Iranian Journal of Immunology
Year:2008 | Volume:5 | Issue:1|Papers Count:8

The efficacy of allergen immunotherapy for the treatment of allergic rhinoconjunctivitis with or without seasonal bronchial asthma and anaphylaxis caused by the sting of the hymenoptera class of insects has been clearly demonstrated in numerous well-designed, placebo-controlled trials. Immunotherapy whether by subcutaneous injection of allergen extract or by oral/sublingual routes modifies peripheral and mucosal TH2 responses in favour of TH1 responses and augments IL-10 synthesis by TRegs both locally and by peripheral T cells. Recent researches into the cellular and molecular basis of allergic reactions have advanced our understanding of the mechanisms involved in allergic diseases. They have also helped the development of innovative approaches that are likely to further improve the control of allergic responses in the future. Novel approaches to immunotherapy that are currently being explored include the use of peptide-based allergen preparations, which do not bind IgE and therefore do not activate mast cells, but reduce both TH1 and TH2-cytokine synthesis, while increasing levels of IL-10. Alternative strategies include the use of adjuvants, such as nucleotide immunostimulatory sequences derived from bacteria CpG or monophosphoryl lipid A that potentiate TH1 responses. Blocking the effects of IgE using anti-IgE such as omalizumab, a recombinant humanized monoclonal antibody that selectively binds to IgE, has been shown to be a useful strategy in the treatment of allergic asthma and rhinitis. The combination of anti-IgE-monoclonal antibody omalizumab with allergen immunotherapy has proved beneficial for the treatment of allergic diseases, offering improved efficacy, limited adverse effects, and potential immune-modifying effects. This combination may also accelerate the rapidity by which immunotherapy induces TReg cells. If allergic diseases are due to a lack of allergen-specific TReg cells, then effective therapies should target the induction and the development of TReg cells producing cytokines such as IL-10.

Background: Patients with B-cell chronic lymphocytic leukemia (B-CLL) have heterogeneous clinical courses, thus several biological parameters need to be added to the cur-rent clinical staging systems to predict disease outcome. Recent immunophenotypic studies performed mainly in Western populations have demonstrated the prognostic value of CD38 and ZAP-70 expression in B-CLL.Objectives: To investigate the expression pat-tern of a variety of membrane antigens on leukemic cells from Iranian patients with CLL and to find out if there are any differences in the expression of these markers between indolent and progressive groups.Methods: In the present study, peripheral blood samples from 87 Iranian patients with B-CLL were analysed by flow cytometry.Results: In all cases, the neoplastic cells displayed B-CLL phenotype (CD5+/CD19+/sIg+). The vast majority of the cases expressed CD23, but failed to stain for CD3 or CD14. The leukemic cells of most patients expressed CD27 (84/87, 95.4%) and CD45RO (74/87, 83.9%) molecules, suggesting a memory B-cell phenotype. Comparison between the indolent (n=42) and progressive (n=37) patients revealed significantly higher frequency and intensity of CD38 expression in progressive group (40.5%) compared to indolent (11.9%) patients (p<0.05). None of the other membrane antigens were differentially expressed in these two groups of patients.Conclusion: Our results obtained in an Asian ethnic population confirm and extend previous findings obtained from Western populations regarding the association of CD38 expression and disease progression in B-CLL.

Background: The use of dendritic cells (DCs) as a cellular adjuvant provides a promising approach in immunotherapy of cancer. It has been demonstrated that Listeria monocytogenes activated DCs pulsed ex vivo with tumor antigens trigger a systemic Th1-biased specific immune response and a single dose of this vaccine will cause a consider-able anti tumor immunity.Objective: The present study was designed to evaluate the ability of multiple doses of tumor antigen-pulsed DCs, matured in the presence of Listeria monocytogenes components in induction of a potent anti-tumor response and the prevention of tumor formation in an experimental model.Methods: Bone-marrow de-rived DCs (BMDCs) were cultured in the presence of GM-CSF and IL-4. After 5 days, tumor lysates with/without Listeria monocytogenes lysate were added to the culture media for another 2 days. Mice received mature and tumor antigen pulsed dendritic cells subcutaneously in 3 groups. Tumor growth was monitored and two weeks after immunotherapy, cytotoxic activity of CD8+ T cells was evaluated in different groups.Results: According to the findings, repeated doses of vaccine did not lead to a significant increase in the activity of cytotoxic T cells and decreased tumor growth of immunized animals.Conclusion: The current study suggests that increased doses of vaccine do not have sufficient efficiency for prevention of tumor induction. Generation of T regulatory responses upon repeated doses of such vaccines should be considered in future investigations

Background: Patients with end stage renal disease have higher incidence of infection diseases that is thought to be related to impaired immune system.Objective: To determine the antitetanus IgG antibody level in Iranian hemodialysis patients with end stage renal disease and to find its association with sex, age, blood hemoglobin, serum albumin, duration of dialysis, time of dialysis per week, dialysis adequacy, erythropoietin, or iron supplementation, body mass index (BM!) and underlying renal disorder.Methods: We conducted a cross sectional study on a total of 108 Iranian hemodialysis patients with end stage renal disorder, and 36 healthy individuals in the control group matched with the patient group. The patients and controls did not receive any antitetanus vaccine or immunoglobulins a year prior to the investigation. The serum antitetanus IgG antibody levels were measured by an ELISA method.Results: We found 74.3% of patients to have unprotected antitetanus IgG antibody level compared with 52.8% of the control group. Except hemodialysis duration, none of the contributing factors seemed to affect immunity.Conclusion: We conclude that in our study; there is a significant difference in the antitetanus IgG antibody level between hemodialysispatients and the control group and also in the chronic hemodialysispatients.

Background: Inflammation and infectious agents such as Chlamydia pneumoniae have been associated with cardiovascular disease.Objective: To evaluate the serum high sensitivity C - reactive protein (hs-CRP) and antibodies against Chlamydia pneumoniae and Chlamydial heat shock protein-60 (Cp-HSP60) in patients with ischemic heart disease (IHD).Methods: 62 patients with IHD having either acute myocardial infarction (AMI; n=31) or unstable angina (UA; n=31) and 31 sex- and age- matched healthy subjects as a control group were en-rolled in this study. Serum samples of participants were tested for the presence of hs-CRP and antibodies against C. pneumoniae and Cp-HSP60 using ELISA method.Results: The seroprevalence of anti-C. pneumoniae antibody in AMI group (93.5%) or UA group (90.3%) was significantly higher than the control group (61.3%; p<0.001). The seroprevalence of anti-Cp-HSP60 IgG was 22.6% in healthy subjects with mean end titer of 43.1 ± 6.32. The seropositive rates of anti-Cp-HSP60 were 48.4%, 54.8% and 51.6% in AMI, UA and the overall IHD groups with mean end titers of 94 ± 22.86, 113.8 ± 24.25 and 103.9 ± 16.57, respectively. Both the seroprevalence and the mean titer of anti-Cp-HSP60 in patients groups were significantly higher than those observed in the control group (p<0.04 and p<0.03, respectively). Moreover, the mean serum hs-CRP levels was significantly higher in the IHD group as compared to the control group (21.6mg/ml ± 3.73vs 2.5mg/ml ± 0.52; p<0.00001). The mean serum hs-CRP levels of AMI (30.3mg/ml ± 6.07) or UA (12.9mg/ml ± 3.85) groups were also significantly higher than those observed in the control group (p<0.00001 and p<0.001, respectively). Further-more, the difference of the mean serum hs-CRP levels between AMI and UA groups was also significant (p<0.02).Conclusions: These results showed that the seroprevalence of antibodies against C. pneumoniae and Cp-HSP60 and the serum levels of hs-CRP and anti-Cp-HSP60 IgG were higher in patients with IHD.

Background: There are many therapeutic methods for allergic conditions. CpG oligonucleotides play a critical role in immunity via the augmentation of Th1 and suppression of Th2 responses.Objective: In the present study we aimed to estimate the effectiveness of intranasal administration of CpG ODN plus Chenopodium album allergen in allergic asthma compared with the administration of allergen alone and to find out how CpG ODN therapy is useful in the treatment of allergen induced asthma.Methods: BALB/c Mice were intraperitoneally and intranasally sensitized with allergenic extract precipitated on aluminum hydroxide. Therapy with CpG/Ag was performed intranasally. After antigenic challenge, a number of Immunologic variables such as serum IgE and IgG, systemic and local IL-10 and IFN-y were studied in splenocytes, and lung tis-sue culture supernatants, respectively.Results: Our study indicated that intranasal ad-ministration of CpG/Ag had significant increases in both systemic and local levels of IL-10 and IFN-y (p£0.001), but showed no significant effect on the levels of IgE, IgG2a, and IgG1 in serum (p=0.06). This study demonstrated that CpG ODN has therapeutic effects not only on splenocytes but also on nasal lymphocytes to produce IFN-y as a Th1 cytokine, and IL-10 as a regulatory cytokine.Conclusion: According to these data from the mouse model, we conclude that intranasal administration of CpG motifs before allergen exposure may be useful for the control of allergic asthma. Therefore, further investigations on humans using CpG motifs are recommended in order to modulate the allergic effects of Chenopodium album as well as other regional allergens.

Common variable immunodeficiency syndrome (CVID) is one of the most common primary immunodeficiency disorders (1). In addition to causing recurrent infections with pathogenic and opportunistic organisms, it is frequently reported in association with autoimmune diseases (1). Idiopathic thrombocytopenic purpura (ITP) is one of the autoimmune diseases that frequently coexists with CVID (2, 3). The treatment options for ITP, especially if chronic or recurrent, require careful attention in the presence of CVID. This is due to the fact that treatment modalities like corticosteroids, splenectomy, and immunosuppressive drugs may carry a considerable risk of overwhelming infections in patients with CVID (4). We report an adult female patient in whom CVID was detected after the occurrence of ITP.

Angina is a symptom of coronary heart disease and comprises different types including stable and non stable angina. Many factors play a role in unstable angina. Among which are aCL, aPL, ANCA, and anti-dsDNA, that may act in the induction of immunological response leading to the development of unstable angina. Immuno-inflammatory activity mediated by different antibodies may also have a role in unstable angina.