2^nd International Conference on Autoimmunity November 06-07, 2017 Frankfurt, Germany

Ioannis Gkougkourelas is currently working in Clinical Immunology Unit at Hippokration General Hospital Thessaloniki, Greece. His research interest is mainly focused on Lupus. He has attended many international conferences & published papers in immunology journals.

Introduction: Soluble Triggering Receptor Expressed on Myelocytes -1 (sTREM-1) is an innate immunity receptor which participates in infectious as well as aseptic infl ammatory reactions. Its levels in serum indicate the magnitude of Systemic Infl ammatory Reaction Syndrome (SIRS) and can be used to discriminate between infectious and non-infectious causes. Recently, the plasma level of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) has been proposed as a lupus biomarker, signifi cantly correlated with disease activity.

 

Methods: 16 treatment naive SLE patients (mean age: 32±11 years, female/male ratio: 15:1) and 17 healthy individuals of the same age were included in the present study. Th e diagnosis of SLE was based on 2012 Systemic Lupus International Collaborating Clinics (SLICC) classifi cation criteria. All patients were recruited from the clinical immunology outpatient clinic of the 2nd Department of Internal Medicine, Hippokration Hospital of Th essaloniki, over a period of two years. We performed enzyme-linked immune sorbent assay in the serum by the commercially available kit (USCN Life Sciences) following the manufacturer's protocol. Results were expressed as mean +/- sd. Spearman correlation test was used to identify the statistical correlation between sTREM-1 levels in serum and SLEDAI.

 

Results: Median serum sTREM-1 levels were signifi cantly higher in patients with SLE (43.2, range 10.2–80.1 pg/ml) compared to healthy controls (5 pg/ml; range 3.3-8.3 pg/ml) with p<0.001. When using the Spearman’s rank correlation to study the correlation of s-TREM-1 with SLEDAI, it was found that s-TREM-1 levels positively correlated with activity score (r=0.65 p=0.43).

 

Conclusion: In conclusion, in spite of the enormous number of studies demonstrating lupus biomarkers, reliable biomarkers to predict lupus fl are and/or response to treatment have yet to be identifi ed. Larger studies are needed to clarify if sTREM-1 could play a role in determining the activity status of SLE or even herald a fl are.

Sherif Mohamed Ismail is a Research Physician working in clinical research in the fi eld of Rheumatology at Internal Medicine Department of the Medical Sciences division at National Research Center of Egypt. His work mainly focused on genetic and epigenetic markers and connections to rheumatic diseases and their pathogenesis, working as a part of a team of researchers at the National Research Center of different specialties including the clinical pathology and molecular biology departments. He and his team hope that progressive research will help a better understanding and management of rheumatic disorders in the near future.

Aim: To identify the prevalence of HLA-DRB1 among Egyptian RA patients and to evaluate the association between HLADRB1 and rheumatoid factor (RF) isotypes (IgG, IgM, and IgA), anti-CCP antibodies.

 

Methods: Th e study included 150 RA patients and 150 controls. Quantitative Serum, RF IgM, IgG and IgA isotypes and anticyclic citrullinated peptide (anti-CCP) antibodies were measured using commercially available ELISA. HLA- DRB1 alleles {HLA-DRB1*01, HLA-DRB1*03 and HLA-DRB1*04}, were determined using the Dynal AllSetTM PCR-SSP low resolution typing kits -Dynal, UK). al, UK).

 

Results & Conclusion: HLA-DRB1*01 and *04 were associated with RA (OR: 6.1 95% CI: 3.5-10.7 and OR: 4.4 95% CI: 2.6-7.5 respectively). No association was found between HLA-DRB1*03 and RA (OR: 0.6 95% CI: 0.4-0.9). Th e association of HLADRB1* 01 and/or HLA-DRB1*04 alleles with positive anti-CCP is stronger than with negative anti-CCP (OR: 12.7 95% CI: 6.3- 25.7 and OR: 3.1 95% CI: 1.7-5.6 respectively) and also the association with positive RF isotypes is stronger than with negative RF isotypes compared to controls (OR:8.2, 95% CI:4.5-14.5 for positive RF IgG and OR: 2.55 95% CI: 1.2-5.5 for negative RF IgG; OR: 7.8 95% CI:4.3-14.1 for positive RF IgM and OR:4.0 95% CI: 2.1-7.8 for negative RF IgM; OR: 9.2 95% CI:4.8-17.8 for positive RF IgA and OR: 4.1 95% CI:2.2-7.4 for negative RF IgA). HLA-DRB1*01 and HLA-DRB1*04 are associated with Egyptian RA patients and carriers of HLA DRB1 *01 and/or *04 alleles are at higher risk of developing anti-CCP positive and RF positive RA than non-carriers.

Farida Karim has completed her MBBS from Jinnah Medical and Dental College Karachi and internship from Aga Khan University Hospital. She is working currently as Medical Offi cer in the Aga Khan University Hospital, Pakistan which is the best and most advanced healthcare service organization. She has published three artilces and working on several other projects that are under reviewing process.

Objective: To determine the clinical and immunological characteristics and short-term outcome of children with systemic lupus erythematosus (cSLE) presented at a tertiary care center in Karachi, Pakistan.

 

Design: A descriptive observational study conducted at the Paediatric Rheumatology Clinic of Aga Khan University Hospital(AKUH), Karachi, from January 2011 to April 2015.

 

Methodology: Data of children <16 years of age, admitted to the Paediatric ward, diagnosed with cSLE, was studied.

 

Results: 32 children satisfying the criteria of American College of Rheumatology (ACR) for cSLE were enrolled. A female predominance was observed, with 87.5% of the patients being female. Mean age at symptom onset was 10.5+2.7 years and 8.8+2.1 years in females and males respectively. Mean age at diagnosis was 11.3+2.8 years in females and 9.4+1.9 years in males. Fever was the most common non-specifi c symptom found in 84% patients. 69% children were found to be anemic and 56% had signs of arthritis at presentation. Renal involvement was observed in 47% patients. Th e most common immunological markers were found to be serum Anti-neutrophil antibodies (ANA), positive in 88% patients, followed by Anti-double-stranded DNA antibodies (anti ds-DNA), raised in 81% cases. Overall response rate to therapy was 50% in 20 children who were followed for four years.

 

Conclusion: We found that cSLE encompasses a wide variety of manifestations with a female preponderance. Fever and Arthralgia are the most frequent clinical fi ndings. Hemolytic anemia is the most common laboratory abnormality, with ANA and Anti ds-DNA positivity in a majority of patients.

Paraskevi Chaitra is a PhD student in Medical Genetics at Cyprus School of Molecular Medicine (CSMM). She is working on Proteomics and Genetics of Systemic Sclerosis.The proteomics part is carried out through the PRECISESADs project. Human skin biopsies were obtained from SSc patients voluntarily participating in the project by the collaborating clinicians. Samples are sent to CING where they are analyzed using mass spectrometry. The genetics part is carried out on Cypriot SSc patients and healthy volunteers, and the samples are analyzed using Restriction Fragment Length Polymorphism and SNaPshot techniques. Her life goal is to undertake critical research and provide essential services to people who suffer from complex diseases such as systemic sclerosis. Through her PhD project, she aims to discover specifi c proteomic and genetic biomarkers to facilitate an early prognosis, diagnosis and therapeutic targeting of SSc.

Statement of the Problem: Systemic sclerosis (SSc) is an autoimmune rheumatic disease characterized by vasculopathy, inflammation and fi brosis. It is a complex and heterogeneous disease, as many organs of the body may be aff ected and symptoms vary among individuals. As the aetiology and pathogenesis of the disease are currently unclear, its prognosis and diagnosis are challenging and thus up to date there is no cure for SSc. Th erefore, the purpose of this study is to discover specific proteomic biomarkers gaining insights into the mechanisms implicated in SSc pathogenesis and facilitating the early prognosis, more accurate diagnosis and therapeutic targeting of the disease.

 

Methodology & Th eoretical Orientation: Human biopsies were obtained from aff ected and non-aff ected skin areas of SSc patients and have been classifi ed based on histological criteria. Proteins were extracted from human skin biopsies, purified, reduced, alkylated and digested with trypsin. Purified peptides were analyzed on a Waters SYNAPT G2Si HDMS instrument operated in ion mobility mode using a UDMSE approach. Data were processed by the Progenesis QI and functional annotation analysis performed using multiple bioinformatics resources.

 

Findings: Proteomic analysis led to identifi cation and quantifi cation of more than 1500 diff erentially expressed proteins.Differential expression of approximately 1000 out of these proteins including interferons and interleukins, have statistically significant fold Change of ≥1.5 or ≤0.667. Further pathway analyses showed that the identifi ed dysregulated proteins were involved in multiple pathways including, antigen processing and presentation and complement pathway, which is known to be associated with autoimmune diseases.

 

Conclusion & Significance: Using MS-based proteomic analyses of SSc human skin biopsies, we identifi ed several proteins that might be implicated in the pathogenesis and development of SSc. Th e most diff erentially expressed proteins as well as differentially expressed proteins that are involved in autoimmunity-related pathways could be considered as potential SSc biomarkers.

 

This work has received support from the EU/EFPIA/ Innovative Medicines Initiative Joint Undertaking PRECISESADS grant

no 115565.www.precisesads.eu

Prof.Hany El-Saadany (MD) is the Head of department in Internal medicine & Rheumatology unit. Recently he had shifted to Kobri El-Kobba military medical complex. He has published many papers in reputed journals and attended in many national conferences

Background: IgG4 related disease (IgG4-RD) is systemic fi broinfl ammatory condition characterized by remissions and relapses(1,2) .Glucocorticoids and rituximab are used for inducing remission (3,4). The duration of remission variable and the current predictors of relapse are insuffi cient and depends mainly on laboratory measures ignoring the clinical picture of the patient .

 

Obectives: At our center,we adopt 6 measures in a newly designated index to predict any relapse of the disease aft er treatment of IgG4-patient. Th e Objective of this prospective study is a preliminary assessment of this index in predicting the disease relapse

 

Methods: In a prospective cohort study,during the period of june 2015 till.june 2017,25 egyptian patients fullfi ling the clinicopathological criteria for diagnosis of IgG4-RD in Kobri El-Kobba medical military complex,are included in the study. Of them , 21 patients are treated by glucocorticoids and 4 by rituximab 2 doses of 1gm with 15 days in between .At our center,we adopt using 6 measures in a newly designated prediction index for relapse extending the benefi ts of the current predictors of relapse which are mainly laboratory. Th e new index,which is named for simplicity( Saadany index)aft er the surname of the author, consists of a very trusted measure based on a clinical bases which is IgG4 responder index (IgG4- RI) and a questionnaire of the patient assessing the well being and the daily activity in addition to the laboratory predictor parameters of elevated IgE titer,circulating eosinophils,circulating plasmablasts by fl owcytometry gated to CD138,CD38,CD20 (5),IgG4 titer. Estimation of the score is as follows,4 points to IgG4-RI, and 1 point to any other elevated element of the other parameters than the baseline before treatment to make the sum at its maximum 9 points. Measurements is done aft er 1 month of the end of glucocorticoid treatment and 6 months of the end of rituximab treatment respectively. And then once quarterly for the rest of 2 years.

 

Results: 17 patients of the 21 (80.9%)treated with glucocorticoids that had a score less than 3/9 didn’t relapse. 4 patients (19%) who had a score more than 3/9 developed a relapse. 2 of them (50%) which had a score 6,7 respectively developed multisystem relapse. 4 patients of 25 included in the study are treated with rituximab ,3 of them which had a score less than 3/9 didn’t relapse

and the other (25%) who had a score 5/9 relapsed.

 

Conclusion: Up to our experience at our center,the use of this simple,easy applicable,mixed clinical and investigative measurement index , predicts well the possibility of relapse aft er treatment of a cohort of IgG4-RD patients either byglucocorticoids or rituximab and the higher scores are associated with a multisystem relapse . Further research propably a large multicenter prospective study is recommended for more accurate evaluation.

Encyclopedia of Bio analytical Methods for Bioavailability and Bioequivalence Studies of Pharmaceuticals (E-BABE).It is a unique encyclopedia involving bio analytical methods for bioavailability and bioequivalence (BA/BE) studies of pharmaceuticals for suitable method selection with thousands of combinations and searches against these methods. Most scrutinized literature was collected from diff erent sources such as Afghanistan Pharmaceutical Directorate. Th e bio analytical method assessment of the studied drug product, carried out in our laboratories, covers two aspects of evaluation. Th e first one is the drug in-vitro evaluation including conformity of drug active ingredient content and content uniformity employing official pharmacopoeia methods, and also the determination of the drug dissolution rate in accordance with the official methods. Th ese tests have been conducted to verify compliance of the drug product to applied quality standards. Th e second aspect involves biological or in vivo evaluation. Th is evaluation consists of microbiological assay for the label claim of the studied drug product, and development and validation of a suitable and reproducible bio analytical assay method to obtain plasma concentration-time profi le. Data obtained to be employed for assessment of the drug product kinetics. Depending on the chemistry of the drug product, reversed-phase high performance liquid chromatography (RPLC) has been chosen, as the analytical technique, in developing drug assay method, due to its explosive popularity for analytical separations. This choice was also due to many factors as will follow. Th e variation of element composition alone extends both retention and selectivity in RPLC over an extremely broad range of analyses. Practically, all reversed phase separations are carried out on stationary phases with chemically modifi ed hydrophobic surfaces. Minor variations in the surface chemistry and geometry can lead to noticeable differences in surface interactions and, as a result, to diff erences in chromatographic selectivity. Mobile phase (eluent) is by far the major “tool” for the control of analyte retention in RPLC. Variations of the eluent composition, type of organic modifier, pH, and buff er concentration provide the chromatographer with a valuable set of variables for successful development of aseparation method. Mobile-phase pH aff ects the analyte ionization and thus its apparent hydrophobicity and retention. Most drug products may be ionizable, and therefore their retention is aff ected by the mobile-phase pH. The infl uence of temperature and type and concentration of organic analyte and pH modifi er ionization are also related to HPLC retention. All the choices the biocatalyst has in terms of bonded phase, aqueous phase modifi er, and organic modifi er can have synergistic eff ects on the analyte retention and selectivity in RPLC. Th ese parameters illustrating the power of the selection of the most suitable parameters for control of the analyte retention and selectivity, and therefore the choice of a better analytical assay method, in terms of the following validation parameters.

Reyhaneh Abgoon has received her Master’s degree in Cellular and Molecular Biology from Azad University. Her research interests include Immunology, Molecular Immunology, especially Autoimmune Diseases. She is working as a Supervisor in Banej Elixir molecular research institute in Tehran. She has presented several research abstracts about alopecia areata which is an autoimmune disease at various international conferences.

Objective: Alopecia areata (AA) is an autoimmune disease characterized by patchy hair loss aff ecting both scalp and body hair. Although the etiology and pathogenesis of this disease are still unknown, a polymorphism within IL-12B gene has been described in few studies to be associated with AA susceptibility. Yet, these fi ndings had so far not been independently replicated, and no data on a possible association of IL-12B mutation and AA in Iranian population were available.

 

Methods: Th is study contains 30 AA patients and 15 healthy controls. Genomic DNA was isolated using DNG-plus and PCRRFLP analysis was performed to detect IL-12B rs3212227 polymorphism. Several relevant information such as demographic data (age, gender) or clinical characteristics were analyzed for a possible eff ect of these factors on susceptibility to AA in patients who carry CC, AC, and AA genotypes.

 

Results: No association between the IL-12B rs3212227 mutation and susceptibility to AA was observed in our Iranian cohort. PCR-RFLP results showed that frequency of CC genotype (13.3% vs. 6.6%) are similar in both patient and control groups. AC genotype was detected in 46.6% and 6.6% of patients and controls, respectively. Th e AA genotype which is wild genotype had a higher frequency in healthy individuals. Statistical analyses indicate that there is no signifi cant diff erence in the distribution of genotypes between patients and controls (P=0.12). Although the C allele frequency of IL-12B was higher in the patients than control subjects (36.6% vs. 10% respectively), but there is no signifi cant diff erence (P=0.12).

 

Conclusion: We here demonstrate that the IL-12B rs3212227 polymorphism is not associated with the risk to develop AA in our Iranian cohort. Th erefore, this study failed to confi rm a reported association between gene mutation and susceptibility to AA. Hence, the genetic predisposition to develop AA greatly varies among diff erent ethnic groups.

Segawa Gerald is currently undertaking a Master’s Degree at the age of 25 years from Mountains of the Moon University where he volunteers as Student Lecturer. He is the Project director of Reach Young People Uganda Organization, a premier Social work service organization. He has published more than 15 papers in different Newspapers and offered his work to the all continent of Africa.

Biological studies have always constituted a large pool of inspiration for the design of systems. In the last decades, two biological systems have provided a remarkable source of inspiration for the development of new types of algorithms: neural networks and evolutionary algorithms. In recent years, another biological inspired system has attracted the attention of researchers, the immune system and its powerful information processing capabilities. In particular, it performs many complex computations in a highly parallel and distributed fashion. Th e key features of the immune system are pattern recognition, feature extraction, diversity, learning, memory, self-regulation, distributed detection, probabilistic detection, adaptability,specificity, etc. The mechanisms of the immune system are remarkably complex and poorly understood, even by immunologists. Several theories and mathematical models have been proposed to explain the immunological phenomena. Th ere is also a growing number of computer models to simulate various components of the immune system and the overall behavior from the biological point Biography.

Maryam Tabarestani Emrani is pursuing Master of Science in Genetics at Islamic Azad University of Tehran. One of the diseases that have been increased dramatically in Iran in past decades is Rheumatoid Arthritis (RA). Due to lack of study and information about RA, she decided to choose this topic for her MS project, which is “The study of proinfl ammatory cytokine IL-6 expression via inducing propolis combination in CIA disease”.

Introduction: Interferon gamma is one of the most important regulative indices of the body’s immunity system and cellular modifier, in most of the inflammatory diseases such as rheumatoid arthritis, lupus, MS the cytokine balance Th 1/Th2 undergoes broad changes that are related to disease pathogenesis. Quercetin is of fl avonoids family and has a modular function on the immune system. In this research, the eff ect of Quercetin was studied on arthritis pathogenesis due to collagen induction using IFN-γ expression assay and multiplication of T lymphocytes as an immunity cellular index.

 

Materials & Methods: Male Balb/C mice were divided into 3 groups, the fi rst group of BCII and CFA were immunized at the rate of 100 μg at hypodermis of toe and second group on 28th day aft er the fi rst immunization in the tail norm with BCII and IFA and third group on the 42nd day received the second booster, the entire injections were at the rate of 100 μg. Th e arthritis rate due to collagen was measured with wood experiment. Each of the three immunized groups (Prime/Booster1/Booster2) whose toe had infl amed were treated with Quercetin and 14 days aft er the last immunization in each group the rats were subjected to the spinal cord injury, their spleen was extracted and 2x106/cell cellular suspension was prepared in RPMI1640 medium with 10% BCS. IFN-γ measurement and T lymphocyte proliferation rate was evaluated via Elisa, LTT and Brdu method respectively, the results were assessed via One Way ANOVA statistical analysis.

 

Results: The results showed that among the groups treated with Quercetin in each group in the fi rst injection in relation to the control groups a significant diff erence exists at P<0.05 and they had achieved this diff erence to increase IFN-γ expression and cellular proliferation rate with both Booster1 and Booster2 methods in relation to the prime group a signifi cant diff erence was observed at P<0.05.

 

Conclusion: Th e research showed that several types of natural and synthetic flavonoids have an ability to regulate and modify the immune system and establishment of Th 1/Th 2 balance from the pre-infl ammatory cytokines has an inhibitory effect, even quercetin as a fl avonoid can increase the proliferation of T lymphocytes and IFN-γ that is cellular immunity index and can be introduced as a pharmaceutical candidate in the treatment of diseases such as rheumatoid arthritis.

Systemic sclerosis (SSc) is a chronic systemic infl ammatory disease, characterized by vascular dysfunction, immune alteration and tissue fi brosis. Recent data suggests that patients with other autoimmune diseases have shown an expansion of unusual T-Cell population identifi ed as CD4+/CD8+CD28- T-cells. CD4+/CD8+CD28- T-cells represent an aggressive T-Cell subset that diff ers from conventional CD4+/CD8+CD28 T-helpers in both phenotype and function. CD4+/CD8+CD28- T-Cell have pro-infl ammatory functions and releases high number of cytotoxic enzymes. Chronic antigenic stimulation results into the aggregation of late diff erentiated, antigenic specific, oligoclonal T-Cell, particularly within the CD4+/CD8+T-Cells compartments. Th ey are characterized by loss of CD28 co-stimulatory receptors and /or gain of CD57 expression. It is interesting to see how this T cell subsets are expanded during the infection of human cytomegalovirus (HCMV). RegulatoryT (Treg) believed to be converted into pathogenic cells and produces higher number of infl ammatory cytokines thought to be a crucial step in the progression of many autoimmune diseases but whether loss of normal Treg cell function contributes to SSc is unknown. By considering the role of the diff erent T cell subsets, we have aimed to evaluate the percentage of the CD4+/CD8+CD28- T-cell, Treg cells and CD57+ CD4+/CD8+CD28- T-cell to understand whether the percentage of these T-cell subpopulations correlates with anti-HCMV antibodies and with treatment. In other autoimmune pathologies these cells are responsible for the production of proinflammatory cytokines and cytotoxic enzymes, so it would be interesting to clarify their role in scleroderma and to evaluate possible correlation with the presence of previous HCMV infection. Th e percentage of Treg cells does not seem to be diff erent between patients and healthy controls.

Nega Berhane has research expertise in Biotechnology, Cancer Research, Cell Biology. He had completed his Ph.D. in Biotechnology from University of Gondar, Ethiopia; He has published many papers in reputed journals and attended in many national conferences

Background & Aim: Plasmodium falciparum is the most dangerous species of plasmodium parasites in terms of lethality and morbidity. In diff erent studies, polymorphisms in the tumor necrosis factor alpha (TNF-α) gene have been associated with increased susceptibility to mild malaria infection and severe malaria. Th e aim of this study was to determine the frequency of TNF-α-308 G > A gene polymorphism in P. falciparum malaria infected patients living in Dembiya Woreda, North Gondar, North West Ethiopia and to assess the eff ect of TNF-α-308 gene polymorphism and diff erent demographic factors on the risk of malaria infection.

 

Methods & Results:Two hundred blood samples were collected from November to December 2014 from clinically confirmed P. falciparum malaria patients (n=100) and from P. falciparum seronegative individuals (n=100) who live in the study area.TNF-α-308 G > A polymorphism was detected using PCR- RFLP techniques. Th e mean age of P. falciparum malaria patient study subjects was 23.2±8.36 years old. Age (P=0.000) and occupation (P=0.046) were associated risk factors for malaria infection at 95% CI. Th e allele frequency in malaria patient study subjects was 0.92 for TNF-α-308G (TNF-1) and 0.08 for TNF-α-308A (TNF-2). Th e distribution of TNF-α-308 genotypes in cases (P=0.065) and controls (P=0.677) were consistent with the Hardy-Weinberg equilibrium.

 

Conclusion: There was no statistically signifi cant association between TNF-α-308 genotypes and malaria infection (P=0.616). Further studies with large number of sample size and assessment in diff erent malaria endemic areas of the country are warranted for generalization.

Rebecca Heath is a UK trained medic who has worked in the Manchester, Melbourne, the Nepali Himalayas and Ghana before her interest in rural and remote medicine and Aboriginal health found her at home in the Red Desert of Alice Springs for a couple of years before heading to Papua New Guinea in the Pacific to teach Emergency Medicine and work on capacity building programs in Madang. Keen to help fi nd ways to develop practical and useful strategies to update practice in low income settings, as well as understand some of the complex challenges these contexts provide, she has focused on asthma, which is notoriously poorly managed in the Pacific.

Objective: To implement evidence based practice guidelines using a culturally sensitive change management approach and improve asthma management in a developing world setting.

 

Methods Setting: Emergency Department, Modilon hospital, Madang, Papua New Guinea. Nearly 700,000 people live in Madang Province and Modilon Hospital (with 258 beds) is the only government hospital in the region.

 

Study Design: Asthma management analysis, A questionnaire was completed by Emergency Department staff during consultations with known asthma patients consisting of patient demographics, departmental and discharge management.Results were compared to international evidence based guidelines. 2) Action research with program change model: An action research approach using a 4 step model of program change (exposure, adoption, implementation and practice) was adopted with staff education and consultation to design and implement a new departmental asthma guideline. Culturally sensitivity and flexibility were maintained throughout. 3) Asthma management analysis: 3 months after the guideline implementation asthma management was re-analysed in the form of a questionnaire and results compared to original management. A ‘post mortem’ questionnaire was also conducted with staff to review progress and inform practice learnings. Outcomes measured: Treatment in line with evidenced-based asthma management guidelines, patient perception of treatment and frequency of Emergency department visits. Staff perceptions of treatment change outcomes and approach in managing the clinical changes.

 

Results: Prior to intervention, asthma management involved frequent use of IV and oral antibiotics, IV steroids, paracetamol, simultaneous use of multiple short acting oral bronchodilators, limited use of oral steroids (of variable dose and duration) and no spacers, preventative steroid inhaled therapy, or asthma action plans. At 3 months staff felt the program improved asthma management. Data is still being collected.

Conclusion:A 4 step model of program change was used to develop and implement asthma treatment guidelines.

Bidisha Ukil is pursuing her PhD under the supervision of Dr. Larisha M. Lyndem in the Department of Zoology, Visva-Bharati University, Santiniketan, India. She has been registered for PhD programme since 2013 and since then been working on the nervous system and energy metabolism of Hymenolepis diminuta, a cestode parasite that affects rodent hosts but is a silent threat to human population as well. She has made this approach as a cestode parasite’s survival solely depends on its nerve-muscular co-ordination that monitors its migration and attachment within host’s body. Antagonistic effects of the leaf extracts of three species of Senna plants may interrupt such activities of the parasite and thus may lead to their expulsion from the host body. Ms. Ukil has experienced and well trained in raising the parasitic model in rodents and maintain its life cycle in the laboratory. She has been exposed to many fi elds of parasitology through her participation in conferences nationally.

Statement of the problem: Helminthiasis is a major infectious disease caused by parasitic helminths and has become a global health problem thus affecting human population. These helminths have also become resistant to available synthetic drugs which lead to a search of natural medicines. Three species of Senna plants were reported to cause structural and biochemical alterations against the cestode parasite Hymenolepis diminuta. Since no studies were made on the effect of these plant extracts on neuro-anatomy structure or co-ordination and energy unit of the parasites, it is thus important to observe if this plant has got any alteration in the structure as these poses important aspects for survival of the parasites.

 

Methodology and Theoretical Orientation: Ethanolic leaf extracts (40mg/ml) of three species of Senna plants were tested against Hymenolepis diminuta. Neurotransmitter activity was studied through its enzyme acetylcholinesterase assay.Immunohistochemical study was done as a supporting experiment for identifying the neuroanatomy using anti Serotonin antibody from rabbit as primary antibody and fl uoresceneisothiocyanate conjugated swine anti rabbit IgG as secondary antibody. Morphology of mitochondria was studied through transmission electron microscopic (TEM) study after fixing the paralysed worms in 3% gluteraldehyde. Findings: Both histochemical and immunohistochemical studies showed changes in the intensity of the stain in treated parasites from control. TEM studies revealed disruption in the outer membrane of the mitochondria as well as its cristae.

 

Conclusion and Significance: Senna plant extracts showed to have an infl uence on the neural structure and coordination as well as on structure of mitochondria of the parasite and can be regarded as a future positive potent anthelmintic drug therapy.

Prof. Dr. Hedef El-Yassin was pursuing as faculty in University of Baghdad in the Department of Biochemistry and in College of Medicine. He has many research publications & attended national & international conferences

Background & Aim: Older age is usually accompanied by functional decline due to loss of skeletal muscle mass and quality.Sarcopenia and muscle frailty are both highly relevant entities with regards to functionality and autonomy of older adults.European Working Group on Sarcopenia in Older People (EWGSOP) founded in 2009 has put the main criteria for clinical diagnosis of sarcopenia including the following domains: Physical performance, Muscle strength and /or Muscle mass. Sarcopenia is also associated with modifi cations in biological functions, including infl ammation, glucose, regulation, hormone

production, cellular, communication and protein storage. However, no laboratory guidelines' have yet been established for confirmatory testes of the diagnosis. Th e aim of the present work is to shed a light on the variations of some infl ammatory markers in a group of sarcopenic Iraqi patients and to aid in the clinical diagnosis of the disease.

 

Subjects & Methods: Th e study included (100) sarcopenic subjects (50 male and 50 female) and (50) non sarcopenic subjects (25male and 25 female). Information were taken from each subject (age, gender, patients with inflammatory disease (rheumatoid arthritis systemic lupus erythematosus (SLE)), diabetes mellitus, thyroid disease and patients taking steroid therapy were excluded. Subjects with primary sarcopenia were diagnosed by: Short Physical Performance Battery (SPPB) and dual-energy X-ray absorptiometry (DEXA) to determine (Appendicular skeletal muscle mass (ASM), Total lean body mass (TLBM) and Body Mass Index (BMI)). Th ere are two methods used in the study process, 1-Clinical diagnostic measurements: Physical performance: Short Physical Performance Battery (SPPB), Muscle strength: hand grip. 2-Biological markers (in serum): Markers of infl ammation: interleukin (IL)-6, alpha1-antichymotrypsin (ACT).

 

Results: Mean values of (α1ACA) in control group were more than study group and men more than women and their mean values were decreasing with aging. While (IL-6,) mean values in study group, were more than control group and in women more than men except BMI in male more than female and values increase with increasing age.

 

Conclusions: Mean values of (α1ACA) in control group were more than study group and in women less than men because sarcopenia is defi ned as a reduction in ASM/height2, and total lean body. Alpha 1-antichymotrypsin has a direct relation with ASM. While (IL-6,) have indirect relation with ASM and α1ACA. So, clinical variables values were increased: with age, in study group more than control group in women more than men.

Ioannis Gkougkourelas, is expertise in Hematology, Internal Medicine (General Medicine), Clinical Immunology in Aristotle University of Thessaloniki, Greece. He has many research publications & attended national & international conferences

Introduction: Lupus nephritis is an ominous manifestation of Systemic Lupus Erythematosus (SLE) requiring aggressive immunosupressants. Biopsy is the gold standard for diagnosis. A lot of studies have investigated the possible role of various biomarkers in blood and/or urine to aiming to early discovery of kidney involvement in SLE with contradictory results. No single biomarker has been established as a screening tool for the Lupus nephritis. Soluble Triggering Receptor Expressed on Myelocytes (sTREM-1) has been correlated with activity score of SLE (SLEDAI) but few studies have been investigated sTREM-1 in Lupus nephritis Patients and methods: We investigated the levels of sTREM-1 in urine of 8 SLE patients with biopsy proven nephritis and 10 patients with active SLE but no kidney involvement ( according to EULAR criteria). The patients were choosen randomly by the Outpatient clinic of Clinical Immunology Unit of 2nd Internal Medicine Dpt. Th e overall severity of the disease in both groups was at the same class according the SLEDAI index. We performed enzyme linked immune sorbent assay in the urine by the commercially available ki (USCN Life Sciences) following the manufactures protocol. Results were expressed as mean+/- sd. Mann –Whitney test was performed to assess possible signifi cant diff erences, p<0.05 was considered significant.

 

Results: The mean value of sTREM-1 in patients with nephritis was 28+/-2.3 pg/ml and the mean SLEDAI index was 13+/-5.Patients with SLE without nephritis (mean SLEDAI 12+/-4) was signifi cantly lower 6+/-5 pg/ml.

 

Discussion: sTREM-1 is increased in urine of patients with Lupus Nephritis relative to SLE patients without kidney involvement. sTREM-1 could be a candidate biomarker measured in urine helping the physician to discriminate patients suspicious for SLE nephritis.

Jae Chul Lee, Department of Biology, School of Life Sciences, Chungbuk National University, Cheongju, Korea & has many research publications & attended national & international conferences

Osteoarthritis (OA) is a degenerative joint disease characterized by abrasion, and ultimately, destruction of the articular cartilage and trabecular bone loss. OA is still considered a devastating disease, which requires an aggressive therapeutic approach. Despite the therapeutic potential of human adipose-derived mesenchymal stem cells (AD-MSCs), the molecular parameters needed to defi ne the stemness remain largely unknown. Using high-density oligonucleotide microarrays, the differential gene expression profi les between a fraction of human adipose-derived (AD) mononuclear cells and its MSC subpopulation were obtained. Of interest, a subset of 58 genes preferentially expressed at 7-fold or higher in the group treated with human AD-MSCs. Th is subset contained numerous genes involved in the inflammatory response, immune response, lipid metabolism, cell death, cell proliferation, and DNA repair. Additionally, four protein networks were constructed. The interaction network consisted of 46 proteins encoded by up-regulated genes. However, the interaction network also consisted of 38 proteins encoded by down-regulated genes. My results provide a basis for a more reproducible and reliable quality control using genotypic analysis for the defi nition of human AD-MSCs. Therefore, these results will provide a basis for studies on molecular mechanisms controlling the core properties of human MSCs.

Farida Karim has completed her MBBS from Jinnah Medical and Dental College Karachi and internship from Aga Khan University Hospital. She is working currently as Medical Offi cer in the Aga Khan University Hospital, Pakistan which is the best and most advanced healthcare service organization. She has published three artilces and working on several other projects that are under reviewing process.

Design:A descriptive observational study conducted at the Paediatric Rheumatology Clinic of Aga Khan University Hospital (AKUH), Karachi, from January 2011 to April 2015.

 

Methodology:Data of children <16 years of age, admitted to the Paediatric ward, diagnosed with cSLE, was studied.

 

Results:32 children satisfying the criteria of American College of Rheumatology (ACR) for cSLE were enrolled. A female predominance was observed, with 87.5% of the patients being female. Mean age at symptom onset was 10.5+2.7 years and 8.8+2.1 years in females and males respectively. Mean age at diagnosis was 11.3+2.8 years in females and 9.4+1.9 years in males. Fever was the most common non-specifi c symptom found in 84% patients. 69% children were found to be anemic and 56% had signs of arthritis at presentation. Renal involvement was observed in 47% patients. Th e most common immunological markers were found to be serum Anti-neutrophil antibodies (ANA), positive in 88% patients, followed by Anti-double-stranded DNA antibodies (anti ds-DNA), raised in 81% cases. Overall response rate to therapy was 50% in 20 children who were followed for four years.

 

Conclusion:We found that cSLE encompasses a wide variety of manifestations with a female preponderance. Fever and Arthralgia are the most frequent clinical findings. Hemolytic anemia is the most common laboratory abnormality, with ANA and Anti ds-DNA positivity in a majority of patients.