Evaluation of IFNAR2 and TYK2 transcripts' prognostic role in COVID-19 patients: a retrospective study

Background and objectives

This study aimed to investigate the possible prognostic significance of interferon alpha-beta receptor subunit 2 (IFNAR2) and tyrosine kinase 2 (TYK2) expressions.

Methods

We conducted a retrospective study including COVID-19 adult patients. All blood samples were collected before any interventions. The expressions of IFNAR2 and TYK2 were assessed using real-time PCR in venous blood samples of 54 cases and 56 controls. The transcript quantities of IFNAR2 and TYK2 genes were assessed using a Delta-Ct method.

Results

Our findings show no significant differences in gene expression levels for IFNAR2 and TYK2 between patients who required oxygen (O2) therapy and those who did not (p-value = 0.732 and p-value = 0.629, respectively). Likewise, there were no significant differences in IFNAR2 and TYK2 expressions between patients hospitalized for less than 7 days and those hospitalized for 7 days or more (p-value = 0.455 and p-value = 0.626, respectively). We also observed a weak correlation between IFNAR2 expression and CRP (p-value = 0.045, r = 0.192). There was a negative correlation between the expression levels of IFNAR2 and TYK2 transcripts in COVID-19 patients (p-value = 0.044; partial correlation coefficient = -0.283). Additionally, IFNAR2 and TYK2 were significantly downregulated in the COVID-19 group compared to healthy subjects (p-value = 0.002 and p-value = 0.028, respectively). However, neither IFNAR2 nor TYK2 expression was significantly different between the case subgroups based on COVID-19 severity. The IFNAR2 ΔΔCt (B = -0.184, 95% CI: -0.524-0.157, p-value = 0.275) and the TYK2 ΔΔCt (B = 0.114, 95% CI: -0.268-0.496, p-value = 0.543) were not found to be significant predictors of hospitalization duration. The area under the curve (AUC) for IFNAR2 expression is 0.655 (p-value = 0.005, 95% CI: 0.554-0.757), suggesting its poor discriminative value.

Conclusion

We were unable to comment definitively on the prognostic power of IFNAR2 and TYK2 expressions in COVID-19 patients, and larger-scale studies are needed. The principal limitations of this study included the lack of longitudinal analysis and limited sample size.

Prediction of cerebral aneurysm rupture risk by machine learning algorithms: a systematic review and meta-analysis of 18,670 participants

It is possible to identify unruptured intracranial aneurysms (UIA) using machine learning (ML) algorithms, which can be a life-saving strategy, especially in high-risk populations. To better understand the importance and effectiveness of ML algorithms in practice, a systematic review and meta-analysis were conducted to predict cerebral aneurysm rupture risk. PubMed, Scopus, Web of Science, and Embase were searched without restrictions until March 20, 2023. Eligibility criteria included studies that used ML approaches in patients with cerebral aneurysms confirmed by DSA, CTA, or MRI. Out of 35 studies included, 33 were cohort, and 11 used digital subtraction angiography (DSA) as their reference imaging modality. Middle cerebral artery (MCA) and anterior cerebral artery (ACA) were the commonest locations of aneurysmal vascular involvement-51% and 40%, respectively. The aneurysm morphology was saccular in 48% of studies. Ten of 37 studies (27%) used deep learning techniques such as CNNs and ANNs. Meta-analysis was performed on 17 studies: sensitivity of 0.83 (95% confidence interval (CI), 0.77-0.88); specificity of 0.83 (95% CI, 0.75-0.88); positive DLR of 4.81 (95% CI, 3.29-7.02) and the negative DLR of 0.20 (95% CI, 0.14-0.29); a diagnostic score of 3.17 (95% CI, 2.55-3.78); odds ratio of 23.69 (95% CI, 12.75-44.01). ML algorithms can effectively predict the risk of rupture in cerebral aneurysms with good levels of accuracy, sensitivity, and specificity. However, further research is needed to enhance their diagnostic performance in predicting the rupture status of IA.

Characteristics of HHV-7 meningitis: a systematic review

There are limited data on HHV-7 meningitis and this systematic review used electronic search to gather pieces of evidence regarding its characteristics. Nine articles were included which three were case reports and the rest of the articles were retrospective studies. Altogether, 32 cases were described in the literature that 13 were females and 26 were aged less than 16 years old. The HHV-7 meningitis has been reported in any season, especially in winter. It affected both immunocompetent and immunocompromised individuals and mostly presented with fever and headache, however rash and seizure have also been documented. The CSF analysis in general showed an elevated range of cell count with lymphocytic predominance and normal to slightly elevated protein levels. Thirteen patients did not receive treatment for HHV-7 meningitis and full recovery was gained in the majority of cases after about 10 days. This review summarizes characteristics of HHV-7 meningitis in the literature, and yet epidemiological studies are needed to shed more light which eventually could be helpful for the diagnosis and management of this disease.

Psychosis of Epilepsy: A 10-Year Iranian Clinical Survey

Objective: Psychoses of epilepsy usually have an acute onset, accompanied by brief symptom duration and a risk of recurrence. Managing these conditions can be challenging due to the potential for seizures associated with certain antipsychotic medications, as well as exacerbating psychosis resulting from some antiepileptic medications. Our objective in this study was to assess the occurrence of psychosis among patients with epilepsy, as well as identify the factors linked to the presence and severity of psychosis in this population. Method : In this study, we included a total of 514 subjects diagnosed with epilepsy referring to our neuropsychiatry clinic affiliated with Tehran University of Medical Sciences from April 2011 to December 2021, among whom 57 patients showed psychotic presentations. We compared baseline and clinical characteristics between patients with psychosis of epilepsy and non-psychosis patients who also had epilepsy. Results: Marital status was the sole demographic factor that displayed a statistically significant difference between the psychosis and non-psychosis groups (P = 0.019). There was no significant difference observed between the two groups regarding family history of epilepsy and age at the onset of the epilepsy. Patients with psychosis experienced significantly more frequent seizures and generalized type (P < 0.001). Participants were matched for demographics and other clinical factors between the refractory and controlled psychosis groups, except for the psychosis frequency (P = 0.007). The type of epilepsy was significantly associated with psychosis when adjusted for the covariates (P < 0.001). Conclusion: Patients with psychosis of epilepsy experienced more episodes of epilepsy than non-psychotics. We identified generalized epilepsy as an independent risk factor for the development of psychosis. Additional cohorts are warranted to explore the factors associated with epilepsy-related psychosis across diverse populations.

IFI27 transcription is an early predictor for COVID-19 outcomes, a multi-cohort observational study

Purpose

Robust biomarkers that predict disease outcomes amongst COVID-19 patients are necessary for both patient triage and resource prioritisation. Numerous candidate biomarkers have been proposed for COVID-19. However, at present, there is no consensus on the best diagnostic approach to predict outcomes in infected patients. Moreover, it is not clear whether such tools would apply to other potentially pandemic pathogens and therefore of use as stockpile for future pandemic preparedness.

Methods

We conducted a multi-cohort observational study to investigate the biology and the prognostic role of interferon alpha-inducible protein 27 (IFI27) in COVID-19 patients.

Results

We show that IFI27 is expressed in the respiratory tract of COVID-19 patients and elevated IFI27 expression in the lower respiratory tract is associated with the presence of a high viral load. We further demonstrate that the systemic host response, as measured by blood IFI27 expression, is associated with COVID-19 infection. For clinical outcome prediction (e.g., respiratory failure), IFI27 expression displays a high sensitivity (0.95) and specificity (0.83), outperforming other known predictors of COVID-19 outcomes. Furthermore, IFI27 is upregulated in the blood of infected patients in response to other respiratory viruses. For example, in the pandemic H1N1/09 influenza virus infection, IFI27-like genes were highly upregulated in the blood samples of severely infected patients.

Conclusion

These data suggest that prognostic biomarkers targeting the family of IFI27 genes could potentially supplement conventional diagnostic tools in future virus pandemics, independent of whether such pandemics are caused by a coronavirus, an influenza virus or another as yet-to-be discovered respiratory virus.

The Open, Randomized, Positive Control Clinical Trial of Guluronic Acid (G2013) on SARS-CoV-2 Patients

INTRODUCTION

Recently, the coronavirus disease 2019 (COVID-19) infection, with a vast spectrum of clinical and paraclinical symptoms has been a major health concern worldwide. Therapeutical management of COVID-19 includes antiviral and anti-inflammatory drugs. NSAIDs, as the second-line therapy, are often prescribed to relieve the symptoms of COVID-19. The α-L-guluronic acid (G2013) is a non-steroidal patented (PCT/EP2017/067920) agent with immunomodulatory properties. This study investigated the effect of G2013 on the outcome of COVID-19 in moderate to severe patients.

METHODS

The disease's symptoms were followed up during hospitalization and for 4 weeks postdischarge in G2013 and control groups. Paraclinical indices were tested at the time of admission and discharge. Statistical analysis was performed on clinical and paraclinical parameters and ICU admission and death rate.

RESULTS

The primary and secondary outcomes indicated the efficiency of G2013 on COVID-19 patients' management. There were significant differences in the duration of improvement of fever, coughing, fatigue/malaise. Also, a comparison of paraclinical indices at the time of admission and discharge showed significant change in prothrombin, D-dimer, and platelet. As the main findings of this study, G2013 significantly decreased the percentage of ICU admission (control:17 patients, G2013:1 patient) and death (control: 7 cases, G2013:0).

CONCLUSION

These results conclude that G2013 has sufficient potential to be considered for moderate to severe COVID-19 patients, can significantly reduce the clinical and physical complications of this disease, has a positive effect on modulating the coagulopathy process, and aids in saving lives.

High incidence of type 1 diabetes, type 2 diabetes and gestational diabetes in Central Iran: A six years results from Semnan health cohort

Introduction

Diabetes incidence has increasingly risen in Iran and other low- and middle-income nations in recent decades. In the Semnan Greater Area of Iran, we evaluate the incidence of type 1 diabetes (T1D), type 2 diabetes (T2D), and gestational diabetes during 2015–2020 as well as their six-year trend.

Methods

This is a retrospective analysis of data (n = 820401) from the Integrated Health System (sib) in Semnan province during 2015–2020. All diabetes cases with diagnostic codes based on the International Classification of Diseases 10 (ICD-10) are listed by year. The Grid Search method was used to obtain the exact number and time of points when the incidence of diseases changes significantly (Joinpoints). Average Annual Percent Change-Annual Percentage Change (AAPC-APC) values and slop changes in the estimated regression line with 95% confidence interval were utilized based on diabetes types to determine Joinpoints. P-value < 0.05 is considered statistically significant.

Results

The proportions of diabetes types (T1D, T2D, and gestational diabetes) among 820401 diabetics were 4.18%, 94.84%, and 0.97%, respectively. APC value denotes that T1D has increased by 12.47% per year on average in this period (P-value < 0.01). The incidence of T2D and gestational diabetes has increased between 2015 and 2020 (APC = 15.02 and APC = 136.138, respectively; P-value < 0.1).

Conclusions

In summary, the incidence of diabetes in Semnan province is constantly increasing. T2D, meanwhile, has a higher proportion. Nevertheless, gestational diabetes had the highest increase annually. Well-designed surveys investigating the reasons for diabetes increment especially gestational ones and its burden are needed.

•

The incidence of diabetes has been increasing in Iran and other low- and middle-income countries over the past decades.

•

The incidence of diabetes in Semnan has been steadily increasing from 2015 through 2020. T2D, meanwhile, has a higher proportion.

•

Although the trends in the incidence of T1D, T2D and gestational diabetes were increasing, gestational diabetes increased more than the other types.

Attitudes and Knowledge of Infertile Iranian Couples Among Treatment With Assisted Reproductive Technologies During COVID-19 Pandemics

Objective: The coronavirus disease 2019 (COVID-19) pandemic affected the continuation of all non-emergency medical treatment and patients potentially suffer from restrictions including patients under infertility treatment. This study aimed to evaluate the knowledge and attitudes of infertile couples about continuing assisted reproductive technologies (ARTs) therapy during the COVID-19 outbreak, in Sari, Iran. Materials and methods : We conducted a prospective longitudinal investigation on potential infertile couples for treatment with ARTs referred to our infertility clinic from March 2020 to June 2020. Ninety-two patients were studied voluntarily and anonymously in this study. A self-developed structured questionnaire was used to assess the attitude towards continuing infertility treatment. A P-value of less than 0.05 was considered statistically significant. Results: Thirty-two patients (33.33%) had decreased motivation to continue treatment during the COVID-19 pandemic. Fear of transmission to the fetus (28.13%) had the highest frequency among the causes of decreased motivation to continue treatment (P-value = 0.011). Trust on the support of the treatment team (56.67%) was the most common reason for not reducing motivation in patients without decreased motivation (P <0.001). Conclusion: Despite the COVID-19 pandemy, in Iran most infertile patients tended to continue ARTs. Although many patients had passable knowledge on COVID-19, the stress of infertility and the high desire of infertile couples to have children did not deter them from continuing their therapy.

Atorvastatin therapy in COVID-19 adult inpatients: A double-blind, randomized controlled trial

Introduction

Efficacious therapies are urgently required to tackle the coronavirus disease 2019 (COVID-19). This trial aims to evaluate the effects of atorvastatin in comparison with standard care for adults hospitalized with COVID-19.

Methods

We conducted a randomized controlled clinical trial on adults hospitalized with COVID-19. Patients were randomized into a treatment group receiving atorvastatin + lopinavir/ritonavir or a control group receiving lopinavir/ritonavir alone. The primary outcome of the trial was the duration of hospitalization. The secondary outcomes were the need for interferon or immunoglobulin, receipt of invasive mechanical ventilation, and O2 saturation (O2sat), and level of C-reactive protein (CRP) which were assessed at the onset of admission and on the 6th day of treatment.

Results

Forty patients were allocated and enrolled in the study with a 1 to 1 ratio in atorvastatin + lopinavir/ritonavir and lopinavir/ritonavir groups. Clinical and demographic characteristics were similar between the two groups. CRP level was significantly decreased in the lopinavir/ritonavir + atorvastatin group (P < 0.0001, Cohen’s d = 0.865) so that there was a significant difference in CRP level on the 6th day between the two groups (P = 0.01). Nevertheless, there was no significant difference in O2sat on day 6. Although the duration of hospitalization in the lopinavir/ritonavir + atorvastatin group was significantly reduced compared to the control group (P = 0.012), there was no significant difference in the invasive mechanical ventilation reception and the need for interferon and immunoglobulin.

Conclusion

Atorvastatin + lopinavir/ritonavir may be more effective than lopinavir/ritonavir in treating COVID-19 adult hospitalized patients.

Evaluation of the Drug Hypersensitivity Reactions Prevalence in Hospitalized Children in Sari City from 2014 to 2018: An Original Research

Background: Drug allergy is a subtype of Adverse Drug Reaction (ADR) mediated by the immunologic system. Extreme drug allergy is poorly known in children that contribute to hospitalization in our region. Objectives: This research aimed to study major drug hypersensitivity reactions in the north of Iran among the hospitalized children. Methods: This cross-sectional study was conducted at Bou Ali Sina Hospital in the north of Iran. We analyzed the medical files of 140 children admitted to the hospital with drug allergies from 2014 to 2018. The inclusion criteria were based on the DRESS (drug reaction with eosinophilia and systemic symptoms) scoring system, and those who scored more than four were enrolled. Patients with incomplete medical charts were excluded. The sampling methodology was based on the consecutive census method. Results: In the current study, 62 patients were females (44.29%), and 78 were males (55.71%). Ninety-six cases (68.57%) were children under five, and 44 cases (31.43%) were over five years old. Most ADRs were seen in patients from urban areas (58.57%) than in rural areas (41.43%). In 116 children (82.6%), maculopapular rashes were seen. Phenobarbital and cefalexin had the highest levels of drug reactions, including 85 persons (55.19%) and 18 persons (11.69%), respectively. Pruritus, fever, and scaling were the most common symptoms observed in the patients. The most commonly used treatment was antihistamines. Conclusions: The most causative medication inducing ADR was phenobarbital. The maculopapular rash was the most common skin manifestation, and there were no relationships between sex, age, medication type, and type of hypersensitivity reactions.

Evaluation of the effectiveness of N-acetylcysteine on accelerating the recovery of renal failure in patients with leptospirosis, a randomized clinical trial study

BACKGROUND

Limited studies have been conducted on patients with renal function recovery regarding severe leptospirosis. The purpose of this study is to evaluate the effectiveness of N-acetylcysteine (NAC) in accelerating the reduction of serum creatinine in patients with leptospirosis.

PATIENTS AND METHODS

This is a clinical trial study involving 64 patients with leptospirosis, with microscopic agglutination tests used to confirm the diagnosis of acute kidney injury. NAC was given to patients with a glomerular filtration rate of less than 60 ml/min at 1200 mg every 12 h, and it lasted for 48 h. Next, 32 patients were measured and the relationship between the length of hospitalization, age, and sex was also examined. Additionally, the two groups of case and control were compared in terms of the rate of decrease in serum creatinine level in three different time periods. The Shapro-Wilk test was used to investigate the distribution of data.

RESULTS

No significant differences were observed in the decrease in serum creatinine level on the first, third, and seventh days of hospitalization and also in the use of NAC between the case and control groups (P = 0.255). In addition, the use of NAC had no significant effect on reducing the length of hospitalization (P = 0.067).

CONCLUSION

Recovery of acute kidney injury following leptospirosis and drugs that accelerate the healing process in these patients require further studies with greater sample size and longer follow-up time.

A VPS13B mutation in Cohen syndrome presented with petechiae: An unusual presentation

Cohen syndrome (CS) is a rare autosomal recessive disorder. CS includes a range of clinical symptoms including retinal dystrophy and myopia. The new VPS13B mutation could cause CS-induced neutropenia and petechiae in patients with CS.

Mathematical analysis of the role of pituitary-adrenal interactions in ultradian rhythms of the HPA axis

The hypothalamic-pituitary-adrenal (HPA) axis is a biological system in the human body that plays an important role in controlling stress and regulating various physiological elements, including the immune system, emotions, and moods in tense situations. Over the past two decades, several ordinary or delay differential equations models of the HPA axis have been proposed. In the majority of studies presented so far, corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and cortisol are among the main variables employed to build the HPA axis models. In the present study, based on a previously introduced hypothesis which asserts that ultradian rhythms in the HPA axis are produced by the pituitary-adrenal network alone and these rhythms can endure in the absence of CRH secretion, a simple two-dimensional delayed dynamical model of the HPA axis based on only ACTH and cortisol is introduced. The model is shown to be able to capture the ultradian (low frequency) rhythms of ACTH and cortisol released into the bloodstream. By mathematical analysis of the model using the Hopf bifurcation theorem, it is also demonstrated how oscillating solutions can emerge. Also, the model employs physiologically reasonable parameter values to exhibit how in the absence of CRH secretion, a simple model of the pituitary-adrenal interaction can be used to produce ultradian rhythms of both cortisol and ACTH hormones.

A 33-year-old man with COVID-19 presented with subacute thyroiditis: A rare case report and literature review

We report the first case of the novel coronavirus disease 2019 (COVID-19) presenting with subacute thyroiditis in Ghaemshar, Mazandaran Province, Iran. In our patient, with the initiation of corticosteroid therapy, the symptoms of subacute thyroiditis gradually disappeared with a slow increase in thyroid-stimulating hormone (TSH) and the gradual elimination of thyrotoxicosis. This case shows that decreased TSH and persistent thyrotoxicosis may make the patient's condition worse. Managing this complication can take several weeks and can be complicated.

Effects of mannuronic acid (M2000) on gene expression profile of signal transducer and activator of transcription proteins (STATs) in rheumatoid arthritis patients

Rheumatoid arthritis (RA), a form of inflammatory arthritis, is a chronic joint disease characterized by pain and inflammation that affects 0.5% to 1% of the population worldwide. The safety, efficacy, tolerability, and potency of β-D-mannuronic acid (M2000) as a novel NSAID with immunosuppressive property has been reported by several in vitro studies, experimental models and clinical trials phase I/II and III in ankylosing spondylitis and rheumatoid arthritis (RA) patients This research is designed to study the therapeutic efficacy of oral administration of mannuronic acid in RA patients who had inadequate response to conventional drugs and to assess the effect of this drug on gene expression of the signal transducer and activator of transcription (STATs) protein (STAT1, STAT3, STAT4, and STAT6). The study has included 15 RA patients who had an insufficient response to the conventional therapy. The oral dose of mannuronic acid was 1000mg divided into two 500 mg doses per day for 3 months as an addition to conventional therapy. There were 15 healthy volunteer in the control group. Blood samples were collected from both groups, once from healthy controls and twice from RA patients before and after treatment by M2000. The peripheral blood mononuclear cells (PBMCs) were isolated to assess the gene expression level of STAT1, STAT3, STAT4, and STAT6 using the real-time PCR method. Results obtained in this study demonstrated a significant difference in the gene expression level of STAT1 between healthy controls and patients before treatment as well as a significant reduction in RA patients after treatment compared with the level before treatment. In addition, the gene expression level of STAT3 and STAT4 showed a significant reduction in RA patients after treatment compared to patients before treatment, while there was no significant difference between RA patients before treatment and the healthy control group for both molecules. On the other hand, there was no change in the gene expression level of STAT6 among all groups. The outcomes of this study confirmed that β-D-mannuronic acid (M2000) has the ability to control the levels of STAT1, STAT3 and STAT4 in RA patients, and might be beneficial in the management and therapy of RA.

Hydroxychloroquine-induced Stevens-Johnson syndrome in COVID-19: a rare case report

The international outbreak of respiratory illness termed coronavirus disease 2019 (COVID-19) began in December 2019 that has affected >0.8 million individuals. Self-limiting respiratory tract involvement, severe pneumonia, multiorgan failure and death are the spectrum of COVID-19. To date, there are no especial therapeutic agents for COVID-19 infections. One such medication includes the antimalarial hydroxychloroquine (HCQ), which recently reported as a possible therapy for shortening the duration of COVID-19 symptoms, reducing inflammatory reactions to infection, impairing the exacerbation of pneumonia and boosting lung imaging findings. Like all medications, HCQ has side effects and may occur in COVID-19 patients. Here, we report on the case of a 42-year-old woman, presented with fever and dry cough, who had COVID-19 and 2 days later presented with a pruritic erythematous maculopapular rash, which started from the distal of upper extremities and rapidly, involved the entire body.

Relationship Between the Prevalence of Blood Groups and Severity of Leptospirosis: A Case-Control Study

Introduction:

The correlation between the prevalence and severity of leptospirosis with blood groups has not been investigated so far, but several studies have been conducted to link the infectious diseases with blood groups. The aim of this study was to investigate the prevalence of blood type in patients with leptospirosis and its association with disease severity.

Methods:

This is a case-control study performed on hospitalized patients with the diagnosis of leptospirosis in Mazandaran province, Iran, in 2018. The control group was selected from among the families of patients. Blood groups (ABO and Rh) and severity of the disease were assessed. Data were analyzed by SPSS 22.

Results:

A total of 300 people (150 in the case and 150 in the control) enrolled in the study. The mean age was 44.35 ± 15.39 years and 81.3% were men. The highest frequency of blood type in both groups was O+, A+, and B+, respectively. There was a statistically significant difference in the frequency of blood groups (P = .037). Comparison between severity of disease and blood types (ABO, Rh) showed no significant difference (P > .05).

Conclusions:

According to our study, O+ was the most common among patients with leptospirosis. The frequency of O in patients was significantly higher than in the control group, but there was no significant relationship between leptospirosis and Rh. The prevalence of this blood type was higher in people with a severe form of the disease. Finally, there is no statistically significant difference between the severity of the disease and ABO and Rh.

COVID-19 in Children: A Narrative Review

BACKGROUND: In December 2019, coronavirus (CoV) disease 2019 (COVID-19) was detected in Wuhan, China, which is known as severe acute respiratory syndrome CoV 2 (Severe acute respiratory syndrome [SARS]-CoV-2). AIM: This study attempted a narrative review of the researches about COVID-19 in children. METHODS: We searched all articles between 2000 and April 2020 in PubMed, Scopus, and ScienceDirect related to COVID-19 in children, using the following terms: “COVID-19,” “coronavirus,” “SARS-CoV-2” in combination with “pediatrics,” or “children.” RESULTS: The most common method of transmitting the disease to children was through close contact with family members through respiratory droplets. Coinfection is common in pediatric with COVID-19 infection. One of the most important transmission routes is oral feces. The severity of the disease was mild or asymptomatic in most children. The most common clinical symptoms were fever and cough, and gastrointestinal symptoms were more common in children than in adults. Infants and preschoolers had more severe clinical symptoms than older children. The most common radiographic findings from the lungs were bilateral ground-glass opacity. Increased procalcitonin and lactate dehydrogenase should be considered in children. The use of intravenous immunoglobulin, lopinavir/ritonavir, and oseltamivir, along with oxygen therapy, had the greatest effect on improving children’s conditions. CONCLUSIONS: The most important way to prevent this disease in children is to follow the health tips of family members. Although the number of children with the disease is low, children are vulnerable to infection. Antiviral medications along with the use of muscle relaxants and oxygen therapy have a great impact on children’s condition.

Cytotoxic and apoptotic properties of a novel nano-toxin formulation based on biologically synthesized silver nanoparticle loaded with recombinant truncated pseudomonas exotoxin A

Bacterial toxins have received a great deal of attention in the development of antitumor agents. Currently, these protein toxins were used in the immunotoxins as a cancer therapy strategy. Despite the successful use of immunotoxins, immunotherapy strategies are still expensive and limited to hematologic malignancies. In the current study, for the first time, a nano-toxin comprised of truncated pseudomonas exotoxin (PE38) loaded silver nanoparticles (AgNPs) were prepared and their cytotoxicity effect was investigated on human breast cancer cells. The PE38 protein was cloned into pET28a and expressed in Escherichia coli, BL21 (DE3), and purified using metal affinity chromatography and was analyzed by 15% sodium dodecyl sulfate-polyacrylamide gel electrophoresis. AgNPs were biologically prepared using cell-free supernatant of E. Coli K12 strain. Nanoparticle formation was characterized by energy dispersive spectroscopy, transmission electron microscopy, and dynamic light scattering. The PE38 protein was loaded on AgNPs and prepared the PE38-AgNPs nano-toxin. Additionally, in vitro release indicated a partial slow release of toxin in about 100 hr. The nano-toxin exhibited dose-dependent cytotoxicity on MCF-7 cells. Also, real-time polymerase chain reaction results demonstrated the ability of nano-toxin to upregulate Bax/Bcl-2 ratio and caspase-3, -8, -9, and P53 apoptotic genes in the MCF-7 tumor cells. Apoptosis induction was determined by Annexin-V/propidium flow cytometry and caspases activity assay after treatment of cancer cells with the nano-toxin. In general, in the current study, the nano-toxin exhibit an inhibitory effect on the viability of breast cancer cells through apoptosis, which suggests that AgNPs could be used as a delivery system for targeting of toxins to cancer cells.

Promoter region single nucleotide polymorphism of siglec-8 gene associates with susceptibility to allergic asthma

Aim: Siglec-8 is exclusively expressed on mast cells, eosinophils and basophils. Possible association of six siglec-8 single nucleotide polymorphisms (SNPs) with susceptibility to allergic asthma in the Azeri population of Iran was investigated in this study. Materials & methods: A total of 194 patients and 190 normal subjects were enrolled. PCR single strand conformation polymorphism (PCR-SSCP) was used to determine the genotypes of the studied SNPs. Results: The rs36498 showed significant association with allergic asthma (odds ratio [OR]: 0.65; p = 0.022) and the T allele was found as a protective allele (OR: 0.61; p = 0.008). Also, eosinophil count in the CC genotype was significantly higher than that in the other genotypes (p = 0.026). Conclusion: The rs36498 is thought to influence the expression level of siglec-8. Siglec-8 could be a potential therapeutic target for allergic asthma.

Topiramate-Induced Acute Psychotic Symptoms: A Case Report

A 36-year-old man, married, nurse, presented with feeling fear and injury from imaginary creatures to a psychiatric clinic in Sari, Iran. Symptoms began two days before admission when tablet Topiramate was started due to the increasing intensity of chronic headache. About one hour after the first dose, Symptoms became apparent and resolved when he woke up. There was no hallucination and loss of consciousness. Next day, following use the same dose, the symptoms appeared. Eventually, Topiramate was discontinued and the patient did not experience similar symptoms in follow up.

Leptospirosis presented with erythema nodosum on four limbs: an unusual presenting

Leptospirosis is a common disease between humans and animals characterized by a wide range of clinical manifestations. Erythema nodosum (EN) is a common clinical form of panniculitis or subcutaneous adipose inflammation caused by hypersensitivity responses to antigens, but the presence of EN in a subject with leptospirosis is a very rare case presentation. We will present a 42-year-old man with a headache, myalgia, nausea and rigid tender on the shin and both forearms, which was a typical form of EN lesions.

COVID-19 Presented With Deep Vein Thrombosis: An Unusual Presenting

On December 31, 2019, the World Health Organization was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province, China. The pneumonia was caused by a virus called SARS-Cov-2 (severe acute respiratory syndrome coronavirus 2), which was later named coronavirus infectious disease 2019 (COVID-19). The symptoms most commonly reported by patients affected by COVID-19 include fever, dry cough, and shortness of breath. In this report, we present a case of a 57-year-old woman who presented to the clinic's infectious department with swelling, pain, warmth, and redness in the left leg who was treated with therapeutic heparin. There were no typical and distinguished symptoms of COVID-19, and she had no risk factor for deep vein thrombosis. Then chest X-ray revealed bilateral patchy ground-glass opacity, and computed tomography angiography was performed to rule out pulmonary thromboembolism, which showed no evidence of thrombosis. Left lower limb venous color Doppler ultrasound revealed dilatation and thrombosis in the external iliac and left iliac veins up to the level of the bifurcation of the common iliac veins, as well as thrombosis to the superficial and small saphenous veins. Because of ground-glass opacity and lymphopenia, nasal swabs were used for sampling, and SARS-CoV-2 nucleic acid was detected by reverse transcription polymerase chain reaction (RT-PCR). This case aims to arouse the medical staff's awareness of deep vein thrombosis as a clinical symptom of COVID-19 even if the patient has no typical symptoms of COVID-19.

β-D-Mannuronic Acid (M2000) as a Landmark in Pharmacology

OBJECTIVES

The goal of this article is to retrace the studies of β-D-Mannuronic Acid (M2000) as a new immunosuppressive drug with non-steroidal anti-inflammatory drugs (NSAIDs) property in miscellaneous aspects including in vitro, in vivo examinations, clinical trials and related to clinical trials studies. Our goal is to compare the effect of this drug with other similar drugs through varied researches and to follow tolerability, biocompatibility, potency, safety, and efficacy of this medication in different studies, as well as to evaluate its therapeutic effectiveness in various diseases.

MATERIALS AND METHODS

Different methods were applied in the studies of β-D-Mannuronic Acid under in vitro, in vivo examinations, and clinical trials phase I, II and III and related investigations to these clinical trials using different techniques showing the efficacy of this medication in the treatment of various diseases.

RESULTS

The administration of β -D-Mannuronic Acid showed the greatest tolerability and biocompatibility compared to diclofenac, piroxicam, and dexamethasone without or very low side effects. The drug has shown a punchy effect on many molecules which participate either in physiologic or in pathogenic activities in animal models and human. This new drug not only revealed the anti-inflammatory and immunosuppressive properties but also based on the results of various investigations, β-D-Mannuronic Acid showed the antidiabetic, cardioprotective and anti-tumoral effects.

CONCLUSION

β-D-Mannuronic Acid (M2000) as a novel immunosuppressive drug with NSAID properties along with antidiabetic, cardioprotective and anti-tumoral efficacy showed great tolerability and safety profile. In addition, it has no or mild adverse events compared with many other medicines, therefore this medicament could be considered as a landmark in pharmacology and represent turn point in the treatment of different diseases based on the experimental and in vitro studies explained and clinical and related studies proved.

T-bet+ Cells Polarization in Patients Infected with Helicobacter pylori Increase the Risk of Peptic Ulcer Development

BACKGROUND

Peptic ulcer disease (PUD) is a common disease worldwide moreover known as stomach ulcer or peptic ulcer. Increased the number of T CD4⁺ helper cells in response to gastric infection by Helicobacter pylori (H. pylori) play an important role in the development of PUD. The aim of this study was to determine the frequency of T-bet⁺ cells in H. pylori-infection, its interaction with Th17/Treg cells and its association with the clinical consequences of the infection.

METHODS

A total of 63 patients with PUD, 89 patients with gastritis and 48 H. pylori-negative subjects were enrolled in this study. The number of T-bet⁺ cells were determined by immunohistochemistry.

RESULTS

The numbers of T-bet⁺ cells and INF-γ expression in infected patients were significantly higher than uninfected. Moreover, the number of T-bet⁺ cells and INF-γ expression in infected patients with PUD were significantly higher than infected patients with gastritis. Additionally, the number of T-bet⁺ cells and INF-γ expression were found to be inversely correlated with degree of H. pylori density and chronic inflammation score (CIS) in infected patients with gastritis disease, but this correlation was positive in the infected patients with PUD. The number of T-bet⁺ cells was found to be positively correlated with the number of Th17 cells and inversely correlated with the number of Treg cells in infected patients with gastritis and PUD.

CONCLUSION

Abnormal hyper-activation of T-bet⁺ cells during H. pylori-infection may lead to tissue damage caused by immunopathologic reactions.

Detection of Diazinon Residue in Honey and Honey Bee (Apis mellifera) in Bandar-Abbas and Meshkinshahr, Iran

Background: The excessive use of pesticides for crops by farmers, their destructive effects on beneficial organisms, such as bees, have become a big problem today. This study was designed to find out if the honey bee (Apis mellifera) and the honey be affected by diazinon.  Methods: Six hives were purchased, 3 hives in Bandar-Abbas and remaining were considered for Meshkinshahr. Plants around the hive were sprayed with diazinon at a concentration of 2/1000. Sampling took place 15d after spraying, and diazinon residue was measured by the HP TLC. The study was conducted in 2017–2018. Results: The amount of diazinon residue in honey and honey bee was measured and compared with existing studies. The amount of diazinon residue in honey bee was found to be 0.017mg/kg in Bandar Abbas, and 0.005mg/kg in Meshkinshahr hives. There was nothing in honey. Conclusion: Honey is safe for consumers.

The Oral Administration Effect of Drug Mannuronic Acid (M2000) on Gene Expression of Matrix and Tissue Inhibitor of Metalloproteinases in Rheumatoid Arthritis Patients

BACKGROUND

Rheumatoid Arthritis (RA) is a complex disease involving an unknown number of genes, and affecting a large number of organs, tissues, and sites across the body. It is affecting approximately 1% of the population worldwide. The safety and therapeutic efficacy of β-D-mannuronic acid (M2000) as a novel NSAID with immunosuppressive property has been demonstrated under in vitro, in vivo examinations and clinical trials phase 1/11 in Ankylosing Spondylitis (AS) patients in addition to phase I/11 and 111 in Rheumatoid Arthritis (RA) patients.

OBJECTIVE

In this study, our goal is to evaluate the therapeutic efficacy of oral administration of M2000 on gene expression of the matrix metalloproteinase (MMP2, MMP9) and tissue inhibitor of metalloproteinase (TIMP1, TIMP2) as inflammatory molecules in the progression of rheumatoid arthritis.

METHODS

The study has included 15 RA patients who had an insufficient response to the conventional drug. Therefore, mannuronic acid was used as an additive to the conventional regime. The research was a single-blinded study. The dose of M2000 was 500mg orally twice per day for 12 weeks. There were 15 healthy participants considered as control. Blood samples have been collected from both groups once from the healthy control and twice from RA patients before and after treatment with M2000. The Peripheral Blood Mononuclear Cells (PBMCs) were isolated for assessment of the gene expression level of MMP2, MMP9, TIMP1, and TIMP2 using the real-time PCR method.

RESULTS

The gene expression level of MMP2 and MMP9 reported a significant reduction in RA patients after treatment with M2000 compared to before treatment. On the other hand, the gene expression level of TIMP2 demonstrated a significant increase in RA patients after treatment with mannuronic acid compared to before treatment, but there was no significant difference between the group of RA patients before treatment and the control group. Vice versa to other molecules, there was no significant difference in the level of TIMP1 in compression with RA patients before and after treatment.

CONCLUSION

our findings proved that the β -D- mannuronic acid) as a novel NSAID with immunosuppressive property has a significant effect on the gene expression level of MMP2, MMP9 and TIMP2 molecules in RA patients.

Detection of Diazinon Residue in Honey and Honey Bee (Apis mellifera) in Bandar-Abbas and Meshkinshahr, Iran

BACKGROUND

The excessive use of pesticides for crops by farmers, their destructive effects on beneficial organisms, such as bees, have become a big problem today. This study was designed to find out if the honey bee (Apis mellifera) and the honey be affected by diazinon.

METHODS

Six hives were purchased, 3 hives in Bandar-Abbas and remaining were considered for Meshkinshahr. Plants around the hive were sprayed with diazinon at a concentration of 2/1000. Sampling took place 15d after spraying, and diazinon residue was measured by the HP TLC. The study was conducted in 2017-2018.

RESULTS

The amount of diazinon residue in honey and honey bee was measured and compared with existing studies. The amount of diazinon residue in honey bee was found to be 0.017mg/kg in Bandar Abbas, and 0.005mg/kg in Meshkinshahr hives. There was nothing in honey.

CONCLUSION

Honey is safe for consumers.

Investigating the Association of Orosomucoid 1-like 3 (ORMDL3) Gene Polymorphism (rs12603332) with Susceptibility to Allergic Asthma in Iranian Northwestern Azeri Population

Orosomucoid 1-like 3 (ORMDL3) gene, located on chromosome 17q21, is an asthma candidate gene that encodes ORMDL3. This molecule has been reported to play a role in airway remodeling and bronchial hyper-responsiveness. In this study, we aimed to investigate the possible association of ORMDL3 single nucleotide polymorphism (SNP) (rs12603332) with susceptibility to allergic asthma in Iranian Northwestern Azeri population. 193 asthmatic patients and 185 normal individuals were included. Genomic DNA was extracted and genotyping was performed by standard restriction fragment length polymorphism-polymerase chain reaction RFLP-PCR method using BstUI restriction enzyme. Our results showed dominant presence of TC genotype and C allele in both patients (49.2% and 59.8%, respectively) and controls (48.6% and 60%, respectively). Frequency of genotypes and alleles showed no significant difference between two groups (p=0.994 and p=1.00, respectively). None of alleles could be defined as risk allele for allergic asthma (OR=0.99, 0.88-1.12, 95% CI). We failed to show significant association between ORMDL3 rs12603332 with predisposition to allergic asthma in Iranian Northwestern Azeri population. More studies with larger number of participants should be done to find more reliable results for such association.  

Investigating the Association of Orosomucoid 1-like 3 (ORMDL3) Gene Polymorphism (rs12603332) with Susceptibility to Allergic Asthma in Iranian Northwestern Azeri Population

Orosomucoid 1-like 3 (ORMDL3) gene, located on chromosome 17q21, is an asthma candidate gene that encodes ORMDL3. This molecule has been reported to play a role in airway remodeling and bronchial hyper-responsiveness. In this study, we aimed to investigate the possible association of ORMDL3 single nucleotide polymorphism (SNP) (rs12603332) with susceptibility to allergic asthma in Iranian Northwestern Azeri population. 193 asthmatic patients and 185 normal individuals were included. Genomic DNA was extracted and genotyping was performed by standard restriction fragment length polymorphism-polymerase chain reaction RFLP-PCR method using BstUI restriction enzyme. Our results showed dominant presence of TC genotype and C allele in both patients (49.2% and 59.8%, respectively) and controls (48.6% and 60%, respectively). Frequency of genotypes and alleles showed no significant difference between two groups (p=0.994 and p=1.00, respectively). None of alleles could be defined as risk allele for allergic asthma (OR=0.99, 0.88-1.12, 95% CI). We failed to show significant association between ORMDL3 rs12603332 with predisposition to allergic asthma in Iranian Northwestern Azeri population. More studies with larger number of participants should be done to find more reliable results for such association.

Effects of Viola tricolor Flower Hydroethanolic Extract on Lung Inflammation in a Mouse Model of Chronic Asthma

Asthma is a chronic inflammatory disease of the lungs driven by T cell activation. Viola tricolor L. as a traditional medical herb could suppress activated T lymphocytes and has been used empirically for asthma remedy. In the present study, we investigated the anti-inflammatory effect of Viola tricolor and its underlying mechanism on asthma characteristics induced by ovalbumin (OVA) in mice. BALB/c mice were randomly divided into six groups: normal control, Ovalbumin (OVA) control, OVA mice treated with Viola tricolor (50, 100 and 200 mg/kg) and dexamethasone (3 mg/kg). All mice except normal controls were sensitized and challenged with OVA. Asthmatic mice were treated orally in the last 7 days of OVA challenge. The total and differential leukocyte counts, Interleukin (IL)-4 and interferon (IFN)-γ levels in bronchoalveolar lavage fluid (BALF) were determined. H&E staining for lung inflammation was performed. Viola tricolor treatment at 200 mg/kg significantly decreased IL-4 level but did not considerably affect the IFN-γ level. Therefore, it effectively reduced asthma characteristics including infiltration of leukocytes particularly eosinophil and peribronchial inflammation as compared to dexamethasone. However, Viola tricolor at 100 mg/kg had the most prominent inhibitory effect on the IL-4 level and also markedly increased IFN-γ level. As result, it prevented further reduction of inflammatory parameters in this group compared to the Viola tricolor-treated group at 200 mg/kg. Our study demonstrated that Viola tricolor has anti-inflammatory effects via inhibition of T-helper type 2 (Th2) cytokine production and validated its empirical usage in traditional medicine.  

Effects of Viola tricolor Flower Hydroethanolic Extract on Lung Inflammation in a Mouse Model of Chronic Asthma

Asthma is a chronic inflammatory disease of the lungs driven by T cell activation. Viola tricolor L. as a traditional medical herb could suppress activated T lymphocytes and has been used empirically for asthma remedy. In the present study, we investigated the anti-inflammatory effect of Viola tricolor and its underlying mechanism on asthma characteristics induced by ovalbumin (OVA) in mice. BALB/c mice were randomly divided into six groups: normal control, Ovalbumin (OVA) control, OVA mice treated with Viola tricolor (50, 100 and 200 mg/kg) and dexamethasone (3 mg/kg). All mice except normal controls were sensitized and challenged with OVA. Asthmatic mice were treated orally in the last 7 days of OVA challenge. The total and differential leukocyte counts, Interleukin (IL)-4 and interferon (IFN)-γ levels in bronchoalveolar lavage fluid (BALF) were determined. H and E staining for lung inflammation was performed. Viola tricolor treatment at 200 mg/kg significantly decreased IL-4 level but did not considerably affect the IFN-γ level. Therefore, it effectively reduced asthma characteristics including infiltration of leukocytes particularly eosinophil and peribronchial inflammation as compared to dexamethasone. However, Viola tricolor at 100 mg/kg had the most prominent inhibitory effect on the IL-4 level and also markedly increased IFN-γ level. As result, it prevented further reduction of inflammatory parameters in this group compared to the Viola tricolor-treated group at 200 mg/kg. Our study demonstrated that Viola tricolor has anti-inflammatory effects via inhibition of T-helper type 2 (Th2) cytokine production and validated its empirical usage in traditional medicine.

Investigation of Fc Receptor-Like 3 (FCRL-3) Gene Polymorphism (rs7528684) with Susceptibility to Allergic Asthma in Iranian North-Western Azeri Population

BACKGROUND

Asthma is a clinical setting in which multiple cellular and molecular mechanisms are involved. Additionally, increasing genetic studies have provided evidence that single nucleotide polymorphisms (SNPs) in asthma relevant genes confer susceptibility to the disease. Fc receptor-like (FCRL) 3, a transmembrane molecule basically involved in B-cell signaling, mediates immune-disorders including allergy. Aim of study was to investigate the possible association of rs7528684 SNP in FCRL3 gene with a predisposition to allergic asthma in Iranian North-western Azeri population.

METHODS

The frequency of genotypes and alleles of rs7528684 SNP in the FCRL3 gene was determined using the TaqMan genotyping method in 191 asthmatic patients and 186 healthy controls.

RESULTS

The most frequent genotype in patients and control groups were CT (n = 81, 42.4%) and TT (n = 76, 40.9%), respectively. Statistical analysis showed no significant difference in genotype frequency (p = 0.81) and also in frequency of C and T alleles (p = 0.52) between two groups.

CONCLUSIONS

Our results revealed no association between the rs7528684 SNP with susceptibility to allergic asthma in the included population. More studies in different ethnic groups will result in more valid conclusions.

Development of a novel explant culture method for the isolation of mesenchymal stem cells from human breast tumor

BACKGROUND

Mesenchymal stem cells (MSCs) were isolated from various sources, including various types of tumors. However choosing an appropriate isolation method is an important step in obtaining cells with optimal quality and yield in companion with economical considerations. The purpose of this study was to isolate more pure MSCs from human breast tumor tissue by a modified explant culture method.

METHODS AND MATERIALS

The tumor tissues (n = 8) were cut into 1 to 3-mm cube-like pieces (explant). Each explant was placed in a well of 24-well format plates, cultured in Dulbecco's Modified Eagle's medium (DMEM), and maintained at 37°C with 5% humidified incubator. Morphological phenotypes of the cells were surveyed by an inverted microscope and wells with rather homogenous fibroblast-like morphology cell were considered as positive and selected for more expansion and characterization.

RESULTS

A total of 185 wells, 63.7% of wells were positive that were chosen for expansion. Flowcytometry analysis demonstrated that isolated cells were positive for CD73, CD44, CD29, CD105, and CD90 but negative for CD11b, CD45, CD34, and HLA‑DR. In addition, cells possessed the capability of multipotential differentiation into osteoblasts and adipocytes.

Up-regulated Th17 cell function is associated with increased peptic ulcer disease in Helicobacter pylori-infection

BACKGROUND

During Helicobacter pylori (H. pylori) infection CD4⁺ T cells in the gastric lamina propria are hyporesponsive and polarized by Th1/Th17 cell responses controlled by Treg cells. The objective of this study was to determine the number of Th17 cells in gastric mucosa of patients with gastritis and peptic ulcer and determined the relationship between main virulence factor of H. pylori and Th17 cells.

METHODS AND MATERIALS

A total of 89 H. pylori-infected gastritis patients, 63 H. pylori-infected peptic ulcer patients and 48 H. pylori-negative non-ulcer dysplasia patients were enrolled in this study. The number of Th17 was determined by immunohistochemistry. IL-8 and IL-17A expressions were determined by real-time polymerase chain reaction (qPCR). Also, the grade of chronic and active inflammation was investigated for involvement according to the density of neutrophils and mononuclear in gastric mucosal crypts, from one to all crypts.

RESULTS

The number of Th17 cells and the expression of IL-8 and IL-17A in infected patients were significantly higher than uninfected subjects. The number of Th17 cells and the expression of IL-8 and IL-17A in infected patients with peptic ulcer were significantly higher than patients with gastritis. Additionally, the numbers of Th17 cells as well as the expression of IL-8 and IL-17A were positively correlated with the degree of H. pylori density in infected patients with peptic ulcer, while this correlation was negative in infected patients with gastritis. The numbers of Th17 cells as well as the expression of IL-8 and IL-17A were positively correlated with the degree of chronic inflammation.

CONCLUSION

The predominant Th17 cell responses may play a role in the pathogenesis of peptic ulcers disease in infected patients.

Generation and Characterization of Siglec-F-Specific Monoclonal Antibodies

Siglec-F (SF) is a surface glycoprotein expressed by mouse eosinophils and induces caspase- and mitochondria-dependent apoptosis after engagement with its cognate ligand or specific antibodies. This targeting eosinophils by monoclonal antibodies may help diverse diseases associated with increased frequency of eosinophils including allergy and asthma. In this paper, production of murine and rat monoclonal antibodies (mAbs) against Siglec-F has been addressed. Balb/c mice were immunized with siglec-F1 (SF1) and siglec-F2 (SF2) synthetic peptides conjugated to a carrier protein. Rats were immunized with Chinese hamster ovary CHO cells overexpressing Siglec-F (CHO-SF) or with Siglec-F-human immunoglobulin FC fusion protein (CHO-SF-Ig). Hybridomas were produced by standard protocol and screened for their reactivity by enzyme-linked immunosorbent assay (ELISA), western blotting (WB), and flow cytometry. In parallel, polyclonal antibodies were generated in New Zealand White rabbits immunized with SF1 and SF2 peptides. Three mouse and three rat mAbs were generated against synthetic peptides and SF-Ig, respectively. All mouse monoclonal and rabbit polyclonal antibodies reacted well with immunizing molecules in ELISA and detected specific band of Siglec-F in WB. However, they failed to detect native molecule in flow cytometry analysis. Quite the contrary, rat mAbs did not reacted with the denatured protein in WB, instead exhibited significant reactivity with CHO-SF cells in flow cytometry. Based on the heavily glycosylated nature of Siglec-F, it seems that generation of anti-SF antibodies able to detect native protein needs a properly folded molecule for immunization. Monoclonal antibodies reported here are invaluable tools for studying linear and conformation epitopes of SF and tracing mouse eosinophils.

Investigating the Association of ADAM33 Single Nucleotide Polymorphisms (SNPs) with Susceptibility to Allergic Asthma in Azerbaijan Population of Iran: A Case-control Study

Asthma, affecting a growing number of populations, is a clinical condition with complex cellular and genetic factors. Single nucleotide polymorphisms (SNPs) in gene coding for molecules, which play major roles in the immunopathogenesis of asthma have been considered recently as genetic predisposing factors this disease. Possible association between two SNPs in a disintegrin and metalloprotease 33 (ADAM33), which participates in airway remodeling, and susceptibility to asthma was studied in this study. 190 patients with asthma and 180 healthy controls were enrolled in this case-control study. Using conventional PCR method, specific bands were amplified and the frequency of genotypes of T1 (rs2280091) and V4 (rs2787094) ADAM33 SNPs were determined by digestion with NcoI and PstI, respectively. The results showed that the frequency of genotypes of T1 and V4 were not significantly different between patients and controls (p=0.54 and p=0.85, respectively). On the other hand, no significant differences were seen in allele frequency of both T1 and V4 SNPs (p=0.15 and p=0.47, respectively). In agreement with some other studies in different populations, our results showed no association between frequency of genotype or alleles of both T1 and V4 SNPs in ADAM33 gene and predisposition to asthma in Azerbaijan population of Iran. Genetic differences in different ethnic groups might be involved in such inconsistent results. More studies in populations with larger number of patients and healthy individuals are needed for concluding remarks for involvement of ADAM33 SNPs in asthma.

Downregulated regulatory T cell function is associated with increased peptic ulcer in Helicobacter pylori-infection

BACKGROUND

Helicobacter pylori (H. pylori) chronically colonizes gastric/duodenal mucosa and induces gastroduodenal disease such as gastritis and peptic ulcer and induces vigorous innate and specific immune responses; however, the infection is not removed, a state of chronic active gastritis persists for life if untreated. The objective of this study was to determine the number of regulatory T cells (Tregs) in gastric mucosa of patients with gastritis and peptic ulcer and determined the relationship between main virulence factor of H. pylori and Tregs.

METHODS AND MATERIALS

A total of 89 patients with gastritis, 63 patients with peptic ulcer and 40 healthy, H. pylori-negative subjects were enrolled in this study. Expression of CD4 and Foxp3 was determined by immunohistochemistry. Antrum biopsy was obtained for detection of H. pylori, bacterial virulence factors and histopathological assessments. TGF-β1, IL-10 and FOXP3 expressions were determined by real-time polymerase chain reaction (qPCR).

RESULTS

The numbers of CD4⁺ and Foxp3⁺ T cells as well as the expression of IL-10, TGF-β1, FOXP3, INF-γ and IL-17A in infected patients were significantly higher than the ones in uninfected patients. Also, the number of CD4⁺ T cells was independent on the vacuolating cytotoxin A (vacA) and outer inflammatory protein A (oipA), but it was positively correlated with cytotoxin-associated gene A (cagA). Instead, the number of Foxp3⁺ T cells was dependent on the vacA and oipA, but it was independent on cagA. The number of Foxp3⁺ T cells and the expression of IL-10, TGF-β1 and FOXP3 in infected patients with gastritis were significantly higher than the ones in infected patients with peptic ulcer. Moreover, the number of CD4⁺ T cells and the expression of IL-17A and INF-γ was the lowest in the gastritis patients, however, increased progressively in the peptic ulcer patients. Additionally, the numbers of CD4⁺ and Foxp3⁺ T cells as well as the expression of IL-10, TGF-β1, FOXP3 and INF-γ were positively correlated with the degree of H. pylori density and chronic inflammation.

CONCLUSION

Tregs are positively associated with vacA alleles and oipA status of H. pylori and histological grade but negatively associated with peptic ulcer disease.

Treatment of Experimental Nephrotic Syndrome with Artesunate

The present study was designed to test the therapeutic effect of a new antimalarial drug, artesunate in experimental model of nephrotic syndrome. To induce this experimental model, Adriamycin was given once by a single intravenous injection (7.5 mg/kg) through the tail vein. Six days after injection of Adriamycin, therapeutic protocol was developed by intraperitoneally (IP) administration of 5 mg/kg artesunate (ARS). Total of IP injections were 14, of which 5 injections were made every day and 9 injections were carried out at regular 48-h intervals. Therapeutic protocol was terminated on day 28 and animals were killed on day 49. The results showed that treatment with ARS caused a significant reduction in the level of proteinuria, urine urea and urine sodium compared with nontreated controls. In addition, decrease in serum triglyceride and increase in the level of serum albumin was significant in treated group with ARS compared with nontreated controls. Moreover, treatment with ARS significantly reduced glomerular polymorphonuclear (PMN) and mononuclear cells infiltration, hypercellularity, karyorrhexis, wire loops, and hydropic change in capillary network within the renal cortex, as well as decreased hyalin casts. On the other hand, healthy controls receiving ARS showed a significant decrease in amounts of serum triglyceride, urine urea, and urine sodium and potassium compared with normal group. These data suggest that artesunate therapy can ameliorate proteinuria, and suppress the progression of glomerular lesions in experimental model of nephrotic syndrome; it may also be recommended as a lipid-lowering drug.

Dynamics of the HPA axis and inflammatory cytokines: Insights from mathematical modeling

In the work presented here, a novel mathematical model was developed to explore the bi-directional communication between the hypothalamic-pituitary-adrenal (HPA) axis and inflammatory cytokines in acute inflammation. The dynamic model consists of five delay differential equations 5D for two main pro-inflammatory cytokines (TNF-α and IL-6) and two hormones of the HPA axis (ACTH and cortisol) and LPS endotoxin. The model is an attempt to increase the understanding of the role of primary hormones and cytokines in this complex relationship by demonstrating the influence of different organs and hormones in the regulation of the inflammatory response. The model captures the main qualitative features of cytokine and hormone dynamics when a toxic challenge is introduced. Moreover, in this work a new simple delayed model of the HPA axis is introduced which supports the understanding of the ultradian rhythm of HPA hormones both in normal and infection conditions. Through simulations using the model, the role of key inflammatory cytokines and cortisol in transition from acute to persistent inflammation through stability analysis is investigated. Also, by employing a Markov chain Monte Carlo (MCMC) method, parameter uncertainty and the effects of parameter variations on each other are analyzed. This model confirms the important role of the HPA axis in acute and prolonged inflammation and can be a useful tool in further investigation of the role of stress on the immune response to infectious diseases.

The immunomodulatory effects of fish-oil supplementation in elite paddlers: A pilot randomized double blind placebo-controlled trial

BACKGROUND

Physical exercise can induce imbalance of different cytokines by leading them towards an inflammatory and immunosuppressive milieu. Fish-oil (FO) supplementation may modulate the mentioned skewed balance following intense exercise. Therefore, we decided to investigate the effect of intense physical exercise and FO supplementation on cytokine production and helper T (Th) cell phenotype in male elite paddlers.

SUBJECTS AND METHODS

Male elite paddlers consumed 6 g/day of either FO capsules (n=11) containing 3.6 g long chain n-3 polyunsaturated fatty acids (1.2 g docosahexaenoic acid and 2.4 g eicosapentaenoic acid) or placebo capsules (n=11) for 4 weeks. The paddlers simultaneously undertook a program of increasing exercise. Blood samples were taken from all the subjects 48 h before and after the 4 weeks of supplementation.

RESULTS

Our results show that while FO supplementation decreases the production of tumor necrosis factor (TNF)-α and interleukin (IL)-1β in the elite paddlers, it increases the production of IL-6. On the other hand, while there was no change in IL-4 secretion, the production of interferon (IFN)-γ was significantly decreased after 4 weeks FO consumption. We also showed that the production of IL-10 was significantly higher in the FO group compared to the placebo. Finally, we found that fish-oil consumption shifts the balance between Th cells towards Th2 phenotype during intensive exercise.

CONCLUSION

Our results suggest that the consumption of n-3 polyunsaturated fatty acids during intense exercise can induce the anti-inflammatory and immunosuppressive cytokine networks that are associated with a reduced Th1/Th2 ratio in elite paddlers.

Identification of Toxoplasma gondii protein fractions induce immune response against melanoma in mice

Dendritic cells (DCs) play a crucial role in the initiation of adaptive immune responses against tumor cells. We recently found that protein components of Toxoplasma gondii (T. gondii) could mature DCs efficiently. Therefore, in this study, we aimed to find the most effective protein components of T. gondii which are able to mature DCs and consequently instruct immune responses in tumor-bearing mice. Soluble tachyzoite antigens (STAgs) were fractionated by ammonium sulfate precipitation and subsequently by anion-exchange HPLC. Immature DCs (iDCs) were treated by these protein fractions and were monitored for IL-12p70 and IL-10 production. Moreover, the capacity of mature DCs (mDCs) to induce lymphocyte proliferation was investigated. Ultimately, we analyzed the ability of mDCs in instructing immune responses in tumor-bearing mice. We found that ammonium sulfate fraction one (A1) matured-DCs produced higher IL-12 level and IL-12/IL-10 ratio; therefore, this fraction was selected for further fractionation by anion-exchange HPLC. The results showed that anion-exchange HPLC fraction 14 (C14) matured-DCs secrete higher levels of IL-12p70 and IL-12p70/IL-10 ratio. Survival of the mice matured by A1 fraction increased significantly compared to other groups. Moreover, SDS-PAGE electrophoresis showed that different obtained fractions have distinct proteins based on their size. These results demonstrate that two protein fractions of T. gondii are able to mature DCs more efficient.

Comparative Immune Response in Children and Adults with H. pylori Infection

Helicobacter pylori (H. pylori) infection is generally acquired during early childhood; therefore, the immune response which usually takes place at this age may influence or even determine susceptibility to the infection contributing to the clinical outcomes in adulthood. Several cytokines including IL-6, IL-10, and TGF-β1 as well as Foxp3(+) cell numbers have been shown to be higher; however, some other cytokines consisting of IL-1β, IL-17A, and IL-23 are lower in infected children than in infected adults. Immune response to H. pylori infection in children is predominant Treg instead of Th17 cell response. These results indicate that immune system responses probably play a role in persistent H. pylori infection. Childhood H. pylori infection is also associated with significantly lower levels of inflammation and ulceration compared with adults. This review, therefore, aimed to provide critical findings of the available literature about comparative immune system in children and adults with H. pylori infection.

IL-22 Produced by T helper Cell 22 as a New player in the Pathogenesis of Immune Thrombocytopenia

Idiopathic thrombocytopenic purpura (ITP) as an autoimmune disease is identified by low count platelet due to decreaed platelet production as well as increased platelet destruction by autoimmune mechanisms in which platelet autoantigen(s) react with the patient's immune system. In ITP a shift toward B cells producing autoantibodies together with CD4+ T helper cells have been reported. T helper cell 22 (Th22) as a new subset of CD4+ T cells is distinctly apart from Th17 and other known CD4+ T cell subsets due to the expression of its specific gene and function. Th22 subset show chemokine receptor CCR4+ CCR6+ CCR10+ phenotype and its key transcription factor is aryl hydrocarbon receptor (AHR). In addition, Th22 cells can be recognized by secretion of a distinguished profile of effector cytokines, including interleukin (IL)- 22, IL- 13, and tumor necrosis factor-α (TNF-α). The amount of Th22 and IL-22 is increased in several autoimmune disorders and positively related to disease severity. The purpose of the present review is to discuss the role of Th22 and its cytokine IL-22 in the immunopathogenesis of ITP.