effect of cell derived microparticles in transfusion medicine and adaptive immune system

This article reviews will focus on the concept and formation of micro particles [MPs] in circulation and their role in transfusion medicine and immune system. MPs are cell membrane derived vesicles which express markers of their parent cells and are found in circulation at low levels. Exact functions of MPs are unclear. In here, Physiological almost all types of circulating MPs including platelets MPs [PMPs], leukocytes MPs [LMPs], red blood cells MPs [RMPs] and endothelial cells MPs [EMPs] have been discussed. Furthermore, MPs present in plasma and blood products and their levels increase during storage. Thus, it can be stated that MPs are likely to cause transfusion reactions, particularly thrombotic complications and Transfusion-Related Acute Lung Injury [TRALI]. Also, it is shown that the MPs may affect the immune system. However, to prove these, more and extensive studies both in vivo and in vitro need to be done

Hydrostatic pressure affects in vitro maturation of oocytes and follicles and increases granulosa cell death

This study examines the effects of hydrostatic pressure on in vitro maturation [IVM] of oocytes derived from in vitro grown follicles. In this experimental study, preantral follicles were isolated from 12-day-old female NMRI mice. Each follicle was cultured individually in Alpha Minimal Essential Medium [alpha-MEM] under mineral oil for 12 days. Then, follicles were induced for IVM and divided into two groups, control and experiment. In the experiment group follicles were subjected to 20 mmHg pressure for 30 minutes and cultured for 24-48 hours. We assessed for viability and IVM of the oocytes. The percentage of apoptosis in cumulus cells was determined by the TUNEL assay. A comparison between groups was made using the student's t test. The percentage of metaphase II oocytes [MII] increased in hydrostatic pressure-treated follicles compared to controls [p<0.05]. Cumulus cell viability reduced in hydrostatic pressure-treated follicles compared to controls [p<0.05]. Exposure of follicles to pressure increased apoptosis in cumulus cells compared to controls [p<0.05]. Hydrostatic pressure, by inducing apoptosis in cumulus cells, participates in the cumulus oocyte coupled relationship with oocyte maturation

role of serum level of interleukin-6 in severity of pulmonary complications of sulfur mustard injuries

Diverse studies suggest that interleukin-6 [IL6], as a member of cytokines family, has a major role in inflammatory processes of airways and lungs. In this study, an attempt was made to determine the serum level of IL6 in sulfur mustard [SM] injured patients and its comparison with controls. The measured IL6 mean level in patients with chemical injuries [0.76 +/- 0.3 ng/ml] was significantly higher than the control group's mean level [0.34 +/- 0.12 ng/ml]. Furthermore, patients with moderate to severe symptoms had a serum level of [0.95 +/- 0.92 ng/ml] which was significantly higher than mild [0.47 +/- 0.54] and control [0.34 +/- 0.12] groups. The outcome of this research program demonstrates that an increase in serum level of IL6 can have a role in pulmonary complications of SM, similar to other well defined pulmonary diseases. However, further studies are required to clarify the role and mechanism of IL6 in such patients

Efficacy and Tolerability of MlC601 in Patients with Mild to Moderate Alzheimer Disease who were Unable to Tolerate or Failed to Benefit from Treatment with Rivastigmine.

Aim: To evaluate the efficacy and tolerability of MLC601 in patients with mild to moderate Alzheimer disease (AD). Study Design: This is an open-label pilot study. Place and Duration of Study: It was conducted at three university referral centres in Iran from September 2009 until November 2011. Methodology: One-hundred and twenty four outpatients with mild to moderate AD who had previously failed to tolerate or benefit from treatment with Rivastigmine for 6 months at a dose of 2 to 12 mg per day were switched to a MLC601 regimen of one capsule three times per day for up to 18 months. Outcome measures included adverse events (AEs), withdrawal rate, and changes in the Mini-Mental State Examination (MMSE) and the cognitive subscale of the AD Assessment Scale (ADAS-cog) relative to baseline measurements. Results: Two patients were lost to follow up, and 122 patients completed the 18-month trial. The mean age of the participants was 65.3±6.4 years (range 54-82), and 77 (63.1%) of the participants were female. Improved cognitive function was observed in the first 6 months of the regimen (ADAS-cog=-3.1±10.1; MMSE=1.2±3.0), and the stabilisation of cognitive decline was observed over the remaining 12 months (ADAScog=- 1.6±7.6; MMSE=0.8±4.2). AEs were predominantly gastrointestinal and occurred in 7.3% of patients. Conclusions: MLC601 showed good tolerability and promising effects on cognitive function in AD patients during 18 months of treatment.

Prevention and treatment of respiratory consequences induced by sulfur mustard in Iranian casualties

About 100,000 Iranian have been exposed to chemical weapons during Iraq-Iran conflict [1980-88]. After being spent of more than two decades, still about 30,000 of them are under follow-up treatment. The main aim of this study was to review various preventive and therapeutic methods for injured patients with sulfur mustard in different phases. For gathering information, we have used the electronic databases including Scopus, Medline, ISI, IranMedex, Irandoc sites. According to this search strategy, 104 published articles associated to respiratory problems and among them 50 articles related to prevention and treatment of respiratory problems were found and reviewed. There is not any curative treatment for sulfur mustard induced lung injuries, but some valuable experienced measures for prevention and palliative treatments are available. Some useful measures in acute phase include: Symptomatic management, oxygen supplementation, tracheostomy in laryngospasm, use of moist air, respiratory physical therapy, mucolytic agents and bronchodilators. In the chronic phases, these measures include: Periodic clinical examinations, administration of inhaled corticosteroids alone or with long-acting beta 2 agonists, use of antioxidants, magnesium ions, long term oxygen supplement, therapeutic bronchoscopy, laser therapy, and use of respiratory tract stents. Most treatments are symptomatic but using preventive points immediately after exposure could improve following outcomes

Vascular endothelial growth factor in bronchoalveolar lavage fluid in sulfur mustard exposed lung patients

To determine the levels of vascular endothelial growth factor isoform consisting of 165 amino acids [VEGF165] in Bronchoalveolar Lavage fluid from Mustard Exposed Patients. Bronchoscopy with Bronchoalveolar Lavage was performed on sulphur mustard exposed patients. A total of 39 patients with documented exposure to Sulfur Mustard during the Iran-Iraq war participated in this study, of which 38 patients were males and one patient was female. The mean +/- SD age of patients was 41 +/- 6.6 years. The mean time after exposure to sulfure mustard was 19 +/- 1.7 years. Eighteen patients had concomitant war injuries but they were not related to the respiratory system. While twenty-two patients had a history of submassive persistent hemoptysis. There was no case with massive hemoptysis. Most of the patients had small airway obstruction [FEV1/FVC% = 78.14 +/- 9.76 and FEV% = 82.79 +/- 18.23]. Twenty-three patients had significant air trapping in the chest. High Resolution Computed Tomography was compatible with BOS. VEGF 165 concentrations in BALF were 36.87 +/- 34.68 pg/ml. When corrected to total protein of Bronchoalveolar Lavage Fluid [BALF] it was 0.76 +/- 0.70 pg/mg. BALF of VEGF did not correlate with hemoptysis or air trapping in chest HRCT. Thus, there was also no correlation between level of VEGF165 in BALF and any of PFT indexes [FVC, FEV1, MMEF or PEF]. Although VEGF is one of the cytokines which has an important role in chronic pulmonary disorders, it seems that it has no essential role in the severity of Mustard Lung Disease

Candida albicans structural and secreted proteins modulate CD4/CD8 ratio in tumor infiltrating lymphocytes of spontaneous adenocarcinoma bearing mice

Candida albicans is one of the most important opportunistic pathogens that suppress immunologic mechanisms of the host. It is speculated that structural and secretory proteins of C. albicans have immunomodulatory effects in cancer. To evaluate the effects of C. albicans structural and secreted proteins on intratumoral CD4/CD8 ratio as well as the survival rate in BALB/c tumor model. Structural and secretory proteins from C. albicans were isolated and examined for their effects on tumor growth and survival of adenocarcinoma bearing mice. The results indicated that in mice treated with C. albicans structural protein, the survival rate significantly decreased compared with the control groups. Also, mice treated with secretory proteins showed a decrease in survival rate but it was not statistically significant [p>0.05]. Investigating the frequency of tumor infiltrated CD4+ and CD8+ T lymphocytes indicated that the percentages of tumor infiltrated CD4+ T lymphocytes in response to structural and secreted proteins were higher compared to the control groups. Our study suggests that C. albicans structural and secreted proteins modulate intratumor T lymphocyte infiltration

Effect of protein and DNA components of toxoplasma gondii on IL-12 production from dendritic cells and T cell proliferation

The aim of the present study was to investigate the effect of protein and DNA components of Toxoplasma gondii on maturation of dendritic cells and their efficiency in IL-12 production and proliferation of T cells. for DC generation, Bone marrow cells were cultured in the presence of GM- CSF and IL-4 for 5 days. Tumor lysate and protein or DNA components of Toxoplasma gondii were added to the culture media and incubated for another 2 days. LPS was added as control for DC maturation. Proliferation of T cells were determined by MLR and IL-1 production was measured by ELISA kit. Maturation of dendritic cell were determined by flowcytometry. DCs treatment with protein components of Toxoplasma gondii caused a significant increase in IL- 1 2 production and proliferation of T cells [P<0.001]. Different compositions of microbial body like protein and DNA components of Toxoplasma gondii can cause augmentation of antigen presentation capacity of DC and their IL-12 production capability. Among these components the protein was more effective as compared to DNA

Effect of invasive aspergillosis infection on the immune responses of Cancer mice

Using a cancer murine model of invasive aspergillosis [IA], we investigated the expression of TLR-2, Dectin-1 and the level of cytokine production by CD4+ T helper cells in different groups of mice [with or without cancer], also, the effect of invasive aspergillosis on the immune response pattern of cancer mice. Patterns of susceptibility and resistance to infection obtained with different groups of mice injected with Aspergillus fumigatus conidia. TLR-2 and Dectin-1 analyzed applying flowcytometry and cytokine production of cultured splenocytes by ELISA method. Cancer mice that challenged with A. fumigatus conidia showed significant increase in TLR-2 and Dectin-1 levels compared with the two other control groups [normal mice challenged with A. fumigatus and non-infected cancer mice]. Moreover, it showed insignificant decrease in IFN-gamma and IL-10 levels and insignificant increase in TNF-alpha level. The data demonstrated remarkable rise in IL-4 level and the mortality of cancer mice that intravenously infected with A. fumigatus. Probably IA causes stimulation in innate immunity and Th2 cells, also some disorganization in cytokine production in CD4+ T helper cells. We hypothesize that concomitance of IA and cancer may change the microenvironment for local or systemic immune responses. Other complementary studies could help supporting our hypothesis

Clinical differentiation between resistant asthma and chronic bronchiolitis: testing a practical approach

Intractable asthma is a challenging clinical problem. This study was conducted to determine whether a subset of patients with Intractable asthma may be misdiagnosed and have a form of bronchiolitis instead and also to determine the effectiveness of macrolide therapy in these patients. Seventy six patients with Intractable asthma were re-treated with recommended maximal doses of oral prednisolone for 5 days, beclomethasone, cromolyn sodium, salbutamol and ipratropium bromide for 30 days. Thirty five patients were considered as unresponsive and constituted the study group. They underwent high-resolution CT [HRCT] scan following which they were offered with video-assisted thoracoscopic surgical biopsy. Group 1 [n=27] refused biopsy and each was treated with macrolide therapy, while Group 2 [n=8] underwent biopsy, and then received macrolide therapy. The patients were treated and followed for three months. The study group consisted of 27 patients, with a mean age of 46.9 +/- 11.1 years. The mean duration of time between the onset of symptoms and the start of this study was 8.1 years. In group 2, no patient had pathologic findings of asthma, and 7/8 had a form of bronchiolitis. There was significant improvement in dyspnea, cough and pulmonary function indices at the end of the 3-month in both groups [p<0.001]. Our results suggest that patients with Intractable asthma could be misdiagnosed and some of them have some forms of chronic bronchiolitis. We believe that any patient who does not respond to standard treatments for Intractable asthma should be evaluated with expiratory HRCT; those with significant air trapping should be considered for a course of macrolide therapy or biopsy for better identification of the underlying disease

Trauma in pregnancy

Trauma is leading complication and one of the causes of mortality of pregnancy. Trauma can bet lead to fetus death and threatening occurrences of mother s life, whether resulting from vehicles accident or suicide and quarrel. It must be sured of opening of airway in pregnant women involved in Trauma and necessity of the complete oxygen should be prescribed or the patient is under cannulation and mechanical treatment; since during pregnancy the womb is out of pelvis and cause to pressure on the inferior vena cava and also pregnancy cause to reduce of digestion system movements and the pregnants's stomach must be assumed full, in cardiopulmonary resuscitation and helping to protect of airway and service to vital organs the mentioned items must be considered and in order to reject of any probable injury of fetus and other processes of pregnancy, it is necessary that at least 4 hours of monitoring to be done. Surveys shows that the trauma resulting from pregnancy can be preventable and with observance of safety measures and quick diagnosis of suspecting cases of severe injury we able to reduce of mother and fetus mortality