Iranian Journal of Allergy, Asthma and Immunology
Volume:2 Issue: 2, Jun 2003

Multi drug resistance(MDR) is a major problem in the treatment of cancer and hemalological malignancies. This resistance is multi factorial and is the result of decreased intra cellular drug accumulation. This is partly due to the presence of a 170KD intra membranous protein termed P-glycoprotein(P-gp) that is an energy-dependent efflux pump which has increased expression on drug-resistance cells. In this study we identified the presence of P-gp by staining with Fluorescent Iso Thio Cyanate (FITC) conjugated anti P-gp in acute leukemia patients and flow cytometry in addition to performing immunophenotype analysis and French, American British (FAB) classification. Results revealed that one fifth of leuke mic patients expressed P-gp and this phenotype was more prevalent in Acute Undifferentiated Leukemia(AUL) and Acute Myelogenous Leukemia (AML) than in Acute Lymphoblastic Leukemia(ALL). Other findings showed a logical rela tionship between this phenotype and age groups. There was not any association between P-gp+ phenotype and FAB and Immunophenotyping sub classification, but there was a linear relationship between CD34 and CD7 expression and P-gp+ phenotype. The accumulation of P-gp molecule that was stated as Mean Fluores cence Intensity (MFI) on the blasts1 membrane of AUL and AML patients showed marked increase in comparison to ALL. Furthermore MFI in P-gp+ relapsed patients was much more than P-gp+ pretreatment patients.

Asthma management is a major concern because some asthmatic patients either do not respond or else hardly respond to treatment. Therefore in the present study, an attempt has been made to determine the predictors of treatment response in asthmatic patients.Thirty six asthmatic adults including 13 male and 23 female were studied dur ing a 3 month treatment period. Asthma symptom score (SS) and wheezing were recorded before and after treatment. Pulmonary function tests (PFTs) including forced vital capacity (FVC), forced expiratory volume in one second (FEVj), peak expiratory flow (PEF), maximal expiratory measured at the beginning and the end of the study. The increase in PFT values 10 min after 200 ug inhaled salbutamol (in percentage) was considered as reversibility in airway constriction.There were significant improvements in SS (/JKO.001) and PFT variables (/;><0.05 topO.001) except of MEF2S due to 3 months treatment. However, the reversibility of airway constriction improved after treatment but these improve ments were not statistically significant except that of PEF (p<0.05). There were significant correlations between both baseline symptom score and wheeze with an improvement seen in these two parameters (p<0.05 to p(0.001). There were also significant correlations between reversibility in FEV, with improvement in FEV and MEF25 aftet treatment and between reversibility in PEF and improve ment in FEV, at end of the study Q]<0.Q5 to/KO.001).The results of these study showed that a well conducted therapeutic program could lead to improvement in symptoms, wheeze, and PFT values. In addition symptom score, wheeze, and reversibility in FEV1 and PEF could be good indi cators of response to treatment in asthma.

Primary complement deficiencies are rare and two related patients are reported here. The first patient is a 41- year- old man with eighteen episodes of pneumo coccal meningitis and other purulent infections. The serum C3 level was checked at three separate times, showing that this was a primary C3 deficient case; other immunological tests were however normal. This patient now takes prophylactic antibiotics and the meningitis has not recurred, but he does have glomerulone phritis. The second case is a 40 - year-old woman with repeated episodes of orofacial and laryngeal edema and dyspnea. The serum C1INH levels were 4.3 to 7 mg/dL which were very low compared with normal healthy subjects (C,INH was 40-50 mg/dL in ten normal controls) and C4 was lower than normal but other immunological tests were normal. Other causes of angioedema such as lymphoproliferative disorders were excluded. She had hereditary angioedema with out a family background. The condition may be due to genetic mutation. The angioedema was controlled with Danazol and Stanasol. As our patients are re lated, this may suggest a genetic relationship between these two disorders.

One of the most prevalent manifestations of primary antibody deficiencies is gastrointestinal disorders.In this study we reviewed 83 patients including 25 with X-Linked agamma globulinemia. 40 with common variable immunodeficiency, 14 with IgA defi ciency and 4 with IgG subclass deficiency. The mean age of patients was 10 year (l-28yr). The ratio of male to female was 1.5.Gastrointestinal system was affected in more than half (57.8%) of them. The most common symptom was diarrhea (56.6%o) and the most prevalent pathogen was. G. Lamblia.Other disorders were chronic active hepatitis in 6 patients, ulcerative colitis in 2, small intestinal villus atrophy in 5, nodular lymphoid hyperplasia of small in testine in 3 and chronic gastritis in 4 patients. One patient suffered from abdomi nal lymphoma.We found a direct correlation between failure of patients to thrive and the duration of the delay in diagnosing the underlying disease. This difference was more apparent in those with both antibody deficiency and gastrointestinal involve ment.

Epstein barr virus (EBV) is one of seven known herpes virus pathogenic for humans.Since it is ubiquitous, it infects nearly 95% of individuals worldwide by adulthood. EBV is the etiologic agent of infectious mononucleosis(IM)and is implicated in burkitt lymphoma,nasopharyngeal carcinoma and x-linked lymphoproliferative syndrome.Diagnosis of IM based upon clinical manifesta tions in conjunction with hematologic evidence for lymphocytosis;and serologi cal changes such as heterophil antibody and or antibodies to EBV specific pro teins.The purpose of this study was to determine the frequency of acute and chronic infections by examining the levels of antibodies against viral capsid (VCA-IgG and VCA-IgM) and Epstein Barr nuclear antibody (EBNA-IgG) in the serum of children with IM syndrome (patient group) and the serum of unaffected children (control group). This longitudinal case-control study was performed on thirty one children between 1 to 14 years old who were admitted to the pediatric ward of Rasool Akram hospital; based on diagnostic parameters for IM within two years(1998-2000). Fortheen patients were eliminated due to other diagnosis. The average age of remaining 17 patients was 6.9+3.3, male/female ratio= 9/8.The results of this study showed a significant difference (p 0.038)between the amount of EBNA-IgG but no significant difference in the amount of VCA-IgG,VCA-IgM between case and control groups.. There is no difference between case and con trol groups in negative values for VCA- IgM, VCA -IgG and EBNA-IgG.

Neuropeptides, possessing specific and functional receptors on various cells of the immune system, have the potential to regulate immune responses; and the macrophages as important components of defense against various agents, are at their influence. In this study the effect of neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) on IL-1 beta production by herpes sim plex type-1 (HSV-1)-infected and also uninfected mouse peritoneal macrophages were considered. Each neuropeptide separately has upregulated IL-1 beta produc tion by HSV-1 infected macrophages with the greatest effect at the concentrations of 10''9M for both SP and CGRP, but no synergistic effect on IL-1 production has been observed in the presence of both neuropeptides at optimal concentrations. IL-ip production by uninfected macrophages was also moderately enhanced in the presence of each neuropeptide, but not in the presence of both neuropeptides simultaneously. It can be concluded that IL-1 S3 production, which is part of mac rophage mediated inflammatory response to HSV-1, is enhanced by specific doses of neuropeptides.

Bovine tropical Theileriosis caused by Theileria annulata is an economically important disease of cattle. An enzyme linked immunosorbent assay (ELISA) was used to determine antibody levels in vaccinated and unvaccinated cattle, us ing cellular schizont as antigen and its results were compared with immunofluo-rescent assay (IFA). For this test 126 sera collected (105 vaccinated, 31 not vacci nated) from cows and assayed with ELISA which among them 104 sera were positive and 32 sera were negative. Same sample assayed with IFA in which 99 were positive sera and 37 were negative sera. Thereby the sensitivity and speci ficity of this ELISA on comparsion with IFA were 95.5% and 66.6% respectively. This study revealed that ELISA could be successfully used for both differentiat ing vaccinated and not vaccinated cattle and obtaining the titer of vaccinated cattle.

In present study different protein measurement methods are evaluated on the allergenic extract of Chenopodium album pollen, which was previously prepared in our laboratory and applied in skin prick testing in comparison with a commer cial extract. The protein content of similar amounts of these two extracts which had caused similar skin reactions were measured with different protein assays such as protein nitrogen unit, Lowry procedure, ultra-violet absorption, and base catalyzed hydrolysis and ninhydrin (B.H.N.). The latter is recommended by World Health Organization (W.H.O.) in order to determine total protein of standard al lergenic extracts. Our study indicated some differences between protein amounts measured by the various procedures. According to W.H.O. reports regarding the advantages of B.H.N, assay, due to good correlation with biological activity of allergenic extracts, we also found that this method can indicate the potency of extracts much more precisely.

MTT assay is designed for spectrophotometric quantification of cell growth and viability without using the radiactive isotopes. The aim of this study is com parison of LTT and MTT as sensitive poliferation assays in immunodeficient pa tients. 20 immunodeficient and 20 healthy subjects were selected in this study. All of them had normal lymphocytes count, normal CD3 and negative DTH reac tion to PPD, DT and Candida. The immunodeficient patients regularly suffered from herpes, Candida and staph abscess. The lymphocytes of immunodeficient control groups were treated with PHA as mitogen. The lymphocyte proliferation was evaluated by MTT and LTT. The results showed a strong correlation between LTT and MITT between immunodeficient patients and healthy controls. The sen sitivity test for MTT was 90%, and the sensitivity test for LTT was 98%. MTT method can be considered as a non-radiactive evaluation of cell proliferation.Detecting cell proliferation with accurate, sensitive, fast, easy and safe method is more preferable than LTT.