Injectable hydrogels based on biopolymers for the treatment of ocular diseases.

Injectable hydrogels based on biopolymers, fabricated utilizing diverse chemical and physical methodologies, exhibit exceptional physical, chemical, and biological properties. They have multifaceted applications encompassing wound healing, tissue regeneration, and across diverse scientific realms. This review critically evaluates their largely uncharted potential in ophthalmology, elucidating their diverse applications across an array of ocular diseases. These conditions include glaucoma, cataracts, corneal disorders (spanning from age-related degeneration to trauma, infections, and underlying chronic illnesses), retina-associated ailments (such as diabetic retinopathy, retinitis pigmentosa, and age-related macular degeneration (AMD)), eyelid abnormalities, and uveal melanoma (UM). This study provides a thorough analysis of applications of injectable hydrogels based on biopolymers across these ocular disorders. Injectable hydrogels based on biopolymers can be customized to have specific physical, chemical, and biological properties that make them suitable as drug delivery vehicles, tissue scaffolds, and sealants in the eye. For example, they can be engineered to have optimum viscosity to be injected intravitreally and sustain drug release to treat retinal diseases. Their porous structure and biocompatibility promote cellular infiltration to regenerate diseased corneal tissue. By accentuating their indispensable role in ocular disease treatment, this review strives to present innovative and targeted approaches in this domain, thereby advancing ocular therapeutics.

Hearing Loss Prevalence, Years Lived With Disability, and Hearing Aid Use in the United States From 1990 to 2019: Findings From the Global Burden of Disease Study.

OBJECTIVES: This article describes key data sources and methods used to estimate hearing loss in the United States, in the Global Burden of Disease study. Then, trends in hearing loss are described for 2019, including temporal trends from 1990 to 2019, changing prevalence over age, severity patterns, and utilization of hearing aids. DESIGN: We utilized population-representative surveys from the United States to estimate hearing loss prevalence for the Global Burden of Disease study. A key input data source in modeled estimates are the National Health and Nutrition Examination Surveys (NHANES), years 1988 to 2010. We ran hierarchical severity-specific models to estimate hearing loss prevalence. We then scaled severity-specific models to sum to total hearing impairment prevalence, adjusted estimates for hearing aid coverage, and split estimates by etiology and tinnitus status. We computed years lived with disability (YLDs), which quantifies the amount of health loss associated with a condition depending on severity and creates a common metric to compare the burden of disparate diseases. This was done by multiplying the prevalence of severity-specific hearing loss by corresponding disability weights, with additional weighting for tinnitus comorbidity. RESULTS: An estimated 72.88 million (95% uncertainty interval (UI) 68.53 to 77.30) people in the United States had hearing loss in 2019, accounting for 22.2% (20.9 to 23.6) of the total population. Hearing loss was responsible for 2.24 million (1.56 to 3.11) YLDs (3.6% (2.8 to 4.7) of total US YLDs). Age-standardized prevalence was higher in males (17.7% [16.7 to 18.8]) compared with females (11.9%, [11.2 to 12.5]). While most cases of hearing loss were mild (64.3%, 95% UI 61.0 to 67.6), disability was concentrated in cases that were moderate or more severe. The all-age prevalence of hearing loss in the United States was 28.1% (25.7 to 30.8) higher in 2019 than in 1990, despite stable age-standardized prevalence. An estimated 9.7% (8.6 to 11.0) of individuals with mild to profound hearing loss utilized a hearing aid, while 32.5% (31.9 to 33.2) of individuals with hearing loss experienced tinnitus. Occupational noise exposure was responsible for 11.2% (10.2 to 12.4) of hearing loss YLDs. CONCLUSIONS: Results indicate large burden of hearing loss in the United States, with an estimated 1 in 5 people experiencing this condition. While many cases of hearing loss in the United States were mild, growing prevalence, low usage of hearing aids, and aging populations indicate the rising impact of this condition in future years and the increasing importance of domestic access to hearing healthcare services. Large-scale audiometric surveys such as NHANES are needed to regularly assess hearing loss burden and access to healthcare, improving our understanding of who is impacted by hearing loss and what groups are most amenable to intervention.

In situ preparation of MOF-199 into the carrageenan-grafted-polyacrylamide@Fe3O4 matrix for enhanced adsorption of levofloxacin and cefixime antibiotics from water.

In this research study, a novel method, an in-situ growth approach, to incorporate metal-organic framework (MOF) into carrageenan-grafted- polyacrylamide-Fe3O4 substrate was introduced. Carrageenan-grafted-polyacrylamide-Fe3O4/MOF nanocomposite (kC-g-PAAm@Fe3O4-MOF-199) was fabricated utilizing three stages. In this way, the polyacrylamide (PAAm) was grafted onto the carrageenan (kC) backbone via free radical polymerization in the presence of methylene bisacrylamide (MBA) as cross-linker and Fe3O4 magnetic nanoparticles. Next, the kC-g-PAAm@Fe3O4 was modified by MOF-199 via an in-situ solvothermal approach. Several analyses such as Fourier transform infrared spectroscopy (FT-IR), X-Ray diffraction (XRD), field emission scanning electron microscopy (FESEM), energy-Dispersive X-ray Spectroscopy (EDX), thermogravimetric analysis (TGA), vibrating sample magnetometer (VSM), Brunauer-Emmett-Teller (BET) demonstrated the successful synthesis of kC-g-PAAm@Fe3O4-MOF-199 magnetic hydrogel nanocomposite. The XRD pattern of magnetic hydrogel nanocomposite illustrated characteristic peaks of Fe3O4, neat kC, and MOF-199 with enhanced crystallinity in comparison with kC-g-PAAm@Fe3O4. TGA showed it has a char yield of 24 wt% at 800 °C. VSM confirmed its superparamagnetic behavior (with Ms of 8.04 emu g-1), and the BET surface area of kC-g-PAAm@Fe3O4-MOF-199 was measured at 64.864 m2 g-1, which was higher than that of kC-g-PAAm@Fe3O4 due to the highly porous MOF-199 incorporation with a BET surface area of 905.12 m2 g-1). The adsorption effectiveness of kC-g-PAAm@Fe3O4-MOF-199 for eliminating cephalosporin and quinolones antibiotics, i.e., Cefixime (CFX) and Levofloxacin (LEV) from the aquatic area was considered. Several experimental setups were used to evaluate the efficacy of adsorption, such as solution pH, amount of adsorbent, contact duration, and initial concentration. The maximum adsorption capacity (Qmax) of the prepared magnetic hydrogel nanocomposite was found to be 2000 and 1666.667 mg-1 for LEV and CFX using employing 0.0025 g of adsorbent. The Freundlich isotherm model well described the experimental adsorption data with R2CFX = 0.9986, and R2LEV = 0.9939. And the adsorption kinetic data were successfully represented by the pseudo-second-order model with R2LEV = 0.9949 and R2CFX = 0.9906. Hydrogen bonding, π-π interaction, diffusion, and entrapment in the hydrogel network all contributed to the successful adsorption of both antibiotics onto the kC-g-PAAm@Fe3O4-MOF-199 adsorbent. Other notable physicochemical properties include the three-dimensional structure and availability of the reactive adsorption sites. Moreover, the adsorption/desorption efficacy of magnetic hydrogel nanocomposites was not significantly diminished after four cycles of recovery.

Magnetic poly(1,8-diaminonaphthalene)-nickel nanocatalyst for the synthesis of antioxidant and antibacterial isoxazole-5(4H)-ones derivatives.

A magnetic poly (1,8-diaminonaphthalene)-nickel (PDAN-Ni@Fe3O4) composite as a multifunctional nanocatalyst was prepared in several steps including (I) synthesis of poly (1,8-diaminonaphthalene) (PDAN), (II) modification of PDAN with NiSO4 (PDAN-Ni) and (III) preparation of magnetic nanocatalyst by iron (I and II) salts in the existence of PDAN-Ni complex (PDAN-Ni@Fe3O4). Fourier-transform infrared spectroscopy (FTIR), elemental analysis (CHNSO), vibrating-sample magnetometer (VSM), X-ray diffraction (XRD), energy-dispersive X-ray (EDX), field emission scanning electron microscope (FESEM), ultraviolet-visible (UV-vis), and thermogravimetric analysis (TGA) were applied to characterize the prepared nanocatalyst. The PDAN-Ni@Fe3O4 was applied as an environmentally friendly nanocatalyst for the isoxazole-5(4H)-ones synthesis via a one-pot reaction between aryl/heteroaryl aldehyde, hydroxylamine hydrochloride, and ß-ketoester. The nanocomposite was also used for the synthesis of some new alkylene bridging bis 4-benzylidene-3-methyl isoxazole-5(4H)-ones. The catalyst's reusability, and the antioxidant and antibacterial activities of both catalyst and products, were studied. Results showed that the nanocatalyst and isoxazole-5(4H)-ones have antioxidant activity of 75% and 92%, respectively. In addition, the antibacterial test showed that the nanocatalyst and isoxazole-5(4H)-ones have highly active versus Staphylococcus aureus and Escherichia coli bacteria. The reusability and stability of the nanocatalyst, a medium to higher product yield and conversion, a faster reaction time, and the use of green solvents were a few benefits of this study.

Arabic Gum-Grafted-Hydrolyzed Polyacrylonitrile@ZnFe2O4 as a Magnetic Adsorbent for Remediation of Levofloxacin Antibiotic from Aqueous Solutions.

The Arabic gum-grafted-hydrolyzed polyacrylonitrile/ZnFe2O4 (AG-g-HPAN@ZnFe2O4) as organic/inorganic adsorbent was obtained in three steps using grafted PAN onto Arabic gum in the presence of ZnFe2O4 magnetic nanoparticles and then hydrolysis by alkaline solution. Fourier transform infrared (FT-IR), energy-dispersive X-ray analysis (EDX), field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), thermogravimetric analysis (TGA), vibrating sample magnetometer (VSM), and the Brunauer-Emmett-Teller (BET) analysis analyses were used to characterize the chemical, morphological, thermal, magnetic, and textural properties of the hydrogel nanocomposite. The obtained result demonstrated that the AG-g-HPAN@ZnFe2O4 adsorbent showed acceptable thermal stability with 58% char yields and superparamagnetic property with magnetic saturation (Ms) of 24 emu g-1. The XRD pattern showed that the semicrystalline structure with the presence of ZnFe2O4 has distinct peaks which displayed that the addition of zinc ferrite nanospheres to amorphous AG-g-HPAN increased its crystallinity. The AG-g-HPAN@ZnFe2O4 surface morphology exhibits uniform dispersion of zinc ferrite nanospheres throughout the smooth surface of the hydrogel matrix, and its BET surface area was measured at 6.86 m2/g, which was higher than that of AG-g-HPAN as a result of zinc ferrite nanosphere incorporation. The adsorption effectiveness of AG-g-HPAN@ZnFe2O4 for eliminating a quinolone antibiotic (levofloxacin) from aqueous solutions was investigated. The effectiveness of adsorption was assessed under several experimental conditions, including solution pH (2-10), adsorbent dose (0.0015-0.02 g) contact duration (10-60 min), and initial concentration (50-500 mg/L). The maximum adsorption capacity (Q max) of the produced adsorbent for levofloxacin was found to be 1428.57 mg/g (at 298 k), and the experimental adsorption data were well explained by the Freundlich isotherm model. The pseudo-second-order model satisfactorily described the adsorption kinetic data. The levofloxacin was mostly adsorbed onto the AG-g-HPAN@ZnFe2O4 adsorbent via electrostatic contact and hydrogen bonding. Adsorption-desorption studies demonstrated that the adsorbent could be efficiently recovered and reused after four consecutive runs with no significant loss in adsorption performance.

Molecularly Imprinted Magnetic Nanocomposite Based on Carboxymethyl Dextrin for Removal of Ciprofloxacin Antibiotic from Contaminated Water.

Broad-spectrum antibiotics from the fluoroquinolone family have emerged as prominent water contaminants, among other pharmaceutical pollutants. In the present study, an antibacterial magnetic molecularly imprinted polymer (MMIP) composite was successfully fabricated using carboxy methyl dextrin grafted to poly(aniline-co-meta-phenylenediamine) in the presence of Fe3O4/CuO nanoparticles and ciprofloxacin antibiotic. The characteristics of obtained materials were investigated using FTIR, XRD, VSM, TGA, EDX, FE-SEM, zeta potential, and BETanalyses. Afterward, the MMIP's antibacterial activity and adsorption effectiveness for removing ciprofloxacin from aqueous solutions were explored. The results of the antibacterial tests showed that MMIP had an antibacterial effect against Escherichia coli, a Gram-negative pathogen (16 mm), and Staphylococcus aureus, a Gram-positive pathogen (22 mm). Adsorption efficacy was evaluated under a variety of experimental conditions, including solution pH, adsorbent dosage, contact time, and initial concentration. The maximum adsorption capacity (Qmax) of the MMIP for ciprofloxacin was determined to be 1111.1 mg/g using 3 mg of MMIP, with an initial concentration of 400 mg/L of ciprofloxacin at pH 7, within 15 min, and agitated at 25 °C, and the experimental adsorption results were well-described by the Freundlich isotherm model. The adsorption kinetic data were well represented by the pseudo-second-order model. Electrostatic interaction, cation exchange, π-π interactions, and hydrogen bonding were mostly able to adsorb the majority of the ciprofloxacin onto the MMIP. Adsorption-desorption experiments revealed that the MMIP could be retrieved and reused with no noticeable reduction in adsorption efficacy after three consecutive cycles.

Engineered Cobalt Single-Atoms@BiFeO3 Heteronanostructures for Highly Efficient Solar Water Oxidation.

Efficient charge-carrier separation and their utilization are the key factors in overcoming sluggish four-electron reaction kinetics involved in photocatalytic oxygen evolution. Here, a novel study demonstrates the significance of Na2 S2 O8 as a sacrificial agent in comparison to AgNO3 . Resultantly, BiFeO3 (BFO) and titanium doped-oxygen deficient BiFeO3 (Ti-BFO-R) nanostructures achieve ≈64 and 44.5 times higher O2 evolution in the presence of Na2 S2 O8 compared to AgNO3 as a sacrificial agent, respectively. Furthermore, the presence of Co single atoms (Co-SAs) deposited via immersion method on BFO and Ti-BFO-R nanostructures led to achieving outstanding O2 evolution at a rate of 16.11 and 23.89 mmol g-1 h-1 , respectively, which is 153 and 227.5 times higher compared to BFO (in the presence of AgNO3 ), the highest O2 evolution observed for BFO-based materials to date. The successful deposition of Co-SAs is confirmed by aberration-corrected high-angle annular dark-field scanning transmission electron microscopy (AC HAADF-STEM) and X-ray absorption near-edge structure (XANES). The charge transfer investigations confirm the significance of Co-SAs on BFO-based photocatalysts for improved charge-carrier separation, transport, and utilization. This novel study validates the excellent role of Na2 S2 O8 as a sacrificial agent and Co-SAs as a cocatalyst for BFO-based nanostructures for efficient O2 evolution.

Carbohydrate polymer-based nanocomposites for breast cancer treatment.

Breast cancer is known as the most common invasive malignancy in women with the highest mortality rate worldwide. This concerning disease may be presented in situ (relatively easier treatment) or be invasive, especially invasive ductal carcinoma which is highly worrisome nowadays. Among several strategies used in breast cancer treatment, nanotechnology-based targeted therapy is currently being investigated, as it depicts advanced technological features able of preventing drugs' side effects on normal cells while effectively acting on tumor cells. In this context, carbohydrate polymer-based nanocomposites have gained particular interest among the biomedical community for breast cancer therapy applications due to their advantage features, including abundance in nature, biocompatibility, straightforward fabrication methods, and good physicochemical properties. In this review, the physicochemical properties and biological activities of carbohydrate polymers and their derivate nanocomposites were discussed. Then, various methods for the fabrication of carbohydrate polymer-based nanocomposites as well as their application in breast cancer therapy and future perspectives were discussed.

A review on the effectiveness of nanocomposites for the treatment and recovery of oil spill.

The introduction of unintended oil spills into the marine ecosystem has a significant impact on aquatic life and raises important environmental concerns. The present review summarizes the recent studies where nanocomposites are applied to treat oil spills. The review deals with the techniques used to fabricate nanocomposites and identify the characteristics of nanocomposites beneficial for efficient recovery and treatment of oil spills. It classifies the nanocomposites into four categories, namely bio-based materials, polymeric materials, inorganic-inorganic nanocomposites, and carbon-based nanocomposites, and provides an insight into understanding the interactions of these nanocomposites with different types of oils. Among nanocomposites, bio-based nanocomposites are the most cost-effective and environmentally friendly. The grafting or modification of magnetic nanoparticles with polymers or other organic materials is preferred to avoid oxidation in wet conditions. The method of synthesizing magnetic nanocomposites and functionalization polymer is essential as it influences saturation magnetization. Notably, the inorganic polymer-based nanocomposite is very less developed and studied for oil spill treatment. Also, the review covers some practical considerations for treating oil spills with nanocomposites. Finally, some aspects of future developments are discussed. The terms "Environmentally friendly," "cost-effective," and "low cost" are often used, but most of the studies lack a critical analysis of the cost and environmental damage caused by chemical alteration techniques. However, the oil and gas industry will considerably benefit from the stimulation of ideas and scientific discoveries in this field.

Poly(aniline-co-melamine)@MnFe2O4 nanocatalyst for the synthesis of 4,4'-(arylmethylene) bis (1H-pyrazole-5-ol) derivatives, and 1,4- dihydropyrano[2,3-c]pyrazoles and evaluation of their antioxidant, and anticancer activities.

In this work, magnetic poly(aniline-co-melamine) nanocomposite as an efficient heterogeneous polymer-based nanocatalyst was fabricated in two steps. First, poly(aniline-co-melamine) was synthesized through the chemical oxidation by ammonium persulfate, then the magnetic nanocatalyst was successfully prepared from the in-situ coprecipitation method in the presence of poly(aniline-co-melamine). The resulting poly(aniline-co-melamine)@MnFe2O4 was characterized by FTIR, FESEM, XRD, VSM, EDX, TGA, and UV-vis analyses. The catalytic activity of poly(aniline-co-melamine)@MnFe2O4 was investigated in the synthesis of 4,4'-(arylmethylene)bis(1H-pyrazole-5-ol) derivatives, and new alkylene bridging bis 4,4'-(arylmethylene)bis(1H-pyrazole-5-ol) derivatives in excellent yields. The yield of 1,4-dihydropyrano[2,3-c]pyrazoles, 4,4'-(arylmethylene)bis(1H-pyrazol-5-ol), yields, and new alkylene bridging bis 4,4'-(arylmethylene)bis(1H-pyrazol-5-ol) derivatives were obtained 89%-96%, 90%-96%, and 92%-96%, respectively. The poly(aniline-co-melamine)@MnFe2O4 nanocatalyst can be recycled without pre-activation and reloaded up to five consecutive runs without a significant decrease in its efficiency. In addition, the antioxidant activity of some derivatives was evaluated by DPPH assay. Results showed that the maximum antioxidant activity of 4,4'-(arylmethylene)bis(1H-pyrazole-5-ol) derivatives and 1,4-dihydropyrano[2,3-c]pyrazoles were 75% and 90%, respectively. Furthermore, 4,4'-(arylmethylene)bis(1H-pyrazole-5-ol) derivatives and 1,4-dihydropyrano[2,3-c]pyrazoles showed good potential for destroying colon cancer cell lines. Consequently, the poly(aniline-co-melamine)@MnFe2O4 nanocomposite is an excellent catalyst for green chemical processes owing to its high catalytic activity, stability, and reusability.

Metal-organic framework-based materials for the abatement of air pollution and decontamination of wastewater.

Developing new and efficient technologies for environmental remediation is becoming significant due to the increase in global concerns such as climate change, severe epidemics, and energy crises. Air pollution, primarily due to increased levels of H2S, SOx, NH3, NOx, CO, volatile organic compounds (VOC), and particulate matter (PM) in the atmosphere, has a significant impact on public health, and exhaust gases harm the natural sulfur, nitrogen, and carbon cycles. Similarly, wastewater discharged to the environment with metal ions, herbicides, pharmaceuticals, personal care products, dyes, and aromatics/organic compounds is a risk for health since it may lead to an outbreak of waterborne pathogens and increase the exposure to endocrine-disrupting agents. Therefore, developing new and efficient air and water quality management systems is critical. Metal-organic frameworks (MOFs) are novel materials for which the main application areas include gas storage and separation, water harvesting from the atmosphere, chemical sensing, power storage, drug delivery, and food preservation. Due to their versatile structural motifs that can be modified during synthesis, MOFs also have a great promise for green applications including air and water pollution remediation. The motivation to use MOFs for environmental applications prompted the modification of their structures via the addition of metal and functional groups, as well as the creation of heterostructures by mixing MOFs with other nanomaterials, to effectively remove hazardous contaminants from wastewater and the atmosphere. In this review, we focus on the state-of-the-art environmental applications of MOFs, particularly for water treatment and air pollution, by highlighting the groundbreaking studies in which MOFs have been used as adsorbents, membranes, and photocatalysts for the abatement of air and water pollution. We finally address the opportunities and challenges for the environmental applications of MOFs.

Neutropenia associated with X-linked Agammaglobulinemia in an Iranian referral center.

X-linked Agammaglobulinemia (XLA) is a hereditary immunodeficiency, characterized by an early onset of recurrent bacterial infections, hypogammaglobulinemia and markedly reduced B lymphocytes number. In order to determine the association of neutropenia among Iranian patients with XLA, hospital records of 30 patients with confirmed XLA in Children Medical Center Hospital, were reviewed. Eight out of 30 XLA patients (26.7%) developed neutropenia during the course of the disease. In two patients, episodes of neutropenia were identified before or at the time of diagnosis of XLA. Other six patients whom were not visited regularly and did not receive periodical immunoglobulin replacement therapy experienced neutropenia after diagnosis of XLA. Neutropenia in XLA is mainly associated with infection and is resolved with intravenous immunoglobulin replacement and antibiotics therapy.

Association of tumor necrosis factor-alpha and interleukin-10 gene polymorphisms in Iranian patients with pre-eclampsia.

PROBLEM: Considering that certain cytokines may change during pre-eclampsia (PE), because of functional polymorphisms in their genes, our purpose was to determine the association between tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) gene polymorphisms and development of PE. METHOD OF STUDY: The genetic polymorphisms of TNF-alpha and IL-10 was studied by polymerase chain reaction-sequence specific primers in the DNA of peripheral blood cell from 160 patients with PE and 100 healthy pregnant women. RESULTS: We found a significant difference between TNF-alpha A allele (-308) and G allele (-238) in PE patients compared with those of the control groups. A significantly higher C/C genotype frequency of IL-10 (-592 and -819) was observed in the PE patients than in the control groups. In addition, the frequencies of three common IL-10 haplotypes (GCC, ACC, and ATA) did not show any significant difference between the study groups. CONCLUSION: These findings would support the concept of contribution of TNF-alpha and IL-10 gene polymorphisms in the pathogenesis of PE in our population.

Evaluation of humoral immune function in patients with bronchiectasis.

Bronchiectasis is a chronic debilitating condition characterized by abnormal dilated thick-walled bronchi. To investigate humoral immune function in bronchiectatic patients, this study was performed. Forty patients with established diagnosis of bronchiectasis, who were referred from two tertiary care pulmonology centers in Tehran, were investigated in this study. Immunoglobulin isotypes concentrations and IgG-subclasses were measured by nephelometry and enzyme-linked immunosorbent assay (ELISA) methods, respectively. All patients received unconjugated pneumococcal vaccine, and blood samples were taken before and 21 days after vaccination. Specific antibodies against whole pneumococcal antigens were measured using the ELISA method. Fifteen (37.5%) out of 40 patients were diagnosed to have defects in antibody mediated immunity including 5 (12.5%) patients with immunoglobulin class deficiency (2 with common variable immunodeficiency and 3 with IgA deficiency), 3 (7.5%) with IgG subclass deficiency and 7 (17.5%) patients had Specific antibody deficiency (SAD) against polysaccharide antigen despite normal levels of serum immunoglobulins and IgG subclasses. Our study along with several other studies confirmed that all patients with bronchiectasis should undergo thorough immunological evaluation in order to identify the presence of the underlying immunologic defect. This evaluation should include serum immunoglobulins, IgG subclasses concentrations and also determination of serum antibodies against pneumococcal antigens. Early diagnosis and appropriate treatment will prevent the subsequent complications and improve quality of life of affected individuals.

Immunologic evaluation of patients with recurrent ear, nose, and throat infections.

PURPOSE: In this study, we aimed to study the frequency of possible underlying immunodeficiency responsible for susceptibility to ear, nose, and throat (ENT) infection. MATERIALS AND METHODS: One hundred three (72 males and 31 females) consecutive children and adult patients with history of recurrent or chronic ENT infections, referred by otolaryngologists to the Department of Allergy and Clinical Immunology, Children's Medical Center, Tehran University of Medical Sciences (Tehran, Iran), were enrolled to the study from March 2003 to March 2006. For each patient, demographic information and medical histories of any ENT infections were collected by reviewing the patient's records. We measured immunoglobulin isotype concentrations and immunoglobulin (Ig) G subclasses by nephelometry and enzyme-linked immunosorbent assay methods, respectively. Of 103 patients, 75 received unconjugated pneumococcus polyvalent vaccine, and blood samples were taken before and 21 days after vaccination. Specific antibodies against whole pneumococcal antigens were measured using enzyme-linked immunosorbent assay method. Existence of bronchiectasis was confirmed in each patient using high resolution computed tomography scan. RESULTS: Among 103 patients, 17 (16.5%) patients were diagnosed to have defects in antibody-mediated immunity including 6 patients with immunoglobulin class deficiency (2 common variable deficiency and 4 IgA deficiency), 3 with IgG subclass deficiency (2 IgG2 and 1 IgG3), and 8 with specific antibody deficiency against polysaccharide antigens. In our series, bronchiectasis was detected in 5 cases associated with primary immunodeficiency. CONCLUSIONS: Long-standing history of ENT infections could be an alarm for ENT infections associated with primary antibody deficiency.