Iranian Journal of Allergy, Asthma and Immunology
Volume:6 Issue: 1, Mar 2007

HLA-G is normally expressed on human trophoblast cells. It is a non-classical MHC molecule class I b. The role of HLA-G in diabetic type 1 is not known. We investigated the role of IFN-β in induction HLA-G expression on the monocyte derived dendritic cells (DC) in diabetes type 1. Treatment of dendritic cell with IFN-β in vitro from diabetic patients (n=20) and normal subjects (n=20) resulted to the production and expression of HLA-G on these cells from both groups. However, comparison of DC from the diabetic patients with DC from the controls revealed lower levels of HLA-G molecules in DC from diabetic patients. Using mixed lymphocyte reaction (MLR), it was found that DC expressing HLA-G mediated the inhibition of autologous T cell activation. It is concluded that IFN-β can increase HLA-G in DC from diabetic patients; subsequently it may prevent the immune regularly pathway in the diabetic pathogenesis.

Allergic asthma is a multifactorial disease, influenced by genetic and environmental factors. Recent family-based studies have revealed evidence for linkage of human chromosomes 5q31-33, 12q15-24, 11q13 and 15q23.6 as regions likely to contain genes related to asthma. Among the candidate genes in these regions are the genes encoding for human interleukin-4, interleukin-13 and interleukin-16. To evaluate this linkage, we examined an Iranian population of patients with asthma. A total of 30 patients with allergic asthma and 50 normal subjects were studied. Allergic asthma was confirmed using skin prick test and spirometry. DNA was extracted from blood cells and IL-4 (-590C>T), IL-13 (R130Q) and IL-16 (-295T>C) polymorphisms were determined by PCR-RFLP method. Out of 30 patients with allergic asthma, the following genotypes for IL-4, IL-13 and IL-16 cytokines were found: IL-4 genotypes consisted of 17 (56.7%) CC, 8 (26.7%) CT and 5 (16.7%) TT; IL-13 genotypes consisted of 11 (36.7%) GG, 13 (43.3%) GA and 6 (20%) AA; IL-16 genotypes consisted of 23 (76.7%) TT and 7 (23.3%) CT. No patient showed CC genotype for IL-16. A higher proportion of case subjects with the C allele for the IL-4, G allele for the IL-13 and T allele for the IL-16 polymorphisms was found compared with the T, A and C alleles, respectively. These results suggest an influence of genetic variability at the promoter of IL-4 gene (-590C>T) and a coding region of IL-13 gene (R130Q) on the occurrence of allergic asthma and no relationship between IL-16 promoter polymorphism (-295T>C) and this disease.

Mustard gas (MG), as a chemical warfare agent was used by the Iraqi army in Iran-Iraq conflict against military men in the battlefield in 1985.The serum levels of IgG, IgA and IgM of patients exposed to MG in the battlefield were measured by single radial immunodiffusion from day 3 up to one month after exposure to MG. The serum levels of IgG in patients showed significant decrease on day 3 after exposure to MG. However, the levels of IgG in the serum samples collected from the patients during 4-18 days after exposure to MG were found to increase. The increase in serum IgG levels in the sera of patients which were collected during 19-31 days after exposure to MG was found to be highly significant, surpassing those from the controls. The levels of serum IgA in patients during one month after exposure to MG showed alterations similar to those of serum IgG, however the serum alterations of the patients IgA, comparing to those of the normal controls were not significant. The serum levels of IgM in patients did not show marked alterations during one month after exposure to MG comparing to those of the normal controls. The initial decrease in serum levels of IgG in patients is discussed in terms of a possible leakage of IgG into the skin blisters and into other severely affected parts of the body such as respiratory system, whereas the subsequent increase in serum IgG is interpreted as due to (auto) antigenic stimulation of the patients’ immune systems.

The prevalence of asthma remains difficult to determine with precision with no absolute or gold standard for diagnosis. International Study of Asthma and Allergies in Childhood (ISAAC) developed video questionnaire for epidemiological studies with less reliance on understanding written asthma questionnaire. The aim of this research was to determine the agreement between the ISAAC written and video questionnaires (AVQ3.0) on respiratory symptoms and reported asthma. We studied 3000 children aged 13-14 years in Urmia, Iran who completed sequentially the ISAAC written and video questionnaires (AVQ3.0) at school. The agreement between responses to the two questionnaires for reported wheeze ever, current wheeze, wheeze on exercise, and nocturnal wheeze (the latter three questions relating to symptoms in the previous 12 months), and to any combination of the latter three questions was examined by using concordance and kappa coefficients as measures of agreement. The prevalence of wheeze ever, current wheeze, wheeze on exercise, and nocturnal wheeze were significantly lower based on responses to the video questionnaire compared to the written questionnaire. Although concordance between video and written questionnaires was high (75% to 93%) for related questions, agreement measured by the kappa statistic for each question was only poor i.e. 0.22, 0.21, 0.13 for resting wheeze, exercise induced wheeze, and nocturnal wheeze, respectively. We conclude that the video questionnaire yields lower reported prevalence rates for asthma symptoms, and that there is poor agreement between responses to the two questionnaires in Iranian children.

Allergic rhinitis is the most common cause of allergic diseases. The recent guidelines of Allergic Rhinitis and its Impact on Asthma (ARIA) group, classified it to intermittent (less than 4 days per week and for less than 4 weeks) and persistent (more than 4 days per week or lasting more than 4 weeks regardless of the number of days per week). The present study evaluates the patients with ARIA classification.The patients referred to Motahhari Clinic (Shiraz, Iran) were evaluated. Age, sex, seasonal or perennial, intermittent or persistent type, duration, sneezer or blocker, diurnal change and presence of allergic conjunctivitis were recorded. The patients who had one or more symptoms of; impairment of sleep, daily activity or work in school or troublesome symptoms had moderate to severe disease and those who did not have these problems have mild disease.The information of 96 patients (46 male and 50 female) were analysed (mean age±SD: 24.45±10.37 years). The mean duration of disease was 4.26±4.12 years, was more in female (P<0.05). Seasonal allergic rhinitis was present in 49 (52%) patients; 30 male, 19 female (P=0.007), perennial in 15 (16%), 1 male, 14 female and mixed type in 29 (30%); 11 male, 18 female. Mild intermittent rhinitis was diagnosed in only 2 (2%) patients, 1 male and 1 female, mild persistent rhinitis in 23 (24%); male 11, female 12; moderate/severe intermittent rhinitis in 4 (4%); 3 male, 1 female; and moderate/severe persistent rhinitis in 56 (58%); 22 male, 34 female (P<0.05). Fifty-seven percent were more sneezer and 36% were more blocker type, sneezers suffered more in days and others more at nights. Others were both sneezer and blocker. Sixty percent had allergic conjunctivitis too, 76% of them were moderate/severe persistent, and 85% were in seasonal or mixed groups. Eleven patients (12%), in persistent group, had history of asthma. Family history of allergic rhinitis and asthma was found in 53% and 25% of patients, respectively.According to new guidelines for classification of allergic rhinitis, most of the patients are moderate to severe types. The classification of allergic rhinitis to seasonal and perennial disease is not proportional to intermittent and persistent types of classification.

This study represents an attempt to determine the prevalence of exercise-induced bronchospasm among soccer player children. A total of 234 soccer player boys of all soccer schools from Shahr-Rey enrolled in this study. They did not have any history of a recent or chronic respiratory tract disease, a history of allergic diseases, and history of bronchodilator drugs consumption during the 24 hours prior to the study. Pulmonary function test (PFT) was performed for each participant before exercise and 6 and 15 minutes after playing soccer. The diagnosis of EIB was by a decrease in forced expiratory volume in 1 second (FEV1) by at least 10% and in peak expiratory flow rate (PEFR) by at least 15% with exercise challenge. If there was reduction in one parameter alone, the participants were considered as prone to EIB. Considering both FEV1 and PEFR the prevalence of EIB was 2.1% and 18.4% were prone to EIB. If FEV1 or PEFR tests were used as criteria for diagnosis of airway obstruction, the prevalence of EIB would be 6% and 15.8%, respectively. There was no significant difference between the post of players, family history of allergic disease and EIB in soccer players. This study suggests that at least 2.1% of soccer players will develop bronchospasm even if they do not have any history of asthma and allergy.

Hyper-IgM syndromes are characterized by profound reduction of serum IgG, IgA, and IgE levels with normal or increased concentrations of serum IgM. CD40 ligand deficiency is X-linked form of the disease, which results in a lack of immunoglobulin class switching from IgM to IgG in B cells. In addition to the recurrent infections, a number of patients suffer from neutropenia. There are some evidences indicating the effect of G-CSF in combination with intravenous immunoglobulin (IVIG) in improvement of neutrophil counts, which has become the most common procedure to control neutropenia.In this report we present a 6 year-old patient of CD40 ligand deficiency, who suffered from chronic, severe neutropenia. Administration of IVIG was started for him when the diagnosis was made at the age of 1.5 years and he was on the regular IVIG therapy after that time untill now for a period of 4.5 years. IVIG and prophylactic antibiotic therapy, despite cessation of granulocyte colony-stimulating factor, injection after one month, corrected the severe neutropenic state of this patient. It seems that regular administration of sufficient doses of IVIG can be useful in the management of neutropenia in CD40 ligand deficiency, which results in better quality of life with decreasing occurrence of infection.

β- thalassemia major is a common hemoglobinopathy in humans. In some journals, numerous studies have reported different prevalence of hepatitis C among β- thalassemia major because thalassemic patients need multiple blood transfusions and blood transfusion is a common transmission pathway for hepatitis C virus. Thus this study was performed for detection of anti-HCV between β- thalassemia major patients in our region.