Review Article
Nasrollah Ghahramani
Volume 1, Issue 2 , September 2004, Pages 78-96
Abstract
The subject of transplant immunosuppression has generated significant interest in recent years. Excellent immunosuppression, advances in surgical technique, post-transplantation care, and infection control have resulted in excellent outcomes. There is widespread support for the notion that the fundamental ...
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The subject of transplant immunosuppression has generated significant interest in recent years. Excellent immunosuppression, advances in surgical technique, post-transplantation care, and infection control have resulted in excellent outcomes. There is widespread support for the notion that the fundamental objective in transplant immunology should be the achievement of specific graft tolerance. However, until this objective evolves into reality, investigators are in search of the “ideal immunosuppressant”, which should target predominantly the immune system with minimal consequences for other tissues and minimal metabolic, cardiovascular and renal complications. While immunosuppressants have been associated with a tremendous trade-off in terms of morbidity, new agents have provided the investigators with the opportunity to formulate strategies that employ combination therapies with the goal of decreasing doses of individual agents and minimizing their toxicities. Multiple small studies have addressed the issue of minimizing immunosuppressants, but there is a need for well-designed clinical trials which should evaluate protocols that will reduce acute rejection, as well as chronic allograft nephropathy. They should address methods to identify subsets of patients who would maximally benefit from avoidance or withdrawal of steroids or calcineurin inhibitors. Other promising areas of research include tolerance studies among the sensitized recipients, and development of optimal immunosuppression based on genotype. In general, future trials must include a more diverse population of recipients, particularly the immunologically high risk groups.
Original Article
Abdollah Jafarzadeh; Jalal Khoshnoodi; Shayesteh Ghorbani; Saleh Mohaghegh Hazrati; Babak Faraj Mazaheri; Fazel Shokri
Volume 1, Issue 2 , September 2004, Pages 98-104
Abstract
Objective: To compare immunogenicity of a recombinant hepatitis B (HB) vaccine in two groups of neonates born in two cities of Iran with different geographic and ethnic backgrounds. Materials and Methods: Ten micrograms of a recombinant HB vaccine was administered under field condition to Iranian ...
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Objective: To compare immunogenicity of a recombinant hepatitis B (HB) vaccine in two groups of neonates born in two cities of Iran with different geographic and ethnic backgrounds. Materials and Methods: Ten micrograms of a recombinant HB vaccine was administered under field condition to Iranian healthy neonates at 0, 1.5 and 9 months intervals. The subjects consisted of two groups of 290 and 231 neonates selected from two cities located at north-west (Urmia) and south-east (Kerman) of Iran, respectively. The level of anti-HBs antibody was quantitated in serum 2-4 weeks after administration of the last vaccine dose, by sandwich ELISA. Results: A higher seroprotection rate (anti-HBs> 10 IU/L) (98.3% vs. 96.1%) and significantly increased serum anti- HBs antibody titer (11869 vs. 6104 IU/L) (P<0.001) were induced in vaccinated neonates from Urmia city, compared to those born in Kerman. Conclusion: These findings suggest contribution of ethnic and/or environmental factors in the antibody response to recombinant HB vaccine in human.
Original Article
Gholamali Yousefi-Pour; Sadegh Izadi; Abbas Ghaderi
Volume 1, Issue 2 , September 2004, Pages 105-110
Abstract
Objective: To investigate possible immunological humoral correlates in newly diagnosed adult-onset generalized tonic-clonic epilepsy among Iranian patients before and after sodium valproate treatment. Patients and Methods: 72 adult patients with newly diagnosed idiopathic generalized tonic-clonic ...
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Objective: To investigate possible immunological humoral correlates in newly diagnosed adult-onset generalized tonic-clonic epilepsy among Iranian patients before and after sodium valproate treatment. Patients and Methods: 72 adult patients with newly diagnosed idiopathic generalized tonic-clonic epilepsy were recruited. Serum antinuclear antibodies (ANA), anti-cardiolipin antibodies (aCL), anti-dsDNA antibodies, total serum immunoglobulins (IgM, IgG, IgA) and C3 and C4 complements were determined before and after 12 months of therapy with sodium valproate. Similar parameters were also measured in 32 age and sex-matched healthy volunteers. Results: Patients group had a significantly greater level of IgG class aCL (30.6% versus 12.4%, P = 0.004) and anti-dsDNA antibodies (23.9% versus 0%, P = 0.001) when compared with healthy volunteers, however, ANA titre was relatively the same in both groups. Sodium valproate significantly decreased anti-dsDNA antibodiles (P = 0.002), IgM concentrations (P = 0.034), and increased the number of ANA positive patients (P = 0.002). Conclusion: Changes in serum level of autoantibodies in patients with new onset idiopathic generalized convulsion were found to be high. These abnormalities are associated with both seizure disorders per se and also antiepileptic drugs. We suggest that in epileptic patients with an autoimmune basis, administration of anti-epileptic drugs having modulatory effects on immune system should be considered.
Original Article
Akbar Rajaee; Mohammad Ali Nazarinia; Seyed Modjtaba Hakim; Mitra Amini; Maryam Ayatollahi; Abbas Ghaderi
Volume 1, Issue 2 , September 2004, Pages 111-117
Abstract
Objective: The clinical value of IgG anticardiolipin antibody in patients with Behçet's disease with or without vascular thrombosis was evaluated. Methods: IgG isotype of anticardiolipin (aCL) antibody was assessed in 40 Behçet's disease (BD) patients with venous or arterial thrombosis, ...
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Objective: The clinical value of IgG anticardiolipin antibody in patients with Behçet's disease with or without vascular thrombosis was evaluated. Methods: IgG isotype of anticardiolipin (aCL) antibody was assessed in 40 Behçet's disease (BD) patients with venous or arterial thrombosis, 40 BD patients without venous or arterial thrombosis and 80 healthy subjects as controls. The levels of IgG aCL were determined by an indirect ELISA method. Color Doppler Sonography, Magnetic Resonance Imaging and conventional angiography were the procedures used for other clinical evaluations. Results: Out of 40 patients with vascular thrombosis, 20(50%) were positive for low to moderate level of IgG aCL. In patients without thrombosis 22(55%) were positive for low to moderate level of IgG aCL while in none (0%) of the healthy subjects the IgG aCL was positive, neither low nor moderate. The number of patients with headache but having a normal cerebral magnetic resonance imaging (MRI), was higher in anticardiolipin positive patients without vascular thrombosis as compared to those with vascular thrombosis, (P = 0.001). Arthritis was noticed in both patents groups. 15% of aCL positive patients without thrombosis had arthritis as compared to none in aCL negative patients without thrombosis (P = 0.02). Conclusion: The results of this study indicate that although the frequency of IgG aCL was found to be higher in Iranian patients with BD in comparison with the previous reports, except in arthritis the observed elevated IgG aCL does not correlate with clinical disease manifestations, or vascular thrombotic complications.
Original Article
Sara Kashef; Reza Amin; Maryam Ayatollahi; Abbas Ghaderi
Volume 1, Issue 2 , September 2004, Pages 117-123
Abstract
Background: Antiphospholipid antibody syndrome (APS) can either occur as a primary syndrome or associated with other autoimmune diseases such as systemic lupus erythematosus (SLE). Anticardiolipin antibody (aCL) of IgG and/or IgM isotype in blood, measured by a standardized ELISA is the most acceptable ...
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Background: Antiphospholipid antibody syndrome (APS) can either occur as a primary syndrome or associated with other autoimmune diseases such as systemic lupus erythematosus (SLE). Anticardiolipin antibody (aCL) of IgG and/or IgM isotype in blood, measured by a standardized ELISA is the most acceptable laboratory criteria. APS IgG isotype, particularly IgG2 subclass is more strongly associated with thrombosis. Objectives: This study was done to determine the prevalence of IgG aCL and its subclasses in relation to APS symptoms, in a group of juvenile rheumatoid arthritis (JRA) and juvenile systemic lupus erythematosus (SLE) patients. Methods: In this prospective study, 28 JRA and 16 SLE patients, aged 3-18 years, were enrolled. IgG aCL was assayed by standard aCL ELISA. IgG subclasses were also assayed by ELISA on sera with medium to high titers of aCL. ACL assay was performed on at least two occasions for each patient, over 3-6 months period of follow up. Results: 29% (8/28) of JRA patients and 44% (7/16) of SLE patients had aCL. Six of SLE patients displayed APS related manifestations: hemolytic anemia, thrombocytopenia, arterial occlusion, valvular heart disease, livedo reticularis and pulmonary hypertension, but none of them had persistant medium or high titer of aCL. The lack of association of high titer of aCL with APS related symptoms was observed in two patients. The IgG subclasses were primarily IgG1 and IgG3. Conclusion: The prevalence of IgG aCL in this group of pediatric SLE and JRA is not uncommon but it’s relation to clinical manifestations is not clear. IgG1 and IgG3 subclasses were not associated with thrombosis, which is in agreement with previous studies.
Original Article
Ali Akbar Amirzargar; Abdol Ali Danesh; Farideh Khosravi; Mohammad Hossein Niknam; Behrouz Nikbin
Volume 1, Issue 2 , September 2004, Pages 125-129
Abstract
Background: Pulmonary tuberculosis (PTB) has recently become a major problem in developed countries especially in immune compromised HIV infected individuals. Cytokines, their genes and receptors have been implicated in the protective immunity, pathophysiology and development of tuberculosis. ...
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Background: Pulmonary tuberculosis (PTB) has recently become a major problem in developed countries especially in immune compromised HIV infected individuals. Cytokines, their genes and receptors have been implicated in the protective immunity, pathophysiology and development of tuberculosis. Material & Methods: In the present study the genotype frequencies of a number of polymorphic genes coding for cytokines or for cytokine receptors have been investigated in a case control study including a group of 40 Iranian PTB patients and 40 healthy individuals. The allelic polymorphism of cytokines SNPs were analyzed according to the protocols of the cytokine component designed for the 13th IHW by the Heidelberg University group. Using PCR-SSP method the following cytokine genes have been determined: IL-1 ¿ (T/C –889), IL-1¾ (C/T +3962), IL-1R (C/T pstI 1970), IL-1RA ( T/C mspaI 1100), IL-4RA (G/A +1902), IL- 12 (C/A –1188), TGF- ¾ (C/T codon 10, G/C codon 25), TNF-¿ (G/A –308, G/A –238), IL-2 (T/G –330 G/T +166), IL-4 (T/G –1098, T/C –590, T/C –33), IL-6 (G/C –174, G/A nt 560), IL-10 (G/A –1082, C/T –819, C/A –592). Results: From IL-1R cluster (pro- inflammatory cytokines) a positive significant association was found at position pstI 1970 C/T polymorphism where the C allele was over presented in the PTB patients (60% vs. 37.5%, P = 0.04). A significant negative association at codon 10 TGF- ¾ C/T polymorphism has also been shown in our patients, where the T allele was not detected in the patients but 10% of the control subjects expressed this allele (Fisher exact test, P = 0.05). At this codon allele T (Leucine substitution) is associated with high TGF- ¾ production. For TNF ¿ an insignificant tendency was found at position -308 A/G polymorphism where the G allele carried by 80% of cases and 65% of controls (P = 0.07). At position -238 a negative association was found at the GA polymorphism (10% vs. 25%, P = 0.07). For IL-6 an insignificant positive association at position -174 C/G polymorphism, G allele (57.5% vs. 37.5, P = 0.07) was found. At the other cytokine genes no specific association were found. Conclusion: In conclusion it is suggested that C allele at position pstI 1970 of IL-1 cluster increases and T allele at codon 10 of TGF- ¾ decreases in PTB patients.
Original Article
Ali Rafinejad; Mohammad Hossein Niknam; Ali Akbar Amirzargar; Farideh Khosravi; Forouzan Karimi; Bagher Larijani
Volume 1, Issue 2 , September 2004, Pages 130-132
Abstract
Background: Type 1 Diabetes (T1D) is a chronic and progressive autoimmune disorder. Cytokines play a critical role in the pathogenesis of T1D. Objective: IFN-¹ polymorphism was investigated in T1D and compared with normal controls. Methods: Thirty patients suffering from T1D and 40 ...
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Background: Type 1 Diabetes (T1D) is a chronic and progressive autoimmune disorder. Cytokines play a critical role in the pathogenesis of T1D. Objective: IFN-¹ polymorphism was investigated in T1D and compared with normal controls. Methods: Thirty patients suffering from T1D and 40 normal controls were studied simultaneously using PCR technique. IFN- ¹ gene was evaluated at position 5’UTR +5644. Results: There was a significant difference between patient and control groups in TT genotype (P<0.05). Conclusion: In this study, we found a negative association between IFN-¹ gene at position 5’UTR +5644 and T1D in Iranian patients pointing to T allele as a protective factor against T1D.
Original Article
Hedaiat Akbari; Reza Farid-Hosseini; Sara Miri; Reza Amin
Volume 1, Issue 2 , September 2004, Pages 133-137
Abstract
Background: Allergic rhinitis is one of the most common forms of allergic disorders affecting children. The prevalence rate of allergic rhinitis differs among countries and even among regions within the same country. Objectives: To determine the prevalence of childhood allergic rhinitis and the ...
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Background: Allergic rhinitis is one of the most common forms of allergic disorders affecting children. The prevalence rate of allergic rhinitis differs among countries and even among regions within the same country. Objectives: To determine the prevalence of childhood allergic rhinitis and the presence and significance of eosinophilia in nasal secretions. Method: 4584 children aged 11-15 years-old of both sexes with allergic rhinitis were studied. The study was done during a four-season period. After physical examination of the nose, smear was taken from nasal secretions and it was stained. The results compared with nasal smears related to 340 healthy children controls. Results: 445 cases (9.7%) were diagnosed as having allergic rhinitis, on the basis of clinical criteria. Significant nasal eosinophilia was present in 274 (62%) of children with allergic rhinitis. 226 students (5.8%) of Shiraz school children had proven or classic allergic rhinitis. Conclusion: Allergic rhinitis is one of the major health problems among children in Shiraz. Eosinophilia of nasal secretions had a diagnostic specificity of 96% and sensitivity of 62% and seems to be having a moderate value as screening test for nasal allergy.
