American journal of clinical and experimental immunology最新文献

The XEN Gel Stent offers a unique Ab-interno approach for managing glaucoma and has shown a favorable risk profile relative to traditional trabeculectomy. XEN implantation has almost exclusively been reported in patients with open angle glaucoma and data in patients with angle closure glaucoma is limited. We report a postoperative complication of the XEN Gel Stent in a patient with primary angle closure glaucoma. An 86-year-old man with primary angle closure glaucoma underwent combined phacoemulsification and XEN implantation. After approximately two months, intraocular pressure was elevated and the stent was occluded by iris pigmentary deposits, traversing from the proximal to the distal conjunctival ends of the stent. Using an Ab-interno approach, the implant was successfully explanted, and the patient's intraocular pressure was notably lowered.

Background: Considering that patients with opioid dependence are at higher risk of inadequate sedation during operations, and the rescue analgesia in these patients are usually greater than the general population; the aim of this study was comparison of sedation quality of dexmedetomidine and morphine in patients with opioid use disorder undergoing cataract surgery.

Methods: This clinical trial was conducted on 60 patients with opioid use disorder underwent cataract surgery that were referred to Feiz Hospital, Isfahan, Iran in 2018. Patients were randomly divided into two groups as the dexmedetomidine group started 1 μg/kg dexmedetomidine in 10 minutes before surgery and then continued with 0.5 μg/kg/h while the morphine group received 0.1 mg/kg of morphine before surgery. Sedation score, pain intensity, hemodynamic parameters, analgesic request and side effects were compared in the two groups.

Results: There was no significant differences between groups based on Ramsay score before, during and after surgery (P > 0.05), the pain intensity in the morphine group was significantly lower during the recovery period than dexmedetomidine group, the duration of recovery and sedation in the morphine group was significantly more than the dexmedetomidine group, and nausea and vomiting and eye pain in the morphine group were significantly higher than dexmedetomidine (P < 0.05).

Conclusion: Morphine usage was more effective in pain relief than dexmedetomidine in patients with opioid use disorder undergoing cataract surgery, but the complications and recovery time were higher in morphine usage. Also the sedation was similar in both groups.

Background: Matrix metalloproteinase-9 (MMP-9), an enzyme with major role in remodeling of extracellular matrix, has been the focus of attention in some previous studies in the field of breast cancer. In the current study the relationship between matrix metalloproteinase-9 and some clinicopathological factors of breast carcinoma has also been evaluated.

Methods: Formalin-fixed and paraffin-embedded tissue specimens from three groups including 40 invasive breast carcinoma (tumor group) and their adjacent normal tissue (tumor control), as well as 40 normal mammoplasty specimens (normal control) were studied. The samples were from the pathology archive of Alzahra Hospital, Isfahan, Iran, from 2016 to 2018. The status of intraepithelial MMP-9 were studied and compared in these three groups using immunohistochemistry.

Results: The extent of intraepithelial MMP-9 immunostaining in all positive specimens was 100%. The results of intraepithelial MMP-9 staining intensity was as follow: 12.5% strong, 27.5% moderate, 27.5% mild, and 32.5% negative in tumor group; 17.5% strong, 22.5% moderate, 32.5% mild, and 27.5% negative in tumor control group; and 10% strong, 40% moderate, 27.5% mild, and 22.5% negative in normal control group. Intraepithelial MMP-9 immunostaining intensity showed significant difference between tumor and tumor control groups (P<0.001). Intraepithelial MMP-9 immunostaining intensity showed no significant difference between tumor and normal control groups, and between tumor control and normal control groups (P>0.05). No significant relationship was seen between intraepithelial MMP-9 immunostaining intensity and age, tumor size, tumor grade, and lymph node status in tumor group (P>0.05).

Conclusion: Intraepithelial MMP-9 expression increases in some breast carcinomas. Normal breast tissue adjacent to carcinoma does not show such increase. However, intraepithelial MMP-9 expression in breast carcinoma does not show any significant relationship with age, tumor size, tumor grade, and lymph node status.

Background: In the worldwide, there are the pandemic of the virus coronavirus disease 2019 (COVID-19) and there is no approved treatment for this disease.

Case presentation: This study reported a new case with COVID 19 with neurological symptoms such as headache and loss of consciousness without any symptoms and imaging of COVID 19 in admission but RT-PCR COVID 19 of patient was positive and during hospitalization patient had increasing cerebrospinal fluid (CSF) volume in sub-arachnoid space, micro-hemorrhaging in basal ganglia and down ward cerebellar tonsile herniation in the brain imaging, also there were rhabdomyolysis and thrombotic thrombocytopenic purpura in the lab data. Finally, based on abnormal electroencephalogram (EEG), brain death was diagnosed for patient in end of hospitalization. In the 8^th of admission day, the patients died after cardiovascular arrest.

Conclusion: The COVID 19 can be associated with different symptoms such as neurological complication and brain death was unusual complication in COVID19.

Bladder carcinoma (BC) is one of the most common malignancies of the urinary system in developed countries, with a high number of recurrences. The secondary lymphoid organs (SLO) are crucial for initiating the adaptive immune response. They are developed as a part of a genetically preprogrammed process during embryogenesis. However, SLO's organogenesis can be reduplicated de novo in other tissues by a process termed lymphoid neo-genesis, giving rise to tertiary lymphoid structures (TLS). These well-organized lymphoid structures in cancer are essential modulators of cancer immunologic response, and the histological examination of TLS gave a new strategy for cancer immunotherapy. This review explores the biological and histological characteristics of TLS in muscle non-invasive and invasive BC.

Background: There is an on-going debate on how best to test toxic indoor air. Toxicological methods based on condensed water samples and cell culture technique are newly introduced research tools which were tested in this study.

Methods: Pupils (n=47) from a water-damaged and (n=56) healthy schools were interviewed using a questionnaire. Indoor air was collected with a novel condensed water sampling technique and human THP-1 macrophages were exposed to the condensate. The cytotoxicity of cotton wool swab samples was tested using human BJ fibroblasts. Conventional microbiological culture methods were also performed.

Results: Gastrointestinal problems (GI) were reported by 51% from the study cohort but only 4% of the control cohort, relative risk RR=14.30. For any neurological or neuropsychological symptoms, the RR was 63.04, muscular-skeletal pain RR=58.28, headache RR=31.00, respiratory symptoms RR=22.64, fatigue RR=21.45, sub febrility RR=15.49, ear infections RR=7.74, skin rash RR=5.96, all being statistically significant (P<0.001). All indoor air (n=7) and cotton wool samples (n=2) taken from the water-damaged classroom or in proximity of the problematic classrooms were toxic in cell culture assays. Low numbers of moisture-damage indicators were recovered from wall, passive air, and swab samples, namely Aspergillus ochraceus species group, Aspergillus, Eurotium species group, Fusarium, Tritirachium, Scopulariopsis genus group and Aspergillus versicolores species group.

Conclusions: Indoor air toxicity and dampness-related microbiota recovered from the classrooms were associated with multi-organ morbidity of the school occupants. These results corroborated our previous reports from two adult cohorts i.e. evidence of causality. These new toxicological methods based on condensed water and cell culturing techniques seem to be superior to conventional microbiological methods in correlating with clinical symptoms.

Different organ perturbation and multiple complications might occur after cardiopulmonary bypass (CPB). A variety of solutions might be used for pump priming with different advantages and disadvantages. The advantage of fresh frozen plasma (FFP) inclusion in pump prime has been shown in post-CPB coagulation management. Acquired hypogammaglobulinemia is the disadvantage of albumin (ALB) pump prime. Our aim was to assess the impact of FFP prime on the post-pump serum level of immunoglobulin G (IgG) and its subclasses. Fifty-six patients under the age of 5 years old who were scheduled for cardiac surgery on CPB were randomly primed with FFP or ALB. Any innate or acquired immune deficiency was considered as exclusion criteria. The pre-CPB and 24-hour post-CPB collected blood samples were analyzed by the nephelometric method for the plasma level of IgG and its four subclasses. Twenty-two patients (mean age and weight of 13 months and 6.8 kilograms) in the ALB prime group and 26 patients (mean age and weight of 15 months and 8.1 kilograms) in the FFP prime group completed the study. Using paired t-test and repeated measures ANOVA test, patients in the ALB prime group had a significant drop in the post-CPB serum level of total IgG (597±138 mg/dL to 379±179 mg/dL, P value <0.001) and its two subclasses of IgG1 and IgG3. In contrast, there was a slight elevation in the serum level of total IgG (549±207 mg/dL to 630±180 mg/dL, P value =0.008) and its two subclasses of IgG2 and IgG4 in patients who had FFP prime solution. In conclusion, compared to the ALB prime solution, FFP inclusion in prime could hamper the pediatric post-CPB induced hypogammaglobulinemia.

Objective: ACE2 is crucially involved in the infection sustained by SARS-CoV-2, as it allows the entry of the virus into target cells while counteracting local inflammation, oxidative stress, and fibrosis. In this narrative review, we aim to discuss the usefulness of ACE2-derived peptides in the infection sustained by SARS-CoV-2.

Methods: A total of 49 papers pertinent to the purpose of the review were selected from the PubMed and Google Scholar databases. Clinical trials registered at ClinicalTrials.gov and dealing with the use of ACE2-derived medications in COVID-19 were also searched and discussed.

Results: Preclinical and clinical evidence shows that drugs mimicking or potentiating the effects of ACE2 may reduce the viral load and dampen the inflammatory and fibrotic pathways leading to respiratory distress. ACE2-derived therapeutic peptides may have a better pharmacokinetic and pharmacodynamic profile than other ACE2-based medications. They could be easily screened through peptide libraries and chemically modified in order to ameliorate the pharmacological properties. Furthermore, their local administration via an intranasal delivery or inhalation may reduce the risk of systemic side effects, thus conferring a good safety profile.

Conclusion: ACE2-derived peptides may play a dual beneficial role in COVID-19, by either preventing virus spread or inhibiting the secretion of pro-inflammatory mediators in airways. Viral, host, and environmental factors may affect the effectiveness of this therapeutic approach to a various extent and represent therefore a matter of investigation for future studies.

Background: Pharmaceuticals to inhibit mammalian target of rapamycin (mTOR) protein, which plays an integral role in T cell survival and function, have been used to prevent complications associated with organ transplantation. Although studies have individually shown that resveratrol can inhibit mTOR and that inhibiting mTOR leads to attenuated immune function, no studies to date have examined these two functions conjointly under one study. Therefore, we hypothesize that resveratrol will decrease mTOR activation and expression as well as attenuate stimulated T cell activation and proliferation in peripheral blood mononuclear cells (PBMC).

Methods and materials: Human PBMC were isolated and cultured. The cells were pre-treated with resveratrol (50 μM) overnight (18 hrs) before stimulation. The cells were collected for subsequent biochemical analysis after 1, 3, and 5 days. Additionally, the cells were stained with proliferation dye and cultured for 24 hours in PMA/Ionomycin with resveratrol for flow cytometry analysis.

Results: Resveratrol treated stimulated PBMCs displayed a significant decrease in activated phosphorylation of mTOR at days 1, 3, and 5 (P < 0.0329). Markers of T cell activation, tumour necrosis factor-alpha (TNF-α) and interferon-gamma (INF-γ), were also significantly reduced along with T cell proliferation following stimulated PBMC resveratrol treatment when compared to vehicle-treated controls (P < 0.01).

Conclusion: Taken together, our data suggest that resveratrol can decrease the immune response of stimulated T-cells and inhibit the expression and activation of mTOR mediated cellular signalling under the same study setting. Therefore, resveratrol proposes a possible adjunctive therapy option for patients undergoing organ transplantation.

Background: Carbamazepine is a first line treatment for focal epilepsy. Tegretol and Tegatard are two trade name of Carbamazepine. Tegretol is produced by Novartis Pharmaceutical Company, Switzerland. Recently, Raha pharmaceutical Company in Iran has produced CBZ which trade named is Tegatard. Extended usage of Tegatard instead of Tegretol has economic benefits for Iranian families. In this clinical trial, we aimed to compare therapeutic efficacy and safety of Tegretol and Tegatard in patients suffering from focal seizures with or without secondary generalization.

Methods: 200 patients with provoked or non-provoked focal seizure with or without secondary generalization were screened and 180 patients were fulfilled the criteria to enter this double blinded clinical trial study. Patients were divided into two groups, the first group (A) received Tegretol and the second group (B) Tegatard. Carbamazepine (CBZ) was prescribed with doses 10-20 mg/kg every 12 hours by neurologists. The patients were visited after 1, 3 and 6 months and the side effects and lab data in patients were investigated.

Results: Patients were divided into two groups, 88 patients in group A (Tegretol) (50 males and 38 females) and 92 in group B (Tegatard) (51 males and 41 females). Mean age of patients was 35.39±11.17 years. There was no significant difference according to age and gender, Carbamazepine dosage, EEG recording, neuroimaging change and adverse effects of antiepileptic drug between two groups (P>0.05). Regarding the drug efficacy, in group A and B, 60 (68%) and 58 (63%) patients were seizure free after 6 month follow up; respectively. The differences between two groups were not statistically significant (P value =0.46).

Conclusion: Tegatard is an effective drug with similar efficacy, similar side effects and cost-effectiveness compared with Tegretol and could be used widely when indicated.