Genomic Testing Identifies Monogenic Causes in Patients with Very Early-Onset Inflammatory Bowel Disease: A Multi-center Survey in an Iranian Cohort

Patients with very early-onset inflammatory bowel disease (VEO-IBD) may present because of underlying monogenic inborn errors of immunity (IEI). Strong differences have been observed in the causes of monogenic IBD among ethnic populations. This multi-center study was carried out on 16 Iranian patients with VEO-IBD. We reviewed clinical and basic immunologic evaluation including flow cytometry and immunoglobulin levels. All patients underwent clinical whole exome sequencing (WES). Sixteen patients (8 females and 8 males) with a median age of 43.5 months were enrolled. The median age at the onset of symptoms was 4 months. Most patients (12, 75%) had consanguineous parents. Chronic non-bloody diarrhea (13, 81.3%) and perianal diseases including perianal abscess (6, 37.5%), anal fissure (6, 37.5%), or anal fistula (2, 12.5%) were the most common manifestations. WES identified a spectrum of genetic variants in 13 patients (81.3%): IL10RB (6, 37.5%), MVK (3, 18.8%), and CASP8, SLC35C1, G6PC3, and IKBKB in one patient, respectively. In 3 patients (18.7%) no variant was identified. Flow cytometry identified a spectrum of abnormalities that helped to assess the evidence of genetic diagnosis. At the end of the survey, 3 (18.8%) patients were deceased. This high rate of monogenic defects with a broad spectrum of genes reiterates the importance of investigating IEI in patients with infantile-onset IBD.

Pathogenic bacteria associated with outbreaks of respiratory disease in Iranian broiler farms

BACKGROUND

Multi-causal respiratory infections are more commonly observed than uncomplicated cases with single agents in the commercial poultry industry. Recently, increased mortality rates associated with respiratory clinical signs have been reported in Iranian broiler farms.

OBJECTIVES

The present study aimed to determine the spectra of avian mycoplasmas (Mycoplasma gallisepticum, MG and Mycoplasma synoviae, MS) and Ornithobacterium rhinotracheale (ORT) in the broiler farms with the multi-causal respiratory disease (MCRD) from 2017 to 2020.

METHODS

Trachea and lung tissue samples were collected from 70 broiler flocks presenting increased mortality and acute respiratory disease. MG, MS, and ORT were detected by performing polymerase chain reaction with primers complementary to the 16S rRNA, vlhA, and 16S rRNA genes, respectively.

RESULTS

Genetic materials of MG, MS, and ORT were detected in five, three, and five of the 70 flocks. Based on the phylogenetic analysis of the complete mgc2 coding sequences, all MG strains formed a distinct cluster along with other Iranian MG isolates. According to the phylogenetic analysis of the partial vlhA gene of MS strains, two isolates were located along with Australian and European strains. In addition, one of them displayed an out-group association with MS isolates from Jordan. Phylogenetic analysis of Iranian ORT strains using a partial sequence of the 16S rRNA gene showed a distinct group among the other ORT strains.

CONCLUSIONS

The results indicate that MG, MS, and ORT are not predominantly responsible for the MCRD. However, continuous monitoring of poultry flocks could be significant for obtaining valuable information related to different MG, MS, and ORT strains and designing effective control strategies.

Improved cell proliferation and testosterone secretion following exposure of TM3 Leydig cells to three-dimensional scaffold and light emitting diode

Green LED and three-dimensional (3D) scaffolds have recently received extensive attentions due to their impact on cell proliferation and differentiation. Melatonin, a circadian rhythm-regulating hormone, is involved in some physiological phenomena including testosterone biosynthesis. Lower testosterone biosynthesis results in some disorders such as puberty retarding, andropause, and muscle weakness. Therefore, our aim was to investigate the proliferation of Leydig cells and their testosterone-related Gene expression and secretion under the influence of 3D scaffold, green light and melatonin. The experimental groups of TM3 cells embedded in the 3D scaffold, were exposed to green light, melatonin, both and all three factors. Expression of cell cycle genes including PCNA, CYCLIND1, CDC2 and CDKN1B, and testosterone related genes; GATA4 and RORα were also examined. 3D scaffold enhanced Leydig cells proliferation, and testosterone-related genes expression. While melatonin decreased cell proliferation and testosterone-related genes expression. Green light did not significantly change the results but slightly decreased cell proliferation and testosterone synthesis. The combination of green light with melatonin significantly reduced the proliferation rate of TM3 cells and the expression of steroidogenic genes, while the combination of green light with scaffold improved the results. In general, the use of scaffolding enhances proliferation and testosterone-related genes expression of TM3 Leydig cells. Also, application of green light and scaffolding reduces the deleterious effects of melatonin on these cells.

A Comparison between Electron Gamma Shower, National Research Council/Easy Particle Propagation (EGSnrc/Epp) and Monte Carlo N-Particle Transport Code (MCNP) in Simulation of the INTRABEAM ® System with Spherical Applicators

BACKGROUND

Online Monte Carlo (MC) treatment planning is very crucial to increase the precision of intraoperative radiotherapy (IORT). However, the performance of MC methods depends on the geometries and energies used for the problem under study.

OBJECTIVE

This study aimed to compare the performance of MC N-Particle Transport Code version 4c (MCNP4c) and Electron Gamma Shower, National Research Council/easy particle propagation (EGSnrc/Epp) MC codes using similar geometry of an INTRABEAM^® system.

MATERIAL AND METHODS

This simulation study was done by increasing the number of particles and compared the performance of MCNP4c and EGSnrc/Epp simulations using an INTRABEAM^® system with 1.5 and 5 cm diameter spherical applicators. A comparison of these two codes was done using simulation time, statistical uncertainty, and relative depth-dose values obtained after doing the simulation by each MC code.

RESULTS

The statistical uncertainties for the MCNP4c and EGSnrc/Epp MC codes were below 2% and 0.5%, respectively. 1e9 particles were simulated in 117.89 hours using MCNP4c but a much greater number of particles (5e10 particles) were simulated in a shorter time of 90.26 hours using EGSnrc/Epp MC code. No significant deviations were found in the calculated relative depth-dose values for both in the presence and absence of an air gap between MCNP4c and EGSnrc/Epp MC codes. Nevertheless, the EGSnrc/Epp MC code was found to be speedier and more efficient to achieve accurate statistical precision than MCNP4c.

CONCLUSION

Therefore, in all comparisons criteria used, EGSnrc/Epp MC code is much better than MCNP4c MC code for simulating an INTRABEAM^® system.

Association of obesity and pulse pressure with hypertension in an Iranian urban population

Objective:

Nowadays, obesity is an important health problem and pulse pressure (PP) is a good predictor of cardiovascular events. The aim of study was to determine the association of obesity and PP with hypertension (HTN) in individuals aged 30 years or older in the urban population of Jahrom, Iran.

Materials and Methods:

In this study, we used a multistage stratified sampling method to select participants among the urban population aged 30 years or older. Height, weight, and blood pressure were obtained by a trained physician. Obesity was defined according to the World Health Organization classification. Angina was assessed with reliable and validate Rose questionnaire. Data were record by SPSS-16. Categorical and continues variables analyzed by Chi-squared, independent t-test, and one-way ANOVA test. Binary logistic regression analysis method was used for the association of PP and obesity with HTN and Rose angina that adjusted for age, gender, education class, marital status, smoking, total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein. A P < 0.05 was considered as statistical significance.

Results:

The prevalence of obesity was 18.1% that was greater in women (24.8% vs. 9.9%, P < 0.001). The prevalence of Rose angina and HTN in obese individuals were more than in normal weight individuals (24.8% vs. 16.4%, P = 0.027) and (42.0% vs. 31.1%, P < 0.001), respectively. Furthermore, patients in higher PP groups were older, were more possible to had HTN and had greater diastolic blood pressure (DBP), systolic blood pressure (SBP), and mean arterial pressure (MAP) in compared to individuals in the lower PP group. The individuals with HTN had greater DBP, SBP, MAP, PP, and body mass index (BMI) than individuals without HTN. However, individuals who had Rose angina, only had higher PP and BMI in compared to ones without Rose angina. The obese individuals had 1.97 (1.22–3.17, P = 0.005) fold for HTN risk than individuals with normal weight. In addition, PP weakly increased the risk of HTN about 1.09 fold (1.07–1.10, P < 0.001). However, Rose angina was associated only to overweight status (odds ratio = 1.51, confidence interval 95%: 1.03–2.20), P = 0.035) than individuals in normal weight group.

Conclusion:

Obesity and PP were higher in hypertensive individuals and overweight in individuals with Rose angina. It is time to pay more attention to abnormal BMI.

Photobiomodulation and gametogenic potential of human Wharton's jelly-derived mesenchymal cells

Recently, light emitting diode (LED) irradiation has been introduced as a new strategy to enhance proliferation and affect differentiation of stem cells. Human Wharton's jelly-derived mesenchymal (hWJM) cells have unique characteristics that make them an appropriate source of stem cells for use in basic and clinical applications. In this study, we aimed to evaluate the effect of polarized (PL) and non-polarized (NPL) red light irradiation on gametogenic differentiation of hWJM cells in the presence or absence of bone morphogenetic protein 4 (BMP4) and retinoic acid (RA). Exposure of hWJM cells to PL and NPL red LED (625 nm, 1.9 J/cm²) with or without BMP4+RA pre-treatment effectively differentiated them into germ lineage when the gene expression pattern (Fragilis, DAZL, VASA, SCP3 and Acrosin) and protein synthesis (anti-DAZL, anti-VASA, anti-SCP3 and anti-Acrosin antibodies) of the induced cells was evaluated. These data demonstrated that photobiomodulation may be applied for gametogenic differentiation in-vitro.

Prevalence and clinical characteristics of metabolically unhealthy obesity in an Iranian adult population

PURPOSE

The incidence of obesity is globally increasing and it is a predisposing factor for morbidity and mortality. This study assessed the prevalence of metabolically unhealthy (MU) individuals and its determinants according to body mass index (BMI).

MATERIALS AND METHOD

In our cross-sectional study, 891 persons aged 30 years or older participated. Participants were classified as obese (BMI ≥30 kg/m²), overweight (BMI 25-<30 kg/m² and normal weight (BMI <25 kg/m²). Metabolic health status was defined using four existing cardio-metabolic abnormalities (elevated blood pressure, elevated serum concentrations of triglyceride and fasting glucose and a low serum concentration of high density lipoprotein cholesterol). Then, two phenotypes were defined: healthy (existence of 0-1 cardio-metabolic abnormalities) and unhealthy (presence of 2 or more cardio-metabolic abnormalities).

RESULT

Overall, 10.9% (95% confidence interval (CI): 8.8-13.0) and 7.2% (95% CI: 5.5-8.9) of participants were MU obese and metabolically healthy obese, respectively. The prevalence of MU was higher in overweight (55.6%; 95% CI: 50.6-60.6, p<0.001) and obese (60.2%; 95% CI: 52.8-67.6, p=0.001) subjects than in individuals with a normal weight (37.5%; 95% CI: 29.4-42.6). Multiple logistic regression analysis showed an association of a MU state with age and dyslipidaemia in the BMI subgroups and with female sex in the normal weight individuals.

CONCLUSION

The prevalence of a MU state increased with increasing BMI. Ageing and dyslipidaemia were associated with an unhealthy metabolic state in normal weight, overweight and obese subjects and with the female sex in normal weight subjects.

Effects of polarized and non-polarized red-light irradiation on proliferation of human Wharton's jelly-derived mesenchymal cells

Light emitting diode (LED) irradiation has recently been introduced as an encouraging strategy for promotion of cell proliferation. Human umbilical cord Wharton's jelly-derived mesenchymal (hUCM) cells are among the most available mesenchymal cells with a promising application in regenerative medicine. The aim of the present study was to examine the effect of polarized (PL) and non-polarized (NPL) red-light emitted by LED on various proliferation properties of hUCM cells. Cell proliferation was assessed 48 h after irradiation of hUCM cells by different energy densities. Cell density increased to a significant level both in PL and NPL irradiation at 0.954 J/cm² following WST-1 assay. Staining of irradiated and non-irradiated cells with Hoechst after 3 and 6 days revealed an increased proliferation rate in irradiated cells, but the non-irradiated cells proliferated more than irradiated cells at day 9 of cultivation. Similar results were obtained in trypan blue assay. Scratch repair test for 18 h with an interval of 6 h did not reveal a significant difference between irradiated and non-irradiated cells. In addition, CFU-F assay in PL irradiated cells was higher than control when 500 cells/plate was cultivated. Totally, this study revealed that hUCM cells could be induced to achieve higher number of cells by PL and NPL red-light irradiation after 48 h.

Kisspeptin serum levels in acute myocardial infarction patients and healthy individuals

Introduction: Acute myocardial infarction (AMI) is a leading cause of mortality worldwide for which several risk factors have been identified. Kisspeptin is a multifunctional peptide observed in atherosclerotic plaques. This study aimed to compare kisspeptin serum levels in AMI patients and healthy individuals. Methods: This case-control study was conducted on patients visiting the Cardiology department of Peymanieh Hospital, Jahrom University of Medical Sciences, Iran. Participants were randomly divided into a case and a control groups; the former consisting of 90 AMI patients and the latter of 90 healthy individuals with no cardiac diseases. Blood samples were collected from the participants who also completed the given questionnaire. The enzyme-linked immunosorbent assay (ELISA) test was used to determine kisspeptin levels following serum separation from collected blood samples. Data analysis was performed in SPSS-19 using descriptive (mean and standard deviation) and analytical (The Mann-Whitney U test) statistical tests. Results: The mean age of treatment and control groups was 60.91 and 61.72 years, respectively. The majority (73.3%) of participants in this study were men. Kisspeptin serum concentrations were demonstrated to be significantly lower in the case group than the control group (P<0.001). The results of Mann-Whitney U test revealed that kisspeptin serum concentrations of case and control groups did not have a significant relationship with such variables as gender, smoking, and ST-segment elevation and non-ST-segment elevation (P>0.05). Conclusion: The results revealed that kisspeptin serum concentrations of AMI patients were significantly lower than those of healthy individuals. Accordingly, kisspeptin deficiency appears to be a risk factor for AMI. However, due to the multifunctional nature of this peptide, further studies are necessary to discover its precise mechanism of action.

Lack of Association Between rs17568 Polymorphism in OX40 Gene and Myocardial Infarction, Southern of Iran

Tumor necrosis factor (TNF) is one of the inflammatory cytokines which has an important role in inflammation and migration of other inflammatory cells to the atherosclerotic plaques. OX40 is a member of the TNF super family receptor protein. OX40 and OX40 ligand are co-stimulators for T-cells and can increase inflammatory response in atherosclerotic plaques. The aim of this study was to determine the association of rs17568 polymorphism in OX40 gene with premature myocardial infarction. This case control study was done on 100 patients with premature acute myocardial infarction (AMI) and a similar number of sex, age and some other cardiovascular risk factor matched healthy people. The OX40 rs17568 polymorphism was genotyped, using PCR-RFLP method. A-allele frequency of rs17568 SNP was lower non-significantly in Premature AMI, compared to healthy subjects (49% vs. 51%). The analysis of rs17568 (A/G) polymorphism showed an odds ratio of 1.127 (95% CI: 0.635-1.999; P= 0.686) for the GG genotype and 5.761 (95% CI: 1.200-27.655; P= 0.029) for the AG genotype, compared to the AA genotype. The results of this study indicate that the rs17568 SNP of OX40 gene is not associated with premature AMI in the evaluated population.

The Association Between Pre-Diabetes With Body Mass Index and Marital Status in an Iranian Urban Population

Pre-diabetes increased the development of diabetes mellitus (type 2). The aim of study was to determine the association of body weight, education and marital status with pre-diabetes in an Iranian urban population.A sample of 788 subjects (360 men and 428 women) between the ages 30-85 years participated in our study and anthropometric measurements, educational level and fasting blood sugar of participants were recorded. The t and Chi square tests were used for continuous and categorical variables. The association of age, BMI categories, educational level and marital status to pre-diabetes was assessed by estimating the odds ratio. A p-value ≤ 0.05 were considered significant. The analysis was done using SPSS version 11.5. Our study showed that pre-diabetic subjects were older and low educated than normoglycemic subjects. Mean BMI and educational level were associated to pre-diabetes only in women. The odds of being pre-diabetes also were higher in obese women than in normal BMI women. No relationship was found between education and marital status with pre-diabetes in both men and women. Based on our finding, it is possible that advancing age and obesity has increased in pre-diabetes. This highlights the importance of population based survey to monitor blood glucose for effective prevention and control.

Insulin resistance and serum levels of interleukin-17 and interleukin-18 in normal pregnancy

We performed this study to evaluate the role of Interleukin-17 (IL-17) and Interleukin-18 (IL-18) in insulin resistance during normal pregnancy. This descriptive cross sectional study was carried out on 97 healthy pregnant women including 32, 25, and 40 individuals in the first, second, and third trimesters, respectively, and on 28 healthy non pregnant women between the autumn of 2012 and the spring of 2013. We analyzed the serum concentrations of IL-17 and IL-18 by using the enzyme linked immunosorbent assay (ELISA). Insulin resistance was measured by homeostasis model assessment of insulin resistance equation. No significant differences between the demographic data of the pregnant and non pregnant groups were observed. Insulin resistant in pregnant women was significantly higher than the controls (p=0.006). Serum IL-17 concentration was significantly different in non pregnant women and pregnant women in all gestational ages (p<0.05). Serum IL-18 level was significantly lower in subjects with first, second, and third trimesters of pregnancy in compared to non pregnant women (p<0.05). No significant correlations were found between serum IL-17 and IL-18 levels with insulin resistance (r=0.08, p=0.34 vs. r=0.01, p=0.91, respectively). Our data suggested that IL-17 and IL-18 do not appear to attribute greatly to pregnancy deduced insulin resistance during normal pregnancy.

Relation of type 2 diabetes mellitus with gender, education, and marital status in an Iranian urban population

BACKGROUND

Type 2 diabetes mellitus is one of the most important cardiovascular risk factors.

OBJECTIVES

This study was performed to assess the relationship of diabetes with gender, education, and marital status in an Iranian urban population.

METHODS

A total of 892 men and women aged 30-85 were recruited using a cluster-stratified sampling method from an urban population. Using a questionnaire, demographical data including gender, education, and marital status were collected. A blood sample after fasting for at least eight hours was collected from each subject. Associations of type 2 diabetes mellitus and studied variables were tested for significance.

RESULTS

The prevalence of diabetes mellitus was 11.6%; 11.1% in men and 12.1% in women with no significant difference between them. Diabetes mellitus was most prevalent in the oldest age (age more than 60 years, 22.9%) and low education groups (17.9%, P < 0.001). Marital status was not significantly related to diabetes mellitus (P= 0.37).

CONCLUSION

The prevalence of diabetes mellitus is related to education within the Iranian population. Thus preventive strategies should be based on the affective factors.

Estimation of left ventricular end diastolic pressure (lvedp) in patients with ischemic heart disease by echocardiography and compare it with the results of cardiac catheterization

BACKGROUND

Doppler echocardiography has been proposed as an appropriate non-invasive assay to estimate left ventricular end diastolic pressure (LVEDP). The aim of present research was to estimate the LVEDP in patients with ischemic heart disease by echocardiography and compare it with the results of cardiac catheterisation and to determine the effect of different echocardiographic variables on its measurement.

METHODS

In this descriptive-analytic study, patients with diagnosed ischemic heart disease were selected by nonrandomized sampling method. Selected population underwent M-mode and pulse doppler echocardiographic evaluation and parameters such as Q-Mitral valve E (Q-MVE), Q-Aortic valve closure (Q-AVC), Aortic valve closure-E (AVC-E), Q-Mitral valve closure/Aortic valve closure-E (Q-MVC/AVC-E), left ventricle-deceleration time (LV-DT), peak velocity-deceleration time (PV-DT) and A/E velocity time integral (A/E VTI) were evaluated. Immediately after echocardiography all patients underwent left heart catheterization for LVEDP measurement. The relation between different echocardiographic measurements and LVEDP, obtained by cardiac catheterization, was evaluated.

RESULTS

In this study, 47 patients with ischemic heart disease with mean age (±SD) of 53±13 were studied. There was a significant correlation between LVDEP and A/E VTI (r=0.44, P=0.001, and also between LVEDP and PV-DT in patients with A/E VTI ≥1.1(r=-0.58, P=0.02). There was a significant correlation between LVEDP and Q-MVC/AVC-E in patients with LVEDP >18mmHg (r=0.76, P=0.03) and those with LVEDP ≤18 mmHg and A/E VTI <1.1 (r=0.37, P=0.03). The correlation between LVEDP and A/E VTI was more significant in men, in patients aged >50 years with EF >55%, without LVH, without MR and those with coronary artery disease (P<0.05).

CONCLUSION

Some echocardiographic indices such as A/E VTI, Q-MVC/AVC-E and PV-DT are able to measure LVEDP especially in male patients aged >50 years, without LVH, without MR and those with coronary artery disease but it is necessary to determine specific conditions and factors affecting these indices, by further studies.

Cloning and expression of malarial pyrimidine enzymes

We have cloned genes encoding three enzymes of the de novo pyrimidine pathway using genomic DNA from Plasmodium falciparum and sequence information from the Malarial Genome Project. Genes encoding dihydroorotase (reaction 3), orotate phosphoribosyltransferase (reaction 5), and OMP decarboxylase (reaction 6) have been cloned into the plasmid pET 3a or 3d with a thrombin cleavable 9xHis tag at the C-terminus and the enzymes were expressed in Escherichia coli. To overcome the toxicity of malarial OMP decarboxylase when expressed in E. coli, and the unusual codon usage of the malarial gene, a hybrid plasmid, pMICO, was constructed which expresses low levels of T7 lysozyme to inhibit T7 RNA polymerase used for recombinant expression, and extra copies of rare tRNAs. Catalytically-active OMP decarboxylase has been purified in tens of milligrams by chromatography on Ni-NTA. The gene encoding orotate phosphoribosyltransferase includes an extension of 66 amino acids from the N-terminus when compared with sequences for this enzyme from other organisms. We have found that other pyrimidine enzymes also contain unusual protein inserts. Milligram quantities of pure recombinant malarial enzymes from the pyrimidine pathway will provide targets for development of novel antimalarial drugs.

Molecular analysis of the bvg-repressed urease of Bordetella bronchiseptica

Bordetella bronchiseptica is a ureolytic mammalian respiratory pathogen. We have investigated the regulation of urease in B. bronchiseptica and the potential role of this enzyme in eukaryotic invasion and intracellular survival. Our results indicate urease is a bordetella virulence repressed gene. Urease activity in virulent B. bronchiseptica BB7865 is up-regulated from basal levels by 5 gl1 magnesium sulphate at 37 degrees C. At 30 degrees C, urease activity remained at basal levels, even in the presence on magnesium sulphate, suggesting a second temperature dependent mechanism of urease regulation was also operating. Urease was not inducible by 10 mM urea nor up-regulated in nitrogen limiting conditions. To evaluate the role of urease in intracellular invasion and survival urease-negative mutants of B. bronchiseptica BB7865 and B. bronchiseptica BB7866 were created by transposon mutagenesis, and compared to the urease-positive parental strains in a HeLa cell invasion assay. We demonstrate that increasing the concentration of urea in the assay increased survival of the urease-positive but not urease-negative strains after 24 h, suggesting that urease does have a role in intracellular survival. Partial DNA sequence analysis of an 11.0 kb EcoRI DNA fragment encoding urease activity revealed an open reading frame containing 50%, 45%, 45%, and 41% homology to the UreA urease subunit protein of Klebsiella aerogenes, Proteus vulgaris, Helicobacter pylori and Proteus mirabilis respectively. We also show Bordetella pertussis to contain sequences homologous with a DNA probe containing the gene encoding UreA of B. bronchiseptica indicating the possible presence of cryptic urease genes in this species.