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1.
GMS Hyg Infect Control ; 14: Doc11, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31538044

RESUMO

Introduction: Multidrug-resistant tuberculosis (MDR-TB) is one of the major public health threats especially in developing countries. In Iran, the emergence and spread of MDR-TB are likely to pose a significant problem for the National Tubeculosis Control Program (NTP). In this study, to determine the trend of MDR-TB in Tehran, the results of published studies were analyzed. Methods: Several databases were searched, including Medline, Embase, Web of Science and Iranian databases. Studies which report the prevalence of MDR-TB by World Health Organization (WHO)-endorsed drug susceptibility testing (DST) methods were included in the study. Data were analyzed with SPSS 20 (SPSS, Chicago, Illinois, USA). Results: Analysis of the MDR-TB trend did not show any increase among new TB cases, but the trend of MDR-TB was significantly increased among previously treated cases. The prevalence of MDR-TB from 48.0% in 1996 reached 58.0% in 2004 (P<0.05). Conclusions: Our analysis shows an increasing trend in MDR-TB, particularly in retreatment cases. This study strongly highlights the need to develop further strategies for surveillance, monitoring, and management of MDR-TB cases.

2.
Asian Pac J Cancer Prev ; 20(8): 2281-2285, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31450896

RESUMO

Introduction: Lung cancer is the most common cause of cancer-related death among males and females. The diagnosis of lung cancer is of great importance for clinical considerations and follow-up treatment. This study aimed to examine the expression of CEA, LUNX, and CK19 biomarkers in the cancerous and healthy tissues of patients suffering from NSCLC. Methods: In this study, 30 patients with NSCLCs referring to Masih Daneshvari Hospital in Tehran were voluntarily selected prior to taking any treatment. A tissue sample from the center and a sample of healthy tissues close to the cancerous masses were prepared by a specialist in the bronchoscopy sector and tested using real-time RT-PCR. Results: Positive CEA mRNA was observed in cancerous tissues in the center of tumors of 25 out of 30 cases. In the healthy tissue group, the same was found in 10 out of 30 cases (P<0.001). The markers CK19 and LUNX mRNAs showed to be positive in cancerous samples in the center of tumors of 15 and 22 out of 30 cases, and in the healthy tissue group, the expression was observed in 5 and 4 out of 30 cases, respectively(P<0.001). Conclusion: This study confirms that the aformentioed markers are the ones with a relatively appropriate sensitivity and specificity for the diagnosis of lung cancer.


Assuntos
Biomarcadores Tumorais/metabolismo , Antígeno Carcinoembrionário/metabolismo , Carcinoma Pulmonar de Células não Pequenas/patologia , Glicoproteínas/metabolismo , Queratina-19/metabolismo , Neoplasias Pulmonares/patologia , Fosfoproteínas/metabolismo , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/metabolismo , Masculino , Pessoa de Meia-Idade , Prognóstico
3.
Comp Immunol Microbiol Infect Dis ; 65: 201-206, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31300114

RESUMO

BACKGROUND: Blastocystis and tuberculosis are two public health issues that are frequently reported in regions with low level of hygiene. Therefore, the current study aimed to investigate Blastocystis subtype and allele distribution in TB patients. METHODS: Totally, 161 stool samples were taken from TB patients who were undergoing anti-MTB treatment. Stool samples were concentrated using conventional formalin-ether technique and examined using Lugol's iodine staining under light microscopy. DNA extraction was carried out and discriminative fragment was amplified and sequenced. With comparison in GenBank database, relevant subtypes and alleles were characterized and phylogenetically analyzed using MEGA v.7 and Tamura 3-parameter model. RESULTS: In total, from 161 stool samples, 19 samples were suspected to be Blastocystis-positive. The expected fragment was amplified in 13 (8.07%) of samples. Accordingly, 11/13 (84.62%) of Blastocystis cases settled in urban and 2/13 (15.38%) were villagers. Close-contact with animals was also seen among 7/13 (53.84%) of samples. Subtype 1 (7/13; 53.84%) was the most prevalent followed by subtype 2 (5/13; 38.46%) and subtype 3 (1/13, 7.69%). All ST1 were allele 4, while alleles 9, 11 and 12 were seen in ST2 and allele 34 was the only allele observed in ST3. All three subtypes were clearly separated, while there was no separation between sequences from TB and non-TB patients. CONCLUSION: Blastocystis ST1 was the most prevalent subtype in TB patients and there was no difference between Blastocystis isolates from TB and non-TB human subjects.


Assuntos
Infecções por Blastocystis/parasitologia , Blastocystis/genética , Filogenia , Tuberculose/parasitologia , Adulto , Alelos , Blastocystis/classificação , DNA de Protozoário/genética , Fezes/parasitologia , Feminino , Variação Genética , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Ribossômico 18S/genética , Análise de Sequência de DNA , Fatores Socioeconômicos
4.
Gastroenterol Hepatol Bed Bench ; 12(2): 138-142, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31191838

RESUMO

Aim: This study was performed to evaluate the potential efficacy of silymarin in the management of anti-tuberculosis medication's induced liver injury. Background: Hepatic toxicity is the most serious complication in treatment of tuberculosis. Methods: In a randomized double blind clinical trial (ACTRN12610000643077), 55 cases with hepatotoxicity caused by anti-tuberculosis drugs were divided into two groups. Informed consents were obtained. The intervention group received silymarin and the control group received placebo. Severity of liver injury, the duration necessary for normalization of liver function and hospital stay were compared between the two groups. Results: There was not any statistically significant difference in the rate of adverse effects between silymarin and placebo groups. Conclusion: Although silymarin is considered a safe herbal medication, it was not effective to treat hepatic toxicity of anti-tuberculosis drugs.

5.
Clin Res Hepatol Gastroenterol ; 43(5): 594-602, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31080115

RESUMO

BACKGROUND: The introduction of direct acting antivirals (DAAs) for hepatitis C virus (HCV) treatment promises shorter treatment duration, higher cure rates and fewer side effects. Naturally, occurring Resistance Associated Substitutions (RASs) are major challenge to the success of the HCV antiviral therapy. AIM: To determine the naturally occurring NS5A and NS5B RASs in Iranian HCV and HCV/human immunodeficiency virus (HIV) patients. METHODS: A total of 209 DAA-naïve chronic HCV patients including 104 HCV mono-infected and 105 HCV/HIV co-infected cases were enrolled. Amplification and Sanger population sequencing of NS5A and NS5B regions of HCV genome were carried out. The amino acid sequence diversity of the NS5A and NS5B regions were analyzed using geno2pheno HCV. RESULTS: NS5A RASs were detected in 25.5% of HCV and 16.9% of HCV/HIV subjects. In HCV cases, clinically relevant RASs were L28M followed by M28Vand Q30H and Y93H/N. In HCV/HIV subjects, clinically relevant RASs were Y93H/N followed by L28M and P58T and M28V/T and Q30R. NS5B RASs were observed in 11.8% of HCV and 5.9% of HCV/HIV subjects. Clinically relevant substitutions were included V321A/I, C316Y, S282R and L159F. The major S282T mutation was not observed. CONCLUSION: The emergence of RASs is a growing issue in the setting of current treatment with DAAs. Although currently, screening of RASs is recommended before specific DAA regimens, it should be consider in patients with therapeutic failure and in the cases of retreatment.

6.
Microb Drug Resist ; 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-30822197

RESUMO

Introduction: Carbapenem-resistant Acinetobacter baumannii (CRAB) is recognized to be among the most difficult antimicrobial-resistant gram-negative bacilli to control and treat. An understanding of the epidemiology of CRAB and the mechanisms of resistance to carbapenems is necessary to develop strategies to curtail their spread. Methods: Electronic databases were searched from January 1995 to December 2017 for all studies, which: (1) provide data on the frequency and antibiotic resistance profile of the isolated A. baumannii and (2) describe the mechanisms of carbapenem resistance in detail. Results: Sixty-eight studies were found referring to mechanisms of carbapenem resistance in clinical isolates of A. baumannii, and 56 studies were found referring to the frequency of CRAB. The pooled frequency of carbapenem resistance was 85.1% (95% confidence interval [CI]: 82.2-88.1) in 8,067 clinical isolates of A. baumannii. Resistances due to blaOXA23 (55.3%), blaOXA24 (41.4%), and blaOXA58 (5.2%) genes were the most prevalent reported mechanisms of resistance to carbapenem, respectively. Conclusions: Our data warn that CRAB will rise if the current situation remains uncontrolled. Better control infection strategies and antibiotic managements, particularly in the health care systems, are needed to limit the spread of this pathogen.

7.
Dis Markers ; 2019: 1907426, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30886653

RESUMO

Introduction: Tuberculosis (TB) remains a major threat to human health. Due to the limited accuracy of the current TB diagnostic tests, it is critical to determine novel biomarkers for this disease. Circulating exosomes have been used as diagnostic biomarkers in various diseases. Objective of the Study: In this pilot study, we examined the expression of miRNAs as biomarker candidates for the diagnosis of TB infection. Methods: Serum-derived exosomes were isolated from TB patients and matched control subjects. The expression of miR-484, miR-425, and miR-96 was examined by RT-PCR methods. Results: The expression of miR-484, miR-425, and miR-96 were significantly increased in serum of TB patients which correlated with the TB infection level. A receiver operating characteristic (ROC) curve analysis showed the diagnostic potency of each individual serum exosomal miRNA with an area under the curve (AUC) = 0.72 for miR-484 (p < 0.05), 0.66 for miR-425 (p < 0.05), and 0.62 for miR-96 (p < 0.05). Conclusion: These results demonstrate that exosomal miRNAs have diagnostic potential in active tuberculosis. The diagnostic power may be improved when combined with conventional diagnostic markers.


Assuntos
Exossomos/metabolismo , MicroRNAs/sangue , Tuberculose Pulmonar/sangue , Adolescente , Adulto , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
8.
Int Arch Allergy Immunol ; 179(1): 62-73, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30904913

RESUMO

Recurrent severe bacterial and fungal infections are characteristic features of the rare genetic immunodeficiency disorder chronic granulomatous disease (CGD). The disease usually manifests within the first years of life with an incidence of 1 in approximately 200,000 live births. The incidence is higher in Iran and Morocco where it reaches 1.5 per 100,000 live births. Mutations have been described in the 5 subunits of NADPH oxidase, mostly in gp91phox and p47phox, with fewer mutations reported in p67phox, p22phox, and p40phox. These mutations cause loss of superoxide production in phagocytic cells. CYBB, the gene encoding the large gp91phox subunit of the transmembrane component cytochrome b558 of the NADPH oxidase complex, is localized on the X-chromosome. Genetic defects in CYBB are responsible for the disease in the majority of male CGD patients. CGD is associated with the development of granulomatous reactions in the skin, lungs, bones, and lymph nodes, and chronic infections may be seen in the liver, gastrointestinal tract, brain, and eyes. There is usually a history of repeated infections, including inflammation of the lymph glands, skin infections, and pneumonia. There may also be a persistent runny nose, inflammation of the skin, and inflammation of the mucous membranes of the mouth. Gastrointestinal problems can also occur, including diarrhea, abdominal pain, and perianal abscesses. Infection of the bones, brain abscesses, obstruction of the genitourinary tract and/or gastrointestinal tract due to the formation of granulomatous tissue, and delayed growth are also symptomatic of CGD. The prevention of infectious complications in patients with CGD involves targeted prophylaxis against opportunistic microorganisms such as Staphylococcus aureus, Klebsiella spp., Salmonella spp. and Aspergillus spp. In this review, we provide an update on organ involvement and the association with specific isolated microorganisms in CGD patients.


Assuntos
Infecções Bacterianas/etiologia , Doença Granulomatosa Crônica/complicações , Micoses/etiologia , Autoimunidade , Criança , Pré-Escolar , Feminino , Doença Granulomatosa Crônica/genética , Doença Granulomatosa Crônica/imunologia , Humanos , Lactente , Abscesso Hepático/etiologia , Pneumopatias/etiologia , Masculino , NADPH Oxidases/genética , Dermatopatias/etiologia
9.
Trans R Soc Trop Med Hyg ; 113(5): 234-241, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30624729

RESUMO

BACKGROUND: Co-infection of human tuberculosis (TB) and intestinal parasites infections (IPIs) is a public health problem, especially in low- and middle-income countries. There is no data on this issue in Iran. Therefore, we investigated the prevalence of IPIs among patients with TB in Iran. METHODS: Stool samples were collected from 161 patients with TB and 181 healthy people (non-TB group). Standard parasitological methods including direct slide smear, formalin-ether concentration, trichrome, modified Ziehl-Neelsen and chromotrope 2R staining techniques were used for detection of intestinal protozoa and helminths. Nested-PCR and sequence analysis were used to identify the genotypes of Cryptosporidium and human-infecting species of microsporidia. Data analysis was performed using SPSS version 16. RESULTS: The frequency of IPIs in the non-TB group (16.5%) was slightly lower than in patients with TB (21.1%), although statistical significance was not observed (OR, 0.74; 95% CI, 0.43-1.27; P= 0.28). Blastocystis (11.8%) was the most common parasite detected in patients with TB. Infection with multiple parasites in the non-TB group (2.2%) was significantly lower than in patients with TB (7.5%) (OR, 0.28; 95% CI, 0.08-0.88; P=0.02). The ova of Taenia spp., Ascaris lumbricoides and Hyamenolepis nana were identified in three patients with TB (1.9%), while only one person (0.5%) in the non-TB group was infected with Enterobius vermicularis. The results of genotyping revealed two C. parvum subtype families (IIa and IId) and three E. bieneusi genotypes (Ebcar4, IH and jLD-1). CONCLUSION: Our results showed a higher prevalence of IPIs in patients with TB in comparison with non-TB subjects. Moreover, our findings suggest a proper health education program for good personal hygiene habits, and also preventative measures to avoid the acquisition of IPIs in patients with TB.

10.
Sci Immunol ; 3(30)2018 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-30578351

RESUMO

Hundreds of patients with autosomal recessive, complete IL-12p40 or IL-12Rß1 deficiency have been diagnosed over the last 20 years. They typically suffer from invasive mycobacteriosis and, occasionally, from mucocutaneous candidiasis. Susceptibility to these infections is thought to be due to impairments of IL-12-dependent IFN-γ immunity and IL-23-dependent IL-17A/IL-17F immunity, respectively. We report here patients with autosomal recessive, complete IL-12Rß2 or IL-23R deficiency, lacking responses to IL-12 or IL-23 only, all of whom, unexpectedly, display mycobacteriosis without candidiasis. We show that αß T, γδ T, B, NK, ILC1, and ILC2 cells from healthy donors preferentially produce IFN-γ in response to IL-12, whereas NKT cells and MAIT cells preferentially produce IFN-γ in response to IL-23. We also show that the development of IFN-γ-producing CD4+ T cells, including, in particular, mycobacterium-specific TH1* cells (CD45RA-CCR6+), is dependent on both IL-12 and IL-23. Last, we show that IL12RB1, IL12RB2, and IL23R have similar frequencies of deleterious variants in the general population. The comparative rarity of symptomatic patients with IL-12Rß2 or IL-23R deficiency, relative to IL-12Rß1 deficiency, is, therefore, due to lower clinical penetrance. There are fewer symptomatic IL-23R- and IL-12Rß2-deficient than IL-12Rß1-deficient patients, not because these genetic disorders are rarer, but because the isolated absence of IL-12 or IL-23 is, in part, compensated by the other cytokine for the production of IFN-γ, thereby providing some protection against mycobacteria. These experiments of nature show that human IL-12 and IL-23 are both required for optimal IFN-γ-dependent immunity to mycobacteria, both individually and much more so cooperatively.


Assuntos
Imunidade Inata/imunologia , Interferon gama/imunologia , Interleucina-12/imunologia , Interleucina-23/imunologia , Infecções por Micobactéria não Tuberculosa/imunologia , Mycobacterium/imunologia , Humanos , Interleucina-12/deficiência , Interleucina-12/genética , Interleucina-23/deficiência , Interleucina-23/genética , Linhagem
11.
BMC Infect Dis ; 18(1): 552, 2018 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-30409207

RESUMO

BACKGROUND: Genetic mutations that reduce intracellular superoxide production by granulocytes causes chronic granulomatous disease (CGD). These patients suffer from frequent and severe bacterial and fungal infections throughout their early life. Diagnosis is usually made in the first 2 years of life but is sometimes only diagnosed when the patient is an adult although they may have suffered from symptoms since childhood. CASE PRESENTATION: A 26-year-old man was referred with weight loss, fever, hepatosplenomegaly and coughing. He had previously been diagnosed with lymphadenopathy in the neck at age 8 and prescribed anti-tuberculosis treatment. A chest radiograph revealed extensive right-sided consolidation along with smaller foci of consolidation in the left lung. On admission to hospital he had respiratory problems with fever. Laboratory investigations including dihydrorhodamine-123 (DHR) tests and mutational analysis indicated CGD. Stimulation of his isolated peripheral blood neutrophils (PMN) with phorbol 12-myristate 13-acetate (PMA) produced low, subnormal levels of reactive oxygen species (ROS). Aspergillus terreus was isolated from bronchoalveolar lavage (BAL) fluid and sequenced. CONCLUSIONS: We describe, for the first time, the presence of pulmonary A. terreus infection in an adult autosomal CGD patient on long-term corticosteroid treatment. The combination of the molecular characterization of the inherited CGD and the sequencing of fungal DNA has allowed the identification of the disease-causing agent and the optimal treatment to be given as a consequence.


Assuntos
Aspergillus/isolamento & purificação , Doença Granulomatosa Crônica/diagnóstico , Infecções Respiratórias/diagnóstico , Corticosteroides/uso terapêutico , Adulto , Aspergillus/genética , Sequência de Bases , Líquido da Lavagem Broncoalveolar/microbiologia , Análise Mutacional de DNA , DNA Fúngico/química , DNA Fúngico/isolamento & purificação , DNA Fúngico/metabolismo , Doença Granulomatosa Crônica/complicações , Doença Granulomatosa Crônica/tratamento farmacológico , Humanos , Pulmão/diagnóstico por imagem , Masculino , Neutrófilos/citologia , Neutrófilos/efeitos dos fármacos , Neutrófilos/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Infecções Respiratórias/complicações , Infecções Respiratórias/microbiologia , Rodaminas/análise , Acetato de Tetradecanoilforbol/farmacologia , Tomografia Computadorizada por Raios X
12.
Iran J Public Health ; 47(7): 980-987, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30181996

RESUMO

Background: We conducted this study among adults with pulmonary tuberculosis (TB) who received treatment, in order to determine the risk factors associated with survival of during treatments. Methods: A retrospective cohort study was conducted from 2005-2015 with newly registered TB patients in the Hospital of Masih Daneshvari Doctor, Tehran, Iran. Overall, 5313 patients met our study's cohort definition, but the analysis was performed on 2299 patients (43.2%) who had a correct address and they could be traced-out by the Medical - registry. Time in days was used in survival model and patients who were still alive (until last follow-up date) considered as censored. To study the effect of risk factors on patients' survival, the generalized gamma regression model was used. Results: Based on the results of univariate analysis, gender (RR=2 (95% CI: 1.1-3.7), high school education (Relative Risk: RR=0.3 (95% CI: 0.2-0.7), higher education (RR=0.3 (95% CI: 0.1-0.9), smoker (RR=2.5 (95% CI: 1.4-4.2), drug user (RR=2.4 (95% CI: 1.4-4), TB contact (RR=0.5 (95% CI: 0.3-0.8) and HIV positive (RR=4 (95% CI: 1.7-9.2) affected patients' survival. Moreover, the results of multivariate analysis showed that, gender (RR=5.5 (95% CI: 2.2-13.5), age (RR=1.1 (95% CI: 1-1.1), adverse drug effect (RR=2.5 (95% CI: 1.2-5.4), smoker (RR=3.3 (95% CI: 1.2-9.4), TB contact (RR=0.2 (95% CI: 0.1-0.5), diabetic mellitus (RR=3 (95% CI: 1-8.3), HIV positive (RR=26 (95% CI: 4.6-145.9) and comorbidities (RR=4.9 (95% CI: 2-11.6) were identified as factors affecting patients' survival. Conclusion: Our data indicated associated risk factors in TB mortality and could suggest way to progressing national tuberculosis program (NTP) for predicating and plan for effective interventional strategies.

13.
Iran J Allergy Asthma Immunol ; 17(3): 250-257, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29908542

RESUMO

Tuberculosis (TB) remains a major threat to human health. Understanding the strategies mycobacteria take to overcome immune defense is important in order to control the infection. Micro (mi)RNAs are master regulators of most pathways in the human body.  Infection with mycobacterium impacts upon the host metabolic pathways as they are subverted to obtain the nutrition for intracellular TB survival. In this study, we aimed to investigate the effect of Bacillus Calmette-Guérin (BCG) infection on the expression of three miRNAs (miR-1224, -484 and -425), which are important in infection and in the regulation of metabolic pathways. Peripheral blood monocyte-derived macrophage (MDM) cultures were prepared and infected with BCG at a multiplicity of infection (MOI)=10 or left uninfected as a control. 72h post-infection, RNA was extracted from the cultured cells and cDNA synthesis and real-time PCR performed. Expression levels miRNAs were normalized to the levels of U6 snRNA (Rnu6) using the 2-ΔΔCt method. Infection with BCG resulted in a highly significant increase in miR-1224 expression (24.4±3.8-fold induction) in human MDMs. The induction of miR-484 (1.8±0.3-fold increase) and of miR-425 (1.2±0.2-fold increase) was less increased compared to miR-1224. Mycobacterium tolerates a hostile microenvironment by escaping from lysosomal degradation and providing a lipid-rich niche by trigger with and re-pattering host metabolism. This study highlighted the potential roles of miRNAs in host responses upon mycobacterium infection.


Assuntos
Vacina BCG/imunologia , Macrófagos/imunologia , MicroRNAs/genética , Infecções por Mycobacterium/genética , Mycobacterium bovis/fisiologia , Células Cultivadas , Humanos , Macrófagos/microbiologia , Monócitos/citologia
14.
Int J Prev Med ; 9: 48, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29899886

RESUMO

Background: Close contact investigation is the essential key in tuberculosis (TB) case finding and an effective strategy for TB control program within any society. Methods: In this prospective study, 1186 close family contacts of hospitalized TB patients (index) in a referral TB hospital in Tehran-Iran were passively studied. These people were studied to rollout TB infection and disease. Demographic characteristics, clinical and laboratory data of these individuals were reviewed and summarized for analysis. Results: A total of 886 (74.4%) close-family contacts completed their investigation. The index TB patients of these individuals were sputum smear negative for acid-fast bacilli in 137 cases (11.6%) and the rest were smear positive. A total of 610 (68.8%) close-family contact ruled out for TB infection or disease (Group I). A total of 244 cases (27.5%) had latent TB infection (Group II) and active TB (Group III) was confirmed in 32 cases (3.6%). A significant difference was shown for female gender, signs and symptoms, family size, and positive radiological finding between Group I and Group II. The study of index parameter including positive sputum smear/culture did not reveal any significant difference, but positive cavitary lesion significantly more has seen in active TB group (P = 0.004). Conclusions: This study emphasizes on sign and symptoms and radiological finding in TB contact investigation, where index parameters including positive smear/culture, does not implicate any priority. Although cavitary lesions in index patient have more accompanied by active TB, close contact study should include all of TB indexes. This investigation should include chest radiography for these individuals.

15.
Rep Biochem Mol Biol ; 6(2): 118-124, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29765993

RESUMO

Background: Infectious diseases such as ventilator- associated pneumonia (VAP) are one of the serious problems in intensive care units (ICU) of hospitals. To date, there has been no appropriate clinical and diagnostic marker for early detection of this disease. In this study, expression of PIK3R3 and ATp2A1 genes in patients with VAP were assessed to be used as biomarkers to identify and confirm the disease. Methods: This study was conducted by using peripheral blood samples of 60 individuals, including 30 patients with VAP and 30 healthy volunteers. First, the peripheral blood samples were taken and then RNA was extracted and converted into cDNA. Finally, the assessment of genes was performed by Real-time PCR. Results: In peripheral blood samples, 46.6% and 30% were positive for PIK3R3 expression in patients and healthy groups, respectively. The ATp2A1 expression in patients and healthy controls were found 40% and 23.3%, respectively. Comparing the ΔCT obtained for the PIK3R3 and ATp2A1 genes showed statistically significant differences between the two groups of patients and healthy subjects (p=0.042, p=0.036). Conclusion: ATp2A1 and PIK3R3 may be used as biomarkers for early detection of VAP disease. However, further studies are required.

17.
Immunol Res ; 66(1): 59-66, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29178041

RESUMO

Tuberculosis (TB) is a crucial public health problem with prevalence of multidrug resistant (MDR) rising. An accurate TB biomarker is urgently needed to monitor the response to treatment in patients with MDR tuberculosis. To analyze interaction between selected MDR-TB purified protein and immune cells, dendritic cells from MDR-TB patients and healthy subjects were stimulated by 55KDa protein fractions (Rv0147). The purified proteins identified by proteomic techniques (two-dimensional gel electrophoresis, mass spectrometry) and peptide sequences are known to bind a MHC class I alleles which are extracted from the Immune Epitope Database and Analysis Resource database ( www.iedb.org ). T cells were isolated from PBMC by negative selection and cells were cultured in RPMI-1640 at 37 °C and 5% CO2. Cell culture was assayed for cytokine IL-10 and INF-γ by ELISA. We found that INF-γ production was significantly (335 ± 35.5 pg/ml, P ˂ 0.05) upregulated after protein candidate (Rv0147) stimulation by dendritic cells from MDR-TB patients, whereas IL-10 production was greatly reduced compared with production in healthy subjects (212 ± 9.94 pg/ml, P ˂ 0.05). In fact, the purified protein, Rv0147, stimulated dendritic cells from MDR-TB patients, failed to produce IL-10 and directly stimulates INF-γ production by T cells. These results suggest that the purified protein, Rv0147, may stimulate Th1 type protective cytokine response in MDR-TB patients but not in normal subjects. The production of INF-γ but not IL-10 in the presence of purified protein, Rv0147, may be shifted to Th1 responses in MDR-TB patients and supports its potential as protein vaccine candidates against TB.


Assuntos
Proteínas de Bactérias/imunologia , Células Dendríticas/imunologia , Epitopos Imunodominantes/imunologia , Metaloproteinases da Matriz/imunologia , Mycobacterium tuberculosis/fisiologia , Células Th1/imunologia , Tuberculose/imunologia , Biomarcadores , Células Cultivadas , Técnicas de Cocultura , Resistência a Múltiplos Medicamentos , Humanos , Imunidade Celular , Interferon gama/metabolismo , Interleucina-10/metabolismo , Ativação Linfocitária , Vacinas contra a Tuberculose/imunologia
18.
Infect Disord Drug Targets ; 18(1): 72-80, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28521672

RESUMO

AIM: To evaluate the feasibility of the revised "Clinical Guideline for HIV and TB" in the Great Tehran Prison during October 2013 to June 2014. METHODS: The guideline includes all aspects of HIV/TB diagnosis based on active case finding (ACF), treatment and care services. Before the implementation, a focus group discussion was conducted, and attended by experts on prison health. The objective was to identify defects and limitations of the guideline. After the discussion, the guideline was revised. The Great Tehran Prison contains three separate units; all prisoners are taken first to "reception and identification unit (quarantine)" and then send to two housing units according to their legal status. An HIV ACF strategy was employed in the quarantine, and two units through a voluntary provider-initiated HIV testing. Three staff of the triangular clinic trained the prisoners about common routes of HIV transmission and the symptoms of TB in the units. In the quarantine, all prisoners were examined for all HIV-risk factors, HIV testing and symptoms of TB. In unit one, healthcare staff continued the ACF process, while in unit two, the peers of prisoners were assigned as the healthcare communicators to proceed with the strategy. At this caring process, when the test result was positive, then the process of care, treatment and follow ups was initiated. Moreover, the use of directly observed therapy (DOT) for antiretroviral therapy (ART) and TB was applied to the sick prisoners. There was also a follow-up caring for released prisoner to refer them to care and treatment services outside the prison. RESULTS: The guideline was implemented in the prison successfully. CONCLUSION: Regarding feasibility of the guideline, the investigators of this study suggest that the guideline should be implemented in other prisons across the country.


Assuntos
Infecções por HIV/tratamento farmacológico , Prisioneiros , Tuberculose/tratamento farmacológico , Adulto , Terapia Antirretroviral de Alta Atividade/métodos , Terapia Diretamente Observada , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Prisões , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Tuberculose/microbiologia , Organização Mundial da Saúde
19.
Clin Respir J ; 12(1): 62-67, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27059900

RESUMO

OBJECTIVE: To screen for Tuberculosis (TB) in human immunodeficiency virus (HIV) people in an effort to improve early TB diagnosis and reduce TB transmission. METHODS: A prospective study was conducted on adult HIV people from 2008 to 2011. Three samples of sputum, cell blood count, tuberculin skin test (TST) and chest X-ray were obtained from all patients. The characteristics of HIV patients with TB and HIV patients without TB were compared to each other. RESULTS: Of the 154 HIV patients included, 58 (38%) had tuberculosis with a mean CD4 cell count of 68 cells/mm3 . Active TB was found in 56 (47%) patients with a history of intravenous drug use. Cough (OR = 3.1, 95% CI 1.2-7.79), positive TST (OR = 8.15, 95% CI 3.28-20.25) and an abnormal chest X-ray (OR = 5.1, 95% CI 1.84-14.2) were the predicting factors for detecting active TB among HIV patients. The sensitivity and specificity of a combination of any symptoms with chest X-ray, smear, TST or all of these were 96.5% and 86.5%, respectively. CD4 cell count <100 (OR = 2.67; 95% CI 1.23-5.78) and smoking (OR = 13.4; 95% CI 3.04-59.4) remained independently associated with TB in a multivariate analysis. CONCLUSION: There was a high prevalence of TB within the HIV population. Screening for TB among these patients can be carried out at every clinic or health facility using a combination of symptoms, TST, chest X-ray and smear sample.


Assuntos
Infecções por HIV/epidemiologia , HIV , Tuberculose Latente/epidemiologia , Mycobacterium tuberculosis/isolamento & purificação , Escarro/microbiologia , Tuberculose Pulmonar/epidemiologia , Adulto , Comorbidade/tendências , Feminino , Seguimentos , Infecções por HIV/virologia , Humanos , Irã (Geográfico)/epidemiologia , Tuberculose Latente/microbiologia , Masculino , Prevalência , Estudos Prospectivos , Teste Tuberculínico , Tuberculose Pulmonar/microbiologia
20.
Hum Immunol ; 79(1): 63-69, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29107084

RESUMO

BACKGROUND: Sarcoidosis is a granulomatous disease of unknown etiology. Macrophages play a key role in granuloma formation with the T cells, having a significant impact on macrophage polarization (M1 and M2) and the cellular composition of the granuloma. This study evaluates macrophage polarization in granulomas in pulmonary sarcoidosis. MATERIALS AND METHODS: Tissue specimens from the Department of Pathology biobank at the Masih Daneshvari Hospital were obtained. Paraffin sections from 10 sarcoidosis patients were compared with those from 12 cases of tuberculosis using immunohistochemical staining. These sections consisted of mediastinal lymph nodes and transbronchial lung biopsy (TBLB) for sarcoidosis patients versus pleural tissue, neck, axillary lymph nodes and TBLB for tuberculosis patients. The sections were stained for T-cells (CD4+, CD8+) and mature B lymphocytes (CD22+). CD14+ and CD68+ staining was used as a marker of M1 macrophages and CD163+ as a marker for M2 macrophages. RESULTS: Immunohistochemical staining revealed a 4/1 ratio of CD4+/CD8+ T-cells in sarcoidosis granuloma sections and a 3/1 ratio in tuberculosis sections. There was no significance difference in single CD4+, CD8+, CD22+, CD14+ and CD68+ staining between sarcoidosis and tuberculosis sections. CD163 expression was significantly increased in sarcoidosis sections compared with those from tuberculosis subjects. CONCLUSION: Enhanced CD163+ staining indicates a shift towards M2 macrophage subsets in granulomas from sarcoidosis patients. Further research is required to determine the functional role of M2 macrophages in the immunopathogenesis of sarcoidosis.


Assuntos
Granuloma/imunologia , Pulmão/patologia , Linfonodos/patologia , Macrófagos/fisiologia , Pleura/patologia , Sarcoidose Pulmonar/imunologia , Tuberculose/imunologia , Adulto , Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/metabolismo , Diferenciação Celular , Citocinas/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Receptores de Superfície Celular/metabolismo , Células Th2/imunologia , Adulto Jovem
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