Iranian Journal of Allergy, Asthma and Immunology
Volume:7 Issue: 3, Sep 2008

Phage-displayed random peptide libraries (RPL) provide a powerful technique for identification, structural and functional analysis of ligands for many different target molecules, including, antibodies, receptors or other proteins. This strategy has been verified to be an effective tool for research in immunology and successfully has been used to determine the target sequence for monoclonal and polyclonal antibodies. The peptide library approach provides great promise for characterization of ligands with no prior information concerning antibody specificity. This would allow the recognition of candidate antigens involved in initiation or perpetuation of autoimmune diseases. This technology also offers the potential for new therapeutic opportunities, production of diagnostic reagents, or even development of effective new vaccines. This review focuses on studies regarding the identification of autoantigens recognized by antibodies in autoimmune diseases using phage-display peptide libraries.

Garlic is known as a potent spice and a medicinal herb with broad therapeutic properties ranging from antibacterial to anticancer and anticoagulant. Our previous studies have shown some immunoregulatory effects for aged garlic extract, suggesting a key role for 14-kD glycoprotein of garlic in shifting the cytokine pattern to T helper-1. In present study, we investigated the effect of 1, 2, and 3 times intraperitoneal injections of aged garlic extract on an established allergic airway inflammation in murine model (BALB/c mice). The garlic extract, isolated by biochemical method, includes proteins precipitation by ammonium sulfate. After injection of the aged garlic extract, IFN-, anti allergen specific IgE and IgG1 were measured in lavage and serum by ELISA and histological assessment was performed on the lung tissues. The results indicated that three-time intra peritoneal injections of the aged garlic extract caused a significant decrease in the hallmark criteria of allergic airway inflammation levels which included eosinophil percentage in lavage, peribronchial lung eosinophils, IgG1 level in lavage and serum, mucous producing goblet cells grade and peribronchial and perivascular inflammation. Our findings in the present research suggested that aged garlic extract has the potential of attenuation of inflammatory features of allergic airway inflammation in murine model.

Bronchial asthma is a multifactorial disease whereby both environmental and genetic factors contribute to its aetiology and/or clinical severity. The aim of this study was to examine the association of 22 cytokine gene polymorphism in the Macedonian population with bronchial asthma (BA). The sample of the population comprised of 301 normal unrelated individuals and 74 patients with BA. Cytokine genotyping was performed by PCR. Susceptible cytokine polymorphisms for BA for ten genotypes (IL-4 -1098/T:T, TNF-α -238/A:G, IL-4 -590/C:C, IL-2 +166/T:T, IL-2 -330/T:T, IL-10 -1082/G:G, IFNγ utr5644/T:T, IL-10 -1082/A:A, IL-1β +3962/T:T, IL-6 -174/G:G), six diplotypes, four haplotypes, and two alleles were found. Protective cytokine polymorphisms for BA for seven cytokine genotypes (IL-4 -1098/G:T, TNF- α -238/G:G, IL-2 -330/G:T, IL-4 -590/C:T, IFNγ utr5644/A:T, IL-1β +3962/C:T, IL-10 -1082/A:G), six cytokine diplotypes, four cytokine haplotypes, and four cytokine alleles were found. We concluded that several cytokine polymorphisms are protective, or susceptible associated with BA in population of Macedonians.

Selective deficiency of immunoglobulin A (IgA) is the most frequent primary hypogammaglobulinemia. As some IgA-deficient patients have IgA antibodies in their plasma which may cause anaphylactic reactions, blood centers usually maintain a list of IgA-deficient blood donors to prepare compatible blood components. In this study we determined the incidence of selective IgA deficiency (SIgAD) in normal adult Iranian population. 13022 normal Iranian blood donors were included in this study. The assay which we used was adapted to the manual pipetting system and ELISA reader was used for screening. Other classes of immunoglobulins (G, M), as well as secretory IgA and IgG subclasses were tested in IgA deficient cases by ELISA. SPSS was used for statistical analysis. Among 13022 studied cases, 11608 blood donors were males (89.14%) and 1414 were females (10.86%). Their mean (±SD) age and weight were 38.5±11 years and 82±12 Kg respectively. Twenty of the screened samples were found by means of ELISA to be IgA-deficient (less than 5mg/dl), (frequency; 1:651). The data could indicate a compensation for IgA deficiency by serum IgM in one of our IgA deficient cases (Patient 5). We observed a correlation between IgG3 and serum IgA in deficient cases (r=0.498, P=0.025). Our results indicate that in present study the prevalence of S IgA D is in agreement with data from other Caucasians populations (from 1:300 to 1:700). In conclusion, Selective IgA Deficiency could be almost asymptomatic in most cases in general population. Our study suggests that; due to high frequency of IgA deficiency in Iran, it seems necessary to measure IgA levels for every blood donor and blood recipient to find IgA deficient cases.

Allergic rhinitis (AR) is a common form of allergic disorder in Iran and rest of the world. This study was conducted to investigate the symptoms and paraclinical aspects of this allergy among Iranian patients. A total of 206 patients (51.5%: male), with one of the specific symptoms of AR, from March 2005 to March 2007 were enrolled in the study. A written questionnaire was completed for each patient. Furthermore, paraclinical evaluations including CBC, serum total IgE, spirometry and skin prick test (SPT) with common allergens were done for the patients. The ages of our patients ranged from 2 to 62 years of age (mean age of 18 - /+11.8 years). Mean age of onset of symptoms was 11.6 -/+ 9.9 years. In 82% of cases histories of other allergic diseases were seen in patients or their family members. Rhinorrhea was the most common symptom in our patients (77.9%). Frequencies of mild persistent, moderate - severe persistent, mild intermittent and moderate -severe intermittent types of AR were 20.5%, 41%, 21% and 17.5%, respectively. Frequencies of positive SPTs in all cases, patients with persistent and intermittent allergic rhinitis were 86.7%, 88.2% and 84.1%, respectively. The most common allergens in positive SPTs, were trees, weeds, grasses and Dermatophagoides pteronysinus. About 55.5 % of patients showed elevated total IgE levels (≥ 100 IU/ML). Abnormal spirometry results were seen in 33.5% of cases. The present study showed that among paraclinical investigations for AR, positive SPTs with aeroallergens, are more consistent with clinical findings. Regarding high ferequency of abnormal spirometry, we recommend that clinical suspicion about hyperreactive airway disease in AR patients is mandatory and performing spirometry for these cases is necessary whenever possible.

Common Variable Immunodeficiency (CVID) is a heterogeneous group of disorders characterized by hypogammaglobulinemia and an increased susceptibility to recurrent infections as well as autoimmunity and malignancies. Idiopathic Thrombocytopenic Purpura (ITP) and Autoimmune Hemolytic Anemia (AIHA) are two autoimmune disorders which may be seen in association with CVID. Among 85 CVID patients, seven cases had ITP and/or AIHA (8%). Four of these patients had one or more episodes of ITP, one patient had AIHA, and two patients had both ITP and AIHA (Evans syndrome). Almost, all patients experienced chronic and recurrent infections mostly in respiratory and gastrointestinal systems during the course of the disease. Among the seven patients, five presented their underlying disease with recurrent respiratory and/or gastrointestinal tract infections, while in two remaining patients, CVID was presented with ITP. Three patients died until now; two because of hepatic failure and one due to pulmonary hemorrhage. As CVID is prone to autoimmune disorders, it should be considered as a differential diagnosis of adult-onset ITP and possibly in children. Chronic and recurrent ITP, especially in the presence of propensity to respiratory and gastrointestinal infections mandate the evaluation for an underlying immune dysregulation such as CVID.

Dentin Bonding Agents (DBA) have been used as root-end filling materials. Present study evaluated the effects of polymerized DBA on secretion of pro-inflammatory cytokines by normal human monocytes. In this study, monocytes were directly isolated from human peripheral blood, and exposed to cured Scotch Bond 1 (single bond) and Prime and Bond for 36 and 72 hours. Secretion of IL-1β and TNF-α in the presence of lipopolysaccaharide was evaluated in supernatants of monocyte culture. DBAs significantly caused reduction of cytokine production by human monocytes after 36 and 72 hours. Prime and bond exposure caused more prominent decrease in TNF-α production after 72 hours. We conclude that DBA in polymerized form can alter normal function of human monocytes.

Immunodeficiency and autoimmune disease may occur concomitantly in the same individual. Some of the immunodeficiency syndromes, especially humoral defects are associated with autoimmune disorders. Hematological manifestations such as thrombocytopenia and hemolytic anemia are the most common presentations. Persistent antigen stimulation due to an inherent defect in the ability of the immune system to eradicate pathogens is the primary cause leading to autoimmunity in patients with primary immunodeficiency states.We describe a 10 year old Iranian girl with chronic granulomatous disease -the autosomal recessive type with mutation of NCF1 gene P47- associated with selective IgA deficiency, refractory immune thrombocytopenia that showed an excellent response to Rituximab (Anti-CD20 monoclonal antibody).Patients with primary immunodeficiencies may have variable autoimmune manifestations. So for early detection and appropriate treatment, autoimmune diseases should always be suspected in such patients.

An 8-year old boy with polyarthritis and nail involvement is presented in this report. Nail involvement in Reiter''s syndrome is a rare condition that may include painless erythematous nduration of the base of the nail fold; subungual parakeratotic scaling and thickening opacification, ridging of the nail plate.