Iranian Journal of Allergy, Asthma and Immunology
Volume:10 Issue: 4, Dec 2011

The CD30 antigen seems to play a costimulatory role in maintaining the physiological balance between T-helper (Th)1/Th2 immune responses. In this study, plasma and in vitro soluble CD30 (sCD30) secretion was investigated in patients with coronary artery disease (CAD) as a plausible marker of dysregulated immune response.Twenty one patients with angiographically confirmed CAD and 31 healthy controls took part in this study. The levels of the activation marker sCD30 were determined in plasma and phytohaemagglutinin (PHA)-stimulated and unstimulated peripheral blood mononuclear cell cultures by ELISA. Plasma sCD30 levels did not differ significantly between the patients and controls. However, spontaneous sCD30 secretion was significantly lower in patients with CAD compared to controls (p < 0.001). The soluble CD30 levels were significantly increased in the supernatant of PHA-stimulated PBMCs compared to unstimulated cultures in both groups of patients and controls (p < 0.001). PHA-stimulated sCD30 secretion was found to be lower in patients compared to controls; however, the difference was not statistically significant. Plasma sCD30 levels were not statistically different in patients with chronic stable CAD, a well-known Th1-mediated disease, compared to controls; whereas decreased spontaneous and PHA-stimulated sCD30 secretion in patients with CAD might indicate the progressive shift towards a Th1 immune response.

All-trans retinoic acid (ATRA), as an active metabolite of vitamin A, has been shown to affect immune cells. This study was performed to evaluate the effect of ATRA on viability, proliferation, activation and lineage-specific transcription factors of CD4+ T cells. CD4+ T cells were separated from heparinized blood of healthy donors and were cultured in conditions, some with, some without ATRA. Viability was assessed by PI flowcytometry and proliferation was measured by MTT assay. CD69 expression was determined by flowcytometry as a measure of cell activation. Lineage-specific transcription factors (FOXP3, RORγt and T-bet) were examined by intracellular staining and flowcytometry. High doses of ATRA (0.1-1 mM) caused extensive cell death in both PBMCs and CD4+ T cells. Doses of ATRA equal to or lower than 10 µM did not adversely affect cell viability and proliferation in comparison to culture medium without ATRA. Doses of ATRA between 10 µM and 1nM significantly increased cell activation when compared to culture medium without ATRA. ATRA could increase FOXP3+ and also FOXP3+RORγt+ T cells while it decreased RORγt+ and T-bet+ T cells. This study showed that doses of ATRA up to 10 µM are safe when using with CD4+ T cells in terms of cell viability, proliferation and activation. We could also show that ATRA diverts the human immune response in neutral conditions (without adding polarizing cytokines) by increasing FOXP3+ cells and decreasing RORγt+ cells. ATRA could be regarded as a potential therapy in inflammatory conditions and autoimmunities.

Allergic rhinitis and asthma share common epidemiological features and inflammatory processes. The aim of the present study was to document the influence of natural allergen exposure in exhaled NO (eNO) and in spirometric parameters of patients with seasonal allergic rhinitis(SAR) and to investigate the differences among subjects with positive versus negative bronchial provocation to metacholine(BPMch).Twenty-six non-smoking patients (13F/13M; mean age 28.4ys) with a documented history of SAR, 15 healthy, non-atopic(6F/9M; mean age 37.1ys) and 6 non-symptomatic atopic subjects (3F/3M; mean age 36.5ys) were studied. At the first visit during pollen season each subject filled symptom-score card, underwent eNO and nasal NO (nNO) measurements and spirometry. BPMch was performed within the next 10 days. At the second visit out of pollen season, all measurements but BPMch were repeated. Control subjects underwent eNO and nNO measurements.eNO was significantly increased during pollen season in BPMch positive vs BPMch negative(46.22±32.60 vs 17.81±12.67, p=0.014) and vs non-atopic controls(11.40±5.84, p<0.001) as well as atopic controls(13.56±5.34, p=0.001). No difference was detected out of pollen season in both patient's groups. nNO values were increased only in BPMch(+) group compared to both control groups in pollen season (vs non-atopics p=0.002, vs atopics p=0.002) and only vs non-atopics out of season, p=0.004. Regression analysis has shown that the difference in FEF25-75 values (off season-in season) is a predictor of positive BPMch.eNO is markedly increased in BPMch patients with allergic rhinitis while mid-expiratory flow may represent an early marker of lower airway involvement in respiratory allergy.

Multiple sclerosis (MS) is an autoimmune multifactorial degenerative disease with detrimental affliction on central nervous system. MHC class I chain- related geneA,B(MICA and MICB) are nonclassical human leukocyte antigens that can affect on some diseases and also on transplantation. The purpose of this study was to evaluate the MICA and MICB MRNA expression in multiple sclerosis patients. In this study, we evaluated MICA and MICB MRNA expression in the peripheral blood mononuclear cells by reverse transcryptase-polymerase chain reaction(RT-PCR) in MS patients and normal controls. The results of this study showed that 32.6% of patients with progressive clinical outcome over expressed MICB genes in comparison with controls (p=0.002). It is concluded that the high expression of MICB gene in MS patients is an important criterion of MS disease that it may be due to the interaction between MICB and its receptor on CD8+T or NK cells.

H. pylori is a human pathogen that colonizes the epithelium of the stomach. The host immune response may influence the disease process, where cytokines play important roles in the development of disease. In this study, the concentrations of selected cytokines in the gastric antrum and stomach body mucosa and also in the serum were evaluated. Eighty patients according to their rapid urease test were divided into two groups: H. pylori positive (n=39) and H. pylori-negative (n=41). The concentrations of cytokines in biopsies and serum were determined by ELISA method. The mean TNF-α and IFN-γ levels in the infected group were significantly higher than that of uninfected patients. In contrast, IL-10 level in most patients was undetectable. The mean antral of stomach TNF-α and IFN-γ levels were significantly higher than that of the stomach body. IFN-γ serum level showed positive correlation with antrum and stomach body levels, whereas no correlation was found in TNF-α in different samples. Higher levels of TNF-α and IFN-γ in antral indicate that the colonization of bacteria in the antrum may be higher than stomach body (culture results from two sites support this statement). Increased serum level of IFN-γ indicates the activation of circulating-T cells against infection. Induced H. pylori-related TNF-α is concentrated is gastric mucosa and this pathogen does not cause any significant change in the serum level of this cytokine. Therefore H. pylori by inducing certain inflammatory cytokines but not IL-10 may contribute the process of disease development.

The prevalence of exercise induced asthma (EIA) in Iran is not known. In the present study the prevalence of EIA among female students of guidance school in the city of Mashhad was evaluated. A total of 1690 female students aged 12-14 years in ten randomly selected schools in north east of Iran (Mashhad) completed an asthma symptoms- specific questionnaire. One hundred forty four randomly selected students including 49 symptomatic and 95 asymptomatic cases participated in a 6 minutes free run test (until reaching 70-75% of MHR (maximum heart rate) for evaluating EIA. Pulmonary function tests (PFT) were measured before (baseline), immediately, 5 minutes and 15 minutes after exercise. The prevalence of asthma symptoms among the studied students was 12.54%. There was not significant difference in any of PFT values between asymptomatic and symptomatic students. The results of exercise test showed that totally 61.22% of symptomatic students responded to exercise test (their post-exercise PFT values decline more than 15%) while only 16.82% of asymptomatic students were responders to exercise (p<0.001). However, in both asymptomatic and symptomatic responder students, all PFT values declined significantly after exercise compared to baseline values (p<0.05 to p<0.001) and there was not any significant difference between two groups.The results showed that although higher number of symptomatic students showed EIA, some asymptomatic students also sowed EIA.

Several studies have demonstrated that herbal extracts possess various biological effects including anti-inflammatory and anti-cancer activities. The present study was aimed to investigate the protective effects of the Astragalus gypsicolus (AG) hydroalcoholic extract in early allergic sensitized mice induced by ovalbumin. Phytochemical assay was used to recognize the main active constituents in the AG hydroalcoholic extract. Mice were immunized with subcutaneous injection of ovalbumin and aluminum hydroxide. Efficiency of sensitization was assessed by serum IgE levels and eosinophil count. After sensitization, two doses of extract (250 mg/kg and 500 mg/kg) were injected intrapritoneally. On day 14, mice were challenged with intrapritoneal injection of ovalbumin. IL-4 and IFNγ levels in broncoalveolar lavage fluid, which had been collected on day 15, were assessed by Enzyme-Linked Immunosorbent Assay (ELISA) kit. Our results indicate two main active constituents including flavonoids and terpenoids are present in the AG hydroalcoholic extract. Intrapritoneal injection of the AG hydroalcoholic extract was able to decrease IL-4 and increase IFNγ. It seems the AG hydroalcoholic extract has the potential to modulate the balance of Th1/Th2 cytokines in allergy.

Primary antibody deficiencies (PAD) are a group of immune system disorders, associated with decreased levels of secretory and protective immunoglobulins. Because of the important role of immunoglobulins in the protection of oral cavity, patients with PADs are more susceptible to dental caries or oral manifestations. This study was performed to investigate the oral and dental manifestations of PADs patients. In this study, 33 patients with PADs (21 common variable immunodeficiency, 8 X-linked agammaglobulinemia and 4 hyper IgM syndrome) and 66 controls were examined; the number of decayed, missed and filled teeth (DMFT) were investigated. Aphthous was the most frequent manifestation in PADs patients (38.7%), which was significantly16.7% higher than the controls (p=0.03). The patients with PADs showed significantly higher presentation of other oral and dental manifestations, including herpes sores, candidiasis tonsillitis, gingivitis, calculus, enamel hypoplasia and other ulcerations. The mean DMFT scores were 6.15±3.6 and 1.93±0.4 in PADs patients and controls, respectively (p<0.001). Although the patients with common variable immunodeficiency had higher means of DMFT in comparison with other groups of PADs, this difference was not statistically significant. This study showed significantly higher frequency of oral and dental manifestations in the patients with PADs compared to controls. Therefore, regular examination of oral cavity could be suggested in this group of immunodeficient patients.

Immunophenotyping of lymphocytes is very essential for evaluation of immune system. Due to the effect of environmental factors and ethnical diversity on immune system, establishment of an internal normal range of lymphocyte subsets is a necessity for each population. The aim of this study was to determine the normal range of T and B lymphocytes, and NK cells in normal Iranian adults.Two hundred and thirty three Iranian normal adult volunteers took part in this study. Complete Blood Count (CBC) was performed for them with Sysmex (KX21) and cells with CD3, CD4, CD8, CD19 and CD16/56 surface markers were simultaneously detected by flow cytometry method with FACstar system. Their percentile and absolute count were determined.The volunteers were 150 male and 83 female. Mean percentages of lymphocyte subpopulation were: CD3 (67.66 ±7.76), CD19 (14.41±5.09), CD4 (39.22±6.7), CD8 (25.42 ±5.4) and CD16/56 (10.14±6.42). Also, their mean absolute count of lymphocyte bearing CD3, CD19, CD4 and CD8 were 1,504±505/µl, 332±186/µl, 827±313/µl and 522±185/µl, respectively.Our results are comparable with similar Asian results from other Asian population, but are different from European population, we therefore conclude that it is necessary for each laboratory to establish an internal normal range for the lymphocytes bearing above- mentioned markers.

The hyperimmunoglobulin E syndrome is a rare complex primary immunodeficiency characterized by high serum IgE levels, eczema, and recurrent infections. We present a case of 2-years-old girl with eczema and repeated bacterial skin and lung infections since the period of infancy. The patient also had eosinophilia, high serum levels of IgE, and cows-milk hypersensitivity. We describe the case, in order to illustrate the difficulty of establishing the diagnosis hyper-immunoglobulin E syndrome in a toddler.