Background and objective: To our knowledge, no previous studies have focused on the immunomodulatory effects of fresh royal jelly (RJ) administration on systemic lupus erythematosus (SLE) in humans. Our aim was to study the effect of fresh RJ administration on the disease course in children with SLE with some immunological markers (CD4 and CD8 regulatory T cells and T lymphocytes apoptosis). Methods: This was an open-label study in which 20 SLE children received 2 g of freshly prepared RJ daily, for 12 weeks. Results: The percentages of CD4CD25high FOXP3cells (CD4 regulatory T cells) and CD8 CD25high FOXP3cells (CD8 regulatory T cells) were significantly increased after RJ treatment when compared with baseline values. Apoptotic CD4 T lymphocytes were significantly decreased after RJ therapy when compared with baseline values and the control group. Conclusion: This is the first human study on the effect of RJ supplementation in children with SLE. Our results showed improvements with 3-month RJ treatment with regard to the clinical severity score and laboratory markers for the disease. At this stage, it is a single study with a small number of patients, and a great deal of additional wide-scale randomized controlled studies are needed to critically validate the efficacy of RJ in SLE.

Abstract Gaucher disease (GD) is the most prevalent lysosomal storage disorder. Gaucher disease is associated with remarkable alterations in the immune system, and GD patients are more susceptible to infections and are at a higher risk of developing autoimmune disorders and malignancies. In a case–control study, we used three-color flow cytometric immunophenotyping for determination of the frequency of lymphocyte subpopulations and activated T lymphocytes among 18 children with GD1 under enzyme replacement therapy managed in Assiut University Hospitals. We found significant increases in the frequencies of total lymphocytes, CD19?, CD3?, CD4?, and CD8? in children with GD1 when compared to healthy control. The frequencies of activated T lymphocytes (CD3?HLA-DR?), activated T-helper cells (CD4?HLA-DR?), and activated T-suppressor/cytotoxic cells (CD8?HLA-DR?) were significantly higher in GD1 as compared to healthy children. Our data show that the increased proportion of activated T lymphocytes in children with GD1 raises the issue of their possible involvement in the pathogenesis of the immune dysfunction seen in these patients. Our data suggested that the activated T lymphocytes could play a role in the clinical course of GD1. The relationship of these cells to immune disorders in GD1 children remains to be determined.

Objective: The aim of our study is to assess the clinico-electrophysiological profile of children with Guillain–Barré syndrome (GBS) in Upper Egypt and to compare the efficacy of plasmapheresis versus other treatment modalities. Patients and methods: This was a retrospective study of children from January 2010 to October 2014 diagnosed as GBS. It included 62 cases. Results: Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was the most prevalent type of GBS in our locality. As regards the treatment, 32 cases received plasmapheresis while 30 patients received intravenous immunoglobulin. We found a significant decrease in the duration of hospitalization and a significant increase in the number of children with complete recovery in cases treated with plasmapheresis. Conclusion: GBS is not uncommon in children of Upper Egypt, with AIDP the most prevalent type. Plasmapheresis is the best treatment modalities for GBS as it reduces the duration of hospital stay and hastens the recovery of those children.

Background: Despite improvements in asthma medication, Intubation is deemed necessary in severe asthma with its complications. Non-invasive ventilation is the evolving method to manage acute respiratory failure in these patients. But the effect of non-invasive ventilation is unclear and there are debates regarding its safety. Aims: To assess the effect of NIV in acute asthma. Design: Two years of a prospective interventional study. Methods: Patients with acute asthma were classified into two groups: 1 (standard medical therapy alone) and group 2 (addition of NIV to medical therapy). Demographic, physiological, functional data and blood gas results were recorded. The primary outcomes were the improvement in forced expiratory volume in the first second (FEV1), heart rate, respiratory rate, PaO2, PaCO2, and pH. The secondary outcomes were the need for invasive mechanical ventilation, intensive care unit (ICU) and hospital stay. Results: Ninety patients with severe acute asthma (57 females and 33 males, mean ± SD age 52 ± 15.7 y, FEV1 60% of predicted). APACHE II score was higher in NIV group. There was a significant improvement after 6 hours in respiratory rate (16.6 ± 3.7), heart rate (95.8 ± 11.3), and PaO2 (88.09 ± 20.2). After 1h and 24 hours > 50% improvement in FEV1 was significantly greater in the NIV group. The time needed to alleviate accessory muscle use was shorter in the NIV group. The failure rate was more with group1 (4 patients needed intubation, but only 2 patients in group 2). There was no mortality in any group of our study. Conclusion: The use of NIV was effective in improving oxygenation, heart rate, and respiratory rate, shorten the length of hospital and ICU stay in acute severe asthma.

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