الفهرس | Only 14 pages are availabe for public view |
Abstract Asthma is a common long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms reversible air flow obstruction, and bronchospasm .symptoms include episoides of wheezing, coughing, chest tightness, and shortness of breath. Asthma is thought to be caused by a combination of genetic and environmental factors Diagnosis is usually based on the pattern of symptoms, response to therapy over time, and spirometry. Asthma is classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flowrate. Nephrotic syndrome: edema, proteinuria > 40 mg / m2 / h or urineprotein /creatinine (Up/cr)ratio > 200 mg/mmol, hypoalbuminemia ≤ 2.5 g/dl, hyperlipidemia. Remission was defined as: complete, if Up/cr < 0.2 persisted for 3 consecutive days or the first morning urine dipstick test was zero or trace for 3 consecutive days; partial , if > 50 % reduction in first morning Up/cr from presenting ratio and absolute Up/cr 0.2–2, serum albumin > 2.5 g/dl, and no edema; or no remission, in the case of failure to reduce urine protein excretion by 50 % from baseline or persistent excretion Up/cr > 200 mg/mmol. Leukotrienes contribute to the pathophysiology of asthma , and cause or potentiate the following symptoms: airflow obstruction, increased secretion of mucus, mucosal accumulation, bronchospasm ,infiltration of inflammatory cells in the airway wall. leukotrienes (LTs) have been demonstrated to play an important role in inflammatory reactions in glomeruli after immune or nonimmune injuries. LTs appear to play counter-regulatory roles within the inflamed glomeruli that influence the glomerular basement membrane (GBM) permeability, vascular tone, and other pivotal pathophysiological events. Our hypothesis depends on classification of children according to their clinical phenotypes into 3 groups; asthmatic nephrotic patients, patients with nephrotic syndrome and healthy group. This approach to asthma phenotyping is multidimensional approach based upon clinical symptomatology, study of airway inflammatory biomarkers (TsIgE, peripheral eosinoophilic% and ULTE4), laboratory tests of nephrotic syndrome (serum C3, serum cholesterol, serum albumen and creatinine) and genetic analysis (SNPs of LTC4S 444 A/C and cysLTR1 927 T/C) together with PFTs and skin test. could be trial to improve the way for aproper selection of therapy. In current study asthmatic nephrotic patients showed significant increase in serum C3 and ULTE4 when compared to nephrotic group. And significant increase TsIgE when compared to nephrotic group and control. Distribution of LTC4S (444 AC) genotypes showed insignificant difference between case and control . whereasCysLTR1 (927T / C)polymorphism showed a common distribution of C alle in male wth failure of female to show this result. |