Jalaleddin Shams

Shahed University, Teheran, Tehrān, Iran

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Publications (18)17.62 Total impact

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    ABSTRACT: Abstract Context: Sulfur mustard (SM), with an old manufacturing history still remains as potential threat due to easy production and extensive effects. Objectives: Increasing studies on SM indicates the interest of researchers to this subject. Almost all human body organs are at risk for complications of SM. This study offers organ-by-organ information on the effects of SM in animals and humans. Methods: The data sources were literature reviews since 1919 as well as our studies during the Iraq-Iran war. The search items were SM and its all other nomenclatures in relation to, in vivo, in vitro, humans, animals, eye, ocular, ophthalmic, lungs, pulmonary, skin, cutaneous, organs and systemic. Amongst more than 1890 SM-related articles, 257 more relevant clinicopathologic papers were selected for this review. Results: SM induces a vast range of damages in nearly all organs. Acute SM intoxication warrants immediate approach. Among chronic lesions, delayed keratitis and blindness, bronchiolitis obliterans and respiratory distress, skin pruritus, dryness and cancers are the most commonly observed clinical sequelae. Conclusion: Ocular involvements in a number of patients progress toward a severe, rapid onset form of keratitis. Progressive deterioration of respiratory tract leads to "mustard lung". Skin problems continue as chronic frustrating pruritus on old scars with susceptibility to skin cancers. Due to the multiple acute and chronic morbidities created by SM exposure, uses of multiple drugs by several routes of administrations are warranted.
    Cutaneous and Ocular Toxicology 04/2013; · 1.04 Impact Factor
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    ABSTRACT: Abstract Context: Sulfur mustard (SM), with an old manufacturing history still remains as potential threat due to easy production and extensive effects. Objectives: Increasing studies on SM indicates the interest of researchers to this subject. Almost all human body organs are at risk for complications of SM. This study offers organ-by-organ information on the effects of SM in animals and humans. Methods: The data sources were literature reviews since 1919 as well as our studies during the Iraq-Iran war. The search items were SM and its all other nomenclatures in relation to, in vivo, in vitro, humans, animals, eye, ocular, ophthalmic, lungs, pulmonary, skin, cutaneous, organs and systemic. Amongst more than 1890 SM-related articles, 257 more relevant clinicopathologic papers were selected for this review. Results: SM induces a vast range of damages in nearly all organs. Acute SM intoxication warrants immediate approach. Among chronic lesions, delayed keratitis and blindness, bronchiolitis obliterans and respiratory distress, skin pruritus, dryness and cancers are the most commonly observed clinical sequelae. Conclusion: Ocular involvements in a number of patients progress toward a severe, rapid onset form of keratitis. Progressive deterioration of respiratory tract leads to "mustard lung". Skin problems continue as chronic frustrating pruritus on old scars with susceptibility to skin cancers. Due to the multiple acute and chronic morbidities created by SM exposure, uses of multiple drugs by several routes of administrations are warranted.
    Cutaneous and Ocular Toxicology 04/2013; · 1.04 Impact Factor
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    ABSTRACT: The most important long-term morbidity problem of sulfur mustard (SM) toxicity is pulmonary complications but the pathogenesis of these complications is not clearly understood. This study evaluates the peripheral blood mononuclear sub-sets and their correlation with pulmonary function in SM exposed civilian cases 20years post-exposure as gathered in the context of the Sardasht-Iran Cohort Study (SICS). Samples were randomly selected from two groups, SM-exposed (n=372) and control (n=128), with the same ethnicity, culture, and demography. Three color flow cytometry was applied for peripheral blood mononuclear sub-population determination. Results indicated a significant decrease in CD45+/CD3+, CD45+/CD3+/CD4+, and an increase in CD3+/CD16+56+ percentages. It was also found that absolute count of NK cells was highly increased in peripheral blood of exposed cases. There was a significant increase in NK cell count of SM exposed group with pulmonary problems as compared to the same group without pulmonary problems (p-value<0.04) based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The findings showed a significant negative correlation between absolute numbers of T lymphocyte and FVC % and positive correlation with FEV1/FVC%. The results also demonstrated that absolute numbers of monocytes had a negative correlation with FVC %. We propose that NK and T cells are probably involved in the pathogenesis or immune reactions to the delayed pulmonary complications induced by SM. This hypothesis should be tested in a more severe pulmonary complicated group.
    International immunopharmacology 02/2013; · 2.21 Impact Factor
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    ABSTRACT: Chemokines play an important role in acute and chronic pulmonary diseases. The aim of this study was to evaluate the levels of chemokines, MMP-9, and PMN elastase in spontaneous sputum and serum of patients 20years after SM exposure. In context of Sardasht-Iran Cohort Study (SICS) 40 male volunteers with a history of SM exposure in June 1987 and complain of excessive sputum were recruited in the study. The volunteers were clinically examined and their history was collected by internists. Sputum and serum levels of IL-8, fractalkine, MCP-1, RANTES, MMP-9, and PMN elastase were measured using ELISA kits (R&D System). Spirometries were performed on all the participants. Sputum level of fractalkine was significantly lower in the hospitalized group (N=16, Median=1.05; IQR=0.41-2.62) than non-hospitalized group (N=18, 4.031; IQR=0.947-8.203) (p=0.042). However, serum levels of fractalkine were higher in the hospitalized group (Mean±SD=2.08±5.09) than in the non-hospitalized (Mean±SD=0.53±0.87) group (T-test, p=0.03). Serum levels of PMN-elastase were also higher in the hospitalized group (Mean±SD; 64,794.43±26,820.08) than in the non-hospitalized group (Mean±SD=44,049.33±17,675.85) (p=0.017). There was no relationship between the cytokines and the studied factors in sputum and the GOLD classification, but the serum levels of fractalkine and MMP-9 were significantly higher in the more severe (grades 3-4) group. There was no significant correlation between sputum and serum levels of measured inflammatory mediators and pulmonary complications in the patients who were exposed to SM 20years earlier. Pathophysiologic process involved in SM induced pulmonary problems might be different from those in other chronic pulmonary diseases such as COPD and asthma.
    International immunopharmacology 01/2013; · 2.21 Impact Factor
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    ABSTRACT: Cancer is a growing health problem around the world. Although there are different therapeutic methods for cancer such as lymphoma and melanoma cancers, none of them have possessed complete efficacy up to now. Therefore, discovery of novel anti-cancer drugs is important. In this study, the cytotoxic effect of Cuscuta extract, a traditional Iranian medicinal herb, on melanoma cell line (SK-MEL-3) and human Burkitt lymphoma (Raji) is evaluated. MTT assay was performed for cytotoxic effect of Cuscuta extract. The most cytotoxic effects of Cuscuta extract on SK-MEL-3 and Raji cell lines were 80 and 81%, respectively, compared to a control group. According to our data, Raji cells are more sensitive to Cuscuta than the SK-MEL-3 cells. Cuscuta extract seems to be a good candidate as an anti-cancer agent against lymphoma and melanoma cancers. To clarify the effective molecules and their mechanisms, further studies are undertaken in our laboratory on animal models and humans.
    Food and Agricultural Immunology 01/2012; · 0.73 Impact Factor
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    ABSTRACT: Gastric cancer (GC) is the fourth most common cancer and second leading cause of cancer-related death worldwide. Therefore, discovery of novel anti-cancer herbal drugs is of importance. Herbal medication is now being used for treatment of various diseases, including cancer in many countries. In this study, the cytotoxic effect of traditional herbal medicines (Aloe vera, Ginger, Ziziphora and Saffron extracts) was investigated on gastric AGS cell line. MTT assay was performed for cytotoxic effect of these herbal medicines. The most cytotoxic effects of Ginger, Ziziphora and Saffron extracts on AGS cell line were 47, 88 and 67%, respectively, compared to control group. According to our data, among these herbal extracts, Ziziphora has the highest cytotoxic effect on AGS cell line. Ziziphora extract seems to be a good candidate as an anti-cancer agent against GC. To clarify the effective molecules and their mechanisms, further studies are undertaken on animal models and humans.
    Food and Agricultural Immunology 01/2011; · 0.73 Impact Factor
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    Maryam Khalili, Nima Mahboobi, Jalaleddin Shams
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    ABSTRACT: Metastatic tumors to oral cavity and jaws are rare, and mandible is the most commonly involved location. Because the most common jaw symptom is pain, these lesions could be misdiagnosed as pathologic entities with dental origin. In this article a case of metastatic breast carcinoma initially diagnosed as pulpal/periapical disease is presented and discussed. A 40-year-old female patient was referred to our department with vague pain in right mandibular area. Clinical and radiographic examinations were performed, leading to the initial diagnosis. Patient's medical history was reevaluated, and an incisional biopsy was performed to confirm the final diagnosis. Regarding the initial signs and symptoms, a pulpal/periapical inflammatory process was considered in the differential diagnosis. Because lip paresthesia was also noted, a more aggressive process was suspected. Patient's medical records and histopathologic slides were requested and reviewed carefully. The diagnosis of metastatic breast carcinoma was confirmed by comparing the histopathologic findings of the jaw lesion with previous slides of the breast. Despite their rarity, metastatic tumors should be considered in the differential diagnosis of inflammatory and reactive lesions of the jaws. These lesions might be diagnosed first by the patient's dentist or by the maxillofacial surgeon. This case emphasized the importance of a complete and careful work-up with particular attention to detailed medical history as well as careful clinical and radiographic inspection for unusual signs and symptoms.
    Journal of endodontics 05/2010; 36(5):922-5. · 2.95 Impact Factor
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    ABSTRACT: Sulfur mustard (SM) is highly toxic for various organs. The eyes, skin, respiratory tract, as well hematopoietic and immune systems are the main organs affected by SM. Granulocyte-macrophage colony stimulating factor (GM-CSF) is a potent cytokine that plays an important role in the hematopoietic and immune system. The aim of this study was to determine the serum levels of GM-CSF and its relation to blood cell count and other inflammatory cytokines 20 years after SM exposure. The association of GM-CSF with the clinical severity of pulmonary, ophthalmic and dermatologic complications has also been studied. In this historical cohort study named as Sardasht-Iran Cohort Study (SICS), 369 SM exposed male participants and 125 unexposed volunteers were studied. The serum concentrations of cytokines were measured by ELISA technique. The severity of clinical complications was graded according to the criteria verified by the Medical Committee of the Foundation of Martyr and Veterans Affairs. The serum levels of GM-CSF in the SM exposed group did not display any significant differences with the control group. Median of GM-CSF was 7.33 and 9.39 pg/ml in the SM exposed group and the controls respectively. There was a positive correlation between the serum levels of GM-CSF and the percent of eosinophils only in the exposed group. Moreover, positive correlations were found between circulating levels of GM-CSF with IL-1alpha, IL-1beta, TNF-alpha and IL-6. This correlation was not observed between GM-CSF and IL-8 in both study groups. The serum levels of GM-CSF did not show any significant association with clinical complications.
    International immunopharmacology 10/2009; 9(13-14):1499-503. · 2.21 Impact Factor
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    ABSTRACT: The selectins (L, P and E) are carbohydrate-binding membrane glycoproteins acting as adhesion molecules involved in the development of different inflammatory reactions. Various eye, skin and lung diseases are associated with induction of soluble selectins. In this study serum levels of soluble forms of selectins (sL-selectin, sP-selectin and sE-selectin) were evaluated in the sulfur mustard (SM) exposed and the control groups using ELISA method. sL-selectin was significantly lower in the SM exposed group compared to the control group (1131.5+/-16.3 and 1205.7+/-26.9 pg/ml respectively; p=0.021). The serum levels of sP-Selectin was significantly reduced in the SM exposed group in comparison to the control group (149.35+/-2.61 and 170.25+/-5.16 pg/ml respectively; p<0.001). sE-selectin was significantly increased in sera of the exposed group compared to the control group (29.64+/-0.902 and 24.61+/-1.26 pg/ml respectively; p=0.003). sL-selectin positively correlated with the percentage of polymorphonuclear cells and negatively with the percentage of lymphocytes. There was a significant correlation between the count of platelets and sP-selectin in both the control and exposed groups. The change in the pattern of selectins in the SM exposed group in comparison to the control group may indicate suppressed acute inflammatory condition in which new remodeling of cytokine expression play a more crucial role in the immune-regulation.
    International immunopharmacology 10/2009; 9(13-14):1477-81. · 2.21 Impact Factor
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    ABSTRACT: Insights into long-term clinical consequences of sulfur mustard have emerged from some investigations but less is known about the basic and molecular mechanisms of these complications. Sardasht-Iran Cohort Study is a comprehensive historical cohort study on Sardasht chemical victims' population which was designed to find out the long-term complications of sulfur mustard exposure and the basic mechanisms underlying clinical manifestations. This paper describes the design and methodology of Sardasht-Iran Cohort Study. In Sardasht-Iran Cohort Study, 500 individuals including 372 subjects from Sardasht, as the exposed group, and 128 subjects from Rabat, as the unexposed age-matched control group were evaluated. The exposed group was divided into two groups based on the severity of clinical complications at the time of exposure. Different samples including blood, sputum, saliva, tear, urine, and semen were collected for immunologic, hematologic, biochemical, and other laboratory analysis. Data were gathered from medical records, clinical examinations, laboratory tests, and questionnaires for psychological and lifestyle situations. The important distinctions setting this study apart from the previous ones are discussed. The Sardasht-Iran Cohort Study provides important information on various aspects of long-term consequences of sulfur mustard exposure. This database will provide a better position to suggest guidelines for the diagnosis, treatment, and prevention of delayed complications in the patients exposed to sulfur mustard.
    Archives of Iranian medicine 02/2009; 12(1):5-14. · 1.22 Impact Factor
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    ABSTRACT: Sulfur mustard (SM) has widely been used against the military and civilians during the Iraq-Iran war (1980–1988). It mostly affects the respiratory system. A large historical cohort study was designed to evaluate the pulmonary status of non-military victims in Sardasht, Iran, in comparison with a matched control group 20 years after a single massive exposure. The exposed group was divided into two subgroups of hospitalized and non-hospitalized based on the severity of the injuries indicated by hospitalization a few days following exposure. All participants’ respiratory symptoms and signs were evaluated by internists. Dyspnea (n = 261; P = 93.2%) was the most common symptom. Chronic cough, cough severity, sputum, hemoptysis, dyspnea, pattern of dyspnea, severity of dyspnea (P <0.001 for all), and chest pain (P = 0.003) were statistically significantly different between the two groups. Wheezing was the most common pulmonary finding (11.4%). There was also a statistically significant difference in the auscultation of wheezing (P = 0.045) and rhonchi (P = 0.018) between the hospitalized and control groups. Considering objective findings, pulmonary involvement was observed in 24.3% (n = 68, P = 0.007).
    01/2009; 28(1):8-13.
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    ABSTRACT: To describe the long-term health status of Sardasht civilians 20 years after sulfur mustard exposure, a historical cohort study was carried out in Sardasht (Iran) that included 372 exposed and 128 unexposed civilians. Their symptoms, diagnoses, drug use, and general health were compared. The most common complaints were about the respiratory system (93.5%), eyes (52%), skin (94.7%), and anxiety and depression (69.2%). Respiratory (42.5%), skin (75.5%), ophthalmic (19.6%), and mental (62.7%) diseases were diagnosed by specialists and they were more common in the exposed group than the control group (P < 0.001). Most of the exposed group had used drugs (70.6%), which was more than control group (42.8%). It seems that exposure to sulfur mustard caused a lot of health problems in Sardasht. Identifying the pathophysiology of these problems can help them more, but more investigation is needed.
    01/2009; 28(1):3-7.
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    ABSTRACT: Sulfur mustard has various toxic effects. Some of the complications due to sulfur mustard toxicity are well known and some are unclear. In this study, serum total bilirubin and some hematologic parameters were evaluated in populations exposed to different doses of sulfur mustard. The sulfur mustard–exposed victims from Sardasht-Iran were divided into two groups 20 years after exposure, based on hospitalization at the time of the exposure. Studied groups were hospitalized and not hospitalized (n = 169 and n = 203, respectively). Liver function tests including total serum bilirubin, direct bilirubin, SGOT, SGPT, ALP, and hematologic parameters composed of RBC count, hemoglobin, hematocrit, and RBC indexes were evaluated. Total counts for RBC, MCV and total serum bilirubin were significantly different between the two groups, but there was no statistically significant difference in direct bilirubin, SGOT, SGPT, ALP, hemoglobin, hematocrit, MCH, MCHC between the two groups.
    01/2009; 28(1):44-47.
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    ABSTRACT: Sulfur mustard (SM) is an alkylating agent used several times by Iraqi forces as a chemical warfare agent in the Iraq-Iran war (1980–1988). Eyes, skin and respiratory system are the most sensitive organs to SM exposure. This agent has a suppressor effect on the immune system. As we did not find any study on the late rheumatologic complications of SM in the exposed victims in literature, in this study we investigated these complications in Sardasht (Iran) civilians 20 years after exposure. In a cohort study, 370 victims of Sardasht (that divided into two groups: hospitalized, n = 167, and non hospitalized, 203) in comparison to 128 control subjects from Rabat (Iran). The chief rheumatologic complaints, the physical examinations, the most probable clinical diagnosis and the rheumatic laboratory tests were compared between the study groups. The chief complaint was lower extremity pain; the most frequent physical finding was widespread tenderness and the most frequent clinical diagnosis was psychogenic pain. Among laboratory tests, only anti nuclear antibody (ANA) had significantly higher titer in the hospitalized victims than in the control subjects (P = 0.02). The most frequent rheumatologic complications were degenerative diseases of joints and spine. There was no significant difference in inflammatory disease between the two groups, but there were more rheumatoid arthritis patients among the victims. Higher ANA titers may indicate some autoimmune disorders as late rheumatic complications of SM.
    01/2009; 28(1):34-38.
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    ABSTRACT: Mustard gas was the most extensively used chemical agent in the Iraq-Iran war (1980–1988). It affects many important organs and systems; however, its cardiovascular effects are still unclear. In a historical cohort study, we evaluated the symptoms and signs of mustard gas exposed victims (397 cases) and compared the findings with the control group (132 persons). Typical chest pain was more frequent in the exposed group (11% versus 0%, P = 0.450). In addition, exertional dyspnea was found in 50% of the exposed group versus 30% in the control group (P = 0.162). Chest pain and dyspnea were more frequent in the exposed group and cardiac signs were the same in the two groups. Further studies must be planned for evaluating ischemic and valvular heart diseases, myopathy and other cardiovascular problems in these victims.
    01/2009; 28(1):30-33.
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    ABSTRACT: Sulfur mustard (SM) is a vesicant or blistering chemical agent that possesses mutagenic and carcinogenic properties and alkylates DNA. Little is known about the long-term effects of sulfur mustard on blood cells. The aim of this study is to examine the long-term effects of SM on peripheral blood cells in SM victims of the Iraq-Iran war (1980–1988). This study, which is a part of Sardasht Iran Cohort Study (SICS) was designed in two groups: exposed (372 participants from Sardasht) and control (128 unexposed people from Rabat). The exposed group was divided into hospitalized and not hospitalized subgroups based on the severity of lesions at exposure time. A comparison was made between the study groups’ overall blood exams. The hospitalized group had significantly higher numbers of red blood cells (p = 0.003) than not hospitalized and the control groups. The exposed group had significantly higher HCT and MCV (P = 0.007) than the control group. Exposure group had significantly lower numbers of PLT (P = 0.001), WBC (P = 0.006) and PMN (P = 0.001) than the control group but from clinical viewpoint this difference is not valuable. Further, lymph cells (P = 0.001) in the exposed group were significantly higher than in the control group. Our research findings suggested the probability of severe damage to bone marrow and predisposing to infection in other organs (especially lung) due to exposure to SM in the exposed group.
    01/2009; 28(1):39-43.
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    ABSTRACT: Sulfur mustard (SM) was the most common chemical warfare agent used by Iraqi military forces against Iranian soldiers and civilians in border towns. Studies about late skin complications in SM-exposed people and its comparison with those in a proper control group are limited. The present paper, which is a part of the Sardasht-Iran Cohort Study is concerning with the skin findings of SM exposure 20 years after the chemical bombardment of Sardasht town (Iran) in comparison with the skin findings of the Rabat population. There are two major subgroups of SM exposure: a hospitalized group with moderate to severe problems at exposure time (n = 168), and a not hospitalized group with mild problems (n = 194), and the other is a control group (n = 128) selected from Rabat. Each participant was examined by a dermatologist in the research team. The most common skin lesions in the exposed groups based on their frequency were: eczema (27.6%), xerosis (24.6%), cherry angioma (19.9%), hyperpigmentation (15.5%), mustard scar (14.6%) and seborrheic dermatitis (10.8%), but in the control group, they were: eczema (28.9%), xerosis (11.7%), seborrheic dermatitis (11.7%) and cherry angioma (9.4%). In the exposed group, itching (P < 0.001), burning (P = 0.037), xerosis (P = 0.002), hyperpigmentation (P = 0.002) and cherry angioma (P = 0.007) were seen more often than in the control group and the differences were statistically significant. It is concluded that SM exposure causes significant delayed skin findings. In the exposed group, further follow up was needed for more long-term skin complications such as skin cancers, and there are many questions about the underlying pathophysiology and immunology of SM cutaneous complications that should be investigated.
    01/2009; 28(1):24-29.
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    ABSTRACT: Eyes are very sensitive to sulfur mustard (SM) gas because they have wet surfaces. The severity of ocular damage is related to the dose and duration of exposure to SM, and recovery may take up to several years after the exposure. We conducted a large cohort study to evaluate the ocular signs and symptoms of 367 chemical war victims in Sardasht City, Iran, 20 years after their exposure to mustard gas. The results of these chemical war victims (i.e., the cases) were compared with the results for 128 unaffected civilians (i.e., the controls). Photophobia was the most significant symptom in the cases (36.8%) (compared with 20.3% in the controls) (p < or = .001). Ocular surface discomfort (burning, itching, and redness) was the second most significant symptom in the cases (29.2%) (compared with 19.5% in the controls) (p = .034). Other symptoms such as foreign-body sensation, tearing, pain, blurring of vision, and dry eye sensation were not significantly different between the 2 groups. In the slit-lamp findings, bulbar conjunctival abnormality was the most significant sign in the cases (9.3%) (compared with 1.6% in the controls) (p = .004). Limbal tissue changes were the second most significant sign in the cases (3.0%) (compared with 0.0% in the controls) (p = .048). Other slit-lamp findings related to tearing and abnormalities in the lids and cornea were not significantly different between the 2 groups. Our findings in the present study showed that photophobia and ocular surface discomfort (burning, itching, and redness) were the most significant symptoms. In addition, bulbar conjunctival abnormalities and limbal tissue changes were the most significant signs among the sulfur mustard chemical war victims.
    Cutaneous and Ocular Toxicology 02/2008; 27(4):317-26. · 1.04 Impact Factor