The Role of Th17 cells in the pathogenesis of asthma and immunotherapy is being a new concept and paradigm. Immunotherapy on asthma requires long periods of time, so administration of an adjuvant had been considered to improve its efficacy. The aims of this study was to evaluate the therapeutic efficacy of immunotherapy combined with probiotics and Nigella sativa in the number of Th17 cells and the improvement of clinical symptoms of asthma. A total of 31 children with mild asthma were evaluated and then randomized to receive immunotherapy or immunotherapy plus Nigella sativa or immunotherapy plus probiotic or immunotherapy plus Nigella sativa plus probiotic openly for 14 weeks. Statistical analysis found no significant difference in the mean number of Th17 cells pre and post test in all four treatment groups, however we found a significant differences asthma control test (ACT) score before and after the immunotherapy + Nigella sativa treatment (p = 0.001), before and after immunotherapy + probiotic treatment (p = 0.004), as well as before and after immunotherapy plus Nigella sativa plus probiotic treatment (p = 0.000). Correlation test found a significant association between the number of Th17 cells and ACT score in all groups. The combination immunotherapy with Nigella sativa and probiotics did not reduce the number of peripheral blood Th17 cells mild asthmatic children, but can improve the clinical symptom.
Chronic kidney disease (CKD) is a serious health problem in children, with increasing morbidity and mortality rates throughout the world. Children with CKD tend to experience magnesium (Mg) defi ciency that can stimulate an infl ammatory response in the body. One of the infl ammatory responses is an increase of Interleukin-6 (IL-6). Study to analyze the correlation between Mg and IL-6 in pre-dialysis CKD children. The methods a cross sectional study was conducted in Dr Soetomo General Academic Hospital from November 2018 to April 2019. Children with pre-dialyis CKD were included in this study. Variables of serum Mg level (mg/dL) and infl ammatory marker (IL-6) were measured from the blood and analyzed by ELISA method. The correlation between Mg and IL-6 was analyzed with Spearman’s correlation test with p <0.05. Result a total of 47 children (27 boys vs 20 girls) between 3 months to 18 years old, with pre-dialysis CKD and no history of magnesium supplementation were included. The primary disease that causes of CKD were lupus nephritis (38.3%), nephrotic syndrome (23.4%), urologic disorder (23.4%), tubulopathy (10.6%) and others (4.3%). The average IL-6 level was 55.42±43.04 pg/dL and Mg level was 2.06±1.54 mg/dL. There were no signifi cant correlation between IL-6 level and Mg level with staging of CKD and duration of illness (p>0.05), but there was a signifi cant correlation between serum Mg level and IL-6 level (r=-0.748; p<0.001). Magnesium levels have a signifi cant inverse correlation with IL-6 levels in pre-dialysis CKD children. The lower the Mg levels in the blood, the higher IL-6 levels and vice versa.
Introduction: Anemia is a frequent complication of chronic kidney disease (CKD) in children and it causes an increase in morbidity, mortality and accelerates the rate of progression of CKD. Inflammation and impaired kidney clearance increase plasma hepcidin, inhibiting duodenal iron absorption and sequestering iron in macrophages. However, the role of hepcidin in increasing the risk of anemia in children with CKD is still uncertain. This study aimed to investigate the association between hepcidin levels and anemia in children with pre-dialysis CKD. Methods: A cross-sectional study was conducted at Dr. Soetomo Academic Hospital from December 2018 to February 2019. Children with pre-dialysis CKD were enrolled in this study. The subject had no history of erythropoietin administration and blood transfusion 3 months before the blood sample were withdrawn. A complete blood count, ferritin serum, transferrin saturation (TSAT) and hepcidin serum were performed. The correlations between Hepcidin and ferritin level, between ferritin level and anemia, and between TSAT and anemia were analyzed using Spearman correlation and the Mann-Whitney test.
Results: A total of 47 children, 27 boys and 20 girls, ranged in age from 3 months to 18 years old. There was a significant correlation between hepcidin and ferritin levels (p=0.006) and the value of the Spearman correlation was r=0.392. While the correlation between ferritin level and anemia showed a significant result, p=0.001. However, TSAT did not show any significant correlation with anemia (p=0.230).
Conclusion: There was an indirect association between hepcidin level and anemia by increasing ferritin level that induces anemia in pre-dialysis CKD children.
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