يکشنبه ٢٨ آبان ١٣٩٦
 

Acute Epstein -Barr virus hepatitis without mononucleosis syndrome: A case report

Abstract: Elevated liver enzymes accompanied by Infectious Mononucleosis syndrome are widely seen in primary Epstein-Barr virus infection whileacute symptomatichepatitiswithouttypicalpresentationsof EBV is extremely rare. In the followingreport, we presenta patient with acute isolated hepatitis due to laboratory confirmed Epstein-Barr virus. © 2017 RIGLD.

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Recurrent drug-induced hepatitis in tuberculosis-comparison of two drug regimens

Drug-induced hepatitis (DIH) is one of the major complications among the treatment of patients with tuberculosis (TB); it might even be fatal. This study tries to address the recurrence of DIH with 2 anti- TB regimens. In the retrospective study from 2007 to 2010, 135 TB patients with DIH who were older than 16 years were entered to study. The patients with DIH were randomly treated with a regimen, including isoniazid, rifampin, and ethambutol, plus either ofloxacin or pyrazinamide. The patients were reviewed for occurrence of recurrent DIH. Cure and completed treatment were considered as acceptable treatment outcomes, whereas default of treatment, treatment failure, and death were considered to be unacceptable outcomes. Therefore, 135 subjects with DIH were reviewed, and 23 patients (17%) experienced recurrence of hepatitis (19 cases in the ofloxacin group and 4 cases in the pyrazinamide group). There is no significant difference in recurrence of hepatitis between these 2 groups (P 5 0.803). An acceptable outcome was observed in 95 patients (70.4%), and an unacceptable outcome was seen in 14 cases (10.3%). There was no significant difference in outcomes between these 2 regimens (P 5 0.400, odds ratio 5 1.62, 95% confidence interval, 0.524-4.98). The results of our study suggest that ofloxacin-based anti-TB regimen does not decrease the risk of recurrent DIH. Therefore, adding ofloxacin in the case of DIH is not recommended. © 2014 Lippincott Williams & Wilkins.

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The effects of smoking on treatment outcome in patients newly diagnosed with pulmonary tuberculosis

Abstract: S E T T ING: Smoking is reported to be associated with tuberculosis (TB), but its effect on sputum smear conversion remains a matter for discussion. OBJ E C T I V E : To assess the effects of smoking and smoking cessation on treatment outcomes in patients newly diagnosed with TB in Iran. DESIGN: Newly diagnosed smear-positive TB patients were included in the study. All smokers participated in a smoking cessation programme. Sputum smear status was evaluated at the end of month 2, 5 and 6 of treatment, and smoking status was evaluated at the end of month 2. Differences in smear conversion rates were compared between the three groups, i.e., non-smokers, smokers and quitters. RESULT S : A total of 183 smokers and 151 non-smokers were included. When smoking cessation was assessed after 2 months, 42.6% (78/183) of the smokers were found to have quit. The cure rate at the end of 6 months, precisely compatible with the conversion rate, was significantly higher among non-smokers (P 0.004) and quitters at 2 months (P 0.049) than among persisting smokers (83.4%, 80.8% and 67.6%, respectively). CONCLUS ION: Cure rates in patients newly diagnosed with pulmonary TB were higher in non-smokers and quitters at 2 months than in smokers. Smoking cessation advice should be included in TB control programmes. © 2017 The Union.

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Role of epigenetics in the pathogenesis of asthma

Abstract: BACKGROUND: Asthma is a complex, heterogeneous and chronic airway inflammatory disease with different clinical phenotypes caused by diverse triggers and pathophysiological mechanisms. Asthma heritability has been established in many genetic studies but it is evident that only genetic elements are not responsible for the development of asthma. Increasing rate of asthma incidence during past decades has implicated the role of epigenetics in development of asthma. Environmental factors perform as initiator signals through epigenetic mechanisms. Three epigenetic mechanisms have been identified, including DNA methylation, histone modifications, and small noncoding RNAs. These mechanisms regulate the immune responses and inflammatory genes expression in asthma and allergy. This review explains the role of epigenetic modifications in controlling Th2 response and IgE production in asthma and also briefly overviews the role of environmental factors such as pollutions, allergens, prenatal exposures and diet in developing asthma. Recognizing environmental risk factors and their effects on epigenetic mechanisms would be of great interest for prognostic and preventive aspect in treatment of asthma. Copyright © Spring 2017, Iran J Allergy Asthma Immunol. All rights reserved.

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Water-pipe smoke condensate increases the internalization of Mycobacterium Bovis of type II alveolar epithelial cells (A549)

Abstract: Background: Tuberculosis (TB) is a major global health problem, and there is an association between tobacco smoke and TB. Water pipe smoking has become an increasing problem not only in Middle Eastern countries but also globally because users consider it as safer than cigarettes. The presence of high levels of toxic substances in water-pipe smoke may be a predisposing factor that enhances the incidence of pulmonary disorders. For example, uncontrolled macropinocytosis in alveolar epithelial cells following exposure to water-pipe smoke may predispose subjects to pulmonary infection. Here, we studied the effects of water-pipe condense (WPC) on the internalization of Mycobacterium Bovis BCG by macropinocytosis in the alveolar epithelial cell line A549. Methods: A549 cells were exposed to WPC (4 mg/ml) for 24, 48, 72 and 96 h. Cell viability was studied using the methyl thiazolyldipenyl-tetrazolium bromide (MTT) reduction assay and proliferation by bromodeoxyUridine (BrdU) incorporation. Cells were exposed to FITC-Dextran (1 mg/ml) (as a control) and FITC-BCG (MOI = 10) for 20 min at 37 °C before cells were collected and the uptake of BCG-FITC determined by flow cytometry. Similar experiments were performed at 4 °C as a control. The Rho-associated protein kinase (ROCK) inhibitor Y-27632 (1 μM) was used to assess the mechanism by which WPC enhanced BCG uptake. Results: WPC (4 mg/ml) increased the uptake of BCG-FITC after 72 (1.3±0.1 fold, p<0.05) and 96 (1.4±0.05 fold, p<0.05) hours. No effect on BCG-FITC uptake was observed at 24 or 48 h. WPC also significantly increased the uptake of FITC-Dextran (2.9±0.3 fold, p<0.05) after 24 h. WPC significantly decreased cell viability after 24 (84±2%, p<0.05), 48 (78±, 3%, p<0.05), 72 (64±2%, p<0.05) and 96 h (45±2%, p<0.05). Y-27632 completely attenuated the increased uptake of BCG by WPC. Cell proliferation showed a decreasing trend in a time-dependent manner with WPC exposure. Conclusion: WPC exposure increased epithelial cell endocytosis activity and death as well as enhancing their capacity for macropinocytosis. Our in vitro data indicates possible harmful effects of WPC on the ability of lung epithelial cells to phagocytose mycobacterium. © 2017 The Author(s).

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Underlying causes of persistent and recurrent Pneumonia in children at a pulmonary referral hospital in Tehran, Iran

Abstract: There is limited data on recurrent or persistent pneumonia in children, particularly in the developing world. This is a retrospective, cross-sectional study of children with recurrent or persistent pneumonia admitted to the Pediatric Department of Massih Daneshvari Hospital, Tehran, Iran. Methods: Children under 18 years of age, who were admitted to the hospital with pneumonia between 2007 and 2013, were investigated to find out the prevalence of recurrent and persistent pneumonia and to recognize their underlying diseases. Descriptive statistics were calculated for all data. Results: Out of 601 children admitted for pneumonia, 229 (38.1%) met the criteria for recurrent or persistent pneumonia. An underlying illness was identified in 194 patients (84.72%). The most common underlying causes of recurrent pneumonia included aspiration syndrome (51.75%), recurrent wheezing (20.17%), and congenital heart diseases (20.17%). The most common underlying illness of persistent pneumonia included pulmonary tuberculosis (38.75%), recurrentwheezing (28.75%), and aspiration syndrome (26.25%). Conclusions: The result showed that the majority of patients with recurrent or persistent pneumonia had an underlying illness. New strategies and guidelines are required for early diagnosis of underlying causes of recurrent or persistent pneumonia in children. © 2017, Academy of Medical Sciences of I.R. Iran. All rights reserved.

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A new ataxia-telangiectasia mutation in an 11-year-old female

Abstract: Background: Ataxia-telangiectasia (A-T), a rare inherited disorder, usually affects the nervous and immune systems, and occasionally other organs. A-T is associated mainly with mutations in the ataxia telangiectasia mutated (ATM) gene, which encodes a protein kinase that has a major role in the cellular response to DNA damage. We report here a novel ATM mutation (c.3244_3245insG; p.His1082fs) in an 11-year old female. This subject presented with typical features, with the addition of chest manifestations including mediastinal lymphadenopathy and diffuse bilateral micronodular infiltration of the lungs, along with a high EBV titer. The subject died as a result of rapid B-cell lymphoma progression before chemotherapy could be initiated. This case highlights the need for the rapid diagnosis of A-T mutations and the detection of associated life-threatening outcomes such as cancers. © 2017 The Author(s)

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Bovis Bacillus Calmette-Guerin (BCG) infection induces exosomal miRNA release by human macrophages

Tuberculosis (TB) remains a significant global health concern and its diagnosis is challenging due to the limitations in the specificity and sensitivity of the current diagnostic tests. Exosomes are bioactive 30-100nm vesicles produced by most cell types and are found in almost all human body fluids. Exosomal microRNAs (miRNAs) can transfer biological information between cells and tissues and may act as potential biomarkers in many diseases. In this pilot study, we assessed the miRNA profile of exosomes released from human monocyte-derived macrophages upon infection with Mycobacterium bovis Bacillus Calmette-Guerin (BCG). Methods: Human monocytes were obtained from the peripheral blood of three healthy subjects and driven to a monocyte-derived macrophage (MDM) phenotype using standard protocols. MDMs were infected with BCG or left uninfected as control. 72h post-infection, exosomes were collected from the cell culture medium, RNA was isolated and RNA-seq performed. The raw reads were filtered to eliminate adaptor and primer sequences and the sequences were run against the mature human miRNA sequences available in miRBase. MicroRNAs were identified using an E value <0.01. miRNA network analysis was performed using the DIANA miRNA tool, miRDB and functional KEGG pathway analysis. Results: Infection of MDMs with BCG leads to the release of several exosomal miRNAs. These included miR-1224, -1293, -425, -4467, -4732, -484, -5094, -6848-6849, -4488 and -96 all of which were predicted to target metabolism and energy production-related pathways. Conclusions: This study provides evidence for the release of specific exosomal miRNAs from BCG-infected MDMs. These exosomal miRNAs reflect host-pathogen interaction and subversion of host metabolic processes following infection. © 2017 The Author(s).

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