Prevalence of Hypertension and Obesity-related Hypertension in Urban School-aged Children in Rasht.

INTRODUCTION: Hypertension is a worldwide health concern. Complications of hypertension not only affect adult patients, but also involve children. Given the importance of assessing children with hypertension in order to decrease adulthood complications, we aimed to assess the prevalence of hypertension in urban school-aged children in Rasht, Iran. MATERIALS AND METHODS: This cross-sectional study was conducted on 2072 school-aged children in Rasht, Iran, from January 2013 to December 2015. Inclusion criteria were age between 7 and 17 years and residence and attending school in the urban area of Rasht. RESULTS: Overall, 205 (9.9%) and 144 (6.9%) of the participants were hypertensive and prehypertensive, respectively. The mean systolic blood pressure was 124.54 ± 11.86 mm Hg in the children. The prevalence of obesity in the children was 3.5%. Comparing the normal, prehypertensive, and hypertensive groups, there was a significantly increasing trend regarding age, height, weight, and body mass index associated with higher blood pressure categories. CONCLUSIONS: This study showed a high rate of hypertension among school-aged children in Rasht. Hypertensive children tended to be have a higher body mass index than the prehypertensive and normal-weight participants. Case identification and early assessment of these children is recommended.

Immunostimulant properties of chemical delivery systems in vaccine development.

One approach to improve the vaccine quality is the incorporation of immunomodulators and/or adjuvants with modified delivery systems. The use of delivery systems especially chemical carriers is a promising strategy in the prevention and treatment of infections, cancers, allergies and autoimmune diseases. These systems are able to elicit an effective immune response as well as stability and safety in vaccine development. Synthetic microparticles, liposomes, chitosan, virus like particle, polymeric nanogel, phytosome, noisome, and micro/ nanospheres have been applied as carriers, providing a broad variety of immunomodulatory effects in vaccines. The potency and nature of immune responses rely on the physicochemical properties of the vaccine constructs (e.g., size and charge), the route of injection, the biochemical characteristics and the amount of antigen. Three main steps are necessary for vaccine efficiency such as targeting, activation and transfection/ antigen presentation. These systems can generally influence the type and direction of immune responses. This review describes different vaccine delivery systems developed to generate immunomodulatory effects.

Whole recombinant Pichia pastoris expressing HPV16 L1 antigen is superior in inducing protection against tumor growth as compared to killed transgenic Leishmania.

The development of an efficient vaccine against high-risk HPV types can reduce the incidence rates of cervical cancer by generating anti-tumor protective responses. Traditionally, the majority of prophylactic viral vaccines are composed of live, attenuated or inactivated viruses. Among them, the design of an effective and low-cost vaccine is critical. Inactivated vaccines especially heat-killed yeast cells have emerged as a promising approach for generating antigen-specific immunotherapy. Recent studies have indicated that yeast cell wall components possess adjuvant activities. Moreover, a non-pathogenic protozoan, Leishmania tarentolae (L.tar) has attracted a great attention as a live candidate vaccine. In current study, immunological and protective efficacy of whole recombinant killed Pichia pastoris and Leishmania tarentolae expressing HPV16 L1 capsid protein was evaluated in tumor mice model. We found that Pichia-L1, L.tar-L1 and Gardasil groups increase the IgG2a/IgG1 ratio, indicating a relative preference for the induction of Th1 immune responses. Furthermore, subcutaneous injection of killed Pichia-L1 generated the significant L1-specific IFN-γ immune response as well as the best protective effects in vaccinated mice as compared to killed L.tar-L1, killed Pichia pastoris, killed L.tar and PBS groups. Indeed, whole recombinant Leishmania tarentolae could not protect mice against C3 tumor mice model. These data suggest that Pichia-L1 may be a candidate for the control of HPV infections.

A non-pathogenic live vector as an efficient delivery system in vaccine design for the prevention of HPV16 E7-overexpressing cancers.

The attenuated or non-pathogenic live vectors have been evolved specifically to deliver DNA into cells as efficient delivery tools in gene therapy. Recently, a non-pathogenic protozoan, Leishmania tarentolae (L.tar) has attracted a great attention. In current study, we used Leishmania expression system (LEXSY) for stable expression of HPV16 E7 linked to different mini-chaperones [N-/C-terminal of gp96] and compared their immunogenicity and protective effects in C57BL/6 mice against TC-1 challenge. TC-1 murine model is primary C57BL/6 mice lung epithelial cells co-transformed with HPV16 E6, HPV16 E7 and ras oncogenes. Our results showed that subcutaneous administration of mice with both the recombinant L.tar-E7-NT (gp96) and L.tar-E7-CT (gp96) led to enhance the levels of IFN-γ and also IgG2a before and after challenge with TC-1. Furthermore, L.tar-E7-CT (gp96) live vaccine indicated significant protective effects as compared to control groups as well as group vaccinated with L.tar-E7. Indeed, the recombinant live vector is capable of eliciting effective humoral and cellular immune responses in mice, but however, further studies are required to increase their efficacy.

Different domains of glycoprotein 96 influence HPV16 E7 DNA vaccine potency via electroporation mediated delivery in tumor mice model.

DNA vaccines have emerged as a promising approach for generating antigen-specific immunotherapy. However, due to their low immunogenicity, there is a need to enhance DNA-based vaccine potency. Two main strategies to increase DNA-based vaccine potency are the employment of immuno-adjuvants such as heat shock proteins (HSPs) and a method of improving the delivery of naked plasmid DNA by electroporation. In the current study, we evaluated the effects of linkage of human papillomavirus (HPV) type 16 E7 as a model antigen to N-terminal and C-terminal of glycoprotein 96 (NT-/CT-gp96) on the potency of E7-specific immunity generated by DNA vaccines. We found that subcutaneous DNA injection with E7-CT (gp96) followed by electroporation generates the significant E7-specific IFN-γ immune responses as well as the best protective effects in vaccinated mice as compared to E7 or E7-NT (gp96) DNA vaccines. Therefore, our data indicate that subcutaneous administration of E7 DNA linked to CT (gp96) fragment followed by electroporation can significantly enhance the potency of DNA vaccines. Indeed, the structural domains of immuno-chaperones show the potential of generating effective immune responses against different clinical disorders such as cancer. Altogether, our results show that comparable regions of gp96 (N-/C-terminal fragments of gp96) may have qualitatively different immunological effects in vaccine design.

Psychological disorders in patients with chronic constipation.

AIM: The aim of present study was to screen two categories of psychiatric disorders in chronic functional constipation. BACKGROUND: It has been established that the prevalence of mood and anxiety disorders among patients with functional gastrointestinal disorders is higher than in the general population. PATIENTS AND METHODS: Fifty four constipated patients were recruited from patients referred to the motility disorder department of Research Center for Gastroentrology and Liver Diseases, and screened for psychiatric disorders using HADS (Hospital Anxiety and Depression Scale) and MINI (Mini International Neuropsychiatric Interview). RESULTS: The results showed a relatively high prevalence of anxiety and depression both in HADS (33.3% and 22.2% respectively) and MINI (33.3% and 31.5% respectively). CONCLUSION: Based on our results the prevalence of mood and anxiety disorders in constipated patients is much higher than general population and in order to reduce health care costs for constipated patients, we need to have an intervention program for comorbid psychological dysfunctions which affect the course of gastrointestinal disorders.

Neurocognitive effects of phenobarbital discontinuation in epileptic children.

PURPOSE: Phenobarbital (PB) is the most widely used antiepileptic drug in the world, but its possible deleterious cognitive and behavioral side effects remain an important concern among physicians and patients.We therefore investigated whether discontinuation of PB in children with epilepsy is accompanied by improvement in cognitive function. METHODS: Neuropsychiatric performance was evaluated with the Wechsler Intelligence Scale for Children-Revised (WISC-R), in two consecutive 7-month periods, in two groups of children with epilepsy 6-12 years old who had been seizure-free for at least 2 years and whose only antiepileptic drug was PB. The case group comprised 24 patients who discontinued PB, and the control group was comprised of the 21 children who continued to take PB. RESULTS: Discontinuation of PB improved Total IQ in the case group compared to the control group (P = 0.027). This increase was mostly in performance (nonverbal) items; verbal items remained almost unchanged. CONCLUSION: These findings suggest that PB affects cognitive function, and the performance (nonverbal) deficits are diminished after discontinuation of therapy.