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

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.