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Mohamed MM, Bakheet MA, Magdy RM, El-Abd HS, Alam-Eldeen MH, Abo-Haded HM. The clinico-radiological findings of MSUD in a group of Egyptian children: Contribution to early diagnosis and outcome. Mol Genet Genomic Med 2021; 9:e1790. [PMID: 34432377 PMCID: PMC8580081 DOI: 10.1002/mgg3.1790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 12/26/2022] Open
Abstract
Background Maple syrup urine disease (MSUD) is an autosomal recessive inborn error of amino acid metabolism, with unique clinico‐radiological findings. This study aims to show the benefit of using the clinico‐radiological findings for early diagnosis of children with MSUD, and confirming this diagnosis using the tandem mass spectrometry (MS/MS), in order to avoid deleterious outcome. Methods A prospective cohort study conducted in the period from August 2016 to December 2020. Twenty‐one children were included either by selective screening or by high‐risk screening. All children had clinical and neurodevelopmental evaluation, brain magnetic resonance imaging (MRI) assessment, and blood amino acids analysis at diagnosis. Patients were followed clinically. Results Most children had acute onsets neuro‐developmental symptoms, with wide range of brain parenchyma involvement on MRI (hyperintensity). Diagnosis of MSUD was confirmed by detecting high serum levels of leucine/isoleucine (mean value 2085.5 μmol/L) in all patients, and elevated levels of serum valine in (81%) of children. In addition, all children showed elevated leucine: alanine ratio, and leucine: phenylalanine ratio. Conclusions The characteristic clinico‐radiological features can help in the early diagnosis of MSUD children, thus preventing the delay in laboratory diagnosis and improving their outcomes.
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Affiliation(s)
- Montaser M Mohamed
- Pediatric Neurology Unit, Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed A Bakheet
- Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Rofaida M Magdy
- Metabolic and Genetic Unit, Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Heba S El-Abd
- Department of Medical Genetics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Hany M Abo-Haded
- Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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2
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Salem SS, Saleh NY, Soliman SE, Abo-Haded HM. On-admission plasma levels of BNP, MR-proADM, and cTnI in pediatric heart failure: contributions to diagnosis, prognosis, and outcome. Ir J Med Sci 2021; 191:263-270. [PMID: 33564973 DOI: 10.1007/s11845-021-02533-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study is to evaluate the use of on-admission plasma levels of BNP, MR-proADM, and cTnI in diagnosing the clinical severity and progression of heart failure (HF) in children with CHD. Also, to correlate the levels of these biomarkers with the HF outcome (survival versus in-hospital mortality). RESULTS A prospective cohort study conducted in period from January 2017 to March 2018. All children presenting with HF had a Ross score assessment, echocardiography, and on-admission plasma level assay of BNP, MR-proADM, and cTnI. Patients were followed clinically throughout their hospital stay. The discriminatory power of on-admission measurement of each biomarker was determined using the receiver-operating characteristic (ROC). The results showed a significantly high on-admission plasma level of the 3 biomarkers among CHD cohort children than healthy controls (p < 0.001). Linear correlation was noted between the 3 biomarkers with Ross score, ejection fraction, and duration of hospital stay. Furthermore, significant association between on-admission level of the 3 biomarkers (BNP, MR-proADM, and cTnI) with patient's in-hospital mortality (p = 0.0003, Beta coefficient = 0.842; p = 0.0495, Beta coefficient = 0.183; and p < 0.001, Beta coefficient = 0.635, respectively), with on-admission BNP (cut of point 507.13) predicting in-hospital mortality, with 95.5% sensitivity, 88% specificity. CONCLUSIONS There is a high diagnostic value of measuring the on-admission levels of BNP, MR-proADM, and cTnI regarding the clinical severity and disease progression in the setting of pediatric heart failure, but the BNP level was more superior in prediction of the patients' outcome.
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Affiliation(s)
- Sherif S Salem
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Nagwan Y Saleh
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Shimaa E Soliman
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Hany M Abo-Haded
- Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
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3
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Khoshhal SQ, Al-Mutairi MB, Alnajjar AA, Morsy MM, Salem S, Salmi AA, El-Harbi KM, Abo-Haded HM. The efficacy and safety of percutaneous balloon angioplasty for aortic coarctation in children. Acute and mid-term results in a single center experience. Saudi Med J 2020; 41:1252-1258. [PMID: 33130847 PMCID: PMC7804232 DOI: 10.15537/smj.2020.11.25452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess the efficacy and safety of balloon angioplasty (BAP) procedure for treatment of coarctation of the aorta (CoA) in children. Methods: A retrospective study included 27 consecutive children, underwent BAP for either native-CoA (Na-CoA) or recoarctation (Re-CoA). Medical records, echocardiographic findings, angiographic and hemodynamic data were collected from the hospital database. Follow‑up was scheduled at 1, 3, 6, 12 months after the procedure. The study took place over a period of 4.5 years, from April 2014 to January 2019, in Madinah Cardiac Center, Madinah, Northwest region, Saudi Arabia. RESULTS The mean age of patients was 11.86±8.96 months. Seven children had Na-CoA and 20 children had Re-CoA. The success rate of the procedure was achieved in 23 children (85%), as BAP reduced the mean systolic pressure gradient across the CoA (Na-CoA: from 45.28± 18.3 to 9.8± 6.57 mm Hg, p=0.0009), and in Re-CoA groups (from 42.48±16.7 to 10.9±8.5 mm Hg, p less than 0.0001). In mid-term follow-up, the need for re-intervention occurred in 8 children of the cohort (3 children [42.8%] from the Na-CoA group, and 5 children [25%] from the Re-CoA group). Conclusions: Balloon angioplasty is considered a safe procedure for the management of CoA, but its efficacy remains questionable especially for young infants with Na-CoA type. However, it is a reliable option for managing Re-CoA children, with a lower rate of future re-intervention.
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Affiliation(s)
- Saad Q Khoshhal
- Department of Pediatrics, Faculty of Medicine, Taibah University, Madinah, Kingdom of Saudi Arabia. E-mail.
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4
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Khoshhal SQ, Al-Mutairi MB, Alnajjar AA, Morsy MM, Salem SS, Al-Muhaya M, El-Harbi KM, Abo-Haded HM. Transcatheter device closure of ventricular septal defects in children: a retrospective study at a single cardiac center. Ann Saudi Med 2020; 40:396-402. [PMID: 33007168 PMCID: PMC7532053 DOI: 10.5144/0256-4947.2020.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Ventricular septal defect (VSD) is the most common congenital heart disease in the pediatric population. Nowadays, trans-catheter closure is considered a feasible method of therapy for most muscular and some perimembranous types of VSDs. OBJECTIVE Assess the safety, efficacy and outcome of percutaneous transcatheter closure of VSDs in children. DESIGN Retrospective, single center study. SETTING Madinah Cardiac Center, Madinah, Saudi Arabia. PATIENTS AND METHODS The study included all consecutive children who underwent transcatheter closure of isolated VSD during the period from December 2014 to January 2019. The data were collected from hospital database medical records. Transthoracic echocardiography (TTE) and an electrocardiogram (ECG) were done before and after the procedure in all the patients. The device was implanted by the retrograde or antegrade approach. All patients were subjected to follow-up evaluation at 1, 3, 6, 12 months, and annually thereafter with TTE and ECG. MAIN OUTCOME MEASURES Procedure success rate, clinical follow-up, TTE. SAMPLE SIZE 70 children. RESULTS The mean (standard deviation) age of patients was 10.2 (4.1) years (range: 2-18 years), and their mean body weight was 30.9 (13.9) kg (range: 7.0-57.7 kg). Forty-eight (68.6%) children had muscular VSD (mVSD), and 22 (31.4%) children had perimembranous VSD (pmVSD). The majority of defects were closed via the retrograde approach using the Amplatzer muscular occluder device. At 24 hours after the procedure, the success rate was 90%. Only four (5.7%) cases had major adverse events including complete atrioventricular block, hemolysis, and thrombus formation. CONCLUSION Transcatheter closure is a safe and feasible procedure in VSDs of various morphologies, with a low adverse event rate. LIMITATIONS Retrospective design, single-center study, absence of control group. CONFLICT OF INTEREST None.
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Affiliation(s)
- Saad Q Khoshhal
- From the Department of Pediatrics, Faculty of Medicine, Taibah University, Madinah, Saudi Arabia
| | - Mansour B Al-Mutairi
- From the Department of Pediatrics, Madinah Cardiac Center, Madinah, Saudi Arabia
| | | | - Mohamed M Morsy
- From the Department of Pediatrics, Madinah Cardiac Center, Madinah, Saudi Arabia.,From the Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Sherif S Salem
- From the Department of Pediatrics, Madinah Cardiac Center, Madinah, Saudi Arabia.,From the Department of Pediatrics, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
| | - Mustafa Al-Muhaya
- From the Department of Pediatrics, Madinah Cardiac Center, Madinah, Saudi Arabia
| | - Khaled M El-Harbi
- From the Department of Pediatrics, Faculty of Medicine, Taibah University, Madinah, Saudi Arabia
| | - Hany M Abo-Haded
- From the Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Carlus SJ, Almuzaini IS, Karthikeyan M, Loganathan L, Al-Harbi GS, Carlus FH, Al-Mazroea AH, Morsy MM, Abo-Haded HM, Abdallah AM, Al-Harbi KM. A novel homozygous TPM1 mutation in familial pediatric hypertrophic cardiomyopathy and in silico screening of potential targeting drugs. Eur Rev Med Pharmacol Sci 2020; 24:7732-7744. [PMID: 32744700 DOI: 10.26355/eurrev_202007_22299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Familial hypertrophic cardiomyopathy (HCM) is the most common genetic cardiac disease. While sarcomeric gene mutations explain many HCM cases, the genetic basis of about half of HCM cases remains elusive. Here we aimed to identify the gene causing HCM in a non-consanguineous Saudi Arabian family with affected family members and a history of sudden death. The impact of the identified mutation on protein structure and potential drug targets were evaluated in silico. MATERIALS AND METHODS Triplets (two HCM subjects and one patent ductus arteriosus (PDA) case) and unaffected parents were screened by targeted next-generation sequencing (NGS) for 181 candidate cardiomyopathy genes. In silico structural and functional analyses, including protein modeling, structure prediction, drug screening, drug binding, and dynamic simulations were performed to explore the potential pathogenicity of the variant and to identify candidate drugs. RESULTS A homozygous missense mutation in exon 1 of TMP1 (assembly GRCh37-chr15: 63340781; G>A) was identified in the triplets [two HCM and one patent ductus arteriosus (PDA)] that substituted glycine for arginine at codon 3 (p.Gly3Arg). The parents were heterozygous for the variant. The mutation was predicted to cause a significant and deleterious change in the TPM1 protein structure that slightly affected drug binding, stability, and conformation. In addition, we identified several putative TPM1-targeting drugs through structure-based in silico screening. CONCLUSIONS TPM1 mutations are a common cause of HCM and other congenital heart defects. To date, TPM1 has not been associated with isolated PDA; to our knowledge, this is the first report of the homozygous missense variation p.Gly3Arg in TPM1 associated with familial autosomal recessive pediatric HCM and PDA. The identified candidate TPM1 inhibitors warrant further prospective investigation.
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Affiliation(s)
- S J Carlus
- Cardiogenetics Unit, Pediatrics Department, College of Medicine, Taibah University, Al-Madinah, Kingdom of Saudi Arabia.
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Saleh NY, Salem SS, Abo-El Fotoh WM, Soliman SE, Abo-Haded HM. Angiotensin-converting enzyme insertion/deletion (ACE I/D) gene polymorphism in Egyptian children with congenital heart disease. Birth Defects Res 2020; 112:963-969. [PMID: 32343056 DOI: 10.1002/bdr2.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/16/2020] [Accepted: 04/04/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Congenital heart diseases (CHDs) are the leading cause of infant deaths worldwide. The relationship between angiotensin-converting enzyme (ACE) gene polymorphism and CHDs is not clear. The aim of this work is to assess the presence of an association between ACE I/D polymorphism and CHD in Egyptian population. SUBJECTS AND METHODS Seventy CHD cases and 70 controls were incorporated in this study. DNA was isolated from their peripheral blood, and then ACE I/D gene polymorphism was tested by polymerase chain reaction (PCR). RESULTS There was no significant difference among the frequencies of the DD, II, and DI genotypes in patients and controls (26 [37.1%], 37 [53.3%], and 4 [5.7%], 5 [6.7%]), 40 (57.2%), 28 (40%), respectively (p value = 1 and OR [95% CI] = 1.1). There was no significant difference between D allele (DD + DI) and II genotype distribution among patients and controls (p value = 1 and OR [95% CI] = 1.2 [0.3-2.9]). Moreover, there was no difference between I allele (II + DI) and DD frequency (p value = 0.2 and OR [95% CI] = 0.6 [0.3-1.2]). CONCLUSIONS ACE I/D gene polymorphism might not be a risk factor of CHD in Egyptian children. Additional widespread studies are needed to affirm these data.
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Affiliation(s)
- Nagwan Y Saleh
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Sherif S Salem
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Wafaa Mm Abo-El Fotoh
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Shaimaa E Soliman
- Department of Medical Biochemistry, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt.,Medical Biochemistry Unit, Pathology Department, Faculty of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Hany M Abo-Haded
- Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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7
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El-Agamy DS, Ibrahim SRM, Ahmed N, Khoshhal S, Abo-Haded HM, Elkablawy MA, Aljuhani N, Mohamed GA. Aspernolide F, as a new cardioprotective butyrolactone against doxorubicin-induced cardiotoxicity. Int Immunopharmacol 2020; 72:429-436. [PMID: 31030099 DOI: 10.1016/j.intimp.2019.04.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/03/2019] [Accepted: 04/21/2019] [Indexed: 12/15/2022]
Abstract
Endophytic fungi have known as a promising source of secondary metabolites. γ-Butyrolactones are a class of metabolites reported from Aspergillus genus, which attracted much attention for their bioactivities. This study aimed to assess the potential cardioprotective effects of aspernolide F (AF) separated from the endophytic fungus A. terreus against doxorubicin (DOX)-induced cardiotoxic effects in rats. Animals were treated with two different doses of AF for 10 days prior to DOX injection. Electrocardiographic (ECG), biochemical, histopathological and immunohistochemical analyses were performed. Results have shown that AF effectively protected against DOX-induced cardiac damage as AF counteracted DOX-induced ECG abnormalities and attenuated serum markers of cardiotoxicity (creatine kinase-MB, lactate dehydrogenase, troponin I, and troponin T). Histopathological examination of cardiac tissue revealed a remarkable improvement in DOX-induced lesions. In addition, AF ameliorated DOX-induced oxidative damage and increased the levels of antioxidants in cardiac tissues. AF treatment inhibited the activation of nuclear factor-κB (NF-κB) and decreased the immuno-expression of NF-κB in cardiac tissue. Furthermore, AF caused a marked lowering in the level of inflammatory cytokines (nitric oxide, tumor necrosis factor-α, and interleukin-6) in the cardiac tissue. Collectively, this study demonstrates the cardioprotective activity of AF against DOX-induced cardiac damage which may be due to its antioxidant and anti-inflammatory activities.
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Affiliation(s)
- Dina S El-Agamy
- Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al Madinah Al-Munawwarah 30001, Saudi Arabia; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Sabrin R M Ibrahim
- Department of Pharmacognosy and Pharmaceutical Chemistry, College of Pharmacy, Taibah University, Al Madinah Al-Munawwarah 30001, Saudi Arabia; Department of Pharmacognosy, Faculty of Pharmacy, Assiut University, Assiut 71526, Egypt.
| | - Nishat Ahmed
- Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al Madinah Al-Munawwarah 30001, Saudi Arabia
| | - Saad Khoshhal
- Cardiogenetic Team, Pediatric Dept., College of Medicine, Taibah University, Al Madinah Al-Munawwarah 30078, Saudi Arabia
| | - Hany M Abo-Haded
- Cardiogenetic Team, Pediatric Dept., College of Medicine, Taibah University, Al Madinah Al-Munawwarah 30078, Saudi Arabia; Cardiology Unit, Department of Pediatrics, Mansoura University, 35516, Egypt
| | - Mohamed A Elkablawy
- Department of Pathology, College of Medicine, Taibah University, Al Madinah Al-Munawwarah 30078, Saudi Arabia; Department of Pathology, Faculty of Medicine, Menoufia University, Menoufia 32511, Egypt
| | - Naif Aljuhani
- Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al Madinah Al-Munawwarah 30001, Saudi Arabia
| | - Gamal A Mohamed
- Department of Natural Products and Alternative Medicine, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Pharmacognosy Department, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut 71524, Egypt
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Elmarsafawy H, Matter M, Abo-Haded HM, Rakha S, Hafez MM, Alsawah GA, Abuelkheir MM. Transcatheter closure of patent ductus arteriosus, evaluating the outcome: Single center experience in Mansoura, Egypt. Progress in Pediatric Cardiology 2019. [DOI: 10.1016/j.ppedcard.2018.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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9
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El-Agamy DS, El-Harbi KM, Khoshhal S, Ahmed N, Elkablawy MA, Shaaban AA, Abo-Haded HM. Pristimerin protects against doxorubicin-induced cardiotoxicity and fibrosis through modulation of Nrf2 and MAPK/NF-kB signaling pathways. Cancer Manag Res 2018; 11:47-61. [PMID: 30588110 PMCID: PMC6304079 DOI: 10.2147/cmar.s186696] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background/purpose Pristimerin (Pris) is triterpenoid compound with many biological effects. Until now, nothing is known about its effect on doxorubicin (DOX)-induced cardiotoxicity. Hence, this study investigated the impact of Pris on DOX-induced cardiotoxic effects. Materials and methods Rats were treated with Pris 1 week before and 2 weeks contaminant with repeated DOX injection. Afterwards, electrocardiography (ECG), biochemical, histopathological, PCR, and Western blot assessments were performed. Results Pris effectively alleviated DOX-induced deleterious cardiac damage. It inhibited DOX-induced ECG abnormities as well as DOX-induced elevation of serum indices of cardiotoxicity. The histopathological cardiac lesions and fibrosis were remarkably improved in Pris-treated animals. Pris reduced hydroxyproline content and attenuated the mRNA and protein expression of the pro-fibrogenic genes. The antioxidant activity of Pris was prominent through the amelioration of oxidative stress parameters and enhancement of antioxidants. Furthermore, Pris enhanced the activation of nuclear factor-erythroid 2 related factor 2 (Nrf2) signaling pathway as it increased the mRNA and protein expression of Nrf2 and Nrf2-dependent antioxidant genes (GCL, NQO1, HO-1). Additionally, the anti-inflammatory effect of Pris was obvious through the inhibition of mitogen activated protein kinase (MAPK)/nuclear factor kappa-B (NF-kB) signaling and subsequent inhibition of inflammatory mediators. Conclusion This study provides evidence of the cardioprotective activity of Pris which is related to the modulation of Nrf2 and MAPK/NF-kB signaling pathways.
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Affiliation(s)
- Dina S El-Agamy
- Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah 30001, Saudi Arabia.,Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Khaled M El-Harbi
- Cardiogenetic Team, Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah Al-Munawwarah 30001, Saudi Arabia,
| | - Saad Khoshhal
- Cardiogenetic Team, Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah Al-Munawwarah 30001, Saudi Arabia,
| | - Nishat Ahmed
- Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah 30001, Saudi Arabia
| | - Mohamed A Elkablawy
- Department of Pathology, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah 30001, Saudi Arabia.,Department of Pathology, Faculty of Medicine, Menoufia University, Menoufia 32511, Egypt
| | - Ahmed A Shaaban
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt.,Department of Pharmacology, Faculty of Pharmacy, Aqaba University of Technology, Aqaba 77110, Jordan
| | - Hany M Abo-Haded
- Cardiogenetic Team, Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah Al-Munawwarah 30001, Saudi Arabia, .,Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt,
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10
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Morsy MM, Algrigri OO, Salem SS, Abosedera MM, Abutaleb AR, Al-Harbi KM, Al-Mozainy IS, Alnajjar AA, Habeb AM, Abo-Haded HM. The spectrum of congenital heart diseases in down syndrome. A retrospective study from Northwest Saudi Arabia. Saudi Med J 2017; 37:767-72. [PMID: 27381537 PMCID: PMC5018641 DOI: 10.15537/smj.2016.7.14536] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives: To to define the frequency and patterns of congenital heart disease (CHD) among children with Down syndrome (DS) in Northwest Saudi Arabia. Methods: We included children with confirmed DS referred to the regional pediatric cardiology unit in Madinah Maternity and Children Hospital between January 2008 and December 2013. Children were identified from the unit’s data-base and the charts were reviewed retrospectively. We excluded term and preterm children with patent ducts arteriosus (PDA) and persistent foramen oval spontaneously resolved during the first 4 weeks of life. Results: A total of 302 children with DS were identified (50.3% male). Of these, 177 (58.6%) had CHD. Atrioventricular septal defect (AVSD) was the most frequent lesion identified in 72/177 (40.7%) followed by mixed left to right shunt defects (14.7%) and secundum atrial septal defect (ASD) (11.8%). Ventricular septal defect was detected in 10.7% and 8.5% had PDA beyond the neonatal period. There was no gender difference in the frequency of CHD (p=0.9) and the presence of CHD was not related to the genetic cause of DS (p=0.9). Conclusion: The frequency of CHD in our DS cohort is comparable with Europe, Asia, and other KSA regions. However its pattern appears to be different from some areas in KSA.
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Affiliation(s)
- Mohamed M Morsy
- Department of Pediatric Cardiology, Madina Cardiac Center, Madinah, Kingdom of Saudi Arabia. E-mail.
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Abo-Haded HM, Elkablawy MA, Al-johani Z, Al-ahmadi O, El-Agamy DS. Hepatoprotective effect of sitagliptin against methotrexate induced liver toxicity. PLoS One 2017; 12:e0174295. [PMID: 28334048 PMCID: PMC5363865 DOI: 10.1371/journal.pone.0174295] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 03/07/2017] [Indexed: 01/24/2023] Open
Abstract
Sitagliptin is selective dipeptidyl peptidase-4 inhibitor (DPP4-I), used clinically as a new oral anti-diabetic agent. This study explored the underlying mechanisms of the hepatoprotective role of sitagliptin pretreatment against methotrexate (MTX) induced hepatotoxicity in mice. Forty mice were divided into four groups (10 mice each); control, MTX, and two sitagliptin groups (pretreated with sitagliptin 10 and 20 mg/kg/day, respectively) for five consecutive days prior to MTX injection. Results showed that MTX induced marked hepatic injury in the form of cloudy swelling, hydropic degeneration, apoptosis and focal necrosis in all hepatic zones. Biochemical analysis revealed significant increase in the serum transaminases, alkaline phosphatase and lactate dehydrogenase in MTX group. Oxidative stress and depressed antioxidant system of the hepatic tissues were evident in MTX group. MTX down-regulated nuclear factor erythroid 2-related factor 2 (Nrf2) expression and reduced its binding capacity. Additionally, MTX increased the activation and the expression of nuclear factor kappa-B (NF-κB) and downstream inflammatory mediators. MTX induced the activation of inducible nitric oxide synthase (iNOS) and increased nitrite/nitrate level. Finally, hepatic cellular apoptosis was clearly obvious in MTX-intoxicated animals using TUNEL staining. Also, there was increase in the immunoexpression of pro-apoptotic protein Bax, increase in Bax and caspase-3 levels and decrease in the level of anti-apoptotic Bcl2 in liver. On the other hand, sitagliptin pretreatment significantly ameliorated all of the above mentioned biochemical, histopathological, immunohistochemical changes induced by MTX. These results provide new evidences that the hepatoprotective effect of sitagliptin is possibly mediated through modulation of Nrf2 and NF-κB signaling pathways with subsequent suppression of inflammatory and apoptotic processes.
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Affiliation(s)
- Hany M. Abo-Haded
- Cardio-genetic team, College of Medicine, Taibah University, Almadinah Almonawarah, Saudi Arabia
- * E-mail:
| | - Mohamed A. Elkablawy
- Department of pathology, College of Medicine, Taibah University, Almadinah Almonawarah, Saudi Arabia; Department of Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Zeyad Al-johani
- Cardio-genetic team, College of Medicine, Taibah University, Almadinah Almonawarah, Saudi Arabia
| | - Osama Al-ahmadi
- Cardio-genetic team, College of Medicine, Taibah University, Almadinah Almonawarah, Saudi Arabia
| | - Dina S. El-Agamy
- Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Almadinah Almonawarah, Saudi Arabia; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
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El-Agamy DS, Elkablawy MA, Abo-Haded HM. Modulation of cyclophosphamide-induced cardiotoxicity by methyl palmitate. Cancer Chemother Pharmacol 2017; 79:399-409. [DOI: 10.1007/s00280-016-3233-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 12/26/2016] [Indexed: 11/29/2022]
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Fathy A, Abo-Haded HM, Al-Ahmadi N, El-Sonbaty MM. Cardiac functions assessment in children with celiac disease and its correlation with the degree of mucosal injury: Doppler tissue imaging study. Saudi J Gastroenterol 2016; 22:441-447. [PMID: 27976640 PMCID: PMC5184745 DOI: 10.4103/1319-3767.195550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/AIMS Celiac disease (CD)-associated cardiologic disorders is a growing concern. However, data regarding cardiac affection in children with CD are few. This study aimed at assessing the subclinical impact of CD on the global myocardial performance in Saudi children with CD using Doppler tissue imaging (DTI). PATIENTS AND METHODS Conventional two-dimensional echocardiography was performed among 20 Saudi children with CDas well as 20 age and sex-matched healthy controls. DTI were used to determine right ventricular (RV) and left ventricular (LV) Tei indexes. These findings were correlated with the Modified Marsh Classification of the histologic findings in CD. RESULTS LV and RV Tei indexes were significantly higher in children with CD than the control group (mean ± standard deviation: 0.47 ± 0.05 vs. 0.31 ± 0.18; P< 0.0005 and 0.51 ± 0.04 vs. 0.32 ± 0.05; P< 0.0001, respectively). RV Tei index was found to be positively correlated with the Modified Marsh Classification of CD (r = 0.7753, P< 0.0001). LV Tei index tended to be more affected in patients with more severe histologic findings, however, such relation did not reach statistical significance (r = 0.2479, P = 0.292). Fractional shortening did not correlate with the Modified Marsh Classification of histologic findings in CD patients (r= -0.11, P = 0.641). CONCLUSIONS Subclinical myocardial dysfunction of both ventricles occurs in children with CD. The DTI method appears to be more sensitive than conventional two-dimensional echocardiography in the early detection of myocardial dysfunction in children with CD.
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Affiliation(s)
- Abeer Fathy
- Department of Pediatrics, College of Medicine, Taibah University, Madinah, Saudi Arabia,Address for correspondence: Dr. Abeer Fathy, Department of Pediatrics, College of Medicine, Taibah University, Madinah, Saudi Arabia, Mansoura University Children Hospital, Mansoura, Egypt. E-mail:
| | - Hany M. Abo-Haded
- Department of Pediatrics, College of Medicine, Mansoura University, Mansoura, Egypt
| | - Najat Al-Ahmadi
- Department of Pediatrics, Maternity and Children Hospital, Madinah, Saudi Arabia
| | - Marwa M. El-Sonbaty
- Department of Child Health, Medical Research Division, National Research Centre, Cairo, Egypt
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El-Agamy DS, Abo-Haded HM, Elkablawy MA. Cardioprotective effects of sitagliptin against doxorubicin-induced cardiotoxicity in rats. Exp Biol Med (Maywood) 2016; 241:1577-87. [PMID: 27037281 DOI: 10.1177/1535370216643418] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 03/14/2016] [Indexed: 01/01/2023] Open
Abstract
There is a large body of evidence suggesting that inhibitors of dipeptidyl peptidase-4, such as sitagliptin, may exhibit beneficial effects against different inflammatory disorders. This investigation was conducted to elucidate the potential ability of sitagliptin to counteract the injurious effects of doxorubicin in cardiac tissue. Male Wistar rats were pretreated with sitagliptin for 10 days then treated with a single dose of doxorubicin (20 mg/kg, i.p). Electrocardiography, biochemical estimation of serum and tissue markers, and histo- and immunopathological examinations were done. Results have shown that supplementation with sitagliptin resulted in significant improvement of cardiac function with contaminant decrease in serum markers of doxorubicin-induced cardiotoxicity. These results were supported by the histopathological results. Furthermore, a marked protection against oxidative stress was evident through reduction of lipid peroxidation and prevention of reduced glutathione content depletion and superoxide dismutase activity reduction in cardiac tissue of rats pretreated with sitagliptin in combination with doxorubicin. Moreover, sitagliptin ameliorated the activation of nuclear factor kappa-B and the release of inflammatory cytokines, tumour necrosis factor-alpha and nitric oxide. Finally, sitagliptin attenuated doxorubicin-induced increase in the expression of pro-apoptotic protein Bax and in the apoptotic marker, caspase-3. Collectively, these data indicate that sitagliptin pretreatment could alleviate doxorubicin-induced cardiotoxicity via reducing oxidative damage and its subsequent inflammation and apoptosis.
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Affiliation(s)
- Dina S El-Agamy
- Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah 30001, Saudi Arabia.
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Hany M Abo-Haded
- Pediatric Cardiology Unit, Department Of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed A Elkablawy
- Department of Pathology, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah 30001, Saudi Arabia
- Department of Pathology, Faculty of Medicine, Menoufia University, Menoufia 35516, Egypt
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15
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Abo-Haded HM, Barakat TS, Hafez MM. Myocardial performance in children with autoimmune hepatitis: Doppler tissue imaging study. Eur J Pediatr 2013; 172:1511-9. [PMID: 23812510 DOI: 10.1007/s00431-013-2073-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 06/11/2013] [Indexed: 01/09/2023]
Abstract
Autoimmune hepatitis (AIH) is a member of autoimmune diseases family which can increase risk of cardiovascular morbidity and mortality. This study aimed to assess subclinical impact of AIH on global myocardial performance in affected children using Doppler tissue imaging (DTI) and to correlate it with total serum immunoglobulin-G (IgG). Thirty children with AIH (mean age = 12.67 ± 2.9 years) was included as the study group and 20 age- and sex-matched healthy children (mean age = 11.93 ± 2.66 years) as the control group. Conventional two-dimensional echocardiography was performed to both groups and DTI were used to determine right ventricular (RV) and left ventricular (LV) Tei indexes. Total serum IgG levels at initial diagnosis of AIH were correlated to the cardiac functions of AIH patients. RV and LV Tei indexes were significantly higher in AIH group (mean ± SD: 0.46 ± 0.088 vs. 0.26 ± 0.01, P < 0.0001 and 0.45 ± 0.086 vs. 0.31 ± 0.02, P < 0.0001, respectively). Also, total IgG concentrations were correlated positively with the LV Tei index (r = 0.69, P < 0.0001) and with the RV Tei index (r = 0.61, P < 0.0003) and correlated negatively with the mitral systolic (Sm) velocity (r = -0.76, P < 0.0001) and with tricuspid systolic (Sm) velocity (r = -0.66, P < 0.0001). On the other hand, fractional shortening did not correlate with serum IgG concentrations (r = -0.04, P = 0.821). In conclusion, the DTI technique appears to be more sensitive than conventional echocardiography in the early detection of myocardial dysfunction in AIH children.
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MESH Headings
- Adolescent
- Biomarkers/blood
- Case-Control Studies
- Child
- Cross-Sectional Studies
- Echocardiography, Doppler, Pulsed
- Female
- Hepatitis, Autoimmune/blood
- Hepatitis, Autoimmune/complications
- Hepatitis, Autoimmune/diagnostic imaging
- Hepatitis, Autoimmune/immunology
- Humans
- Immunoglobulin G/blood
- Male
- Ventricular Dysfunction, Left/diagnostic imaging
- Ventricular Dysfunction, Left/etiology
- Ventricular Dysfunction, Right/diagnostic imaging
- Ventricular Dysfunction, Right/etiology
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Affiliation(s)
- Hany M Abo-Haded
- Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt,
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