BIENNIAL CONGRESS ON IMMUNOLOGY, ASTHMA AND ALLERGY | Year:2007 | دوره:6 |Papers Count:64

Cow’s milk allergy (CMA) is one of the most widespread human allergies, especially in very young children. Though CMA is the most studied, little is known about the recognition of milk allergen patterns in allergic patients as a prerequisite for the development of efficient diagnostic and prognostic tools. Several factors explain the difficulties of such studies, since (i) milk contains a large number of potential allergens; (ii) the majority of these allergens consist of complex suspensions rather than solutions; (iii) the major allergens such as caseins can’t be purified to homogeneity in large amounts. To override these difficulties we developed a sensitive microarray assay that in combination with near-infrared fluorescence detection was used to study the immune response to milk and purified native and recombinant proteins. This new assay allowed us to assess the binding ability of a large number of allergens to the serum IgE pool of young patients using lower amount of the clinical material. Our data showed that bovine lactoferrin belongs to strong milk allergens. We confirmed that bovine caseins are the main allergens in milk and a-S1 was more representative than a-S2, b and k, which were recognized with almost similar frequency by sera of patients. The recombinant a-S1, a-S2, b and k-caseins caseins purified from the /Escherichia coli/ host, which does not provide phosphorylation and glycosylation of these proteins, were recognized with the same efficiency as their native counterparts by patients’ IgE. Recombinant caseins devoid of post-translational modifications, appear to be useful for the development of /in vitro/ and /in vivo/ diagnostic tools of CMA, especially in microarray-based diagnostic tools.

COPD is characterised by a slowly progressive irreversible airflow obstruction which is due to peripheral airway inflammation and loss of lung elastic recoil resulting from parenchymal destruction. Cigarette smoking is the major risk factor for COPD. Genes, including those for alpha1-antitrypsin (AAT), a1-anti chymotrypsin (AACT), a2-macroglobulin etc, have also been associated with the development of COPD. AAT is a highly pleiomorphic protein, thus reflecting a pleiomorphic gene locus, with roughly 100 alleles having been identified to date. The most common variant, M, characterized by normal serum AAT levels. The Z and S variants are associated with AAT deficiency. Individuals with the ZZ genotypes have severe AAT deficiency, and are at increased risk for COPD. This research is conducted with the aim of identification and report of AAT variants in COPD patients. Study subjects were 76 Patients (62 male and 14 female) with COPD who were selected from lung disease center and their reports including personal characteristics (age, sex, etc), illness family history, clinical symptoms, were closely examined. Iso electrophorese focusing technique was used to identify AAT phenotypes. 76 control subjects who were similar with respect to age, race, habit smoking and sex. Statistical analyseswere performed with SPSS. The associations of the Z and S mutations with COPD were tested by the fisher's exact test. The prevalence of MS heterozygosity in all of the study subjects was 2 of 76 (2.6%) compared with 1 of 76 (1.3%) control subjects. Six of 76 (7.9%) of subjects in the study were heterozygous for the Z alleles (MZ), compared with 0 of 76 (0%) control subjects. One ZZ individual (1.3%) was detected, whereas no individual with SS or SZ phenotypes were found. The prevalence of MZ heterozygotes in study subjects was increased (P=0.028) compared with control subjects after correction for age, gender, and smoking history. The results also, demonstrated no difference (P=1.000) in the prevalence of MS heterozygotes in the study group compared with the control group. Probably, these results’ indicating the Z, but not the S, allele is a risk factor for COPD in the heterozygous state and may reflect the fact that the S allele is a mild deficiency variant and if an increased risk of COPD is associated with the S allele, it would be expected to be small. The percentage of the predicted FEV1 was reduced in MZ compared with MM individuals among those with clinically established COPD.

Introduction: Recent epidemiologic studies showed the complex and multifactorial relation between pollinosis augmentation and atmospheric pollution. Pollutants have a direct impact on the physiology of pollens, as well as indirect impact on its ontogenesis via their effect on the producing plants.Objective: This research tries to measure the effects of air pollutants on the pollen structure of the Cupressus arizonica planted in the highest polluted areas of Tehran and its probable influence on the augmentation of pollen allergenicity.Materials and Methods: Pollen samples were collected from C.arizonica trees planted in the high traffic areas of Tehran and also in non-polluted in the suburbs. Scanning electron microscopy was used to examine and compare shapes and strucures of non-polluted and polluted pollens. The existence and percentage of different pollutant elements in pollen tectums were determined and compared via spectrometric analysis.Results and Conclusion: Our microscopic examinations showed that air pollution considerably improved the fragility of pollen exine, causing numerous cracks in its surface and facilitating pollen content liberation. Spectrometric analysis showed the abundant presence of S (37%) on polluted pollen surfaces, which is one of the most irritating elements and may increase the allergenic potency of pollens. On the other hand, this observation reflected the fact that important effects of air pollution on C.arizonica allergenic pollens increase the production of micronic and submicronic aerosols which may have a negative repercussion on the health of urban population.

Introduction: Allergic diseases are a great problem in human societies. in this study we evaluate major immunologic features of asthma and allergies in a selected population from Immunologic Research center of Rasool Akram Hospital.Material & Methods: Study population includes 53 asthmatic or rhinitis and 32 healthy subjects. their peripheral blood was collected and major lymphocyte subpopulations (B cells, NK cells, T-cytotoxic and T-helper cells) analyzed by using proper CD markers and two-color flow cytometry.Results: The numbers and percentages of T-helper cells, T-cytotoxic and NK cells was relatively greater in allergic patients (p<.001 and p<.01 respectively).The percentages of adhesion Molecules, such as CD54 and CD62 on T Cell was increased significantly in patient population (p<.002 and p<.03 respectively). Interesting Allergic subjects exhibited increased B cells were present at significantly lower levels in asthmatics, both in total numbers (p<.04) and percentages (p<.01).Discussion: These results help establish immunological parameters for asthma and Allergic in Iranian populations from Rasool Akram Hospital which will be considered for therapeutic Strategies.

Background: allergic disorders are the most common disorder in many parts of the world. Skin prick test is still a worldwide commonly technique in allergy diagnosis and identifying the allergens. The purpose of this study is to determine the more common allergens using skin prick test.Materials and methods: this study was done from 2003 to 2005. Patients with allergic rhinitis, asthma and atopic dermatitis referred to Allergy Clinic of Vali-e-Asr Hospital of Zanjan City, submitted to skin prick test with a series of indoor, outdoor and food allergens.Results: 111 females and 89 males, 4-60 year of ages were recruited. 83% subjects showed at least one positive skin prick test. The skin prick tests were positive for grass (Rye grass 41%), weed (pigweed 27%, Herb 20%), tree (olive 22%, Ash 20%, butirytis 19.5% ), mites (D.P 16%, D.F 16%), cockroach 14.5%, feather 11%, mold (aspergillus 11.5%, alternaria 7.5%), food (wheat 9%, pepper7.5%, egg 6.5%).Conclusion: pollens are common allergens in our study as the same as similar study in the other part of Iran. The most positive food in skin test was wheat, without any positive history of reaction after ingestion of bread and strong positive skin prick test to grass in these patients, suggest the cross reactivity between grass and wheat.

Rashes in the anogenital and buttock regions are some of the commonest dermatological problems occurring in infancy. The most frequent causes seen in clinical practice are ulcerating haemangiomas, bullous impetigo and severe irritant contact dermatitis. Other causes include nutritional deficiencies, bullous diseases, trauma, Langerhans cell histiocytoses and inflammatory disorders such as pyoderma gangrenosum and Crohn’s disease and primary immunodeficiencies. We present an infant with 6 month age with punched out ulcers in inguinal and buttock regions that was referred for immunodeficiency work up but in our investigations a different diagnosis was made for her.

Introduction: Allergic diseases are common with increasing over the last 30 years; almost 30% of people have a kind of allergic disorders. Mites in house dust are the most important allergens in allergic disorders. The optimal growth conditions for mites are temperature and humidity and the most important sites are inside bedding, mattresses and carpets. The aim of this study is the survey the frequency of Dermatophagoides and their allergens at the homes of allergic patients.Methods: In this descriptive cross-sectional survey which has been performed from 2004 to 2005 in Tabriz and Mashhad cities-two major industrial centers-22 allergic patients with positive skin prick test to mites from each city were selected and all of the methods for evaluation of mites and their allergens (specific antibodies of DerP and DerF, density of mites and concentrations of mite allergens) were measured. Due to high density of mites in carpets and bedding, samplings were obtained from these two sites.Results: The frequency of mites and their allergens in two large provinces of the country are lower compared to studies performed in other parts of the country.The frequency mite density at the homes of allergic patients was %38.2, P=38.2, CI 95%: 24.4-52.1, specific antibody to mite allergens was %25.5, P=25.5, CI 95%: 19.7-31.4 and concentration of HDM allergens which is performed by ELISA, was not detectable. On the other hand, there was positive correlation between severity of the disease and reaction to skin prick test and also severity of skin prick test reaction and mite density.Conclusion: Mites are common in the world, but the incidences of them are various in different parts of the world. The most important factor in frequency and growth of them is environmental humidity, and the other factors such as carpets and bedding have less importance.

Objective: The aim of this study was to determine the Th1 and Th2 serum cytokines, in patients with psoriasis and to compare their cytokine levels with those of normal control subjects.Methods: Serum levels of Interferon-gamma (IFN-γ), Interleukin-2 (IL-2), Interleukin-4 (IL-4), and Interleukin-10 (IL-10) were measured by enzyme linked immunosorbent assay in 40 patients with psoriasis and in 40 normal controls.Results: Compared with control subjects, patients with psoriasis had elevated levels of IFN-γ and IL-2 (P<0.001). In addition, a positive correlation was found between the levels of IFN-γ, IL-2 and disease severity.Conclusion: These results imply that Th1 secreting inflammatory cytokines may contribute to the pathogenesis of psoriasis.

Introduction: Selective IgA deficiency (SIgAD) is commonest primary immunodeficiency and has been associated with allergic diseases, e.g. bronchial asthma. IgE in serum is raised in atopic asthma and IgE abnormality in levels was reported among (SIgAD) population. The aim of the study was to determine IgE levels in serum of SIgAD adult patients with bronchial asthma.Material and method: 74 adult asthmatic patients who were previously identified as SIgAD enrolled and IgE levels in serum were measured by manufactures recommendation with ELISA method.Results: 32 adult asthmatic subjects with high IgE levels>200 IU/ML were found among SIgAD population 43% .The mean age was recorded 28.00±10.22 SD years. The age ranges 15-46 years. The male to female ratio was 1. IgE hypogammaglobulinemia with IgE<10 Iu/ml was detected %0.06 in 5 subjects.Discussion: The significant IgE hypergammaglobulinemia was observed among SIgAD asthmatic patients. It may be due to noticeable, increased prevalence of allergy in SIgAD population. But IgE hypogammaglobulinemia was considerable in study group. IgE abnormality levels in serum were found in asthmatic patients with SIgAD.

INTRODUCTION: Autoimmune processes are marked by the formation of autoantibodies, chronic inflammatory processes, and clinical symptoms which are caused by restriction or loss of function of the corresponding organ. Autoimmune thyroiditis is the most common cause of acquired hypothyroidism. Genetic factors, environmental influences as well as oxidative stress play an essential role in the development of the illness. Reactive oxygen species (ROS) generated during various metabolic and biochemical reactions have multifarious effects that include oxidative damage to DNA leading to various human degenerative and autoimmune diseases. Since increasing amounts of circumstantial evidence within the last few years indicate that autoimmune diseases such as autoimmune thyroiditis are triggered by free radicals, antioxidants may well be considered for the prevention and supportive treatment of such illnesses. The best synergy between antioxidants in nature is found in plant foods, which are rich in micronutrients and phytochemicals. In order to objectify these connections we investigated the influence of micronutrients from fruit and vegetables in addition to standard therapy with L-thyroxine.METHODS: We conducted a randomized, prospective controlled study in 26 patients (age 11-17 years) suffering from autoimmune thyroiditis with hypothyroidism. We divided the patients in 2 groups. Group A (n=14) was treated with L-thyroxine in addition to a encapsulated fruit and vegetable juice powdered concentrate (FVJC) orally. Group B (n=12) was treated only with L-thyroxine. We measured TSH, FT3, FT4, TPO-Ab, TG-Ab, TSH-receptor-Ab, CRP, Malondialdehyde (MDA), Fe, Ferritin, Se, Zi, Cu, and Vitamin D, and assessed all patients clinically before, during and after therapy.RESULTS: In group A we observed clinically a statistically significant improvement of all symptoms (physical and mental performance, intolerance of cold, constipation, hair loss) measured by means of a visual analogue scale (VAS) 4 weeks after therapy , compared to the group B (p<0.01). Parallel to the clinical improvement we measured in group A a statistically significant reduction of TSH and MDA levels in blood (p<0.01) 8 weeks after therapy and a statistically significant decrease of TPO-Ab and TG-Ab 24 weeks after therapy, compared to group B (p<0.05).CONCLUSION: For the first time we were able to show that this approach led to a reduction in oxidative stress (measured with MDA values), to a decrease in the autoantibodies TPO-Ab and TG-Ab, to lower TSH levels, and also to a clear improvement in the clinical symptoms. These results speak for a complex immunological and metabolic process which cannot be positively influenced by the substitution of exogenous thyroid hormones alone. It is definitely conceivable that the micronutrients not only modulate the immune system, but also support metabolism in those human cells which are damaged and destroyed by excessive formation of free radicals in this disease, and result in better utilisation of the thyroid hormones in the cell.

INTRODUCTION: Angioedema is caused by pathologic alterations that occur in the deep dermis and subcutaneous tissue and presents with swelling as the prominent manifestation and the appearance of the skin itself may be normal. The lesions have little or no associated pruritis, and the swelling may be described as painful or burning in nature. Many prescribed drugs can cause it as an adverse effect which in severe forms can be life-threatening. In this report a case of angioedema following the intake of a drug is described.CASE REPORT: This is a case report of a 74-year-old male who was started on Finasteride because of benign prostatic hyperplasia; 2 days later, he presented with perioral swelling. He had no past history of angioedema. He was examined for C1 Inhibitor protein that quantitative level was 639 and functional evaluation was normal.DISCUSSION: Finasteride is a competitive inhibitor of 5 alpha- reductase enzyme, and is used for treatment of benign prostatic hyperplasia and androgenetic alopecia; further evaluation is needed to determine whether angioedema should be added to the list of adverse events associated with finasteride.The recognition of drugs inducing angioedema constitutes a challenge to physicians to be cautious about prescribing such drugs for sensitive patients. Appropriate selection of drugs can prevent severe complications and can be life-saving.

Asthma management is a major concern and many guidelines were developed regarding the management procedure of this debases special Global Initiative Strategy for treatment of asthma (GINA). However, these gridlines is poorly applied in under deployment countries. Therefore in the present study, an attempt has been made to examine the effect of application of GINA guideline on treatment efficacy in asthmatic patients in our country. Thirty-one asthmatic adults were randomly divided into control group (15 patients, male and female) and study group (15 patients, male and female) and were studied for 2 months. Asthma symptom score (SS), asthma severity, frequency of symptoms/week and wheezing were recorded at the beginning (first visit), one month after treatment (second visit) and at the end of the study (third visit). Pulmonary function tests (PFTs) including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximal mid expiratory flow rate (MMEF), peak expiratory flow (PEF), maximal expiratory flow at 75%, 50%, and 25% of the FVC (MEF75, MEF50, and MEF25 respectively) were also measured and the drug regiment of the patients was evaluated at three different visit. All asthma symptoms, frequency of asthma symptoms/week, chest wheezing and pulmonary function test (PFT) values in study group, were significantly lower in second and third visits than first visit (p<0.05 t0 p<0.001). In second and third visits all symptoms in the study group improved and were significantly different from control group (p<0.05 to p<0.001). The usages of drugs in the study group were decreased at the end of the study. The results obtained in the study showed that treatment of asthmatic patients according to GINA guideline can lead to significant improvement in symptoms, severity of the diseases, wheeze, and PFT values.

Objective: One of the major sources of allergic components is fruit. Modern Aechniue and methods has been tried to separate those for diagnostic approach to allergy clinics and also for established experimental allergic models in laboratory and therapeutics goals. Extract of cucumis melo consist “cucumisin” which is a very potent allergen. We decided to use total extracts of cucumis melo for experimental animal model of allergy.Material and Methods: 3 groups of animals (6 Inbred Balb/c mice) were used for this experimental study. The animals administered orally by complete extract of fruit mixed in drink water for 12 hours daily (according to appropriate).Concentration: (1/2, 1/4, 1/8). After 2 weeks with appearance of erythema and pruitus in skin, the animals were scarified with euthanasi technique and then we prepared blood samples for peripheral evaluation of basophilli and serum IgE level measurement. Excise some pieces of duodenum and skin sample for histological determination of tissue eosinophils and basophils and pathological studies Result: we detected great systemic basophile in all of the samples (up to 15%) in blood circulation. Another definds will be present in congress time.Discussions and conclusion: Appearance of systemic and sever basophilli leads us to establish and induction of an experimental allergic model for pharmacological study in allergy. If we can prove the increased serum level of IgE and measurement of skin/intestinal mucosal basophil and audiophile, we deduce and will be successful in our study. Purification and isolation of crude extract to 14, 36, 54 and 67 KD of cucumisin leads us to a more specific Allergic and Experimental model in laboratory investigations.

Allergy is common in children and adults. Rhinitis is a kind of allergic diseases with clinical symptoms such as sneezing, nasal itching and rhinorrhea. Recent investigations have been showed rhinitis effect on function and number of immune cells. In order to elucidate the role of immune system in the disease, T lymphocyte subpopulations in students suffering allergic rhinitis were investigated.Thirty patients with allergic rhinitis and thirty non-allergic and healthy students (control group) were studied. Allergic patients and control group were selected randomly among student girls of Ahwaz University of Medical Sciences residing in accommodation. Blood samples were taken, stained with monoclonal antibodies against CD4 and CD8 surface markers and analyzed by flow cytometry. The percentage of T helper (TCD4+) lymphocytes and T cytotoxic (T CD8+) lymphocytes were determined. The data from two groups were compared and statistically analyzed using SPSS software and t test.The results showed the mean percent of TCD4+ cells increased statistically in test group compared with control group (p<0.013). The mean percentage of TCD8+ cells and CD4/CD8 ratio were not changed significantly in test group in comparison with control group.It seems CD4+ T lymphocytes have a role in allergic rhinitis. More investigations including function of the cells in pathogenesis and treatment of allergic rhinitis are suggested.

Background: Human T lymphocyte Virus (HTLV) is a virus from retroviridae family which is presented as the cause of T cell leukemia, Spastic Paraparesis and tissue Necrotizing lymphadenitis. It is mainly transmitted by contaminated blood products, blood recipients such as Thalassemia, Hemophilia or Hemodialysis patients are at a high risk of infection to this virus. However, immunodeficiency in hemodialysis patients increases this risk. The aim of this study is to survey the seroprevalence of HTLV in hemodialysis patients and blood donors, and to analyze the effectiveness of each risk factor.Material & Methods: In this Descriptive cross-sectional study, first data was collected about demographic features such as age, sex and the frequency of blood transfusion through a year in hemodialysis patients and blood donors (as control group) of Urmia, Iran in 2006. Blood serum was evaluated serologically in both of two groups by enzyme-linked immunosorbent assay (ELISA) for HTLV I /II and finally all collected data was analyzed by descriptive and chi-square tests by means of SPSS software ver11.5.Results: 114 hemodialysis patients and 2046 blood donors was evaluated and there were 65 men (57%) and 49 women (42.9%) in hemodialysis group. Also there were 1910 (93.4%) men and 136 women (6.6%) among healthy blood donors.Mean age of hemodialysis patients was 45 years old. 3 persons of 114 hemodialysis patients were seropositive for HTLV (prevalence of 2.63%), which two of them were female and one was male. Among all blood donors, 1997 persons (97.6%) were seronegative for HTLV and 49 persons (2.4%) were seropositive in ELISA serologic laboratory test and positive cases was confirmed by western blot. Finally in this group, total seroprevalence of HTLV was calculated 0.34%.Discussion: Because we do not perform blood products screening in our region, blood recipients are at a high risk of HTLV infection. More transfusion times and immunodeficiency in hemodialysis patients has increased HTLV incidence in this group. So screening for HTLV in high risk groups suggested in this study.

 Introduction: Toxoplasmosis, a disease caused by the parasite Toxoplasma gondii, is considered as one of the health problems worldwide. Drug therapy can control the Toxoplasma infection, but it cannot eradicate Toxoplasma gondii nor prevent the reactivation of the infection. Vaccination seems to be the most efficacious method to prevent and control the infection. The dense granule antigen 2 (GRA2) has been introduced as a promising vaccine candidate in animal models.Materials and Methods: C57BL/6 mice were immunized with either a recombinant GRA2 (rGRA2) protein, formulated in monophosphoryl lipid (MPL) adjuvant, or a DNA vaccine encoding GRA2 protein. Mice were challenged with cysts of T. gondii and brain cysts were counted one month later.Results: Mice immunized with rGRA2 decreased brain cyst production by 52.6 % (p<0.03) as compared to the control group. In contrast, DNA vaccination with GRA2 failed to protect against the infection following the challenge with cysts of Tehran strain. A significant decrease in the cyst number of reGRA2 protein immunized group (52.6%) compared to control group was observed and indicated the considerable protection induced by reGRA2 protein. The results showed that immunization with pcDNA3.1-GRA2 construct did not induce considerable protection against infection.Discussion: The results showed that vaccination of C57BL/6 mice with the rGRA2 is more protective against chronic T. gondii infection than a GRA2 DNA vaccine. The use of other adjutants and/or combination use of DNA and protein and DNA might improve the protective efficacy of rGRA2 protein.

Background: Over-expression of BCL-2 proto-oncogene has been stated to be involved in solid tumor formation and linked to program cell death pathways. Cell line models indicate that BCL-2 over-expression enhances both tumorigenicite and metastatic potential. To evaluate the BCL-2 protein expression on breast tumor paraffin embedded fixed tissue and sought for association with the BCL-2 protein release in patient serum, the present study was designed.Methods & Materials: Immunohistochemistry method was applied for breast tumor sections on 35 surgically removed patient samples and 35 normal or benign tissue samples. The serums taken from both patient and control group was tested for soluble BCL-2 (BMs244/3 Kit) using ELISA technique. Tumor stage, grade, size, patient menopause, ages, from patient files were utilized to analysis the association between the parameters assayed.Results: The analysis shows that 67.6% of the tumor sections were positive for BCL-2 expression and 32.4% negative. The BCL-2 protein expression in normal/benign section tumor was 57.12% positive and 42.85% negative. The BCL-2 serum levels were 3.6+1.07ng/ml in patient group and 3.23+0.06ng/ml in control group. A weak correlation was found between BCL-2 serum levels and tissue expression of the molecules (r=0.382, P=0.049). a negative association (but not statically significance) was obtained between BCL-2 and low grade stages (r=-0.375, P=0.08). A positive and significant correlation was achieved between BCL-2 and menopause with r=0.523, P=0.005, and also between ages and serum BCL=2 with r=0.488, P=0.011.Conclusion: Although majority of the breast tumor tissue express the BCL-2, the mean BCL-2 serum levels were not significantly difference between the patient control groups. So, the present data would lead us to use the BCL-2 expression in tissue at the level of protein expression or mRNA level, but the using of the serum level would be very limited for clinical propose.

Introduction: Asthma is the most common respiratory disorder to complicate pregnancy and represents a significant public health issue. On many occasions these patients are unable to perform standardized spirometry. The Impulse Oscillometry Technique (IOS) may be suitable in this application since it allows the assessment of airway obstruction by requiring minimum patient cooperation.Aim: Our aim was to identify the relationship between R5, X5, and Resonant Frequency to the 1s forced expiratory volume (FEV1) and forced vital capacity (FVC) in pregnant women.Methods: In 20 asthmatic pregnant patients aged 20-32 yr (mean 26.7 yr) spirometry and impulse oscillometry (Erich Jaeger, Germany) was performed according to standard guidelines and manufacturer’s instructions. Relationships between spirometric indices and total Resistance (R5), central resistance (R20), peripheral reactance (X5) and Resonance Frequency (FRes) were obtained using correlation and regression analysis. Volumes are expressed in litres and resistance in kpa.1.s.Results: Mean ± SD of FEV1 was 2.7±0.4, FVC was 3.4±0.5, FEV1/FVC was 81.11±8.4, R5 was 0.54±0.15, X5 was -0.16±0.14 and FRes was 0.57±0.19. There was significant (p<0.001) correlation between the FEV1 and R5, X5, Z5 and FRes.R5: FEV1=3.73-1.76R5,  R²=0.44; FVC=4.11-1.21R5, R²=0.11X5: FEV1=3.10+1.98X5, R²=0.47; FVC=3.65+1.23X5, R²=0.10FRes: FEV1=3.74-5.13 fres, R²=0.64; FVC=4.28 -4.42 fres, R²=0.26Conclusion: These results suggest that Impulse Oscillometry is a valuable tool to assess airway obstruction as it is simple and requires minimal subject cooperation. This new field of oscillometry application may be particularly useful in patients who are unable to perform spirometry. Further studies are required to determine the sensitivity and specificity of this technique.

Introduction: Hepatitis B virus infection has a higher mortality and is more likely to result in a carrier state in uraemic patients. Although the efficacy of hepatitis B vaccines in patients under chronic hemodialysis treatment has been well documented, the persistence of immunity in this population remains largely unknown.Method: In this study we have followed 141hemodialysis patients up to 3 years after primary hepatitis B vaccination to evaluate the persistence of immunity (as indicated by serum levels of antibody to hepatitis B surface antigen –anti-HBs- higher than or equal to 10 mIU/Mi.Results:85 (60.28%) patients developed anti-HBs levels above 10 mIU/mI after vaccination; the remaining 56(39.71%) vaccines were considered nonresponders and were given a booster dose that again failed to elicit an immunoresponse. After 3 years of follow-up, 21out of 56 (37.5%) responders had no detectable anti-HBs levels in the serum (antibody loss occurring during 1 year in 4cases within 1 and 2 years in 11, and within 2 and 3 years in 6 other cases.Conclusions: When compared with the responders that lost their antibodies during the follow-up period, those who remained immunoreactive 3 years after vaccination was initiated were younger and had higher anti-HBs levels at 8 months of follow-up. Two hepatitis B virus infections were detected among nonresponders during the follow-up period. Based on these data, we conclude that patients undergoing chronic hemodialysis therapy not only have lower response rates to hepatitis B vaccination than healthy adults, but also that these are frequently transient

Introduction & Objectives: The World Health Organization estimates that there are at least 170 million children less than 15 years old deaths directly attributable to the tuberculosis in the world. The aim of the present study was to survey the evaluation of benefits of Tuberculin Test for identification of tuberculosis in the children who were vaccinated with BCG vaccine in the high level.Methods: This study is a cross-sectional descriptive investigation that was performed on children aged 7-11 years old in Tabriz, northwest of Iran, in 2004. Cluster random sampling was used in this study and 1024 cases were participated who received BCG vaccine previously. Tuberculin test was done on the basis of Mantox Skin Test method. The data including age, sex, etc. were gathered through a questionnaire and analyzed using SPSS software system.Results: All the 992 participants were tested by Tuberculin test (3% were not available). In general 88% of the cases were from urban regions and 12% were from rural areas. 80.5% of the cases had postulations due to BCG vaccine that were injected in childhood. 34.3% had no indurations, but 37.5% had ≥ 10 mm indurations, 16.2% had ≥ 15mm indurations.Discussion & Conclusion: Significant difference was observed in indurations diameter of participants (P<0/05). Significant differences were also observed among indurations diameter, age, places of birth, BCG postulation and response to Tuberculation reactions of participants (P<0/0001). Our results in this study showed that Tuberculin Test (Mantox Skin Test) could be a useful method for identification of tuberculosis infections in high risk societies using high level of BCG vaccination.

Background: Presence of antisperm antibodies (ASAs) in infertility and their negative effects on fertility is subject of challenges among researchers. Most of studies show different and controversy results.Methods: Investigating of condition of serumic ASAs (IgG, IgM and IgA) in fertile and infertile people, we applied flow cytometry technique using serum of 29 fertile and 61 infertile men and women.Results: Comparing the mean of different classes of ASAs (IgG, IgM and IgA) in fertile and infertile people showed no meaningful difference. Comparing the serumic ASAs (IgG, IgM and IgA) positive fertile and infertile cases showed no significant and meaningful difference.Conclusion: The results of this survey show that the study of presence of ASAs using the method applied in this study (and similar studies), is not useful in prognostication of the role and effect of ASAs in infertile people. However, regarding with negative effect of many types of ASAs in reduction of rate of fertility, instead of assaying of total ASAs, we recommend the assay of those ASAs witch exert special effects on sperm (including antibodies which damage fertilization, activate the complement cascade, etc.).

Introduction: The Magnesium ions (Mg) have significant effects on respiratory system in asthmatic patients. Improvement of hypomagnesaemia may lead to decreasing rate of hospitalization and morbidity. The aim of the study was to determine the blood serum magnesium value in chronic stable asthma and to compare with general healthy population.Materials and methods: forty-two consecutive and volunteer patients with chronic stable asthma according to the definite criteria, healthy sex and age-matched were recruited. Secondary causes of hypomagnesaemia were ruled out by questionnaire. Serum blood sample was obtained for assignment magnesium value. Normal MG values in serum were1.8 mg/dl and 1.9 mg/dl in males and females, respectively.Results: in the final exam the significant difference was evident between two groups (P<0.001). 40.5% hypomagnesaemia was found in chronic stable asthma. Overall mean age was (40.16±12.8 SD). Mean Mg value was (1.85±0.28 SD). Male to female ratio was 23/19.Discussion: hypomagnesaemia was confirmed in chronic stable asthma in Iranian patients. It may be due to using individual medication in asthma management and/or dietary habits of Iranian should be considered. But further investigation will required.

Objectives: Recurrent spontaneous abortions (RSA) are one of the most painful experiences for couples expecting a child. A significant proportion of these unexplained RSA cases may be caused by immunopathological failure. Therefore immunotherapy have been used to treat women with otherwise unexplained recurrent pregnancy loss.Method & Materials: In a cross sectional study 120 cases of RSA which non-immunopathological reasons were excluded on them underwent a detailed immunological screening protocol including alloimmune and autoimmune examinations. Based upon these parameters, the immunopathological background of RSA was certified or excluded. In patients with immunopathological problems immunotherapy (Aspirin, low molecular weight heparin, Intravenous Immunoglobulin …) depends on their background disorder was applied during their next pregnancy.Results: Overall live births were reported in 79.2% of pregnancies. 83.5% (102) of cases got aspirin, 80.8% (97) LMWH and 65.8% (77) IVIG therapy. In 86.3% ASA, 92.2% LMWH and 80.8% of cases (59/73) IVIG treatment was successful, with the outcome of healthy newborn. A direct relation has been found between number of abortions in previous pregnancies and unsuccessful pregnancy outcome in our study (p value<0.001), also abnormal CD3 and CD4 percentage no IVIG in our course of treatment and failure of pregnancy. (P value<0.001 & 0.05).Conclusion: Results show that immunopathological checkup and immunotherapy are useful treatments for the patients with unexplained RSA. However the success of this method depends on the adherence of the checkup protocol, because unsuccessful therapy of non-clear cases can reduce the efficiency. More high quality clinical trial studies are required in this area.

Background: LAD I is a rare, inherited, autosomal recessive, immunodeficiency disease. Based on the expression degree of CD18, the disease was subdivided into severe (<1% expression of CD18) and moderate (1%-30% expression of CD18) phenotypes. The purpose of this report is to evaluate severe and moderate forms of the disease in the LAD patients.Method: Fifteen patients with LAD type I who were referred to the department of Clinical, Immunology and Allergy in Children Medical Center over the last 14 years were evaluated in the study. A specific questionnaire was completed for them all and laboratory findings included CBC, CD18, CD11 (a, b, c) were reported.Results: Clinical details of 15 patients were reviewed (10 male, 5 female). Patients' ages ranged from 10 months to 14 years (median 4 years).In our study we found seven patients (46.7%) with severe phenotype (four male, three female). Six patients (40%) had moderate phenotype (four male, two female). The occurrence of infection was the most prominent clinical manifestation in the LAD I patients. Five patients (71.4%) with severe phenotype LAD I had a history of delayed umbilical cord separation, but in moderate phenotype three of them (50%) had this symptom. Since diagnosis, six (46.2%) of the LAD I patients had died that four of them had severe and two had moderate phenotypes.Discussion: The more severe phenotype usually results in mortality prior to 2 years of age due to extensive necrotizing bacterial infections. A partial or moderate form of LAD type I has a milder clinical course. Patients with the moderate phenotype are usually diagnosed later in life, pyogenic infections are not as severe as in the classic form and do not typically have delayed umbilical cord separation.

Background: Following the introduction of addressable laser bead immunoassays (ALBIA) into our clinical laboratory, it was noted that certain sera would exhibit reactivity to numerous antigens in the array. To further understand the nature of this reactivity, we analyzed the reactivity of sequential sera that were identified over a one-year period.Methods: Sera that demonstrated reactivity to 6 or more of the 8 antigens in an ALBIA kit (QuantaPlex 8: chromatin, Sm, RNP, Scl-70, ribosomal P protein, SS-A/Ro, SS-B/La, Jo-1) were tested for auto-antibodies by indirect immunofluorescence (IIF) on HEp-2 cell substrates, for IgG, IgM and IgA rheumatoid factor, chromatin and ribosomal P protein by ELISA and by LINE immunoassay (LIA) and immunoblotting (IB).Results: In one calendar year, 40/4096 (0.8%) sera analyzed in a routine clinical laboratory setting demonstrated reactivity to 6 or more antigens in the QuantaPlex 8 kits. There was no common IIF pattern that could be attributed to the polyreactive sera. There was no apparent correlation of polyreactivity with IIF titers, indeed, 4/40 (10%) sera had a negative ANA at the screening dilution of 1/160. When subjected to IB, LIA and ELISA, polyreactivity to three or more antigens was confirmed for 12/40 (30%) of sera while 8/40 (20%) had reactivity to 1-2 antigens and 20 (50%) did not react with any antigens in these assays. Overall agreement of positive or negative tests between the ALBIA and IB, LIA and ELSIA was 75% for chromatin, 50% for SS-A, 27.5% for Sm, 25% for Rib-P, 22.5% for RNP, 20% for Scl-70, 15% for Jo-1 and 7.5% for SS-B. 17/40 (42.5%) had a positive IgM, IgG or IgA rheumatoid factor, and 12/40 (30%) had all three isotype rheumatoid factors.

Introduction and Aims: Local oral immune factors may play a role in the protection against oral diseases and defences against microbial agents. Salivary immunoglobulin A (IgA) is a major factor for the local host defence against caries and periodontal disease. The aims of this study were to determine the concentrations of salivary IgA and IgE levels in breast-fed and formula-fed children at infancy period.Material and Methods: Totally, 80 healthy 5-year children were included in the study. According to the type of feeding at infancy period, the children were divided into two groups. 50 breast-fed and 30 formula-fed in infancy period. One millilitre of saliva was collected from all participants and centrifuged and stored at -70˚C. The salivary IgA and IgE concentrations were measured using of ELISA technique.Results: In breast-fed children the salivary IgA levels (39.6mg/l±17.3) were significantly (p=0.0001) higher than that observed in formula fed-children (26.9mg/l±14). However, the salivary IgE levels were significantly (p=0.047) lower in breast-fed compared with formula-fed children (5.01 IU/ml±19.70vs 11.7IU/ml±39.4).Conclusion: The results indicate that breast feeding enhances salivary IgA levels in the early period of life which may contribute to oral cavity immunity. However, higher levels of salivary IgE levels were observed in formula-fed subjects, which may have a potential role for the development of allergy or inflammatory reactions.

Introduction: IL-8 plays important roles in CNS development, modulation of neuronal survival and excitability. Among IL-8 receptors, only CXCR2 is known to be present in the brain. The ability of individuals in producing IL-8 is partially determined by IL-8 −251 A/T polymorphism. Therefore, the aim of the present study was to investigate the association between IL-8 −251 A/T and CXCR2 +1208 C/T gene polymorphisms and susceptibility to multiple sclerosis (MS).Subjects and Methods: Two hundred and twenty-three MS patients and 319 healthy and ethnic matched controls were included in this study. IL-8 promoter (−251 A/T) and CXCR2 (+1208 C/T) gene polymorphisms were genotyped via allele specific PCR (AS-PCR) method.Results & Discussion: A significant difference was found in IL-8−251 A/T polymorphism between MS patients and controls (p=0.04). This deference was a result of a higher incidence of the low producer allele of IL-8 (T allele) in MS patients compared to controls. The results became more significant when the patients and controls were classified (TT) and (AT + AA) genotypes (p=0.02).we suggest that in initial steps of infection, lower ability in recruitment of immune cells to CNS in IL-8 −251 T allele carriers may lead to slower eradication of viral infection which cause increased damage to CNS. However we hypothesized that individuals with IL-8 −251 TT genotype are more susceptible to MS development because they may not be able to repair neuronal damage as efficiently as IL-8 −251 A allele carriers.  However, no significant association existed between CXCR2 +1208 C/T polymorphism and MS susceptibility or different clinical parameters in patients.Conclusion: In summary, carriers of IL-8 −251 T allele may have increased susceptibility to MS because of their differences in neuron survival or increased chances of viral persistence compared to carriers of A allele.

INTRODUCTION: Asthma is defined as a chronic inflammatory disease of airways that is characterized by increased responsiveness of the tracheobronchial tree to a multiplicity of stimuli.  Asthma is a very common disease with immense social impact. The prevalence of asthma is rising in many parts of the world, but it is unclear whether this is due to an actual increase in incidence or merely to the fact that the size of the overall population is growing. Each year approximately 470000 hospital admissions and 5000 deaths in the USA are attributed to asthma. Hospitalization rates have been highest among blacks and children, and death rates for asthma are consistently highest among blacks aged 15-24 year. So we can detect this disease as a health public problem.METHODS: This was a descriptive analytical study. The research community includes all the 384 patients with asthma the hospitalized customers in Tohid and Beasat medical centers in the city of Sanandaj. Research samples were selected on an easy and objective based method. The data was collected using questionnaires that included of parts. (Personal information-practice-amount of information) and was analayzed using computer tools and chi-square.RESULTS: The findings showed that most of the test subjects were male (%59.9) and (%34) more than 51 years age, (%87) married. Also with (%56) living in city and, (%7) hospitalized for the first time. Data showed that awareness of self-care in asthma as well as accidents for patients suffering from it was good (%14.6) and weak (%74.2). Also they had (%20.8) good practice; mostly (%74.2) had weakness practice. Data showed a significant relationship between some demographic characteristics and the success rate of self care in asthma.CONCLUSION: It is now well established that asthma is a chronic disease that should, in all but its mildest forms, be treated long-term. The scheme outlined herein is based on, but is not a precise copy of the US. Patient teaching is a critical component of care for the patients with asthma. Multiple inhalers, different types of inhalers, anti-allergy therapy, anti-reflux medications, and avoidance measures are all integral for long – term control. Regarding significant statical relationship between personal information with amount of knowledge and practice of subject units, smeltzer 2004 writes: The patient then carries out daily therapy as part of self-care management, with input and guidance by the health care. Periodic assessments and ongoing monitoring of asthma are essential to determine if the goals of therapy are being met. Clinical assessment and patient self–assessment are the primary methods for monitoring asthma. A home visit to assess the environment for allergens may be indicated for the patients with recurrent exacerbations.

Introduction: Cupressus arizonica has been abundantly planted in numerous countries causing a signifiant augmentation of allergy diseases from the middle of winter to the beginning of spring.Objective: The aim of this study was to compare pollen protein content in two major varieties of C.arizonica planted in Tehran, C.arizonica var.arizonica and C.arizonica var.glabra, in order to determine pollen’s specificity of each variety.Materials and Methods: The Pollen grains were directly collected from mature male cones of trees planted in different areas of the city. Pollen’s proteins were extracted in 0.01M PBS (pH 7.4), and were analysed by SDS PAGE. Total protein content of extracts was measured and compared via Bradford assay.Results: Our investigations revealed an appreciable difference in pollen protein contents of each variety and a new major protein, with an approximate molecular weight at about 33 kD has been detected for the first time in both varieties.Discussion:There is some intraspecie specificities in Arizona cypress pollen extracts. The major allergen of Cupresuss Arizonica pollen, Cup a 1 (45 kD), has been reported as the most representative protein in pollen extracts of mediterranean countries, but in our autochtone extracts of both varieties, a protein band at 33 kD was more representative. These observations seem to indicate some relative differences of C.arizonica pollen protein content in the different environmental and climatic conditions of Tehran and mediterranean countries. The confirmation of this aspect would facilitate the preparation of an effective extract improving the diagnosis of the allergy to Cupressus arizonica.

Introduction: Allergy is defined as “untoward physiological events mediated by a variety of different immunologic reaction”. The presences of critical levels of fungal spores in the environment are among them, such as Ulocladium, Cladosporium, and Alternaria which are the major indoor allergens. Other species are: Aspergillus, Fusarium, Rhizopus, Mucor, Penicillium, Phoma, Helminthosporium, Drechslera and Aureobasidium. Mould Allergy can be induced by production of enzyme, toxins or protein and polysaccharide of cell wall. Mould allergy symptoms include: skin rashes, runny nose, watery eyes, itchy nose and throat, coughing, sneezing, asthma, pneumonitis and sinusitis.Method: The pillows for fungal contamination have been examined in the hospitals of U.K and showed that the typical used pillow contains a substantial load of many species of fungi, particularly A.fumigatus (2006). Another report that was a case of acute hypersensivity pneumonitis induced by an oil fan heater.Results: Inhaled fungal spores could cause asthma. Mould allergy was confirmed by use of a purified and standardized extract and SPT, CPT and RAST were performed.Discussion: In 1924 Storm Van Ieewen from Holland suggested that inhaled fungal spores could cause asthma. Between the prevalence of fungal species in the home environment and the prevalence as skin-test allergens of the test was positive for more than 50% of persons who expose with moulds. It is important that know, mould will grow as long as there is moisture, nutrients and suitable temperature for growth. To control mould, one need is to keep the house or building dry and clean.

In this paper, we present data on the prevalence of sinusitis and its relationship to bronchial asthma among asthmatic patients ranging from 2-16 years. Sinusitis was observed in 52 of 71 patients (73/2%) and the maxillary sinus was the most common involved sinus. The most common finding in waters x-ray was mucosal wall thickening greater than 6 mm .38/5% of patients with sinusitis had never symptom or sign of sinusitis. The most common symptom in asthmatic patients with sinusitis was constant purulent nasal discharge. We did not find statistical difference between asthmatic patient with or without sinusitis with regard to severity of asthma and hospital admission p>0.05. We suggest that antibiotic therapy for sinusitis should be given only to asthmatics patients when not response to usual treatment and obvious signs of sinusitis, because the abnormal finding in the waters x-Ray in asthmatic patients may be due of chronic hyperplastic eosinophilic sinusitis (CHS).

Introduction: A growing body of evidence indicates that perinatal factors modulate immune development and thereby may affect childhood asthma risk. In this study, we examined the associations between birth by Cesarean Section (C-section) and atopic disease (asthma) occurrence in children and adults.Methods: Subjects were born in Iran and were over 5 years old during their enrollment in the Children's Medical Center. Our analysis was restricted to 228 children born at or after 37 weeks of gestation with a birth weight of 2500 g or greater based on birth certificate data. Information about sociodemographic factors, reporting physician-diagnosed asthma and other atopic diseases, was obtained by using a self-administered structured questionnaire. Logistic regression models were fitted to compute odds ratios (ORs) and 95% confidence intervals (CIs).Results: The Cesarean section and normal Delivery were 65.78% (i.e., 150 of 228), 34.22 %(78 of 228) in the asthmatic group respectively but were 74.13% (129 of 174) and 25.85% (45 of 174) in the normal health subjects respectively. Children and adults born by C-section were at increased risk for asthma (OR, 1.33; 95% CI, 1.01-1.75) compared with those born vaginally.Conclusion: We conclude that birth by C-section or processes associated with it may increase the risk for asthma disease in children and adults.

Background: Anaphylaxis is a generalized and potentially life-threatening clinical syndrome. We studied recurrences of anaphylaxis carried out in children who referred to Immunology, Asthma and allergy center. (IAARI)Materials & Methods: Children referred to the clinic of allergy with a previous diagnosis of anaphylaxis were considered in this study (2003-2006). A detailed clinical history and the number of attacks were recorded. For all of the patients, skin prick tests and specific IgE measurement were performed for suspected allergens.Results: 39 anaphylactic patients (1m to 13 yrs) were entered in this study. 48/1% of patients were male and 24/1% were female. Causative allergens were determined due to clinical history and laboratory tests. 6 (15%) patients had only one episode of anaphylaxis, 10(25%) patients had two episodes while others (58%) had more episodes of anaphylaxis in their life.Maximum attack number of anaphylaxis was 7 which were due to milk in 4 patients and wheat in 1 patient, also 3 cases of multifactorial food anaphylaxis were identified for the first time. All of them were sensitive to milk, wheat and egg and case 1 and 2 were also sensitive to soya beans.Conclusion: These data remind the physicians of high recurrences of food anaphylaxis and multifactorial food anaphylaxis. Performing prick test and measurement of specific IgE for common food allergens is suggested after stabilizing patients in the first episode of anaphylaxis. Anaphylactic patients should always have epinephrine autoinjector device with themselves.

PURPOSE: To assess the Indication and effect of immunosuppression therapy in Secondary glaucoma patients.SETTING: Immunology and glaucoma Service, Department of Ophthalmology and Visual Sciences, Nickookary University Hospital.METHODS: All consecutive patients with glaucoma secondary to uveitis and inadequate intraocular pressure (IOP) control (IOP >21 mm Hg) under maximum-tolerated medical therapy had immunosuppression. Eleven patients with active uveitis were treated. The etiology of the uveitis was recorded. The ocular variables were IOP, best corrected visual acuity, number of antiglaucoma medications, and complications. Success was defined as an IOP between 6 mm Hg and 21 mm Hg (inclusive) without medication (complete success), or with 1 or more antiglaucoma The mean follow-up was 45.9 ± 11.6 months (range 23 to 56 months).RESULTS: immunosuppression therapy significantly reduced IOP from a mean baseline value of 35.1±7.0 mm Hg (range 23 to 48 mm Hg) to a mean final value of 18.1±4.9 mm Hg (range 12 to 30 mm Hg) (P<.0001). Complete success was achieved in 6 eyes (54.5%) and qualified success, in 10 eyes (90.9%). The mean number of pretreatment and final antiglaucoma medications was 3.4±0.8 (range 2 to 4) and 0.7±1.2 (range 0 to 3), respectively (P =.0004). Complications were minor and included transient hyphema and postoperative IOP spike.CONCLUSION: This preliminary study suggests that immunosuppressant therapy is a safe, effective surgical alternative for treating glaucoma in patients with uveitis.

Background: Mycobacterial tuberculosis is a major cause of mortality and morbidity worldwide. Infection with this bacterium is known to induce the development of autoantibodies and a few of these antibodies are also known to be diagnostic markers for some other diseases. ANCA’S are one of autoantibodies used in clinical setting for diagnosing systemic vasculitic syndrome. More than 20 studies investigating ANCA positivity in diseases other than small vessel vasculitis. This study was undertaken to determine the prevalence of ANCA in pulmonary tuberculosis which could lead to false diagnosis of Wegner’s granulomatosis or vice versa.Material and Method: In a case-control study 32 consecutive smear positive pulmonary TB patients and 32 normal individuals were studied. All cases and controls screened for ANCA by indirect immunoflurecent (IIF) and also MPO and PR3 were tested by ELISA.Results: Perinuclear pattern (P-NACA) was detected in 25% of cases and 6.25% of controls and cytoplasmic pattern (C-NACA) in 3.1% of both cases and controls by IIF assay. ANCA specificities by ELISA in cases revealed that 75% had anti-myleperoxidase and 12.5% had anti-Proteinase 3. In controls 3.12% had anti-MPO and no person had anti – PR3. The positive ANCA significantly correlated with tuberculosis (p value<0.018) and also positive MPO significantly correlated with TB. (p value<0.01)Conclusion: Autoantibodies especially ANCA’S may present in both diseases (Wegner Granulomatosis and Tuberculosis). The presence of autoantibodies in TB patient could have a multifactorial etiology. The presence of human T lymphocytes reactive to heat stress proteins may be an important target of immune response against certain intracellular auto-antigens such as MPO from PMN added to the mechanism of molecular mimicry would explain the association of ANCA and TB.

This study investigated the bio-effects of 50 Hz electromagnetic field exposure on some immunological factors (ACTH, cortisol and glucose levels) in male guinea pigs. The ability of 50 Hz electromagnetic (e.m.) fields to interfere and weaken the endocrine system has been of interest to the scientific community since the human population has become increasingly more exposed. 60 day old guinea pigs, with average weights 350-400 g, were divided into two groups, one the control while the other was exposed to an alternating e.m. field of 50 Hz, intensity 0.207 µT, for 4 hours a day for 5 consecutive days, and weighed before and after the exposure period, and the cortisol and the glucose levels were measured. After 5 days, the animals were anaesthetized and their heart blood withdrawn. The blood serum was monitored for ACTH, cortisol and glucose levels.The results showed that the 50 Hz e.m field acted on the guinea pigs without any significant weight change, but significantly affected the ACTH, cortisol and glucose levels, 33%, 27% and 56% respectively in comparison with the control group. The e.m. field thus appears to able to change the serum levels of ACTH, cortisol and glucose, with the consequence of possible change in endocrinological regulation.

Introduction: Asthma is an inflammatory disease which triggered by a variety factors such as air pollutants. High concentrations of Formaldehyde and polycyclic aromatic hydrocarbons (PAHs) are found in traffic density of ambient air in large cities and may cause respiratory allergic responses in human beings and can be a potential factor in developing occupational asthma as well as exacerbated ever asthma. The PAHs from motor engine are as pro-inflammatory compounds and enhanced IgE responses. The aim of the study was to compare IgE levels in serum between drivers and non-drivers with asthma.Materials and methods: Eighty-five drivers with asthma, as case group, and one hundred-fifthly non-drivers with asthma, as control groups, were sequentially enrolled among outpatient clinic of respiratory disorders. Age, sex matched was performed between groups of study. Asthma diagnosed based on the ATS criteria. IgE antibodies in serum measured according to manufacture recommendation.Results: The mean age in drivers was recorded 47.56±10.41 SD. The mean white blood cells were seen 7809.41±2375.35 SD. The eosinophil proportion was 2.92±2.03 SD. The mean IgE antibodies were 232.60±250.83 SD.The mean age in control groups was 47.90±10.29 SD. The WBC was observed 7648.67±2486.73 SD. The eosinophil proportion was recorded 3.32±2.54 SD. The IgE levels were found 236.34±253.23 SD.The independent samples T test was carried out between IgE variables. P value was greater than 0.05.Discussion: No significant difference was noted between IgE levels in both groups. The result may be under the influence of highly significance of air pollutants in Tehran.

Tumour hypoxia is associated with malignant progression and a poor clinical outcome for patients with avariety of cancers. An important aspect of malignant progression is the ability of tumor cells to evade immune detection and killing. We previously showed that certain adaptive responses of tumor cells to hypoxia, i. e. drug resistance, invasion metastasis, can be inhibited by activating nitric oxide (NO) signaling via administration of low concentrations of NO mimetic agents. Thus the aim of the present study was to determine if exposure of tumor cells to hypoxia renders them less susceptible to killing by NK cells and, if so, whether such effect of hypoxia can be prevented by the NO mimetic glyceryl trinitrate (GTN). A [51Cr]-release assay was used to determine NK activity against tumor cells. Results revealed that pre-incubation of the metastatic DU-145 prostate cancer cell line and the highly NK-sensitive K562 cell line (target cells) in 1% O2 (vs. 20% O2) for 24h resulted in increased resistance to the NK killing activity of fresh or interleukin-2 activated peripheral blob lymphocytes (PBLs). When the hypoxic pre-incubation was performed in the presence of GTN (1nM), the resistance to the NK killing was significantly decreased. These results indicate that tumor hypoxia may contribute to malignant progression by increasing the ability of tumor cells to evade NK activity. The findings also suggest that NO mimetics may be used as potential adjuvants to immunotherapy. (Supported by the "Ride for Dad" Prostate Cancer Fund).

Background: UniCAP is an automatic autoanalyser that can be used for determining total and specific IgE in allergic diseases, and RAST (Radioallergosorbent test) is a classical technique for specific IgE.Objective: The objective of this study was to compare the results obtained from RAST and CAP system in serum patients with Cow's milk allergy.Materials and Methods: The population of this study consisted of 24 patients with cow's milk allergy. All the patients had clear history of anaphylaxis to cow's milk protein. A blood sample was taken from each patient and both RAST (Allergopharma) and UniCAP 100 (Phadia) were performed for determining specific IgE to cow's milk protein (on the basis of KU/L and Grade 0-5). Finally, the results were compared with t test.Results: Our patients were 15 males and 9 females. The values for Cow's milk specific IgE determined by RAST ranged from 0 to 71.00 KU/L (mean =5.85KU/L, Grade= 0-4) and by UniCAP 100 were from 0.25 to 95.40 (mean=18.69KU/L, Grade=0-5). A significant difference (P=0.005) was between mean of specific IgE in methods of RAST and UniCAP 100.Conclusion: It seems that UniCAP is more precise than RAST in determining specific IgE in serum of patients with cow's milk allergy. It can owe solid phase of UniCAP system.

Introduction: Recent studies have proposed a decline in tuberculosis infection is a factor underlying the rising severity and prevalence of atopic disorders in developed countries. There are also conflicting reports on the effect of Bacillus Calmette-Guerin (BCG) vaccination on the subsequent development of atopy and asthma. BCG as the most potent inducer of TH1 is believed to suppress TH2 dependent atopic reaction.Methods: Trying to prove this hypothesis, in a case-control simple sampled 100 patients below the age of 5, who were known case of asthma with variable severity, received 5-unit intra-dermal tuberculin test. The patients were also BCG - vaccinated at birth. As the control group 100 healthy children previously vaccinated at birth, who were age-adjusted with case group, underwent tuberculin test (PPD) as well. After 48 hours, induction area was measured in two vertical and longitudinal diameters. At the same time, the severity of asthma in the case group was determined (according to the classification of National Institutes of Health, National Institutes of Heart, lung and blood), by asking mothers about the frequencies of night and day symptoms or intervals of attacks. The patients were divided into three groups: mild, moderate and severe groups (mild intermittent and mild persistent groups were classified as one).Results: In our case group, mean size of PPD skin test response was 1.7mm±2.99 mm but in the control group mean size was 4.42mm ± 3.69mm (p<0.0001). Also in another test we divided our case group into two groups; PPD skin test less than 5mm and more than 5 mm; again with a significant P value.Conclusion: As a conclusion, patients with definite asthma had a significant weaker response to PPD test. This is indicator of weaker TH1 response in allergic patients, can be proposed that stimulation of TH1- immune system by BCG vaccination at birth can influence subsequent development of allergic diseases dominantly mediated with TH2- Immune system. This may promise a revolution in the future of asthma. Regarding the severity of asthma, no significant evidence supported the relation between severity of asthma and PPD skin test response; it may be explained by dominancy of moderate asthma group.

Background of the study: Chronic Granulomatous Disease (CGD) is a primary immunodeficiency characterized by early onset of recurrent and severe infections. The molecular defects causing CGD are heterogeneous and lead to absence, low expression, or malfunctioning of one of the phagocyte NADPH oxidase components. In this abstract forty-five families, thirteen of which were non-consanguineous, with clinically diagnosed CGD were studied. The method used: Neutrophil functional assays (DHR123, NBT) performed for affected members and their mothers, followed by western blot analysis and mutation screening by SSCP and sequencing.The results obtained: Neutrophil oxidative burst assays revealed mosaic pattern in 10 mothers and western blot analysis revealed gp91 phenotype in their affected sons. Mutation screening in CYBB gene using PCR-SSCP analysis followed by sequencing, showed 8 different mutations including one novel mutation. Western blot analysis for 24 patients whose mother had no mosaic pattern by oxidative burst assays, showed 15 patients with p47º phenotype, among which 9 had delta GT. For the rest of the patients we found 6 patients with p22º phenotype, one patient with p67º phenotype and two patients who expressed all four subunits of NADPH oxidize. Molecular basis of the defects of these patients and the rest of the patients is under study. We also reached to the conclusion that the molecular defects causing CGD are strongly heterogeneous.

Introduction: Propranolol, a beta-adrenergic blocker has been used for the treatment of a large number of cardiovascular diseases. This drug is also an inhibitor of phosphatidic acid (PA) phosphohydrolase and phosphatidic acid biosynthesis. Phosphatidic acid is a growth factor for tumor cells. In addition, the inhibitory effects of Propranolol on the development of a tobacco-induced pulmonary adenocarcinoma and also its cytotoxicity on rat and human lung macrophages and human lung tumor cell line have been reported. The widespread and long-term use of propranolol in lots of heart diseases as well as its cytotoxicity against some tumor cells prompted us to investigate its cytotoxic effect on a human T leukemic cell line (MOLT-4).Materials and Methods: The MOLT-4 cells were cultured in complete RPMI medium and then incubated with different concentrations of Propranolol (0.0004 -0.4mM) for 10 and 20 hours. The cytotoxicity was then assessed by 3-[4,5-dimethyl thiazol-2,5-diphenyltetrazoliumbromide (MTT) reduction and also trypan blue dye exclusion methods.Results: Propranolol induced a significant dose-dependent cytotoxic effect on human MOLT-4 cell line in less than 10 hours compared to untreated control cells.Discussion: The results showed that human T leukemic cell line was dose-dependently-sensitive to Propranolol. Further studies investigating the in vivo effect of Propranolol on leukemic patients and also other leukemic cells are warranted.

Introduction: Sulfur mustard (SM), used as a potential chemical warfare agent, is able to develop asthma disease. A link between allergy and asthma has long been recognized. The atopy is common among adults with asthma. Phenotypic patterns of asthma are expressive of diversity in clinical features between atopic and non-atopic types, such as onset of disease, response to therapy, and type of bronchial hyper-responsiveness. The purpose of the study was to determine prevalence of atopic asthma between SM induced asthma in Iranian veterans, to compare with non-exposed control asthma, and to assess the status atopic markers between groups of the study. The study has not been performed in Iran and other countries yet.Materials and Methods: the protocol comprised a randomized sample of SM induced asthma subjects, male, aged 32 to 67 years , were investigated in case-control study by using a questionnaire, skin-prick test (SPT) for 10 common aeroallergen extracts panel and measurement of total serum IgE antibody levels by ELIZA method. During two stages, the whole 63 subjects as a case were compared with 65 non-exposed control asthma participants.Results: The prevalence of atopic asthma was found 60% and 18% in case and control groups, respectively. A highly significant improvement was noted between SM induced asthma (case) with non-exposed asthma (control) groups according to Pearson Chi-Square test (X<0.001). Age distribution was found among middle-age-adults. Mean total IgE levels and eosinophilia counts were significantly higher among case group and allergic exposed subgroups. Frequencies of SPT to various aeroallergens were notable. Frequencies of Rhinitis 58.7%, and urticaria 27% were significantly higher in allergic exposed subgroup.Conclusion: The study demonstrated the high prevalence of allergic asthma and atopy between SM induced asthma compared to control subjects.

Introduction: CMV continues to be an important cause of mortality and morbidity in HSC recipients. CMV seropositivity has been identified as an important risk factor for the survival of both sibling and unrelated donor HSC recipients. The development of effective T cell immunity is important in the control of CMV infection and disease and depends on a clear understanding of immune reconstitution. There is increasing interest in the role of CD4+ T cells in developing an effective immunity against CMV.Method: We studied CMV-specific CD4+ T cell reconstitution following allogeneic stem cell transplantation in a cohort of 32 patients at risk of CMV reactivation. Patients had been treated with a myloablative or non-myoablative conditioning regimen for hematological malignancies. CMV viremia was monitored by quantitative PCR. CMV-specific CD4 T cells were identified by intracellular cytokine staining before transplantation and every two weeks thereafter. CMV serology of recipient/donor was (+/+) in 53.1%, (+/-) in 34.4% and (-/+) in 12.5%.Results: The reconstitution of CD4+ T cells in the post transplantation period is normally later than CD8+ T cells. Most patients with CMV reactivation had low frequency and number of CMV-specific cells at the time of reactivation and then had increases afterwards. The number of CMV-specific cells did not show such a sharp increase, because of stability of the CD4+T cells. Some patients had a reactivation when there were no detectable CMV-specific CD4+ T cells. The frequency of CMV-specific CD4+ T cells peaked when the viral load was not detectable anymore and then declined afterwards. The number of CMV-specific CD4+ T cells also changed as a variable, but the changes were not sharp and seemed to follow CD4+ T cells recovery.Conclusion: The CMV reactivation seems to happen in the absence or low CMV-specific CD4 response, but a good recovery happens afterward.

Background: Even though cigarette smoking is a known risk factor for many chronic illnesses such as coronary heart and chronic obstructive pulmonary diseases, its effect on the development of asthma is still controversial. Indeed, most studies do not significantly associate asthma with current smoking, although others report an increased risk in former and current smokers compared with nonsmokers The aim of this study was to determine the association between parents’ daily cigarette number and the risk of their children’s asthma.Materials and method: A case control study conducted among asthmatic children who referred to children medical center during 2005-2007. We interviewed 215 patients with physician diagnosed asthma and age under 13 years old. Questions about their parents smoking situation and their daily cigarette number were asked. Patients were matched with 215 healthy children with the same age and sex as control group. Finally data were analyzed by SPSS statistic software.Results: Results showed an increasing rate of smoking in case group and 16.5% of patient’s parents had daily cigarette number of more than 20 versus 7.6% in control group. We found Odds Ratio (OR) =2.38 for parents who had smoked more than 5 cigarettes compared with those who had not smoked or smoked less than 5 cigarettes per day CI: 1.26-4.55 and P=0.0059170.Discussion: Curiously enough, the risk of asthma seems to increase with the number of daily cigarettes in occasional to moderate smokers but to decrease in heavy smokers. Smoking effect of asthma is complex and contradictory. In this study we show that parents’ smoking is an important risk factor for children asthma. It deserves more attention and further studies.

Leukocyte adhesion deficiency (LAD) is a rare autosomal recessive disorder of leukocyte function. These patients usually present with recurrent severe infections, impaired pus formation, and impaired wound healing. Patients with the severe phenotype characteristically have delayed umbilical stump separation (more than 30 days).The reported case was a 3 days old girl, admitting with poor condition and massive bullous and ulcerative skin lesions, progressing to necrotizing and scaling skin lesions .Blood culture was positive for staphylococcus aureus. The neonate responded to broad spectrum antibiotics.Umbilical stump has not separated till 30 days and, in spite of infection treatment, the patients CBC showed hyperleukocytosis. According to these finding, LAD was suspected and with measuring CD11 and CD18 and decreased markers, the case was confirmed.We recommend in neonates with dermal infective lesions together with hyperleukocytosis and stump separation delay, we must consider immune deficiencies, like LAD.

Background: Cesarean delivery modifies infant gut bacterial flora composition which may result in hindered tolerance to allergens, thereby increasing the risk of asthma in accordance with hygiene hypothesis.Objective: To determine the frequency of the cesarean delivery among the asthmatic patients.Method & Material: A cross sectional study was designed and performed between Nov 2003 and Dec 2005 in immunology and allergy department. All the patients who were diagnosed as persistent asthma were enrolled in the study. A questionnaire containing the demographic data; (age, sex) sign and symptom, history of atopy and the route of birth (cesarean section versus normal vaginal delivery) were filled out for each patient.Result: among 270 asthmatic patients who are studied, there was 163 male (60.4%), 107 female (%39.6).The mean ±SD age was 83.33±42.19 months .The mean ±SD age for the boys was 78.2±40.76 and the mean ±SD age for the girls was 91.15±43.33 months. 150 of them (55.6%) were products of a cesarean delivery and the birth in 120 of them (44.4%) was normal vaginal delivery. The rate of birth by cesarean route among the girls with asthma was 66.6% compared with 50.3% in male asthmatics.Discussion: several characteristics of pregnancy including cesarean section have already been reported to influence the like hood of developing childhood asthma. Results of previous studies regarding an association between birth route and asthma are conflicting. The prevalence of the cesarean section in this asthmatic population was about 55.6%. In comparison with total population in which the rate of cesarean section is also elevated (>40% according to an unpublished data) this difference was meaningful (p<0.001).We found an association between cesarean as a rout of birth and asthma development. The small sample size and the confounding factors limit the interpretation and larger studies are required to confirm these findings.

INTRODUCTION: it has been recently documented that smoking is the important causative agent of obstructive pulmonary disease. That is why we decided to do a research in this field. For evaluation of respiratory tract function or pulmonary difficulties we used ST-NBT and SP- NBT and total IgE tests in test or control groups.METHOD & MATERIALS: In this study the test group was composed of 43 non-smoking bakers with the middle age of 40.5 years old (duration of baking bread varied 8 to 18 years). The control group consisted of 31 non-smoking asthmatic patients with middle age of 37.26 years old and twenty healthy non-smoking females with middle age of 36.8 without secondary infection.RESULTS: In this study there were significant differences in total IgE levels between test and control groups (p=0.05). There were no significant differences in SP-NBT test between test and control groups. But there were significant differences in ST-NBT test between bakers and asthmatic and normal function individuals.Discussion: Smoke as a stimulator induces difficulties in immune responses and normal function of respiratory tract. There will be some recommendations for smokers and bakers

Background: Nasal polyposis (NP) is a chronic inflammatory disorder of the upper respiratory tract, which often coexists with asthma. Eosinophils which are found in large number in nasal polyps and asthmatic airways are considered to have a crucial role in pathogenesis of nasal polyps and asthma.Objective: The aim of this retrospective study was to determine whether prevalence of asthma and serum eosinophilia in patients with nasal polyps is higher than control group (patients with no associated respiratory diseases).Methods: 238 patients who had undergone nasal polyp surgery during a five-year period, were retrospectively studied (M=171, F=67, age range: 5-79 yr, mean age: 38 yr). The control group included 200 patients with cholesteatoma. Age and sex were matched in both groups. The diagnosis of asthma was based on a documented physician diagnosis. The other data such as nasal symptoms, intolerance to aspirin, previous polyp surgery and measuring serum eosinophilia were evaluated.Results: In NP group 18.7% were asthmatic and 81.3% non asthmatic. (In comparison with control group, 4% were asthmatic and 96% non asthmatic).Values of asthma and serum eosinophilia in NP patients were significantly higher (p=0.005 and p=0.045, respectively) than control group.Conclusion: We have demonstrated a greater degree of asthma and serum eosinophilia in NP patients compared with control group. This would suggest that eosinophils may have a key role in pathogenesis of these diseases.

Hyper IgE syndrome with recurrent infections is a rare immunodeficiency characterized by recurrent skin infection and pulmonary abcess and extremely elevated levels of IgE in serum, associated facial and skeletal features have been recognized. Their frequency and genetic basis are poorly understood. The patient is a seven-year old girl presented with two year-history of productive cough, super infected facial eczema from infancy and two prior hospitalizations for pneumonia and perianal abcess. She had coarse face, crackles on both lungs, clubbing of fingers, laxicity of elbow joints. Immunological work up revealed eosinophilia and markedly raised IgE levels. In view of the clinical features and other finding diagnosis of hyper IgE syndrome was suggested. Chest X-ray revealed multiple large cystic lesions in left total lung which confirmed by spiral CT-scan. Left thoracotomy and pneumanectomy was done and removed severe adhesions. Histological report revealed cystic adenomatoid transformation. CAT is characterized by the presence of variously sized cysts lined by epithelium. Probably, this is the first report of CAT in a child with hyper IgE syndrome due to repeated infections. Early diagnosis and prophylactic antibiotic therapy is effective in management of these patients.

Background: BCL-2 is an anti-apoptotic marker. The aim of the present study was to assess the serum level of BCL-2 in confirmed GI cancer patient, and compare the result with the two known tumor markers (i.e. CEA and CA19-9) in both case and control groups.M&M: The groups including colon and gastric cancer patients and healthy matched individuals were undertaken. The peripheral blood was taken from GI cancer patient before operation, their sera were isolated, and the molecules markers were assessed using ELISA technique.Results: The mean ± Std serum concentrations of BCL-2 was determined 8.48 ± 5.5ug/ml in gastric, 5.80±2.22 g/ml in colon, and 3.76±1.38mg/ml in control groups. CEA was 54.47±23g/l, 52.95±22.5 g/l and 3.6±1.7 g/l in gastric, colon and healthy group respectively.CA19-9 was calculated 88.6± 96 U/ml, 79.47±0.95 U/ml and 14.6±9 /ml with above ordered, respectively. Correlation analysis indicates that the serum levels of these molecule markers are independent from each other (P>0.5).Conclusion: While CEA and CA19-9 increased up to several folds in both gastric and colon cancer and indicated the status of malignancy in majority of cases, the alteration in BCL-2 serum levels could not be helpful to monitoring the patients. So our data did not support the Giannoulis et al (2004) and similar conclusion performance.

Background: Allergic rhinitis is the most common cause of rhinitis affecting approximately 20% of the population. While allergic rhinitis is not a life-thereatening condition, complications can occur and the condition can significantly impair quality of life, which leads to a number of indirect costs. In susceptible individuals, exposure to certain proteins leads to allergic sensitization, which is characterized by the production of specific IgE directed against these proteins. This specific IgE can be tracked with Standard Skin Prick Test.Methods and Materials : During 1 year of study, 334 cases of allergic disorders referred to our allergy clininc, among them 295 were allergic thrinitis. Standard Skin Prick Test with ALUSTAL prick allergens, aero-allergens and food allergens, were performed for all of them and compared with negative and positive standard control. Wheals of 3-mm and flares of 10-mm larger than negative control regarded as positive test. Results were analyzed with SPSS 11.5 and prevalence of allergens was calculated in different groups of patiets in regard to age. Sex and type of allergic rhinitis (perennial or seasonal)Result : 150 males with mean age of 25.6 years (SD : 14.31) and 145 females with mean age of 28.32 (SD: 12.93) were studied among them 85 patients (30%) had seasonal Allergic Rhinitis (SAR) , 117 patients (41.3 %) had perennial Allergic Rhinitis (PAR), 65 patient (23%) had PAR with seasonal aggravation and 16 patients (5.7%) had only episodic symptoms.116 patients had less than 5 years, 117 patients had 5-10 years and 102 patients had more than 10 years history of rhinitis.Aerpallergen sensitization were detected in 256 (86.5%) of patients and botanical allergens' sensitization were shown to be present in 225 (76%) of patients.Chenopodiacea including Chenopodium alba and Rough pigweed, trees especially ash, platanus, willow and birch, 12 grasses including artemisia, rye-grass and timothy were among the most prevalent botanical allergens.Conclusion: Allergic Rhinitis is the most prevalent allergies which cause signs and symptoms in genetically susceptible patients confronting environmental allergens. In our study, Aerpallergens were studied. As in our studies, Aerpallergens especially botanical Allergens were shown to be the most commom Allergens both in Seasonal and Allergic Rhinitis with 86.5% senssetive to one or more Aerpallergens and 76% sensitive to one or more botanical allergens. We can prevent this illness by this research's results as know the most revalent allergens and avoid contacting those materials. 

Hepatitis C virus (HCV) infection has been associated with a plethora of immune and autoimmune perturbations. A variety of conditions ranging from endocrinopathies to different skin autoimmune disorders with HCV infection has been reported in the literature. Some data accessible so far are controversial. The aim of this study was to investigate the prevalence and clinical significance of HCV infection in a few skin autoimmune diseases known to be related with HCV infection including vitiligo, alopecia areata and psoriasis.Serum samples from 150 patients with a variety of skin autoimmune diseases (65 with vitiligo, 45 with alopecia areata and 40 with psoriasis) were studied and compared with normal controls. Third generation ELISA test was used for detection of antibodies to HCV in human sera and anti-HCV seropositivity was confirmed by recombinant immunoblot assay (RIBA).All patients with alopecia areata, psoriasis and normal controls were anti-HCV negative, whereas anti-HCV antibody was present in 1 patient with vitiligo confirmed by Western blotting. Fisher’s exact test was used to compare relative frequencies. These results indicate that there was no significant difference of anti-HCV antibodies between patients and controls.In this study no relationship was found between vitiligo, alopecia areata and psoriasis with HCV infection, which implies that hepatitis C virus does not play a  direct causal role in the pathogenesis of these autoimmune disorders; however, this does not rule out a ‘hit and run’ virus induced diseases.

There are conflicting ideas about the inverse relationship between delayed type hypersensitivity reaction of BCG and atopic state. Stronger response to PPD test as an indicator of more potent TH1 response is supposed to influence TH2-modulated allergic reactions, but it is still doubtful whether scar of BCG vaccine can also be supposed as an indicator of TH1-immune response or not. In our previous study PPD test response was significantly smaller in asthmatic patients, now in this study the relationship between BCG scar and asthma is investigated.Methods: 100 patients younger than 5 years old, vaccinated at birth, with variable severity of asthma were compared to the same number of age-adjusted healthy control group in a case-control study. Mean of vertical and longitudinal diameter was determined. At the same time, the severity of asthma in the case group was evaluated (according to classification of national institutes of health, national institutes of heart lung and blood), by asking mothers about the frequencies of night and day symptoms or intervals of attacks. The patients were divided to three groups: Mild, Moderate and Severe groups (Mild intermittent and mild persistent groups were classified as one).Result: In 97 case group the mean size of BCG scar was 4.93mm±1.89mm, again in 97 control group the mean size was 4.94mm±1.46mm (P=0.949).Conclusion: contrary to the result of our previous research which showed a significant reverse relation between PPD-skin test response and asthma, but no significant relation was found between BCG scar and asthma, which suggests that BCG-scar is not a good indicator of TH1 response and is probably related to other mechanism such as wound healing.

Introduction: HLA system or major histocomatibility system is one of the impotent factors in appearing many inflammatory diseases.Ankylosing Spondylitis is an inflammatory spinal column diseases which according to survey in Iran 62.8% of this patients are HLA-B*27 positive. HLA-B*27 has different subtypes and for this reason these subtypes are very different in various races and important connection with diseases (side effects of Ankylosing Spondylitis). the detection of its subtypes in society is sectional that for first time is about to perform in Iran.Objective: The detection of HLA-B*27 subtypes abundance in HLA-B*27 positive in Iranian patients with Ankylosing Spondylitis.Method: We collect blood samples of 152 patients with Ankylosing Spondylitis and after screening for determining the HLA-B*27 positive samples with SSP-PCR method, and we separate 87HLA-B*27 positive patients and then we determine the HLA-B*27 subtypes.Conclusion: Iranian AS patients have only 2 subtypes (HLA-B*2705, HLA-B*2702) of HLA-B*27 among 32 different subtypes.Discussion: With determining and recognition of HLA-B*27 subtypes physicians can predict the side effects of this disease such as uveitis, IBD and …

The prevalence of respiratory allergic disorders such as allergic rhinitis and asthma has increased markedly over the last few decades all over the world. Air pollution arising from motor vehicles, industrial sources and also from indoor sources such as that emitted during cooking has been implicated to be one of the most important causes for this sudden and sharp rise in allergic disorders. Epidemiological studies have shown a consistent and significant association between ambient levels of various air pollutants, in particular, oxides of nitrogen, oxides of sulphur, ozone and particulate matter, and prevalence of allergic rhinitis and asthma both in children and adults, both in prospective and cross-sectional studies. Exposure chamber studies of human volunteers exposed to various air pollutants have revealed increased prevalence of respiratory symptoms and decrements in lung function even during short periods of exposure. Biopsy studies from the nose and bronchial tissue following exposure to diesel exhaust and other pollutants have shown significant increase in ability to generate allergen-specific IgE, increased production of various pro-inflammatory mediators such as histamine, fibronectin, and increased production of various cytokines including IL-8, GRO-alpha, GM-CSF and TNF-alpha. This is associated with increased expression of capillary adhesion molecules such as ICAM-1 and VCAM-1 and increased cell numbers of mast cells, neutrophils and eosinophils. The airway epithelium is the major cellular sources of these inflammatory mediators. Air pollutants generate reactive oxygen species that drive the molecular machinery inside the cells to generate allergic inflammatory responses.

Introduction: In order to explore the role of this immune inhibitory gene in SSc development, in the present study, the polymorphisms in the CTLA-4 promoter region (-1722 T/C, -1661 A/G and -318 C/T) were investigated.Subjects and Methods: -1722 T/C, -1661 A/G and -318 C/T polymorphisms were genotyped using Polymerase Chain Reaction with Confronting Two-Pair Primers(PCR-CTPP), Restriction Fragment Length Polymorphism (PCR-RFLP) and Amplification Refractory Mutation System (PCR-ARMS) methods, respectively, in 83 SSc patients and 166 healthy controls.Results: All genotypes and allele frequencies in patients were significantly different from the control group (P=0.022 for -1722 T/C, P=0.03 for -1661 A/G and P=0.014 for -318 C/T genotypes). The -1722C, -1661G and -318T alleles contributed to SSc with P=0.012, odds ratio (OR) 2.16, P=0.031, OR 1.82 and P=0.023, OR 2.45, respectively. A significant difference was observed in the frequency homozygous ‘genotype combination’ -1722TT/ -1661AA/-318CC of these three polymorphisms (Pc=0.003). The frequency of this genotype combination was significantly higher in the control group than in patients.Discussion: Statistical analyses indicate increased heterozygous genotypes and mutant alleles in SSc patients, from one side, and increased wild-type homozygous genotypes and wild type alleles in controls subjects, from the other side. In addition, the wild-type homozygous ‘genotype combination’ of these three loci occurred more frequently in the control group than in SSc patients (Pc=0.003).Conclusion: Results of this investigation indicate that -1722C, -1661G and -318T alleles of CTLA-4 gene promoter appear to be associated with SSc, and individuals carrying these alleles may be more susceptible to this disease.

INTRODUCTION: Atopic dermatitis (AD) is a kind of dermatosis typically found among children. The major symptom is itching, which may vary in intensity. The disease presents a chronic course; intensity, and discomfort of symptoms cause serious implications in the life of patients and their families.The incidence of such atopy has been increasing over the last decades, especially in industrialized countries, maybe due to external factors, which foster lesions severity and consequently bring some difficulties to adaptation to school, social and family life.CASE REPORT: A seven-month-old girl was referred to Department of Immunology, Asthma and Allergy of Children Medical Center, Tehran University of Medical Sciences. She had severe atopic dermatitis. Her skin lesions were infected with Herpes (Eczema herpeticum). Her SCORAD was 72.2 at the time of arrival and her Staphyloccocus Aureus culture was positive. She was treated with Acyclovir, cephalexin and hydroxyzine. After 2 weeks without any change in treatment and environmental factors she feels better, her Staphyloccocus Aureus culture became negative, her symptoms and signs had decreased dramatically; her SCORAD was 50.7 then.DISCUSSION: Atopic dermatitis (AD) patients are prone to secondary infections with organisms such as Herpes simplex virus and staphylococcus aureus; therefore any change in appearance of skin lesions should arouse the suspicion of the probable infection. Early treatment with antibiotics can prevent severe complication. It is recommended that all Atopic Dermatitis patients be considered for Staphyloccocus Aureus culture, Staphyloccocus Aureus Antibody evaluation and prophylactic antistaphyloccocal treatment especially in severe cases.

Pressurized metered dose inhalers (PMDI) are the cornerstone of treatment patients with asthma and COPD. However, their usage is reportedly suboptimal in patients and data for the Iranian patients is not available.Objective: To determine correct or incorrect use of PMDI by patients and related factors.Method: PMDI use by 360 consecutive adult patients was observed and marked on a checklist, and data about possible associated factors have been obtained through questionnaires.Results: From direct observation, only 15 patients (4.2%) correctly inhaled PMDI in all steps. 88.4% of patients had incorrect use in at least 3 steps of the PMDI use. 11.7%, 45.8%, 42.5% of the patients performed correctly the 6-8, 3-5, and 0-2 steps of the use of PMDI, respectively. Factors that were positively associated with the correct use were educational level, duration of use of PMDI, and numbers of hospitalizations.Conclusion: PMDI usage is more suboptimal in Iranian patients than western countries. Further interventions are required to improve PMDI usage, and import of other forms of inhalers which need less coordination and are easier than PMDI for application.

Studies have reported that overuse of beta-agonists is associated with increased death or near death episodes from asthma. This is a major concern for some patients with asthma who rely on short-acting beta-agonists as a "quick fix" for their asthma, so it is helpful to monitor the frequency of inhaled beta-agonist use.Adverse effects of frequently administered beta-agonist therapy include: tremor, irritability, arrhythmia, tachycardia, and hypokalemia, and CNS irritability. Patients requiring frequent or continuous nebulized beta-agonist therapy should have continuous cardiac monitoring, because frequent use can cause ventilation-perfusion mismatch and precipitate hypoxemia (oximetry is indicated).Adrenergic agents should be administered with caution in elderly patients and those with cardiac disease.IPROTROPIUM BROMIDE, is available in both MDI and nebulizable formulations, it is widely used in children with asthma and it is approved by u.s. food and drug administration (FDA) in children >12 years of age.Side effects: dry mouth, dizziness, blurred vision, urinary retention, nervousness.CORTICOSTEROIDS: oral or inhaled in high dose may develop suppression of the hypothalamic-pituitary adrenal axis with adrenal insufficiency. Side effects: hoarsness candidiasis in oropharynx or larynx, cataracts, psychiatric disturbances, osteoporosis, delayed growth. Systemic corticosteroid effects as hypercorticism and adrenal suppression, cushings syndrome, muscular atrophy, hypertension, glucoma, aseptic bone necrosis, pancreatitis, GI-bleeding, cerebral pseudotumor, CHF, convulsions.SALBUTAMOL OR ALBUTEROL: side effects: tremor, heart palpitation, muscle cramps, psychotic reaction.SALMETEROL (serevent): side effects: HBP, arrhythmia, liver dysfunction and damage, chest pain, worsening of bronchospasm, anaphylaxis, hypokalemia, heart complications.THEOPHYLINE: Side effects: nausea, vomiting, abdominal pain, tachycardia, palpitations, tremor, GER, arrhythmias, convulsion MONTELUKAST (singulair): side effects: headache, abd-pain, rash, dizziness, diarrhea, cough.COROMOLYN SODIOM: side effects: hoarseness, coughing, burning and stinging.CONCLUSIONS: the drugs that we choose for asthmatic patients should be appropriate with less price and without complications.

Introduction: chronic urticaria is the most common cutaneous disorder seen in outpatient allergy clinics. There are a few reports associating house dust mite sensitivity with chronic urticaria. This study investigates the possible association between house dust mite sensitivity and chronic urticaria.Methods: In this study four groups of patients were enrolled. Group I: Chronic urticaria (35 subjects). Group II: allergic rhinitis (135 subjects). Group III: asthmatic patients (14 subjects).Group 4: allergic rhinitis +asthma (12 subjects). Group II, III and IV considered as positive controls. All the patients underwent skin prick testing with antigens of the house dust mite, Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF), with positive and negative controls.Results: In Group I, 13/35 (37.1%); in group II 64/135 (47.4%); in group III 5/14(35.7%) and in group IV 4/12 (33.3%) patients had skin sensitivity to house dust mites .There were no statistical differences between prevalence of positive  skin test to mite in four groups.Conclusion: we suggest a possible association of house dust mite sensitivity with chronic urticaria.

Background: Atopic Dermatitis (AD) is a common skin disorder affecting 12-15% of all children in early childhood. Prevalence of AD is reported to have increased over the 3 decades. The impact is not limited to the child but extends to the entire family.Method: Parents of 40 infants and children with AD (based on Hanifin & Rajka) and 40 infants or children without any chronic disease participated in this study and a physician filled Family Dermatitis Index (FDI) questionnaire for them via face to face interview. The mean total score of each questionnaire in cases and controls were compared by t-test and correlate with severity of AD.Results: The mean diagnose age of AD was 1.57±0.53 years (4 months to 4 years) and the mean±SD score for FDI was 13.17±4.49. For the control group, the mean age of their children was 2.68±1.32 years and the mean±SD score for the FDI was 1.05±1.19. The difference between the mean of FDI in control and patients groups was also significantly different (p<0.001). The correlation between the FDI with severity of AD was significant.Conclusion: AD is a common skin disease that places a large burden on patients, their families, and the society. We can detect the severity of AD directly related to the high impact of AD on their parent̉ s lives. It should be suggested that education and psychosocial support for targeting parents and caregivers that may decrease family and personal burden and improve the long-term physical outcomes.

Aspergillus fumigatus, a widely distributed sport-bearing fungus, causes multiple diseases in human beings, which include mycotoxicesis, allergic reactions and systemic diseases (invasive aspergillusis) with high mortality rates. Systemic aspergillosis occurs primarily in who have immunodeficiency or immunocompromised, patient with chronic granulomatous, neutropenia, who underline corticosteroid treatments and …. The prevalence of allergic bornchopulmonary aspergillosis (ABPA) has been estimated to be around 1-2% in asthmatics; 0-25% amount patient’s with cystic fibrosis, (CF) even 60% in atopy cystic fibrosis patients has been reported. Attention to high rate of ABPA in CF patients, diagnosis of this allergy, and addling antifungal treatment to protocol of CF patient therapy will be useful to improve the patients.Method: Many studies have been done among children with cystic fibrosis (CF). Skin test, chest radiographs, evolution of purified recombinant allergens from A. Fumigatus, namely Aspf1, f2, f3, f4, and f6 by using ELISA and a Semi-Automated method (ImmunoCAP).Results: Level of specific IgE to A.fumigatus is high in 34% of patients with CF, and significantly level of specific IgE to ASP f2, f4, f6 is higher in CF patients with ABPA than non ABPA.Conclusion: More than 18 Antigen/Allergen of A. fumigatus have been identified. Recent studies have demonstrated that patients with ABPA react to a larger number of the recombinant allergens, but level of IgE specific Asp f2, f4 and f6 are higher than other allergens in sera of these patients. Therefore, these intracellular proteins may be regarded specific marks for ABPA.

Education and prevention are the most important aspects of the management of anaphylaxis, the most deadly of all allergic diseases. Although anaphylactic reactions are rarely anticipated and are unavoidable in the practice of medicine, general and specific preventive measures can decrease the incidence and severity of the reactions.In patients predisposed to anaphylactic episodes, a thorough history for the identification of precipitants, supplemented by serum IgE- specific testing (RAST and immune CAP) or skin tests is necessary. Whenever possible, if the history suggests a reaction to a specific agent, a substitute, non- crossreactive one should be administered. Oral administration of drugs is less probable to produce a severe reaction than the parenteral route. Every patient should remain a minimum of 20-30 minutes in office if receives an injection, and 2 hours if the drug is administered orally for the first time. Patients who have experienced an anaphylactic reaction are at greatest risk to suffer another episode. Such individuals should wear a Medic- Alert bracelet and should keep an identification card in their wallet or purse. Such patients and their families should be instructed to carry an autoinjectable epinephrine (EpiPen) and renew the prescription when the expiration date is reached. In addition, they should have an individualized action plan. Avoidance of b-blockers, ACE inhibitors and MAO inhibitors is recommended. Prophylactic use of corticosteroids and H1& H2 receptor antihistamines may be beneficial in recurrent idiopathic anaphylaxis.Avoidance of the provocative agent (food, antibiotic, aspirin, latex …), desensitization (when an antibiotic critically needed), immunotherapy (insect venom), pretreatment (radiocontrast media) and laboratory tests (skin tests, RAST …) are different therapeutic and diagnostic considerations for prophylaxis of specific anaphylactic syndromes. Therefore prevention and education are of paramount importance in the management of the patient at risk for anaphylaxis.