Unraveling the dynamic mechanisms of natural killer cells in viral infections: insights and implications.

Viruses pose a constant threat to human well-being, necessitating the immune system to develop robust defenses. Natural killer (NK) cells, which play a crucial role in the immune system, have become recognized as vital participants in protecting the body against viral infections. These remarkable innate immune cells possess the unique ability to directly recognize and eliminate infected cells, thereby contributing to the early control and containment of viral pathogens. However, recent research has uncovered an intriguing phenomenon: the alteration of NK cells during viral infections. In addition to their well-established role in antiviral defense, NK cells undergo dynamic changes in their phenotype, function, and regulatory mechanisms upon encountering viral pathogens. These alterations can significantly impact the effectiveness of NK cell responses during viral infections. This review explores the multifaceted role of NK cells in antiviral immunity, highlighting their conventional effector functions as well as the emerging concept of NK cell alteration in the context of viral infections. Understanding the intricate interplay between NK cells and viral infections is crucial for advancing our knowledge of antiviral immune responses and could offer valuable information for the creation of innovative therapeutic approaches to combat viral diseases.

CARD9 deficiency with allergic bronchopulmonary aspergillosis (ABPA)-like presentation: a case report.

PURPOSE: We present a patient with CARD9 deficiency and allergic bronchopulmonary aspergillosis (ABPA)-like presentation. METHODS: Following medical history taking and routine laboratory investigations, an inborn error of immunity was suspected, and the responsible variant was identified using Whole Exome Sequencing and confirmed by Sanger sequencing. RESULTS: A 14-year-old Iranian female presented with a history of chest pain, productive cough, dyspnea, malaise, and recurrent fever. Imaging by computed tomography (CT scan), chest X-ray (CXR), bronchoscopy, transbronchial lung biopsy (TBLB), and histopathology findings led to a diagnosis of ABPA-like presentation. The genetic study showed an autosomal recessive homozygous mutation in the CARD9 gene. Clinical remission was achieved following the administration of voriconazole, which was continued as prophylaxis. CONCLUSIONS: This is the first-time report of a patient with inherited CARD9 deficiency and ABPA-like presentation due to Aspergillus Terrus. This study paves the way to elucidate immunological mechanisms underlying CARD9 deficiency and aspergillosis.

Th17/IL-17 Axis in HTLV-1-Associated Myelopathy Tropical Spastic Paraparesis and Multiple Sclerosis: Novel Insights into the Immunity During HAMTSP.

Human T lymphotropic virus-associated myelopathy/tropical spastic paraparesis (HTLV/TSP), also known as HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and multiple sclerosis (MS) are chronic debilitating diseases of the central nervous system; although the etiology of which is different, similarities have been observed between these two demyelinating diseases, especially in clinical manifestation and immunopathogenesis. Exorbitant response of the immune system to the virus and neurons in CNS is the causative agent of HAM/TSP and MS, respectively. Helper T lymphocyte-17 cells (Th17s), a component of the immune system, which have a proven role in immunity and autoimmunity, mediate protection against bacterial/fungal infections. The role of these cells has been reviewed in several CNS diseases. A pivotal role for Th17s is presented in demyelination, even more axial than Th1s, during MS. The effect of Th17s is not well determined in HTLV-1-associated infections; however, the evidence that we have supplied in this review illustrates the attendance, also the role of Th17 cells during HAM/TSP. Furthermore, for better conception concerning the trace of these cells in HAM/TSP, a comparative characterization with MS, the resembling disease, has been applied here.

What Predict Self-rated Health: A Cross-sectional Study Among Men and Women with Non-cardiac Chest Pain.

The study aimed to determine different lifestyle and clinical factors that predict self-rated health (SRH) in non-cardiac chest pain (NCCP) patients. In this cross-sectional study, 360 NCCP patients filled out questionnaires about depression, somatization, body sensation, type D personality, and pain intensity. In addition, participants' lifestyle and socio-demographic data were obtained. Multiple regression analyses revealed that among men, pain intensity (OR 1.07; 95% CI 1.03, 1.12), depression (3.10; 1.38, 9.18), somatization (1.18; 1.08, 1.29) and sleep quality (6.23; 1.42, 27.27) were associated with self-rated health. In women NCCP patients, depression (2.44; 1.05, 6.82) pain intensity (1.05; 1.01, 1.10), and physical activity (2.21; 1.07, 5.55) were associated with SRH. The results on the predicting factors of SRH in NCCP patients provide potential insights for more advanced clinical management of NCCP. In addition, they can be applied to improve health policies and promote healthy behaviors among NCCP patients.

The Impact of Psychosomatic Factors on Treatment Adherence of Acute Myocardial Infarction Survivors; A Two-Year Follow-Up Study.

Backgroud: Because of the important role of adhering to treatment to reduce major adverse cardiovascular events and mortality, studying the factors affecting treatment adherence (TA) is warranted. This study aimed to identify the impact of psychosomatic factors on adhering to treatment among patients with acute myocardial infarction. Materials and Methods: This is a cohort study as a part of the Isfahan ST-segment-elevated Myocardial Infarction Cohort Study. Psychosomatic factors such as health anxiety, illness denial, irritable mood, and demoralization were assessed among 867 patients at the first visit. The patients were followed for 2 years; TA and major adverse cardiovascular events were checked annually in survivors. Results: The results from binary logistic regression applied to find the association between TA and psychosomatic factors showed that the patients with health anxiety, irritable mood, and demoralization were significantly poor adherent to treatment (odds ratio [95% confidence interval]: 1.39 [1.02, 2.73], 1.51 [1.02, 2.37], and 1.66 [1.02, 2.91]), respectively. The associations remained the same when adjusted for various potential confounders. Conclusions: Psychosomatic factors played an essential role in adhering to treatment among patients with acute myocardial infarction. As a result, appropriate psychological interventions may help the patients adhere to their treatment better.

Isfahan COVID cohort study: Rationale, methodology, and initial results.

Background: The Isfahan COVID Cohort (ICC) study was designed to investigate the short- and long-term consequences of patients with COVID-19 in Iran. This report presents the rationale, methodology, and initial results of ICC. Materials and Methods: ICC is a 5-year multicentric prospective cohort study that is ongoing on two groups including 5000 patients hospitalized with moderate or severe and 800 nonhospitalized patients with mild or asymptomatic COVID-19 in Isfahan. The ICC endpoints are morbidity, mortality, incident cases, or worsening of underlying noncommunicable diseases (NCDs) and their risk factors. In the current analysis, we examined the persistent symptoms and incident NCDs or risk factors in 819 previously hospitalized patients who completed 1-year follow-up. Results: The two most common symptoms were joint pain/myalgia (19.7%) and dry cough/dyspnea (18.7%). Around 60% of patients had at least one symptom which was more common among women than men and in middle aged than younger or older patients. Female (odds ratio [OR] =1.88, 95% confidence interval [CI]: 1.39-2.55) and highly-educated patients (OR = 2.18, 95% CI: 1.56-3.04) had higher risk of having any symptom in 1-year follow-up. New cases of hypertension followed by diabetes then coronary heart disease (CHD) were the most common incident NCDs. Conclusion: During 1-year follow-up after hospital discharge, about 60% of patients experienced persistent symptoms. Incident hypertension, diabetes, and CHD were the most common events seen. Close monitoring and extensive health services with integrative approaches are needed to improve the health status of these patients.

Long-Term Hospital Readmission after ST-Elevation Myocardial Infarction: A 3-Year Follow-up from the SEMI-CI Study.

Background: This study aimed to investigate readmission risk factors after ST-elevation myocardial infarction (STEMI) during a 3-year follow-up. Methods: This study is a secondary analysis of the STEMI Cohort Study (SEMI-CI) in Isfahan, Iran, with 867 patients. A trained nurse gathered the demographic, medical history, laboratory, and clinical data at discharge. Then the patients were followed up annually for 3 years by telephone and invitation for in-person visits with a cardiologist concerning readmission status. Cardiovascular readmission was defined as MI, unstable angina, stent thrombosis, stroke, and heart failure. Adjusted and unadjusted binary logistic regression analyses were applied. Results: Of 773 patients with complete information, 234 patients (30.27%) experienced 3-year readmission. The mean age of the patients was 60.92±12.77 years, and 705 patients (81.3%) were males. The unadjusted results showed that smokers were 21% more likely to be readmitted than nonsmokers (OR, 1.21; P=0.015). Readmitted patients had a 26% lower shock index (OR, 0.26; P=0.047), and ejection fraction had a conservative effect (OR, 0.97; P<0.05). The creatinine level was 68% higher in patients with readmission. An adjusted model based on age and sex showed that the creatinine level (OR, 1.73), the shock index (OR, 0.26), heart failure (OR, 1.78), and ejection fraction (OR, 0.97) were significantly different between the 2 groups. Conclusion: Patients at risk of readmission should be identified and carefully visited by specialists to help improve timely treatment and reduce readmissions. Therefore, it is recommended to pay special attention to factors affecting readmission in the routine visits of STEMI patients.