Print ISSN: 0027-1446

Online ISSN: 2309-6217

Main Subjects : Microbiology

The Serum Level of Proinflammatory TNF-alpha Cytokine in Cyanotic and Acyanotic Congenital Heart Diseases in Mosul City

Asmaa Zeki Sheetawi; Firas Al-Tae; Ahmed Abdullah Ahmed; Mohammed Essmat Ahmed

Annals of the College of Medicine, Mosul, 2022, Volume 44, Issue 1, Pages 1-9
DOI: 10.33899/mmed.2022.133834.1146

Background:Tumor necrosis factor – alpha (TNF-α)  has been proposed to play an important role  in the etiopathology of congenital heart diseases (CHD) worldwide. However, no previous  study about the role of TNF-α in the pathogenesis of CHDs in Mosul city / Iraq has been reported .
Objectives:1) To evaluate the serum levels of TNF-α cytokine in cyanotic and a cyanotic congenital heart diseases (CHDs and to compare the results with control healthy children in Mosul city 2) To find any association between the level of this pro-inflammatory marker  and other  demographic parameters such as age and gender  3) To test the diagnostic validity of this cytokine for the diagnosis of CHD at different cut-off values.
Patients, materials and methods:A case-control study was conducted in the Department of Microbiology / College of Medicine / University of Mosul over two years and 3 months from April 2019 to July 2021. Twenty nine (29) child with a cyanotic congenital heart diseases and seventeen  (17) child with cyanotic heart diseases were included. Another Thirty one (31) healthy child were also included as a controls. . All patients were collected from Al-Khansa teaching hospital in Mosul city. The serum TNF-α concentration was measured in all participants by using ELISA.
Results: Mean age of children with acyanotic heart diseases (2.7 ± 2.9 years) did not significantly differ from that of cyanotics (2.1 ± 1.9) or healthy controls (3.1 ± 1.7) ,  (P>0.05). The average TNF-α level in acyanotic heart diseases was 321.18 ± 325.71 ng/l compared to 120.63 ± 84.33 ng/l in cyanotics and 119.01 ± 139.71 in healthy controls. TNF- α was significantly elevated in acyanotic heart diseases in comparison to healthy children (P = 0.003). No significant difference was noted between acyaotics and cyanotic heart diseases in regards to TNF- α concentrations (P = 0.07). No age or gender effects were noted on TNF-α concentration in both acyanotic and cyanotic heart diseases (P>0.05). At the best cut-off  value of 124 ng/l  TNF-α had a specificity of  90.32% , sensitivity of 48.28% and accuracy rate of 39% as indicated by AUC-ROC curve .
Conclusion: The current study showed  higher TNF- α in acyanotic (but not in cyanotic)  heart diseases compared to healthy controls. TNF-α had poor diagnostic utility to discriminate between CHD and healthy individuals and  therefore not recommended as valuable biological marker for the diagnosis of CHD.

Interleukin – 6 Serum Level and Single Nucleotide Gene -174 G/C promoter Polymorphism in Patients with Rheumatoid Arthritis / Iraq

Ruba Ahmed Ibrahim; Firas Al-Tae

Annals of the College of Medicine, Mosul, 2021, Volume 43, Issue 2, Pages 164-175
DOI: 10.33899/mmed.2021.131144.1108

Objective: To 1) assess IL-6 levels in the serum of patients with rheumatoid arthritis (RA). 2) study IL-6 promoter -174 G>C “single nucleotide polymorphism (SNP)” as an imminent factor for the disease development. 3) find any relation between the level of serum IL-6 cytokine and other parameters such as age, gender, clinical severity of diseases and “disease activity scores (DAS28)”.
Materials & methods: This research was carried out through a case – control approach at “Ibn – Senna Teaching Hospital” in Mosul city between November 2020 and July 2021. It included 61 RA patients diagnosed according to “ACR / EULAR 2010 criteria” and 50 healthy individuals. IL-6 serum levels were ascertained by ELISA and genotyping of IL-6 promoter was accomplished by “sequence-specific primer-polymerase chain reaction (SSP-PCR)”.
Results: Mean IL-6 level in RA (69.42 ng /l ± 62.99) was elevated in comparison to healthy people (14.66 ng /l ± 23.58), P < 0.001. No age or gender effects on IL-6 concentration were noted. The ideal cut-off of IL-6 for discrimination of RA with best discriminative utility compared to healthy controls was 22.80 ng/l. At this value the IL-6 sensitivity was 91.8%, specificity 82.0% and accuracy rate 73.80%. G/G genotype was the most pervasive genotype in both RA patients and controls (70.5% in RA and 64% in healthy controls). However, it did not seem to be a risk factor for RA development compared to G/C or C/C genotypes “(OR = 1.3438, 95% CI=0.605-2.984,P=0.469)”. The mean IL-6 level in patients with GG genotype was (73.70 ng / l ± 71.09) compared to  (58.37 ng /l ± 37.86) in patients with GC genotype. There was no significant difference in the IL-6 level between patients with GG and patients with GC genotypes (P = 0.2375). Although higher IL-6 mean concentration was reported in severe RA, however, no significant difference was found between patients with mild, moderate and severe RA respectively. No correlation of serum levels of IL-6 with genetic promoter polymorphism, clinical severity of diseases or DAS 28 score were reported. 
Conclusion: The concentration of serum IL-6 was elevated in RA in regard to healthy controls which confirmed its pivotal role in RA pathogenesis. Our data did not support the role of IL-6 promoter -174 G> C polymorphism as a risk factor for RA, nor seem to play a major role in the increase of IL-6 level among our patients with RA. 

Detection of Toxoplasma gondii and Herpes simplex IgM antibodies in frequently aborted women during different seasons in Mosul city

Hisham Alkazzaz; nadia mahmood; karam aldabbagh

Annals of the College of Medicine, Mosul, 2020, Volume 42, Issue 1, Pages 57-61
DOI: 10.33899/mmed.2020.127248.1028

Background: Many women suffer from frequent abortions due to many causes; one of these causes is infection with different types of microorganisms. Toxoplasma gondii protozoan and Herpes simplex virus (HSV) are well-known causes of repeated abortion. However, it is unclear whether seasonal changes could affect the re-activation of latent infections with these microorganisms.
Objectives: To detect the percentage of active toxoplasmosis and HSV infections among frequently aborted women, and evaluate seasonal changes on such active infection.
Patients and method: Two hundreds women with frequent abortions were tested for anti-toxoplasma gondii IgM antibodies and anti-HSV IgM antibodies in two different seasons (100 patients in summer and 100 patients in winter) and were compared for variance.
Results: For toxoplasmosis, only 2% of studied women were positive for IgM antibodies in winter in comparison to 3% in summer with a total active infection of 2.5% in both seasons; however, for HSV about 12% were positive in winter and 10% were positive in summer with a total active infection of 11% in both seasons.
Conclusion: Seasonal variance showed no significant change on re-activation of latent infection of both Toxoplasma gondii and HSV in frequently aborted women. The rate of infection in frequently aborted women with HSV is higher than the rate of infection with Toxoplasma gondii in Mosul city.