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Sabry, D., A. E. Amir, R. H. Mahmoud, A. A. Abdelaziz, and W. Fathy, "Role of LncRNA-AF085935, IL-10 and IL-17 in Rheumatoid Arthritis Patients With Chronic Hepatitis C.", Journal of clinical medicine research, vol. 9, issue 5, pp. 416-425, 2017 May. Abstract

BACKGROUND: The current study aimed at testing the effect of corticosteroid therapy on serum levels of interleukin-10 (IL-10) and IL-17 as well as lncRNA-AF085935 in patients of rheumatoid arthritis (RA) associated with hepatitis C virus (HCV) and evaluating the usefulness of using these parameters to predict the therapeutic efficacy of steroids in these patients.

METHODS: Thirty healthy control subjects and 65 chronic HCV patients with RA were included in our study. Patients were subjected to clinical examination, abdominal ultrasound, and liver biopsy and received 6-methyl-prednisolone (PDN) 16 mg/day for 48 weeks. Blood samples were collected from all subjects and serum was separated to assess IL-10 and IL-17 by ELISA and HCV RNA and lncRNA-AF085935 by qRT-PCR.

RESULTS: Our study revealed that there were significant increases in serum levels of IL-10, IL-17 and lncRNA-AF085935 in RA patients associated with HCV compared with healthy control subjects. Also there were significant increases in serum levels of IL-10 and HCV RNA and a significant decrease in serum level of IL-17 in patients after corticosteroid therapy, while lncRNA-AF085935 is not significantly changed.

CONCLUSION: LncRNA-AF085935 might be a useful candidate biomarker for the early detection of RA associated with HCV, providing potential new strategies for early screening and therapy of these patients. IL-17 is a non-invasive prognostic marker to predict the efficacy of corticosteroid therapy in RA patients associated with chronic hepatitis C.

Mazen I Naga, M. A. Amin, Dina A Algendy, ahmed i elbadry, Mai M Fawzi, Ayman R Foda, Serag M Esmat, D. Sabry, L. A. Rashed, M. Kamal, et al., "The Role Of Genetic Polymorphism Of LDL Receptor In Egyptian Population Infected With Chronic HCV, Regarding Response To Treatment", HEPATOLOGY, WILEY-BLACKWELL, 60, pp. 922A-922A, 2014.
El-Menoufy, H., L. A. A. Aly, M. T. A. Aziz, H. M. Atta, N. K. Roshdy, L. A. Rashed, and D. Sabry, "The role of bone marrow-derived mesenchymal stem cells in treating formocresol induced oral ulcers in dogs", Journal of oral pathology & medicine, vol. 39, no. 4: Wiley Online Library, pp. 281–289, 2010. Abstract
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Abdel Aziz, M. T., T. Mostafa, H. Atta, M. A. Wassef, H. H. Fouad, L. A. Rashed, and D. Sabry, "Putative role of carbon monoxide signaling pathway in penile erectile function", The journal of sexual medicine, vol. 6, no. 1: Wiley Online Library, pp. 49–60, 2009. Abstract
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Hassan, R., A. A. Rabea, A. Ragae, and D. Sabry, "The prospective role of mesenchymal stem cells exosomes on circumvallate taste buds in induced Alzheimer's disease of ovariectomized albino rats: (Light and transmission electron microscopic study).", Archives of oral biology, vol. 110, pp. 104596, 2020. Abstract

OBJECTIVE: To elucidate the effect of Alzheimer's disease on the structure of circumvallate papilla taste buds and the possible role of exosomes on the taste buds in Alzheimer's disease.

DESIGN: Forty two ovariectomized female adult albino rats were utilized and divided into: Group I: received vehicle. Group II: received aluminum chloride to induce Alzheimer's disease. Group III: after the induction of Alzheimer's disease, each rat received single dose of exosomes then left for 4 weeks. The circumvallate papillae were prepared for examination by light and transmission electron microscope.

STATISTICAL ANALYSIS: histomorphometric data were statistically analyzed.

RESULTS: Histological examination of circumvallate papilla in Group I showed normal histological features. Group II revealed distorted features. Group III illustrated nearly normal histological features of circumvallate. Silver impregnation results showed apparently great number of heavily impregnated glossopharyngeal nerve fibers in both Groups I & III but markedly decreased in Group II. Synaptophysin-immunoreactivity was strong in Group I, mild in Group II and moderate in Group III. The ultra-structural examination of taste bud cells revealed normal features in Group I, distorted features in Group II and almost normal features in Group III. Statistically highest mean of Synaptophysin-immunoreactivity area% was for Group I, followed by Group III, and the least value was for Group II.

CONCLUSIONS: Alzheimer's disease has degenerative effects. Bone marrow mesenchymal stem cell (BM-MSC)-derived exosomes have the ability to improve the destructive changes induced by Alzheimer's disease.

Zayed, S. A., T. M. Gaafar, R. M. Samy, D. Sabry, A. S. Nasr, and F. A. Maksoud, "Production of endothelial progenitor cells obtained from human Wharton's jelly using different culture conditions.", Biotechnic & histochemistry : official publication of the Biological Stain Commission, vol. 91, issue 8, pp. 532-539, 2016 Nov. Abstract

Endothelial progenitor cells (EPC) participate in revascularization and angiogenesis. EPC can be cultured in vitro from mononuclear cells of peripheral blood, umbilical cord blood or bone marrow; they also can be transdifferentiated from mesenchymal stem cells (MSC). We isolated EPCs from Wharton's jelly (WJ) using two methods. The first method was by obtaining MSC from WJ and characterizing them by flow cytometry and their adipogenic and osteogenic differentiation, then applying endothelial growth differentiating media. The second method was by direct culture of cells derived from WJ into endothelial differentiating media. EPCs were characterized by morphology, Dil-LDL uptake/UEA-1 immunostaining and testing the expression of endothelial markers by flow cytometry and RT-PCR. We found that MSC derived from WJ differentiated into endothelial-like cells using simple culture conditions with endothelium induction agents in the medium.

Zayed, S. A., T. M. Gaafar, R. M. Samy, D. Sabry, A. S. Nasr, and F. A. Maksoud, "Production of endothelial progenitor cells obtained from human Wharton's jelly using different culture conditions.", Biotechnic & histochemistry : official publication of the Biological Stain Commission, vol. 91, issue 8, pp. 532-539, 2016 Nov. Abstract

Endothelial progenitor cells (EPC) participate in revascularization and angiogenesis. EPC can be cultured in vitro from mononuclear cells of peripheral blood, umbilical cord blood or bone marrow; they also can be transdifferentiated from mesenchymal stem cells (MSC). We isolated EPCs from Wharton's jelly (WJ) using two methods. The first method was by obtaining MSC from WJ and characterizing them by flow cytometry and their adipogenic and osteogenic differentiation, then applying endothelial growth differentiating media. The second method was by direct culture of cells derived from WJ into endothelial differentiating media. EPCs were characterized by morphology, Dil-LDL uptake/UEA-1 immunostaining and testing the expression of endothelial markers by flow cytometry and RT-PCR. We found that MSC derived from WJ differentiated into endothelial-like cells using simple culture conditions with endothelium induction agents in the medium.

Aboud, H. M., M. O. Mahmoud, M. Abdeltawab Mohammed, M. Shafiq Awad, and D. Sabry, "Preparation and appraisal of self-assembled valsartan-loaded amalgamated Pluronic F127/Tween 80 polymeric micelles: Boosted cardioprotection regulation of Mhrt/Nrf2 and Trx1 pathways in cisplatin-induced cardiotoxicity.", Journal of drug targeting, vol. 28, issue 3, pp. 282-299, 2020. Abstract

This study aimed to develop valsartan (VAL)-loaded mixed micelles and investigate their cardioprotective potential and molecular mechanisms through Mhrt/Nrf2 and Trx1 pathways. VAL-loaded mixed micelles have not been elaborated and their impact on Mhrt/Nrf2 and Trx1 pathways has not been yet inspected. VAL-loaded mixed micelles were prepared, incorporating Pluronic F127 and Tween 80, adopting thin-film hydration method. The micelles were evaluated for drug entrapment efficiency, loading characteristics, particle size, morphology, drug release and micelles storage stability. The pharmacokinetic studies were explored in rats. Also, VAL suspension and mixed micelles were tested in cisplatin-induced cardiotoxicity in rats either pre to or simultaneously with cisplatin. RNA expression of lnc Mhrt and protein expression of Nrf2, Trx1, Ask1, AMPK and caspase 3, oxidative stress and cardiac injury markers besides tailed DNA% by comet assay were assessed. Pharmacokinetic studies evoked a 3.75-fold increase in oral bioavailability as compared with VAL suspension. Overall, treatment with VAL-loaded mixed micelles was superior to VAL suspension in decreasing oxidative stress and cardiac injury markers and restoring the abnormalities occurred in Mhrt/Nrf2 and Trx1 pathways. Thus, mixed micelles would be promising nanocarrier for the engineering of VAL with reinforced pharmacokinetics and cardioprotection characteristics.

Shousha, H. I., R. Fouad, T. M. Elbaz, D. Sabry, M. M. Nabeel, A. H. Abdelmaksoud, A. M. E. Sharkawy, Z. A. Soliman, G. Habib, and A. O. Abdelaziz, "Predictors of recurrence and survival of hepatocellular carcinoma: A prospective study including transient elastography and cancer stem cell markers.", Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology, vol. 21, issue 2, pp. 95-101, 2020. Abstract

BACKGROUND AND STUDY AIMS: To investigate whether the measurement of liver stiffness (LSM) using fibroscan and the serum Cancer Stem Cells (CSC): Ep-CAM and cytokeratin-19, could predict the recurrence of hepatocellular carcinoma (HCC) and their impact on clinical outcome and overall survival.

PATIENTS AND METHODS: This is a prospective study, including 179 HCV-related HCC patients. All patients were treated following the BCLC guidelines. All HCC patients had transient elastography, measurements of Ep-CAM and cytokeratin-19 before and six months post-treatment. We looked for predictors of recurrence and performed a survival analysis using Kaplan-Meier estimates.

RESULTS: TACE was the most common procedure (77.1%), followed by microwave ablation (15.6%). Complete ablation was achieved in 97 patients; 55 of them developed HCC recurrence. After treatment, LSM increased significantly with a significant reduction in CSCs levels in complete and partial response groups. The median time to observe any recurrence was 14 months. LSM increased significantly post-treatment in patients with recurrence versus no recurrence. Higher levels of CSCs were recorded at baseline and post-treatment in patients with recurrence but without statistical significance. We used univariate analysis to predict the time of recurrence by determining baseline CK-19 and platelet levels as the key factors, while the multivariate analysis determined platelet count as a single factor. The univariate analysis for prediction of overall survival included several factors, LSM and EpCAM (baseline and post-ablation) among them, while multivariate analysis included factors such as Child score B and incomplete ablation.

CONCLUSION: Dynamic changes were observed in LSM and CSCs levels in response to HCC treatment and tumour recurrence. Child score and complete ablation are factors that significantly affect survival.

Assem, M., S. Kamal, D. Sabry, N. Soliman, and R. M. Aly, "Preclinical Assessment of the Proliferation Capacity of Gingival and Periodontal Ligament Stem Cells from Diabetic Patients", Open Access Macedonian Journal of Medical Sciences, pp. 1-6, 2018. moustafa_paper.pdf
Ahmed G Abdel Salam, Hazem M Ata, T. M. Salman, L. A. Rashed, D. Sabry, and M. F. Schaalan, "Potential therapeutic utility of mesenchymal stem cells in inflammatory bowel disease in mice", International immunopharmacology, vol. 22, issue 2, pp. 515-521, 2014.
Alaa El-Din, Y., D. Sabry, A. H. Abdelrahman, and S. Fathy, "Potential therapeutic effects of induced pluripotent stem cells on induced salivary gland cancer in experimental rats.", Biotechnic & histochemistry : official publication of the Biological Stain Commission, pp. 1-8, 2018 Oct 19. Abstract

Salivary gland neoplasms exhibit complex histopathology in a variety of tumor types and treatment options depend largely on the stage of the cancer. Induced pluripotent stem cells (iPS) have been investigated for treating induced salivary gland cancer and for restoring salivary gland function. We investigated iPS treatment for salivary gland cancer both in vitro and in vivo. For our study in vitro, we re-programmed human skin fibroblasts to form iPS cells using a plasmid containing Oct4, Sox2, L-MYC and LIN28. For our study in vivo, we used 30 white male albino rats divided into the following groups of 10: group 1 (control): rats were injected with phosphate-buffered saline (PBS), group 2 induced squamous cell carcinoma (SCC): rat submandibular glands were injected with squamous carcinoma cells (SCC), group 3 (induced SCC/iPS): SCC treated rats treated with 5 × 106 iPS cells. Submandibular glands from rats of all groups were examined histologically and real time PCR was performed for amylase, and COX I and COX II gene expression. We confirmed that submandibular gland specimens included tumor tissue before starting treatment with iPS. iPS treated cases exhibited regeneration of salivary glands, although minor degenerative and vascularization changes remained. The acinar cells regained their proper organization, but continued to exhibit abnormal activity including hyperchromatism. iPS cells may be useful for treating salivary gland carcinomas.

Fouad, H., D. Sabry, K. Elsetohy, N. Fathy, and D. I. N. A. OMAR, "Potential therapeutic effect of amniotic stem cell transplantation on ovarian function and folliculogenesis in rats with induced ovarian failure", Journal of Evidence-Based Women’s Health Journal Society, vol. 5, issue 3, pp. 99-110, 2015.
SH Ahmad, D. Sabry, Olfat Noh, and M. Samir, "Potential proliferative effect of lipopolysaccharide preconditioning on human umbilical cord blood-derived endothelial progenitor cells", African Journal of Biotechnology, vol. 14, issue 13, pp. 1167-1173, 2015.
Sabry, D., N. Aboraia, and M. Samir, "A potential association between psoriasin to rs4819554 of IL-17RA gene polymorphism in psoriasis Egyptian patients.", Archives of dermatological research, vol. 312, issue 4, pp. 273-281, 2020. Abstract

Interleukin 17 (IL-17) is one of the pro-inflammatory cytokine. Psoriasin is a noticeably over-expressed protein found in the skin lesions of psoriatic patients. Our current study was planned to examine the association of (- 947 A/G) single nucleotide polymorphism (SNP) in IL-17RA promoter region (rs4819554) with psoriasis susceptibility in Egyptian psoriatic patients. Our study included 100 patients and 100, age as well as sex matched, control groups. IL-17RA SNP association was studied using allelic discrimination. RT-qPCR and ELISA were done to assess IL-17 expression. ELISA was performed to assess psoriasin expression. Our study showed a significant association between IL-17 rs4819554 SNP and psoriasis risk, evidenced by higher G allele and AG genotype frequencies in psoriatic patients when compared to controls (allelic: OR 2.283, 95% CI 1.321-3.946, p = 0.003, and genotype: OR 3.026, 95% CI 1.356-6.752, p = 0.007). Additionally, serum psoriasin level was significantly increased when comparing psoriatic patients to controls (p = 0.0003). Moreover, significant increase in IL 17 gene and protein level in AA, AG psoriatic genotypes compared to the corresponding genotypes in normal control (p = 0.0004). IL-17 rs4819554 is significantly associated with psoriasis, and with psoriasin level, in the Egyptian population.

Sabry, D., O. Nouh, S. Marzouk, and A. Hassouna, "Pilot study on molecular quantitation and sequencing of endometrial cytokines gene expression and their effect on the outcome of in vitro fertilization (IVF) cycle", Journal of Advanced Research, vol. 5, issue 5, pp. 595-600, 2014.
Shehab, H., D. Sabry, M Mokhtar, M. Mabrouk, W. Elakel, M. Tawfik, Y Korriem, and G. Esmat, "P1101 THE VITAMIN D RECEPTOR FOKI GENE POLYMORPHISM IS ASSOCIATED WITH POOR RESPONSE TO TREATMENT IN CHRONIC HEPATITIS C GENOTYPE 4", HEPATOLOGY, WILEY-BLACKWELL, 60, pp. S445, 2014.
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Aziz, A. E., M. Talaat, M. F. El-Asmer, T. Mostafa, S. Mostafa, H. Atta, M. Abdel Aziz Wassef, H. Fouad, L. Rashed, D. Sabry, et al., "ORIGINAL RESEARCH—BASIC SCIENCE: Heme Oxygenase vs. Nitric Oxide Synthase in Signaling Mediating Sildenafil Citrate Action", The journal of sexual medicine, vol. 4, no. 4ii: Wiley Online Library, pp. 1098–1107, 2007. Abstract
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Abdel Aziz, M. T., T. Mostafa, H. Atta, L. Rashed, S. A. Marzouk, E. M. Obaia, D. Sabry, A. A. Hassouna, A. M. El-Shehaby, and A. T. Abdel Aziz, "Oral phosphodiesterase-5 inhibitors: effect of heme oxygenase inhibition on cGMP signalling in rat cavernous tissue", Andrologia, vol. 39, no. 2: Wiley Online Library, pp. 66–70, 2007. Abstract
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Mohammed, R. S., W. Ibrahim, D. Sabry, and S. I. El-Jaafary, "Occupational metals exposure and cognitive performance among foundry workers using tau protein as a biomarker.", Neurotoxicology, vol. 76, pp. 10-16, 2020. Abstract

INTRODUCTION: Human exposure to heavy metals is a potential risk for developing cognitive impairment. Aluminum (Al) foundry is one of industries that involve occupational exposure to different metals.

AIM OF THE WORK: to evaluate the cognitive performance of Aluminum foundry workers in relation to different metals exposure.

MATERIALS AND METHODS: a cross sectional study conducted on 75 Al foundry workers and 75 non-occupationally exposed subjects as controls. Personal interview with specially designed questionnaire, Assessment of cognitive functions done using Montreal cognitive assessment (MocA), Stress, depression and sleep were also assessed. Serum levels of Aluminum (AL), Lead (Pb), manganese (Mn), Zinc (Zn) and tau protein were measured.

RESULTS: Exposed group showed significant increase in serum levels of Aluminum, lead, Manganese and tau protein, p value < 0.005 (mean ± SD 0.56 ± 0.18, 22.3 ± 5.01, 42.04 ± 7.4, 1.53 ± 0.58 Vs 0.36 ± 0.11, 13.4 ± 1.29, 39.4 ± 4.4, 1.03 ± 0.44 respectively) with significant decrease of zinc level compared to control (mean ± SD 46.4 ± 5.2 Vs 88.8 ± 6.04, p value 0.005). There was a significant decrease MocA scores among exposed population, (mean ± SD 24.4 ± 3.4 compared to 28.4 ± 1.3 in non exposed, p value < 0.005). which was affected by serum levels of lead, aluminum, manganese and tau protein (β -0.165, -8.958, -.286, -2.341 respectively and p < 0.005).Stress scores was higher in exposed workers than control but not affecting cognitive performance.

CONCLUSION: occupational exposure to metals can cause cognitive dysfunction which may be subtle, so there is a need for formal cognitive testing at baseline, and on regular intervals during working period. Serum tau protein could be used as a prognostic biomarker for the hazardous effect of occupational exposure to these metals on the neuronal cells.

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Harb, I. A., H. Ashour, D. Sabry, D. F. El-Yasergy, W. M. Hamza, and A. Mostafa, "Nicorandil prevents the nephrotoxic effect of cyclosporine-A in albino rats through modulation of HIF-1α/VEGF/eNOS signaling.", Canadian journal of physiology and pharmacology, vol. 99, issue 4, pp. 411-417, 2021. Abstract

Despite that cyclosporine-A (CsA) is a widely used immunosuppressive drug, its nephrotoxic effect limits its long-term administration. Herein we tried to investigate its renal effect on endothelial dysfunction targeting the hypoxia-inducible factor (HIF-1α) / vascular endothelial growth factor (VEGF) / endothelial nitric oxide synthase (eNOS) pathway and the possible modulation by nicorandil. Eight groups of adult male Wistar rats were included: (1) control; (2) vehicle group (received oil); (3) glibenclamide 5 mg·kg·day administered orally; (4) nicorandil 10 mg·kg·day administered orally; (5) CsA 25 mg·kg·day administered orally; (6) combined administration of CsA and nicorandil; (7) glibenclamide was added to CsA; and (8) both CsA and nicorandil were combined with glibenclamide. The treatment continued for six weeks. Combined nicorandil with CsA improved renal function deterioration initiated by CsA. CsA decreased the renal expression levels ( < 0.001) of HIF-1α, eNOS, and VEGF, inducing endothelial dysfunction and triggering inflammation, and upregulated the profibrotic marker transforming growth factor (TGF-β). Nicorandil fixed the disturbed HIF-1α/VEGF/eNOS signaling. Nicorandil corrected the renal functions, confirmed by the improved histological glomerular tuft retraction that was obvious in the CsA group, without significant influence by glibenclamide. Proper protection from CsA-induced nephrotoxicity was achieved by nicorandil. Nicorandil reversed the disturbed HIF-1α/VEGF/eNOS pathway created by CsA.

Sherif, I. O., N. H. Al-Shaalan, and D. Sabry, "Neuroprotective Potential of Bone Marrow-Derived Mesenchymal Stem Cells Following Chemotherapy.", Biomedicines, vol. 9, issue 7, 2021. Abstract

Cisplatin (CP) is extensively used in the medical oncology field for malignancy treatment, but its use is associated with neurological side effects that compromise the patients' quality of life. Cytotherapy is a new treatment strategy for tissue damage that has recently emerged. The use of bone marrow-derived mesenchymal stem cells (BM-MSCs) was investigated for its therapeutic potential against CP-induced chemobrain as well as various models of brain damage. This study was carried out to elucidate, for the first time, the role of the intravenous injection (IV) of BM-MSCs against CP-induced neurotoxicity in a rat model through investigation of the parameters of oxidative stress, inflammation, and apoptosis in brain tissue. A rat model of neurotoxicity was generated by intraperitoneal injection of 7.5 mg/kg CP while 2 × 10 BM-MSCs was given by IV as a therapeutic dose. Injection of CP led to a significant rise in malondialdehyde and nitric oxide levels accompanied by a marked depletion of superoxide dismutase and reduced glutathione content in brain tissue in comparison to the normal control (NC) rats. Furthermore, a remarkable rise in the brain levels of inflammatory cytokines interleukin (IL)-1β and IL-6, together with the expression of apoptotic marker caspase-3, and the downregulation of the brain expression of proliferating marker Ki-67 in brain tissue were detected in the CP group compared to the NC group. Histopathological alterations were observed in the brain tissue of the CP group. BM-MSCs mitigated the biochemical and histopathological alterations induced by CP without affecting brain cell proliferation. BM-MSCs could be used as a promising neuroprotective agent against CP-induced neurotoxicity.

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Abdel Aziz, M. T., A. M. Rezq, H. M. Atta, H. Fouad, AM Zaahkouk, H. H. Ahmed, D. Sabry, and H. M. Yehia, "Molecular signalling of a novel curcumin derivative versus Tadalafil in erectile dysfunction", Andrologia, vol. 47, issue 6, pp. 616-625, 2015.
Hamed, E. A., M. M. El-Saied, K. Saad, H. A. - Z. Yousef, A. O. Mohamed, and D. Sabry, "Molecular mechanisms underlying fibrosis and elastin destruction in childhood interstitial lung diseases.", Pathophysiology : the official journal of the International Society for Pathophysiology, 2016 Sep 21. Abstract

OBJECTIVE: This study aimed to evaluate fibrosis and elastin destruction in childhood interstitial lung disease (chILD) patients.

METHODS: Sixty patients and twenty healthy children were recruited. On admission, evaluation of chILD severity was made using Fan chILD score. Participants provided urine and blood samples. Plasma levels of transforming growth factor (TGF)-β1, connective tissue growth factor (CCN2), soluble factor related apoptosis (sFas) and long non-coding RNAs and urinary levels of desmosine/urinary creatinine (UDes/UCr) were measured.

RESULTS: In patients, clinical findings were crackles (100.00%), tachypnea (65.00%), cardiomegaly (45.00%), digital clubbing (43.30%), cough (33.00%), cyanosis (26.70%), hepatomegaly (28.30%) and wheezes (23.30%). Categorizing of the patients with Fan chILD clinical score revealed that most patients 33.30% scored (3, symptomatic with abnormal saturation/cyanosis during exercise) then 28.30% scored (5, symptomatic with clinical and echocardiographic features of pulmonary hypertension), 18.30% scored (2, symptomatic with normal room air saturations), 15.00% scored (1, asymptomatic) and 5.00% scored (4, symptomatic with abnormal room air saturation/cyanosis at rest). TGF-β1, CCN2, sFas, lncrRNA-2700086A05Rik relative gene expression and UDes/UCr levels were higher in patients than controls (P=0.002, P=0.001, P=0.001, P=0.001, P=0.001, respectively). In patients, significant positive correlations were found between TGF-β1 and CCN2, sFas, UDes/UCr; between CCN2 and both sFas and UDes/UCr; between UDes/UCr and sFas. Morbidity and mortality rates were 46.70% and 10.00%, respectively.

CONCLUSION: Markers of fibrosis (TGF-β1, sFas, CCN2) and elastin destruction (UDes/UCr) were increased in chILD especially in patients with long disease duration. So blockage of their pathways signals may offer novel therapeutic targets.

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