fixation
In Vitro Effect of Crude Extract from Traganum Nudatum on Glucose-Uptake in Liver Slices Isolated from Westar Rats
Get PDFBackground: Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both. There are many classes of drugs used for treatment, and these include insulin sensitizers, insulin secretagogues, and agents that delay the absorption of carbohydrates from the bowel. This study intends to investigate the effect of crude extract from a plant from South Algeria Traganum nudatum (Chenopodiaceae) on glucose uptake in liver slices isolated from Wistar rats.
Methods: The liver slices were incubated for 90 min at 37° in normoglycaemic (1g/l of glucose) and hyperglycaemic (3g/l of glucose) KRBA Krebs Ringer Bicarbonate Albumin 4% media using 24 well-polyethylene plates. In each, well different concentrations of insulin (10, 50 and 100µU/ml) and hydromethanolic crude extract (100, 200 and 500µg/ml) were added. After every 30 minutes, aliquots of the culture media were assayed for the determination of glucose left.
Results: Tests showed that the glucose left after 90 minutes in the media which contained insulin at 100µg/ml was the lowest (0.44 and 1.41 )g/l in the normo and hyperglycaemic media respectively, which reflect that insulin at this concentration was the most effective on the stimulation of glucose uptake. The extract had the highest effect at 500µg/ml, the concentrations of glucose left after 90 minutes of incubation were found to be (0.38 and 1.31)g/l in the normoglycaemic and hyperglycaemic media respectively.
Conclusion: From the obtained results, it can be concluded that our extract seems to have an insulin-like effect on glucose uptake in liver slices isolated from Wistar rats
Colorectal cancer in elderly patients : An epidemiologic study at University Hospital of Tlemcen
Get PDFBackground : Colorectal cancer has a high incidence and occurs formost patients aged more than 65 years.[1]This population is a very heterogenus group,ranging from the very fit to the very frail.it has often been untreated due to the comorbid diseases,[2.3]however,thanks to comprehensive geriatric assessement which can detect unsuspected health problems,medical care of these patients has been improved[4]
The objective of this study is to establish the epidemiological,clinical ,histological and therapeutic profiles of colorectal cancer in this population
Methods : We carried out a prospective and descriptive study that includes 69 elderly patients with colorectal cancer treated from january 2016 to december 2018 in medical oncology department at the University Hospital Center of Tlemcen
Results : average age at diagnostic is71years[66-92].The comorbid diseases consist in High Blood Pressure :(46%),diabetes(27%),other cardiovascular diseases(11.6%) and dyslipidemia(6%).Right sided colon was more often achived (57%) than the left one(11%) Adenocarcinoma is the most frequent histological type(59%). The tumor was classifed as stage I (10%),stageII(23%),stageIII(24.6%) and stageIV(26%).Lymphnodes metastasis were observed in 18.5%of cases,metastasis were localised mostly in liver(77%). 58% of patients were assigned to conservative surgery wile 7% inderwent radical one. 26% of patients had adjuvant chemotherapy,20% palliative one associated with target agents and 6 % had concomittent chemoradiotherapy.
The mean geriatric score of G8 was 13,so the type of drugs and doses were adapted according to geriatric evaluation.The toxicity of treatment was dominated by diarrhea grade1 in 10% of cases ,neuropathies grade 1 in 7%,vomiting grade 3 in 4% and hand-food syndrom grade3 in 1.5%
The average survival is 13 months
Conclusion :
Aging is one of the factors we need to take into account to establish treatment strategy of elderly with colorectal cancer ,however,patients aged more than 65 years must be treated in the same way as younger subjects together with a personalised strategy considering the comorbidities ,performance status and life styl