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Allergy, Asthma and Immunology - Volume:3 Issue: 3, Sep 2004

Iranian Journal of Allergy, Asthma and Immunology
Volume:3 Issue: 3, Sep 2004

  • 54 صفحه،
  • تاریخ انتشار: 1383/06/15
  • تعداد عناوین: 8
  • Clinical and Immunological Spectrum of Common Variable Immunodeficiency (CVID)
    Anthony David B. Webster Pages 103-113
    We have analysed data from 150 patients initially classified as having CVID. About 10% had laboratory abnormalities suggesting known single gene disorders (eg: hyper-IgM syndrome), and in a few a genetic defect has been confirmed. We have attempted to sub-classify the remaining patients by analysis of their circulating lymphocytes. B lymphocyte markers have been used to estimate the numbers of circulating immature and class switched B cells; there is an association between the presence of high relative numbers of immature circulating B cells, splenomegaly and autoimmune disease. About 25% of CVID patients have a moderate CD4+ T lymphopenia, sometimes with a relative expansion of CD8+ T cells. About 30% of CVID patients have persistent relatively high levels of circulating CD8+ T cells binding immunogenic peptides from EBV or CMV. Many of these patients also have high relative numbers of circulating CD8+ perforin positive T cells, and there is evidence that these cells may be responsible for neutropenia or inflammatory bowel disease in some patients. The clinical spectrum of CVID is diverse, with some patients suffering from few infections, and over 50% have evidence of structural lung damage. About 25% of UK patients have chronic inflammation in various organs, particularly the lungs, liver and spleen, often with granulomatous changes. Steroids are used to treat many of the patients with chronic inflammatory complications, although trials are in progress with anti-TNF agents. The incidence of these inflammatory complications is different between countries, being rare in Sweden. Attempts to correlate clinical phenotypes with the laboratory abnormalities described above have been disappointing, suggesting that unknown genetic factors unrelated to the cause of the immunodeficiency determine the complications; attempts to identify some of these factors will be discussed. Finally a provisional scheme to sub classify CVID patients according to lymphocyte abnormalities will be presented, the purpose being to focus the screening of candidate genes causing CVID to specific subsets of patients.
  • Maryam Izad, Mohammad Vodjgani, Mohammad Hossein Nicknam, Jamshid Lotfi, Davood Fathi, Ali Akbar Amirzargar Pages 115-119
    Interferon- gamma (IFN- γ) is an important immune regulator and inflammatory cytokine which is implicated in the pathogenesis of multiple sclerosis (MS). A single nucleotide polymorphism, T to A, at position +874 in the first intron has previously been shown. This polymorphism is associated with IFN- γ production level. To study the effect of this polymorphism on susceptibility to multiple sclerosis, we screened genomic DNA samples from clinically definite MS patients and their unaffected first-degree relatives as controls, using sequence-specific primers (PCR-SSP). The results indicated that MS patients showed a lower TT (21.2% vs. 30.3%) and higher AA (21.2% vs. 12.1%) genotypes compared to controls, although there were statistically no differences in the IFN- γ genotype distribution between these two groups. Thus, our data indicate that there is no association between IFN- γ +874 polymorphism and MS susceptibility or severity of the disease.
  • Afshin Afshari, R. Elizbeth Holme Pages 121-125
    The measurement of anti-streptokinase antibodies can distinguish the patients who may benefit from streptokinase and those who should be treated with some other thrombolytic regimen. Neutralising titration test is a commonly used classical assay for measuring anti-streptokinase antibodies and in this assay the ability of anti-streptokinase antibodies in patients'' sera in preventing the lytic effect of streptokinase is assessd. As we showed previously the presence of r-tPA in the serum may interefere with the neutralising titration test, we investigated this interference in vitro. The level of neutralising anti-streptokinase antibodies in a serum sample with known levels of the antibodies were measured in absence and presence of increasing amount of r-tPA including therapeutic values. Increasing amount of r-tPA in vitro induced a sudden reduction in the measurable titre of anti-streptokinase antibody levels in a serum with elevated levels of anti-streptokinase antibodies. This effect of r-tPA, which is through activation of plasminogen has not been reported previously. We suggest this assay is unsuitable for clinical diagnosis of anti-streptokinase antibodies.
  • Behzad Hooshmand, Alireza Monsef, Mohammad Amirmadglesi, Mani Kashani Pages 127-131
    The aim of this study was to evaluate an enzyme – linked immunosorbent assay (ELISA) for the detection of anti – helicobacter pylori (H. pylori) specific IgG antibodies in specimens of oral fluid.All subjects over the age 18 years undergoing endoscopy for any reason were asked to participate in the study. Two groups of 44 patients in each were selected as HP+ and HP-. At the same time, 5 milliliters of unstimulated saliva was collected from these patients, and the antibody titration against H.P. was evaluated by “ELISA” method.In overall, the level of salivary antibody in H.P+ group was significantly more than those in H.P- group (P<0/001). In the best cut – off, sensitivity and specificity obtained in this test were respectively 88.6% and 81.8% and positive predictive and negative predictive values were determined as 83% and 87.8%, respectively. Positive Likelihood Ratio and negative likelihood ratio were 6.8 and –0/083, respectively.Oral fluid ELISA is relatively a comfortable, fast and noninvasive test for diagnosis of H. pylori infection.
  • Farhad Vaez Zadeh, Farhad Esmaily, Mohammad Kazem Sharifi, Yazdi Pages 133-137
    Different strains of Escherichia coli (E. coli) from human, chickens, and the common strain between human and chickens were isolated and typed with mono-specific antibody. The E. coli strains from each group of human, chicken and common between human and chicken were selected. The polypeptide patterns of selected strains were analyzed and compared with each other by Sodium dodecyle sulphate polyacrylamide gel electrophoresis (SDS - PAGE). The SDS - polyacrylamide gel electrophoresis patterns between the strains were very similar, although the densities of some of the peptide bands were different, and some were missing in some strains. A similar comparison was made on extracted outer membrane proteins (OMP) using Triton X-100 and sodium dodecyle sulphate on the above-mentioned strains. The polypeptide patterns between the strains 078 (chicken strain), 06 (human strain) and O2 (the common strain between human and chicken) were also very similar and two major bands with molecular weights of 44 KD and 25 KD were very distinctive, and seen between all the strains.The passive haemoagglutination tests (PHA) in chickens injected OMP from the common strain (O2), showed increased level of antibody after the second injection which remained constant after repeated injections.In the challenge study, with LD100 from homologous strain of O2, a significant protection was observed in the groups injected the OMP (extracted from O2 strain), compared with controls injected saline.The results of this study indicate that purified E. coli outer membrane protein, can induce a significant protection immunity against colibacillus diseases in chickens, and probably in immunocompromised hosts with repeated urinary infections.
  • Behnaz Gharegozloo, Zuhair M. Hassan, Sussan K. Ardestani, Nasser Tavassoli Pages 139-143
    Despite recent advances in burn wound management, sepsis remains the main cause of death in patients resuscitated after major thermal injury. Increased susceptibility to infections has been related to severe suppression of the immune system.The aim of this study was to induce immune suppression with blister fluid injection, and to modulate immune response by use of cimetidine and pyrimethamine in animal model.Male Balb/c mice were injected with blister fluid intrapritoneally (ip). Fluids were collected from parital-thickness burn blisters and then the delayed type hypersensitivity (DTH) to sheep red blood cell (SRBC) and the effects of different doses of immunomodulators (Cimetidine and Pyrimethamine) on this response were quantitated.A marked suppression of DTH was observed in mice injected with blister fluid. Pyrimethamine and Cimetidine at all three doses caused a significant enhancement of DTH response to SRBC compared with blister fluid injected in control group.This finding represents evidence of a host defense defect within the burn wound and also indicates the blister fluid exhibit immunosuppressor factor that can modulate with immunomadulatory drugs like cimetidine and pyrimethamine.
  • Soheila Alyasin, Reza Amin, Shiva Neamati Pages 145-148
    Asthma is the most common chronic respiratory disease of children in the world. Serial studies in the world have showed an increased prevalence of bronchial asthma. In this study, the children younger than 12 years old referred to Jahrom hospital and clinic due to asthma were selected. We issued 100 questionnaires, according to International Study of Asthma and Allergies in Childhood (ISAAC) criteria and were completed by the physicians. The ratio of male to female was 1 to 9. The patients who were under the age of 4, 3 and 1 year were 82%, 60% and 15% respectively. Passive smoking was present in 56% of the patients, and 22% had pets at home like cat, dog or bird. Home dampness was present in 33%. Ninety percent of patients had used breast feeding during the first year of life. Seventy percent of patients had family history of asthma. Food allergy was present and could trigger asthma in 15%. The result of ISSAC questionnaire showed that during the last year wheezing was present in 10%, 6% had 1-3 attacks and 4% had 4-12 attacks. Sleep disturbance by wheezing had occurred in 5% but cough in 16%. Thirteen percent of patients had wheezing after exercise. In Jahrom town the climate is warm and dry. In this town asthma in children is more common among the children who are younger than 4 years old. The risk factor like smoking at home, pets and home dampness should be eliminated from their environment.
  • Nasser Ebrahimi Daryani, Asghar Aghamohammadi, Mohammad, Reza Mousavi Mirkala, Mohammad Bashashati, Nima Rezaei, Babak Haghpanah, Ali, Asad Hashtroudi, Alireza Sayyah Pages 149-152
    Common variable immunodeficiency (CVID) is a primary immunodeficiency disease characterized by hypogammaglobulinemia and recurrent bacterial infections especially in respiratory and gastrointestinal systems. We present here 2 cases of CVID with gastrointestinal complications.Case 1 is a 25-year-old man with a history of chronic diarrhoea from childhood. Ultrasonography revealed ascites, with liver size smaller than normal. Liver biopsy showed non-specific hepatitis. Lymphoid proliferation and Histiocytosis were reported in his ascites cytology. Moreover friability in colonoscopy due to moderate active chronic colitis was detected. Case 2 is a 26-year-old man with chronic diarrhoea since 8 years. Abdominal sonography revealed increased liver echogenicity, increased liver size, and some enlarged lymph nodes beside pancreas. Colonoscopy revealed friability and decreased vascularity while biopsy showed moderate active chronic colitis. Lymph node biopsy showed unusual immunologic reaction. Moreover, small bowel transition test showed nodularity. CVID should be considered in any patient with gastrointestinal manifestations especially chronic diarrhoea in association with recurrent bacterial infections in other organs. Diagnostic delay results in more morbidity and complications in untreated patients.