Background Effects of the cytokine system, in which of tumor necrosis factor alpha (TNF-α) is a part, on serotonin metabolism as well as on the hypothalamic-pituitary-adrenal (HPA)-axis, may induce changes in the structure and function of the brain, possibly leading to the development of depression in SLE patients. For this purpose, we aimed to assess serum TNF-α levels in SLE patients, and to explore its possible relationship with depression among these patients.Methods: 60 SLE adult patients were enrolled in this study and further subdivided into two equal groups (30 with active SLE and 30 with inactive SLE) using SLEDAI score, in addition to 30 age and sex matched healthy controls. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to provide broad coverage of psychiatric diagnoses was done for all subjects, and severity of depression was assessed using Beck depression Inventory. TNF-α levels were measured using ELISA technique. Results: Depression was identified in 63.3% of active SLE group, 40% in the inactive SLE group and 16.7% in the control group with p value <0.001. TNF-α levels were higher significantly in the active group versus inactive group and control p value <0.001.In the multivariate analysis, sera TNF-α levels were independently associated with depressive symptoms odds ratio = 1.004, 95% CI = 1.001 to 1.006, p-value =0.020). Conclusions: Depression was more prevalent among SLE patients with active disease. Serum TNF-α was the only independent predictor of depression in SLE patients.

Probiotics, prebiotics, and synbiotics modify various aspects of local and systemic immune function in multiple experimental models. However, their impact and mechanisms of action are not known across all products or noticed in every population studied, and impacts on in vitro, ex vivo, or other measures of immune function do not necessarily result in an impact on infection and illness in vivo. Studies have discussed that intestinal microbiota has an essential role in enhancing the immune system against viruses. The regulatory impact of the intestinal microbiota on viral infection is connected with local and systemic immune responses and plays a part in congenital and adaptive immune responses. The microbiota composition critically modulates the production of virus-specific CD4 and CD8 T cells and antibody responses following influenza virus infection. The intestinal microbiota has an important role in the stabilizing of immune homeostasis by augmenting the integrity of the barrier functions of the gut mucosa, which is a crucial aspect of systemic immunity. In conclusion, the intestinal microbiota can influence organismal immunity locally and systemically, proximally, and distally. Studying the possible mechanism by which the intestinal microbiota maintains host immunity can provide a clearer understanding of the occurrence and development of diseases.

The SARS-COV-2 rapid spread caused an international public health emergency with unprecedented rates of morbidity and mortality. Post COVID-19 condition occurs as a spectrum of symptoms that present four or more weeks after acute infection with SARS-CoV-2. Most published data to date state 50-70% of hospitalized patients experienced at least one post-acute COVID-19 symptom up to 3 months after discharge. Commonly reported symptoms include; neurocognitive post COVID-19 (fatigue, dizziness, inattention, and brain fog), respiratory post-COVID (dyspnea, chest pain, and cough), and mental health related symptoms (insomnia, depression, and posttraumatic stress disorder). Additionally, gastro-intestinal post COVID-19 (diarrhea, vomiting, and abdominal pain) along with decline in quality of life and decreased ability to perform activities of daily living were reported. The response to post COVID-19 symptoms is still in its infancy despite being an emerging crisis as scientific evidence and robust data are nonetheless required for clear definition, identification of time frame, classification and management of the condition. New studies are needed to identify total and individual incidence/prevalence rates of different clinical presentations of post COVID-19 symptoms. These future studies will help us to o improve early recognition of long term symptoms after acute infection of COVID-19.

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune multisystem disease with an array of variable presentations in which the kidney is the most affected organ and influences the overall outcome of the patients. Methodology: The study is a case control study conducted on 90 SLE patients diagnosed according to ACR criteria grouped into three subgroups. It aims at evaluating the role of serum tumor necrosis factor alpha (TNFα), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in diagnosing renal flares and predicting the prognosis in lupus nephritis patients. Results: A highly significant difference was observed between both the SLE starting dialysis group, the SLE nephritis ( LN ) group, and the control group regarding neutrophil to lymphocyte ratio and TNFα (p<0.001 & ˂0.001, respectively). The median serum Neutrophil/Lymphocyte and TNFα were statistically significantly higher in the SLE starting dialysis patient group than the LN patients and the control group. A cut-off value of ≤ 200 for serum TNFα level and of ≤ 4.8 for Neutrophil/lymphocyte ratio sufficiently differentiated between the LN patients and the SLE patients starting dialysis. TNFα cut-off value showed sensitivity of 76.67%, specificity of 96.67%, positive predictive value of 95.8% and negative predictive value of 80.6 %. Neutrophil/Lymphocyte cut-off showed sensitivity of 70.00%, specificity of 70.00%, positive predictive value of 70.00% and negative predictive value of 70.00 %. Conclusion: NLR and TNFα serum levels appear to be useful biomarkers for disease flares and tissue injury in LN patients. Both can identify disease activities, relapses and remissions in lupus nephritis patients.

Egyptian children have different socio-economic statuses (SES). We examined differences between two groups of children from high (H) and low (L) SES with food allergy (FA). METHODS: We administered a questionnaire to caregivers of children up to 12 years of age with FA from two groups of 25 seen at allergists' private offices (H-SES) and a public hospital (L-SES). RESULTS: L-SES and H-SES had similar male predominance, age of weaning, and having only one FA (68% and 64%) (11 (IQR 7-15) and 12 (IQR 10-12) months) (64% and 92%), respectively, and in the symptom being cutaneous (100% and 84%) and gastrointestinal (52% and 48%), being severe (48% and 44%) and in emergency room care (40% and 28%). There were statistically significant differences in L-SES group being older (134.4 68.64 months) than H-SES (91.44 626.64 months), born vaginally (76% vs 64%) and having milk allergy (60% vs 16%), respectively, and in H-SES group compared to L-SES having egg as the commonest allergen (56% vs 36%), being on dietary elimination (52% vs 12%) and on sublingual immunotherapy (44% vs 36%), in earlier symptom onset, earlier age at diagnosis and higher vs 96 (48-96) months), (36 (IQR 24-48) vs 96 (IQR 48-102) months), (421 (IQR 237-504) vs 214 (IQR 124-319) IU/dl), respectively. No children were prescribed epinephrine auto-injector. CONCLUSIONS: FA presents and is managed differently among Egyptian children based on SES, highlighting disparities and suggesting environmental factors play a role.