Background/Purpose. Chronic periodontitis is an inflammatory disease of gums that causes loss of supporting structures of teeth, that is, gingiva, periodontal ligament, cementum, and alveolar bone. Levels of various cytokines in the serum, gingival tissues, and gingival crevicular fluid in patients with chronic periodontitis have been studied, but limited data are available on the level of cytokines in saliva. Therefore, a study was designed to determine levels of salivary IL-6 and IL-17 in patients with calculus associated chronic periodontitis. Materials and Methods. It was a comparative, cross-sectional study that is comprised of 41 healthy controls and 41 calculus associated chronic periodontitis patients (CP patients). According to the degree of attachment loss, CP patients were subcategorized as mild (CAL 1-2 mm), moderate (CAL 3-4 mm), and severe (CAL > 5 mm) forms of periodontitis. Salivary levels of IL-6 and IL-17 were determined using enzyme-linked immunosorbent assay (ELISA) technique. Data was analyzed using SPSS 20.0. Results. Between healthy controls and CP patients (moderate and severe disease), a statistically significant difference was observed in the concentrations of IL-6 and IL-17. In CP patients, the highest mean ± SD of salivary IL-6 and IL-17 was observed in severe CP, followed by moderate and mild CP. Regarding level of IL-6, a statistically significant difference was observed between mild and severe disease and between moderate and severe subcategories of CP patients. Similarly, statistically significant difference was observed in the level of IL-17 between mild and moderate, mild and severe disease, and moderate and severe disease. Conclusion. The levels of salivary IL-6 and IL-17 were increased significantly in calculus associated CP patients as compared to healthy controls and these levels increased with the progression of CP. Clinical Significance. Salivary levels of IL-6 and IL-17 may help in the subcategorization of CP.

Chronic periodontitis is inflammation of supporting structures of teeth caused by microorganisms, and Porphyromonas gingivalis is one of the most common organisms. Periodontitis has been associated with different systemic diseases and rheumatoid arthritis (RA) is one of them. Periodontitis and RA share several features such as inflammation and bone destruction. Enzyme peptidyl arginine deaminase (PAD) is responsible for citrullination of arginine and citrullinated antigens are generated by posttranslational modification. Anti-cyclic citrullinated peptide antibodies and citrullinated peptides (a-enolase, vimentin, fibrinogen, and Type II collagen) are associated with breakdown of self-tolerance in RA. P. gingivalis is the only periodontopathic organism to produce PAD that is responsible for citrullination of arginine. Therefore, patients of periodontitis should be evaluated for RA.

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Background: Dental caries is characterized by demineralization of inorganic portion of tooth and destruction of organic substances of tooth, which often leads to cavitation. The immune mechanisms play an important role in the pathogenesis of dental caries.This study was designed to determine the levels of salivary IgA, TGF-β and IL-17 in patients with dental caries. Methodology: This was a comparative study of 87 individuals (29 healthy controls and 58 patients with dental caries) recruited from the Punjab Dental Hospital, Lahore. Group I included patients with dental caries up to 5 DMFT score (Decayed Missing Filled Teeth), group II had patients with 6 or more DMFT score and group III consisted of healthy individuals without dental caries. Commercially available ELISA kits were used for the detection of salivary IgA, TGF β and IL-17. Results: Highest mean ± SD level of IL-17(2.99±1.11ng/L)and TGFβ (127.8 ±74.0ng/L) were detected in group III. While highest mean ± SD level of salivary IgA (μg/ mL) was detected in the group I (34.64±6.37μg/mL) Conclusion: Level of salivary IgA was increased in patients of dental caries while levels of IL-17and TGFβ were decreased in patients of dental caries as compared to healthy individuals. Bangladesh Journal of Medical Science Vol.18(3) 2019 p.536-539

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BACKGROUND: Tuberculosis (TB) is an infectious disease that affects millions of people around the world. The innate immune response against TB starts by interaction of several receptors on monocytes with mycobacterium tuberculosis (MTB). CD14 is one of these receptors present on the monocytes which facilitate the entry of MTB into the cell. Certain polymorphisms in CD14 gene, for example, CD14 (−159 C>T) in the promotor region have suggested susceptibility of TB. AIM: This study was designed to determine and compare CD14 (−159 C>T) gene polymorphism and its surface expression in pulmonary TB patients (before and during anti-TB treatment) and healthy controls. MATERIALS AND METHODS: The study population comprised three groups (pulmonary TB patients before treatment, pulmonary TB patients during treatment, and healthy controls) whereas 53 blood samples were collected from each group. The percentage of monocytes and CD14 mean fluorescence intensity (MFI) was measured by flow cytometry whereas polymerase chain reaction-restriction fragment length polymorphism was used to determine gene polymorphism. RESULTS: CD14 MFI was significantly high in healthy controls than in TB patients (432 as compared to 193 and 365, p < 0.0001). There was no significant difference in CD14 single nucleotide polymorphism allele frequencies or genotypes between TB patients and healthy controls. CONCLUSION: CD14 gene (−159 C>T) polymorphism was not associated with pulmonary TB disease in a sample of Pakistani population and surface expression of CD14 receptor on peripheral blood monocytes decreases with active TB disease and during treatment.

Introduction: Autoimmune phenomenon is attributed to a number of diseases which were once considered idiopathic. In humans, production of auto antibodies (a-Abs) against self-antigens is quite frequent but earlier their presence was associated with autoimmune diseases, however a-Abs have been documented in non-autoimmune disorders i.e. complicated pregnancy, cancer, stroke etc. In Pakistan, limited data is available on frequency of a-Abs, therefore this study was designed to determine serum level of antinuclear antibody (ANA), Rheumatoid factor (RF) and anti dsDNA antibodies in apparently healthy population. Materials and methods: After written informed consent, blood sample of 256 subjects was obtained by random sampling. Participants of established autoimmune diseases were excluded. Enzyme linked immunosorbent assay (ELISA) was used to determine ANA, RF and anti-dsDNA antibody. Categorical variables were compared by using χ 2 test. A p value <0.05 was considered statistically significant. Results: Rheumatoid factor was the most frequent a-Ab (18%), followed by anti dsDNA (7.4%), while ANA was the lowest (0.4%) antibody detected. Only RF had a statistically significant association with gender (p=0.047). No association of these antibodies with age was detected. Conclusion: Rheumatoid factor auto antibody was more prevalent as compared to ANA and dsDNA antibody in healthy adults.

Laboratory diagnostic capacity is crucial for an optimal national response to a public health emergency such as the COVID-19 pandemic. Preventing laboratory-acquired infections and the loss of critical human resources, especially during a public health emergency, requires laboratories to have a good biorisk management system in place. In this study, we aimed to evaluate laboratory biosafety and biosecurity in Pakistan during the COVID-19 pandemic. In this cross-sectional study, a self-rated anonymous questionnaire was distributed to laboratory professionals (LPs) working in clinical diagnostic laboratories, including laboratories performing polymerase chain reaction (PCR)-based COVID-19 diagnostic testing in Punjab, Sindh, Khyber Pakhtunkhwa, and Gilgit-Baltistan provinces as well as Islamabad during March 2020 to April 2020. The questionnaire assessed knowledge and perceptions of LPs, resource availability, and commitment by top management in these laboratories. In total, 58.6% of LPs performing COVID-19 testing reported that their laboratory did not conduct a biorisk assessment before starting COVID-19 testing in their facility. Only 31% of LPs were aware that COVID-19 testing could be performed at a biosafety level 2 laboratory, as per the World Health Organization interim biosafety guidelines. A sufficiently high percentage of LPs did not feel confident in their ability to handle COVID-19 samples (32.8%), spills (43.1%), or other accidents (32.8%). These findings demonstrate the need for effective biosafety program implementation, proper training, and establishing competency assessment methods. These findings also suggested that identifying and addressing gaps in existing biorisk management systems through sustainable interventions and preparing LPs for surge capacity is crucial to better address public health emergencies.