Saba Arshi

Iran University of Medical Science, Teheran, Tehrān, Iran

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Publications (30)44.17 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Primary immunodeficiency disorders (PID) are rare and heterogeneous group of disease. In attempts to ad- dress and to provide an estimate of the precise prevalence of these disorders in Iran, the Iranian Primary Immunodeficiency Registry (IPIDR) was established in 1999. The Registry is currently being expanded and is a part of IAARI (Immunolo- gy, Asthma & Allergy Research Institute). Method: During (2006-2013), 1857 patients who were re- ferred to IAARI with possible diagnosis of PID were enrolled in this study.Primary and advanced screening tests were done and after confirmation of diagnosis all patients registered in IPIDR (Ipidr.tums.ac.ir) Results: fifty hundred and sixty-five patients (354 M/211F) had definite or probable diagnosis of PID; Consanguinity rate and family history of previous child with PID were 58% and 24.6%, respectively. Genetic studies were done in 50.8% of patients and in 37.3% of them specific mutation was found. The most com- mon form of immunodeficiency was congenital defects of phagocyte number, function, or both. (43.5%), mainly chronic granulomatous disease, followed by Well-defined syndromes with immunodeficiency (32.6%), predominantly antibody disor- ders (16%), combined immunodeficiencies (9.7%), Comple- ment deficiencies (8.8%), Diseases of immune dysregulation (7.2%) and defects of innate immunity (2.1%) Conclusion: Recent development in molecular diagnosis can help in early and definite diagnosis of PID. Accurate diagnosis of these conditions are essential for eval uation of PID burden , better decision in prevention and treatment strategies and research studies
    16th Biennial Meeting of the European Society for Immunodeficiencies (ESID 2014), Prague, Czech Republic; 10/2014
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    ABSTRACT: BackgroundCD4+ CD25+ T-regulatory (Treg) cells play critical roles in maintaining peripheral tolerance and preventing autoimmunity. As characteristics of Treg cells have not been precisely investigated in chronic urticaria (CU) yet, this study was performed.Objective To determine the frequencies of circulating CD4+ CD25+ FOXP3+ T cells and serum levels of interleukin (IL)-10, transforming growth factor (TGF)-β, and IL-17 in patients with chronic autoimmune urticaria and chronic idiopathic urticaria compared to healthy controls.Methods Peripheral blood mononuclear cells (PBMCs) were obtained from patients with CU and healthy controls. The frequency of CD4+ CD25+ T cells in PBMCs and expression levels of FOXP3 were detected by flow cytometry. The serum levels of IL-10, TGF-β, and IL-17 were measured by enzyme-linked immunosorbent assay.ResultsA significant decrease in the percentage of circulating CD4+ CD25+ FOXP3+ T cells was detected in patients with CU, compared to control subjects. However, no significant difference was detected on the serum levels of IL-10, TGF-β, and IL-17 between patients with CU and control subjects.Conclusions This study demonstrated that the frequency of Treg cells in PBMCs was decreased in patients with CU. Further studies are needed to clarify the exact role of Treg cells in the pathogenesis of CU and factors regulating their function.
    International journal of dermatology 10/2014; · 1.18 Impact Factor
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    ABSTRACT: Background Vitamin D is hypothesized to have some roles in innate and adaptive immunity, inflammation reduction, and remodeling; therefore, it is supposed to affect the asthma phenotype, severity, and response to inhaled corticosteroid (ICS). Objective To explore the synergistic effects of vitamin D supplementation in addition to asthma controllers (ICS or ICS plus long-acting β-agonist) on airway functions. Methods A randomized clinical trial was conducted in 130 individuals aged 10 to 50 years who lived in Tehran during a 24-week period. Data on age, sex, body mass index, stage of asthma, serum total IgE, history of allergic rhinitis, atopic dermatitis, food allergy, and urticaria were collected. Spirometric parameters (forced expiratory volume in 1 second [FEV1] and ratio of FEV1 to forced vital capacity) and serum vitamin D measurement were obtained before and 8 and 24 weeks after the intervention. Patients were divided in 2 groups randomly. Both groups received asthma controllers (budesonide or budesonide plus formoterol) according to their stage, but the intervention group received vitamin D supplementation (100,000-U bolus intramuscularly plus 50,000 U orally weekly) in addition to asthma controllers. Results FEV1 improved significantly in both groups after 8 weeks, but no significant difference was found between the 2 groups at baseline (P = .20) or after 8 weeks (P = .99); however, a significant improvement was seen in the intervention group in the last 16 weeks, and FEV1 was significantly better in the intervention group than the other group after 24 weeks (P < .001). Conclusion Vitamin D supplementation associated with asthma controllers could significantly improve FEV1 in mild to moderate persistent asthma after 24 weeks.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 08/2014; · 3.45 Impact Factor
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    ABSTRACT: Primary immunodeficiency disorders (PID) are a group of heterogeneous disorders mainly characterized by severe and recurrent infections and increased susceptibility to malignancies, lymphoproliferative and autoimmune conditions. National registries of PID disorders provide epidemiological data and increase the awareness of medical personnel as well as health care providers. This study presents the demographic data and clinical manifestations of Iranian PID patients who were diagnosed from March 2006 till the March of 2013 and were registered in Iranian PID Registry (IPIDR) after its second report of 2006. A total number of 731 new PID patients (455 male and 276 female) from 14 medical centers were enrolled in the current study. Predominantly antibody deficiencies were the most common subcategory of PID (32.3 %) and were followed by combined immunodeficiencies (22.3 %), congenital defects of phagocyte number, function, or both (17.4 %), well-defined syndromes with immunodeficiency (17.2 %), autoinflammatory disorders (5.2 %), diseases of immune dysregulation (2.6 %), defects in innate immunity (1.6 %), and complement deficiencies (1.4 %). Severe combined immunodeficiency was the most common disorder (21.1 %). Other prevalent disorders were common variable immunodeficiency (14.9 %), hyper IgE syndrome (7.7 %), and selective IgA deficiency (7.5 %). Registration of Iranian PID patients increased the awareness of medical community of Iran and developed diagnostic and therapeutic techniques across more parts of the country. Further efforts must be taken by increasing the coverage of IPIDR via electronically registration and gradual referral system in order to provide better estimation of PID in Iran and reduce the number of undiagnosed cases.
    Journal of Clinical Immunology 03/2014; · 3.38 Impact Factor
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    ABSTRACT: Background: Aspirin-exacerbated respiratory disease (AERD) is a syndrome frequently seen in patients with chronic rhinosinusitis and nasal polyposis (CRSwNP). However, there are few studies on evaluating the prevalence of aspirin (acetylsalicylic acid [ASA]) hypersensitivity in patients with CRSwNP using the oral aspirin challenge (OAC) test. This cross-sectional study was designed to determine the frequency of ASA hypersensitivity and factors associated with it in patients with CRSwNP in Tehran, Iran. Methods: Adult patients with CRSwNP who were presented to the asthma and allergy clinic were recruited for the study. After confirming CRS and NP, OAC was performed to evaluate/confirm the diagnosis of ASA hypersensitivity. Atopic evaluation was performed using skin-prick test, nasal smear, blood eosinophil count, and serum total IgE. Results: Eighty Iranian patients (43 women and 37 men) with CRSwNP were enrolled (mean age, 38.9 ± 10.7 years). OAC was performed in all of the patients and 39 patients (48.8%) had a positive reaction; among them, 14 (35.8%) had a self-reported history of ASA hypersensitivity. Concomitant asthma, previous polyp surgery, high polyp score, and ASA hypersensitivity history were all associated with positive OAC (p Conclusion: ASA hypersensitivity is common in patients with CRSwNP in Tehran, Iran. Patients at risk for AERD should be evaluated for the presence of ASA hypersensitivity with ASA provocation challenge test to confirm the diagnosis.
    American journal of rhinology & allergy 01/2014; 28(3). · 1.74 Impact Factor
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    ABSTRACT: Objective(s): According to the occupationally risk of infection in staff workers who have direct contact with mycobacterium species, we investigated their immunological parameters and compared with healthy purified protein derivative (PPD) negative volunteers. Materials and Methods : We investigated 20 PPD positive volunteers working at Tuberculin Unit of Razi Vaccine and Serum Research Institute and PPD negative healthy controls with no exposure or history of active tuberculosis. The percentages of circulating lymphocyte subpopulations were detected by flowcytometry. IL-4 and IFN-γ production levels were measured by ELISA in supernatants of PPD-stimulated peripheral blood mononuclear cells (PBMCs) culture. Results : Tuberculin workers showed an increase in IFN-γ level and significant decrease of CD4+ T cells percentage and CD4/CD8 ratio compared to PPD negative normal individuals. However the IL-4 production and percentage of other lymphocyte population has been unchanged. Discussion: These observations suggest that the immunological parameters of tuberculin workers with PPD positive reaction, who are occupationally exposed to mycobacterium antigens, could be changed. Future studies will be directed towards cytokine networking and regulatory lymphocytes, which will help us validate the significant data presented in this study.
    Iranian Journal of Basic Medical Science 09/2013; 16(9):962-4. · 0.24 Impact Factor
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    ABSTRACT: This study was performed to investigate the serum level of interleukin (IL)-13, IL-4, and interferon (IFN)-γ in chronic rhinosinusitis with nasal polyps (CRSwNP) and subsequent inflammation pattern and comorbidities including asthma and aspirin intolerance. A case-control study was conducted on 60 adult patients with CRSwNP with mean age of 37.7±12.7 (ranging from 18 to 70) years, and on 20 healthy controls. Serum levels of IL-13, IL-4, and IFN-γ were assessed, using enzyme-linked immunosorbent assay to be compared between case and control groups. Serum level of total immunoglobulin (Ig) E was also assessed in the patients with CRSwNP. Serum level of IL-13 in the patients with CRSwNP was significantly higher than the controls (0.98±1.56 vs. 0.34±0.16 pg/ml, respectively, p=0.002). IL-4 and IFN-γ did not differ significantly between the two groups. Total IgE level was significantly increased in the patients with CRSwNP, compared to the normal values (301.43±516.54 IU/ml, p=0.033). Among the patients with CRSwNP, 12/60 (20%) had aspirin intolerance and 44/60 (73.3%) had asthma. IgE was also higher in asthmatics than non-asthmatics patients (364.9±586.6 vs. 126.7±135.7, respectively, p=0.015). Patients with aspirin intolerance had higher levels of IFN-γ (4.7±1.4 vs. 4.1±0.6, respectively, p=0.022). IL-13 with high level of total IgE was observed in the patients with CRSwNP, which predisposes them to have concomitant asthma. IFN-γ seems to be down-regulated in the patients with CRSwNP, but could be over-expressed in the presence of aspirin intolerance.
    Allergologia et Immunopathologia 08/2013; · 1.23 Impact Factor
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    ABSTRACT: BACKGROUND: Primary antibody deficiencies (PADs) are a heterogeneous group of disorders, characterised by increased susceptibility to recurrent bacterial infections. Common variable immunodeficiency (CVID) is the most important PAD from the clinical point of view and selective IgA deficiency (IgAD) is the most common PAD. However, the underlying gene defect in both is still unknown. As a recent study in Europe showed an association between a single nucleotide polymorphism (SNP) of AICDA gene with PADs, this study was performed to evaluate such an association in Iranian patients. METHODS: Fifty-eight patients with PAD, including 39 CVID and 19 IgAD, as well as 34 healthy volunteers, were enrolled in this study. Genotyping was done in all groups for an intronic SNP in AICDA (rs2580874), using real-time PCR genotyping assay. RESULTS: The less frequent genotype of AICDA in IgAD patients was AA, seen in 10.5% of the patients, which was much lower than the 30.8% in CVID patients and 38.2% in the controls. However, these differences were not significant. Indeed the GG genotype in the patients with PADs was seen in 20.7%, compared to 8.8% in the controls without any significant difference. CONCLUSIONS: There was no significant association between the previously reported genetic variant of AICDA gene and the development of CVID or IgAD, but further multi-center studies are also needed.
    Allergologia et Immunopathologia 05/2013; · 1.23 Impact Factor
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    ABSTRACT: Leucocyte adhesion deficiency type 1 (LAD-1) is a rare autosomal recessive primary immunodeficiency disorder, characterised by the absence or deficient expression of the adhesion molecules on leucocytes. The disease is usually associated with leucocytosis, recurrent severe bacterial and fungal infections without pus formation and impaired wound healing. Omphalitis, delayed umbilical cord separation, perirectal abscess, sepsis, necrotising enterocolitis, pneumonia, gingivitis and periodontitis are common features of disease.1---3 Although some forms of primary immunodeficiency diseases could develop malignancies, there is no report of non-Hodgkin’s lymphoma in patients with LAD.
    Allergologia et Immunopathologia 05/2013; · 1.23 Impact Factor
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    Allergologia et Immunopathologia 04/2013; · 1.23 Impact Factor
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    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 02/2013; 110(2):119-20. · 3.45 Impact Factor
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    Allergologia et Immunopathologia 12/2012; · 1.23 Impact Factor
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    ABSTRACT: The Link between allergic rhinitis and asthma is well known. Bronchial hyperreactivity (BHR) may be present in rhinitis. The present study was aimed to compare airway responses in patients with rhinitis symptoms alone following exercise challenge, and to determine relationship of two different respiratory function tests.98 subjects with rhinitis were investigated by spirometry and impulse oscillometry before and after exercise challenge.No significant difference was detected between spirometry and impulse oscillometry measurements before and after exercise challenge in subjects with rhinitis alone. No correlation between spirometry and impulse oscillometry indices was found in pre and post-exercise stages.We therefore conclude that exercise challenge is not an appropriate test to determine airway hyperresponsive in subjects with rhinitis symptoms alone and findings of spirometry and impulse oscillometry are not interrelated.
    Iranian journal of allergy, asthma, and immunology 09/2012; 11(3):259-66. · 0.65 Impact Factor
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    ABSTRACT: INTRODUCTION Hyper IgE-syndrome, firstly called Job’s syndrome in 1966 by Davis, Schaller and Wedgwood on the basis of similarity of the condition to the sore boils of Biblical Job, was modified in description by Buckley, but the genetic etiology was not clear for 40 years. It is a rare immunodeficiency diseases characterized by high serum levels of IgE, eosinophilia, eczema and frequent lung and skin infections. The more common inheritant form, Autosomal dominant variant is caused by mutations in STAT 3(signal transducer and activator of transcription 3), whereas the autosomal recessive form is caused by mutations in DOCK 8(dedicator of cytokinesis 8) and TYK2 (tyrosine kinase). Infectious causes include viruses like Molluscum contagiosum and Herpes simplex, papilloma viruses, mostly detected in DOCK 8 deficiency, bacteria, fungi reported in TYK2 deficiency. There have also been reports of different neoplasms, especially in DOCK 8 deficiency such as NK/T cell lymphoma, diffuse large B cell lymphoma, squamous cell carcinoma, neuroendocrine carcinoma, adenocarcinoma, acute myeloid leukemia and mucosal papiloma. The first carcinoma case associated with Hyper-IgE syndrome was vulvar squamous cell carcinoma in 1998.Through advances in early diagnosis of such immune deficiencies, there has been a decline in mortality or even morbidity of the patients due to the infections, but considering malignancies, the incidence of mortality still exists as high. CASE REPORT The patient is a 15 year old boy who was referred to the Department of Immunology and allergy due to a huge left periorbital, several disperse clustering perioral and disseminated warty skin lesions all over the body. His problems were started at the age of seven when he experienced an episode of loss of consciousness without fever following which perioral and periorbital vesiculopustular lesions and a left unilateral blurred vision began to appear. The process of the disease has been described in the frame of herpes involvement of the CNS, skin and cornea. Since the time the patient has been involved with recurrent hospital admissions because of cutaneous, genital, corneal herpetic lesions and one episode of perianal area involvement with molluscum contagiosum. Two years before his current admission he had been diagnosed of moderately differentiated SCC of the nasal area due to which a total rhinectomy had been administered. In his recent admission, following a fourteen day intravenous antibiotic and antiviral therapy in order to control his active infectious lesions, a multidisciplinary simultaneous operation was performed in order to excise his palpebral and facial lesions by ophthalmologists and otolaryngologists. The parents were not consanguineous. The patient’s two male siblings were expired because of severe gastroenteritis at the age of 8 months and 3 years. The only alive 17 year old sister is quite healthy. PHYSICAL EXAM The effects of a total rhinectomy operation was apparent as missed portions of both bony and cartilagenous parts of the nose, beyond which the osteoms of maxillary sinuses could be detected.A large tumoral mass originated from the left upper eyelid with fleshy consistency and conglomerated appearance with persistent pus and serosanguinous discharges covered the entire left glob, hiding the eye completely.There were multiple raised vesiculobollous clusters of lesions seen periorally and perinasally which were super-infected with Staphylococcus aureus. Disseminated SMALL-SIZED WARTY skin lesions were detected all over the trunk. There was no evidence of mucosal involvement. Both lungs were clearly auscultated and there were no signs of pulmonary distress.
    ESFpid 2012, france; 07/2012
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    ABSTRACT: Recently it has been suggested that, the worldwide increase in allergic diseases such as asthma, allergic rhinitis and food allergy is associated with low vitamin D intake. This study measured the vitamin D levels in patients with allergic rhinitis and compared the results with the general population. Vitamin D levels were assessed in 50 patients with allergic rhinitis diagnosed clinically by Allergic Rhinitis and its Impact on Asthma 2008 criteria and the result of skin prick test for aeroallergens. There was no control group, and the study results were compared with the results of another study evaluating vitamin D status in the 5,329 people of normal population of Iran. The prevalence of severe vitamin D deficiency was significantly higher in patients with allergic rhinitis than the normal population, 30% and 5.1% respectively (p = 0.03). Also women with allergic rhinitis had lower vitamin D levels. Measuring vitamin D serum levels could be helpful in the routine assessment of patients with allergic rhinitis in Iran.
    Asia Pacific allergy. 01/2012; 2(1):45-8.
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    ABSTRACT: Pediatric patients with leukocyte adhesion deficiency type-I (LAD-I) experience severe and recurrent life-threatening bacterial infections with failure of pus formation and delayed wound healing. LAD-I is a rare inherited disease caused by mutation in the leukocyte CD18 integrin expression, resulting in defective adherence and migration of leukocytes, in particular neutrophilic granulocytes through the intravascular space. Hematopoietic SCT is the only curative treatment option available to patients with LAD-I. Since 2007, in a prospective trial, reduced-intensity conditioning regimen have been developed for 10 consecutive patients with LAD-I who were referred to our center. Based upon available data, it is the first time that such a number of patients affected by LAD-I have been treated with this regimen. This study attempts to show that reduced-intensity regimen leads to a favorable result in LAD-I patients even in those who have experienced comorbid complications. Following transplantation, some patients develop mixed chimerism, however, in our study mixed chimerism was not followed by transplant rejection.
    Bone marrow transplantation 07/2011; 47(5):646-50. · 3.00 Impact Factor
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    ABSTRACT: Malaria is still one of the most important health-problems in the world and is endemic in Iran. Since 1994, after collapse of former Soviet Union, a new threat of malaria importation emerged from those countries into the northern Iran. This work was carried out to provide further evidence on the status of anopheline species composition, the malaria parasite species, and natural infectivity of mosquitoes distributed in Pars-Abad district, on the borderline of Azerbaijan in northwestern Iran. Mosquitoes were collected from May to December 2008 in anopheline seasonal activity and were identified at the species level. The genus- and species-specific primers against Plasmodium ssrDNA gene were used for specific amplification on female mosquito head+thorax. Members of the Anoheles maculipennis complex were identified by sequence analysis of the ribosomal internal transcribed spacer II (ITS2-rDNA). Morphological character-based identification showed that out of 1455 anopheline female specimens, 1121 (77%) were of A. maculipennis s.l. and 334 (23%) were of Anoheles hyrcanus. Molecular analysis of the species complex indicated the presence of Anoheles sacharovi 984 (67.6%) and A. maculipennis 137 (9.4%) in the region. None of themosquito's head-thorax was found to be naturally infected by malaria parasite. Results of this study, particularly high dominance of A. sacharovi, suggest a potential risk of malaria epidemic in the region, and the need for a continuous epidemiological surveillance.
    Acta tropica 07/2011; 119(1):44-9. · 2.79 Impact Factor
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    ABSTRACT: Allergic Rhinitis (AR) is one of the most common chronic diseases in the developed countries. This study was performed to investigate the effect of CpG-ODN in alteration of T-helper (Th)1/Th2 balance of patients with AR treated with intranasal corticosteroids (INCs) and antihistamines. Peripheral blood mononuclear cells (PBMCs) of 20 patients with AR were isolated before and after 45 days therapy. Cytokine production (IL-4, IL-10, IL-13, IFN-γ) and specific Ch.a IgE in response to CpG co-administration of natural chenopodium album (CpG/Ch.a) or recombinant Ch.a (CpG/rCh.a) allergen were investigated in supernatants.of cultured PBMCs using ELISA Intracellular IL-10 was also assessed in CD4+ cells using flow cytometry. Significant increase in production of IFN-γ and IL-10 and decrease in production of IL-4 were found in supernatants of cultured PBMCs activated with CPG/ch.a and CPG/rch.a. of both CpG/Ch.a and CpG/rCh.a compared to allergens alone, before and after therapy. After therapy, IFN-γ production with CpG/Ch.a was significantly increased in comparison with before (237 vs. 44 pg/ml, p=0.001). IFN-γ and IL-10 production with CpG/rCh.a was significantly increased after therapy compared to before (407.6 vs. 109 pg/ml, p=0.01 for IFN-γ; 171.7 vs. 52.6 pg/ml, p=0.008 for IL-10), whilst IL-4 was significantly decreased (2.1 vs. 5.8 pg/ml, p=0.02). Intracellular IL-10 expression was also significantly increased in response to either CpG/Ch.a or CpG/rCh.a that showed intracellular assay could be more sensitive than ELISA. Also, treatment with intranasal corticosteroids and antihistamines could enhance this CpG effect, in vitro.
    Iranian journal of allergy, asthma, and immunology 06/2011; 10(2):101-10. · 0.65 Impact Factor
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    ABSTRACT: Patients with allergic rhinitis (AR) show increased production of the Th2-related cytokines. Almost always, intranasal corticosteroid (INC) and antihistamine are used as routine therapy of AR. This study was performed to determine the in vitro secretion of cytokines profiles of PBMCs in patients with AR sensitive to Chenopodium album (Ch.a) pollens before and after treatment with INC (Fluticasone propionate) and oral antihistamine (Loratadine). PBMCs of 20 patients with AR, were tested in vitro for cytokine production. These cells were stimulated with natural or recombinant Ch.a. The levels of IL-4, IL-13 and IFN-, were measured in supernatants of cultured cell 96h after stimulation using ELISA. The PBMCs of 20 normal individuals were also similarly treared for comparison of results. The production of IL-4 by the patients' cells stimulated with either Ch.a or rCh.a was significantly higher than normal levels before therapy (p=0.04 and p=0.02, respectively). After therapy, a significant decrease in production of IL-4 and a significant increase in production of IL-10 were found in PBMCs stimulated with natural Ch.a, in comparison to the results before stimulation (p=0.03 for IL-4; p=0.04 for IL-10). Similarly, these results were seen in the production of IL-4 and IL-10 stimulated with rCh.a allergen after therapy in comparison to the results before stimulation (p=0.01 for IL-4; p=0.03 for IL-10). This study suggests INC (Fluticasone propionate) and oral antihistamine (Loratadine) have the capacity to inhibit the production of IL-4 and shift Th2/Th1 responses, probably due to increase the level of immunoregulatory IL-10. Therefore, it could be concluded that therapy with INC and antihistamine has pharmacologic and immunologic therapeutic effects on AR patients.
    Iranian journal of allergy, asthma, and immunology 12/2010; 9(4):225-30. · 0.65 Impact Factor