Oxidative stress and age-related changes in T cells: Is thalassemia a model of accelerated immune system aging?

Iron overload in β-thalassemia major occurs mainly due to blood transfusion, an essential treatment for β-thalassemia major patients, which results in oxidative stress. It has been thought that oxidative stress causes elevation of immune system senescent cells. Under this condition, cells normally enhance in aging, which is referred to as premature immunosenescence. Because there is no animal model for immunosenescence, most knowledge on the immunosenescence pattern is based on induction of immunosenescence. In this review, we describe iron overload and oxidative stress in β-thalassemia major patients and how they make these patients a suitable human model for immunosenescence. We also consider oxidative stress in some kinds of chronic virus infections, which induce changes in the immune system similar to β-thalassemia major. In conclusion, a therapeutic approach used to improve the immune system in such chronic virus diseases, may change the immunosenescence state and make life conditions better for β-thalassemia major patients. © 2016 Termedia Sp. z o.o. All rights reserved

The comparison of the effects of the spinal anesthesia with low dose of bupivacaine and sufentanil with normal dose of bupivacain for orthopedic surgery of lower limb

زمینه و هدف: یکی از روش های موثر در کاهش بروز افت فشارخون، بی حسی نخاعی با دوز کم ماده بی حسی موضعی است. هدف این مطالعه مقایسه افت فشارخون و سایر عوارض بی حسی نخاعی دوز کم بوپیواکایین و سوفنتانیل با دوز معمول بوپیواکایین به صورت منفرد در جراحی اندام تحتانی بود. روش بررسی: این مطالعه که از نوع کارآزمایی بالینی تصادفی است شامل 150 بیمار بود که در سال های 1388 و 1389 تحت جراحی اندام تحتانی قرار گرفتند. بیماران بطور تصادفی به دو گروه مورد شامل 75 نفر بیمار که با 5/7 میلی گرم بوپیواکایین 5/0 درصد به همراه 5 میکروگرم سوفنتانیل و گروه شاهد شامل 75 نفر بیمار که با 15 میلی گرم بوپیواکایین تحت بی حسی نخاعی قرار گرفتند، تقسیم شدند. فاکتورهای مرتبط با بی حسی نخاعی از قبیل تغییرات فشار خون، بلوک حسی، درد و خارش در حین و بعد از بی حسی نخاعی ثبت و اندازه گیری شدند. داده ها با استفاده از آزمون های آماری کای دو، تی و فیشر مورد تجزیه و تحلیل قرار گرفتند. یافته ها: دو گروه از نظر متغیرهای زمینه ای با یکدیگر تفاوتی نداشتند. افت فشار خون اکثراً طی 10 دقیقه اول بی حسی نخاعی و بطور قابل توجهی در گروه شاهد رخ داد و بنابراین در این گروه بیشتر نیاز به استفاده از کاتکول آمین‌ها شد. تغییرات فشارخون سیستولیک در دقایق 3-1، 5-3 و 10-5 (01/0P=) و تغییرات فشارخون سیستولیک در دقایق 3-1، 10-5 و 15-10 (05/0

Serologic Biomarkers in Pemphigus Monitoring: C-reactive Protein, Macrophage Migration Inhibitory Factor, and Prolactin Levels Versus Autoantibody Assays

Evaluation and monitoring of pemphigus vulgaris (PV) typically involve autoantibody detection by enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence (IIF). We aimed to determine the levels of antipemphigus immunoglobulin (Ig) G autoantibodies using ELISA and IIF (as standard biomarkers), and compare it to prolactin, macrophage migration inhibitory factor (MIF), and C-reactive protein (CRP) (as nonstandard biomarkers) to determine which of these non-standard biomarkers is appropriate for PV monitoring. The experiment was performed before and during therapy. Anti-Dsg immunoglobulin G autoantibodies were measured using ELISA and IIF (as standard biomarkers) versus prolactin, MIF, and CRP (nonstandard), before 1 and 3 months after the treatment. Before beginning the treatment, the severity of the disease was determined using the pemphigus disease area Index (PDAI). We enrolled 60 newly diagnosed patients with PV (32 men and 28 women; mean age=43.8±14.2 years). Before treatment, the levels of anti-Dsg1, anti-Dsg3, and IIF were high and had a significant relationship with PDAI. PDAI also had a connection with the levels of CRP and prolactin. The anti-Dsg1, anti-Dsg3, IIF, and CRP titers decreased in patients treated with conventional (prednisolone plus azathioprine) and rituximab therapy during and after treatment. In conclusion, anti-Dsg1, anti-Dsg3, and IIF autoantibody titers remain standard biomarkers for assessing disease activity, severity, and PV monitoring. The trend of CRP was similar to that of anti-Dsg1, anti-Dsg3, and IIF. Thus, CRP may be used for PV monitoring

The Use of Telemedicine in the Diagnosis of Skin Diseases: Review of Clinical Outcomes

Introduction: Tele-dermatology is considered by telemedicine service providers about more than a decade. Many reasons, including safety, high diagnostic accuracy compared with physical examination, image-based diagnosis and relatively low cost for installing required systems are making Tele-dermatology successful remarkable. This study introduced Tele-dermatology and its kind and the results of different studies were conducted in clinical area in compare with physical examination is investigated. Method: This review article was done using available library resources and searching online database and articles which published between 2000–2014 in Tele-dermatology field were assessed. Results: Findings showed that, in average the conformity of the proposed diagnosis in skin disease for Tele-dermatology compared with visiting were (79.4 %), for treatment plans were (76.7 %) and reduction of attended visiting was(% 55.6). Also about the servicing fees skin a significant reduction of direct and indirect costs of skin care services show cost- effectiveness of Tele-dermatology. Conclusion: Although most of the researchers and experts agree with the effectiveness of Teledermatology for providing professional health care services and increasing the accessibility of these services, this method is not the final solution to overcome all difficulties related to the shortage of human and financial resources in healthcare system. It should be considered as a complementary to resolve some problems in providing high quality healthcare

Relationship between the serum levels of IL-2 and recurrence of pemphigus vulgaris

To EditorPamphigus vulagaris (PV) is an autoimmune disease with the characteristics of the epithelial layer destruction and production of blister lesions. Antibodies attack desmoglein 1 and 3 which play a crucial role in the epithelial cell adhesion, and this event is the main cause of this disease. If PV left untreated it would be fatal [1]. From the epidemiological point of view, it is more prevalent in females than males and it is more common in the 4th and 5th decades of life. Its treatment is mainly by the administration of corticosteroids, nevertheless in spite of appropriate curative measures, PV sometimes relapses and becomes problematic [2]; hence finding suitable solutions to prevent its recurrence will be of great help for the patients.In this regard two men aged 56 and 59 years old from Isfahan, Iran, were referred to the Dermatology Clinic of the Alzahra Hospital. They showed some lesions on their trunks. Referring to their past medical history, we found that both of them had PV, and the direct immunofluorescence test corroborated the disease by showing the characteristics deposition of IgG in a lace like pattern. The patients were treated by corticosteroids, (prednisolone 70 mg/day) and azathioprine 50mg/Day. Finally, they were discharged from the hospital after successful remedy.Cytokines profile analysis by the ELISA method (ELISA kit for IL-2 supplied by the U-CyTech Biosciences, Yalelaan 48, 3584 CM Utrecht and Netherlands) showed that the serum levels of IL-2 increased in the two patients (95 pg/ml and 169 pg/ml, respectively).This finding is consistent with the finding of Blitstein et al. [4]  who have  found  that  an  increase  in  the serum levels of  IL-2 plays an essential role in the PV recurrence. In addition, Prussick et al. [3] have also found that IL-2 therapy has been associated with the recurrence of PV, perhaps due to its ability to trigger autoantibody generation due to stimulation of both T and B cells. Thus by designing the monoclonal antibody drugs against IL-2 and its administration, we may prevent the disease recurrence and therefore, enhance the life span in the patients [3]. Nevertheless, more studies are needed to clarify the role of IL-2 in PV recurrence in the future.</p

Synergistic antitumor effect of NVP-BEZ235 and CAPE on MDA-MB-231 breast cancer cells

Triple negative breast cancer (TNBC) is the most lethal and aggressive kind of breast cancer. Studies with TNBC cells suggest that tumor environmental cytokines such as Transforming Growth Factor β1 (TGF-β1) have important roles in tumors fate. In the present study, we aimed to investigate, the effect of phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway dual inhibitor, NVP-BEZ235 and Caffeic acid phenyl ester (CAPE) on TNBC cell line (MDA-MB-231), stimulated with TGF-β1 for 14 days in vitro. We found that TGF-β1 as a local tumor environmental cytokine plays important role in the progression and invasiveness of TNBC cells. NVP-BEZ235 inhibited the enhanced cell viability and CXCR4 expression induced by TGF-β1. In addition, the combined treatment of TNBC cell lines with CAPE and NVP-BEZ235 synergistically inhibited cell growth and reduced CXCR4 expression. Also, treatment of MDA-MB-231 cells with CAPE and NVP-BEZ235 led to decreasing the expression levels of p-FOXO3a in a time-dependent manner. Overall, these results suggest that tumor metastasis and progression in TNBC cells can be effectively reduced through the concurrent use of NVP-BEZ235 and CAPE. This could be of particular interest in assessing the effects of this therapy in the reduction of tumor metastasis and progression in other tumor types

The Evaluation of Perioperative Safety of Local Anesthesia with Lidocaine Containing Epinephrine in Patients with Ischemic Heart Disease

The use of local anesthesia with lidocaine containing epinephrine in patients with cardiac disease is controversial in the literature. The aim of our study was determining the safety of use the local anesthesia contain epinephrine in patients with ischemic heart disease that undergoing reconstructive surgery. Thirty two patients that had known ischemic heart disease and candidate to undergo reconstructive surgery for skin tumor enrolled in this study.  All patients continued their medication for cardiac disease till morning of the operation. 10 ml lidocaine 2% containing 1:100,000 epinephrine was injected in patients for local anesthesia. The hemodynamic changes and electrocardiographic variables before injection were compared with them after injection, during surgery and till 6 hours postoperation period. A 12 lead electrocardiogram was recorded in all our cases for detection of myocardial ischemic changes. The mean age, weight and height were 58.2±10.4, 74.8.±14.4 kg and 164.5± 8 cm respectively. Twelve patients (37.5%) were diagnosed with systemic hypertension and 10 patients with diabetes (31.2%). The comparison of change of systolic, diastolic and mean blood pressure between baseline, during procedure and after operation defined that our subjects did not have any significant disturbance in blood pressure in perioperative period. The comparison of baseline heart rate with heart rate after injection, during procedure and in postoperation period indicated a significant changes in this variable (P=0.044). The heart rhythm during the perioperative period also failed to exhibit alterations. The ischemic change was not recorded in our patients before injection compared to after injection. None of our patients have any early complications because of infiltration of local anesthetic containing epinephrine in our patients. The use of 10 ml 2% lidocaine with epinephrine 1:100,000 in patients with cardiac disease represent a safe anesthetic procedure. These patients experienced a more profound anesthesia with hemodynamic stability and without myocardial ischemic changes

Comparison between Chondrogenic Markers of Differentiated Chondrocytes from Adipose Derived Stem Cells and Articular Chondrocytes In Vitro

Objective(s): Osteoarthritis is one of the most common diseases in middle-aged population in the world. Cartilage tissue engineering (TE) has been presented as an effort to introduce the best combination of cells, biomaterial scaffolds and stimulating growth factors to produce a cartilage tissue similar to the natural articular cartilage. In this study, the chondrogenic potential of adipose derived stem cells (ADSCs) was compared with natural articular chondrocytes cultured in alginate scaffold.   Materials and Methods: Human ADSCs were obtained from subcutaneous adipose tissue and human articular chondrocytes from non-weight bearing areas of knee joints. Cells were seeded in 1.5% alginate and cultured in chondrogenic media for three weeks with and without TGFβ3. The genes expression of types II and X collagens was assessed by Real Time PCR and the amount of aggrecan (AGC) and type I collagen measured by ELISA and the content of glycosaminoglycan evaluated by GAG assay. Results: Our findings showed that type II collagen, GAG and AGC were expressed, in differentiated ADSCs. Meanwhile, they produced a lesser amount of types II and X collagens but more AGC, GAG and type I collagen in comparison with natural chondrocytes (NCs). Conclusion: Further attempt should be carried out to optimize achieving type II collagen in DCs, as much as, natural articular chondrocytes and decline of the production of type I collagen in order to provide efficient hyaline cartilage after chondrogenic induction, prior to the usage of harvested tissues in clinical trials

The Hemodynamic Effects of Spinal Block with Low Dose of Bupivacaine and Sufentanil in Patients with Low Myocardial Ejection Fraction

The aim of this study was to assess the effect of spinal block with low dose of bupivacaine and sufentanil on patients with low cardiac output who underwent lower limb surgery. Fifteen patients who had ejection fraction less than 40% (group 1) were compared with 65 cases with ejection fraction more than 40% (group 2) in our study. Our subjects underwent spinal block with 7.5 mg hyperbaric bupivacaine 0.5% and 5 µg sufentanil. We recorded early events such as hypotension, bradycardia, vasopressor need and ST segment change in our cases. The average mean arterial pressure decreased 13% (110 mmHg to 95.7 mmHg) in group 1 and 20% (160 mmHg to 128 mmHg) in group 2 (P<0.001). Hypotension due to spinal anesthesia was observed in none of our subjects in both groups and none of our cases need to vasopressor support. All patients remained alert, and no ST segment changes were observed in two groups. In our study none of subjects complained of pain intraoperatively. The subjects were without complaints during the spinal anesthetic in both groups. Spinal block with low dose local anesthetic and sufentanil was a safe and effective method for lower limb surgery in patients with low ejection fraction