Objective: Bacillus Calmette-Guérin (BCG) has been shown to be an effective treatment for superficial transitional cell carcinoma (TCC) of the bladder, but the precise mechanism of action of BCG remains poorly understood. Fibronectin (FN) has been found to play a role in BCG therapy. Although adjuvant BCG has been shown to improve the clinical outcome of superficial bladder cancer (SBC), a significant proportion of patients fail to respond to it. Identification of the subset of patients that are going to develop recurrent disease or stage progression after BCG therapy is very important. Telomerase activity represents a potential tool for tumor detection. The aim of the present study was to give an insight into the diagnostic and prognostic values of the quantitative urinary estimation of both fibronectin (FN) and the catalytic subunit of the complex human telomerase reverse transcriptase [hTERT]) as non invasive tumor markers for early detection of patients with high risk superficial transitional cell carcinoma (TCC) and after trans-urethral resection of bladder tumors (TURBT) that received adjuvant BCG immunotherapy to explore its association with recurrence-free-survival (RFS) or development of invasive disease. Materials and methods:The study was carried out on 10 healthy individuals as a control group (group I) and 20 Egyptian patients with histologically confirmed superficial bladder cancer (group II). Patients were underwent formal TURBT. Morning urine samples were collected from every patient, 1 day before and 2days, two weeks, six weeks, three months, six months and one year after TURBT. Also, morning urine samples were collected from the healthy individuals. Urine samples were used for cytological examination, estimation of fibronectin level using ELISA technique and for the quantitative analysis of hTERT using quantitative real time RT-PCR technique. Results: The results showed that urinary fibronectin level and normalized hTERT-mRNA were significantly higher in SBC patients before TURBT (group II) versus control group (P<0.001). hTERT-mRNA and urinary fibronectin levels were significantly different in group II before and 2 days after TURBT. Urinary fibronectin and normalized hTERT-mRNA were significantly lower 2 weeks and 6 weeks after TURBT than patients group 2 days after TURBT. Both markers were significantly lower in fifteen patients 3 months, 6 months and one year after TURBT when compared with their levels 2 days after TURBT. There was insignificant difference of both markers between the control group and fifteen patient one year Bull. Egypt. Soc. Physiol. Sci. 30 (1) 2010 Abdel Aleem et al. 74after TURBT. The remaining five patients suffered recurrence of tumor. This approach enabled us to identify cutoff values of urinary fibronectin which characterized by 90% sensitivity and 100% specificity and 93.3% accuracy, and that for urinary normalized hTERT with 85% sensitivity and 80% specificity and 83.3% accuracy. Conclusion: On the basis of these results, it could be concluded that both urinary ...

Background: Leprosy is a chronic granulomatous infectious disease caused by the bacterium Mycobacterium leprae. Leprosy "Type 1" reactions (T1R), reversal reactions, occur in 30-40% of borderline patients with cellular immune responses to M. leprae. "Type 2" reactions (T2R), also known as erythema nodosum leprosum (ENL), occur only in lepromatous (LL) and borderline lepromatous (BL) patients with a high bacterial load and little or no cellular immunity to M. leprae. Corticosteroids alleviate symptoms in T1R and T2R, but many patients have multiple, recurrent episodes. The Objective of the present study is to verify the validity of measuring chitotriosidase activity and neopterin level, products of activated macrophages, adenosine deaminase activity and monocyte chemoattractant protein-1 (MCP-1) as markers of leprosy and to detect their values in diagnosis of different types of leprosy. Methods: This study was conducted on 15 healthy subjects and 75 leprotic patients that were classified into 5 groups [tuberculoid leprosy (TT), borderline tuberculoid (BT), borderline borderline (BB), borderline lepromatous (BL), and lepromatous leprosy (LL)], each group formed of 15 patients, depending on clinical, bacteriological and histopathological pattern. Patients were further grouped with a BI≥2 as multibacillary (MB, n=45), whereas those with BI<2 were grouped as paucibacillary (PB, n=30). Thirty-four of the aforementioned patients were diagnosed with reactions of which 17 had type II/erythema nodosum leprosum (ENL) and 17 had type I/reversal reaction (RR). Reactions were treated using prednisolone for 12 weeks. Venous blood sample was collected from each subject and processed for estimation of the activity of chitotriosidase and adenosine deaminase, neopterin and MCP-1 levels. Results: both chitotriosidase activity and neopterin level were elevated in leprosy patients with significant elevation in MB than PB leprosy with significant lowering in the patients with reactional leprosy after prednisolone therapy. Adenosine deaminase activity was significantly elevated in TT, PB and reactional leprosy. MCP-1 was significantly elevated in LL, MB and ENL. Conclusion: chitotriosidase and neopterin could be considered as promising markers for differentiation of MB from PB patients and useful for determining the response of reactional leprosy to therapy. Adenosine deaminase could be useful in distinguishing TT, PB and reactional leprosy. MCP-1 could be considered a fair marker in LL, MB and ENL. In addition, these findings may provide new clues to the pathogenesis of leprosy reactions.