Celiac disease is an enteropathy induced by ingestion of gluten triggering an immune response in genetically predisposed individuals. MiRNAs are small non-coding RNAs that have a role as regulators of gene expression at the post transcriptional level. The aim of this study is to evaluate the possibility of using circulating miRNAs as non-invasive biomarkers in pediatric patients with celiac disease. In addition, we examine the effect of a gluten-free diet on the expression of these miRNAs in serum of CD patients. The expression pattern of miR-21 and miR-31 was estimated in serum of 25 untreated CD patients (recently diagnosed), 25 treated CD patients (on gluten-free diet) and 20 healthy controls using qRT-PCR. Our results demonstrated the significant up-regulation of microRNA-21 in the untreated celiac patients in comparison with the treated group and healthy controls. Moreover, miR-31 expression was significantly under-expressed in the untreated celiac patients in comparison with the treated group and healthy controls. Furthermore, the results showed that miR-21 expression level was significantly positively correlated with the tTG IgA auto-antibodies. In conclusion, circulating miRNA-21 and miRNA-31 could serve as potential non-invasive biomarkers for pediatric CD patients. their implication in the dysfunction of intestinal barrier and their association with certain clinical manifestation (9). MiRNAs are small endogenous single-stranded non-coding RNAs that regulate gene expression through the control of stability and translation of the mRNA (10,11). MiRNAs have been associated with various pathological conditions of the immune system (12). Many studies have reported the aberrant expression of miRNAs in intestinal biopsies of celiac patients, while the role of circulating miRNAs and their expression levels are still undefined compared to that of tissue miRNAs (4). Capuano et al. (2011) evaluated the miRNA expression pattern in the small intestine of children with active CD, children with CD on GFD and control children without CD. Their results showed the overexpression of miR-449a and the decrease of miR-124a expression in CD patients and GFD treated CD patients than in controls (13).

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by familial aggregation and genetic predisposition. MicroRNAs (MiRNAs) serve as critical biomarkers in lupus patients because of their aberrant expression in different SLE stages. The study aimed to investigate the correlation of miR-31 and miR-21 with IL-2 in SLE patients as regulatory biomarkers in the activation of T lymphocytes of Egyptian lupus patients. Quantitative RT-PCR is carried out to estimate the expressions of miR-31 and miR-21, and IL-2 levels were determined using ELISA in plasma of 40 patients with SLE, 20 of their first-degree relatives and 20 healthy controls. The study also determined the systemic lupus erythematosus disease activity index (SLEDAI) score and proteinuria in SLE patients. The results revealed that miR-31 was lower expressed, while miR-21 was high expressed in SLE patients compared to their first-degree relatives and controls. MiR-31 was negatively correlated with SLEDAI and proteinuria in lupus patients, while miR-21 showed positive correlation with them. Also we found that there is a significant positive correlation between miR-31 and IL-2 in SLE patients, while miR-21 was negatively correlated with IL-2 level in patients. In conclusion, the study disclosed a significant association between miR-31 and miR-21 expression with IL-2 level in SLE patients. The regulatory biomarkers of miR-31 and miR-21 might have an impact on regulating IL-2 pathway expression and in turn on the activation of T lymphocytes in SLE.

Objectives:To evaluate the performance of GeneXpert MTB/RIF assay for direct diagnosis of pulmonary tuberculosis (PTB).Methods:This is a cross-sectional study conducted between October 2013 and February 2016 at Abbassaia Chest Hospital and Ain Shams University Hospital, Cairo, Egypt. Inclusion criteria were adults between 18 and 60 years with suspected PTB and classified into 5 clinical categories based on their clinical, radiological, and laboratory findings: confirmed TB, probable TB, possible TB, unlikely TB, and not TB. Two sputum samples from each participant were analyzed by GX and the results were compared by conventional culture.Results:In total, 218 participants were enrolled: 71 had confirmed TB; 112, highly probable TB; 20, probable TB; 10, unlikely TB; and 5, no TB. The sensitivity and specificity of the GX assay were 93% and 98.3% respectively. GeneXpert was positive in 93% of confirmed TB and 2.2% of probable TB cases.Conclusions:GeneXpert is a rapid and promising technique with good sensitivity (93%) and specificity (98.3%), but it cannot be used as a standalone PTB diagnostic tool. There is a need for more GX evaluation studies in countries with low TB incidence.

Objectives: T regulatory cells (Treg) and proinflammatory T H 17 cells are newly identified T lymphocyte subsets, which have significant effects on autoimmunity and inflammation. Tregs play key role in the maintenance of selftolerance. T H 17/Treg disturbed balance has been reported to contribute to several autoimmune diseases. Our aim was to assess the Treg/T H 17 pattern and T H 17 related cytokines, in peripheral blood of Egyptian rheumatoid arthritis patients, and their relation to disease activity score (DAS). Analyzing IL17A and IL23 as indicators of T H 17 function, was to study the effect of T H 17 in RA. Methods: 100 Egyptian rheumatoid arthritis patients, divided into Group I (14), Group II (48), Group III (38), with low <3.2, moderate 3.2 to <5.1 and high >5.1, activity DAS score respectively; and 50 healthy age and sex matched controls were enrolled. Peripheral blood T H 17 and Treg (CD4 + CD25 + Foxp3 +) frequencies were analyzed by flowcytometry, and the serum levels of interleukins (IL17A), (IL23) were determined by ELISA. Results: Active RA patients (groups II and III) revealed an obvious increase in peripheral T H 17 frequencies, and levels of T H 17-related cytokines, and a significant decrease in Treg (CD4 + CD25 + Foxp3 +) frequencies in group III, when compared to healthy controls. T H 17/Treg ratios were positively correlated with serum concentrations of IL17A and IL23 cytokines. Frequencies and levels showed statistical significant correlation with DAS scoring. Conclusions: Our study indicated that T H 17/Treg balance was disturbed in peripheral blood of RA patients, leading to an increase of proinflammatory cytokines, correlating with DAS, and suggesting an important role in the development of RA.

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