Effects of Serum Vitamin D and Efficacy of Subcutaneous Immunotherapy in Adult Patients With Allergic Rhinitis

Immunotherapy is the standard of treatment for long-life relief of symptoms of allergic rhinitis. Vitamin D may affect the outcomes of treatment. This study evaluated the clinical efficacy of subcutaneous allergen immunotherapy in adult patients with allergic rhinitis based on the serum level of vitamin D. Patients with persistent allergic rhinitis and positivity for skin prick test were evaluated by Sino-nasal Outcome Test (SNOT-22) and Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) before subcutaneous allergen immunotherapy and during the maintenance phase to assess the relation of the serum level of vitamin D and the clinical efficacy of immunotherapy. After immunotherapy, the greatest reduction in SNOT-22 scores were reported in patients with vitamin D sufficiency (39.0 ± 9.2), followed by vitamin D suboptimal provision (35.1 ± 12.1), insufficiency (25.0 ± 7.5), and deficiency (18.3 ± 6.0) (P < 0.001). The MiniRQLQ reduction in patients with vitamin D sufficiency, suboptimal provision, insufficiency, or deficiency was 30.7 ± 8.7, 27.1 ± 8.7, 20.0 ± 8.6, or 17.4 ± 7.1, respectively (P < 0.001). Both of SNOT-22 and MiniRQLQ scores decreased significantly following immunotherapy in patients with different levels of vitamin D. However, these effects were more pronounced when the level of vitamin D was sufficient.

Isolation of aspergillus species from nasal cavity and bedroom of healthy volunteers and patients with allergic rhinitis in Mashhad, Iran

The purpose of this study was to investigate the presence, frequency and comparison of Aspergillus spp. in nasal cavity and bedroom of healthy volunteers and patients with allergic rhinitis. In this cross-sectional study, a group of patients with allergic rhinitis [N=50] were selected based on positive skin prick test. Healthy volunteers were chosen to be in the comparison group by matching in age, gender, and no history of respiratory system disease. Samples from nasal cavity and different parts of bedroom were collected and cultured. Cultured Aspergillus spp. was identified by standard mycological techniques. The most common species isolated from all samples of healthy volunteers was A. flavus [88%], followed by A. niger [76%] and A. fumigatus [74%]. A. flavus [56%] was the predominant species isolated from all samples of patients, followed by A. niger [34%] and A. fumigatus [6%]. A. flavus was the most prevalent species of Aspergillus both healthy volunteers and patients. The presence of Aspergillus in homes does not necessarily imply a cause and effect relationship with illness, but we speculate that A. flavus may be a major source of aeroallergens along with A. niger and A. fumigatus; and should alert physicians and healthcare professionals to do more vigorous environmental testing

Comparison of two flow cytometric methods for detection of human invariant natural killer T cells [iNKT]

Invariant natural killer cells [iNKT] are an important immunoregulatory T cell subset. Currently several flow cytometry-based approaches exist for the identification of iNKT cells, which rely on using the 6B11 monoclonal antibody or a combination of anti-V alpha 24 and anti-V beta 11 antibodies. The aim of this study was to compare the ability of two flow cytometry-based methods for detecting the frequency of circulating iNKT cells. The frequency of iNKT cells was detected in the peripheral blood of 37 healthy adult donors by flow cytometry using the 6B11 antibody or a combination of anti-V alpha 24 and anti-V beta 11 antibodies. The frequency of iNKT cells detected by 6B11 antibody or by combination of anti-V alpha 24 and anti-V beta 11 antibodies was significantly different [0.54% vs. 0.31%, respectively, p<0.001] but the values were highly correlated [Spearman r=0.742, p<0.0001]. The results of this study indicate that different combinations of mAbs detect different frequencies of peripheral blood iNKT cells and a consensus in the field needs to be established to allow better assessment of iNKT-related studies and suggest using different methods for accurate identification of iNKT cells

Association of the expression of IL-4 and IL-13 genes, IL-4 and IgE serum levels with allergic asthma

Immune and inflammatory responses mediated by cytokines, play important roles in the pathophysiology of asthma. These responses are associated with overexpression of Th2 cytokines such as IL-4 and IL-13. These two cytokines use common receptors for signaling that lead to identical immunological effects and regulation of the Th1/Th2 balance. The aim of this study was to determine whether patients with allergic asthma display overexpression of IL-4 and IL-13 genes. Using RT-PCR, we examined the expression of IL-4 and IL-13 genes in twenty asthmatic cases and twenty normal individuals. Total levels of serum IgE and IL-4 were also determined by ELISA method. Expression of IL-13 gene in 70% of patients with allergic asthma was higher than controls [P=0.01]. There was no correlation between the expression of IL-13 gene and total level of serum IgE [P=0.07]. Expression of IL-4 gene was detected in 30% of the patients and none of the normal individuals as determined by RT-PCR [P=0.01]. Mean of serum IgE levels in patients and controls were 84.9 IU/ml and 62.2 IU/ml, respectively. Level of serum IgE was more than 100 IU/ml in 30% of patients [P=0.03]. Mean of serum IL-4 levels in patients and controls were 15.73 pg/ml and 13.07 pg/ml, respectively. There was a relation between levels of serum IgE and IL-4 in 73% of cases. The results showed that there was a correlation between the expression of IL-4 gene and the level of serum IL-4. Levels of serum IgE and IL-4 were considerably higher in asthmatics than nonasthmatic controls

Assessment of the immune system activity in Iranian patients with major depression disorder [MDD]

Major Depression Disorder [MDD] is a common disorder with prevalence of 15% among men and up to 25% among women. In recent years the association of immune system alterations and MDD has been investigated. Assessments of immunologic and inflammatory responses in these patients enhance our knowledge of the etiology and pathogenesis of this disease. To investigate the changes in immunoglobulin and cytokine serum levels and lymphocyte subsets in patients with MDD. We studied 37 adult patients with MDD, diagnosed based on DSM-IV diagnostic criteria, and 15 healthy controls matched with the patients. Plasma concentration of interleukin-4 [IL-4], IL-10, TNF alpha, and IFN gamma were measured by ELISA and serum immunoglobulins by SRID. Total number of NK cells [CD16 and CD56], B cells [CD19], and T cells [CD8, CD4, and CD3] were determined by flow cytometry. We found no significant differences in plasma concentration of IL-4, IL-10, TNF-alpha, IFN-gamma, and immunoglobulins as well as total number of NK cells, B cells, and T cells between major depressed patients and healthy control subjects. We conclude that in our patients, there were no significant differences in immune system activity between MDD patients and controls

Association between the polymorphisms of IL-4 gene promoter [-590C>T], IL-13 coding region [R130Q] and IL-16 gene promoter [-295T>C] and allergic asthma

Allergic asthma is a multifactorial disease, influenced by genetic and environmental factors. Recent family-based studies have revealed evidence for linkage of human chromosomes 5q31-33, 12ql5-24, Ilql3 and 15q23.6 as regions likely to contain genes related to asthma. Among the candidate genes in these regions are the genes encoding for human interleukin-4, interleukin-13 and interleukin-16. To evaluate this linkage, we examined an Iranian population of patients with asthma. A total of 30 patients with allergic asthma and 50 normal subjects were studied. Allergic asthma was confirmed using skin prick test and spirometry. DNA was extracted from blood cells and IL-4 [-590C>T], IL-13 [R130Q] and IL-16 [-295T>C] polymorphisms were determined by PCR-RFLP method. Out of 30 patients with allergic asthma, the following genotypes for IL-4, IL-13 and IL-16 cytokines were found: IL-4 genotypes consisted of 17 [56.7%] CC, 8 [26.7%] CT and 5 [16.7%] TT; IL-13 genotypes consisted of 11 [36.7%] GG, 13 [43.3%] GA and 6 [20%] AA; IL-16 genotypes consisted of 23 [76.7%] TT and 7 [23.3%] CT. No patient showed CC genotype for IL-16. A higher proportion of case subjects with the C allele for the IL-4, G allele for the IL-13 and T allele for the IL-16 polymorphisms was found compared with the T, A and C alleles, respectively. These results suggest an influence of genetic variability at the promoter of IL-4 gene [-590C>T] and a coding region of IL-13 gene [R130Q] on the occurrence of allergic asthma and no relationship between IL-16 promoter polymorphism [-295T>C] and this disease

Association between HLA-DRB1 *01 and HLA-Cw*08 and outcome following HTLV-I infection

Human T cell lymphotropic virus type I [HTLV-I]-associated rnyelopa-thy/tropical spastic paraparesis [HAM/TSP] is an inflammatory disease which occurs in less than 2% of HTLV-I -infected individuals. High proviral load, high HTLV-I-specific CD8[+] cytotoxic T lymphocyte frequency [CTL] and host genetic factors such as HLA all appear to be associated with HTLV-I infection. Previous studies have shown that HLA-DRB1*01 increases the risk of HAM/TSP in Japanese HTLV-1 infected individuals. To investigate the association between HLA class II DRB1 alleles and HLA class I alleles [HLA-Cw*08, B54, A*02 and A-30] in HTLV-I infected individuals in Mashhad. Here we determined the frequency of HLA class II DRBl, using INNO-LIPA reverse hybridization line probe assay, and HLA class I alleles [HLA-Cw*08,B54, A*02 and A-30] by PCR-SSCP method in healthy controls, HAM/TSP patients and HTLV-I infected individuals born and resident in Mashhad. The frequency of HLA-DRB1*01 alleles in this population was different from other areas of Iran. The frequency of HLA-DRB1*01 was significantly increased in HAM/TSP patients compared with carriers [p 0.028; OR=9.4]. The frequency of HLA-Cw*08 was also significantly increased in HAM/TSP patients compared with controls [p=0.03; OR=13.5]. Our results may suggest that possession of HLA-DRB1*01 increases the risk of HAM/TSP in HTLV-I-infected individuals and HLA-Cw*08 correlates with low CTL immune response in HAM/TSP patients

Study of alpha1-antitrypsin phenotypes frequencies in patients with primary antibody deficiency

Primary antibody deficiencies are the most frequent primary immunodeficiency disorders. Bronchiectasis as a feature of these disorders may be developed due to some factors such alpha-1-antitrypsin deficiency. In order to determine the prevalence of two common alpha-1-antitrypsin deficiency alleles [PI*Z and PI*S] in Iranian patients with antibody deficiency, this study was performed. The prevalence of PI*M, PI*S, and PI*Z allele combinations was determined in 40 patients with primary antibody deficiency [with and without bronchiectasis] and compared with 60 healthy control subjects. Phenotyping was performed by isoelectric focusing. The phenotype frequencies among patients were as follow: M in 92.5%, S in 2.5% and Z in 5%. There was not any significant difference in distribution of alleles or phenotypes between patients and control subjects. Moreover, no significant difference was found between patients with and without bronchiectasis. We did not find evidence to support an association between alpha-1-antitrypsin phenotypes and primary antibody deficiencies in a small, controlled study. Larger studies will be required to clarify the relationship between alpha-1-antitrypsin genotype and susceptibility to bronchiectasis in patients with antibody deficiency

Association between the polymorphism of TGF- beta 1 gene promoter [-509C>T] and idiopathic chronic Urticaria

Idiopathic Chronic Urticaria [ICU], the most common form [70-80%] of chronic urticaria is supposed to have immune basis causes. It is speculated that the promoter polymorphism of TGF- beta 1 gene may be involved in ICU. This condition is thought to affect at least 0.1% of the population and often can be severe and difficult to treat. A total of 40 patients with ICU and 41 normal subjects were studied. DNA was extracted from whole blood and TGF- beta 1 promoter -509C>T polymorphism was determined by PCR-RFLP method. Out of the 40 patients with ICU, 11 [27.5%] had CC, 26 [65%] had CT and 3 [7.5%] had TT genotypes. A higher proportion of case subjects with the C allele [CT type or CC type] was found compared with the T allele. These results do suggest an influence of genetic variability at the promoter of TGF- beta 1 gene [-509C>T] on the occurrence of ICU. This polymorphism has been shown as a useful genetic change in our study. Further work is required to confirm this result

prevalence allergic rhinitis among 11-15 Years-old children in Shiraz

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. To determine the prevalence of childhood allergic rhinitis and the presence and significance of eosinophilia in nasal secretions. 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. 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. 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