Iranian Journal of Allergy, Asthma and Immunology
Volume:14 Issue: 1, Feb 2015

Polymorphisms in the β subunit of the high affinity receptor for IgE (FcεRIβ) and interferon-γ (IFN-γ) genes may influence the risk of asthma. However, the results in Asian population are still debatable. We performed a meta-analysis to ascertain the association between the FcεRIβ E237G, FcεRIβ -109C/T, and IFN-γ 874T/A polymorphisms and asthma in an Asian population.Databases including PubMed, Chinese National Knowledge Infrastructure (CNKI), Weipu, and Wan Fang (Chinese) databases were searched to find the relevant studies. The effect summary odds ratio (OR) with 95% confidence interval (CI) was calculated.There was no significant difference in dominant model and allele model (EG + GG vs. EE: OR = 1.14, 95%CI = 0.94-1.40; G vs. E: OR = 1.13, 95%CI = 0.95-1.34) for FcεRIβ E237G, and no significant association was observed in the subgroup analysis by age and atopic status. A significantly decreased risk of asthma was observed in allelic model (C vs. T: OR=0.88, 95%CI=0.80-0.98) for FcεRIβ -109C/T, significant association was found in dominant model (AT+TT vs. AA: OR=0.56, 95% CI=0.33-0.97) for IFN-γ 874T/A.This meta-analysis suggested that FcεRIβ E237G is not an influencing factor for asthma in Asian population. FcεRIβ -109C/T and IFN-γ 874T/A polymorphisms may be influencing factors for asthma in the Asian population.

The use of flow cytometry in the clinical laboratory has grown substantially in the past decade. Flow cytometric analysis provides a rapid qualitative and quantitative description of multiple characteristics of individual cells. For example, it is possible to detect the cell size and granularity, aspects of DNA and RNA content and the presence of cell surface and nuclear markers which are used to characterize the phenotype of single cells.Flow cytometry has been used for the immunophenotyping of a variety of specimens including whole blood, bone marrow, serous cavity fluids, (cerebrospinal fluid) CSF, urine and all types of body fluids. The technique has also been applied to human bronchoalveolar lavage (BAL) fluid, peritoneal fluids and blood.In this review, we describe the current status of the application of flow cytometry as a diagnostic tool in various lung diseases.We focus on the analysis of BAL cell composition in chronic obstructive lung disease (COPD), asthma, lung cancer, sarcoidosis, tuberculosis and idiopathic eosinophilic pneumonia (IEP).

The aetiology behind odor-related chronic somatic symptoms (O-RCSS) is unknown, although both immunological and psychiatric causes have been suggested. The aim of this study was to investigate the occurrence of self-reported asthma and hay fever and psychiatric symptoms in individuals having O-RCSS compared to individuals with similar chronic somatic symptoms (CSS) which were not odors-related, and also compared to healthy controls.Data from the Hordaland Health Study were used. 13,799 individuals, 40-45 years, answered a questionnaire including 16 questions related to somatic symptoms. They also indicated if the symptoms were odor-related, and answered questions about asthma and hay fever. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale.38 (0.6%) men and 106 (1.4%) women had O-RCSS, whereas 88 (1.5%) men and 192 (2.5%) women had CSS. Adjusted logistic regression analyses showed increased odds of self-reported asthma in those with O-RCSS compared to those with CSS (males: 3.81, 1.06-13.8, females: 2.60, 1.05-6.93) and compared to male and female controls (3.56, 1.89-6.68 and 4.81, 1.92-12.1 respectively). Increased odds of self-reported hay fever were in addition seen in females with O-RCSS. There were no differences in psychiatric symptoms between individuals with O-RCSS and CSS, although individuals in both groups showed increased odds compared to male and female controls.Increased occurrence of self-reported asthma was exclusively found among male and females with O-RCSS, compared to CSS and controls. Increased occurrence of psychiatric symptoms was seen both in individuals with O-RCSS and CSS.

Asthma and atopic dermatitis are common allergic diseases, and their prevalence has increased in urban children. Recently, it is becoming understood that forest environment has favorable health effects in patients with chronic diseases. To investigate favorable clinical and immunologic effects of forest, we examined changes in clinical symptoms, indirect airway inflammatory marker, and serum chemokines before and after a short-term forest trip.The forest trips were performed with 21 children with asthma and 27 children with atopic dermatitis. All participating children were living in air polluted urban inner-city. We measured spirometry and fractional exhaled nitric oxide (FeNO) in children with asthma and measured scoring atopic dermatitis (SCORAD) index and Thymus and Activation-Regulated Chemokine (TARC)/CCL17 and Macrophage-Derived Chemokine (MDC)/CCL22 levels in children with atopic dermatitis before and after the forest trip. Indoor air pollutants such as indoor mold, particulate matter 10 (PM10) and total volatile organic compounds (TVOCs) of each child’s home and the accommodations within forest were measured.A significant increase in forced vital capacity (FVC) and a significant decrease in FeNO were observed after the forest trip in children with asthma. SCORAD indices and MDC/CCL22 levels were significantly decreased after the forest trip in children with atopic dermatitis. Airborne mold and PM10 levels in indoor were significantly lower in the forest accommodations than those of children’s homes; however, TVOC levels were not different between the two measured sites.Short-term exposure to forest environment may have clinical and immunological effects in children with allergic diseases who were living in the urban community.

Emotional Freedom Technique (EFT) as a new therapeutic technique in energy psychology has positive effects on psychological and physiological symptoms, and quality of life. In this research we studied the effect of this treatment on immunological factors.This study tested whether 8-week group sessions of EFT (compared to a wait-list control group) with emphasis on patient''s respiratory, psychological and immunological problems in chemically pulmonary injured veterans (N=28) can affect on immunological and psychological factors.Mixed effect linear models indicated that EFT improved mental health (F=79.24, p=0) and health-related quality of life (F=13.89, p=0.001), decreased somatic symptoms (F=5.81, p=0.02), anxiety/insomnia (F=24.03, p<0.001), social dysfunction (F=21.59, p<0.001), frequency and severity of respiratory symptoms (F=20.38, p<0.001), and increased lymphocyte proliferation with nonspecific mitogens Concanavalin A (Con A) (F=14.32, p=0.001) and Phytohemagglutinin (PHA) (F=12.35, p=0.002), and peripheral blood IL-17 (F=9.11, p=0.006).This study provides an initial indication that EFT may be a new therapeutic approach for improving psychological and immunological factors.

Asthma as a chronic inflammatory airway disease is considered to be the most common chronic disease that is involving genetic and environmental factors. Toll like receptors (TLRs) and other inflammatory mediators are important in modulation of inflammation. In this study, we evaluated the role of TLR2 Arg753Gln and TLR4 Asp299Gly polymorphisms in the asthma susceptibility, progress, control levels and lung functions in Iranian patients.On 99 asthmatic patients and 120 normal subjects, TLR2 Arg753Gln and TLR4 Asp299Gly polymorphisms were evaluated by PCR-RFLP method recruiting Msp1 and Nco1 restriction enzymes, respectively. IgE serum levels by ELISA technique were determined and asthma diagnosis, treatment and control levels were considered using standard schemes and criteria.Our results indicated that the genotype and allele frequencies of the TLR2 Arg753Gln and TLR4 Asp299Gly polymorphisms were not significantly different between control subjects and asthmatics and were not related to in asthma features such as IgE levels, asthma history and pulmonary factors.Wherease some previous studies indicated TLRs and their polymorphisms might have some role in asthma incidence and features, our data demonstrated that TLR2 Arg753Gln and TLR4 Asp299Gly gene variants were not risk factors for asthma or its features in Iranian patients. Genetic complexity, ethnicity, influence of other genes or polymorphisms may overcome these polymorphisms in our asthmatics.

Macrophages and T-lymphocytes are involved in immune response to Mycobacterium tuberculosis. Macrophage produces interleukin (IL)-1 as an inflammatory mediator. IL-1 receptor antagonist (IL1-Ra) is a natural antagonist of IL-1 receptors. In this study we aimed to examine the possible association between the variable number of tandem repeats (VNTR) of the IL-1 receptor antagonist (IL1RN) gene and pulmonary tuberculosis (TB) in a sample of Iranian population.Our study is a case-control study and we examined the VNTR of the IL1RN gene in 265 PTB and 250 healthy subjects by PCR.Neither the overall chi-square comparison of PTB and control subjects nor the logistic regression analysis indicated any association between VNTR IL1RN polymorphism and PTB.Our data suggest that VNTR IL1RN polymorphism may not be associated with the risk of PTB in a sample of Iranian population. Larger studies with different ethnicities are needed to find out the impact of IL1RN VNTR polymorphism on risk of developing TB.

Oxidative stress is involved in the pathogenesis of asthma. Paraoxonase 1 (PON1) and arylesterase are esterase enzymes displaying antioxidant characteristics. PON1 activity varies widely among individuals and ethnic groups, partly related to polymorphisms.The aim of this study was to determine the activities of PON1 and arylesterase including the phenotype distribution of PON1 in asthmatic patients and healthy subjects.Forty-nine asthmatic patients and 41 healthy people were included in this study. Serum PON1 and arylesterase activities were determined by spectrophotometric assays, as well as the lipid profiles. The PON1 ratio (salt stimulated paraoxonase/arylesterase) was trimodally distributed and this ratio was used to determine the individual phenotypes of all subjects.The PON1 activity in the asthmatic patients was significantly lower (p=0.024) when compared to the healthy control group, however no significant difference in the activity of arylesterase was observed between the two groups. The prevalence of the PON1 phenotypes in the asthmatic population were 26.5%, 16.3% and 57.2 % for QQ, QR and RR, respectively.PON1 activity was significantly lower in asthmatic patients; in addition, the results of this investigation indicated that PON1 RR phenotype may be an important risk factor in asthma disease.

Asthma environmental triggers play important roles in severity of disease. Passive smoking could exacerbate asthma symptoms and enhance the decrease in lung function. Cotinine levels could be a reflection of passive exposure to the cigarette both in adults and pediatrics. The aim of this study was to determine degree of association of asthma severity and cotinine level as a marker of passive smoking.In a cross-sectional study, 100 pediatric patients (under 10 years old) with asthma were enrolled, 50 of whom, had been exposed to passive smoking and 50 others included as controls. A complete clinical history, lab exam, and spirometry were performed. A sample of urine, serum and saliva was collected from all attendant patients and controls in the study after confirmation of diagnosis and determination of severity of asthma.The results revealed that age, sex, age of onset of asthma, family history and allergic history were not significantly different between two groups of patients. According to GINA classification, percentage of patients with severe asthma was significantly higher in passive smoker group (p=0.001). Cotinine was significantly higher in passive smoker group compared to control group in serum (p=001), saliva (p=0.001), and urine (p=0.0014). In passive smoker group, cotinine levels were significantly higher in serum (p=0.001), urine (p=0.007), and saliva (p=0.01) of patients with severe asthma than moderate and mild asthma. Serum cotinine (OR: 1.81, 95% CI: 1.35-2.32, p=0.024), urine cotinine (OR: 3.56,95% CI = 1.29-5.53, p=0.01) and saliva cotinine (OR: 1.66, 95% CI: 1.23-1.98, p=0.031) were also significantly associated with higher risk of severe asthma.Cotinine levels were higher in passive smokers compared to non-passive smokers. Besides, cotinine was a predictive risk factor for severe asthma.

Allergy to Prosopis juliflora (mesquite) pollen is one of the common causes of respiratory allergy in tropical countries. Mesquite is widely used as street trees in towns and ornamental shade trees in parks and gardens throughout arid and semiarid regions of Iran. The inhalation of mesquite pollen and several species of Amaranthus/Chenopodiaceae family is the most important cause of allergic respiratory symptoms in Khuzestan province. This study was designed to evaluate IgE banding proteins of mesquite pollen extract and its IgE cross-reactivity with other allergenic plants.Twenty patients with allergic symptoms and positive skin prick tests (SPT) for mesquite pollen extract participated in the study. Crude pollen extract was prepared from local mesquite trees and used for the evaluation of allergenic profiles of P. juliflora pollen extract by Sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE) and IgE-immunoblotting.There were several protein bands in mesquite pollen extract using SDS-PAGE with the approximate range of molecular weight of 10-85 kDa. The most frequent IgE reactive bands among the patients'' sera were approximately 20 and 66kDa. However, there were other IgE reactive protein bands among the patients'' sera with molecular weights of 10, 15, 35, 45, 55 and 85kDa. Inhibition experiments revealed high IgE cross-reactivity between mesquite and acacia.There are several IgE-binding proteins in P. juliflora pollen extract. Results of this study indicate that proteins with a molecular weight of 10 to 85 kDa are the major allergens in P. juliflora pollen extract.

A quantitative and qualitative survey of airborne pollen was performed in the city of Karachi, and the pollen counts were correlated with different climatic conditions. The aim of the study was to determine the possible effect of meteorological factors on airborne pollen distribution in the atmosphere of Karachi city.Pollen sampling was carried out by using Burkard spore Trap for the period of August 2009 to July 2010, and a total of 2,922 pollen grains/m3 were recorded.In this survey, 22 pollen types were recognized. The highest pollen count was contributed by Poaceae pollen type (1,242 pollen grains/m3) followed by Amaranthaceae/Chenopodiaceae (948 pollen grains/m3), Cyperus rotundus (195 pollen grains/m3) and Prosopis juliflora (169 pollen grains/m3). Peak pollen season was in August showing a total of 709 pollen grains/m3 and lowest pollen count was observed in January-2010. Pearson’s chi-square test was performed for the possible correlation of pollen counts and climatic factors. The test revealed significant positive correlation of wind speed with pollen types of Amaranthaceae/Chenopodiaceae; Brassica campestris; Asteraceae; and Thuja orientalis. While the correlation of “average temperature” showed significant positive value with Asteraceae and Tamarix indica pollen types. Negative correlation was observed between humidity/ precipitation and pollen types of Brassica campestris; Daucus carota; Ephedra sp.; and Tamarix indica. In the light of above updated data one could identify various aeroallergens present in the air of Karachi city.

Melatonin has both pro-inflammatory and anti-inflammatory properties depending on the stage of inflammation. Despite its therapeutic effect in alleviation of some symptoms of multiple sclerosis; the precise role of melatonin in MS pathogenesis remains a topic of debate. The aim of this study was to measure the urine level of one of melatonin products which is an index of serum melatonin level, in MS patients in the acute phase of relapse and control patients. We also analyzed different clinical and cognitive indices in order to find any correlation with melatonin level.Twenty eight patients who were diagnosed as relapsing-remitting MS, according to the revised McDonald criteria, along with 10 age- and sex-matched control subjects were recruited in our study.Here we showed that urine 6-sulphatoxymelatonin levels (aMT6s; the major metabolite of melatonin) were significantly lower in MS patients compared to control group. Interestingly, urine aMT6s levels significantly correlated with MS Functional Composite score, but not Expanded Disability Severity Score.Based on above findings, there might be new hope in developing a quantitative and objective measure to assess the MS severity especially in neurodegenerative diseases. However, our results should be analyzed cautiously. We didn’t evaluate simultaneous level of 25-OH Vitamin D. It has been recently reported that there is a negative correlation between melatonin and vitamin D levels. Further studies are needed to confirm this hypothesis.

Neuromyelitis optica is an inflammatory demyelinating disease (IDD) of the CNS, which mainly affects optic nerve and spinal cord. Autoantibodies against aquaporin-4 also known as NMO-IgG have been implicated in the pathogenesis of NMO. We evaluated the sensitivity and specificity of NMO-IgG assay for diagnosing NMO patients and differentiating them from MS patients and those with undifferentiated IDD with overlap symptoms.Eligibility of patients with demyelinating disorders was evaluated based on physical examination, laboratory and imaging studies. Thirty four definite NMO patients (disregarding NMO-IgG status), 34 multiple sclerosis (MS) patients with a history of optic neuritis (ON) or myelitis that were matched for age and disease activity and 44 patients with ON or myelitis attacks fulfilling neither criteria of MS or NMO (NMO spectrum) were selected as undifferentiated group. NMO-IgG was measured in the serum of the included patients by cell-based indirect immunofluorescence assay (IFA).NMO antibody was positive in 11 (32.3%), and 4 (9.09%) patients in NMO and undifferentiated groups, but was undetctable in MS patients. NMO antibody was 32% (95%Cl: 19-49%) sensitive in detecting NMO patients. Its specificity in differentiating NMO from MS subjects was 100 %(95% Cl: 90-!00%). NMO antibody was 95% (95% Cl: 0.88-0.98) specific in differentiating NMOs from other demyelinating diseases.Our results showed that although NMO antibody is highly specific for NMO, current method of measuring it with cell-based IFA is not highly sensitive for diagnosing NMO patients.

A new competitive immunochromatography (ICG) strip test based on polyclonal antibody (pAb) conjugated with gold nanoparticles (NPs) was developed and its applications for primary screening of immunoglobulin (Ig) A in serum were evaluated. Nanocolloidal gold as the detection reagent, with an average particle diameter of 20 nm, was synthesized and labelled pAb.The antibody-nanocolloidal gold probe was applied on the conjugate pad, and human IgA was immobilized on a nitrocellulose membrane as the capture reagent to prepare the ICG strip test. It took only 10 minutes to accomplish a semi-quantitative detection of serum IgA in this assay.In the optimized investigational conditions, the ICG strip test could distinguish human serum IgA in the range from 1 to 270 ng/mL with a detection limit of 5 ng/mL.The reliability of testing procedures was examined by performing the ICG strip test with 11 serum samples and comparing the results with those obtained via enzyme-linked immunosorbent assay (ELISA). The ICG strip was sufficiently sensitive and accurate for a rapid screening of IgA in human serum.

Alkylhydroperoxide reductase (AhpC, the 26 kDa antigen) is one of the abundant antioxidant enzymes in Helicobacter pylori and seems to have a good potential for use in development of immunoassays to detect H. pylori infection in clinical specimens. This study aimed to investigate some properties of this antigen by the produced monoclonal antibodies.Five established hybridoma cell lines secreting monoclonal antibodies (MAbs) against 26 kDa antigen of H. pylori were cultivated and MAbs were purified by affinity chromatography. Subsequently, MAbs were conjugated with biotin, and different combinations of capture and tracer antibodies used in sandwich ELISA. Immunoblotting of bacterial extracts were performed to estimate aggregation status of the antigen. Release of antigen from the cultivated bacteria on solid media was examined by sandwich ELISA, and also, existence of interference in fecal extract was investigated by immunoblotting and sandwich ELISA.Our findings showed that the MAbs against 26 kDa antigen of H. pylori could recognize three bands of nearly 25 kDa, 50 kDa, and 75 kDa in immunoblotting. This study also indicated presence of more antigens in the culture medium around the bacteria than the bacterial extract itself. The results of sandwich ELISA and immunoblotting on fecal extracts suggest the presence of interfering agents that prevent detection of antigen by antibody in ELISA but not in immunoblotting.In this study the oligomerization of the 26 kDa antigen, presence of interfering agents in stool matrix, and release of antigen to outside of bacteria, were demonstrated.