Diabetic retinopathy (DR) is a typical microvascular complication of diabetes mellitus (DM) and it remains one of the leading causes of vision loss worldwide. Studies postulated that a distinct metabolic signature of DR exists and can be resolved from that of diabetes alone. Serum Semaphorin3A (Sema3A) levels have also been found to be correlated with the phenotypes of diabetic retinopathy. We aimed to analyze and identify serum metabolites and serum Sema3A levels that could be useful biomarkers of DR progression. This cross-sectional study included 45 type 2 diabetes (T2D) patients. Diabetic patients were divided into three groups based on the status of their complications: non-DR (NDR, n=15), non-proliferative DR (NPDR, n=15), and proliferative DR (PDR, n=15) groups. Serum metabolomic profiles of these patients were determined by using high-performance liquid chromatography-mass spectrometry (HPLC-MS), and serum Sema3A levels measured by ELISA. Metabolomics analysis revealed a set of metabolites that were altered in the serum of PDR patients as compared with NPDR and NDR groups. Among these metabolites total asymmetric dimethylarginine (ADMA) and Kynurenine were potential predictors of PDR patients. Significantly higher serum levels of Sema3A in PDR patients as compared with NPDR and NDR groups (p<0.001), their serum levels were positively correlated with the central macular thickness (r= 0.952, p<0.001) and negatively correlated with the superficial macular density (r=-0.952, p<0.001). In conclusion, the metabolite signatures identified in this study and serum Sema3A levels could be proposed as biomarkers for DR development and progression in T2D patients. However, Sema3A was superior to metabolomics in the prediction of the severity of DR.

Preeclampsia (PE) is a pregnancy disorder characterized by hypertension and end-organ damage. Reliable biochemical markers for diagnosis and prediction of PE severity can improve maternal health, and several of these markers have been suggested till now. The goal of our study was to evaluate maternal serum levels of Perlecan and Ischemia modified albumin (IMA) in PE patients, and to investigate their relationship with the severity. This study included 45 pregnant women, who were divided into three groups: mild PE (n=15), severe PE (n=10), and normal pregnant females (n=20) as a control group. Maternal serum levels of Perlecan and IMA were determined by the enzyme linked immunosorbent assay (ELISA). Preeclamptic women with severe features have significantly higher serum Perlecan and IMA levels than women with mild PE and control (P<0.001 for both). Serum levels of Perlecan and IMA were significantly increased in patients with mild PE as compared with control (P<0.001 for both). Serum Perlecan levels were positively correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), ALT, AST, creatinine, urea, uric acid, and proteinuria, but negatively correlated with platelet count and fetal birth weight. Serum IMA level was positively correlated with SBP, DBP, but negatively correlated with Albumin, and fetal birth weight. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of Perlecan and IMA in the prediction of PE severity. Serum Perlecan had greater sensitivity and lower specificity for severe PE than for mild PE. Serum IMA had greater sensitivity and lower specificity for severe PE than for mild PE. In conclusion, maternal serum Perlecan and IMA levels were biomarkers for monitoring PE and the increase in serum Perlecan levels was in accordance with the severity of PE. Also, Perlecan was superior to IMA as a predictor for PE severity.

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Background: Neonatal sepsis (NS) is one of the leading causes of morbidity and mortality both among term and pre term infants. Early diagnosis of NS is difficult because of non specific signs and symptoms and non infectious disease may mimic NS. Rapid diagnosis of bacterial infections is crucial for early initiation of adequate antibiotic treatment. Systemic inflammation and sepsis lead to an increased release of Pro-Adrenomedullin (pro-ADM) into circulation thus it could be helpful in the early diagnosis of sepsis and in monitoring such conditions. Objective: To determine serum levels of pro-ADM in newborns with sepsis and its relation to diagnosis and prognosis.Methodology: Our study included fifty neonates fulfilled the criteria of sepsis (group1), they were subclassified into 2 subgroups; 29 cases with proven sepsis who had positive blood cultures (group1a) and 21 cases with clinical sepsis who had negative blood cultures (group1b), forty healthy gestational age, birth weight and sex matched neonates served as a control (group 2). Serum levels of Pro-ADM were measured by ELISA in all neonates and blood cultures were done in septic ones. Results: Serum level of Pro-ADM was significantly higher in group1as compared with group 2 (P=0.000) and in group1a as compared with group1b (P < 0.001). There was highly significant increase in serum level of pro-ADM with increased severity of NS (P = 0.000) and in non-survived neonates compared to those who survived (P = 0.000). Serum levels of Pro-ADM were positively correlated with WBCs count, I/T ratio (immature-to-total neutrophil ratio) and CRP serum level (r = 0.361, P = 0.010, r = 0.320, P = 0.024, r = 0.343, P = 0.015) respectively. Conclusions: Pro-ADM can be considered as valuable biomarker for diagnosis and prognosis of NS.