To examine the possible relationship between anti-centromere antibodies (ACA) and pediatric rheumatologic diseases, we investigated the presence of ACA (using enzyme immunoassay) in the sera of 45 children and adolescents with such diseases and compared the results with a group of 42 age- and gender-matched healthy subjects. ACA were present ( > or =10 U/ml) in three out of five patients (60%) with scleroderma (SCD), in seven out of 16 (43.8%) patients with systemic lupus erythematosus (SLE), in two out of five patients (40%) with mixed connective tissue disease (MCTD), in one out of four patients (25%) with dermatomyositis (DMS), and in two out of 14 patients (14.3%) with juvenile rheumatoid arthritis (JRA). ACA were also detected in a single patient with anti-phospholipid syndrome (APL) who had digital gangrene and hemiparesis, as well as in two healthy subjects. ACA positivity was related to the presence of Raynaud's phenomenon in the studied sample, as 86% of patients suffering from the phenomenon were ACA positive. ACA positivity was associated with older age, high blood pressure and high erythrocyte sedimentation rate (ESR) values, and lower hemoglobin and weight and height percentile values. It was also higher among anti-nuclear antibody-positive subjects. Raynaud's phenomenon and ACA positivity shared almost the same clinical and laboratory associations in the studied patients. Thus, ACA are probably among the markers of Raynaud's phenomenon in pediatric rheumatologic diseases. Their value as predictors of future development of the phenomenon needs further evaluation.

Background:The pulmonary component of chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.Hypothesis:The levels of the proinflammatory cytokines, interleukin 1 beta (IL-1β), tumor necrosis factor alfa (TNF-α), and C-reactive protein (CRP), in elderly patients suffering from COPD are increased.Settings and Design:A case control study involving 90 elderly participants from the outpatient clinics of Ain Shams University hospitals.Materials and Methods:The 90 subjects were subdivided into three equal groups ’ group I (control), group II (patients with COPD), and group III (patients with COPD and cardiovascular complications). Comprehensive clinical assessment, pulmonary functions, and echocardiography were performed. The levels of IL-1β, TNF-α, and CRP were measured in the patients’ serum and compared.Statistical analysis:SPSS (Statistical Package for Social Science) version 10.Results:IL1-βand CRP were significantly higher in the third group than the first group (P <0.05). There was a similar significant difference between the second and third group as regards IL1-βand CRP (P < 0.05). Positive significant correlation between CRP and TNF-α with stage of COPD according to FEV1 (P <0.05) were found.Conclusions:Complicated cases of COPD had higher levels of IL1-β and CRP and the more severe the cases, the higher the levels of CRPand TNF-α.

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The antiperinuclear factor (APF) was estimated by immunofluorescent microscopy in the sera of 32 children and adolescents with juvenile rheumatoid arthritis (JRA) in comparison to a group of 16 children and adolescents with other rheumatologic disorders and a group of 20 age-matched healthy subjects. The APF was detected in 17 children with JRA (53%), in only one patient in the group of other rheumatologic disorders (6%), and in 2 healthy children (10%). Accordingly, APF had a sensitivity of 53%, a specificity of 92%, and a diagnostic efficiency of 74% in our series. APF was found to have a higher diagnostic gain in rheumatoid factor (RF) seronegative cases than did the RF in APF negative cases, meaning a higher sensitivity of APF as compared to the RF. The APF seropositivity was neither altered by the use of corticosteroids nor influenced by the age, gender, duration of illness, or number of joints affected. Three out of 5 patients with JRA had the APF detected in their synovial fluid; they were running rather a severe course of illness. The use of the APF could be an aid in the diagnosis of JRA.

Background: Various populations of regulatory T cells play a central role in the development of peripheral tolerance to allergens. Culturing of CD4 + T cells isolated from peripheral blood of allergic patients with vitamin D induces the generation of stable IL-10 producing CD4 + CD25 + Treg cells suppressing the proliferation of T helper cells obtained from the same patients. The immune regulatory role of vitamin D in allergic patients has been controversial and obviously needs a more clarifying research work. Aim of the work: to determine the percentage of induced T regulatory cells producing interleukin 10 after stimulation of T regulatory cells with cow milk allergen in the presence of vitamin D in culture. This aims to further in-vitro study the immune regulatory role of vitamin D in cow milk allergic patients. Results: there is association between decreased level of vitamin D and milk-allergy, as serum level of 25(OH) D3 was insufficient in 16 (80 %) patients (10-29.9 ng/ml) while 4 (20%) patients were sufficient (30-100 ng/ml). Addition of vitamin D, in culture, induces the production of CD4 + CD25 hi Foxp3 + IL10 +. Treg cells within peripheral blood mononuclear cells (PMNCs) isolated from allergic children who had insufficient vitamin D, but not in allergic children who had normal level of vitamin D. Conclusion: this work provides further evidence for an important role of 1,25(OH)2D3 as an immune-modulatory molecule and suggests that supplementation of vitamin-D-deficient individuals, who are reported to have reduced numbers of circulating and Foxp3 + IL10 + Treg cells, may represent an attractive therapy for enhancing endogenous populations of Treg cells in allergy.