Open Access Original Research Article

Burden of Type 1 Diabetes Mellitus (TID) in Saint Vincent and the Grenadines from 2014-2018

Adedeji Okikiade, Ikeokwu Anderson, Olayinka Afolayan-Oloye, Olanrewaju Adeola O., Mane Paulpillai

Asian Journal of Immunology, Page 1-14

Background: Type 1 Diabetes Mellitus (TID), is a disease that has long been connoted to as insulin-dependent, childhood-onset, young adult-onset or juvenile onset diabetes with essential insulin deficiency that requires daily insulin administration with peak onset during puberty (10-15) years of age.

Aim: This study was aimed at assessing the Burden of TID among diagnosed Autoimmune disease in Saint Vincent and the Grenadines.

Methods: From 2014 to 2018, individuals with Autoimmune, Immunological and Rare disease were identified from the hospital records of Milton Cato Memorial Hospital, which records information on all patient coming in for healthcare services. A structured data extraction tool was employed to extract the data from the hospital record using the open data kit (ODK). Data was analysed using Statistical Package for Social Sciences (SPSS) version 23 and R Studio statistical software for analysis. The Chi-square test was used to test for association. All statistical tests were two-tailed and Level of Confidence was set at 95%, and P values < 0.05 was considered to be statistically significant.

Results: The mean age of patient with Type 1 Diabetes was 26.58 ± 11.73 yrs. old and the median Age was 31 years. old, almost two-third 81(64.8%) were females. Yearly, women showed a significantly higher incidence of T1D than men, there was an annual decrease in the incidence from 2014 to 2018, with a peak incidence in 2014 (0.49/1000 person-years). There was an annual decrease in the incidence from 2014 to 2018, with a peak incidence in 2017 for male (0.40/1000 person-years) and in 2014 for females (0.69/1000 person-years). The lowest incidence was noted in 2018 (0.00/1000 person-years) and (0.08/1000 person-years) for both male and female respectively. There was increased mortality in people with T1D with a baseline of 3% in 2014 to 33% in 2018.

Conclusions: Sequel to the findings of this study, the incidence of autoimmune disease, Type 1 diabetes Mellitus have decreased in the last decade, whereas the mortality rates have increased. This finding of increased mortality of T1D suggests that this disease is no longer rare and will have implications for future healthcare planning.

Open Access Original Research Article

Prevalence and Risk Factor Determining Autoimmune Rheumatic Disease and Malignancy

Tasanee Kitumnuaypong, Kittiwan Sumethkul, Warangkana Pichaiwong

Asian Journal of Immunology, Page 15-24

Background: A determine prevalence and identify risk factors of malignancy in autoimmune rheumatic diseases were important for raising awareness of the association between autoimmune rheumatic diseases and malignancy leading to more effective treatments.

Objective: To determine prevalence and risk factors of malignancy in autoimmune rheumatic diseases patients.

Methods: A cross-sectional study was conducted on medical records of patients diagnosed with autoimmune rheumatic diseases and malignancy based on the ICD-10 coding system from January 1, 2013-May 31 2020, at a tertiary referral hospital in Bangkok.

Results: From records of patients diagnosed with autoimmune rheumatic diseases, most were patients with systemic lupus erythematosus (n=2,277), rheumatoid arthritis (n=530), spondyloarthritis (n=379), systemic sclerosis (n=290), dermato/ polymyositis (n = 108), Sjögren syndrome (n=95), and overlap syndrome (n=54). The overall prevalence rate of malignancy in autoimmune rheumatic diseases was 4.2%. Lung and breast were the most common sites. Types of autoimmune rheumatic diseases, age groups, comorbid, and medications were risk factors that could heighten malignancy risk in autoimmune rheumatic diseases. Amongst types of autoimmune rheumatic diseases, demato/ polymyositis and rheumatoid arthritis were heighten risk of malignancy up to 3.88 and 2.60 times over systemic lupus erythematosus. Patients with over 60 years had the higher risk at 3.21 times over those age between 15-25 years. Comorbid disease brought 1.50 times higher risk. As cyclophosphamide, corticosteroids and methrotrexate, some medications increased the risk ranged between 2.79, 1.93 and 0.56 times, respectively.

Conclusions: Evidence confirmed the association of malignancy with all kinds of autoimmune rheumatic diseases, especially rheumatoid arthritis and dermato/ polymyositis, at the highest risk. The study indicated an increased risk of malignancy among elders, patients with comorbid, and corticosteroids, cyclophosphamide, and methrotrexate users.

Open Access Original Research Article

Immune Thrombocytopenia Purpura among the Various Age Groups Patients Attending Jaypee Multi-super Speciality World Class Hospital Noida

Usman Salahuddeen Abdullahi, Mudassir Lawal, Jaya Bharti, Zainul Abidina Garba, Yusuf Yahaya Miya

Asian Journal of Immunology, Page 25-32

Background: Immune mediated thrombocytopenia (ITP) is a common manifestation of autoimmune disease in children. Although patients often present with bruises, petechiae, and some mucosal bleeding, the incidence of life-threatening hemorrhage is rare (0.2-0.9%) but can be fatal when presenting in vital organs.

Study Setting and Design: A facility based cross sectional study was conducted from May 2019 to January 2020 at Jaypee Multi-super Speciality World-class Hospital Laboratory Medicine, sector 128 Noida. This health facility is located in utter Pradesh (UP) in India and is a source of medical care for the underserved population. This research was designed to investigate immune thrombocytopenia purpura among 151 patients attending Jaypee Multi-Super Speciality World Class Hospital Noida.

Methodology: The Complete Blood Count (CBC) was carried out using an automated analyzer (sysmex XN-1000).

Coagulation Analysis procedure (Prothrombin Time (PT) Test and Activated Partial Thromboplastin Time (APTT) was carried out using a Coagulation Analyzer (Destiney plus).

Results: The total subjects with Thrombocytopenia purpura in this research are 151 subjects, 100 (66.2%) are male and the remaining 51 (33.8%) were female respectively. Immune Thrombocytopenic Purpura. Out of 151 subjects recruited for this study Immune Thrombocytopenic Purpura was recorded 23 subjects (15.2%) in which 12 (7.95%) are male and 11(7.29%) were female. This result showed that, the 48 patients (31.8) of the subjects were having a Prothrombin Time (PT) value of less than 14.9 seconds while, the 103 patients (68.2) showed Prothrombin Time of greater than 14.9, the 14.9 was the normal range. Activated Partial Thrombin Time (APPT) of less than 23.0 seconds were recorded in 103 patients (68.2%) of the subjects while, Activated Partial Thrombin Time of greater than 23.0 seconds were recorded in 48 patients (31.8%) of the subjects. International Normalize Ratio (INR) of less than 1.1 were recorded in 43 patients (28.5%) of the subjects while, International Normalize Ratio of greater than 1.1 were recorded in 108 patients (71.5%) of the subjects.

Open Access Original Research Article

Transcriptomic Properties Involved in Allergic Rhinitis Based on RNA-seq Analysis

Bing Guan, Wei Ma, Dejun Ji, Xinyi Yang, Shiming Ye, Yanxian Wang, Haiyong Sun

Asian Journal of Immunology, Page 44-52

Allergic rhinitis (AR) is an allergic disease of the upper respiratory tract, becoming a global health problem with its mechanism still not clearly explained. To unveil the pathogenesis and immunology of AR, a transcriptomic assay was executed between the AR patient and control with nasal turbinate bone hyperplasia by RNAseq method and the data were processed by GO, KEGG and functional network analysis. The results showed that 131 common DEGs were obtained between AR patients and control. Based on the 131 DEGs, GO analysis indicated that these DEGs were enriched on 39 GO terms, including two main functions, positive regulation of myeloid cell apoptosis and leukocyte aggregation. Otherwise, KEGG pathway analysis revealed 87 pathways, including two major pathways: staphylococcus aureus infection pathway and IL-17 signaling pathway. The biological process of the 131 DEGs can be divided into 3 groups: humoral immune response, positive regulation of endopeptidase activity, regulating protein processing. Functional network of the 131 DEGs sketched by Cytoscape software showed that when the degree of the network was raised to 15, only 11 genes had a linking degree more than 5, with only PLEKHC1 linking the up- and down-regulated genes. Coincidently, when diagramming all the 29 genes related directly with CD68, the gene with the largest linking degree, PLEKHC1 was found to be the only down-regulated gene. These results revealed some characteristic genes and IL-17 signaling pathways were critical for the pathogenesis of AR, which provides some evidence for further research on the immunology and pathogenesis of AR.

Open Access Review Article

Immune Competency in a Coronavirus Environment

M. O. Nwokike, A. O. Ogbonna, C. A. Anusiem, E. C. Ogbuagu, S. I. Ghasi

Asian Journal of Immunology, Page 33-43

Coronavirus disease 2019 [COVID-19] belongs to the class of coronaviruses - one of a group of RNA[ribonucleic acid] viruses that infect animals and humans, primarily the upper respiratory and gastrointestinal tract and these are zoonotic, meaning that they can be transmitted between animals and people. The elderly and immunocompromised persons were considered more vulnerable to severe infections of such respiratory tract diseases but the spread of this recent pandemic raises fear that immunodeficiency is not quite the main factor. Vaccines and treatment options are currently being investigated and deployed but there is no definitive evidence that certain medications are effective with regard to preventing illness or transmission of the COVID-19. As is wont in a pandemic of this nature, claims are being made that nutritional regime which is of value in boosting the immune system will either prevent such infections as COVID-19 or enhance recovery. There are also claims that some people are more genetically predisposed to the infection than others. This review brings to the fore information that will clear speculations and make sense of confusing and often conflicting scientific data about the role of immune competence in the prevention, transmission of and recovery from COVID-19 and other similar infections. This involved a Google search for keywords like immunecompetence, influenza, coronaviruses, COVID-19, Nutrient value, Vitamin C and Vitamin D, in all available publications in the public domain without regard to the age of publication. This broad search spectrum is intended to capture all the historical effort to understand the role of immune function in the treatment and recovery to the influenza virus which seems to be the primogenitor of COVID-19.