Iranian Journal of Allergy, Asthma and Immunology
Volume:5 Issue: 4, Dec 2006

Although the structure of human T lymphoptropic virus type I (HTLV-I) has been known well, the function of some proteins encoded by HTLV-I PX region is not fully understood. Furthermore, the responses of the immune system to HTLV-I remain still unknown. Most of HTLV-I-infected individuals show a strong and persistently activated cytotoxic T-cell (CTL) response to the virus. The frequency of HTLV-I specific CTL is higher in patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) compared with HTLV-I carriers. However, the efficacy of the immune response determines the outcome of HTLV-I-associated diseases. Among the risk factors which contribute to the observed differences between HAM/TSP patients and HTLV-I carriers, the interaction between different genes and/or environmental factors seem to be important. These factors may also involve in outcome of HTLV-I infection in infected-individuals.

The number and function of human natural killer (NK) cells are generally assessed to monitor the baseline of immune function, the effect of treatment, the progress of malignancy or metastases and diseases. NK cells recognise and kill target cells in the absence of prior sensitisation and are able to defend the host from infection or prevent the progression of a disease. Human NK cells express CD16 and CD56 which are (massively) being used as a major hallmark for the NK cell. The purpose of this study was to identify the unique subsets of peripheral blood mononuclear cells (PBMC) (%CD3-CD56+ cells) by flow cytometry and to determine whether there is any correlation with functionally mature progeny of (NKp) precursor after five days of culture. The correlation was analysed using samples obtained from 120 Caucasian patients. 20-30ml of whole blood was collected in sterile tube containing preservative free sodium heparin and a similar sample was obtained after five days. Maturation of NKp required the continuous presence of recombinant interleukin 2 (rIL-2), or interleukin 15 (rIL-15) and functional maturity of NK cells was determined by their ability to lyse target cells from the K562 cell line. The NK precursor frequency was measured by limiting dilution analysis (LDA), which The NKpf assay was set up with a range of cell dilutions from 40,000 to 625 per 100ml/well in 96 well culture plates. At the end of the culture period the K562 cell line labelled with Europium (Eu-K562) was added and Eu release measured in culture supernatants using time-resolved fluorometry. The PBMC were set up in parallel cultures under various conditions. On day five cells were collected from culture plates and adjusted to 1x10 cells/ml and then mixed. The mixture was incubated and anti CD3 and anti CD56 were added. NK cells were enumerated in 120 patients by double staining with a combination of anti-CD3- and anti-CD56+. The results of these Immunophenotyping studies by flow cytometry showed no correlation between the NKpf (natural killer precursor frequency) and the percent of CD3-CD56+ cells expressed after five days confirming that CD56 was inadequate as a unique marker for functional NK cells.

Experimental allergic encephalomyelitis (EAE), a demyelinating disease induced in the animals parallels multiple sclerosis in human in several aspects, provides a useful model to investigate multiple sclerosis. In this study, we have therefore used this model to study functions of nerve growth factor (NGF) in EAE. NGF with considerable effects on neuron survival, proliferation and differentiation of the nervous system, is also known to act on cells of the immune system. Simultaneous upregulation of proinflammatory cytokines and increased level of NGF points at possible effects of the nerve growth factor in autoimmune diseases. To investigate roles of NGF in experimental allergic encephalomyelitis in vivo, we therefore decided to apply it intracerebroventricularly at a dose of 0.20 mg/mice prior to the induction of EAE. Our clinical observations showed that in the EAE induced animals who received NGF, severity of the disease was reduced significantly compared to that in saline treated EAE mice. Also neuropathological investigation of spinal cords revealed that in contrast to saline treated EAE mice, no signs of cell death, infiltration and demyelination can be seen in NGF treated EAE mice, suggesting that NGF may have clinical implications in multiple sclerosis.

Magnesium (Mg) is the second most abundant intracellular cation and is involved in numerous physiological functions, including protein folding, intracellular signaling and enzyme catalysis. It has been shown that magnesium deficiency exacerbates pulmonary airways hyper reactivity. Several studies suggest that magnesium level has no effect on asthma but others had shown a contributory effect. Because of its intracellular abundance٫ the aim of this study was to determine if there was any difference in plasma and intracellular Mg concentrations of children with acute asthma compared to non asthmatic children. Twenty nine patients with acute asthma aged 2 to11 years admitted to the emergency department of hospital and 37 non asthmatic children with the same age were included in our study. 0. 5 mL of heparinized whole blood samples of patients who were meeting inclusion criteria at the onset of admission with bronchoconstriction and before using any medication was drawn and it was immediately sent to the laboratory. Plasma and erythrocytes were separated and stored at -20Ċ and later their Mg levels were quantified with atomic absorption spectrophotometry method. The average plasma and intracellular magnesium levels in patients were (0. 79 ± 0. 098 mmol/L) and (1. 17 ± 0. 27 mmol/L) respectively. Results of 37 non asthmatic persons [plasma (0. 85 ± 0. 1 mmol/L) and erythrocytes (1. 33 ± 0. 21 mmol/L)] showed that there was no significant difference between plasma Mg levels in two groups (p 0. 06) but intracellular magnesium level was significantly lower (p 0. 03) in patients group. These results indicate that intracellular Mg level may be a more accurate method to assess Mg level in patients with asthma. Hence, determination of Mg concentration in erythrocytes may be used in evaluation of asthma pathophysiology. There are recommendations for using intravenous Mg sulfate in acute asthma, and this study supports the rational for using it in emergency departments for acute severe asthma.

Asthma affects an estimated 300 million people worldwide. Poor compliance with the prescribed medication leads to increased mortality and morbidity. Various determinants of compliance have been described. The purpose of this study was to determine factors that can influence patients'' compliance with prescribed Metered Dose Inhaler drugs.179 patients with diagnosis of asthma were selected from two asthma clinics in Tehran. 160 of them met the inclusion criteria. Collected data consisted of patients'' demographic data, asthma symptoms and severity, medical history of patients and their attitude towards asthma control and using drugs. Compliance was assessed by four questions regarding using Metered Dose Inhaler drugs.There was a significant correlation between compliance and patient''s literacy level, attitude about using drugs, and their knowledge about asthma (p=0.012, p=0.0001, p=0.001 respectively). However there was significant negative correlation between symptom control score and compliance (r =-0.270, p=0.004). Other factors including sex, patients'' attitude about asthma control and severity of asthma did not show any significant relation.There are four major factors influencing the patients'' compliance: level of literacy, attitude towards asthma management, knowledge about asthma, and symptom control. The negative relation between compliance and symptom control may be caused by patients'' inadequate knowledge towards continuing treatment after improvement in their conditions. The study emphasizes on the importance of enhancing the patients'' compliance. This could be done by providing patients with adequate information about their disease and treatment.

In the management and evaluation of asthma, simple instruments for measurements of peak expiratory flow rate (PEFR) are necessary. The aim of this study was to determine normal PEFR of the healthy children in Babol, Iran. This study was randomly done on 1050 students (primary and secondary schools) in Babol. Mini-Wright peak flow meter was used for measurement of PEFR. The range of age, weight and height were defined. Information was statistically analyzed by SPSS, T- Test and R2 and due to formula with regression. Mean age of 1050 students (525 male and 525 female) who participated in this study was 10.26 years. The mean of PEFR was 262.35±71.97 L/Min. Obtained PEFR with all anthropometrics variants indicate a high correlation. Correlation between PEFR and height was more significant and between PEFR and weight was lower, and according to importance of height and age, formulas suggested for prediction of PEFR in females {(age×4/8)+ (height×0/6)-25)} and in males ({(age×1/7)+ (height×2/1)-208)}. The results of this study can determine normal PEFR and it can be useful for treatment and monitoring of children with asthma who live in this region.

Kawasaki disease is a multi system disorder with varying clinical expressions. This disease is an acute systemic vasculitis of unknown etiology that has recently recognized as a leading cause of acquired heart disease in children of many developed countries. We describe an unusual instance of hair loss in a patient with Kawasaki disease. A 26 months old boy developed prolonged high fever, bilateral conjunctival infection, arthralgia and erythromatosis skin rash. He was admitted to the hospital with the diagnosis of Kawasaki disease. Laboratory results included an erythrocyte sedimentation rate (ESR) above 100 and platelet count > 1000,000. The patient developed acute and unprovoked scalp hair loss. He was treated with intravenous immunoglobulin (IVIG) 2 g/kg and aspirin 100 mg/kg/day with complete improvement of signs and symptoms. This report documents hair loss as an uncommon presentation of Kawasaki disease.

Primary immunodeficiency disorders are a heterogeneous group of genetic disorders, with different modes of inheritance, consisting of more than 100 different types. We constructed the DNA banking of primary immunodeficiency disorders for the first time in Iran. The DNA of 31 immunodeficient patients and their families (total of 92 samples) were collected, as the first step for construction of DNA banking. DNA was isolated from whole blood by salting out method. Among our patients, Common variable immunodeficiency was the most common disorder, followed by X-linked agammaglobulinemia, Ataxia-telangiectasia, Chronic granulomatous disease, Severe combined immunodeficiency, Hyper IgM syndromes, and Leukocyte adhesion defects. DNA banking is a useful method for further detection of mutation in immunodeficient patients and prenatal diagnosis for presence or absence of the disorder in the fetus which can be confirmed by molecular genetics testing.