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Introduction: Tumor necrosis factor alpha (TNF alpha) blockers such as infliximab (IFX) and adalimumab (ADA) had significantly changed the course of inflammatory diseases such as rheumatoid arthritis (RA), spondyloarthritis (SpA) and Crohn's disease (CD). However, about 30% of patients do not respond to these treatments. This lack of response may be due to the formation of antibodies against these drugs (anti-drug antibodies: ADAbs). The aim of this study was to determine the prevalence of ADAbs against IFX and ADA, and the trough serum concentration of IFX and ADA in RA, SpA or CD patients and to assess their impact on the therapeutic response., Methods: A cross sectional, multi-centric study was conducted, including patients with RA, SpA or CD treated with IFX or ADA as a first biotherapy for at least 6 months. ADAbs and trough levels were measured by an Enzyme Linked Immunosorbent assay (ELISA)., Results: 197 patients were included (57 RA, 73 SpA and 67 CD). ADAbs were positive in 40% of cases for IFX and 25% for ADA. They were positive in 40% of SpA, 35% of RA, and 21% of CD. The presence of ADAbs was inversely correlated to the trough levels of IFX and ADA during RA (p = 0.01 and p < 0.0001), SpA (p < 0.01 and p < 0.0001) and CD (p = 0.001 and p = 0.04). For all pathologies, the presence of ADAbs was not correlated with disease activity. Concomitant methotrexate significantly reduced immunogenicity., Conclusion: In our study, the presence of ADAb and low trough levels seem to not affect the therapeutic response in patients on TNF alpha antagonists. Other tracks more than immunogenicity should be investigated to explain the loss of response to these biotherapies., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

This study aimed to investigate whether the single nucleotide polymorphism C677T (rs1801133) of the methylene-tetrahydrofolate reductase (MTHFR) gene was associated with the risk of coronary artery disease (CAD) and circulating homocysteine (Hcy) levels in Tunisian population. 310 angiografically diagnosed CAD patients and 210 controls were enrolled in this study. The MTHFR C677T (rs1801133) polymorphism was genotyped, and the Hcy concentrations were measured. The severity of CAD was evaluated using the Gensini scoring system. Compared to the CC genotype, the TT genotype confers a higher risk for CAD severity with an OR = 9.07 and 95% CI = 3.78-21.8. The T allele was the predisposing allele for CAD and that it was probably associated with CAD severity. The area under the ROC curve for Hcy was 0.764 (95% CI 0.660 to 0.868, p = 0.001). The receiver operating characteristics curve (ROC) for Hcy showed its useful prediction of CAD. Hcy levels were not significantly associated with CAD severity expressed by Gensini Score (GS). The MTHFR C677T (rs1801133) polymorphism influences circulating Hcy levels. The MTHFR C677T polymorphism and hyperhomocysteinemia could have an important role in the prediction of the presence and not the severity expressed by GS of CAD.

Background: Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasians, caused by mutation in cystic fibrosis transmembrane conductance regulator (CFTR). The analysis of some extra and intragenic markers within or closely linked to CFTR gene is useful as a molecular method in clinical linkage analysis. Indeed, knowing that the molecular basis of CF is highly heterogeneous in our population is explained in the present study. In this work, we are interested for the first time to study the polymorphic marker IVS6a GATT in a CF Tunisian population., Methods: Our study involved 80 CF Tunisian patients with a positive sweat test. A cohort of 90 healthy controls was also enrolled. The analysis of the variant IVS6a GATT was conducted by analysis of the fragments on automatic sequencer (ABI Prism 310). A statistical analysis was performed on Statistical Package for the Social Sciences (SPSS) version 20 software., Results: The analysis of genotypic distribution of IVS6aGATT showed a significant difference between the control and CF groups suggesting the involvement of this marker in cystic fibrosis. Furthermore, we noted that the 6 GATT repetition in the homozygous state is more common in CF patients than in the control group (p <0.05). This while the 7GATT/7GATT genotype is more common among controls compared to CF patients (p = 0.002). Regarding the interest of this polymorphism on the clinical expression of cystic fibrosis, we have noted no significant association between 6/6 genotype with different clinical conditions in CF patients outside the CFTR mutation. While a significant association was found between respiratory involvement and mixed (respiratory and digestive) and the 6/6 genotype in patients with the mutation F508del homozygous (p <0.05). In addition, a significant association was also noted with gastrointestinal involvement for non F508del patients/F508del not (p = 0.014). Given that, phenotypic and genotypic heterogeneity of cystic fibrosis, several studies have sought to highlight the role of genetic markers linked to the CFTR gene in the expression and evolution of the disease., Conclusion: Our study on the implication of polymorphic marker IVS6a GATT is one of the first works carried out in the Tunisian population and confirms the usefulness of this marker in the clinical expression of cystic fibrosis.

This study investigates the performance of the combination of biological pre-treatment with Kefir grains (KGs) and photocatalytic process using Ag-doped TiO 2 nanoparticles (NPs) for the simultaneous removal of toxic pollutants from landfill leachate (LFL). After 5 days of 1% (w/v) KGs pre-treatment at 37 °C, TOC, COD, NH 4 + -N, and PO 4 3- removal rates were 93, 83.33, 70 and 88.25%, respectively. The removal efficiencies were found to be 100, 94, 62.5, 53.16 and 47.52 % for Cd, Ni, Zn, Mn and Cu, respectively. The optimal conditions of Ag-doped TiO 2 photocatalytic process were optimized using Box-Behnken design and response surface methodology (BBD-RSM) to enhance the quality of pre-treated LFL. Interestingly, Ag-doped TiO 2 photocatalytic process increases the overall removal efficiencies to 98, 96, 85 and 93% of TOC, COD, NH 4 + -N, and PO 4 3- , respectively. Furthermore, the removal efficiency of toxic heavy metals was gradually improved. In addition, KGs and Ag-doped TiO 2 exhibited excellent recyclability showing the potential of combined biological/photocatalytic process to treat hazardous LFL., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Few comparative studies were interested between edible and non-edible pomegranate varieties. In the present study, flowers, leaves, juice and peel of two pomegranate varieties, ornamental variety "Nana" (NV) and sweet variety "Tounsi" (TV) were compared for their phenolic contents and antioxidant activity. Seeds oils were compared also for their fatty acids (FA) composition.Results showed that peel and juice of NV contained higher content in tannins, Flavonoids and anthocyanins. In contrast, peel and juice of TV were more concentrated in carotenoids and polyphenols. Flowers extracts of TV contained more polyphenols and flavonoids. However leaves from NV provided more polyphenols, flavonoids and anthocyanins. Flowers and leaves proved to be the strongest antioxidants for both varieties. For FA composition, NV was more concentrated in Mono-unsaturated FA (MUFA) however TV contained more Di-unsaturated FA (DiUFA). cis-γ-Linolenic acid was the major FA in NV. Contrariwise punicic acid was the predominant in TV., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The flesh and peel of 19 pear cultivars (8 Tunisian dessert cultivars, 8 European dessert cultivars and 3 French perry pear cultivars) were studied for their phenolic composition. Phenolic compounds were identified by HPLC/ESI-MS 2 and individually quantified by HPLC-DAD. Five classes of polyphenols were present: flavan-3-ols, phenolic acids, flavonols, anthocyanins and simple phenolics (hydroquinones). The total phenolic content ranged between 0.1g/kg Fresh Weight (FW) ('Conference' cultivar) and 8.6g/kg FW ('Plant De Blanc' cultivar) in the flesh and between 1.6g/kg FW ('William vert' cultivar) and 40.4g/kg FW ('Arbi Chiheb' cultivar) in the peel. Procyanidins, analyzed after thioacidolysis, were the main phenolic compounds in all pear cultivars either in the pulp or the peel, their constitutive units being essentially (-)-epicatechin. Tunisian dessert pears and French perry pears are richer in procyanidins with very high degree of polymerization (>100) for Tunisian pears. Peel procyanidins were less polymerized (from 4 to 20). Pear peel phenolic profile was more complex especially for Tunisian cultivars, with flavonols and in some cultivars anthocyanins., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background and Objectives: Sickle cell disease (SCD) is a group of hereditary chronic anemias that manifest essentially as painful crisis and susceptibility to infection. Neonatal screening is a preventive action that reduces the rates of mortality due to complications arising from infections by encouraging early prophylactic penicillin use and pneumococcal vaccination. The purpose of this pilot study was to set up a neonatal screening protocol at a lower cost than one that uses commercially available screening kits., Design and Setting: Pilot study conducted over 1 year in two Tunis maternity hospitals., Patients and Methods: Samples from 9148 newborns were collected using paper printed using a common office printer to collect blood spots from the newborns. A lab-prepared agarose gel for isoelectrofocusing (IEF) was used to test the dried blood samples from these newborns., Results: The IEF on lab-prepared agarose gels was efficient since it was able to detect the main abnormal Hbs previously identified in the Tunisian population (HbS, HbC, HbO, and HbG). Furthermore, when data collected in this screening program were compared with the previously established national data, no statistically significant differences were found. After analysis, results were given back to the families of the patients, and the major Hb cases were directed to one of the hemoglobinopathies specialized centers, where at-risk couples benefited from genetic counselling and were informed about the possibility of prenatal diagnosis., Conclusion: This pilot experiment demonstrated the feasibility of SCD neonatal detection using a lower cost method as well as detection of other main structural Hb variants.

North Africa is one of the major Nasopharyngeal Carcinoma (NPC) endemic regions. Specific food items unique to this area were implicated to be associated with NPC risk, but results were inconsistent. Here we have performed a large-scale case-control study in the Maghrebian population from Tunisia, Algeria and Morocco. From 2002 to 2005, interviews were conducted on 636 cases and 615 controls. Controls were hospitalized individuals from 15 non-cancer hospital departments, or friends and family members of non-NPC cancer subjects, matched by center, childhood household type (rural or urban), age and sex. Conditional logistic regression is used to evaluate the risk of factors. In results, consumption of rancid butter, rancid sheep fat and preserved meat not spicy (mainly quaddid) were associated with significantly increased risk of NPC, while consumption of cooked vegetables and industrial preserved fish was associated with reduced risk. Other foods such as fresh citrus fruits and spicy preserved meat (mainly osban) in childhood, industrial made olive condiments in adulthood, were marginally associated. In multivariate analyses, only rancid butter, rancid sheep fat and cooked vegetables were significantly associated with NPC. In regard to possible causative substances, our results implicate the involvement of butyric acid, a potential Epstein-Barr virus (EBV) activator.

The genetic diversity in Tunisian fig (Ficus carica L.) was studied using RAPD markers. Thirty-five fig cultivars originating from diverse geographical areas and belonging to three collections were analysed. Random decamer primers were screened to assess their ability to detect polymorphisms in this crop. Forty-four RAPD markers were revealed and used to survey the genetic diversity and to detect cases of mislabelling. As a result, considerable genetic diversity was detected among the studied F. carica accessions. The relationships among the 35 varieties were studied by cluster analysis. The dendrogram showed two main groups composed of cultivars with similar geographic origin. Moreover, the male accessions (caprifigs) were clustered indistinctively within the female ones, suggesting a narrow genetic diversity among these accessions. Our data proved that RAPD markers are useful for germplasm discrimination as well as for investigation of patterns of variation in fig. Since this designed procedure has permitted to establish a molecular database of the reference collections, the opportunity of this study is discussed in relation to the improvement and rational management of fig germplasm.