RESUMEN
The present study was performed to assess the immune response in women with human papilloma virus (HPV) DNA⺠and DNAâ» cervical lesions. Eighty women with cervical lesions (age range = 25-70 years) and 20 healthy individuals (control group) were enrolled in the study. Lesions were cytologically classified into four groups: ASC-US (20), CINI (30), CINII-III (16), and cervical carcinoma (14) prior to HPV DNA detection. Estimation of interleukin (IL)-10 and tumor necrosis factor (TNF)-α levels in cervical secretions and serum of the studied patients was performed utilizing ELISA. PCR screening kits were used to detect HPV DNA in cervical smears obtained from the studied cases with the different lesions. IL-10 levels in cervical secretions of HPV DNA⺠were significantly greater than those from DNAâ» patients (i.e., 88.73 vs 24.00 pg/ml) and from controls (i.e., 88.73 vs 8.27 pg/ml) and the levels were higher in DNAâ» patients than in controls (i.e., 24.00 vs 8.27 pg/ml). In comparison, serum IL-10 levels in these patients did not significantly differ from control values (i.e., 13.69 vs 12.16 vs 9.99 pg/ml, respectively). TNFα levels in cervical secretions of the HPV DNA⺠and DNAâ» cases did not significantly differ from values for the controls (i.e., 12.18 vs 9.90 vs 7.90 pg/ml, respectively). Serum TNFα of these patients also did not differ significantly from controls (i.e., 11.59 vs 11.90 vs 10.83 pg/ml, respectively). The detected levels of IL-10 in cervical secretions of patients with HPV DNA⺠lesions was significantly higher than in their sera, while secretion TNFα levels were nominally greater than sera values. Lastly, higher levels of IL-10 were observed in secretions of 10-14 (71.4%) patients who had progressive cervical lesions (HSIL and cervical cancer stages) who were HPV DNA⺠than observed in 20 of 66 (30.0%) of DNAâ» patients with similar progressive lesions. In general, the higher levels of IL-10 than of TNFα suggested a potential down-modulation of tumor-specific immune responses to HPV-infected lesions. This phenomenon appears to provide a tumor 'progressive' microenvironment in these particular patients.
Asunto(s)
Adenocarcinoma/sangre , Interleucina-10/sangre , Infecciones por Papillomavirus/sangre , Factor de Necrosis Tumoral alfa/sangre , Displasia del Cuello del Útero/sangre , Neoplasias del Cuello Uterino/sangre , Adenocarcinoma/patología , Adenocarcinoma/virología , Adulto , Anciano , Cuello del Útero/metabolismo , Cuello del Útero/virología , ADN Viral/análisis , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Persona de Mediana Edad , Papillomaviridae/genética , Papillomaviridae/inmunología , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/virología , Reacción en Cadena de la Polimerasa , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/virología , Frotis Vaginal , Displasia del Cuello del Útero/patología , Displasia del Cuello del Útero/virologíaRESUMEN
OBJECTIVES: To determine whether antiphosphatidyl serine autoantibodies (aPS) are associated with increased risk of occurrence of coronary events in selected patients. METHODS: This study compared 50 patients with coronary events with 30 controls, recruited from the cities of Mosul, Erbil, and Dohuk cities, Northern Iraq, between March 2004 and March 2005. The patient group consisted of 23 individuals with myocardial infarction and 27 with angina. We evaluated the presence of aPS antibodies (IgG and IgM isotypes) by an enzyme-linked immunosorbent assay. The studied cases were less than 50 years of age (mean ± SD, 39.6 ± 5.9) and had no recognizable risk factors. RESULTS: The frequency of detecting IgG aPS was 10/50 (20%) among patients and 1/30 (3.3%) among controls, with significant difference and with adjusted odds ratio (OR) of 3.2 (95%CI, 1.1-9.1; p < 0.05). The IgM aPS frequency was 3/50 (6%) among patients and zero in the controls, with non-significant difference. The three cases were also IgG positive (i.e. the frequency rate for detection of aPS of IgM was the same as for IgG). Moreover, this marker (aPS) was detected in 8/12 (66.7%) of cases with unstable angina, in 2/15 (13.3%) with stable angina, and in none of the cases with myocardial infarction. CONCLUSION: IgG aPS autoantibodies are associated with increased risk of coronary events especially angina of unstable subset.
RESUMEN
OBJECTIVE: The persistence of hepatitis B core immunoglobulin M (HBc IgM) antibody in hepatitis B surface antigen (HBsAg) carriers is a risk factor with hidden dangers and forecasts the existence of liver damage. A trial of lamivudine in such subset of carriers was carried out for the first time in this study. METHODS: A total of 62 HBsAg with hepatitis e antibody individuals (age range, 25-45 years) with persistent HBc IgM antibody were randomized to receive either 100 mg lamivudine (32/62) or placebo (30/62) daily for 6 months. The study was performed from June 2000 to October 2002. The carriers were regular attendees of the Virology Center in Mosul, North Iraq for follow up. Enzyme-linked immunosorbent assay technique was performed to detect the different hepatitis B virus markers. RESULTS: Among the lamivudine group, HBc IgM antibody seroclearance achievement rate was 81.3% and HBsAg seroconversion rate was 9.4% compared to 6.3% and 3.3% in the placebo group. Number of adverse clinical events were observed, but were of mild nature and tolerable by the participants who completed the study. CONCLUSION: The trial of lamivudine in this subset of HBsAg carriers proved to be safe and efficacious. More studies are needed prior to recommending the drug for routine use on selected HBV carriers.
Asunto(s)
Anticuerpos contra la Hepatitis B/efectos de los fármacos , Hepatitis B/tratamiento farmacológico , Inmunoglobulina M/efectos de los fármacos , Lamivudine/uso terapéutico , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Adulto , Portador Sano , Ensayo de Inmunoadsorción Enzimática , Femenino , Cefalea/inducido químicamente , Hepatitis B/sangre , Anticuerpos contra la Hepatitis B/sangre , Antígenos del Núcleo de la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Virus de la Hepatitis B/efectos de los fármacos , Virus de la Hepatitis B/inmunología , Humanos , Inmunoglobulina M/sangre , Irak , Lamivudine/efectos adversos , Masculino , Persona de Mediana Edad , Náusea/inducido químicamente , Inhibidores de la Transcriptasa Inversa/efectos adversos , Resultado del TratamientoRESUMEN
OBJECTIVE: The aim of this study is to evaluate the clinical and prognostic values of persistence of anti-hepatitis B core immunoglobulin M antibody in asymptomatic adults chronic hepatitis B surface antigen anti-hepatitis Be carriers and its absence in others. METHODS: Fifty-two hepatitis B surface antigen/anti-hepatitis Be carriers with and 32 without anti-hepatitis B core immunoglobulin M marker were enrolled in this study. The cases were regular attendees of Public Health Laboratory, Virology Center (the main referral center for viral hepatitis) Mosul, North Iraq, for follow-up and clinical evaluation. The study was performed from June 1999 to June 2001. The studied groups consisted of adults, with mean age of 35.5 year (standard deviation +/- 10). The results of histological findings of 23 carriers with and 12 carriers without anti-hepatitis B core immunoglobulin M who underwent liver biopsy were added to the study. Micro enzymed-linked immunosorbent assays was utilized to detect hepatitis B virus markers. RESULTS: Existence of carrier in the family was significantly associated with persistence of anti-hepatitis B core immunoglobulin M in the studied individuals (p<0.005, odds ratio = 7.4; 95% confidence interval = 1.8 to 38.0), as was the case in the presence of family history of acute hepatitis (p<0.05, odds ratio = 4.6; 95% confidence interval = 4.6 to 21.2). The detection of this antibody was significantly associated with the presence of abnormal liver histology compared to carriers without this antibody (p<0.01, odds ratio = 7.2; 95% confidence interval = 1.8 to 28.7). The study revealed that clustering of carrier cases existed in statistically significant (p<0.001) pattern in family members of carriers with anti-hepatitis B core immunoglobulin M. CONCLUSION: The detection of anti-hepatitis B core immunoglobulin M clinically is a reminder of recent exposure to the virus through different routes, mainly intrafamilial. Ongoing liver changes are observed in the majority of carriers with this antibody indicating the viral activity, albeit in a silent manner, but earlier progress to serious liver sequels may be inevitable. Foretelling that carriers with anti-hepatitis B core immunoglobulin M are more infectious than carriers without this marker is ascertained by the existence and clustering of carrier cases amongst their family members.