IL-10 IS DOWN-REGULATED IN THE CARDIOVASCULAR DISEASES SUSPECTED PATIENTS, INDEPENDENT OF ANGIOGRAPHY. / RIVEN' IL-10 ZNYZhENYY̆ U PATsIIeNTIV IZ SERTsEVO-SUDYNNYMY ZAKhVORIuVANNIaMY, NEZALEZhNO VID PROVEDENNIa ANGIOGRAFIChNYKh DOSLIDZhEN'.

IL-10 and interferon-gamma (IFN-γ) are the important anti and pro-inflammatory cytokines, respectively, which may participate in the cardiovascular disease pathogenesis. Additionally, environmental factors, such as the X-ray, can modulate cytokine expression. Due to the fact that X-ray is used during angiography, hence, angiography may alter expression of the cytokines. OBJECTIVE: Accordingly, this project was aimed to assess IL-10 and IFN-γ serum levels within cardiovascular patients (with and without vessel stenosis) versus healthy controls and also the effects of angiography on the serum levels of the cytokines. MATERIAL AND METHODS: This study was performed on the 80 participants, including twenty cases in each group (healthy controls and cardiovascular patients without vessel stenosis, stenosis of 1 vessel and stenosis of more than 1 vessel) to evaluate IL-10 and IFN-γ serum levels using ELISA technique. The IL-10 and IFN-γ serum levels also compared within group 2, 3 and 4 before and after angiography to explore the effects of the technique on the IL-10 and IFN-γ serum levels. RESULTS: IL-10, but not IFN-γ, serum levels were higher in the healthy controls than all cardiovascular patients. IL-10 and IFN-γ serum levels were not altered after angiography and also were not differ in the smoker versus non- smoker and opium consuming versus non-opium consuming participants. CONCLUSION: Due to the results it may be concluded that IL-10 can be considered as a plausible inhibitor of cardio- vascular diseases independent of angiography duration and X-ray, however, IFN-γ has no effects in the Iranian patients suffering from cardiovascular diseases.

The Impact of Opium Abuse on Lipid Profile in Patients with Diabetes: A Systematic Review and Meta-Analysis.

There is an increasing prevalence of diabetes worldwide and substance abuse has been observed as a problem among some people with diabetes. Therefore, there is an urgent need to understand the association between unhealthy drug use including the abuse of opium and clinical outcomes including its impact on lipid profile in patients with diabetes as the presence of these conditions can increase the risk of cardiovascular morbidity and mortality. AIM: This was a systematic review and meta-analysis which evaluated the impact of opium abuse on lipid profile in patients with diabetes. METHOD: This systematic review was conducted in line with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Three databases (Embase, PubMed, and PsycINFO) plus Google Scholar were searched for relevant articles from database inception to 18 July 2019 based on the Population, Intervention, Comparator, and Outcomes (PICO) framework. The studies included were based on a set of inclusion and exclusion criteria including patients with diabetes who abused opium. Articles were evaluated for risk of bias and the meta-analysis was conducted using Revman. RESULTS: Six articles that met the criteria were included in the systematic review and meta-analysis. The type of substance abused was opium in all the studies. The results of the meta-analysis showed that opium abuse significantly (P = 0.01) lowered total cholesterol compared to control with a mean difference of -0.17 (95% CI, -0.29, -0.04) in patients with diabetes. With respect to high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and body mass index, the differences were not statistically significant (P > 0.05) between those who abused opium compared with the control. Nutritional deficiencies, weight loss and lipid dysregulation due to liver dysfunction which are found in people who abuse substances may explain the findings of the current review with respect to lipid profile in patients with diabetes who abuse opium compared with the control. CONCLUSION: The findings of this systematic review and meta-analysis have shown that opium abuse significantly decreased total cholesterol (P < 0.05) in patients with diabetes. However, the effect of opium abuse on HDL cholesterol, triglycerides, body mass index (BMI) and LDL cholesterol in these patients were not statistically significant (P > 0.05) compared with the control. This result has public health significance in terms of ensuring the promotion of adequate nutritional intake in patients with diabetes who abuse opium.

Impact of opium dependency on clinical and neuropsychological indices of multiple sclerosis patients.

The aim of this study was to determine the effect of opium on clinical and neuropsychological parameters in multiple sclerosis (MS) patients with substance dependency. A cross-sectional study was conducted on MS patients in Rafsanjan, Iran. Forty opium-addict MS patients (10 males and 30 females) aged between 18 and 50 years were compared with 40 MS patients with no addiction. Word-Pair Learning, Mini-Mental State Examination (MMSE), Wisconsin Card-Sorting Test (WCST), Depression, Anxiety, Expanded Disability Status Scale (EDSS), Fatigue, and the Multiple Sclerosis Functional Composite (MSFC) were measured and compared in the two groups. The comparison of two groups showed a significant increase trait anxiety (P < 0.001), fatigue (P = 0.009) and significant decrease in the executive function (P = 0.003), MMSE (P = 0.003), and working memory (P < 0.001) in addicted MS. It indicates the better efficiency of processing in the non-addicted MS patients. The MSFC z-score also was significantly higher in the non-addicted group (P < 0.001). The opium addiction has a negative impact on the clinical and neuropsychological outcome in MS patients.

Impact of chronic lead exposure on liver and kidney function and haematologic parameters.

BACKGROUND: Lead, one of the most widely used metals because of its beneficial physical properties, has been reported to adversely influence several different organs and organ systems. The aim of the present study was to examine the effect of lead exposure on liver and renal function and haematologic parameters. METHODS: This was a case-cohort study comparing adults with occupational, environmental or opium-related lead exposure with blood lead levels [BLL] >10 µg/dL (High blood lead level (HBLL) group and age- and gender-matched normal healthy individuals (Low blood lead level [LBLL] group with BLL <10 µg/dL). The complete blood count and concentrations of serum creatinine, urea, aspartate aminotransferase (AST), alanine aminotransferase (ALT) were recorded for subsequent investigation. RESULTS: The mean BLL was significantly higher in the HBLL than in the LBLL groups (51.36 ± 44.72 vs 4.17 ± 1.97 µg/dL). The Spearman's rho revealed a significant association between BLL and urea (r = 0.25, P < 0.001), creatinine (r = 0.16, P = 0.02), AST (r = 0.42, P < 0.001) and ALT (r = 0.27, P < 0.001). The median [IQR] serum urea (34 mg/dL [27-221]) vs (30 [27-36]), creatinine (0.9 mg/dL [0.8-1]) vs (0.8 [0.7-0.9]), ALT (25 mg/dL [16-49]) vs (22 [16-30]) and AST concentrations (29 mg/dL [20-42]) vs (20 [18-24]) were all significantly higher (P < 0.05) in the HBLL group compared to the LBLL group. The median [IQR] haemoglobin (12.6 g/dL [10.4-15.4]) vs (15.2 [14.6-16.3] and haematocrit (36.9% [31-44.8]) vs (45.6 [43.6-48.2]) were both significantly lower (P < 0.001) in the HBLL group than in the LBLL group. CONCLUSION: The results indicated that people with chronic lead exposure with BLLs greater than 10 µg/dL are at risk of renal, liver and haematologic impairments.

Oxidative stress in opium users after using lead-adulterated opium: The role of genetic polymorphism.

Use of lead-adulterated opium has become one of the major sources of lead poisoning in Iran. This study was designed to assess clinical effects and oxidative stress and its association with GSTM1, GSTT1, NQO1, and ALAD genes polymorphisms and blood lead level (BLL) in lead-adulterated opium users. The oxidative stress status in 192 opium users with lead poisoning symptoms measured and compared with 102 healthy individuals. Gluthatione S-transferase (GST)-M1 and -T1 genes deletion, NQO1 rs1800566, and δ-aminolevulinic acid dehydratase (ALAD) rs1800435 polymorphisms were determined using PCR and PCR-RFLP. The relation between the polymorphisms, BLL, and oxidative stress parameters were analysed using multivariate linear regressions. The common symptoms of lead toxicity were gastrointestinal and neurologic complications. Oxidative stress was significantly higher in opium addicts and lipid peroxidation significantly correlated with BLL. There was significant association between ALAD rs1800435 and BLL, and the BLL was significantly lower in the patients with ALAD 1-2 genotype. Use of lead-adulterated opium causes high frequency of lead toxicity symptoms, hematological and biochemical abnormalities, and oxidative stress which are associated with BLL. Route of opioid use and the polymorphism of rs1800435 in ALAD gene are the major determinants of BLL in lead-adulterated opium users.