Presence of CRISPR CAS-Like Sequences as a Proposed Mechanism for Horizontal Genetic Exchanges between Trichomonas vaginalis and Its Associated Virus: A Comparative Genomic Analysis with the First Report of a Putative CRISPR CAS Structures in Eukaryotic Cells

Introduction

Trichomonas vaginalis genome is among the largest genome size and coding capacities. Combinations of gene duplications, transposon, repeated sequences, and lateral gene transfers (LGTs) have contributed to the unexpected large genomic size and diversity. This study is aimed at investigating genomic exchange and seeking for presence of the CRISPR CAS system as one of the possible mechanisms for some level of genetic exchange. Material and Methods. In this comparative analysis, 398 publicly available Trichomonas vaginalis complete genomes were investigated for the presence of CRISPR CAS. Spacer sequences were also analyzed for their origin using BLAST.

Results

We identified a CRISPR CAS (Cas3). CRISPR spacers are highly similar to transposable genetic elements such as viruses of protozoan parasites, especially megavirals, some transposons, and, interestingly, papillomavirus and HIV-1 in a few cases. Discussion. There is a striking similarity between the prokaryotes/Archaean CRISPR and what we find as eukaryotic CRISPR. About 5-10% of the 398 T. vaginalis possess a CRISPR structure.

Conclusion

According to sequences and their organization, we assume that these repeated sequences and spacer, along with their mentioned features, could be the eukaryotic homolog of prokaryotes and Archaean CRISPR systems and may involve in a process similar to the CRISPR function.

Real-time impact of COVID-19 pandemic on cutaneous leishmaniasis case finding and strategic planning, preventive interventions, control and epidemiology in a region with a high burden of cutaneous leishmaniasis and COVID-19: A cross-sectional descriptive study based on registry data in Ilam-Iran

Background and Aims

Cutaneous leishmaniasis (CL) is a severe parasitic disease affecting people, mostly in underdeveloped nations. As a zoonotic infection yearly incidence of CL depends on several parameters such as demographic, epidemiological, and environmental factors as well as prevention and control measures. The sudden outbreak of pandemics such as SARS-Corona-Virus-2 pandemic, can probably affect the incidence or reporting of other diseases, especially infectious diseases, in various ways such as pressure on health systems, providing sanitary services and its components, lockdowns and changes in people's living habits.

Aim

This study aimed to evaluate the COVID-19 impact on the incidence and other epidemiological aspects as well as control measures of CL in Ilam Province-Iran.

Methods

Required data was extracted from the CL registration system in Ilam from 2014 to 2021 to demonstrate the trend of CL incidence before and after COVID-19 pandemic.

Results

Based on our results, a declining pattern of CL incidence was observed, accompanied by the advent and intensification of the viral pandemic in Iran and Ilam province. Although, this decreasing pattern was not integral in all areas, and even increase in CL detection was emphasized in some regions.

Conclusion

It may be inferred that the COVID-19 pandemic may disrupt treatment programs of CL cases, rodent nest destruction, and fighting vector insects.

COVID-19 vaccination, Peltzman Effect and possible increase in high-risk behaviors: a growing concern on risk compensation and reduced compliance to Public Health protective Measures after vaccines rollout

World is still struggling with widespread dissemination and many unanswered questions about Coronavirus disease-19(COVID-19). Global efforts introduced several candidate vaccines against causing COVID-19, mostly requires require 2 doses of injections and some with about 90-95% efficacy. All strategies against the spread of infection are placed on breaking the chain of virus transmission though protective public health measures and mass vaccination, as yet. The current situation emphasis on the global need for carefully designed policies to maximize vaccine access and uptake. The risk compensation theory states that a drop in perceived risk caused by access to prevention measures may lead to an increase in risky behaviors. The current pandemic has faced people to the sense of risk compensation and behavior change in response to a perceived risk level. Risk compensation phenomenon may significantly defeat the benefits of COVID-19 vaccination, especially if the vaccine is not very effective in real life or in high-risk populations. Acknowledging and be conscious of Peltzman risk compensation has crucial importance in counteracting and neutralizing the false complacency of community also lend more weight to public health efforts. The public health messages and practices should be clearly expressed, straightforward, reliable and applicable. It is important that as efforts made to encourage mass vaccination of population other NPIs needs to be re-established and implemented to ensuring strike the balance of learning to live with COVID-19 in parallel with daily activities and job tasks.

The Prevalence of Blastocystis sp. and Its Relationship with Gas-trointestinal Disorders and Risk factors

Background:

Blastocystis sp., located in the large intestine, is one of the most common zoonotic parasites. Risk factors affect its prevalence and pathogenicity, and it causes gastrointestinal disorders. Thus, this study aimed to investigate the Blastocystis sp. prevalence and its relationship with gastrointestinal disorders, in patients referred to laboratories, and provide some prevention strategies.

Methods:

In this descriptive-analytical study, 1,000 stool specimens were collected from patients referred to Ilam, Iran laboratories from 2018–2019. Wet mount method was conducted on samples, and suspected specimens were confirmed using trichrome staining. The demographic and clinical information was recorded in a questionnaire. Finally, the results were analyzed using the SPSS.

Results:

Blastocystis infection was detected in 81 out of 1,000 patients (8.1%) including 61 (75.3%) males and 20 (24.7%) females. and illiterate people were more at risk. The prevalence in rural was more than urban areas, and it was more in the age group of 31–50 year.

Conclusion:

There was a significant relationship between Blastocystis sp. and risk factors (age, sex, level of education, and residence) and clinical symptoms (stomach ache and nausea) (P<0.05), but interestingly there was no significant relationship between bloating and diarrhea.

Molecular characterization of Trichomonas infections in women of Ilam City, southwestern Iran

Trichomoniasis is a sexually transmitted infection (STI) caused by the flagellated protozoan Trichomonas vaginalis. Little information is available on the epidemiology and genetic diversity of T. vaginalis in Ilam City, southwestern Iran. A descriptive cross-sectional investigation was carried out between July 2017 and December 2018 on the suspected women patients referred to eight gynecology clinics of Ilam City for probable Trichomonas infection. They were undergone a set of clinical, parasitological, and molecular examinations. During clinical consultation, posterior vaginal fornix secretions and urine samples were gathered from the participants. For the reasons such as physical conditions and cultural and religious constraints, most of participating women, especially young girls due to their virginity, preferred to give urine samples instead of vaginal discharge. The presence of Trichomonas was diagnosed by microscopic examination and molecular detection using conventional PCR targeting ITS1-rDNA. A total of 1765 suspected individuals were examined clinically via vaginal secretions (495 specimens) and urine samples (1270 specimens). Of them, 21 (1.18%) cases, including 13 vaginal secretions and 8 urine samples, were positive for Trichomonas infection by microscopy. Slightly more than half of the patients (11/21, 52.4%) complained of vulvar itching, burning, and frequent urination. Cervical lesions, patchy erythema, and vaginal discharge were recorded in 28.6%, 23.8%, and 19% of the patients respectively. All patients with positive microscopic identification were confirmed by amplification of 450-bp fragment of ITS1-rDNA. Phylogenetic analysis revealed a high rate of genetic homogeneity in which all our isolates together with homologous sequences from China, Philippines, Austria, and USA were clustered within the same clade. A statistically significant relationship was recorded between the patients positive for trichomoniasis and the presence of chronic disease (e.g., diabetes, immune system deficiency).

In vitro antileishmanial activity of hydroalcoholic Thymbra spicata extract on Leishmania major promastigotes

Cutaneous leishmaniosis is a major worldwide public health problem with annual incidence of 1.5 million cases across 98 countries. Treatment still relies on the use of chemical drugs with increasing resistance and side effects. The aim of this study was to investigate the anti-leishmanial effect of the hydroalcoholic Thymbra spicata extract on Leishmania major (L. major) promastigotes. In this study, 1×105 L. major promastigotes were cultured in 96-well plates and treated with different concentrations of hydroalcoholic T. spicata extract (12.5 to 400 μg/ml) then incubated at 25°C for 24, 48 and 72 hours. Lethal percentage of promastigotes in each well was determined. RPMI 1640 medium containing L. major promastigotes with glucantime or without any treatment were used as positive and negative controls respectively. The 50% lethal concentration (LC50) of T. spicata extract and glucantime was calculated by GraphPad Prism software. The results indicated a significant decrease in the number of promastigotes treated with T. spicata extract and glucantime in comparison with negative control (P<0.0001). LC50 values for T. spicata extract were 18.49, 8.58, and 1.64 μg/ml after 24, 48 and 72 hours, respectively. In addition, anti-leishmanial effect of T. spicata extract and glucantime were dependent on concentration (P<0.0001). Our study revealed T. spicata extract as an herbal product against L. major promastigotes. However, more investigations are needed to find its antileishmanial activity in vivo and clinical trial studies.

Efficacy of Capparis spinosa Linn Leaf and Fruit Extracts on Giardia Lambia Cysts In vitro

Aims: Giardia lamblia (G. lamblia) is one of the most common intestinal parasites worldwide. There are some side effects and the reports of parasite resistance to metronidazole as the first line treatment of giardiasis. Therefore, it is essential to discover an effect and safe drug to treat giardiasis. Methodology: In this study, the anti-parasitic activity of hydroalcoholic extracts of Capparis spinosa Linn (C. spinosa) leaves and fruits with different concentrations (4 to 0.125 mg/ml) was assessed against human isolates of the G. lamblia cysts and incubated at 37℃. After staining Giardia cysts with 0.1% eosin, the lethal percentage and 50% lethal concentration (LC50) of fruit and leave C. spinosa L extracts and metronidazole on G. lamblia cysts were calculated after 3, 6, 24 and 48 hours. Results: Anti-giardia activity of fruit and leaf extracts of C. spinosa was different between concentrations and time points (p<0.005). The lethal effect of both C. spinosa L extracts and metronidazole increased significantly in a concentration - and time–dependent response (P<0.0001). The highest lethal percentage of G. lamblia cysts was observed a concentration of 4 mg / ml of fruit (100%) and leaf (44%) extracts of C. spinosa L after 48 hours, respectively. LC50 values were 0.38 ± 0.02mg/ml for fruit extract, 2.32 ± 0.1 mg/ml for leaf extract and 0.53 ± 0.03 µg/ml for metronidazole after 48hours. Conclusion: C. spinosa can be effective in eliminating Giardia cyst of contaminated environments and water.

Trichomonas Vaginalis Infection Among Women Attending Laboratory Centers in Ilam, Iran

BACKGROUND

Trichomoniasis is known as a common venereal disease. It is estimated that 180 million people in the world are infected with this disease. The present study was conducted to estimate the prevalence of (Trichomonas vaginalis) T. vaginalis among women who were referred to the central laboratory in Ilam.

METHODS

In this cross-sectional study, 481 women with suspicious symptoms of trichomoniasis were selected during the first six months of 2015 in the central laboratory and Shahid Mostafa laboratory in Ilam, Iran. All patients were referred to the labs by gynecologists. Sterile swabs were used to collect direct smears. The results and questionnaire data were entered into SPSS version 16 and were analyzed using chi-square test and Fisher's exact test.

RESULTS

Direct smear of T. vaginalis demonstrated seven positive cases (1.5%). The highest and the lowest percentages of T. vaginalis infection in women were related to the 45-50 and 20-30 years age groups, respectively. Illiterate women had the highest percentage of infection. No significant relationship was found between the level of education and trichomoniasis infection in women (p = 0.085). The highest infection rate was associated with the use of ectopic contraceptive methods (condoms).

CONCLUSION

The prevalence of T. vaginalis was low among women in Ilam but was high among women who have used tubal ligation and condom to prevent pregnancy. Therefore, more attention is required from healthcare centers for appropriate education to women about the proper use of protective equipment.

Prevalence of Cutaneous Leishmaniasis in Iran (2000-2016): A Systematic Review and Meta-analysis Study

BACKGROUND AND OBJECTIVE

Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis affecting humans. The purpose of this study was to determine the prevalence and epidemiological features of CL in Iran by a systematic review and meta-analysis.

METHODS

The literature search was performed in the SID, Magiran, IranDoc, PubMed, Scopus, Medlib, as well as the Google Scholar search engine databases to find studies on the prevalence of CL. The reference lists of the found articles were also reviewed to obtain additional relevant articles. Studies that were related to treatment and reservoirs of CL were excluded. Forty-four studies were selected for the final analysis.

RESULTS

Meta-analysis with a random-effects model showed that the prevalence of leishmaniasis in Iran was 77 per 100,000 population. Overall, 60% of the patients were men. Most cases of CL occurred in autumn, and the majority of the patients had one lesion, mostly on hands. The most common age group was 20-30 years.

CONCLUSION

In conclusion, CL is an endemic disease in Iran, and its prevalence is largely affected by geographical locations and regional customs. Appropriate preventing measures should be considered to decrease the incidence of CL in Iran.

Ectopic expression of BIRC5-targeting miR-101-3p overcomes bone marrow stroma-mediated drug resistance in multiple myeloma cells

Background

Multiple myeloma (MM) cells gain protection against drugs through interaction with bone marrow stromal cells (BMSCs). This form of resistance largely accounts for resistance to therapy in MM patients which warrants further exploration to identify more potential therapeutic targets.

Methods

We performed miRNA/mRNA qPCR arrays and western blotting to analyze transcriptional and translational changes in MM cells co-cultured with BMSCs. Drug cytotoxicity and apoptosis in MM^GFP-BMSC co-cultures were measured using fluorescence plate reader and flowcytometry, respectively. miRNA was overexpressed in MM cell lines using Lentiviral transduction, miRNA-3’UTR binding was examined using luciferase assay.

Results

We found that BMSCs downregulated miR-101-3p and upregulated survivin (BIRC5) in MM cells. Survivin was downregulated by miR-101-3p overexpression and found to be a direct target of miR-101-3p using 3’UTR luciferase assay. Overexpression of survivin increased viability of MM cells in the presence of anti-myeloma drugs, and miR-101-3p inhibition by anti-miR against miR-101-3p upregulated survivin. Furthermore, overexpression of miR-101-3p or silencing of survivin triggered apoptosis in MM cells and sensitized them to anti-myeloma drugs in the presence of BMSCs overcoming the stroma-induced drug resistance.

Conclusions

Our study demonstrates that BMSC-induced resistance to drugs is associated with survivin upregulation which is a direct target of miR-101-3p. This study also identifies miR-101-3p-survivin interaction as a druggable target involved in stroma-mediated drug resistance in MM and suggests it for developing more efficient therapeutic strategies.

Designing a communication protocol for acquired immunodeficiency syndrome information exchange

INTRODUCTION

Interoperability will provide similar understanding on the meaning of communicated messages to intelligent systems and their users. This feature is essential for controlling and managing contagious diseases which threaten public health, such as acquired immunodeficiency syndrome (AIDS). The aim of this study was also designing communication protocols for normalizing the content and structure of intelligent messages in order to optimize the interoperability.

MATERIALS AND METHODS

This study used a checklist to extract information content compatible with minimum data set (MDS) of AIDS. After coding information content through selected classification and nomenclature systems, the reliability and validity of codes were evaluated by external agreement method. The MindMaple software was used for mapping the information content to Systematized Nomenclature of Medicine-Clinical Terminology (SNOMED-CT) integrated codes. Finally, the Clinical Document Architecture (CDA) format was used for standard structuring of information content.

RESULTS

The information content standard format, compatible selected classification, or nomenclature system and their codes were determined for all information contents. Their corresponding codes in SNOMED-CT were structured in the form of CDA body and title.

CONCLUSION

The complex and multidimensional nature of AIDS requires the participation of multidisciplinary teams from different organizations, complex analyzes, multidimensional and complex information modeling, and maximum interoperability. In this study, the use of CDA structure along with SNOMED-CT codes is completely compatible with optimal interoperability needs for AIDS control and management.

Giardia Lamblia Subtypes and Their Relationship with Clinical Symptoms in Patients with Giardiasis

Giardia lamblia has proved to be the most common intestinal protozoan parasite in humans that causes giardiasis. Given the high mutations in the genome of this parasite, the present study was conducted to determine the prevalence of Giardia lamblia subtypes and their relationship with clinical symptoms in patients who appear to have giardiasis. In 69 stool specimens with an appropriate number of giardia cysts, the DNA was first purified, and the genotype was then determined based on the glutamate dehydrogenase (gdh) gene sequence using PCR-RFLP. Data were collected on the clinical symptoms of the patients through a questionnaire, and their relationship with molecular results was studied. Four samples (5.8%) were found to be of subtype AI, 51 (73.9%) of subtype AII and 14 (20.3 %) of subtype BIII. No BIV subtype was found in the present study. A correlation was observed between Giardia lamblia genotypes (AI, AII and BIII) and abdominal pain. All of the people (100%) who had the AI genotype (i.e. the zoonosis subtype) had been losing weight. There was a significant correlation between weight loss and the AI subtype. All of the people (100%) infected with the BIII genotype experienced diarrhea, and this genotype was found to be associated with diarrhea. The present study found abdominal pain to be the most common symptom of giardiasis in Ilam province. Moreover, humans were found to be the main reservoir for giardia lamblia, although zoonosis subtypes such as AI and BIII still exist in the region and pose a risk for a giardiasis epidemic.

Genotyping of Fasciola hepatica Isolated from Domestic Animals in the West of Iran

OBJECTIVES

The most common parasites responsible for fascioliasis are F. hepatica and F. gigantica. Fascioliasis is an important problem in terms of health and economics. The western part of Iran is one of the major hubs of animal husbandry and the prevalence of fascioliasis is high. The aim of the current study was to determine the Fasciola spp. present in the western part of Iran. In the present study, 45 samples were collected from slaughterhouses in three provinces in the western part of Iran, including Ilam, Lorestan and Kermanshah.

METHODS

The flukes were detected using morphological methods and the DNA of all samples was extracted. The ribosomal internal transcribed spacer (ITS1) was identified by PCR and PCR-RFLP techniques using the Rsa1 restriction enzyme. Then, 15% of the samples were sequenced.

RESULTS

Based on their ITS1 sequence, all samples showed 700 bp bands. The results of sequencing showed a similarity of 99% to 100% across samples. Using the Rsa1 restriction enzyme, all samples produced three distinct bands (60 bp, 100 bp, and 360 bp). These results demonstrated that the most common fasciola in the western part of Iran in sheep and cattle is F. hepatica.

CONCLUSION

The results of the present study showed that only the species F. hepatica is parasitizing livestock in the western part of Iran. Further studies using new molecular markers for more accurate identification of fasciola-causing species will be useful in the control and prevention of fascioliasis.

Determination of genetic diversity of Leishmania species using mini-circle kDNA, in Iran-Iraq countries border

Background and Objective:

Cutaneous leishmaniasis (CL) is one of the most important diseases worldwide, with a different range of prevalence in endemic areas. Anthroponotic and zoonotic CL are two epidemiological forms of CL, in Iran. Although Ilam Province in the west of Iran is one of the main endemic areas of the disease, there is no inclusive study to determine the genetic variations of parasite in these areas. The objective of this study was to determine the genetic diversity of Leishmania species in Ilam Province, using mini-circle kDNA gene.

Materials and Methods:

Direct smears were taken from skin lesions of 200 suspected cases of CL. Smears were stained, screened under light microscope. Polymerase chain reaction (PCR) was performed, using specific kinetoplast DNA primers. Data were analyzed, using the molecular bio-software.

Results:

All the samples were positive by direct examination. PCR results showed all cases were positive for Leishmania major. Although all isolated cases belong to a different county of Ilam province, all were positive for L. major with intra-species genetic diversity, divided into four clades in the dendrogram.

Interpretation and Conclusion:

This variation can affect drug resistance and controlling strategies of parasite. It is possible that different species of sand flies and rodents are the vector and reservoir of parasite, respectively; however, further studies are needed to validate this.

Concise Review: TLR Pathway-miRNA Interplay in Mesenchymal Stromal Cells: Regulatory Roles and Therapeutic Directions

Mesenchymal stromal cells (MSCs) deploy Toll-like receptors (TLRs) to respond to exogenous and endogenous signals. Activation of TLR pathways in MSCs alters their inflammatory profile and immunomodulatory effects on cells from both the innate and adaptive immune systems. Micro-RNAs (miRNAs), whose expression is modulated by TLR activation, can regulate inflammatory responses by targeting components of the TLR signaling pathways either in MSCs or in the cells with which they interact. Here, we review how the miRNA-TLR pathway axis can regulate the immunomodulatory functions of MSCs, including their interactions with monocytes/macrophages and natural killer cells, and discuss the therapeutic implications for MSC-based therapies. Stem Cells 2018;36:1655-1662.

Human and Animal Fascioliasis in Iran: Systematic Review and Meta-analysis

OBJECTIVE

The aim of this study was to investigate the prevalence of fascioliasis in humans, cattle, sheep, and goats, done by a systematic review in Iran.

METHODS

Fifty articles were extracted including Iranian papers such as Google scholar, Magiran, Iran Medex, SID, and Pubmed. Out of these, 21 articles were selected for meta-analysis. Essential information for meta-analysis was extracted from papers and archived in Excel software for calculating by statistical analysis. The variance of each study was obtained using the binomial distribution. Heterogeneity of the studies was surveyed using I2 index. Data were analyzed using a random effect model.

RESULTS

Of 21 collected papers, 1,275,506 samples from cow (507,152), sheep (454,882), goat (207,925), and human (105,547) had been surveyed in Iran. Eight studies were conducted on humans and 13 on animals. The prevalence rate obtained in humans was 3% with a confidence interval (CI) of 95% (1%-7%). Prevalence rate obtained in cows, sheep, and goats was 13% with CI of 95% (10%-16%). The highest level of prevalence was reported from cities in the North in animals with a prevalence of 14%. The highest level of prevalence was reported from Gilan in humans with a prevalence of 0.1%.

CONCLUSION

The prevalence of the Fascioliasis in Iran has reduced in recent years, But the importance of the disease has not reduced and there is a possibility of an epidemic. Furthermore, in many cities of Iran, there is no study on the disease.

Seroprevalence of Toxocara in Children from Urban and Rural Areas of Ilam Province, West Iran

Objectives

The present study was performed to determine the seroprevalence of Toxocara in children ≤ 10 years old, from rural and urban areas of Ilam.

Methods

Serum samples from 383 children ≤ 10 years old, were selected randomly from rural and urban areas of Ilam province and surveyed using enzyme-linked immunosorbent assays.

Results

The total rate of infection with Toxocara was 22% (31% with a history of contact with dogs and cats, and 14% without a history of contact). Of those infected, 23% were male and 18% were female, 36% lived a rural life and 20% had an urban life. A significant correlation was found between the incidence of disease, and urban and rural life, as well as exposure to dogs and cats. There was no correlation between prevalence and gender or age.

Conclusion

Given the high prevalence of infection with Toxocara amongst children in Ilam province, preventive work in the community such as education in risk management and periodic treatment with anti-parasitic drugs and elimination of stray dogs and cats is an appropriate measure.

What are Hidden Facts behind Intestinal Parasitic Infections in Ilam City?

BACKGROUND

Intestinal parasitic infections are the one of the most common health problems in developing countries.

OBJECTIVE

A number of patients die annually due to complications caused by these parasites.Therefore, the aim of this study was to investigate the rate and type of parasitic infections, determine the factors affecting them in Ilam city and also provide strategies to prevent them.In this descriptive cross-sectional study conducted in one of the Ilam labs in 2016, 417 stool specimens were randomly collected. All specimens were examined using direct and ethanol formaldehyde.Suspect specimens were examined using Trichrom staining. Demographic information was also recorded in a questionnaire, and finally the results were analyzed using statistical software SPSS 20.The data were then compared with Chi-square test.

RESULTS

Out of the 417 patients examined, 59 (14.1%) were infected with intestinal parasites. The type of parasitic infection in 9.4% was Blastocystis hominis, 3.6% Entamoeba coli, 0.5% Entamoeba histolytica, 0.5% Giardia and 0.2% Trichomonas hominis.

CONCLUSION

Despite the improvement of public health, parasitic infections are still considered as one of the health problems in the city of Ilam. Therefore, proper planning, public health education, raising the level of health in the area and the provision of safe drinking water are some of the ways to reduce parasitic infections in the region.

Role of micro-RNAs in drug resistance of multiple myeloma

While novel therapeutic approaches have profoundly improved survival of multiple myeloma (MM) patients, drug resistance and treatment refractoriness still persists. This obstacle highly demands thorough investigation into the root and underlying molecular mechanisms to develop more effective strategies. The advent of micro-RNAs (miRNAs) in the study of cancer biology and pathogenesis in recent years has revolutionized therapy in this field and particularly opened new windows to further understanding of tumor drug resistance. However; in spite of the fact that miRNAs involvement in MM pathogenesis and progression has been substantially evidenced, miRNA investigation in MM drug resistance is still in its infancy. Our knowledge of the potential role of miRNAs in MM drug resistance comes from few recent reports confirming that some miRNAs including miR-137/197, miR-21 and miR-221/222 could negatively modulate drug sensitivity of MM cells. Further continuous researches are required to exploit miRNAs to elucidate the critical mechanisms controlling drug resistance in MM. In this review, we will highlight the most recent observations on the role of miRNAs in MM drug resistance. Moreover, approaches and insights into clinical application of miRNAs to overcome MM drug resistance will be discussed.

Role of tumor suppressor p53 and micro-RNA interplay in multiple myeloma pathogenesis

The molecular mechanisms underlying dysregulated wild type (wt) p53 in multiple myeloma (MM) have been subjects of intense investigation for years. Indeed, correlation of rarely occurring TP53 gene mutations or deletions with adverse clinical outcomes in MM patients is strongly established, while in majority of cases wtp53 seems to be non-functional or dysregulated bearing a high clinical impact. Interestingly, findings from recent investigations show that micro-RNAs (miRNAs) may contribute to suppression of wtp53 in MM, as they are now known to function as key regulatory elements in the p53 network. This area is shedding new light on understanding the biologic effects of dysregulated p53 in MM pathogenesis especially drug resistance. miRNAs such as miR-125b (oncomiR) or miR-34a (tumor suppressor-miR) can be negative or positive regulators of wtp53 function, respectively, with specific effects on MM cell viability. On the other hand, our knowledge of miRNA interaction with mutant (mt) p53 in MM, which is rather related to disease progression and resistance to therapy, is limited which demands in-depth exploration. Here, we will put forward the current knowledge on miRNA-p53 interaction in MM and its role in MM pathogenesis including drug resistance. We will also highlight the pre-clinical approaches for therapeutic application of miRNAs targeting p53 pathway.

Role of epigenetics-microRNA axis in drug resistance of multiple myeloma

Despite administration of novel therapies, multiple myeloma (MM) remains incurable with resistance to drugs leading to relapse in most patients. Thus, it is critical to understand the detailed mechanisms underlying the drug resistance of MM and develop more effective therapeutic strategies. Genetic abnormalities are well known to play a central role in MM pathogenesis and therapy resistance; however, epigenetic aberrations mainly affecting the patterns of DNA methylation/histone modifications of genes (especially tumor suppressors) and miRNAs have also been shown to be involved. Importantly, while epigenetic silencing of miRNAs in MM is well documented, some epigenetic markers are known to be direct targets of miRNAs particularly the recently described "epimiRNAs". Drugs targeting epigenetic modifiers (e.g., HDACs, EZH2) can sensitize MM-resistant cells to anti-myeloma drugs and reversibility of epigenetic changes makes these drugs promising therapeutic agents. Therefore, combination of miRNA mimics with inhibitors of epigenetic modifiers would be a more potent therapeutic strategy in MM patients in relapse or refractory to treatments. In this review, we will discuss the findings of recent investigations on epigenetics/miRNA regulatory axis in development of drug resistance in MM and highlight possible approaches for therapeutic applications of such interaction.

Ethanolic Extract of Berberis Vulgaris Fruits Inhibits the Proliferation of MCF-7 Breast Cancer Cell Line Through Induction of Apoptosis

BACKGROUND

As it is obvious, there is much documentation that shows the importance of breast cancer treatment in patients. High expressions of P53 and Bcl-2 are associated with breast cancer, which are reliable factors to follow up the breast cancer. Berberis vulgaris is used as a traditional medicine in cancer. Despite of the fact that many researches have demonstrated its anti-cancer properties, there are no scientific documents to show its efficacy in detail in breast cancer.

OBJECTIVE

Because of traditional use of B. vulgaris and little knowledge about its effects, our research was focused on determining the efficacy and toxicity of B. vulgaris. For this reason, we determined the efficacy of B. vulgaris on breast cancer cells.

METHOD

As described in Method section, standard protocols including MTT assay and qPCR were performed to identify the effect of B. vulgaris ethanolic extract against breast cancer cells.

RESULTS

Our results clearly demonstrated that 35 mg/ml had IC50 against 3t3 normal cells, and 9 mg/ml of B. vulgaris was effective against MCF-7 breast cancer cells. The results demonstrated that even at only 1 mg/ml concentration of B. vulgaris, crude extract was effective, 9 mg/ml and 12 mg/ml of extract had better anti-cancer activity compared with doxorubicin.

CONCLUSION

Despite that the role of anticancer properties of B. vulgaris was clearly defined in some patents, our results demonstrated the potency of B. vulgaris against breast cancer, but further analysis should be performed to candidate this herb as an anti-breast cancer drug.

MiRNA-29a as a tumor suppressor mediates PRIMA-1Met-induced anti-myeloma activity by targeting c-Myc

The proto-oncogene c-Myc plays substantial role in multiple myeloma (MM) pathogenesis and is considered a potential drug target. Here we provide evidence of a novel mechanism for PRIMA-1Met, a small molecule with anti-tumor activity in phase I/II clinical trial, showing that PRIMA-1Met induces apoptosis in MM cells by suppressing c-Myc and upregulating miRNA-29a. Our study further demonstrates that miRNA-29a functions as a tumor suppressor which targets c-Myc. The baseline expression of miR-29a was significantly lower in MM cell lines and MM patient samples compared to normal hematopoietic cells. In addition, ectopic expression of miRNA-29a or exposure to PRIMA-1Met reduced cell proliferation and induced apoptosis in MM cells. On the other hand, overexpression of c-Myc at least partially reverted the inhibitory effects of PRIMA-1Met or miRNA-29a overexpression suggesting the miRNA-29a/c-Myc axis mediates anti-myeloma effects of PRIMA-1Met. Importantly, intratumor delivery of miRNA-29a mimics induced regression of tumors in mouse xenograft model of MM and this effect synergized with PRIMA-1Met. Our study indicates that miRNA-29a is a tumor suppressor that plays an important role during PRIMA-1Met-induced apoptotic signaling by targeting c-Myc and provides the basis for novel therapeutic strategies using miRNA-29a mimics combined with PRIMA-1Met in MM.

PRIMA-1Met induces apoptosis in Waldenström's Macroglobulinemia cells independent of p53

PRIMA-1Met has shown promising preclinical activity in various cancer types. However, its effect on Waldenström's Macroglobulinemia (WM) cells as well as its exact mechanism of action is still elusive. In this study, we evaluated the anti- tumor activity of PRIMA-1Met alone and in combination with dexamethasone or bortezomib in WM cell lines and primary samples. Treatment of WM cells with PRIMA-1Met resulted in induction of apoptosis, inhibition of migration and suppression of colony formation. Upon PRIMA-1Met treatment, p73 was upregulated and Bcl-xL was down-regulated while no significant change in expression of p53 was observed. Furthermore, siRNA knockdown of p53 in WM cell line did not influence the PRIMA-1Met-induced apoptotic response whereas silencing of p73 inhibited latter response in WM cells. Importantly, combined treatment of BCWM-1 cells with PRIMA-1Met and dexamethasone or bortezomib induced synergistic reduction in cell survival. Our study provides insights into the mechanisms of anti-WM activity of PRIMA-1Met and supports further clinical evaluation of PRIMA-1Met as a potential novel therapeutic intervention in WM.

miR-137 and miR-197 Induce Apoptosis and Suppress Tumorigenicity by Targeting MCL-1 in Multiple Myeloma

PURPOSE

Deregulation of miRNA has been implicated in the pathogenesis of multiple myeloma. We identified miR-137 and miR-197, mapped to the chromosome 1p (12)-(21) deletion region, and examined their antimyeloma activity as tumor suppressors.

EXPERIMENTAL DESIGN

The expression of miR-137/197 was examined in multiple myeloma and normal plasma cells by qRT-PCR. Functional effect of miR-137/197 was analyzed by cell viability, apoptosis, clonogenic, and migration assays. Antimyeloma activity of miR-137/197 was further evaluated in vivo by lentiviral-based or lipid-based delivery in a mouse xenograft model of multiple myeloma.

RESULTS

miR-137/197 expression was significantly lower in multiple myeloma cell lines and multiple myeloma patient samples compared with normal plasma cells. Transfection of miR-137/197 resulted in reduction of MCL-1 protein expression, as well as alteration of apoptosis-related genes, and induction of apoptosis, inhibition of viability, colony formation, and migration in multiple myeloma cells. MCL-1 was further validated as a direct target of miR-137/197. Conversely, overexpression of MCL-1 partially reverted the effect of miR-137/197. Importantly, in vivo lentiviral-mediated or intratumor delivery of miR-137/197 induced regression of tumors in murine xenograft models of multiple myeloma.

CONCLUSIONS

Our study reveals a novel role of miR-137/197 as tumor suppressors in mediating apoptosis in multiple myeloma cells by targeting MCL-1. Our findings provide a proof-of-principle that lentivirus-based or formulated synthetic miR-137/197 exerts therapeutic activity in preclinical models, and support a framework for development of miR-137/197-based treatment strategies in patients with multiple myeloma.

Toll-like receptors in human multiple myeloma: new insight into inflammation-related pathogenesis

Multiple myeloma (MM) is a clonal neoplasm characterized by expansion of malignant plasma cells in the bone marrow causing various complications including osteolytic lesions and impaired immune function. It has recently been reported that human myeloma cells express multiple Toll-like receptors (TLRs), and their activation-induced functional responses show heterogeneity among cell lines and patient samples. TLRs are critical germ-line encoded molecules expressed in immune cells as well as in a variety of cancer cells. In multiple myeloma, they may induce cell growth and proliferation or promote cell death. In fact, our current knowledge of Toll-like receptor function has gone beyond their main function as triggers of innate and adaptive immune responses. Considering the essential role of bone marrow microenvironment components in myeloma tumor expansion, survival, invasion and drug resistance, TLR triggering may contribute to adhesion-induced or de novo drug resistance of MM cells. Future preclinical and clinical studies are needed to address if TLRs can be exploited as novel therapeutic targets for MM.

The Prevalence of Pneumocystis jiroveci in Bronchoalveolar Lavage Specimens of Lung Transplant Recipients Examined by the Nested PCR

BACKGROUND

The use of immune suppressive drugs for organ transplant recipients predisposes them to opportunistic infections, especially by fungal agents. Pneumocystis jiroveci, as an opportunistic pathogen, endangers the patients' life in those with immune system disorders. Early detection of latent Pneumocystis infection in susceptible patients may help choose the optimal treatment for these patients.

OBJECTIVES

The aim of this study was to identify and determine the colonization of latent P. jiroveci infection among lung transplant recipients.

PATIENTS AND METHODS

This cross-sectional descriptive study was conducted on lung transplant recipients. Bronchoalveolar lavage (BAL) specimens were collected from 32 patients undergoing bronchoscopy. The samples were aseptically homogenized by 10 mM dithiothreitol, and their DNA was extracted. The mtLSUrRNA gene of P. jiroveci was amplified using nested PCR in two stages. Nested PCR was performed using external primers of pAZ-102-E and pAZ102-H followed by using the PCR product of the first stage and internal primers of pAZ-102-E and pAZ102-L2.

RESULTS

The genome of P. jiroveci was revealed by a 346 bp PCR product in the initial amplification and a 120 bp product in the nested PCR. The results showed that seven BAL specimens (21.9%) from lung transplant recipients were positive for P. jiroveci.

CONCLUSIONS

In molecular epidemiology studies, nested PCR has higher sensitivity than PCR. Results of this study support the colonization of P. jiroveci in patients receiving lung transplantation. Patients who are carriers of P. jiroveci are at a higher risk of P. jiroveci pneumonia.

Drug resistance in multiple myeloma: latest findings and new concepts on molecular mechanisms

In the era of new and mostly effective therapeutic protocols, multiple myeloma still tends to be a hard-to-treat hematologic cancer. This hallmark of the disease is in fact a sequel to drug resistant phenotypes persisting initially or emerging in the course of treatment. Furthermore, the heterogeneous nature of multiple myeloma makes treating patients with the same drug challenging because finding a drugable oncogenic process common to all patients is not yet feasible, while our current knowledge of genetic/epigenetic basis of multiple myeloma pathogenesis is outstanding. Nonetheless, bone marrow microenvironment components are well known as playing critical roles in myeloma tumor cell survival and environment-mediated drug resistance happening most possibly in all myeloma patients. Generally speaking, however; real mechanisms underlying drug resistance in multiple myeloma are not completely understood. The present review will discuss the latest findings and concepts in this regard. It reviews the association of important chromosomal translocations, oncogenes (e.g. TP53) mutations and deranged signaling pathways (e.g. NFκB) with drug response in clinical and experimental investigations. It will also highlight how bone marrow microenvironment signals (Wnt, Notch) and myeloma cancer stem cells could contribute to drug resistance in multiple myeloma.

Micro-RNAs, New performers in multiple myeloma bone marrow microenvironment

The established interaction between multiple myeloma cells and bone marrow microenvironment components provides malignant cells with various survival, growth and drug resistance signals. As a new concept, identification of miRNAs and their related gene/protein targets, signaling molecules and pathways in the context of bone marrow microenvironment will help understanding more deeply the pathogenesis of the disease and possible mechanisms underlying environment-induced drug resistance. Recent studies suggest that bone marrow stromal cells can modulate some miRNAs (miR-21, miR-15a/16) in multiple myeloma cells through direct adhesion, cytokine secretion or transfer of miRNA-containing exosomes, however; the specific miRNA targets are not clear. In spite of a remarkable progress in understanding myeloma biology and therapy, the disease persists to be hard to treat. This review will discuss the most recent findings on miRNAs expression and function in the context of bone marrow microenvironment highlighting the miRNAs as potential therapeutic targets in multiple myeloma.

Lethal Pneumocystis jiroveci pneumonia 24 Years After Kidney Transplantation

INTRODUCTION

Pneumocystis jiroveci is an opportunistic infectious fungus in immunosuppressed patients, particularly in ones with acquired immunodeficiency syndrome (AIDS). The use of immunosuppressive drugs especially corticosteroids predisposes the transplanted patients to a variety of infectious diseases including Pneumocystis infection. In many developed countries, the incidence of Pneumocystis jiroveci pneumonia (PJP) is dwindling in transplant patients receiving appropriate prophylaxis. In this study, definitive diagnosis of Pneumocystis infection in a patient receiving kidney transplant was presented.

CASE PRESENTATION

The patient was a 45-year-old man with a history of kidney transplantation 24 years ago, admitted to a specialized hospital in Tehran because of fever and respiratory distress. Upon admission, the patient showed symptoms of unconsciousness and shortness of breath. Paraclinical tests and complementary examinations such as microscopic observation and molecular analysis confirmed the definitive diagnosis of Pneumocystis infection. Specific treatment with trimethoprim/sulfamethoxazole was carried out alongside other therapeutic measures; but unfortunately the patient did not respond to the specific treatment and died in the course of a progressive disease.

DISCUSSION

The disease progress in these patients can still be fast and deadly. Applying rapid molecular diagnostic techniques to start appropriate and timely treatment is essential. Utilization of such diagnostic methods is recommended in our country.

Epidemiological situation of toxocariasis in Iran: meta-analysis and systematic review

Toxocariasis is the clinical terms applied to infection of human with ascarid nematodes in the order Ascaridida, named toxocara canis and toxocara cati. It is transmitted from dog and cat to humans. Accidental ingestion of parasite eggs causes ocular and visceral larva migrans in human. The aim of this study is to study epidemiology of toxocariasis in Iran using meta-analysis and systematic review. Using main key words of toxocariasis including epidemiology, Toxocara spp. Iran, dog and cat in databases such as SID, Google scholar, Pubmed, Magiran and Iranmedex, a number of 50 articles was extracted. A number of 27 articles of them were eligible for meta-analysis. Data extracted from articles and archived in excel software for analysis. Variance of each study obtained using binomial distribution. Heterogeny of studies surveyed using Cochrans Q test. Data analyzed using Random Effect Model test. Overall prevalence of toxocariasis obtained 21.6% in Iran. In total of 27 articles, 6911 samples including 1543 carnivores, (13 articles), 4569 human sera (10 articles) and 799 soil samples (4 articles) has been investigated. Seropositivity for human toxocariasis 15.8% (95%CI, 9.2-22.5), soil contamination for Txocara spp. eggs 21.6% (95%CI,-1.6-44.8) and dogs and cats infections with adult worm 26.8% (95%CI, 18.7-36.8) was obtained. Results of this study show that prevalence of toxocariasis has a growing trend in Iran. It could be decreased using education, culture making and giving information to people.

Over expression of HIF-1α in human mesenchymal stem cells increases their supportive functions for hematopoietic stem cells in an experimental co-culture model

INTRODUCTION

Bone marrow transplantation is a critical approach for the treatment of many hematological disorders. Success of this approach is dependent on many factors the most important of which is the number of hematopoietic stem cells along with an efficient stroma. Co-transplantation of efficient mesenchymal stem cells can greatly improve the outcome of transplantations. Current researches assign a critical role for hypoxia inducible factor (HIF)-1α in protection of various cells and tissues probably through induction of cytokines. To make this feature applicable to human bone marrow-derived mesenchymal stem cells, we manipulated these cells to over express HIF-1α gene.

MATERIALS AND METHODS

Full-length cDNA of human HIF-1α was inserted into human bone marrow mesenchymal stem cells by pcDNA.3.1 non-viral plasmid vector, and the effect of this over expression on production of some hematopoietic growth factors was explored. Moreover, using a co-culture system, the interactive impact of HIF-1α-overexpressed mesenchymal stem cells on hematopoietic stem cells was evaluated. Results Over expression of HIF-1α in mesenchymal stem cells in normoxia increased production of one of the most important hematopoietic growth factors, Stem cell factor (also known as Steel factor or c-kit ligand). HIF-1α overexpression had no effect on production of other hematopoietic growth factors. In co-culture of mesenchymal stem cells-HIF-1α with hematopoietic stem cells, enhancement of colony formation and reduced differentiation of hematopoietic stem cells were observed. Conclusion Over expression of HIF-1α in human bone marrow-derived mesenchymal stem cells can augment the production of some hematopoietic growth factors, and we suggest this response of mesenchymal stem cells could help to improve the outcome of bone marrow transplantation.

Stimulation of Toll-like receptor-1/2 combined with Velcade increases cytotoxicity to human multiple myeloma cells

An increasing body of evidence supports the important role of adhesion to bone marrow microenvironment components for survival and drug resistance of multiple myeloma (MM) cells. Previous studies suggested that stimulation of Toll-like receptors by endogenous ligands released during inflammation and tissue damage may be pro-tumorigenic, but no studies have been performed in relation to modulation of cell adhesion and drug cytotoxicity. Here, we investigated the effect of TLR1/2 activation on adhesion of human myeloma cells to fibronectin, and their sensitivity to the proteasome inhibitor Velcade. It was found that TLR1/2 activation with Pam3CSK4 increased the cytotoxicity of Velcade in L363, OPM-2 and U266 human myeloma cells. This effect was not related to a decreased adhesion of the cells to fibronectin, but TLR1/2 activation stimulated the caspase-3 activity in Velcade-treated myeloma cells, which may be responsible for the enhanced cell death. Inhibitors of NF-κB and MAPK reduced the stimulatory effect. These findings indicate that TLR activation of MM cells could bypass protective effects of cell adhesion and suggest that TLR signaling may also have antitumorigenic potential.

Genotyping of Hydatid Cyst Isolated from Human and Domestic Animals in Ilam Province, Western Iran Using PCR-RFLP

BACKGROUND

Hydatidosis or cystic hydatid disease is one of the most important diseases in human and animals. Identification of strains is important for improvement of control and prevention of disease. The aim of this study was to determine the strains isolated from human and domestic animals in Ilam Province, Iran, using PCR-RFLP method.

METHODS

Respectively, 30 and 4 animal and human hydatid cysts were collected from different slaughterhouses and hospitals of the province. Protoscolices were separated and their DNA genome was extracted by extraction kit. rDNA-ITS1 of each isolated samples was duplicated by BD1(Forward) and 4s (Reverse) Primers. PCR products were studied by electrophoresis and then were digested using TaqI, HpaII, RsaI and AluI restriction enzymes. RFLP products were studied using electrophoresis on 1% agar gel.

RESULT

A fragment of 1000bp was produced from amplification of rDNA-ITS1 of protoscolices using PCR method. After digestion of PCR product by AluI enzyme, 200bp and 800bp, by RsaI, 655bp and 345bp and by HpaII 700bp and 300bp sizes were obtained. TaqI enzyme had no change in fragment size and it remained 1000bp. Considering the method, Ilam strains was specified as E. granulosus sensu stricto (G1-G3).

CONCLUSIONS

Although sheep strain (G1) is dominated in human and different animal in Iran and the world, but more efforts should be done to clarify the true genotype of Ilam strains specified as E. granulosus sensu stricto (G1-G3).

Evaluation of rabbit antibody response against 8 and 16 kDa recombinant subunits of antigen B from Echinococcus granulosus

OBJECTIVE

To immunize rabbits with 12 and 16 kDa recombinant subunits of antigen B from Echinococcus granulosus (E. granulosus) and measuring polyclonal antibody and humoral immune response using ELISA and gel diffusion.

METHODS

Two mentioned antigens were cloned and expressed in expression vector and purified by affinity chromatography. Four young rabbits were selected and challenged intradermally with yielded recombinant antigens. Rabbits' sera were collected post infection and were tested using ELISA and gel diffusion for polyclonal antibody detection 10 days after last injection.

RESULTS

The specific antibody against the recombinant peptides was efficiently produced within 4 weeks post infection.

CONCLUSIONS

Produced recombinants proteins could induce the immune response of the rabbits successfully. This process might improve the clarification of diagnosis and vaccination as regards hydatidosis.

Seroepidemiological study of human hydatidosis in meshkinshahr district, ardabil province, iran

BACKGROUND

The aim of this study was to conduct a sero-epidemiological survey in Meshkinshahr, Ardabil Province, northwestern Iran to detect the rate of hydatidosis in the city and nearby villages. Literature shows that no such study has been conducted so far.

METHODS

Overall, 670 serum samples were collected from 194 males and 476 females from patients referred to different health centers of the region. All patients filled out a questionnaire and an informed consent. Sera were analyzed using indirect-ELISA test. Ten µg /ml antigens (Antigen B derived from hydatid cyst fluid), serum dilutions of 1:500 and conjugate anti-human coombs with 1:10000 dilutions were utilized to perform the test. Data analysis was conducted using SPSS software ver. 11.5.

RESULTS

The seroprevalence of human hydatidosis was 1.79% by ELISA test in the region. This rate for females was 1.68% and males 2.6%, respectively. There was no significant difference as regards all factors studied and the seropositivity. According to job, farmers and ranchmen had the highest rate of infection as 3.17%. The sero-prevalence of infection was 2.6%% in illiterate people which showed the highest rate. As regards residency, urban life showed no significant difference with rural life (1.1% vs. 2.58%). Age group of 69-90 yr old, with 4.62% as prevalence had the highest rate of positivity.

CONCLUSION

Obtained sero-prevalence of hydatidosis shows more or less a resemblance to other cities of Iran, although due to the specific condition of the city we expected more rate of sero-positivity.