Iranian Journal of Medical Sciences
Volume:44 Issue: 2, Mar 2019

Allergy is becoming a major disease burden globally. Pollens are considered as the main component of aeroallergens that lead to rhinitis and asthma. Due to the lack of a comprehensive investigation on most allergic pollens of trees in the Middle East, the present study aimed to conduct a comprehensive literature review on this topic. The main goal of the study was to provide a checklist for allergists and patients to easily identify the commonest allergic pollens in their locality. The present review provides a broad range of information on the types and geographic locations of the most common allergic pollens of trees in each studied country. In general, among the 23 studied countries, palm and mesquite trees were the common producers of pollen allergen in the Persian Gulf region. Olive tree is common in Turkey, Palestine, and Israel, whereas sycamore tree is the common allergen pollen in Iran. Considering the uneven geographical distribution of these trees in the world, allergists are unable to accurately select the appropriate extracts for the skin prick test based on the information from the neighboring countries. This scenario becomes more complicated if one adds the imported ornamental trees in the picture.

Both mitochondrial dysfunction and aerobic glycolysis are signs of growing aggressive cancer. If altered metabolism of cancer cell is intended, using the glycolysis inhibitor (2-deoxyglucose (2DG)) would be a viable therapeutic method. The AMP-activated protein kinase (AMPK), as a metabolic sensor, could be activated with metformin and it can also launch a p53-dependent metabolic checkpoint and might inhibit cancer cell growth. After treatment with 5 mM metformin and/or 500 µM 2DG, the TE1, TE8, and TE11 cellular viability and apoptosis were assessed by MTT, TUNEL, and ELISA methods. The changes in p53 and Bcl-2 genes expression levels were examined using real-time PCR method. Data were analyzed by Kruskal-Wallis test using the SPSS 17.0 software. Metformin and 2DG, alone and in combination, induced apoptosis in the cell lines. Real-time PCR revealed that metformin induced apoptosis in TE8 and TE11 cells by activating p53, down-regulating Bcl-2 expression. The induced apoptosis by 2DG raised by metformin and the combination modulated the expression of Bcl-2 protein in all cell lines and it was more effective in TE11 cell line. Metformin induced apoptosis in ESCC by down-regulating Bcl-2 expression, and up-regulating p53 and induced apoptosis increased by 2-deoxy-d-glucose. Thus, the combination therapy is an effective therapeutic strategy for esophageal squamous cell carcinoma.

Diabetes is one of the most prevalent metabolic diseases. Irisin (FNDC5 protein) is involved in the new strategy of combating type 2 diabetes. In the liver, the antidiabetic mechanism of silymarin at the molecular level is unknown. This study investigated the effects of silymarin on irisin and the related gene expression and oxidative stress status in the liver of type 2 diabetic rats. Thirty-six rats were divided into 6 groups (n=6 each) by simple randomization: control, control+silymarin (60 mg/kg daily in normal saline orally for 60 days), control+silymarin (120 mg/kg daily in normal saline orally for 60 days), diabetic, diabetic+silymarin (60 mg/kg daily for 60 days), and diabetic+silymarin (120 mg/kg daily for 60 days). Biochemical parameters were measured by spectrophotometric and immunoassay methods, and quantitative polymerase chain reaction was used to evaluate gene expression. The data were analyzed by one-way ANOVA, followed by the Tukey test, using SPSS software, version 16.0. The results were considered statistically significant at a P value less than 0.05. In the diabetic rats treated with silymarin (60 and 120 mg/kg), by comparison with the diabetic group, body weight (P=0.04 and P=0.02), insulin (P<0.001), expression of PGC-1α (P=0.04 and P=0.02), expression of FNDC5 (P=0.03 and P=0.01), and concentration of irisin in the liver (P=0.02 and P=0.01) and serum (P<0.001) were significantly increased, whereas the levels of glucose (P<0.001), HOMA-IR (P=0.03 and P=0.01), and liver injury markers (P<0.001) were significantly reduced. Oxidative stress status and histopathological changes were improved in the treated groups. These results suggest that silymarin because of its ability to upregulate irisin and antioxidant effects can be considered an antidiabetic agent.

Metastasis is the main cause of prostate cancer (PCa) death. The inhibitory effect of N-myc downstream-regulated gene 2 (NDRG2) on the invasiveness properties of PCa cells has been demonstrated previously. However, its underlying mechanisms have not yet been investigated. The present study aimed to investigate the effects of NDRG2 overexpression on the expression of genes involved in epithelial-mesenchymal transition (EMT) including E-cadherin (E-CAD), α- and β-catenins, Slug and Snail, transforming growth factor (TGF)-α and -β, and vascular endothelial growth factor (VEGF). In the present in vitro study, LNCaP cells were divided into three groups, namely NDRG2 group (transfected with PSES-pAdenoVator-PSA-NDRG2-IRES-GFP plasmid), mock group (transfected with mock plasmid), and control group (without transfection). The effect of NDRG2 overexpression on the migration and invasion of LNCaP cells were investigated using the transwell assay. Real-time PCR was used for the evaluation of gene expression. For the statistical analyses, one-way ANOVA, student t test or Mann-Whitney U test were applied using the SPSS software (version 15.0). P values <0.05 were considered statistically significant. The results demonstrated that the overexpression of NDRG2 reduced the invasion and migration of LNCaP cells compared to the control and mock groups (P<0.001). A decreased expression of TGF-β (P=0.002), VEGF (P=0.014), Slug (P=0.005), and Snail (P=0.012); and an increased expression of E-CAD (P=0.009) were observed following NDRG2 overexpression in LNCaP cells. The results of the present study suggest that NDRG2 inhibits the invasiveness properties of LNCaP cells probably through changes in the expression of genes involved in EMT.

Normal sperm function depends on appropriate intracellular calcium (Cai2+) and reactive oxygen species (ROS) levels. Calcium activates NADPH oxidase-5 (NOX5) that leads to ROS generation. The calcium channel of sperm (CatSper) is activated by progesterone and intracellular alkalization. Herein, the interactive role of CatSper, Hv1 channels, and NOX5 enzyme on Cai2+ and ROS generation in human sperm is investigated. The present laboratory in vitro study was carried out in the School of Medicine, Shiraz University of Medical Sciences (Shiraz, Iran) during 2016. Normal semen samples (n=15) were washed and diluted to 20×106 sperm/mL. The diluted samples were divided into 16 groups containing Ham’s F-10 (the control group), 2 µM NNC (CatSper inhibitor), 1 mM ZnCl2 (Hv1 inhibitor), 1 µM DPI (NOX5 inhibitor), NNC+Zn, NNC+DPI, and NNC+Zn+DPI. The other 8 groups were the same as the above except that they contained 1 µM progesterone. Cell viability and Cai2+ were analyzed by flou-3 AM probe and PI staining, respectively, using flow cytometric method. ROS generation was assessed by chemiluminescence method. Statistical analysis was performed using the one-way ANOVA followed by Tukey’s test. P values <0.05 were considered statistically significant. Progesterone increased Cai2+ and ROS generation. The addition of NNC, Zn, or NNC+Zn significantly decreased Cai2+ in the control and progesterone containing groups. Progesterone-induced ROS generation was decreased significantly in all groups containing NNC, Zn, or DPI and reached to the control level when DPI was added to NNC or Zn. There is a functional relationship between CatSper and Hv1 channels in increasing Cai2+. The activity of CatSper and Hv1 channels are required for progesterone-induced ROS generation by NOX5 enzyme.

Bone marrow stromal cells (BMSCs), as a type of mesenchymal stem cells, and the granulocyte colony-stimulating factor (G-CSF), as a type of growth factor, may recover damaged ovaries. The aim of the present study was to investigate the effects of the coadministration of BMSCs and the G-CSF on damaged ovaries after creating a chemotherapy model with cyclophosphamide (CTX) in rats. The present study was performed in Semnan, Iran, in the late 2016 and the early 2017. BMSCs were cultured and were confirmed using the CD markers of stromal cells. Forty female Wistar rats were randomly divided into 4 groups. The rats were injected intraperitoneally with CTX for 14 days to induce chemotherapy and ovarian destruction. Then, the BMSCs were injected into bilateral ovaries and the G-CSF was injected intraperitoneally, individually and together. Four weeks later, the number of ovarian follicles using H&E staining, the number of apoptotic granulosa cells using the TUNEL assay, the number of produced oocytes from the ovaries, and the levels of serum E2 and FSH using an ELISA reader were assessed. Statistical analysis was done using one-way ANOVA with SPSS, version 16.0. The results showed that the effects of the coadministration of 2×106 BMSCs and 70 µg/kg of the G-CSF were significantly more favorable than those in the control group (P<0.001), the BMSC group (P=0.016), and the G-CSF group (P<0.001) on the recovery of damaged ovaries. The efficacy of the coadministration of BMSCs and the G-CSF in the recovery of ovaries damaged by chemotherapy was high by comparison with the administration of either of them separately.

The neuroprotective effects of duloxetine, as an antidepressant agent, and the neurodegenerative effects of methamphetamine have been shown in previous studies. Nonetheless, their exact neurochemical and behavioral effects are still unclear. In the current study, we sought to clarify the molecular mechanisms involved in the protective effects of duloxetine against methamphetamine-induced neurodegeneration. Forty adult male rats were divided randomly into 5 groups. Group 1 was the negative control and received normal saline, Group 2 was the positive control and received methamphetamine, and Groups 3, 4, and 5 were concurrently treated with methamphetamine (10 mg/kg) and duloxetine (5, 10, and 15 mg/kg, respectively). All the treatments were continued for 21 days. Between days 17 and 21, the Morris Water Maze (MWM) was used to assess learning and memory in the treated groups. On day 22, the hippocampus was isolated from each rat and oxidative, antioxidant, and inflammatory factors were measured. Additionally, the expression levels of the total and phosphorylated forms of the Akt and GSK3 proteins were evaluated via the ELISA method. Duloxetine in all the administered doses ameliorated the effects of the methamphetamine-induced cognition impairment in the MWM. The chronic abuse of methamphetamine increased malondialdehyde, tumor necrosis factor-α, and interleukin-1β, while it decreased superoxide dismutase, glutathione peroxidase, and glutathione reductase activities. Duloxetine not only prevented these malicious effects of methamphetamine but also activated the expression of Akt (both forms) and inhibited the expression of GSK3 (both forms) in the methamphetamine-treated rats. We conclude that the Akt/GSK3 signaling pathways might have a critical role in the protective effects of duloxetine against methamphetamine-induced neurodegeneration and cognition impairment.

Insecticides may have negative effects on reproductive organs. Given the interaction between leptin and the hypothalamic-pituitary-gonadal (HPG) axis, we sought to investigate the changes in leptin and the HPG axis in adult male rats poisoned with Proteus and Biscaya insecticides. Our experimental subjects were 110 adult male Wistar rats (80–90 days of age; average weight=200–210 g). They were randomly split into 11 groups of 10 rats: control, sham, and 9 experimental groups namely treatment with 2.75, 5.5, and 11 mg/kg/BW of Proteus, treatment with 1.5, 3, and 6 mg/kg/BW of Biscaya, treatment with 2.75 mg/kg/BW of Proteus+1.5 mg/kg/BW of Biscaya, treatment with 5.5 mg/kg/BW of Proteus+3 mg/kg/BW of Biscaya, and treatment with 11 mg/kg/BW of Proteus+6 mg/kg/BW of Biscaya. Intraperitoneal injections were performed over a 14-day period. For bloodletting at the end of the experiment, blood samples were withdrawn from the rats in order to investigate the serum concentration of luteinizing hormone (LH), follicle-stimulating hormone (FSH), gonadotropin- releasing hormone (GnRH), testosterone, and leptin. The data were analyzed using SPSS, version 16, via ANOVA and the Duncan test. A P value equal to or less than 0.05 was considered statistically significant. Our comparisons between the experimental groups (average and maximum compound concentrations of Proteus and Biscaya) and the control group showed a significant decrease in the mean serum levels of FSH (P=0.001), LH (P=0.001), GnRH (P=0.001), testosterone (P=0.005), and leptin (P=0.001) in all the experimental groups in a dose-dependent manner. Proteus and Biscaya decreased GnRH, LH, FSH, and testosterone by reducing the serum level of leptin in the hypothalamus in a dose-dependent manner.

One of the rare neoplasms of cervix uteri and vagina is clear cell carcinoma; mostly in patients with a positive past medical history of intrauterine diethylstilbestrol (DES) exposure which reveals the importance of other unknown risk factors of gynecologic neoplasms. 2 Asian women referred to the gynecology-oncology department. The first one came with a complaint of prolonged vaginal discharge and the second one with irregular bleeding. Neither did report a history of DES-exposure. On vaginal examination, it was found that both cases had mass which biopsied for histologic study. They were diagnosed with primary Clear Cell Carcinoma of Vagina in the first case and Cervix uteri in the other one. Both patients underwent cytoreductive surgery soon after diagnosis.

Although lead pollution has long been known as a cause of poisoning, it has remained a challenge to reliably diagnose it due to its common symptoms in various diseases. In this article, we report two cases of acute loss of consciousness due to the ingestion of opium-contaminated with lead. The reported cases share patterns of symptoms similar to meningitis and encephalitis which are usual etiology for the loss of consciousness. Lead poisoning is not a usual etiology for loss of consciousness and is considered in cases of occupational or environmental exposure. These reported cases showed a pattern similar to meningitis and encephalitis, but due to the unusual manifestations during their admission and coexistence with gastrointestinal symptoms, we were led to consider poisoning as the cause of consciousness loss. Lead poisoning often goes unrecognized due to a low index of suspicion, but it may turn out to be fatal. Therefore, it should be considered in the differential diagnosis of any neurobehavioral deficits in substance abusers.

Lymphangiomas are benign lesions consisting of abnormal proliferations of lymphatic vessels. Lymphangiomas associated with bone involvement, particularly in vertebral bodies, accompanied by cord compression, are extremely rare, and our literature review yielded only a few relevant reports. We describe a 61-year-old man presenting with progressive paraparesis and sphincter disturbance of 5 months’ duration. Magnetic resonance imaging (MRI) revealed an enhancing T8 vertebral body involvement as well as a homogeneously enhancing posterior epidural mass at the T7–T8 level, with severe cord compression and cerebrospinal fluid (CSF) blockade. The patient underwent surgery via T7–T8 laminectomy, and after the removal of the epidural mass, the surgical procedure was stopped due to severe bleeding. Histopathologic examination reported a lymphangioma. After 10 days, the patient was able to walk. In the sixth postoperative month, MRI showed complete relief of the mass effect. The wide spectrum of the preoperative differential diagnosis of lymphangiomas renders a definite preoperative diagnosis impossible; therefore, histopathologic examination is the sole definite route for their diagnosis. In case of the solitary lymphangiomas of the spine with epidural compression, preoperative angiography and embolization should be considered to reduce intraoperative bleeding and enhance the chance of total resection and total surgical resection should be performed to decrease the likelihood of recurrence.

Penetrating ocular trauma is one of the most important causes of vision loss, especially in men, and can be associated with intraocular foreign bodies. The incidence of intraocular cilia after trauma is very low. Here we report the case of a 24-year-old man who visited Poostchi Ophthalmology Clinic (Shiraz, Iran) due to a gradual vision loss in his left eye over the past 2 months. The probable cause was a foreign object (metal splinter) in the eye as a result of hammering metal on metal. An examination revealed the site of a 2-mm sealed corneal laceration, localized central cataract with intralenticular cilia, and moderate anterior reaction. The patient underwent foreign body removal, lensectomy, and posterior chamber intraocular lens implantation. One day after the operation, the visual acuity of the patient was 20/20. The intraocular cilia may have various clinical presentations; however, there is no report of a case with cilium embedded in the lens without any sight-threatening complications other than localized cataract and a moderate inflammatory reaction. Timely management and operation allow such patients to maintain a good vision.