1M Hafez, 1Z
EL-Morsy, 3F EL-Shennawy, 4S Hawas, 2A
Sheishaa, 2H AL-Marsafawy, 2M Abo-EL-Kheir, 1M
Shokeir, 1T EL-Desoky, 5B EL-Deek, 1G Atia and
1G EL-Bakary.
1Pediatric
Genetics and 2Cardiology Units, Department of Pediatrics,
Immunology Divisions, Departments of 3Clinical Pathology and 4Microbiology,
5Biostatistic Division, Department of Community Medicine, Faculty of
Medicine, Mansoura University, Egypt.
Gene expression of the cytokines; IL-1a, IL-1b, IL-2, IL-4,
IL-6, IL-8, IL-10, IL-12, IFNg, TNFa in rheumatic
fever. The study included 146
children divided into the following groups (G): G1: 29 with active rheumatic
heart disease (ARHD); G2: 8 with active rheumatic fever arthritis (ARFA); G3: 6
with active rheumatic heart disease and arthritis (ARHDA); G4: 36 with inactive
rheumatic heart disease (IARHD); G5: 5 with inactive rheumatic fever and
arthritis (IARFA); G6: 5 with inactive rheumatic heart disease and arthritis
(IARHDA); G7: 7 normal children with streptococcal pharynigitis, G8: 50 healthy
children with age and sex matched as control. All of them were subjected to the
following: (1) clinical examination and laboratory investigations including
complete blood picture, throat culture, (ASO), erythrocyte sedimentation rate
(ESR), C-reactive protein (CRP), electrocardiography (ECG), Echocardiography,
(2) measurement of mRNA and serum levels of IL-1a, IL-1b, IL-2, Il-4, IL-6, IL-8, IL-10, IL-12, IFN-g and TNF-a. All investigations were repeated after treatment only for patients
with ARHD and ARFA. Serum levels of all cytokines were parallel to mRNA
expression levels. In ARHD, the highest level was for IL-1a followed by IL-2 and TNFa (P< 0.001). In ARFA, IL-6 was the most
significantly (P< 0.001) produced cytokine followed by IL-10. In IARHD,
levels of IL-1a and IL-2 were
significantly higher than control. No significant differences were found
between the levels of all cytokines in children with streptococcal pharyngitis
and controls. It is concluded that estimation of IL-1a in carditis and IL-6 in arthritis may be
helpful as minor criteria for diagnosis and follow up of rheumatic activity.
Future therapy of rheumatic carditis with anti IL-1a, IL-2 and TNFa immediately after diagnosis is recommended to prevent or reduce
valvular damage.