Background Inflammatory bowel disease (IBD) is a disease of activity and remission. Lipocalin 2 (LCN2), the coding gene for NGAL is one of the most over-expressed genes in the colonic mucosa in ulcerative colitis (UC) and crohn’s disease (CD). In our research we investigated the utility of serum level of Lipocalin 2 in assessing the activity of IBD Methods This was a single center case control study.It was conducted on 60 IBD patients, 50% (30 patients) were in remission and 50% were active.There were about 28 healthy control. Patients with IBD either UC or CD were enrolled from IBD clinic Mansoura specialized medical Hospital, Egypt. All patients and control group were subjected to investigations including complete blood count (CBC) ,Erythrocyte Sedimentation Rate (ESR) ,C-reactive protein (CRP),Fecal calprotectin and serum neutrophil gelatinase associated lipocalin (NGAL) by ELISA.Patients only were subjected to sigmoidoscopy or ileo-colonoscopy.The activity of IBD was assessed for UC by MAYO score and CD by CDAI. Results NGAL showed significant increase among active IBD patients by mean± SD ng/ml (37.04 ± 9.63) than patients in remission (20.65± 4.35).It showed highly significant correlation with clinical and endoscopic activity of IBD r= 0.80, P<0.0001. Serum NGAL can easily discriminate patients with active IBD from healthy controls with AUC 95% C.I =1.00 (0.94-1.0), at the cutoff 18.52 , P< 0.0001, with sensitivity 100% and specificity 100%. While AUC of NGAL which can discriminate patients with active IBD and those in remission at the cutoff 26.95 was 0.97, P< 0.0001, with sensitivity 93.3% and specificity 93.3%. In relation to fecal calprotectin, there was highly significant correlation between fecal calprotectin and serum NGAL (r=0.69 , P< 0.0001).Both CRP and ESR were positively correlated to NGAL by r=0.38 and r=0.29 (P<0.05) respectively. Figure (1): NGAL ROC curve among active IBD cases versus healthy controls. Conclusion Serum NGAL can easily discriminate patients with active IBD from healthy controls as well as among patients in active or remission of IBD. NGAL in comparison to other markers as fecal calprotectin or CRP or ESR shows better statistical performance for activity of IBD. This clarifies its ability to be a highly significant predictor of activity of IBD besides its lower cost.

Background Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory disorder of the gastrointestinal tract (GIT).It causes progressive structural and functional damage to the GIT epithelium. Chronic inflammation in IBD is characterized by an imbalance in the production of T helper -1 (Th1),Th2 andTh17 cytokines.This imbalance is important in chronic inflammatory process, since the formation of defective immune response to pathogenic agents promotes the recurrence of the disease.Whether interleukin-17A (IL-17A) has pathogenic and/or protective roles in the gut mucosa is controversial.The aim of this study was to detect serum IL-17 levels in IBD patients and its relation to disease activity. Methods This was a single center cross-sectional study, conducted at hepatology & gastroenterology unit, Mansoura specialized Medical Hospital, Egypt.Patients who were aged 18-65 years and diagnosed either UC or CD based on previous colonoscopy were included.55 patients were UC, 24 patients were CD,21 patients were control.Patients who were excluded were <15 y, with history of GIT malignancy or any comorbidities affecting kidney,liver ,etc.All population were subjected to routine history, physical examination& laboratory investigations including serum IL-17 by ELISA besides CBC,CRP,ESR,Stool analysis, fecal calprotectin. Results We found that serum IL-17 level was increased significantly among UC ;median (min-max)= 72(21-502), in CD 54.5(25-260) versus control19(14-35) ng/l, P<0.001.However, it was not correlated to the disease activity either Mayo score of UC or CDAI of CD. It showed significant correlation to the extent of inflammation in UC affecting the colon (either proctosigmoiditis or left sided colitis or pan colitis), also to the type of CD (either inflammatory or stricturing or fistulizing) by P<0.05. It was not correlated significantly with any of the IBD activity markers (either CRP, ESR,or fecal calprotectin).Yet there was only negative significant correlation with Hb level (r =-0.28, p=0.005). AUC was significantly differentiating between IBD and control group =0.993 with the best-detected cut off point from curve is 32 yielding sensitivity of 97.5% and specificity of 95.2%, while for discriminating activity of IBD by IL-17 ;AUC of UC and CD =0.56 & 0.65, with sensitivity 52.6% & 61.5% and specificity 58.3% &63.6 % respectively. Conclusion IL-17 increases in colonic inflammation significantly more than in control group, however its increase is not correlated to IBD activity.

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Inflammatory bowel disease (IBD) is a disease of activity and remission. Lipocalin 2 (LCN2), the coding gene for NGAL is one of the most over-expressed genes in the colonic mucosa in ulcerative colitis (UC) and crohn’s disease (CD). In our research we investigated the utility of serum level of Lipocalin 2 in assessing the activity of IBD. This was a single center case control study.It was conducted on 60 IBD patients, 50% (30 patients) were in remission and 50% were active.There were 28 healthy control. Patients with IBD either UC or CD were enrolled from IBD clinic Mansoura specialized medical Hospital, Egypt. All patients and control group were subjected to investigations including complete blood count (CBC) ,Erythrocyte Sedimentation Rate (ESR) ,C-reactive protein (CRP) and serum neutrophil gelatinase associated lipocalin (NGAL) by ELISA.Patients only were subjected to fecal calprotectin besides sigmoidoscopy or ileo-colonoscopy.The activity of IBD was assessed for UC by MAYO score and CD by CDAI. NGAL showed significant increase among active IBD patients by mean ± SD ng/ml (37.04 ± 9.63) than patients in remission (20.65 ± 4.35) (table 2) .It showed highly significant correlation with clinical and endoscopic activity of IBD r = 0.80, P < 0.0001(table 3). Serum NGAL can easily discriminate patients with active IBD from healthy controls with AUC 95% C.I = 1.00 (0.94-1.0), at the cutoff 18.52, P < 0.0001, with sensitivity 100% and specificity 100%. While AUC of NGAL which can discriminate patients with active IBD and those in remission at the cutoff 26.95 was 0.97, P < 0.0001, with sensitivity 93.3% and specificity 93.3% (Fig. 1 A,B). In relation to fecal calprotectin, there was highly significant correlation between fecal calprotectin and serum NGAL (r = 0.69, P < 0.0001).Both CRP and ESR were positively correlated to NGAL by r = 0.38 and r = 0.29 (P < 0.05) respectively. Serum NGAL can easily discriminate patients with active IBD from healthy controls as well as among patients in active or remission of IBD. NGAL in comparison to other markers as fecal calprotectin or CRP or ESR shows better statistical performance for activity of IBD. This clarifies its ability to be a highly significant predictor of activity of IBD besides its lower cost.

Background: Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related deaths globally. Long non-coding RNAs (lncRNAs) may be considered as potential markers for HCC. The aim of this study is to evaluate the diagnostic and prognostic value of lncRNA ZFAS1 in HCC patients. Materials and methods:The current study included 100 cirrhotic patients with HCC, in addition to 100 cirrhotic patients without HCC as control group. RNA extraction was performed for quantification of ZFAS1 expression by real-time quantitative polymerase chain reaction. Results: ZFAS1 gene expression was significantly elevated in HCC group of patients compared to non-HCC group. The ability to distinguish HCC from cirrhotic controls by ZFAS1 was determined to be 1.00 (95% CI:1.00-1.00). Comparison between the diagnostic performance of ZFAS1 and AFP in differentiating HCC on top of cirrhosis from cirrhosis without HCC showed that, at cutoff values ≥ -4.65 ZFAS1 gene had 100 % specificity and 99% sensitivity while, AFP at cutoff value ≥ 9.4 ng/ml had 100 % specificity and 76% sensitivity. Comparison of AUC for the two parameters demonstrated a significantly higher AUC for ZFAS1 than for AFP (Difference = 0.168, P <0.001). No statistically significant correlation between ZFAS1gene and any HCC characteristic however, a statistically significant correlation between AFP level and sex , BCLC staging was found. Conclusions: lncRNA ZFAS1 is a good diagnostic marker for HCC in cirrhotic patients with high sensitivity and specificity value, however ZFAS1has no prognostic importance in patients with HCC.s