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AbdelMassih AF, Kiraly L, Badaoui HE, Khan M, Hetharsi B, Till JN, Omelchenko AY, Salah AZ, Jburi FTA, Alkhouli L, Taher M, Alhosani N, Youssef O, Iqbal S, Allami Z, Jha NK, Hamad EM, Omar Y, Khan A, Azeez Z, Attia M, Mina M, Ali AA, Afifi YK, Shershaby ME, Musleh A. Predictors of protein losing enteropathy after Fontan completion: An 8-year retrospective study at Sheikh Khalifa Medical City. Glob Cardiol Sci Pract 2023; 2023:e202317. [PMID: 37575289 PMCID: PMC10422871 DOI: 10.21542/gcsp.2023.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/15/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND The Fontan procedure is the final stage of a three-stage palliation process in patients born with a univentricular heart as part of hypoplastic left heart syndrome (HLHS) or other pathologies with a univentricular heart. As essential as this procedure has proven to be for such cases, the Fontan physiology diminishes cardiac output and expands systemic venous pressure, which then leads to venous congestion that can be complicated by protein-losing enteropathy (PLE). This retrospective study aimed to identify the predictors of such complications in all patients who underwent completion of the Fontan procedure at our center (Sheikh Khalifa Medical City/SKMC) in the past eight years. METHODS This study examined the medical records of patients who underwent completion of Fontan repair at our center since the inauguration of the cardiac surgery program of SKMC in the United Arab Emirates (UAE) - 01 Jan 2012 to 31 Dec 2020. Exclusion criteria included the absence of any of the undermentioned data in patient files. Patients were divided into two groups: those who developed PLE and those who did not. For each group, the following data were collected: demographics data (current age and age at completion of Fontan), clinical and laboratory data (oxygen saturation, serum albumin), echocardiographic data (classification of original cardiac diagnosis, degree of atrio-ventricular valve regurgitation, ventricular functions), hemodynamic data (mean pressures of superior vena cava and pulmonary arteries before Fontan completion), operative data (type of initial palliation, type of Fontan, presence of fenestrations and its size) and the need for any cardiac intervention prior to Fontan completion, such as atrio-ventricular valve repair, peripheral pulmonary stenting and arch balloon dilatation. RESULTS Of the 48 included patients,13 (25%) developed PLE. Multivariate regression analysis proved that the best predictors of PLE were superior vena cava mean pressure (P = 0.012) and the degree of atrio-ventricular valve regurgitation (P = 0.013). An oxygen saturation <83% prior to Fontan completion was 92% sensitive in predicting PLE after Fontan completion. CONCLUSION This is a single-center study of the predictors of PLE after Fontan procedure and, as expected from similar studies, SVC pressure higher than 11 mmHg and moderate-to-severe atrio-ventricular valve regurgitation were predictors of Fontan failure. The higher prevalence of PLE in our cohort, as well as lower cut-offs of SVC pressure that can predict complications, may be related to the predominance of hypoplastic left heart in the operated patients, which has been the main referral center for cardiac surgeries in UAE in the last decade.
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Affiliation(s)
- Antoine Fakhry AbdelMassih
- Pediatric Cardiology unit, Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
- Pediatric Cardiology Division, Cardiac Sciences’ department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Laszlo Kiraly
- Pediatric Cardiac Surgery at Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital
| | - Hazem El Badaoui
- Pediatric Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Mohammad Khan
- Pediatric Cardiology Division, Cardiac Sciences’ department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Balazs Hetharsi
- Pediatric Cardiac Intensive Care Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Judit Noemi Till
- Pediatric Cardiac Intensive Care Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Aleksandr Y. Omelchenko
- Pediatric Cardiac surgery Division, Cardiac Sciences’ department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Alaa Ziad Salah
- Pediatrics’ Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | | | - Laila Alkhouli
- Pediatrics’ Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Mina Taher
- Pediatrics’ Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Najah Alhosani
- Pediatrics’ Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Omnia Youssef
- Pediatrics’ Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Sumaiya Iqbal
- Pediatrics’ Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Zahraa Allami
- Pediatrics’ Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Neerod Kumar Jha
- Pediatric Cardiac surgery Division, Cardiac Sciences’ department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Eman Mahmoud Hamad
- Pediatric Cardiac Intensive Care Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Yasmin Omar
- Pediatric Cardiology unit, Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Arshad Khan
- Pediatric Echocardiography, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Zafar Azeez
- Pediatric Cardiology Division, Cardiac Sciences’ department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Michael Attia
- Cardiology department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Mariam Mina
- Pediatrics’ department, Danat Al Emarat Hospital for Women & Children, Abu Dhabi, UAE
| | - Alyaa Al Ali
- Pediatric Cardiac Intensive Care Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | | | - Meryam El Shershaby
- Pediatric Cardiology unit, Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Afnan Musleh
- Pediatric Cardiology Division, Cardiac Sciences’ department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
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AbdelMassih A, Agha H, El-Saiedi S, El-Sisi A, El Shershaby M, Gaber H, Ismail HA, El-Husseiny N, Amin AR, ElBoraie A, Ayad A, Menshawey E, Sefein F, Osman II, Moursi M, Hanafy M, Abdelaziz MS, Arsanyous MB, Khaled-Ibn-El-Walid M, Tawfik MG, Habib M, Mansour ME, Ashraf M, Khattab MA, Alshehry N, Hafez N, ElDeeb NE, Ashraf N, Khalil N, AbdElSalam NI, Shebl N, Hafez NGA, Youssef NH, Bahnan O, Ismail P, Kelada P, Menshawey R, Saeed R, Husseiny RJ, Yasser R, Sharaf S, Adel V, Naeem Y, Nicola YNF, Kamel A, Hozaien R, Fouda R. The role of miRNAs in viral myocarditis, and its possible implication in induction of mRNA-based COVID-19 vaccines-induced myocarditis. Bull Natl Res Cent 2022; 46:267. [PMID: 36415483 PMCID: PMC9672617 DOI: 10.1186/s42269-022-00955-1] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Several reports of unheeded complications secondary to the current mass international rollout of SARS-COV-2 vaccines, one of which is myocarditis occurring with the FDA fully approved vaccine, Pfizer, and others. MAIN BODY OF THE ABSTRACT Certain miRNAs (non-coding RNA sequences) are involved in the pathogenesis in viral myocarditis, and those miRNAs are interestingly upregulated in severe COVID-19. We hypothesize that the use of mRNA-based vaccines may be triggering the release of host miRNAs or that trigger the occurrence of myocarditis. This is based on the finding of altered host miRNA expression promoting virus-induced myocarditis. SHORT CONCLUSION In conclusion, miRNAs are likely implicated in myocarditis associated with mRNA vaccines. Our hypothesis suggests the use of miRNA as a biomarker for the diagnosis of mRNA vaccine-induced myocarditis. Additionally, the interplay between viral miRNA and the host immune system could alter inflammatory profiles, hence suggesting the use of therapeutic inhibition to prevent such complications.
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Affiliation(s)
- Antoine AbdelMassih
- Pediatric Cardiology Unit, Pediatrics’ Department, Faculty of Medicine, Cairo University, P.O. Box 12411, Cairo, Egypt
- Pediatric Cardio-Oncology Clinic, Children Cancer Hospital of Egypt, Cairo, Egypt
| | - Hala Agha
- Pediatric Cardiology Unit, Pediatrics’ Department, Faculty of Medicine, Cairo University, P.O. Box 12411, Cairo, Egypt
| | - Sonia El-Saiedi
- Pediatric Cardiology Unit, Pediatrics’ Department, Faculty of Medicine, Cairo University, P.O. Box 12411, Cairo, Egypt
| | - Amal El-Sisi
- Pediatric Cardiology Unit, Pediatrics’ Department, Faculty of Medicine, Cairo University, P.O. Box 12411, Cairo, Egypt
| | - Meryam El Shershaby
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanya Gaber
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Habiba-Allah Ismail
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nadine El-Husseiny
- Faculty of Dentistry, Cairo University, Cairo, Egypt
- Pixagon Graphic Design Agency, Cairo, Egypt
| | - Abeer Reda Amin
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aly ElBoraie
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aya Ayad
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Esraa Menshawey
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Fady Sefein
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ibrahim Ihab Osman
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mai Moursi
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maram Hanafy
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mariam Sherif Abdelaziz
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mariem Badr Arsanyous
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mariam Khaled-Ibn-El-Walid
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa Gamal Tawfik
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Menna Habib
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mina Ehab Mansour
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mirette Ashraf
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Ayman Khattab
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nada Alshehry
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nada Hafez
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Naheel Essam ElDeeb
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nirvana Ashraf
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha Khalil
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noheir Ismail AbdElSalam
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noura Shebl
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nouran Gamal Ali Hafez
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nourhan Hatem Youssef
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Odette Bahnan
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Passant Ismail
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Peter Kelada
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rahma Menshawey
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rana Saeed
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem Jalal Husseiny
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem Yasser
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Safa Sharaf
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Veronia Adel
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Youstina Naeem
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Youstina Nagy Farid Nicola
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aya Kamel
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rafeef Hozaien
- Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Raghda Fouda
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Massih AA, Kamel A, Zaki AM, Aboudeif A, Emad C, Ramadan D, Gaber H, Bastorous H, Shaker M, Salah N, Hany N, El-Mestkawy N, Sawiris RAN, Mamdouh R, Atalla S, Abozeid S, Ghazi SI, Youssef SA, ElMaghraby Y, Khudhair Z, Hozaien R, El Husseiny N, El Shershaby M. Revisiting the overlooked role of recycled sewage water in high-income countries in adenoviral outbreaks such as the “2022 pediatric hepatitis’ outbreak”. Egypt Pediatric Association Gaz 2022. [PMCID: PMC9402275 DOI: 10.1186/s43054-022-00113-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
On the 5th of April 2022, cases of adenovirus-induced hepatitis were reported in Scotland and then reached multiple parts of the world. While adenovirus normally presents with diarrhea, vomiting, and fever, these novel cases also resulted in the development of fulminant hepatitis in non-immunocompromised cases.
Main body
The responsible pathogen “Adenovirus 41” is an enterovirus. Enteroviruses are spread by the fecal-oral route and are resistant to drying. As such, they predominate in sewage water. Hepatitis is normally restricted to poorer countries, yet this new wave seems to be confined to mostly high-income countries in Europe and the USA. These countries treat and recycle a higher percentage of sewage water. We also propose that the fulminant nature of this strain could be due to either a cross-species mutation or the general decrease in trained immunity post-COVID-19 lockdown.
Short conclusion
Evidence strongly suggests that the link between these new hepatitis cases is recycled sewage water. This should warrant further investigations on the origin of this outbreak by re-visiting the role of recycled sewage water in causing such outbreak.
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AbdelMassih A, Sedky A, Shalaby A, Shalaby AF, Yasser A, Mohyeldin A, Amin B, Saleheen B, Osman D, Samuel E, Abdelfatah E, Albustami E, ElGhamry F, Khaled H, Amr H, Gaber H, Makhlouf I, Abdeldayem J, El-Beialy JW, Milad K, El Sharkawi L, Abosenna L, Safi MG, AbdelKareem M, Gaber M, Elkady M, Ihab M, AbdelRaouf N, Khaled R, Shalata R, Mahgoub R, Jamal S, El Hawary SED, ElRashidy S, El Shorbagy S, Gerges T, Kassem Y, Magdy Y, Omar Y, Shokry Y, Kamel A, Hozaien R, El-Husseiny N, El Shershaby M. From HIV to COVID-19, Molecular mechanisms of pathogens' trade-off and persistence in the community, potential targets for new drug development. Bull Natl Res Cent 2022; 46:194. [PMID: 35818410 PMCID: PMC9258762 DOI: 10.1186/s42269-022-00879-w] [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] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND On the staggering emergence of the Omicron variant, numerous questions arose about the evolution of virulence and transmissibility in microbes. MAIN BODY OF THE ABSTRACT The trade-off hypothesis has long speculated the exchange of virulence for the sake of superior transmissibility in a wide array of pathogens. While this certainly applies to the case of the Omicron variant, along with influenza virus, various reports have been allocated for an array of pathogens such as human immunodeficiency virus (HIV), malaria, hepatitis B virus (HBV) and tuberculosis (TB). The latter abide to another form of trade-off, the invasion-persistence trade-off. In this study, we aim to explore the molecular mechanisms and mutations of different obligate intracellular pathogens that attenuated their more morbid characters, virulence in acute infections and invasion in chronic infections. SHORT CONCLUSION Recognizing the mutations that attenuate the most morbid characters of pathogens such as virulence or persistence can help in tailoring new therapies for such pathogens. Targeting macrophage tropism of HIV by carbohydrate-binding agents, or targeting the TMPRSS2 receptors to prevent pulmonary infiltrates of COVID-19 is an example of how important is to recognize such genetic mechanisms.
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Affiliation(s)
- Antoine AbdelMassih
- Pediatric Department, Pediatric Cardiology Unit, Faculty of Medicine, Cairo University Children Hospital, Cairo University, Kasr Al Ainy Street, Cairo, 12411 Egypt
| | - Abrar Sedky
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Shalaby
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - AlAmira-Fawzia Shalaby
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Alia Yasser
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aya Mohyeldin
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Basma Amin
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Basma Saleheen
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina Osman
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Elaria Samuel
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Emmy Abdelfatah
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eveen Albustami
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Farida ElGhamry
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Habiba Khaled
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hana Amr
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanya Gaber
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ismail Makhlouf
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Janna Abdeldayem
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Karim Milad
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Laila El Sharkawi
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Lina Abosenna
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Madonna G. Safi
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mariam AbdelKareem
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa Gaber
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mirna Elkady
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Ihab
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nora AbdelRaouf
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rawan Khaled
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem Shalata
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rudayna Mahgoub
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sarah Jamal
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Seif El-Din El Hawary
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Shady ElRashidy
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sherouk El Shorbagy
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tony Gerges
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yara Kassem
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yasmeen Magdy
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yasmin Omar
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yasmine Shokry
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aya Kamel
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rafeef Hozaien
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nadine El-Husseiny
- Faculty of Dentistry, Cairo University, Cairo, Egypt
- Pixagon Graphic Design Agency, Cairo, Egypt
| | - Meryam El Shershaby
- Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Cairo, Egypt
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AbdelMassih A, Gaber H, El Shershaby M, Hanafy M, Omar Y, Husseiny R, AlShehry N, Ismail HA, Kamel A, Hozaien R, Khaled G, Amer M, Turki A, Fawzy H, Puligheddu S, Khaled D, Thabet NN, Abdelaziz MS, Barakat M, Sharaf S, Mohamed A, Mohsen D, El Feky A, Adly H, Ibrahim E, Mahmoud R, Reda M, Riad F, Vasile C, Shohdi MA, Hesham N, El-Husseiny N, Ragy R, Fouda R. Learned lesson from COVID-19: can routine immunizations be the first line of defense against the next pandemic? Egypt Pediatric Association Gaz 2022. [PMCID: PMC8978766 DOI: 10.1186/s43054-022-00105-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Single-cell sequencing studies on the lung microenvironment have revealed that the outcome of COVID-19 depends largely on the immune system response rather than the viral load. A robust innate immune response and a regulated adaptive immunity can prevent the worst outcomes such as hospitalization and the need for mechanical ventilation.
Main body
Intriguingly, several vaccines pertaining to the routine vaccination schedule, not only BCG, can skew the immune response towards the aforementioned beneficial effects.
Short conclusion
This means that routine immunization not only can help in the current pandemic but can also offer a rapid rescue in the subsequent epidemics or pandemics until a vaccine is developed.
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AbdelMassih A, El Shershaby M, Gaber H, Habib M, Gamal N, Husseiny R, AlShehry N, Amin A, Heikal B, El-Husseiny N, Moursi M, Ismail HA, Senoussy S, ElSharkawy R, AlZayat HA, ElMahdy G, Moawad H, Genena A, ElKiki A, Reda M, Khalil M, Al Ramady R, Radwan N, Khaled-Ibn-ElWalid M, Amin H, Hozaien R, Kamel A, Fouda R. Should we vaccinate the better seroconverters or the most vulnerable? Game changing insights for COVID-19 vaccine prioritization policies. Egypt Pediatric Association Gaz 2021. [PMCID: PMC8637024 DOI: 10.1186/s43054-021-00086-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background With the rapid rise in COVID 19 cases incomparable to the number of vaccinations available, there has been a demand to prioritize the older age groups receiving the vaccine as they have more risk of morbidity and mortality and thus better outcome from vaccination. Main body Some studies showed a lower seroconversion rate in older group patients; thus, we discuss the necessity to reprioritize vaccinations to younger age groups who have better seroconversion rates, but we may face some ethical dilemma that could hinder our hypothesis. Decreased seroconversion rates in adults are attributable to immuno-senescence which involves a decrease in humoral and cellular-mediated immunity with age. Despite this fact, there remains some ethical dilemma that can hinder widespread vaccination of younger generations, the most important of which is the unknown long-term effects of COVID-19 vaccines due their fast-tracking under the pressure of the pandemic. Short conclusion Prioritizing children vaccination against COVID-19 seems an interesting strategy that can help in containing the pandemic. Resolving some ethical dilemma needs to be done before implementing such strategy.
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AbdelMassih A, Hozaien R, El Shershaby M, Kamel A, Ismail HA, Arsanyous M, El-Husseiny N, Khalil N, Naeem Y, Fouda R. The potential role of inhaled nitric oxide for postexposure chemoprophylaxis of COVID-19. J Genet Eng Biotechnol 2021; 19:165. [PMID: 34677688 PMCID: PMC8532099 DOI: 10.1186/s43141-021-00249-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/24/2021] [Indexed: 11/18/2022]
Abstract
Background Several vaccines have been fast-tracked in an attempt to decrease the morbidity and mortality of COVID-19. However, post-exposure prophylaxis has been overlooked in battling COVID-19. Main text Inhaled nitric oxide is a potential tool in post-exposure prophylaxis of COVID-19. It decreases cytosolic calcium levels, which impairs the action of Furin. SARS-CoV-2 uses Furin to replicate in the respiratory tract. Short conclusion Inhaled nitric oxide could decrease the viral load in the upper respiratory tract, abort clinically symptomatic infection, and prevent subsequent complications. Nitric oxide might be a tool for post-exposure chemoprophylaxis in at-risk groups, especially medical personnel.
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Affiliation(s)
- Antoine AbdelMassih
- Pediatric Cardiology unit, Pediatrics' Department, Faculty of Medicine, Cairo University, Cairo, Egypt. .,Pediatric Cardio-Oncology Department, Children Cancer Hospital of Egypt, Cairo, 57357, Egypt.
| | - Rafeef Hozaien
- Research Accessibility Team, Student and Internship research program Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Meryam El Shershaby
- Research Accessibility Team, Student and Internship research program Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aya Kamel
- Research Accessibility Team, Student and Internship research program Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Habiba-Allah Ismail
- Research Accessibility Team, Student and Internship research program Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mariem Arsanyous
- Research Accessibility Team, Student and Internship research program Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nadine El-Husseiny
- Faculty of Dentistry, Cairo University, Cairo, Egypt.,Pixagon Graphic Design Agency, Cairo, Egypt
| | - Noha Khalil
- Research Accessibility Team, Student and Internship research program Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Youstina Naeem
- Research Accessibility Team, Student and Internship research program Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Raghda Fouda
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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AbdelMassih A, Yacoub E, Husseiny RJ, Kamel A, Hozaien R, El Shershaby M, Rajab M, Yacoub S, Eid MA, Elahmady M, Gadalla M, Mokhtar S, Hassan AA, Abou-Zeid AS, Hussein M, Aboushadi N, Emad N, Zahra N, Hassan A, Hussein E, Ibrahim N, El Nahhas N, Elahmady T, Khallaf M, Mustafa H, Anis N, Albehairy M, Hanna F, Moris L, Ye J. Hypoxia-inducible factor (HIF): The link between obesity and COVID-19. ACTA ACUST UNITED AC 2020; 22:100317. [PMID: 33521378 PMCID: PMC7832240 DOI: 10.1016/j.obmed.2020.100317] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [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: 12/05/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 01/10/2023]
Abstract
The COVID-19 death toll has involved to date more than 1 million confirmed deaths. The death rate is even higher in the obese COVID-19 patients, as a result of hypoxia, due to the interplay between adipose tissue hypoxia and obstructive sleep apnea. The discrepancy of manifestations seen in COVID-19 seems to be mediated by a differential immune response rather than a differential viral load. One of the key players of the immune response is HIF. HIF-1β is a stable constitutively expressed protein in the nucleus; and under hypoxic changes, its activity is unaffected, whereas the HIF-α subunit has a short half-life and because of its degradation by an enzyme known as propyl hydroxylase; under hypoxic conditions, propyl hydroxylase gets deactivated thus leading to the stabilization of HIF-1α. As mentioned before, HIF-1α expression is triggered by hypoxic states, this crippling condition will aggravate the pro-inflammatory characteristics of HIF-1α. The vast majority of decompensated COVID19 cases manifest with drastic lung injury and severe viral pneumonia, the infection-induced hypoxia will the existing hypoxia in obesity. This will additionally augment HIF-1α levels that will provoke the already existing cytokines' storm to fulminant. Consequently, this will directly correlate the effect of a hypoxic environment with the increase of HIF-1α level. HIFɑ exists in two main isoforms HIF-1α and HIF-2α. HIF-1α and HIF-2α act in distinct ways in how they work on different target genes. For example, HIF-2α may act on hemopoietin genes (heme-regulating genes); while HIF-1α acts on EPO. HIF-1α release seems to be markedly augmented in obesity due to adipose tissue hypoxia and obstructive sleep apnea resulting in cyclic hypoxia. HIF-1α can also be secreted by direct viral proteolytic effects. Whereas, HIF-2α is stimulated by chronic hypoxia. HIF-1α exerts detrimental effects on the immune system, characterized by unopposed pro-inflammation at the macrophages, dendritic cells, T cells, and complement levels resulting in cytokines' storm, which is linked to the poor outcomes of COVID-19. On the other hand, HIF-2α role is regulatory and largely opposes the actions mediated by HIF-1α. In view of this, inhibiting HIF-1α release or switching its production to HIF-2α by natural products such as resveratrol or by synthetic drugs, offer a good therapeutic strategy that can prevent COVID-19 worst outcome in infected patients. The approach of breaking the vicious circle between lung damage-induced hypoxia and HIF-1α pro-inflammatory stimulant through drugs is considered to be extremely promising as a therapeutic manner to combat further deterioration of COVID19 cases.
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Affiliation(s)
- Antoine AbdelMassih
- Pediatric Cardiology Unit, Pediatrics' Department, Faculty of Medicine, Cairo University, Egypt.,Pediatric Cardio-Oncology Department, Children Cancer Hospital of Egypt, 57357, Egypt
| | - Elaria Yacoub
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt
| | - Reem J Husseiny
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt
| | - Aya Kamel
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt
| | - Rafeef Hozaien
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt
| | - Meryam El Shershaby
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt
| | - Maram Rajab
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt
| | - Shenoda Yacoub
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt
| | - Maryam A Eid
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Maryam Elahmady
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Mahenar Gadalla
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Sherouk Mokhtar
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Alaa A Hassan
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Aya S Abou-Zeid
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Mahinour Hussein
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Nour Aboushadi
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Nadine Emad
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Nihal Zahra
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Aya Hassan
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Engy Hussein
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Nourhan Ibrahim
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | - Nadine El Nahhas
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt.,Faculty of Dentistry, New Giza University, New Giza, Egypt
| | | | - Mohamed Khallaf
- Residency Training Program, Faculty of Medicine, Cairo University, Egypt
| | - Hadeel Mustafa
- Research Accessibility Team (students' and Interns' Research Program), Faculty of Medicine, Cairo University, Egypt
| | - Nancy Anis
- Pediatric Cardiology Unit, Pediatrics' Department, Faculty of Medicine, Cairo University, Egypt
| | | | - Farid Hanna
- Residency Training Program, Faculty of Medicine, Cairo University, Egypt
| | - Laila Moris
- Residency Training Program, Faculty of Medicine, Al Mansoura University, Egypt
| | - Jianping Ye
- Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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9
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AbdelMassih AF, AbdelAzeam AS, Ayad A, Kamel AY, Khalil A, Kotb B, Waheed D, Menshawey E, Sefein F, Taha F, Ismail HA, Osman I, Iskander J, El Wakil L, Rashad L, Arsanyous MB, El Shershaby M, Mansour M, Ashraf M, Hafez N, Abuzeid NM, AbdElSalam NMN, Hafez NG, Youssef N, Hozaien R, Saeed R, Kamel D, AbdelHameed MA, Ali S. Unleashing the mysterious link between COVID-19 and a famous childhood vasculitis: Kawasaki disease. Egypt Pediatric Association Gaz 2020. [PMCID: PMC7358563 DOI: 10.1186/s43054-020-00029-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) emerged as a small outbreak in Wuhan rapidly progressing into the deadliest pandemic since the Spanish flu of 1918. The disease was deemed trivial in children, until the reporting, few days ago, of an emerging pediatric multi-inflammatory syndrome mimicking Kawasaki disease (KD). Main body This report reveals that coronaviridae were implicated in induction of several post-infectious vasculitides, namely, KD, AHEI, and HSP. This occurs in genetically susceptible individuals to vascular inflammation. Shared genetic susceptibilities between KD and CoV include genes encoding for CD 40, HLAB-15:03, and ACE. This leads to augmented inflammation with hypersecretion of cytokines especially IL-6. Conclusion The revealed relationships between KD and CoV can help to predict the risk of KD in COVID-19 patients through screening levels of upregulated cytokines. It might also signify that classic treatment of KD with IVIG might need to be replaced with anti-cytokine therapy in COVID-19 patients.
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