Cancer-associated immune cells and their modulation by melatonin

OBJECTIVES

Rapidly growing evidence suggests that immune cells play a key role in determining tumor progression. Tumor cells are surrounded by a microenvironment composed of different cell populations including immune cells. The cross talk between tumor cells and the neighboring microenvironment is an important factor to take into account while designing tumor therapies. Despite significant advances in immunotherapy strategies, a relatively small proportion of patients have successfully responded to them. Therefore, the search for safe and efficient drugs, which could be used alongside conventional therapies to boost the immune system against tumors, is an ongoing need. In the present work, the modulatory effects of melatonin on different components of tumor immune microenvironment are reviewed.

METHODS

A thorough literature review was performed in PubMed, Scopus, and Web of Science databases. All published papers in English on tumor immune microenvironment and the relevant modulatory effects of melatonin were scrutinized.

RESULTS

Melatonin modulates macrophage polarization and prevents M2 induction. Moreover, it prevents the conversion of fibroblasts into cancer-associated fibroblasts (CAFs) and prevents cancer cell stemness. In addition, it can affect the payload composition of tumor-derived exosomes (TEXs) and their secretion levels to favor a more effective anti-tumor immune response. Melatonin is a safe molecule that affects almost all components of the tumor immune microenvironment and prevents them from being negatively affected by the tumor.

CONCLUSION

Based on the effects of melatonin on normal cells, tumor cells and microenvironment components, it could be an efficient compound to be used in combination with conventional immune-targeted therapies to increase their efficacy.

The effect of Mediterranean diet on inflammatory biomarkers and components of metabolic syndrome in adolescent girls

BACKGROUND

The prevalence of obesity and metabolic syndrome (MetS) during childhood and adolescence is rising significantly worldwide. Previous studies have shown that following a healthy dietary pattern, like the Mediterranean diet (MD), might be an efficacious approach for the prevention and management of MetS during childhood. In the present study, we aimed to examine the effect of MD on inflammatory markers and components of MetS among adolescent girls with MetS.

METHODS

This randomized controlled clinical trial was conducted on 70 girl adolescents with metabolic syndrome. Patients in the intervention group followed a prescribed MD, while participants in the control group received dietary advice according to the food pyramid. The length of intervention was 12 weeks. Participants' dietary intakes were evaluated using three 1-day food records throughout the study. Anthropometric measures, inflammatory markers, systolic and diastolic blood pressure, and hematological factors were assessed at the baseline and end of the trial. An intention-to-treat approach was taken into account for the statistical analysis.

RESULTS

After 12 weeks, participants in the intervention group had lower weight (Ptime*group ≤ 0/001), body mass index (BMI) (Ptime*group ≤ 0/001), and waist circumference (WC) (Ptime*group ≤ 0/001) compared with those in the control group. In addition, MD resulted in a significantly reduced systolic blood pressure compared to the those in the control group (Ptime*group ≤ 0/001). In terms of metabolic variables, MD led to a significant decrease in fasting blood glucose (FBS) (Ptime*group ≤ 0/001), triglycerides (TG) (Ptime*group ≤ 0/001), low-density lipoprotein (LDL) (Ptime*group ≤ 0/001), homeostatic model assessment of insulin resistance (HOMA-IR) (Ptime*group = 0/02) and a meaningful increase in serum levels of high-density lipoprotein (HDL) (Ptime*group ≤ 0/001). In addition, adherence to the MD resulted in a significant reduction in serum levels of inflammatory markers including Interleukin 6 (IL-6) (Ptime*group = 0/02) and high-sensitivity C-reactive protein (hs-CRP) (Ptime*group = 0/02). However, no significant effect was seen on serum levels of tumor necrosis factor α (TNF-α) (Ptime*group = 0/43).

CONCLUSION

Overall, the findings of the present study revealed that consumption of MD for 12 weeks resulted in a favorable effect on anthropometric measures, components of MetS, as well as on some inflammatory biomarkers.

Therapeutic targets of cancer drugs: Modulation by melatonin

The biological functions of melatonin range beyond the regulation of the circadian rhythm. With regard to cancer, melatonin's potential to suppress cancer initiation, progression, angiogenesis and metastasis as well as sensitizing malignant cells to conventional chemo- and radiotherapy are among its most interesting effects. The targets at which melatonin initiates its anti-cancer effects are in common with those of a majority of existing anti-cancer agents, giving rise to the notion that this molecule is a pleiotropic agent sharing many features with other antineoplastic drugs in terms of their mechanisms of action. Among these common mechanisms of action are the regulation of several major intracellular pathways including mitogen-activated protein kinase (MAPK), extracellular signal-regulated kinase (ERK) and protein kinase B (AKT/PKB) signaling. The important mediators affected by melatonin include cyclins, nuclear factor-κB (NF-κB), heat shock proteins (HSPs) and c-Myc, all of which can serve as potential targets for cancer drugs. Melatonin also exerts some of its anti-cancer effects via inducing epigenetic modifications, DNA damage and mitochondrial disruption in malignant cells. The regulation of these mediators by melatonin mitigates tumor growth and invasiveness via modulating their downstream responsive genes, housekeeping enzymes, telomerase reverse transcriptase, apoptotic gene expression, angiogenic factors and structural proteins involved in metastasis. Increasing our knowledge on how melatonin affects its target sites will help find ways of exploiting the beneficial effects of this ubiquitously-acting molecule in cancer therapy. Acknowledging this, here we reviewed the most studied target pathways attributed to the anti-cancer effects of melatonin, highlighting their therapeutic potential.

The mechanisms of cellular crosstalk between mesenchymal stem cells and natural killer cells: Therapeutic implications

Mesenchymal stem cells (MSCs) are mesenchymal precursors of various origins, with well-known immunomodulatory effects. Natural killer (NK) cells, the major cells of the innate immune system, are critical for the antitumor and antiviral defenses; however, in certain cases, they may be the main culprits in the pathogenesis of some NK-related conditions such as autoimmunities and hematological malignancies. On the other hand, these cells seem to be the major responders in beneficial phenomena like graft versus leukemia. Substantial data suggest that MSCs can variably affect NK cells and can be affected by these cells. Accordingly, acquiring a profound understanding of the crosstalk between MSCs and NK cells and the involved mechanisms seems to be a necessity to develop therapeutic approaches based on such interactions. Therefore, in this study, we made a thorough review of the existing literature on the interactions between MSCs and NK cells with a focus on the underlying mechanisms. The current knowledge herein suggests that MSCs possess a great potential to be used as tools for therapeutic targeting of NK cells in disease context and that preconditioning of MSCs, as well as their genetic manipulation before administration, may provide a wider variety of options in terms of eliciting more specific and desirable therapeutic outcomes. Nevertheless, our knowledge regarding the effects of MSCs on NK cells is still in its infancy, and further studies with well-defined conditions are warranted herein.

Design, synthesis and biological evaluation of flexible and rigid analogs of 4H-1,2,4-triazoles bearing 3,4,5-trimethoxyphenyl moiety as new antiproliferative agents

Several flexible and rigid analogs of 4H-1,2,4-triazoles (compounds 8a-g and 9a-g) bearing trimethoxyphenyl pharmacophoric unit, were designed and synthesized as potential anticancer agents. The in vitro cytotoxic assay indicated that both flexible and rigid analogs (8 and 9, respectively) can potentially inhibit the growth of cancerous cells (A549, MCF7, and SKOV3), with IC₅₀ values less than 5.0 µM. Furthermore, compounds 10a-l as regional isomers of compounds 9 exhibited remarkable cytotoxic activity with IC₅₀ values ranging from 0.30 to 5.0 µM. The rigid analogs 9a, 10h and 10k were significantly more potent than etoposide against MCF7, SKOV3 and A549 cells, respectively. These compounds showed high selectivity towards cancer cells over normal cells, as they had no significant cytotoxicity against L929 cells. In addition, the representative compounds 9a and 10h could inhibit the tubulin polymerization at micro-molar levels. By determining changes in the colchicine-tubulin fluorescence, it was suggested that compound 10h could bind to the tubulin at the colchicine pocket. The molecular docking study further confirmed the inhibitory activity of promising compounds 9a, 10h and 10k on tubulin polymerization through binding to the colchicine-binding site.

Caffeine attenuates seizure and brain mitochondrial disruption induced by Tramadol: the role of adenosinergic pathway

Tramadol (TR) is an analgesic drug used to treat moderate-to-severe pain but it induces seizure even at therapeutic doses. The exact mechanism of TR-inducing seizure is not clear but inhibition of the serotonin, GABA, and nitrous oxide (NOS) pathways are the commonly proposed mechanisms. Adenosinergic system has a crucial function in the modulation of seizure. Also, oxidative damage is an unavoidable effect of the seizure. This study was conducted to evaluate the role of the adenosinergic system on the seizure and oxidative stress biomarkers induced by TR using antagonist of the adenosinergic receptors in the Albino mice. For that purpose, generated clonic seizure, as seizure threshold, was evaluated by TR. Caffeine (CAF; 8 mg/kg, i.p.), a nonselective antagonist of adenosine receptors, was administered 1 hour before the seizure induction. The seizure threshold significantly increased by CAF-treated group when compared to TR group (p < 0.001). Oxidative stress biomarkers such as reactive oxygen species, protein carbonyl content, and lipid peroxidation significantly decreased and glutathione content significantly increased by CAF in brain mitochondria compared to the TR group, whereas oxidative biomarkers significantly increased in the TR group compared to the control group. The results of the present study suggested that the adenosinergic system is involved in seizure induced by TR and meanwhile, inhibition of adenosine receptors can decrease the TR seizure threshold and also decrease the induced oxidative damage in the brain mitochondria.

Immunoregulatory role of melatonin in cancer

Melatonin is a ubiquitous indole amine that plays a fundamental role in the regulation of the biological rhythm. Disrupted circadian rhythm alters the expression of clock genes and deregulates oncogenes, which finally promote tumor development and progression. An evidence supporting this notion is the higher risk of developing malignancies among night shift workers. Circadian secretion of the pineal hormone also synchronizes the immune system via a reciprocal association that exists between the immune system and melatonin. Immune cells are capable of melatonin biosynthesis in addition to the expression of its receptors. Melatonin induces big changes in different immune cell proportions, enhances their viability and improves immune cell metabolism in the tumor microenvironment. These effects might be directly mediated by melatonin receptors or indirectly through alterations in hormonal and cytokine release. Moreover, melatonin induces apoptosis in tumor cells via the intrinsic and extrinsic pathways of apoptosis, while it protectsthe immune cells. In general, melatonin has a profound impact on immune cell trafficking, cytokine production and apoptosis induction in malignant cells. On such a basis, using melatonin and resynchronization of sleep cycle may have potential implications in immune function enhancement against malignancies, which will be the focus of the present paper.

NLRP inflammasome as a key role player in the pathogenesis of environmental toxicants

Exposure to environmental toxicants (ET) results in specific organ damage and auto-immune diseases, mostly mediated by inflammatory responses. The NLRP3 inflammasome has been found to be the major initiator of the associated pathologic inflammation. It has been found that ETs can trigger all the signals required for an NLRP3-mediated response. The exaggerated activation of the NLRP3 inflammasome and its end product IL-1β, is responsible for the pathogenesis caused by many ETs including pesticides, organic pollutants, heavy metals, and crystalline compounds. Therefore, an extensive study of these chemicals and their mechanisms of inflammasome (INF) activation may provide the scientific evidence for possible targeting of this pathway by proposing possible protective agents that have been previously shown to affect INF compartments and its activation. Melatonin and polyunsaturated fatty acids (PUFA) are among the safest and the most studied of these agents, which affect a wide variety of cellular and physiological processes. These molecules have been shown to suppress the NLRP3 inflammasome mostly through the regulation of cellular redox status and the nuclear factor-κB (NF-κB) pathway, rendering them potential promising compounds to overcome ET-mediated organ damage. In the present review, we have made an effort to extensively review the ETs that exert their pathogenesis via the stimulation of inflammation, their precise mechanisms of action and the possible protective agents that could be potentially used to protect against such toxicants.

New potent antifungal triazole alcohols containing N-benzylpiperazine carbodithioate moiety: Synthesis, in vitro evaluation and in silico study

A number of 1H-1,2,4-triazole alcohols containing N-(halobenzyl)piperazine carbodithioate moiety have been designed and synthesized as potent antifungal agents. In vitro bioassays against different Candida species including C. albicans, C. glabrata, C. parapsilosis, C. krusei, and C. tropicalis revealed that the N-(4-chlorobenzyl) derivative (6b) with MIC values of 0.063-0.5 µg/mL had the best profile of activity, being 4-32 times more potent than fluconazole. Docking simulation studies confirmed the better fitting of compound 6b in the active site of lanosterol 14α-demethylase (CYP51) enzyme, the main target of azole antifungals. Particularly, the potential of compound 6b against fluconazole-resistant isolates along with its minimal toxicity against human erythrocytes and HepG2 cells make this prototype compound as a good lead for discovery of potent and safe antifungal agents.

Autophagy, its mechanisms and regulation: Implications in neurodegenerative diseases

Autophagy is a major regulatory cellular mechanism which gives the cell an ability to cope with some of the destructive events that normally occur within a metabolically living cell. This is done by maintaining the cellular homeostasis, clearance of damaged organelles and proteins and recycling necessary molecules like amino acids and fatty acids. There is a wide array of factors that influence autophagy in the state of health and disease. Disruption of these mechanisms may not only give rise to several autophagy-related disease, but also it can occur as the result of intracellular changes induced during disease pathogenesis causing exacerbation of the disease. Our knowledge is increasing regarding the role of autophagy and its mechanisms in the pathogenesis of various neurodegenerative diseases such as multiple sclerosis, Parkinson's disease, Alzheimer's disease, Huntington's disease and Amyotrophic lateral sclerosis. Indeed, getting to know about the pathways of autophagy and its regulation can provide the basis for designing therapeutic interventions. In the present paper, we review the pathways of autophagy, its regulation and the possible autophagy-targeting interventions for the treatment of neurodegenerative disorders.

Molecular analysis of the bacille Calmette-Guérin vaccine strain currently being used in Iran

BACKGROUND

In developing countries, tuberculosis (TB) infection control remains a challenge. The bacille Calmette-Guérin (BCG) vaccine is the only effective vaccine available for TB control. Iran uses a local BCG vaccine strain with an unknown substrain.

OBJECTIVE

To investigate the molecular characteristics of the current BCG strain being used in Iran using comparative genomics of the evolutionarily late strains, including BCG vaccines Pasteur, BCG-Danish, BCG-Glaxo, BCG-Prague, BCG-Frappier, BCG-Connaught and BCG-Moreau.

METHODS

A total of 67 different vials of BCG vaccine were cultured. DNA was extracted using the modified cetrimonium bromide (CTAB) method, and multiplex polymerase chain reaction (PCR) was performed to determine four target genomic regions of difference (RD) 1, RD8, RD16 and SenX3-RegX3, and to see whether RD2 and RD14 were present.

RESULTS

Our results showed that all studied batches were Mycobacterium bovis; molecular analysis revealed that the Iranian vaccine strains possess RD8, RD16 and SenX3-RegX3 regions but not RD1, RD2 and RD14. All of the vaccine batches analysed were compatible with BCG-Pasteur 1173p2, the original strain.

CONCLUSION

All of the BCG strains studied were recognised as the BCG-Pasteur 1173p2 strain. No genetic diversity among stocks and ready-for-use vaccine vials were detected.

Atorvastatin attenuates ethanol-induced hepatotoxicity via antioxidant and anti-inflammatory mechanisms

The aim of this study was to evaluate the role of inflammation and oxidative damage in hepatotoxicity of ethanol. Also we assessed protective effects of atorvastatin against ethanol-induced hepatotoxicity. In this study, the animals were divided into five groups: control, ethanol (10 mg/kg intraperitoneal (i.p.)), ethanol with atorvastatin (10, 20 mg/kg/day, i.p.) and ethanol-vitamin C group which received ethanol (10 mg/kg/day) plus vitamin C (200 mg/kg, i.p.) for 28 consecutive days. Then, the animals were euthanized and liver tissues were separated. Biochemical markers ALT and AST were measured. Moreover, glutathione (GSH) content, lipid peroxidation, protein carbonyl, nitric oxide and tumor necrosis factor-α (TNF-α) were evaluated. The administration of ethanol for 28 days resulted in an increase in liver damage, oxidative stress and inflammatory markers. The atorvastatin was able to prevent the ethanol-induced hepatotoxicity by decreasing the oxidative stress and inflammation processes. Our study showed the critical role of oxidative damage and inflammation in ethanol-induced hepatotoxicity that markedly was inhibited by administration of atorvastatin. Therefore, atorvastatin can be suggested for prevention of ethanol-induced hepatotoxicity.

A Systematic and Mechanistic Review on the Phytopharmacological Properties of Alhagi Species

Alhagi species are well known in Iran (locally known as Khar Shotor) and other parts of Asia as a popular folk medicine. Recent research has shown extensive pharmacological effects of these species. This paper is a comprehensive review of the phytopharmacological effects and traditional uses of Alhagi species and their active constituents with special attention to the responsible mechanisms, effective dosages and routes of administration. The Alhagi species studied in this paper include: A. maurorum, A. camelorum, A. persarum, A. pseudoalhagi, and A. kirgisorum. In order to include all the up to date data, the authors went through several databases including the Web of Science, Embase, etc. The findings were critically reviewed and sorted on the basis of relevance to the topic. Tables have been used to clearly present the ideas and discrepancies were settled through discussion. Alhagi species have significant biomedical properties which can be exploited in clinical use. Proantocyanidin isolated from A. pseudoalhagi has significant biochemical effects on blood factors. Among Alhagi species, A. camelorum and A. maurorum possess the highest anti-microbial activity. Most of the effects observed with A. maurorum are dose-dependent. This paper indicates with emphasis that Alhagi species are safe and rich sources of biologically active compounds with low toxicity. Since DNA damage has been observed following the ingestion of specific concentrations of A. pseudalhagi, care should be taken during administration of the plant for therapeutic use. Further studies are required to confirm the safety and quality of these plants to be used by clinicians as therapeutic agents.

Risk assessment of gas oil and kerosene contamination on some properties of silty clay soil

Soil and ground water resource pollution by petroleum compounds and chemical solvents has multiple negative environmental impacts. The aim of this research was to investigate the impacts of kerosene and gas oil pollutants on some physical and chemical properties, breakthrough curve (BTC), and water retention curve (SWRC) of silty clay soil during a 3-month period. Therefore, some water-saturated soils were artificially contaminated in the pulse condition inside some glassy cylinders by applying half and one pore volume of these pollutants, and then parametric investigations of the SWRC were performed using RETC software for Van Genukhten and Brooks-Corey equations in the various suctions and the soil properties were determined before and after pollution during 3 months. The results showed that gas oil and kerosene had a slight effect on soil pH and caused the cumulative enhancement in the soil respiration, increase in the bulk density and organic matter, and reduction in the soil porosity and electrical and saturated hydraulic conductivity. Furthermore, gas oil retention was significantly more than kerosene (almost 40%) in the soil. The survey of SWRC indicated that the contaminated soil samples had a little higher amount of moisture retention (just under 15% in most cases) compared to the unpolluted ones during this 3-month period. The parametric analysis of SWRC demonstrated an increase in the saturated water content, Θ s, from nearly 49% in the control sample to just under 53% in the polluted ones. Contaminants not only decreased the residual water content, Θ r, but also reduced the SWRC gradient, n, and amount of α parameter. The evaluation of both equations revealed more accurate prediction of SWRC's parameters by Van Genukhten compared to those of Brooks and Corey.

The risk of contralateral breast cancer in daughters of women with and without breast cancer

We aimed to estimate the 15-year and lifetime risks of contralateral breast cancer in breast cancer patients according to the age of diagnosis of the first cancer and the history of breast cancer in the mother. The risks of contralateral breast cancer were estimated for all 78,775 breast cancer patients in the Swedish Family-Cancer Database (age at diagnosis of first breast cancer <70 years). The risk of experiencing a contralateral breast cancer within 15 years of diagnosis was 8.4% [95% confidence interval (CI): 8.1-8.7%] for women with an unaffected mother, was 12% (95%CI: 11-13%) for a woman with a mother with unilateral breast cancer and was 13% (95%CI: 9.5-17%) for women with a mother with bilateral breast cancer. In early-onset diagnosed women (<50 years) with an unaffected mother, the risk of contralateral breast cancer until age 80 was 23% (95%CI: 20-26%) and for late-onset (50-69 years) diagnosed women it was 17% (95%CI: 14-21%). In a woman with a mother with an early-onset unilateral breast cancer, risk of contralateral breast cancer by age 80 was 35% (95%CI: 25-46%). Women with a mother with early-onset bilateral breast cancer had 31% (95%CI: 12-67%) lifetime risk of contralateral breast cancer. The risk of contralateral breast cancer is higher for daughters of breast cancer patients than for daughters of women without breast cancer. Maternal cancer history and age at onset of first breast cancer in women should be taken into account when counseling breast cancer patients about their risk of contralateral breast cancer.

Metastatic sites and survival in lung cancer

OBJECTIVES

Population-based data on metastatic sites and survival in site-specific metastases are lacking for lung cancer and for any cancer because most cancer registries do not record metastases. This study uses a novel population-based approach to identify metastases from both death certificates and national inpatient data to describe metastatic pathways in lung cancer patients.

MATERIALS AND METHODS

17,431 deceased lung cancer patients diagnosed 2002-2010 were identified from the nationwide Swedish Cancer Registry, which is based on compulsory reports. The influence of age at diagnosis, sex, and histological subtype on metastatic spread was investigated. Survival in metastatic lung cancer was assessed by histology and metastatic site.

RESULTS

The most frequent metastatic sites were the nervous system, bone, liver, respiratory system, and adrenal gland. Liver (35%) and nervous system (47%) metastases were common in patients with metastases from small cell lung cancer, and bone (39%) and respiratory system (22%) metastases in adenocarcinoma. Women (43% vs. 35%) and younger patients had more metastases to the nervous system. Median survival after diagnosis was 13 months for non-metastatic and five months for metastatic lung cancer. In this novel data, liver metastases conferred the worst prognosis (three months), especially for large cell histology. Bone metastases also featured poor survival, whereas survival in respiratory and nervous system metastases was better.

CONCLUSION

Metastatic sites and survival in metastatic lung cancer is influenced by sex, histological subtype, and age at diagnosis. Liver and bone metastases signal poor survival, compared with nervous system metastases.

Hodgkin lymphoma after autoimmune diseases by age at diagnosis and histological subtype

BACKGROUND

Increased risk of Hodgkin lymphoma (HL) associated with personal history of several autoimmune diseases (ADs), such as rheumatoid arthritis, systemic lupus erythematosus, sarcoidosis, and immune thrombocytopenic purpura, are known. Whether there are other HL-related ADs and whether the increased risk of HL after ADs holds across sex, age, year of diagnosis, or HL histological subtype is unclear.

PATIENTS AND METHODS

We systematically analyzed the risk of HL in 878 161 Swedish patients diagnosed with 33 different ADs in 1964-2010. During ∼10-year follow-up of ADs patients, 371 incident HL cases were diagnosed.

RESULTS

Significantly increased overall standardized incidence ratio (SIR) for HL after ADs was 2.0 (95% confidence interval: 1.8-2.2); AD-specific SIRs: autoimmune hemolytic anemia 19.9 (7.2-43.6), sarcoidosis 10.3 (7.8-13.4), systemic lupus erythematosus 8.4 (5.2-12.9), immune thrombocytopenic purpura 7.0 (3.2-13.3), polyarteritis nodosa 6.6 (1.2-19.5), polymyositis/dermatomyositis 6.3 (2.0-14.9), Behcet's disease 5.6 (2.7-10.3), Sjögren's syndrome 5.0 (2.1-9.8), rheumatoid arthritis 3.2 (2.6-3.9), polymyalgia rheumatica 2.2 (1.4-3.5), and psoriasis 1.9 (1.3-2.6). Men with AD had slightly higher risk of HL (2.4, 2.0-2.7) compared with women (1.8, 1.5-2.0). Only 23% of ADs were diagnosed before age 35 years and the overall SIR for HL diagnosis before age 35 [1.4, (1.0-1.8)] was lower than that in older ages [35 ≤ age < 50: 2.1 (1.6-2.7); age ≥ 50: 2.2 (2.0-2.5)], except for sarcoidosis [age < 35: 19.3 (10.5-32.5); 35 ≤ age < 50: 10.4 (5.7-17.5); age ≥ 50: 8.4 (5.6-12.1)]. Risks of all classical HLs significantly increased after ADs: lymphocyte depletion 3.7 (1.5-7.6), lymphocyte-rich 3.7 (2.3-5.9), mixed cellularity 2.4 (1.8-3.2), and nodular sclerosis 1.7 (1.3-2.1).

CONCLUSION

Several, but not all ADs (11/33), had a positive association with all classical histological subtypes of HL. Higher risks of classical HL after polyarteritis nodosa, polymyositis/dermatomyositis, Behcet's disease, Sjögren's syndrome, polymyalgia rheumatica, and psoriasis were novel findings of this study.

Familial risk of early and late onset cancer: nationwide prospective cohort study

OBJECTIVE

To determine whether familial risk of cancer is limited to early onset cases.

DESIGN

Nationwide prospective cohort study.

SETTING

Nationwide Swedish Family-Cancer Database.

PARTICIPANTS

All Swedes born after 1931 and their biological parents, totalling >12.2 million individuals, including >1.1 million cases of first primary cancer.

MAIN OUTCOME MEASURES

Familial risks of the concordant cancers by age at diagnosis.

RESULTS

The highest familial risk was seen for offspring whose parents were diagnosed at an early age. Familial risks were significantly increased for colorectal, lung, breast, prostate, and urinary bladder cancer and melanoma, skin squamous cell carcinoma, and non-Hodgkin's lymphoma, even when parents were diagnosed at age 70-79 or 80-89. When parents were diagnosed at more advanced ages (≥ 90), the risk of concordant cancer in offspring was still significantly increased for skin squamous cell carcinoma (hazard ratio 1.9, 95% confidence interval 1.4 to 2.7), colorectal (1.6, 1.2 to 2.0), breast (1.3, 1.0 to 1.6), and prostate cancer (1.3, 1.1 to 1.6). For offspring with a cancer diagnosed at ages 60-76 whose parents were affected at age <50, familial risks were not significantly increased for nearly all cancers.

CONCLUSION

Though the highest familial risks of cancer are seen in offspring whose parents received a diagnosis of a concordant cancer at earlier ages, increased risks exist even in cancers of advanced ages. Familial cancers might not be early onset in people whose family members were affected at older ages and so familial cancers might have distinct early and late onset components.

A retrospective survey of human hydatidosis based on hospital records during the period of 10 years

Hydatid cyst is a parasitic infection that is widely seen endemically in the Middle East countries. We studied hydatid cyst pattern in hospitalized adult patients in our hospital from 2000 to 2010. In this study 89 patients, 50 females and 39 males who were diagnosed to have hydatid cyst were evaluated. The mean age of the patients was 37.3 and the mean hospital stay was 10.1 days. The main complaint was abdominal pain (66.2%). The most common localization of cysts was the liver and the most radiological method to diagnose the disease was ultrasonography followed by CT scan. Our recurrence rate was more than average. We had no mortality and did not find any serious postoperative complication. Safe surgery is a role for hydatid cysts.

Prevalence of Trichomonas vaginalis Infection in Hamadan City, Western Iran

BACKGROUND

Infection with Trichomonas vaginalis is one of the most common sexually transmitted diseases (STDs) in humans. The prevalence of infection in Iran has been reported between 2 to 8%, depending on deferent socio-cultural conditions. This study aimed to determine the prevalence of T. vaginalis in women referred to gynecologic clinics in Hamadan city, West of Iran.

METHODS

This descriptive cross-sectional study was conducted on 750 women who referred to Gynecologic clinics in Hamadan from November 2010 to July 2011. Vaginal samples were obtained from them and examined by wet mount and culture methods for the detection of T. vaginalis.

RESULTS

Sixteen out of 750 vaginal swab specimens (2.1%) were culture positive for T. vaginalis and 13 of these positive specimens (1.7%) were wet mount positive. Only 12 of 42 patients who were clinically diagnosed as having T. vaginalis infection, confirmed by culture method. Five hundred and fifty of the participants women (73.3%) had at least one of signs and symptoms of trichomoniasis. No statistical correlation was observed between clinical manifestations and parasitological results (p>0.05).

CONCLUSION

This study showed low prevalence of T. vaginalis infection in the study population. Since clinical signs of trichomonal vaginitis are the same of other STDs, a confirmatory laboratory diagnosis is necessary. Wet smear as well as culture are sensitive for detection of T. vaginalis.

Risk factor investigation for cardiovascular health through WHO STEPS approach in Ardabil, Iran

Objectives:

Reliable evidence is the keystone for any noncommunicable disease (NCD) prevention plan to be initiated. In this study we carried out a risk factor investigation based on the WHO Stepwise approach to Surveillance (STEPS).

Methods:

The study was conducted on 1000 adults between 15 and 64 years of age living in Ardabil province, north-west Iran during 2006, based on the WHO STEPS approach to surveillance of risk factors for NCD. At this stage only the first and second steps were carried out. Data were collected through standard questionnaires and methods analyzed using STATA version 8 statistical software package.

Results:

29.0% of men and 2.6% of women were current daily tobacco smokers. The mean number of manufactured cigarettes smoked per day was 18.9 among current daily smokers. Smoking was most prevalent among men of low-income families and those of lower education. The mean body mass index (BMI) was 26.6 kg/m², and was significantly correlated with systolic blood pressure. 58.9% were overweight or obese; 18.0% had raised blood pressure and 3.7% had isolated systolic hypertension. The mean number of servings of fruit consumed per day was 1.1; 33.1% had low levels of activity. Combined risk factor analysis showed that 4.1% of participants were in the low-risk group (up to 5.1% among men and 3.2% among women). Those in the high-risk group comprised 25.6% in the 25- to 44-year age group and 49.7% in the 45- to 64-year age group. Mean BMI increased by age in both sexes at least at the first three decades of adult life.

Conclusion:

Based on observed status of risk for cardiovascular health, burden of cardiovascular diseases is expected to increase if an effective prevention strategy is not undertaken.

Nervous system tumors in adult immigrants to Sweden by subsite and histology

BACKGROUND

The coding of histology of nervous system (NS) tumors with various degrees of malignancies differs between cancer registries, whereby the comparison of incidence rates from one registry to another seems difficult. No study has systematically defined whether the change in the risk of NS tumors upon immigration in adulthood varies by subsite or histology. Therefore, we aimed to address this issue amongst the first-generation immigrants to Sweden based on a large uniform cancer registry data (1958-2006).

METHODS

The nationwide Swedish Family-Cancer Database (2008 version; >11.8 million individuals; 1.8 million immigrants; histology code in force since 1958) was used to calculate standardized incidence ratios (SIRs). We analyzed 28,981 adult cases of NS tumors amongst Swedes and 2519 amongst immigrants (age ≥ 30).

RESULTS

Significantly decreased risks for brain glioma were amongst German (SIR = 0.64), Eastern European (0.62), some Asian (0.71), Chilean (0.34), and African immigrants (0.52). We found an increased risk for brain meningioma amongst Finns (1.15) and former Yugoslavians (1.33), whilst only Norwegians (0.71) and Latin Americans (0.21) had a decreased risk. The risk for spinal ependymoma and astrocytoma was increased in Germans (3.66) and former Yugoslavians (8.89). We found no significant difference for peripheral nerve tumors between immigrants and the native Swedes.

CONCLUSION

Significant differences between risk of NS tumors amongst immigrants and the native Swedes may suggest different risk factor profiles for glioma compared to meningioma indicating a higher etiological role of genetic background or childhood environmental risk factors rather than exposures after immigration.

Idiopathic generalized epilepsies: a follow-up study in a single-center

OBJECTIVE

To characterize adult patients with idiopathic generalized epilepsies (IGEs) with precise evaluation and to assess factors related to refractoriness.

MATERIALS AND METHODS

Hospital records of all our patients with IGEs (n = 128) were evaluated in 2005 and followed-up until 2008.

RESULTS

In 2005, 76% of patients were 1-year seizure-free. Seizure freedom increased to 82% during the 3-year follow-up. Seizure freedom was not significantly associated with age, age at diagnosis, epilepsy duration, exposure to inappropriate initial antiepileptic drug (AED), or delay time between starting initial AED and appropriate AED. Women constituted 78% of patients with merely provoked seizures. In 58% of women with recent seizure, one to two avoidable precipitating factors, such as lack of sleep, alcohol, and forgetting to take AED, were observed. In 2008, all patients with no medication, 91% of monotherapy patients, 60% of patients on two AED, and 14% of patients on three AED were seizure-free.

CONCLUSIONS

Most of patients with IGEs can be successfully treated with monotherapy. Refractory seizures in some patients may be because of avoidable factors, especially in young women.

CD 28 gene polymorphism and plasma concentration of soluble CD 28 in Iranian patients with visceral leishmaniasis

In visceral leishmaniasis (VL), the development of protective immunity is associated with expansion of leishmania-specific T-cell responses. Because of the essential role of CD28 in the effectiveness of T-cell activation, this study was carried out to investigate the CD28 gene polymorphism and plasma levels of soluble (s) CD28 molecule in Iranian patients with VL. Plasma concentrations of CD28 in 88 patients with VL, 132 individual with subclinical leishmaniasis, and 100 seronegative healthy controls were measured by enzyme-linked immunosorbent assay. Genotyping of CD28 gene polymorphism was performed by polymerase chain reaction based allotyping method using allele-specific primers for C or T at intron 3 position +17 in three groups. The frequency of CC genotype was significantly higher in subclinical VL patients (42.4%) than active VL group (27.3%) and healthy controls (16%) (P<0.001). Also, the frequency of allele C among subclinical VL group (57.6%) was significantly higher than active VL (40.9%) and control groups (34%) (p=0.003). No significant differences were observed between the plasma levels of sCD28 in three groups. Our findings suggest that the CD28 gene may have significant role in the protection of active VL in the Iranian population.