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DETERMINATION SOME OF COMPLEMENT COMPONENTS IN INFERTILITY WOMEN WITH ANTISPERM ANTIBODIES
تحديد مستوى بعض مكونات المتمم في النساء اللواتي يعانين من العقم

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Abstract

Background: Classical activation of complement by antigen and antibody complex leads to formation of membrane attack complex (MAC) that leads to formation holes on the spermatozoa ending in their destruction. Objective: To determine the complements levels and antisperm antibodies in the sera of infertile women of unknown etiology.Patients and methods: Study group consisted of 45 infertile women consulting Kammal El-Sammarei Hospital for Infertility and In Vitro Fertilization from Jun -2008 to June-2009. Twenty-four (53.3%) patients had primary infertility and the rest had secondary infertility. Control group: consisted of thirty fertile women. Blood samples were collected from them and anti sperm antibodies in the serum were detected by indirect immunofluorescence test (EURO IMMUNE –GERMENY). In addition to that serum were tested for complement levels (C3 and C4) using single radial immune diffusions test (BINDARID) KIT BIRMINGHAM .UK.Results: Detections of antisperm antibodies in the serum of infertile women were (64.4%) which is significantly (p<0.05) higher from control group using indirect immunofluorescence test. There was a significant (p=0.000) difference in the complements levels among infertile women who had ASA positive and ASA negative and control group.Conclusions: These higher levels of complement components may be due to activation of classical pathway by ASA that directed against sperm antigens ending in defect in function and motility of the sperms.Key words: Infertility, antisperm antibody, complement.

خلفية الدراسة: المتمم هو عبارة عن سلسلة من الانزيمات البروتينية, الذى يشكل الجزء الاساسي للجهاز المناعي. تحفيز هذا الجهاز يؤدي في النهاية الى تكوين ثقوب على جدار الخلية.هدف الدراسة: تحديد مستوى المتمم في مصل النساء اللواتي يعانين من العقم مع تواجد الاجسام المناعية الذاتية للحيامن .طريقة العمل: تتالف الدراسة من 45 مريضة يعانين من العقم ويراجعن مستشفى كمال السامرائى للعقم للفترة من حزيران-2008 الى حزيران 2009 ومجموعة اخرى تتألف من 30 امرأة من النساء الطبيعيات القادرات على الانجاب بصورة طبيعية. تم سحب الدم من هاتين الفئتين وتم تحديد مستوى المتمم C3,C4 وكذلك تحديد الاجسام المناعية الذاتية الموجهة ضد الحيامن.النتائـج: كان هناك فرق مهم احصائيا بين تلك الفئتين بالنسبة للاجسام المناعية الذاتية للحيامن والمتمم C3,C4.الاستنتاج: احتمال ارتفاع نسبة المتمم نتيجة لارتفاع نسبة تواجد الاجسام المناعية الذاتية للحيامن ممايودي الى خلل في عمل الحيامن. مفتاح الكلمات: عقم, الاجسام المناعية الذاتية للحيامن, المتمم


Article
THE PREVALENCE AND CLINICAL SIGNIFICANCE OF PERINUCLEAR ANTINEUTROPHIL CYTOPLASMIC ANTIBODY IN PATIENTS WITH INDETERMINATE COLITIS

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Abstract

Background: Indeterminate colitis (IC), a term originated by pathologists to characterize confounding histopathlogic appearance of resected mucosa, has become catch phrase for cases in which diagnostic criteria at all levels elude classification as Crohn's disease (CD) or ulcerative colitis (UC).OBJECTIVES: evaluate the prevalence of pANCA expression in the sera and its isotypes. Patients and methods: PATIENTS GROUP consisted of 60 patients (40 males and 20 females) with indeterminate colitis and their age range was (19-84 years). CONTROL GROUP consisted of 30 (15 males and 15 females) healthy volunteers and their age range was (20- 66 years). Antineutrophil cytoplasmic ( pANCA and cANCA) testing was performed by an IIF technique on ethanol fixed human EOH granulocytes as substrate (EUROIMMUNE- Germany). Sigmoidoscope and colonoscope examination were done for the patients group and biopsies were taken from the patients for histopathological examination.Results:Serological results of ANCA showed a significant increased frequency of pANCA (63.3%) in indeterminate colitis patients as compared to controls (p=0.000). The highest percentage of this pANCA titer was 1:10 (p=0.000) then 1:100 (p=0.008) and most of them was IgG (53.3%) (p=0.000). Sensitivity of pANCA was 60%, specificity of pANCA was 40%, positive predictive value of pANCA was 61.1% and negative predictive value of pANCA was 66.6%. cANCA did not demonstrated in both groups. Conclusions : pANCA was more prevalent in indeterminate colitis and could be used as a predictive serological marker for the outcome of disease.

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