Gehan Ahmed Mostafa

Ain Shams University

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Laila Al‐Ayadhi

King Saud University

Abeer Shehab

Ain Shams University

Gudrun Burda

Samara State Medical University

Gerhard Trittenwein

Medical University of Vienna

Ghada Shousha

Ain Shams University Hospital

M. M. Abd El-Aziz

South Valley University

Geir Bjørklund

The Research Council of Norway

Harald Boigner

University of Vienna

Michael Hermon

Medical University of Vienna

Johann Golej

Medical University of Vienna

Cooperative Institutions

Ain Shams University

KU Leuven

Medical University of Vienna

Heidelberg University

University Hospital Heidelberg

National and Kapodistrian University of Athens

Istituti di Ricovero e Cura a Carattere Scientifico

Cairo University

University Medical Center

Harvard University

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Up-regulated serum levels of interleukin (IL)-17A and IL-22 in Egyptian pediatric patients with COVID-19 and MIS-C: Relation to the disease outcome

Cytokine (2022)

Gehan Ahmed Mostafa Hanan Ibrahim Abeer Shehab Sondos Mohamed Magdy Nada AboAbdoun Soliman

Neutrophilia

Convalescence

10.1016/j.cyto.2022.155870

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Citations (14)

E- Selectin as a Predictor for Overt and Subclinical Cardiovascular Riskin Patients with Juvenile Idiopathic Arthritis

QJM (2024)

Mohammad A. A. Ibrahim Gehan Ahmed Mostafa Ghada Shousha Osama Roshdy Abeer Maghawry Abdel Hameed

Abstract Background The risk of cardiovascular disorders (CVD) was described in adult patients with systemic juvenile idiopathic arthritis (SJIA) as a part of the systemic activity of the disease. Subclinical cardiovascular risk and early atherogenesis were not broadly studied in children. Objectives This work aims to evaluate soluble E-selectin level as a marker of early endothelial injury, as a predictor for early or subclinical CVD among patients with juvenile idiopathic arthritis (JIA). Patients and Methods This cross-sectional study with nested follow up was conducted in the Pediatric Allergy, Immunology and Rheumatology Unit, Children’s Hospital, Ain Shams University on 57 children and adolescents diagnosed as JIA. They were 6 to 16 years old, including 26/57 (45.6%) males and 31/57 (54.4%) females, and 30 matched healthy controls, during the period from September 2021 to September 2022. Patients were enrolled consecutively during activity and remission status of the disease, determined according to juvenile arthritis disease activity score (JADAS). Serum level of endothelium (E)-selectin was measured using ELISA technique. Patients with active JIA were followed till complete remission. Results Serum levels of E-selectin showed higher estimates among JIA patients during activity and remission than in the healthy control group (p < 0.001); whereas there was no significant difference in E-selectin level among the studied categories of JIA (P > 0.05). Conclusion The observed significantly elevated soluble E-selectin levels among pediatric patients with JIA, denotes the possibility of early atherogenesis or subclinical CVD. Correlation with other cardiac evaluation tools in patients with JIA is recommended.

Subclinical infection

10.1093/qjmed/hcae175.828

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Assessment of Serum Levels of Specific IgE to Cow Milk and Gluten Antigens in Autistic Children

QJM (2024)

Gehan Ahmed Mostafa Azza Mohamed Youssef Abeer Shehab Marwa Nagah Beheiry Ghada Shousha

Abstract Background Regimens of dietary restrictions of cow’s milk protein and wheat showed good impact on autistic children without clear explanation. Objective To investigate the possible link between serum levels of specific IgE to cow milk and gluten allergens and the severity of autism in a group of autistic children. Methods This pilot case-control study was conducted at the Department of Pediatrics, Children's Hospital, Faculty of Medicine, Ain Shams University over a period of 6 months, from May 2022 to November 2022. Twenty four autistic children aged 4 to 12 years and twenty four age- and sex-matched healthy children were included after excluding children with any chronic, allergic or autoimmune disease. Diagnosis of autism was settled according to 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Serum levels of specific IgE for 4 cow’s milk proteins and gluten protein were assessed for the patients and healthy children using Enzyme-linked immunosorbent assay (ELISA) technique. Results Mean age of autistic patients was 6.48±2.54 years with 19 males and 5 females were studies who were age and sex matched with healthy children and served as a control group. Serum levels of specific IgE against cow’s milk protein and gluten were undetectable among the 2 groups as their level was below 0.35 ku/l. Boys had significantly higher levels of specific IgE against beta lactoglobulin compared to autistic girls in female ranging from (0.01-0.2) while in males (0.06-0.33) (p = 0.04). Specific IgE to casein was positively correlated to IQ level of the studied patients (r = 0.499, p = 0.13). Conclusion Although milk and gluten intolerance were identified in autistic children, the underlying mechanism is mostly not related to atopy. Further studies should be encouraged to identify the other possible mechanisms.

Cow milk

10.1093/qjmed/hcae175.797

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Eosinophil cationic protein (ECP) as a marker of eosinophil activation in autistic children: relation to autoimmunity

International Journal Of Medical Science And Clinical Invention (2016)

Laila Al‐Ayadhi Gehan Ahmed Mostafa

Background: Eosinophil cationic protein (ECP), a cytotoxic protein contained in eosinophils granules, can contribute to various inflammatory and immune responses. Autism may be one of the pediatric autoimmune neuropsychiatric disorders. The exact possible role of eosinophils in autism has not yet been elucidated. The aim of this study was to evaluate serum expression of ECP and its relation to anti-ganglioside M1 brain specific auto-antibodies in autistic children. Methods: Serum ECP and anti-ganglioside M1 auto-antibodies were measured by ELISA test in 45 autistic children aged between 3-11 years and 45 healthy-matched controls. Results: Serum levels of ECP were significantly higher in autistic children (median (IQR) = 30.8 (14.1) ug/L) than healthy control children (median (IQR) = 13.6 (11.9) ug/L), P < 0.001. There was a significant positive correlation between serum levels of ECP and results of CARS (r=0.98, P < 0.001). Autistic children had significantly higher percent positivity of serum anti-ganglioside M1 auto-antibodies (62.2%) than healthy controls (4.4%), P < 0.001. Autistic patients with positive serum anti- ganglioside M1 auto-antibodies had significantly higher serum levels of ECP (median (IQR) = 33.8 (25) ug/L) than children with negative serum anti-ganglioside M1 auto-antibodies (median (IQR) = 21.8 (5.5) ug/L), P < 0.001. Conclusions: Serum ECP levels were elevated in some autistic children and they were significantly associated with the increased levels of serum anti-ganglioside M1 auto-antibodies. Further research is recommend to determine the pathogenic role of ECP in autism and its relation to brain specific auto-antibodies that have been found in some autistic children.

10.18535/ijmsci/v3i3.09

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Quantitative Electroencephalography Values of Neonates During and After Venoarterial Extracorporeal Membrane Oxygenation and Permanent Ligation of Right Common Carotid Artery

Artificial Organs (2006)

Gerhard Trittenwein Sandra Plenk Elisabeth Mach Gehan Ahmed Mostafa Harald Boigner

Abstract: Venoarterial extracorporeal membrane oxygenation (ECMO) in neonates commonly needs neck vessel cannulation leading to ligation of right common carotid artery (RCCA) in some cases. Quantitative electroencephalography (EEG) measurements provide reproducible data of cerebral function. The aim of this case‐control study was to test whether ligation of the RCCA results in EEG changes after ECMO weaning. Ten mechanically ventilated neonates not treated with ECMO were eligible as control patients. Seven ECMO patients receiving similar sedoanalgesia were investigated during and after ECMO and RCCA ligation. Dominant frequency, absolute alpha, theta, delta, and total powers of right and left frontocentral and temporooccipital derivations were calculated. Dominant frequency did not differ among groups. Power was found to be significantly decreased in all frequency bands during ECMO. After weaning from ECMO, EEG differences between the ECMO and control groups disappeared in spite of permanent RCCA ligation. It is concluded that ligation of the RCCA per se does not result in quantitative EEG changes.

10.1111/j.1525-1594.2006.00240.x

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Extrakorporales Bridging bei akutem Leberversagen im Säuglingsalter

Zeitschrift für Geburtshilfe und Neonatologie (2004)

Harald Boigner Gehan Ahmed Mostafa Edward E Stoll Arnold Pollak Gerhard Trittenwein

Fragestellung: Fulminantes Leberversagen infolge Infektion, Intoxikation oder Autoimmundestruktion führt bei Säuglingen und Kleinkindern in kurzer Zeit zur irreversiblen Enzephalopathie. Da eine Transplantation innerhalb dieses Zeitfensters nicht immer möglich ist, sind Überbrückungsverfahren der hepatischen Elimination für ein defektfreies Überleben notwendig.

10.1055/s-2004-829245

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Serum Anti-Nuclear Antibodies as a Marker of Autoimmunity in Egyptian Autistic Children

Pediatric Neurology (2009)

Gehan Ahmed Mostafa Nabil Kitchener

Antibody titer

10.1016/j.pediatrneurol.2008.10.017

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Serum Levels of the Systemic and Brain-Specific Antibodies in Autistic Children

QJM (2024)

Gehan Ahmed Mostafa Amany Beniameen Ahmed Mehrez Ghada Shousha Abeer Shehab Azza Mohamed Youssef

Abstract Background Some autistic children may have an imbalance of the T-helper (Th)1/Th2 lymphocytes toward Th2. Th2 cells are responsible for the allergic response and the production of antibodies. Aim We were motivated to investigate the frequency of the brain specific antibodies anti- myelin oligodendrocyte glycoprotein and anti-myelin associated glycoprotein (anti-MoG) and systemic antibodies Anti-Nuclear Antibody (ANA) in the serum of a group of Egyptian autistic children. Patients and Methods This pilot case-control study was conducted at the Department of Pediatrics, Children's Hospital, Faculty of Medicine, Ain Shams University over a period of 6 months, from May 2022 to November 2022. Twenty five autistic children aged 4 to 16 years and twenty five age- and sex-matched healthy children were included after excluding children with any chronic, allergic or autoimmune disease. Diagnosis of autism was settled according to 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Serum levels of brain specific antibodies (anti-MoG) and systemic antibodies (ANA) were assessed for the patients and healthy children using Enzyme-linked immunosorbent assay (ELISA) technique. Results Male to female ratio was 3.17:1. Family history of Autism spectrum disorder (ASD) was positive in 2 patients. True seizures were detected in 3/25 (12%) of the studied children. Mild ASD was found among 64% and severe illness was detected among the other 36% of the studied patients using Childhood Autism Rating Scale (CARS). According to anti-ANA 23 healthy control children had negative ANA and the other two had positive ANA. However 23 autistic children had negative ANA and two had borderline level. Anti-ANA not detected among autistic children. According to Anti-MOG 25 healthy control children had negative anti-MOG. However 24 autistic children had negative anti-MOG and one had positive anti- MOG. P-Value of anti-MOG was 1.00 and P-Value of anti-ANA was 0.135. Conclusion Specific brain antibodies, anti-MOG, and systemic antibodies, ANA were not detected in higher levels among autistic children compared to healthy control. The study was limited by the small sample size. ASD patients and healthy children showed comparable serum levels of ANA. One autistic child had positive anti-MOG. Compared to healthy control group, the difference of results of brain antibodies was statistically non-significant.

10.1093/qjmed/hcae175.737

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Low plasma progranulin levels in children with autism

Journal of Neuroinflammation (2011)

Laila Al‐Ayadhi Gehan Ahmed Mostafa

Autoimmunity to brain may play a pathogenic role in autism. In autoimmune disorders, the formation of antigen-antibody complexes triggers an inflammatory response by inducing the infiltration of neutrophils. Local administration of recombinant progranulin, which is an anti-inflammatory neurotrophic factor, potently inhibit neutrophilic inflammation in vivo, demonstrating that progranulin represents a crucial inflammation-suppressing mediator. We are the first to measure plasma progranulin levels in autism.Plasma levels of progranulin were measured, by ELISA, in 40 autistic patients, aged between 3 and 12 years, and 40 healthy-matched children.Autistic children had significantly lower plasma progranulin levels, P = 0.001. Reduced plasma progranulin levels were found in 65% (26/40) of autistic children.On the other hand, there was a non significant difference between plasma progranulin levels of children with mild to moderate autism and patients with severe autism, P = 0.11.Plasma progranulin levels were reduced in a subgroup of patients with autism. Progranulin insufficiency in some patients with autism may result in many years of reduced neutrotrophic support together with cumulative damage in association with dysregulated inflammation that may have a role in autism. However, these data should be treated with caution until further investigations are performed, with a larger subject population, to determine whether the decrease of plasma progranulin levels is a mere consequence of autism or has a pathogenic role in the disease. The role of progranulin therapy should also be studied in autism.

10.1186/1742-2094-8-111

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FATAL PNEUMOCOCCAL MENINGOENCEPHALITIS IN TWO IMMUNIZED CHILDREN IN VIENNA, AUSTRIA

Archives of Disease in Childhood (2008)

Barbara Rath Gehan Ahmed Mostafa Heinz Burgmann Herwig Kollaritsch Gudrun Burda

Background Because national immunization programs are not yet fully in place, invasive pneumococcal disease (IPD) remains a serious illness killing more children in Europe than all other vaccine preventable diseases. The heptavalent pneumococcal vaccine (7-vPC) has recently become part of the immunization schedule in Austria, but vaccination coverage remains low (around 10%). Methods We report 2 cases of fatal pneumococcal meningoencephalitis in previously vaccinated children presenting to the Pediatric Intensive Care Unit in October 2007 and February 2008, both in critical condition. Past medical histories and immune status were within normal limits in both children, ages 5 months and 20 months. Antimicrobial therapy with amoxicillin/clavulanate was initiated Results The serotypes were determined to be 9N and 7F, respectively, both susceptible to penicillins and 3rd generation cephalosporins. The first patient had received only the 2nd dose of 7-vPC, 10 days prior to onset of illness, the second patient had completed all 3 baseline immunizations, but was infected with a strain that is not covered by 7-vPC. Conclusions In settings with low immunization coverage, IPD should remain on top of the list of differential diagnoses in

Pneumococcal vaccine

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