Reference intervals for serum immunoglobulins IgG, IgA, IgM and complements C3 and C4 in Iranian healthy children

Determination of reference ranges of each serum protein in normal population of each country is required for studies and clinical interpretation. The aim of this study was defining reference range values of immunoglobulins and complement components in Iranian healthy children. This study was conducted from June 2003 to June 2006 in Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences. Serum levels of IgG, IgM, IgA, C3 and C4 in 800 Iranian healthy children from newborn to 18 years of age in four population were measured by nephelometry. Kolmogrov-Smirnov tests and Pearson correlation tests were used for analysis. Our results mainly agree with previous reports, except for some discrepancy that might be due to the ethnic and geographic variety. There was a significant difference between two sexes only with IgA in the group of 1-3 months old, which was higher in male group and IgM in groups of 3-5, 6-8 and 9-11 years old that were higher in female groups. Mean of other serum immunoglobulins and complements was not significantly different between male and female groups. These results can be considered as a local reference for use in laboratories, clinical interpretations, and research for Iranian children

Production of human papilloma virus type 16 E6 oncoprotein as a recombinant protein in eukaryotic cells

Cervical cancer is one of the most important and widespread cancer which affects women. There are several causes of cervical cancer; among them HPV types 16 and 18 are the most prominent ones which are recurrent and persistent infections. These genotypes are currently about 70% of cervical cancer causes in developing countries. Due to the importance of these viruses in cervical cancer, we pioneered the production of Human Papilloma Virus type16 E6 oncoprotein as a recombinant protein in order to develop a vaccine. Two HPV oncoproteins, E6 and E7, are consistently expressed in HPV-associated cancer cells and are responsible for malignant transformation. These oncogenic proteins represent ideal target antigens for developing vaccine and immunotherapeutic strategies against HPV-associated neoplasm. In the present study, the cloned E6-oncoprotein of HPV16 in pTZ57R/TE6 vector was used to produce professional expression vector. The target gene was subcloned in a eukaryotic expression vector. The pcDNA3-E6 vector was propagated in E.coli strain DH5 alpha and transfected into CHO cells 72 hours posttransfection. The transfected cells were harvested; mRNA detection and the interest protein production were confirmed by western blot analysis using specific anti E6 monoclonal antibody. HPV16-E6 target protein recognized by specific antibody could be an appropriate form of protein, which can be used for further studies. Due to potential effect of this protein, its DNA construction can be used for DNA vaccine in future studies

Strategic planning in a health leadership sector: a report from UNESCO chair in health education, Iran

Strategic planning defines the formal decision of a company for its future. Like all organizations, health care sectors need to prepare their strategic planning and act according to it. UNESCO chair in health education as a leader health sector, describes the course and steps for preparing its strategic planning based on SWOT analysis technique

Soluble form of fasl [sFasL] in adult asthma

sFasL is the soluble form of FasL inducing apoptosis by binding to Fas. Fas/sFasL could be the most important mechanisms in inflammatory conditions such as asthma by controlling inflammatory responses. This study was undertaken to determine the level of sFasL in allergic and non- allergic asthmatic patients with different stages of asthma control. Twenty asthmatic patients were enrolled and divided into controlled and uncontrolled patient groups. They were divided into 4 subgroups including controlled/allergic, controlled/non-allergic, uncontrolled/allergic and uncontrolled/non-allergic subgroups. Five normal subjects were selected as a control group. From all subjects, 3 ml of blood was obtained and sFasL and IgE serum levels were evaluated by a specific ELISA kit. sFasL in the controlled and uncontrolled patient groups did not have any significant difference; but in the uncontrolled/allergic subgroup, it was significantly lower than that in the control group and also higher in the uncontrolled/non-allergic subgroup insignificantly. In patients with acute inflammatory conditions, sFasL had an increasing effect to control inflammation observed in uncontrolled/non-allergic subgroup, but unexpectedly not in the uncontrolled/allergic subgroup. Probably in allergic patients, there are factors or mechanisms that inhibit sFasL production or expression

Adverse drug reactions in an Iranian department of adult infectious diseases

This study aimed to assess the frequency and severity of adverse drug reactions [ADRs] [WHO definition] in hospitalized adult patients in an infectious diseases referral ward in Tehran. Of 281 patients evaluated over 6 months, a total of 170 suspected ADRs were reported among 101 patients [35.9%]. The most commonly affected organ system was gastrointestinal [47.5%], and the most common class of drugs responsible was anti-infectives [93.1%]. ADRs were high among HIV-positive patients [82.9%], mainly due to anti-tuberculosis drugs. Attention to appropriate prescription of drugs is required with more careful clinical and laboratory monitoring of patients

Relation of Interleukine-4 [C-589T] and Interferon-Gamma [A+874T] allele polymorphism with Asthma

Asthma is a common respiratory disease caused by acute and chronic bronchial inflammation. Clinical manifestations of the disease are closely related to genetics. IL-4 is a cytokine of TH2 lymphocytes, polymorphism in prompter region, C-589T, is associated with IL-4 production, while IFN-gamma, is a cytokine of TH1, and A+874T polymorphism in interon 1 of IFN-gamma is associated with it.s production and release. Cytokine gene polymorphisms could influence pathogenesis of asthma with TH1/THh2 ratio, being of great importance. 81 unrelated asthmatic patients were selected according to ATS characteristics and separated into two groups of controlled and uncontrolled asthma. 80 normal subjects were chosen as control group. After collection of peripheral blood and DNA extraction, PCR-RFLP method was used for genotyping of IL-4, -589 position. For evaluation of polymorphism in +874 position of IFN-gamma ARMS-PCR method was used. Distribution of frequency of IFN-gamma [A+874T] and IL-4[C-589T] polymorphisms didn.t show any statistically significant difference between two patient groups and healthy control group [p >/= 0.05]. There was neither any significant difference [p >/= 0.05] among other parameters. Studies in field of cytokine polymorphism have had variable results. So many studies have mentioned a relationship between cytokine gene polymorphism and susceptibility and/or severity of asthma and some studies have shown that there is no association between these factors we believe that there may exist factors different from IL-4 and IFN-gamma polymorphism which coner the effects of these genetic vaciants in pathogenesis and severity of asthma

[Correlation of null Btk expression and gene noncoding mutations in XLA patients]

X-linked agammaglobulinemia [XLA] is a primary immunodeficiency disorder characterized by recurrent bacterial infections, profound lack of serum antibodies and reduced circulating B lymphocytes. Mutations in Bruton's tyrosine kinase gene [BTK] result in XLA. It is shown that absence of Btk protein expression may be accompanied by no mutations in coding regions in some cases, instead alterations in conserved regulatory domains of promoter and the first intron of BTK gene maybe occurred The aim of this study was evaluation of Btk expression and mutation analysis in coding and regulatory regions of the gene. In this study, eleven XLA patients were enrolled. Btk expression was analyzed by western immunoblotting method. Mutation analysis was carried out in eight patients. In three cases, PCR of the regulatory regions was performed with designed primers, followed by sequencing. According to western blot, normal Btk expression in three patients and null expression in eight others was observed. Mutation analysis showed two novel BTK mutations in two patients [1038-1040 delAGG and IVS8-2delA]. No coding or regulatory region mutations were found in three cases with null Btk expression. Based on these results, three cases with null expression and had no coding or regulatory region mutations are interesting. It is possible that some rare regulatory defects may have been occurred, other than conventional sites. This must be taken into account for future investgations

[Prevalence of asthma symptom in Iran: a meta-analysis]

Asthma is the most prevalent chronic disease in the world. To quantify the national prevalence of asthma symptom, we conducted a systematic review and random effects meta-analysis. After internet search for population-based estimates of Asthma prevalence in Iran, 19 papers were selected from 142 articles, dissertations and reports of research projects published between the years 1998-2003. All studies on children performed by ISAAC protocol were found. We entered the data from studies in children to NCSS software. We used funnel plot for publication bias. In the 19 accepted studies on children under the age of 18 years, 61067 children had been checked by the ISAAC protocol. The lowest prevalence of asthma is 2.7% from Kerman and the highest prevalence is 35.4% from Tehran. Overall prevalence of asthma symptoms in children is 13.14%, [95% confidence interval 9.97-16.30], at the national level. Based on this study the prevalence of asthma symptom in Iran is higher than international norms

Common food allergens in Iranian children

The prevalence of food allergy is different in different parts of the world. Identification of the most common food allergens is a priority in any population to provide effective preventive and curative measures. The aim of this study was to determine the most common food allergens in Iranian children. One hundred and ninety children with skin, respiratory or gastrointestinal symptoms, thought to be due to food allergy, were studied. The total serum IgE and eosinophil count tests were measured in all patients. Allergy to 25 food allergens was determined according to the patient's history, skin prick tests, RASTs [Radioallergosorbent Test] and open food challenge tests. Findings: The most common food allergens were cow's milk, tomato, egg white, egg yolk, beef and almond, respectively. The order of common food allergens in this study was different from other reports; this might be due to the different food habits and /or ethnic diversities

study of cockroach allergy in Iranian children with asthma

Asthma is the most common chronic disease of childhood. Exposure to allergens plays an important role in asthma. Recently, cockroach has attracted attentions as an important allergen. To evaluate cockroach allergy in Iranian children with asthma. 100 children with asthma were studied. After determination of asthma severity, serum total IgE and blood eosinophils were measured. The patients were then skin prick tested with cockroach [Blattella germanica] and some common aeroallergens and food allergens. According to cockroach skin prick test [SPT] results, the patients were divided into two groups [sensitive and non-sensitive] and compared. Positive SPT for cockroach was detected in 29% of patients. Cockroach sensitive group had a more severe asthma [p<0.02]. Asthmatic patients with cockroach allergy had perennial symptoms [p<0.05]. A remarkable number of sensitive patients were born in winter [p<0.05]. Eosinophilia was more common in sensitive group [p<0.02] and they had a higher level of serum total IgE [p<0.04]. The prevalence of cockroach allergy was near to other common aeroallergens. Cockroach sensitive group had perennial symptoms, which are compatible with other indoor allergens. Cockroach allergy was more prevalent in children born in winter. May be these children are kept at home during their first months of life and are more exposed to cockroaches. The higher prevalence of eosinophilia and higher IgE level in sensitive group may be the reasons of more severe asthma in this group

20-year survey of infectious complications in 64 patients with common variable immunodeficiency

Common variable immunodeficiency [CVID] is a heterogeneous primary immunodeficiency disorder, characterized by hypogammaglobulinemia and increased susceptibility to recurrent bacterial infections. To determine the spectrum of infectious complications in patients with common variable immunodeficiency [CVID], we reviewed the hospital records of 64 CVID patients, who were diagnosed in Children's Medical Center during a period of 20 years. Among our patients, there were 38 males and 26 females, with a median age of 12 years [2-42 years] at the time of study. The median age of diagnosis was 6.1 years, with an average diagnostic delay of 5.2 years in our patient's group. Almost all of our patients have suffered from acute and recurrent infections, particularly in the respiratory and gastrointestinal systems. The majority of patients [82.5%] had pneumonia prior to diagnosis. The other infectious complications seen in our patients were as follows: recurrent otitis media [54%], recurrent sinusitis [50.8%], diarrhea [65.1%], and bacterial meningitis [11.1%]. Unusual or opportunistic infections were also seen in some of our patient population, including oral candidiasis in 10 patients, and Pneumocystis carinii pneumonia in 2 subjects. Based on this study, we suggest that hypogammaglobulinemia should be considered in any patient with a history of recurrent infections in different organs, and such patients should have a full assessment of the immune system

BCG dissemination in 40 patients and the review of leukocyte mycobacterium deffect in one patient

We have reviewed the medical records of 40 patients with disseminated [Bacille Calmette-Guerin] BCG from 1996 to 1999 in the Immunology Department of the Children Hospital, Medical Center, Tehran University. These patients are divided in to 3 groups: 1. patients who had disseminated [Bacille Calmette-Guerin] BCG after vaccination and their diagnosis was chronic granulomatous disease. 2. Patients who had disseminated [Bacille Calmette-Guerin] BCG and were diagnosed as having cell mediated immunodeficiency. 3. patients whose Nitroblue Tetrazulium and CMI were around normal, but they could not kill intracellular mycobacterium, because of confirmed deficiency of interferon-gamma receptor and IL[12] receptor. Interferon-gamma receptor or CD119 was checked in 6 patients. In one patient interferon-gamma receptor deficiency was confirmed by flowcytometric analysis. In other patients, this marker was around normal, but presumably they had IL[12] receptor deficiency, which we were unable to detect in our laboratory. In some patients this marker should be checked after preparation of more laboratory facilities