For the past three decades, a large number of genetic studies have been performed to examine genetic variants associated with asthma and its subtypes in hopes of gaining better understanding of the mechanisms underlying disease pathology and to identify genetic biomarkers predictive of disease outcomes. Various methods have been used to achieve these objectives, including linkage analysis, candidate gene polymorphism analysis, and genome-wide association studies (GWAS); however, the degree to which genetic variants contribute to asthma pathogenesis has proven to be much less significant than originally expected. Subsequent application of GWAS to well-defined phenotypes, such as occupational asthma and non-steroidal anti-inflammatory drugexacerbated respiratory diseases, has overcome some of these limitations, although with only partial success. Recently, a combinatorial analysis of single nucleotide polymorphisms (SNPs) identified by GWAS has been used to develop sets of genetic markers able to more accurately stratify asthma subtypes. In this review, we discuss the implications of the identified SNPs in diagnosis of asthma and its subtypes and the progress being made in combinatorial analysis of genetic variants.
Anti-Inflammatory Agents, Non-Steroidal ; Aspirin ; Asthma* ; Asthma, Occupational ; Biomarkers ; Diagnosis* ; Genetic Association Studies ; Genetic Markers ; Genetic Techniques ; Genome-Wide Association Study ; Hope ; Pathology ; Phenotype ; Polymorphism, Single Nucleotide*

BACKGROUND: Total sialic acid determination has been show as an inflammatory marker for type 2 diabetes. No Local study has been done characterize the levels of TSA in gestational diabetes.

OBJECTIVES: To determine inflammatory markers predictive of gestational diabetes; to be able to describe the clinical profile of subjects enrolled in this study and determine the odds ratio for each inflammatory marker

STUDY DESIGN AND METHODOLOGY: Sixty two pregnant patients in their first trimester were included in this study. Inflammatory markers wre measured at 12 weeks and repeated at 24-28 weeks AOG together with screening glucose tets include random sugar at 12 weeks and 75-gram oral glucose tolerance test at 24-28 weeks. Factors independently associated with impaired glucose tolerance (IGT) and gestational diabetes mellitus(GDM) were determined using logistic regression stepwise model technique.

RESULTS: Of the 62 pregnant patients in their first trimester enrolled in study, five were diagnosed to have GDM based on the American Diabetes Association criteria(ADA), four with IGT and 53 with normal glucose tolerance. At 12 weeks gestation, total sialic acid (TSA) was higher among those with IGT and GDM compared to those with normal glucose tolerance (NGT) (mean=241.5 vs 175 vs 161. p=.030). However it was higher in GDM than those with IGT and NGT at 24-28 weeks (mean= 244.8 vs 229.7 vs 177, p = .025). Deranged total sialic acid performed at 24-28 weeks showed a trend for association with gestational diabetes (RR = 3.6, 95% CI 0-4.53, p=0.96). Other factors correlated, include a higher mean age (>26) and a family history of diabetes mellitus . Factors associated with impaired glucose tolerance, include a deranged TSA at 12 weeks, deranged CRP at 24-28 weeks , a deranged ESR both at 12 and 24-28 weeks gestation and a family history of diabetes mellitus.

CONCLUSION: Deranged levels of TSA at 24-28 weeks AOG seem to be associated wuth gestational diabetes. TSA determination at this gestational age can be utilized to screen gesttional diabetes.

Corticosteroids are considered to be one of the most effective medicine for asthma by suppressing airway inflammation. This study was carried out to investigate the effects of prednisolone in the sputum of exacerbated asthmatics. Clinical severity, cell differentials, levels of interleukin (IL)-5, eosinophil cationic protein (ECP), EG2+ eosinophils, and nitric oxide (NO) metabolites were measured. Sputum was examined 2 weeks apart in 13 exacerbated asthmatics before and after prednisolone treatment, and once in 12 stable asthmatics. We used a sandwich ELISA for IL-5, fluoroimmunoassay for ECP, immunohistochemical staining for EG2+ eosinophils, a NO metabolites assay using modified Griess reaction. Exacerbated asthmatics, in comparison with stable asthmatics, had significantly higher proportion of eosinophils, higher level of ECP, higher percentage of EG2+ eosinophils, and NO metabolites. Exacerbated asthmatics after treatment with prednisolone had reduced the proportions of eosinophils, reduced level of IL-5, ECP and percentage of EG2+ eosinophils. FEV1 was correlated with the proportion of eosinophils, ECP, and IL-5 respectively. These findings suggest that prednisolone is considered to be effective medicine for asthma by suppressing eosinophil activation through IL-5.
Administration, Oral ; Adolescence ; Adrenal Cortex/metabolism ; Adult ; Aged ; Anti-Inflammatory Agents, Steroidal/administration & dosage* ; Asthma/metabolism ; Asthma/immunology* ; Asthma/drug therapy* ; Biological Markers ; Blood Proteins/metabolism* ; Eosinophils/metabolism ; Eosinophils/immunology ; Eosinophils/drug effects* ; Female ; Human ; Interleukin-5/metabolism* ; Leukocyte Count ; Male ; Middle Age ; Nitric Oxide/metabolism ; Prednisolone/administration & dosage* ; Sputum/immunology ; Sputum/cytology

BACKGROUND: Procalcitonin (PCT) is a propeptide of calcitonin which is found in elevated concentration in the serum during systemic bacterial, fungal or protozoal infection. To evaluate clinical value of PCT for early differential diagnosis of causes in febrile patients, its levels were serially measured and compared with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). METHODS: Thirty-six patients meeting criteria for the systemic inflammatory response syndrome with fever were allocated into four groups. Sera were collected to measure PCT (immunoluminometric assay), ESR (Westergren method) and CRP (nephelometry) at the onset of fever and twice thereafter at 48 hours intervals. Group I included nineteen patients with bacterial infection who were diagnosed as acute pyelonephritis (n=7), sepsis (n=6), pneumonia (n=2), soft tissue infection (n=3) and infective endocarditis (n=1). Group II included patients diagnosed as viral meningitis (n=2), chickenpox (n=1), cryptococcal meningitis (n=1), and tuberculosis (n=4). Group III included four patients with malaria. Group IV included non-infectious febrile patients diagnosed as adult onset Still's disease (n=2), Kikuchi's disease (n=2) and drug fever (n=1). RESULTS: Patients in group I (median 1.34 ng/mL) and III (2.41 ng/mL) had markedly elevated serum PCT concentrations at the onset of fever, whereas patients in group II (0.20 ng/mL) and IV (0.11 ng/mL) had normal range PCT levels at the onset of fever (P<0.01). All the groups had elevated ESR and CRP levels at the onset of fever. After 48 hours and 96 hours, in patients group I and III, elevated PCT levels were declined with time course (P<0.05). But all the measured ESR and CRP levels had not changed significantly (ESR; P=0.89, CRP; P=0.23). CONCLUSION: Procalcitonin is a more useful serum marker than ESR and CRP for initial differential diagnosis of febrile systemic inflammatory response syndrome. It also provide patient's information earlier than ESR and CRP in febrile patients with bacterial infection and malaria.
Bacterial Infections ; Biological Markers ; Blood Sedimentation* ; C-Reactive Protein* ; Calcitonin ; Chickenpox ; Diagnosis, Differential ; Endocarditis ; Erythrocytes* ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Malaria ; Meningitis, Cryptococcal ; Meningitis, Viral ; Pneumonia ; Pyelonephritis ; Reference Values ; Sepsis ; Soft Tissue Infections ; Still's Disease, Adult-Onset ; Systemic Inflammatory Response Syndrome ; Tuberculosis