1
|
Shahbazi M, Ahmadinejad M, Mahabadi VP, Teimourpour A, Golzadeh K. Frequency, clinical, and laboratory findings of platelet secretion disorders in patients referred to the specialized coagulation laboratory of the Iranian Blood Transfusion Organization. Blood Coagul Fibrinolysis 2024; 35:115-123. [PMID: 38477834 DOI: 10.1097/mbc.0000000000001289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVES Platelet secretion disorders (PSDs) are a subgroup of platelet function disorders (PFDs) caused by defects in the content or release of platelet granules. These patients have a variable degree of mucocutaneous bleeding tendency. The diagnostic facilities of PSDs are imitated in Iran, even in specialized coagulation laboratories. The present study aims to estimate the frequency of PSDs among patients referred to the Iranian Blood Transfusion Organization (IBTO). METHODS The research population includes all patients referred to the specialized coagulation laboratory of IBTO and requested platelet function and von Willebrand testing by their physicians. They were recruited between May 2022 and October 2022 if they were not diagnosed as having procoagulant defects, von Willebrand disease (VWD), Glanzmann thrombasthenia (GT), Bernard-Soulier syndrome (BSS), and platelet count <100 × 10 9 (except in the syndromic forms). Patients with a defect in response to at least two agonists in Light transmission aggregometry (LTA), one agonist in the ATP-secretion study, and/or impairment in the expression of CD62P are considered PSDs. RESULTS Among 121 cases referred to our center over 6 months, 40 patients fulfilled the inclusion and exclusion criteria. Ten patients were diagnosed with PSDs. Six were classified as δ-platelet secretion disorders (δ-PSD), two α-platelet secretion disorders (α-PSD), and two αδ-platelet secretion disorders (αδ-PSD). CONCLUSIONS The prevalence of PSDs in our population study was 25% (10/40), which seems highly prevalent. Therefore, expanding laboratory approaches to platelet function defects is necessary as a routine in our country.
Collapse
Affiliation(s)
- Massoumeh Shahbazi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine
| | - Minoo Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine
| | | | - Amir Teimourpour
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine
| | - Khadijeh Golzadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine
| |
Collapse
|
2
|
Shahbazi M, Ahmadinejad M, Teimourpour A. Utility of the international society on thrombosis and hemostasis-bleeding assessment tool in the diagnosis of patients who suspected of platelet function disorders. Blood Coagul Fibrinolysis 2024; 35:8-13. [PMID: 37994630 DOI: 10.1097/mbc.0000000000001264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
The ISTH-BAT is a structured bleeding assessment tool to record and help diagnose patients with possible bleeding disorders. However, a few studies evaluated the utility of ISTH-BAT in diagnosing patients with platelet function defects (PFDs). In this study, we evaluated the diagnostic utility of ISTH-BAT in predicting PFDs among patients suspected of PFDs. Forty patients suspected of PFDs and 21 normal healthy controls were evaluated by the ISTH-BAT scoring system, light transmission aggregometry (LTA), ATP-releasing assays (lumi-aggregometry), and expression of CD62P for diagnosis of PFDs. Among 40 patients suspected of PFDs, 10 were diagnosed as PFDs using lumiaggregometry and CD62P. The ISTH-BAT score in patients suspected of PFDs [(6, interquartile range (IQR) 1-8] and patients with PFDs was significantly higher than the control group (0; IQR 0-0) ( P < 0.001). Receiver operating characteristic curves indicate that ISTH-BAT is not able to discriminate patients with PFDs from those without PFDs (areas under the curve of 0.620 (95% confidence interval 0.415-0.825). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the ISTH-BAT in predicting the presence of PFDs, respectively, were 40, 73.3, 33.3, and 78.6% in the cut-off ISTH-BAT at least 4 in adult men, at least 6 in adult women, and at least 3 in children (age < 18). The ISTH-BAT scoring system has good discriminatory power in diagnosing patients with PFDs from healthy controls but is ineffective in differentiating them from those without PFDs.
Collapse
Affiliation(s)
- Massoumeh Shahbazi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | | | | |
Collapse
|
3
|
Pagliari MT, Budde U, Baronciani L, Eshghi P, Ahmadinejad M, Badiee Z, Baghaipour MR, Benítez Hidalgo O, Biguzzi E, Bodó I, Castaman G, Goudemand J, Karimi M, Keikhaei B, Lassila R, Leebeek FWG, Lopez Fernandez MF, Marino R, Oldenburg J, Peake I, Santoro C, Schneppenheim R, Tiede A, Toogeh G, Tosetto A, Trossaert M, Yadegari H, Zetterberg EMK, Mannucci PM, Federici AB, Eikenboom J, Peyvandi F. von Willebrand factor neutralizing and non-neutralizing alloantibodies in 213 subjects with type 3 von Willebrand disease enrolled in 3WINTERS-IPS. J Thromb Haemost 2023; 21:787-799. [PMID: 36792472 DOI: 10.1016/j.jtha.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/23/2022] [Accepted: 01/03/2023] [Indexed: 01/12/2023]
Abstract
BACKGROUND Type 3 von Willebrand disease (VWD) is the most severe form of this disease owing to the almost complete deficiency of von Willebrand factor (VWF). Replacement therapy with plasma-derived products containing VWF or recombinant VWF rarely cause the development of alloantibodies against VWF that may be accompanied by anaphylactic reactions. OBJECTIVE The objective of this study was to assess the prevalence of anti-VWF alloantibodies in subjects with type 3 VWD enrolled in the 3WINTERS-IPS. METHODS An indirect in-house enzyme-linked immunosorbent assay has been used to test all the alloantibodies against VWF. Neutralizing antibodies (inhibitors) have been tested with a Bethesda-based method by using a VWF collagen binding (VWF:CB) assay. Samples positive for anti-VWF antibodies were further tested with Bethesda-based methods by using the semiautomated gain-of-function glycoprotein-Ib binding (VWF:GPIbM) and a VWF antigen (VWF:Ag) enzyme-linked immunosorbent assay. RESULTS In total, 18 of the 213 (8.4%) subjects tested positive for anti-VWF antibodies and 13 of 213 (6%) had VWF:CB inhibitors. These 13 were among the 18 with anti-VWF antibodies. Of the 5 without VWF:CB inhibitors, 3 had non-neutralizing antibodies, 1 only inhibitor against VWF:GPIbM, and one could not be tested further. Ten of the 13 subjects with VWF:CB inhibitors also had VWF:GPIbM inhibitors, 6 of whom also had VWF:Ag inhibitors. Subjects with inhibitors were homozygous for VWF null alleles (11/14), homozygous for a missense variant (1/14), or partially characterized (2/14). CONCLUSIONS Anti-VWF antibodies were found in 8.4% of subjects with type 3 VWD, whereas neutralizing VWF inhibitors were found in 6%, mainly in subjects homozygous for VWF null alleles. Because inhibitors may be directed toward different VWF epitopes, their detection is dependent on the assay used.
Collapse
Affiliation(s)
- Maria Teresa Pagliari
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Ulrich Budde
- Hemostaseology Medilys Laborgesellschaft mbH, Hamburg, Germany
| | - Luciano Baronciani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Peyman Eshghi
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Ahmadinejad
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Zahra Badiee
- Hemophilia-Thalassemia Center, Mashhad University of Medical Science, Mashad, Iran
| | | | - Olga Benítez Hidalgo
- Hemophilia Unit, Hematology Department, Hospital Universitari Vall d'Hebron, Spain
| | - Eugenia Biguzzi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Imre Bodó
- Department of Internal Medicine and Hematology - Semmelweis University, Budapest, Hungary
| | - Giancarlo Castaman
- Center for Bleeding Disorders and Coagulation, Careggi University Hospital, Florence, Italy
| | - Jenny Goudemand
- Department of Hematology and Transfusion, University of Lille, CHU Lille, Lille, France
| | - Mehran Karimi
- Hematology Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran
| | - Bijan Keikhaei
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur, University of Medical Sciences, Ahvaz, Iran
| | - Riitta Lassila
- Research Program Unit in Oncology, University of Helsinki, Helsinki University Central Hospital, Coagulation disorders, Helsinki, Finland
| | - Frank W G Leebeek
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Renato Marino
- Hemophilia and Thrombosis Centre, University Hospital Policlinico, Bari, Italy
| | - Johannes Oldenburg
- Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany
| | - Ian Peake
- Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom
| | - Cristina Santoro
- Hematology, Hemophilia and Thrombosis Center, University Hospital Policlinico Umberto I, Rome, Italy
| | - Reinhard Schneppenheim
- Department of Pediatric Hematology and Oncology, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Tiede
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Gholamreza Toogeh
- Thrombosis Hemostasis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alberto Tosetto
- Hemophilia and Thrombosis Center, Hematology Department, San Bortolo Hospital, Vicenza, Italy
| | - Marc Trossaert
- Centre Régional de Traitement de l'Hémophilie - Laboratoire d'Hématologie, Nantes, France
| | - Hamideh Yadegari
- Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany
| | | | - Pier Mannuccio Mannucci
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Augusto B Federici
- Department of Oncology and Oncohematology,Hematology and Transfusion Medicine, L. Sacco University Hospital, University of Milan, Milan, Italy
| | - Jeroen Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
| | - Flora Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
| |
Collapse
|
4
|
Nasri Nasrabadi N, Mohammadpour Dounighi N, Ahmadinejad M, Rabiei H, Tabarzad M, Najafi M, Vatanpour H. Isolation of the Anticoagulant and Procoagulant Fractions of the Venom of Iranian Endemic Echis carinatus. Iran J Pharm Res 2022; 21:e127240. [PMID: 36942067 PMCID: PMC10024320 DOI: 10.5812/ijpr-127240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 11/16/2022]
Abstract
Background The venom of Echis carinatus contains both procoagulant and anticoagulant components that can either promote or block the blood coagulation cascade, and some of these components affect platelet function in different ways. Objectives The present study focuses on setting up a procedure for the purification of crude venom and designing appropriate clotting tests in order to characterize the procoagulant and anticoagulant fractions of E. carinatus venom. Methods Chromatographic methods, including gel filtration, ion-exchange chromatography, and reverse-phase high-performance liquid chromatography (HPLC), were applied for purifying these fractions. Coagulant activity testing, prothrombin time (PT), and activated partial thromboplastin time (APTT) were used to determine procoagulant and anticoagulant properties. For measuring molecular weight, 15% SDS-PAGE electrophoresis with a molecular weight standard ranging from 6.5 to 200 kDa was used. Results We obtained five fractions named F1, F2, F3, F4, and F5. The F1 and F2 fractions showed procoagulant activity, and the F5 fraction had anticoagulant activity. The molecular weight of F2.4.2 from fraction F2 and F5.1 from fraction F5 were analyzed by SDS-PAGE electrophoresis under the reducing condition. These factors were identified as a single protein band at the end of purification. The molecular weights of these purified fractions were estimated to be 7.5 kDa and 38 kDa for F5.1(b) and F2.4.2(b), respectively. Conclusions Our findings suggest an efficient and suitable procedure for the identification and purification of the procoagulant and anticoagulant factors of the venom of Iranian E. carinatus using the PT and APTT assays.
Collapse
Affiliation(s)
- Nafiseh Nasri Nasrabadi
- Student Research Commitee, Pharmaceutical Sciences Research Centre, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasser Mohammadpour Dounighi
- Department of Venomous Animals and Anti-venom Production, Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - Minoo Ahmadinejad
- Pathology Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Hadi Rabiei
- Department of Venomous Animals and Anti-venom Production, Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - Maryam Tabarzad
- Protein Technology Research Center, Shahid Behashti University of Medical Sciences, Tehran, Iran
| | - Mojtaba Najafi
- Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran
| | - Hossein Vatanpour
- Department of Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
5
|
Pagliari MT, Rosendaal FR, Ahmadinejad M, Badiee Z, Baghaipour M, Baronciani L, Benítez Hidalgo O, Bodó I, Budde U, Castaman G, Eshghi P, Goudemand J, Karimi M, Keikhaei B, Lassila R, Leebeek FWG, Lopez Fernandez MF, Mannucci PM, Marino R, Oldenburg J, Peake I, Santoro C, Schneppenheim R, Tiede A, Toogeh G, Tosetto A, Trossaert M, Yadegari H, Zetterberg EMK, Peyvandi F, Federici AB, Eikenboom J. Von Willebrand factor propeptide and pathophysiological mechanisms in European and Iranian patients with type 3 von Willebrand disease enrolled in the 3WINTERS-IPS study. J Thromb Haemost 2022; 20:1106-1114. [PMID: 35092343 PMCID: PMC9305521 DOI: 10.1111/jth.15658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/12/2022] [Accepted: 01/21/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Type 3 von Willebrand disease (VWD) is a severe bleeding disorder caused by the virtually complete absence of von Willebrand factor (VWF). Pathophysiological mechanisms of VWD like defective synthesis, secretion, and clearance of VWF have previously been evaluated using ratios of VWF propeptide (VWFpp) over VWF antigen (VWF:Ag) and factor (F)VIII coagulant activity (FVIII:C) over VWF:Ag. OBJECTIVE To investigate whether the VWFpp/VWF:Ag and FVIII:C/VWF:Ag ratios may also be applied to understand the pathophysiological mechanism underlying type 3 VWD and whether VWFpp is associated with bleeding severity. METHODS European and Iranian type 3 patients were enrolled in the 3WINTERS-IPS study. Plasma samples and buffy coats were collected and a bleeding assessment tool was administered at enrolment. VWF:Ag, VWFpp, FVIII:C, and genetic analyses were performed centrally, to confirm patients' diagnoses. VWFpp/VWF:Ag and FVIII:C/VWF:Ag ratios were compared among different variant classes using the Mann-Whitney test. Median differences with 95% confidence intervals (CI) were estimated using the Hodges-Lehmann method. VWFpp association with bleeding symptoms was assessed using Spearman's rank correlation. RESULTS Homozygosity/compound heterozygosity for missense variants showed higher VWFpp level and VWFpp/VWF:Ag ratio than homozygosity/compound heterozygosity for null variants ([VWFpp median difference, 1.4 IU/dl; 95% CI, 0.2-2.7; P = .016]; [VWFpp/VWF:Ag median difference, 1.4; 95% CI, 0-4.2; P = .054]). FVIII C/VWF:Ag ratio was similarly increased in both. VWFpp level did not correlate with the bleeding symptoms (r = .024; P = .778). CONCLUSIONS An increased VWFpp/VWF:Ag ratio is indicative of missense variants, whereas FVIII:C/VWF:Ag ratio does not discriminate missense from null alleles. The VWFpp level was not associated with the severity of bleeding phenotype.
Collapse
Affiliation(s)
- Maria Teresa Pagliari
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly
| | - Frits R. Rosendaal
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Minoo Ahmadinejad
- Blood Transfusion Research CenterHigh Institute for Research and Education in Transfusion MedicineTehranIran
- Pediatric Congenital Hematologic Disorders Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Zahra Badiee
- Hemophilia‐Thalassemia CenterMashhad University of Medical ScienceMashadIran
| | | | - Luciano Baronciani
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoAngelo Bianchi Bonomi Hemophilia and Thrombosis CenterMilanItaly
| | | | - Imre Bodó
- Department of Internal Medicine and HematologySemmelweis UniversityBudapestHungary
| | - Ulrich Budde
- Hemostaseology Medilys Laborgesellschaft mbHHamburgGermany
| | - Giancarlo Castaman
- Center for Bleeding Disorders and CoagulationCareggi University HospitalFlorenceItaly
| | - Peyman Eshghi
- Pediatric Congenital Hematologic Disorders Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Jenny Goudemand
- Department of Hematology and Transfusion, CHU LilleUniversity of LilleLilleFrance
| | - Mehran Karimi
- Hematology Research Center,Nemazee HospitalShiraz University of Medical ScienceShirazIran
| | - Bijan Keikhaei
- Thalassemia and Hemoglobinopathy Research Center, Health Research InstituteAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Riitta Lassila
- Research Program Unit in OncologyUniversity of Helsinki, Helsinki University Central Hospital, Coagulation DisordersHelsinkiFinland
| | | | | | - Pier Mannuccio Mannucci
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoAngelo Bianchi Bonomi Hemophilia and Thrombosis CenterMilanItaly
| | - Renato Marino
- Hemophilia and Thrombosis CentreUniversity Hospital PoliclinicoBariItaly
| | - Johannes Oldenburg
- Institute of Experimental Haematology and Transfusion MedicineUniversity of BonnBonnGermany
| | - Ian Peake
- Faculty of Medicine, Dentistry and HealthUniversity of SheffieldSheffieldUnited Kingdom
| | - Cristina Santoro
- Hematology, Hemophilia and Thrombosis CenterUniversity Hospital Policlinico Umberto IRomeItaly
| | - Reinhard Schneppenheim
- Department of Pediatric Hematology and OncologyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Andreas Tiede
- Department of Hematology, Hemostasis, Oncology and Stem Cell TransplantationHannover Medical SchoolHannoverGermany
| | - Gholamreza Toogeh
- Thrombosis Hemostasis Research CenterTehran University of Medical SciencesTehranIran
| | - Alberto Tosetto
- Hemophilia and Thrombosis Center, Hematology DepartmentSan Bortolo HospitalVicenzaItaly
| | - Marc Trossaert
- Centre Régional de Traitement de l’Hémophilie–Laboratoire d’HématologieNantesFrance
| | - Hamideh Yadegari
- Institute of Experimental Haematology and Transfusion MedicineUniversity of BonnBonnGermany
| | | | - Flora Peyvandi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoAngelo Bianchi Bonomi Hemophilia and Thrombosis CenterMilanItaly
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly
| | - Augusto B. Federici
- Department of Oncology and Oncohematology, Hematology and Transfusion Medicine, L. Sacco University HospitalUniversity of MilanMilanItaly
| | - Jeroen Eikenboom
- Division of Thrombosis and Hemostasis, Department of Internal MedicineLeiden University Medical CenterLeidenthe Netherlands
| |
Collapse
|
6
|
Gagliardi D, Ahmadinejad M, Del Bo R, Meneri M, Comi GP, Corti S, Ronchi D. Homozygous SOD1 Variation L144S Produces a Severe Form of Amyotrophic Lateral Sclerosis in an Iranian Family. Neurol Genet 2021; 8:e645. [PMID: 34926808 PMCID: PMC8678909 DOI: 10.1212/nxg.0000000000000645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/15/2021] [Indexed: 11/15/2022]
Abstract
Objectives Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disorder characterized by degeneration of motor neurons determining progressive muscular atrophy, weakness, and death from respiratory failure. Methods Here, we report clinical and molecular findings of a novel Iranian family affected with a severe form of early-onset familial ALS. Results Three siblings born to consanguineous parents developed a form of ALS characterized by early-onset lower limb involvement and a fast progression, proving fatal at age 16 years for 1 of them. Molecular analysis of the SOD1 gene revealed the homozygous substitution c.434T>C in exon 5 resulting in the amino acid change p.Leu144Ser (L144S), previously reported as a dominant variant. Both parents were heterozygous carriers. The probands' mother recently developed a late-onset ALS with predominant upper motor neuron involvement. Discussion This report adds p.L144S to the short list of homozygous SOD1 variants and suggests that the development of an earlier-onset and/or faster disease progression can occur when 2 mutated alleles are present.
Collapse
Affiliation(s)
- Delia Gagliardi
- Neuroscience Section, Dino Ferrari Centre, Department of Pathophysiology and Transplantation (DEPT) (D.G., R.D.B., G.P.C.,S.C., D.R.), University of Milan, Italy; Neurology Unit (D.G., M.M., S.C., D.R.), Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Blood Transfusion Research Center (M.A.), High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Neuromuscular and Rare Diseases Unit, Department of Neuroscience (G.P.C.), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Minoo Ahmadinejad
- Neuroscience Section, Dino Ferrari Centre, Department of Pathophysiology and Transplantation (DEPT) (D.G., R.D.B., G.P.C.,S.C., D.R.), University of Milan, Italy; Neurology Unit (D.G., M.M., S.C., D.R.), Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Blood Transfusion Research Center (M.A.), High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Neuromuscular and Rare Diseases Unit, Department of Neuroscience (G.P.C.), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Del Bo
- Neuroscience Section, Dino Ferrari Centre, Department of Pathophysiology and Transplantation (DEPT) (D.G., R.D.B., G.P.C.,S.C., D.R.), University of Milan, Italy; Neurology Unit (D.G., M.M., S.C., D.R.), Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Blood Transfusion Research Center (M.A.), High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Neuromuscular and Rare Diseases Unit, Department of Neuroscience (G.P.C.), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Megi Meneri
- Neuroscience Section, Dino Ferrari Centre, Department of Pathophysiology and Transplantation (DEPT) (D.G., R.D.B., G.P.C.,S.C., D.R.), University of Milan, Italy; Neurology Unit (D.G., M.M., S.C., D.R.), Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Blood Transfusion Research Center (M.A.), High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Neuromuscular and Rare Diseases Unit, Department of Neuroscience (G.P.C.), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Pietro Comi
- Neuroscience Section, Dino Ferrari Centre, Department of Pathophysiology and Transplantation (DEPT) (D.G., R.D.B., G.P.C.,S.C., D.R.), University of Milan, Italy; Neurology Unit (D.G., M.M., S.C., D.R.), Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Blood Transfusion Research Center (M.A.), High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Neuromuscular and Rare Diseases Unit, Department of Neuroscience (G.P.C.), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Corti
- Neuroscience Section, Dino Ferrari Centre, Department of Pathophysiology and Transplantation (DEPT) (D.G., R.D.B., G.P.C.,S.C., D.R.), University of Milan, Italy; Neurology Unit (D.G., M.M., S.C., D.R.), Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Blood Transfusion Research Center (M.A.), High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Neuromuscular and Rare Diseases Unit, Department of Neuroscience (G.P.C.), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Ronchi
- Neuroscience Section, Dino Ferrari Centre, Department of Pathophysiology and Transplantation (DEPT) (D.G., R.D.B., G.P.C.,S.C., D.R.), University of Milan, Italy; Neurology Unit (D.G., M.M., S.C., D.R.), Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Blood Transfusion Research Center (M.A.), High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Neuromuscular and Rare Diseases Unit, Department of Neuroscience (G.P.C.), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
7
|
Bahreini S, Javadzadeh Shahshahani H, Nasizadeh S, Ahmadinejad M. The activity of labile coagulation factors and fibrinogen in thawed plasma during a 5 day storage period in the hospital blood bank refrigerator. Transfus Med 2021; 31:494-498. [PMID: 34605106 DOI: 10.1111/tme.12823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/18/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fresh frozen plasma (FFP) is used to treat coagulation disorders. Even though the activity of labile coagulation factors gradually decreases once thawed, it can be used up to 24 h after thawing, if stored properly. In this study, the level of coagulation factor activity was evaluated in thawed plasma during a 5 day storage period. MATERIALS AND METHODS This cross-sectional study was performed on 40 FFP units prepared in Yazd Blood Center. Samples were thawed in a waterbath for 20-30 min at 30-37°C and then stored in the hospital blood bank refrigerator. The level of fibrinogen concentration, as a stable factor and, coagulation factors V and VIII, as labile factors, were measured in the plasma immediately following the thawing process as well as 24 and 120 h after the process. Data analysis was performed using SPSS software 20. RESULTS The fibrinogen level remained stable for up to 24 h after thawing; after 120 h there was a 1.66% decrease with the mean level of 334.0 ± 53.3 mg/dl. The mean activity of factors V and VIII levels decreased by 12.3%, and 26% respectively over 120 h after thawing when compared to that after 24 h. A 120 h after thawing Factor V activity was above 70% in 87.5% of thawed plasmas and its mean activity was 81.6 ± 11.8. Factor VIII activity was above 70% in only 35% of thawed plasmas with the mean activity of 64.4 ± 17.2. CONCLUSION Thawed plasma can be used for up to 5 days in all therapeutic applications of FFP since it still has the essential hemostatic effects. However, in situations where higher levels of FVIII are needed, Thawed Plasma is not a suitable alternative. In such cases FFP, FVIII concentrate or cryoprecipitated antihemophilic factor should be used.
Collapse
Affiliation(s)
- Sahar Bahreini
- Faculty of Medicine, Ali ibn Abitaleb, Islamic Azad University, Yazd, Iran
| | | | - Soheila Nasizadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Minoo Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| |
Collapse
|
8
|
Ahmadinejad M, Shahbazi M, Chegini A. Heparin-Induced Thrombocytopenia in Iranian Cardiac Surgery Patients Using the 4Ts Clinical Scoring System and Laboratory Methods. Int J Hematol Oncol Stem Cell Res 2021; 15:230-238. [PMID: 35291665 PMCID: PMC8888360 DOI: 10.18502/ijhoscr.v15i4.7478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 09/11/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Heparin-induced thrombocytopenia (HIT) is a serious adverse drug reaction. HIT diagnosis needs an algorithmic approach including clinical evaluation and laboratory tests (screening and confirmatory). Few studies have been conducted on HIT in Iran, and most existing research has been general and based on clinical evaluations alone. The present study was conducted to determine the prevalence of HIT among cardiac surgery patients using an algorithmic approach. Materials and Methods: A cross-sectional study was carried out over a period of 10 months, at Modares Hospital (Tehran, Iran) on 92 patients who were candidates for cardiac surgery. For the clinical evaluation, the 4Ts scoring system was used; in cases with 4Ts scores ≥4, a laboratory evaluation of anti-PF4/heparin antibody (Ab) was performed by enzyme-linked immunosorbent assay (ELISA) and a HIPA test too as a functional confirmatory method. The patients with 4Ts scores ≥4 who were ELISA positive (OD ≥0.2) and HIPA positive were taken as a definite case of HIT. Results: Of the 92 patients who had undergone cardiac surgery, 14 (15%) had 4Ts scores ≥4. Anti- PF4/heparin Ab was detected in eight patients using the ELISA and in six patients using the HIPA. Ultimately, definite HIT was confirmed in five of the patients. Conclusion: The prevalence of HIT was 5.4% among the cardiac surgery patients assessed in the present study. To the researchers’ knowledge, this is the first time that HIT has been evaluated in Iran using a comprehensive algorithmic approach including clinical history-taking and both immunological and functional laboratory tests, and the findings showed a slightly higher HIT frequency in this single-center study in comparison with the other studies carried out in other countries.
Collapse
Affiliation(s)
- Minoo Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Massoumeh Shahbazi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Azita Chegini
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| |
Collapse
|
9
|
Valikhani A, Mirakhorly M, Namvar A, Rastegarlari G, Toogeh G, Shirayeh FV, Ahmadinejad M. Genetic analysis of non-severe hemophilia A phenotype with A discrepancy between one-stage and chromogenic factor VIII activity assays. Transfus Apher Sci 2021; 60:103194. [PMID: 34275734 DOI: 10.1016/j.transci.2021.103194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/26/2021] [Accepted: 06/11/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The diagnosis of hemophilia A (HA) is based on the measurement of factor VIII activity (VIII:C). About one-third of non-severe HA patients show a discrepancy of VIII:C measured by one-stage (VIII:C 1st) and chromogenic (VIII:C chr) assays. Different mutations in the F8 gene may cause the discrepancy in results of the FVIII activity assay. The aim of this study was to investigate F8 gene mutations in patients with assay discrepancies and to evaluate their impact on the results of VIII:C assays. METHODS Mutation analysis was performed on 41 individuals with a discrepancy in VIII:C 1st and FVIII: C chr assays by direct sequencing. In addition, the effect of the variants on FVIII macromolecule structure was investigated by in silico and bioinformatics tools. RESULTS Genetic analysis disclosed 22 different variants, of which 19 were identified for the first time to be involved in the phenotype of VIII:C discrepancy. Most of the variants related to the higher VIII:C 1st were found in A1, A2, A3 domains. The variant related to VIII:C chr > VIII:C 1st was located in the thrombin cleavage site. In silico analysis showed the effect of variants on FVIII macromolecule stability, which may be the possible mechanism causing the discrepancy. CONCLUSION Our data shed light on the impact of genetic defects on VIII:C assay and provided evidence that the consideration of these mutations may open a new window to the proper diagnosis and treatment monitoring of non-severe HA patients.
Collapse
Affiliation(s)
- Amir Valikhani
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | | | - Ali Namvar
- Iranian Comprehensive Haemophilia Care Center, Tehran, Iran
| | | | - Gholamreza Toogeh
- Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Vossough Shirayeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Minoo Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| |
Collapse
|
10
|
Shahbazi M, Ahmadinejad M, Fakhrzadegan S. Severe Prekallikrein Deficiency Associated with Low Level of Factor XII: A Case Report. Iran J Pathol 2021; 16:332-336. [PMID: 34306130 PMCID: PMC8298060 DOI: 10.30699/ijp.2020.131638.2463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/19/2021] [Indexed: 11/06/2022]
Abstract
Hereditary deficiency of plasma prekallikrein (PPK) is a rare autosomal recessive disease. The affected patients are often asymptomatic and diagnosed incidentally during preoperative investigations or during hospitalization by isolated prolongation of activated partial thromboplastin time (aPTT). In this article, we report, a 46-year-old woman who was candidate for two invasive procedures (thyroid FNA and hysterectomy) and underwent preoperative evaluation. Due to prolonged aPTT with normal PT she was referred to the IBTO reference coagulation laboratory for specific coagulation assays. Ultimately, the examinations revealed severe PPK deficiency (<1%) with partial deficiency of factor XII level (25%).
Collapse
Affiliation(s)
- Massoumeh Shahbazi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Minoo Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Shahnaz Fakhrzadegan
- Department of Hematology and Oncology, School of Medicine, Iran University of Medical Science, Tehran, Iran
| |
Collapse
|
11
|
Seidi Zadeh O, Ahmadinejad M, Amoohossein B, Homayoun S. Are Iranian patients with von Willebrand disease type 2N properly differentiated from hemophilia A and do they receive appropriate treatment? Blood Coagul Fibrinolysis 2020; 31:382-386. [PMID: 32815913 DOI: 10.1097/mbc.0000000000000932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
: The defect function of the von Willebrand factor (VWF) in carrying factor VIII (FVIII) leads to von Willebrand disease type 2N (VWD 2N) which could be easily misdiagnosed as hemophilia A. Differentiating of VWD 2N from hemophilia A is crucial for patient treatment and genetic counseling. As a retrospective study, we aimed to evaluate the current diagnostic work-up of Iranian patients with mild/moderate deficiency of FVIII levels and the possibility of misdiagnosis of VWD 2N as hemophilia A. All patients who referred to the reference coagulation laboratory at the Iranian Blood Transfusion Organization in a 10-months period for bleeding diathesis work-up with the request of FVIII activity level were included. Clinical and laboratory phenotypes including International Society on Thrombosis and Hemostasis - Bleeding Assessment Tool, FVIII activity, VWF antigen, VWF ristocetin cofactor, and FVIII binding capacity of VWF were assessed on suspected cases for VWD 2N. In total, the results of 896 patients for investigation of VWD 2N were evaluated and five new patients were identified within unrelated families with abnormal VWF:FVIIIB levels. Four were heterozygous for VWD 2N and one homozygous whom all were misdiagnosed as hemophilia A and underwent inappropriate treatments. The median bleeding score of the VWD 2N population was nine (4-13). In Iran, probably a significant number of VWD 2N patients are misdiagnosed as hemophilia A due to insufficient test panel for subtyping of von Willebrand disease. This study also emphasized the need for inclusion of the VWF:FVIIIB in suspected hemophilia A to achieve an optimal treatment strategy.
Collapse
Affiliation(s)
- Omid Seidi Zadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | | | | | | |
Collapse
|
12
|
Naderi M, Cohan N, Haghpanah S, Miri-Aliabad G, Shahramian I, Ahmadinejad M, Sadeghi S, Dorgalaleh A, Khazaei HA, Karimi M. Correlation of bleeding score with frequency and severity of bleeding symptoms in FXIII deficiency assessing by the ISTH Bleeding Assessment Tool. Transfus Apher Sci 2019; 58:495-497. [PMID: 31303509 DOI: 10.1016/j.transci.2019.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/11/2019] [Accepted: 05/16/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The ISTH bleeding assessment tool (ISTH-BAT) is developed for standardization of bleeding symptoms in bleeding disorders. The aim of this study is to apply this bleeding score for FXIII deficient patients and its relation to the frequency and severity of symptoms. METHODS In this cross-sectional study, 63 patients with severe FXIII deficiency were evaluated for the assessment of bleeding score according to the standard ISTH-BAT questionnaire. All patients were registered at two major thrombosis and hemostasis centers in Iran affiliated to Zahedan University of medical sciences (50 patients) and Shiraz University of medical sciences (13 patients). RESULTS Significant correlations between the bleeding score and number of symptoms (r = 0.668, P < 0.001) and with a number of severe symptoms (r = 0.938, P < 0.001) were detected. There was no significant relationship between the mean bleeding score and CNS bleeding (P = 0.390). CONCLUSION The ISTH-BAT score is an acceptable bleeding assessment tool for standardization and evaluation of patients with FXIII deficiency.
Collapse
Affiliation(s)
- Majid Naderi
- Genetics of Non-Communicable Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Nader Cohan
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ghasem Miri-Aliabad
- Department of Pediatric, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Iraj Shahramian
- Pediatric Digestive and Hepatic Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | - Minoo Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Simin Sadeghi
- Department of Pediatric, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Akbar Dorgalaleh
- Department of Hematology and Blood Transfusion, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Ali Khazaei
- Clinical Immunology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
13
|
Chenani M, Behnamghader A, Khorasani M, Ahmadinejad M. Evaluation of Hemostatic Behavior of Micro and Nano Gelatin/Silica Hybrid in Severe Bleeding. Curr Stem Cell Res Ther 2019; 14:169-176. [DOI: 10.2174/1574888x13666180703143856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/23/2018] [Accepted: 06/12/2018] [Indexed: 11/22/2022]
Abstract
Background:
The pH variation of the injury site is an important factor in the failure of styptic
and its structural damage. In this study, the behaviour of a gelatin-silica hybrid in severe bleeding was
evaluated under different pH values. On the other hand, the effect of the hybrid particle size, which is one
of the key physical properties of the hybrid, has been studied in rapid control of haemostasis.
</P><P>
Method: The hybrid haemostatic behaviour varied drastically by changing the particle size, so that the
hybrid containing SiO2 with the average particle size of about 1 micro-meter (Hyb Gel-MSiO2) demonstrated
very poor ability in platelet adhesion in neutral pH, about 24%. Also, the aPTT was not
shorter than the normal time, whereas reduction of the particle size beyond a certain limit (with nanometer
SiO2 for Hyb Gel-NSiO2) led to both increasing platelet adhesion to 32% and very considerable
reduction of aPTT.
</P><P>
Results: Alignment of all results showed that the particle size reduction improves the haemostatic
behaviour of the hybrid toward its best performance by controlling excessive bleeding. By changing
the pH for a certain particle size, structural integrity, and thereby the hybrid haemostatic behaviour
changed dramatically. Therefore, the nano-hybrid showed the most blood absorption (around 470%) in
natural pH and acceded to a coherent structure. The results demonstrated that in alkaline or acidic
environment, the hybrid haemostatic behaviour was limited. Based on the results of this study, it was
found that changes in the hybrid behaviour in acidic pH were much more drastic than in alkaline pH,
and also the hybrid with the optimum particle size (Hyb Gel-NSiO2) can maintain the structural integrity
with rapid haemostasis (<3 seconds).
</P><P>
Conclusion: Based on the objective that the pH at the injury site change to the alkaline side, the resulting
hybrid has an excellent ability to control excessive bleeding and can be proposed for further in
vivo studies as a novel styptic.</P>
Collapse
Affiliation(s)
- M. Chenani
- Biomaterials Group, Department of Medical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - A. Behnamghader
- Biomaterials Group, Department of Nanotechnology and Advanced Materials, Materials & Energy Research Center, Karaj, Iran
| | - M. Khorasani
- Department of Biomaterial, Iran Polymer and Petrochemical Institute (IPPI), P.O. Box:14965, Tehran, Iran
| | - M. Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| |
Collapse
|
14
|
Hashemi Tayer A, Amirizadeh N, Ahmadinejad M, Nikougoftar M, Deyhim MR, Zolfaghari S. Procoagulant Activity of Red Blood Cell-Derived Microvesicles during Red Cell Storage. Transfus Med Hemother 2018; 46:224-230. [PMID: 31700504 DOI: 10.1159/000494367] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/09/2018] [Indexed: 01/03/2023] Open
Abstract
Background Red blood cells (RBCs) undergo structural and biochemical alterations during storage which are collectively called RBC storage lesion and cause a decrease in RBC recovery and survival. During storage, erythrocytes release an increasing number of microvesicles (MVs) that have key roles in biological processes. We aimed to investigate the procoagulant activity (PCA) of RBC-derived MVs during storage. Methods 20 packed RBCs were stored for up to 42 days. Samples were taken at seven different times and evaluated for the presence of RBC-MVs. MVs were separated, and following filtration flow cytometry was used to characterize RBC-MVs based on the expression of glycophorin A (Gly.A) and annexin V (AnnV) antigens. The coagulant activity of RBC-MVs was tested by clotting time (CT) and PCA assays. Results were compared before and after filtration. Results Flow cytometry revealed a 17.6-fold increase in RBC-MVs after 6 weeks of storage. Significant correlations were found between AnnV+ MVs and PCA (r = 0.96; p < 0.001), and CT (r = -0.77; p < 0.001) which was associated with increased PCA and shortened CT with RBC aging. Filtration of samples efficiently removed MVs (p < 0.001) and also reduced in vitro PCA of MVs (p < 0.001). Conclusion RBC-MVs are procoagulant (particularly AnnV+ MVs) Reduction of MVs from RBC concentrates may reduce the risk of transfusion-induced thrombotic complications.
Collapse
Affiliation(s)
- Akbar Hashemi Tayer
- Department of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Naser Amirizadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Minoo Ahmadinejad
- Hematology and Reference Coagulation Lab, Iranian Blood Transfusion Organization, Tehran, Iran
| | - Mahin Nikougoftar
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Mohammad Reza Deyhim
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Sima Zolfaghari
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| |
Collapse
|
15
|
Abolghasemi H, Panahi Y, Ahmadinejad M, Toogeh G, Karimi M, Eghbali A, Mirbehbahani NB, Dehdezi BK, Badiee Z, Hoorfar H, Eshghi P, Maghsoudi N, Sahebkar A, Gholami-Fesharaki M. Comparative evaluation of the safety and efficacy of recombinant FVIII in severe hemophilia A patients. J Pharmacopuncture 2018; 21:76-81. [PMID: 30151307 PMCID: PMC6054092 DOI: 10.3831/kpi.2018.21.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 03/20/2018] [Accepted: 05/17/2018] [Indexed: 11/09/2022] Open
Abstract
Objective This study compared the safety and efficacy of Safacto® versus xyntha® in patients with severe hemophilia A. Methods Thirty-three male patients with severe hemophilia A were randomly divided into two groups. Seventeen patients received Safacto® and 16 patients received Xyntha® for four consecutive times. The dosage of FVIII was 40-50 IU/kg for each injection. Plasma level of FVIII activity was evaluated before every injection, 15 minutes after the injection and one month after the start of the trial. The rate of factor VIII activity, pain and joint motion were also assessed before and after the treatment. Results Plasma level of FVIII clotting activity in Safacto® and Xyntha® were 1.96±0.5 IU/dl and 1.63±0.5 IU/dl and increased to 88.84±25.2 IU/dl and 100.09±17.8 IU/dl, respectively (P<0.001). Pain score and range of motion improvement were 9.3±0.9 and 8.7±0.1 in Safacto® (P=0.17); and 9.4±0.8 and 8.8±0.3 in Xyntha® (P=0.35), respectively. No allergic or other unfavorable reactions was observed with either of the preparations. Conclusion This study showed that Safacto® has a favorable efficacy and safety profile.
Collapse
Affiliation(s)
- Hassan Abolghasemi
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yunes Panahi
- Pharmacotherapy Department, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Minoo Ahmadinejad
- High Institute of Research, Iranian Blood Transfusion Organization, Tehran, Iran
| | - Gholamreza Toogeh
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Pharmacotherapy Department, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran.,High Institute of Research, Iranian Blood Transfusion Organization, Tehran, Iran.,Hematology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Pediatric Hematology-Oncology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Golestan University of Medical Sciences, Gorgan, Iran.,Department of Thalassemia & Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.,Doctor Sheikh Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.,Isfahan University of Medical Sciences, Isfahan, Iran.,Neuroscience Research Center (NRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mehran Karimi
- Hematology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aziz Eghbali
- Department of Pediatric Hematology-Oncology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Bighan Keikhaei Dehdezi
- Department of Thalassemia & Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Zahra Badiee
- Doctor Sheikh Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Hoorfar
- Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Eshghi
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nader Maghsoudi
- Neuroscience Research Center (NRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | | |
Collapse
|
16
|
Zahedpanah M, Azarkeivan A, Ahmadinejad M, Tabatabaiee M, Hajibeigi B, Maghsudlu M. Evaluation of platelet aggregation in splenectomized beta-thalassemia major and intermedia patients. J Appl Hematol 2018. [DOI: 10.4103/joah.joah_76_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
17
|
Kheirandish F, Mahmoudvand H, Ahmadinejad M, Karimi Rouzbahani A. Genetic characterization of human-derived hydatid cysts of Echinococcus granulosus in Lorestan Province, Western Iran. Trop Biomed 2017; 34:863-869. [PMID: 33592955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The aim of the present investigation was genotyping of hydatid cysts of cystic echinococcosis (CE) patients residing in Lorestan province by sequencing and analyzing of the partial mitochondrial cytochrome c oxidase subunit 1 (cox1). A total of 26 hydatid cysts (6 hydatid cysts) from 6 patients suffering from hepatic CE and 20 formalin-fixed paraffinembedded (FFPE) tissue samples from 20 human patients with histologically confirmed CE. DNA was extracted, and genotyping was performed by sequencing and analyzing mitochondrial cox1 gene. All the samples were analyzed using mitochondrial cox1 primers. In sequencing analysis, the alignment of the determined sequence with those of knows genotypes of E. granulosus demonstrated that the isolates belonged to genotype G1 (sheep strain). Representative nucleotide sequence obtained in this study was deposited in the GenBank database under the accession number LC068913.1. The phylogenetic analysis showed two clusters. One of the clusters includes G3 genotype (HM5630221) and the other cluster represents all strains related to G1 and G3 genotypes which contain genotype defined in this study as well. The obtained findings demonstrated that G1 genotype is predominant strain of human CE in Lorestan province, Iran, which indicating the sheep-doge cycle in this area. Further studies with more sample size should be conducted to be sure of the sheep strain G1 which is predominant strain in this province.
Collapse
Affiliation(s)
- F Kheirandish
- Razi Herbal Medicines Research Center, Department of Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - H Mahmoudvand
- School of Allied Medical Sciences, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - M Ahmadinejad
- Department of Surgery, Alborz University of Medical Sciences, Karaj, Iran
| | - A Karimi Rouzbahani
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| |
Collapse
|
18
|
Shahverdi E, Abolghasemi H, Ahmadinejad M. Combined occurrence of Bernard-Soulier syndrome and prekallikrein deficiency. Blood Res 2017; 52:229-231. [PMID: 29043243 PMCID: PMC5641520 DOI: 10.5045/br.2017.52.3.229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/14/2016] [Accepted: 01/17/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Ehsan Shahverdi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.,Blood and Cancer Research Center, MAHAK Pediatric Cancer Treatment and Research Center, Tehran, Iran
| | - Hassan Abolghasemi
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Minoo Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| |
Collapse
|
19
|
Ahmadinejad M, Alavi S, Ebadi M, Rashidi A, Tabatabaei M, Rezvani A. Combined high molecular weight Kininogen and factor XI deficiency. Haemophilia 2015; 22:e60-1. [PMID: 26572243 DOI: 10.1111/hae.12835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2015] [Indexed: 11/30/2022]
Affiliation(s)
- M Ahmadinejad
- Reference Coagulation Laboratory, Iranian Blood Transfusion Research Center, Tehran, Iran
| | - S Alavi
- Pediatric Congenital Hematologic Disorders Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Ebadi
- Institute of Human Virology, University of Maryland, Baltimore, MD, USA
| | - A Rashidi
- Division of Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - M Tabatabaei
- Reference Coagulation Laboratory, Iranian Blood Transfusion Research Center, Tehran, Iran
| | - A Rezvani
- Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
20
|
Faranoush M, Abolghasemi H, Mahboudi F, Toogeh G, Karimi M, Eshghi P, Managhchi M, Hoorfar H, Dehdezi BK, Mehrvar A, khoeiny B, Vaziri B, Kamyar K, Heshmat R, Baghaeipour MR, Mirbehbahani NB, Fayazfar R, Ahmadinejad M, Naderi M. A Comparison of Efficacy Between Recombinant Activated Factor VII (Aryoseven) and Novoseven in Patients With Hereditary FVIII Deficiency With Inhibitor. Clin Appl Thromb Hemost 2014; 22:184-90. [DOI: 10.1177/1076029614555902] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction: This study compared the efficacy of Aryoseven with Novoseven to control bleeding episodes in patients with hemophilia A with inhibitors. Methods: Sixty-six patients were randomized into 2 groups, with 4 consecutive block randomization. These groups received Aryoseven and Novoseven dosages of 90 to 120 μg/kg intravenously every 2 hours. Results: Median (interquartile range) level of factor VIII (FVIII) inhibitor in groups A and B was 15.0 and 19.0 Bethesda Unit (BU) preadministration. Bleeding onset in group A was 1246 ± 1104 minutes and in group B was 2301 ± 1693 minutes ( P = .311). The Kavakli global response scores and treatment success rate was comparable in both the groups. The side effects in groups A (9.7%) and B (2.9%) were comparable. Conclusion: Biosimilar recombinant activated FVII is found to be as effective as Novoseven in the treatment of acute joint bleeding in patients with hemophilia with inhibitors. Its usage will decrease the gaps in hemophilia.
Collapse
Affiliation(s)
- M. Faranoush
- Iran university of Medical Sciences, Rasool Akram Hospital, Tehran, Iran
| | - H. Abolghasemi
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F. Mahboudi
- Biotechnology Research Center, Pasteur Institute of Iran, Tehran Iran
| | - Gh. Toogeh
- Thrombosis and Hemostasis Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran
| | - M. Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - P. Eshghi
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M. Managhchi
- Thrombosis and Hemostasis Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran
| | - H. Hoorfar
- Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | | | - B. Vaziri
- Biotechnology Research Center, Pasteur Institute of Iran, Tehran Iran
| | - K. Kamyar
- Aryogen Zist Darou Company, Karaj, Iran
| | - R. Heshmat
- Thrombosis and Hemostasis Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran
| | | | | | - R. Fayazfar
- MD, Kerman University of Medical Sciences, Kerman, Iran
| | - M. Ahmadinejad
- High Institute of Research, Iranian Blood Transfusion Organization, Tehran, Iran
| | - M. Naderi
- Zahedan University of Medical Sciences, Ahwaz, Iran
| |
Collapse
|
21
|
Ahmadinejad M, Pour A, Amiri Z. P0090 Comparison of fine needle aspiration, Touch Print, and Crush Print with permanent pathology in the diagnosis of breast lumps in Iranian patients. Eur J Cancer 2014. [DOI: 10.1016/j.ejca.2014.03.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
22
|
Shohrati M, Moshkani M, Pishgoo B, Ahmadinejad M, Najafian N, Najafian B, Kazemisaleh D. Evaluation of Aggregometery Parameters and Efficacy of Plavix versus Clopidex in Patients Suffering from Ischemic Heart Disease: A Randomized Double Blind Clinical Trial. Iran Red Crescent Med J 2014; 16:e15277. [PMID: 24719748 PMCID: PMC3965881 DOI: 10.5812/ircmj.15277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 12/02/2013] [Accepted: 12/24/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ischemic heart disease is the leading cause of death in most societies. In a pathophysiologic point of view, it chiefly results from the formation of thrombus in coronary arteries which could not be only prevented by aspirin. Many of clinical trials have shown the long-term benefits of antiplatelet drugs in reducing the risk of thrombotic accidents. OBJECTIVES Clopidogrel is a thienopyridine derivative used to prevent platelets from adhering together by direct inhibition of Adenosine diphosphate (ADP), the major factor behind platelets aggregation. Sanofi-Aventis and Bristol-Myers are companies that produce Clopidogrel by the name of Clopidogrel bisulfate. Its trade name is Plavix, nonetheless in Iran it is distributed under the name of Clopidex by Exir Company. In this study we are to compare Plavix and Clopidex in terms of efficacy as well as aggregometry parameters like ADP and PRP (Platelet Rich Plasma). PATIENTS AND METHODS This is a double blind clinical trial in which we had two groups of patients suffering from Ischemic heart disease who were selected by inclusion criteria. Group A (36 patients) took Plavix (75 mg/d) and group B (36 patients) used clopidex (75 mg/d) both for 30 days. The aggregometry parameters also consisted of PRP and ADP that were run on the patients before and after the study. Finally, a comparison of aforementioned tests, quality of life, lab parameters and compliance in both groups was provided. RESULTS In groups A and B, the mean levels of PRP before the study were 348000 and 340000/µL respectively. The ADPs were also 73/76 and 68/07 µM that showed no significant difference (P > 0.05).The Means of ADP5 in group A before and after the study were 66.40 and 43.84 µM respectively that there was significant difference (P = 0.001). The Means of ADP5 in group B before and after the study were 58.04 and 40.16 µM respectively that there was significant difference (P < 0.001).The Means of ADP20 in group A before and after the study were 73.76 and 54.97 µM respectively which showed significant difference (P < 0.001). The Means of ADP20 in group B before and after the study were 68.07 and 52.49 µM respectively which showed significant difference (P = 0.001). Difference of ADP5 between group A and B was not significant (P = 0.495). Difference of ADP20 between group A and B was not significant (P = 0.721). The Means of PRP in group A before and after the study were 348000 and 335000/ µL respectively that there was no significant difference (P = 0.66). The Means of PRP in group B before and after the study were 340000 and 336000/ µL respectively that indicated no significant difference (P = 0.81). Difference of PRP between group A and B was not significant (P = 0.563). CONCLUSIONS Our findings suggested that both drugs significantly lessen the ADP level; even so there was no significant difference between two groups in PRP and ADP factors.
Collapse
Affiliation(s)
- Majid Shohrati
- Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Maryam Moshkani
- Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Bahram Pishgoo
- Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | | | - Nastaran Najafian
- Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Bita Najafian
- Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Davoud Kazemisaleh
- Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Davoud Kazemisaleh, Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran, Tel: + 98-2181263419, Fax: + 98-2181263419., E-mail:
| |
Collapse
|
23
|
Shiri R, Yari F, Ahmadinejad M, Vaeli S, Tabatabaei MR. The caspase-3 inhibitor (peptide Z-DEVD-FMK) affects the survival and function of platelets in platelet concentrate during storage. Blood Res 2014; 49:49-53. [PMID: 24724067 PMCID: PMC3974957 DOI: 10.5045/br.2014.49.1.49] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 11/30/2013] [Accepted: 02/19/2014] [Indexed: 11/30/2022] Open
Abstract
Background Although apoptosis occurs in nucleated cells, studies show that this event also occurs in some anucleated cells such as platelets. During storage of platelets, the viability of platelets decreased, storage lesions were observed, and cells underwent apoptosis. We investigated the effects of caspase-3 inhibitor on the survival and function of platelets after different periods of storage. Methods Platelet concentrates were obtained from the Iranian Blood Transfusion Organization in plastic blood bags. Caspase-3 inhibitor (Z-DEVD-FMK) was added to the bags. These bags along with control bags to which no inhibitor was added were stored in a shaking incubator at 22℃ for 7 days. The effects of Z-DEVD-FMK on the functionality of platelets were analyzed by assessing their ability to bind to von Willebrand factor (vWF) and to aggregate in the presence of arachidonic acid and ristocetin. Cell survival was surveyed by MTT assay. Results At day 4 of storage, ristocetin-induced platelet aggregation was significantly higher in the inhibitor-treated (test) than in control samples; the difference was not significant at day 7. There was no significant difference in arachidonic acid-induced platelet aggregation between test and control samples. However, at day 7 of storage, the binding of platelets to vWF was significantly higher in test than in control samples. The MTT assay revealed significantly higher viability in test than in control samples at both days of study. Conclusion Treatment of platelets with caspase-3 inhibitor could increase their functionality and survival.
Collapse
Affiliation(s)
- Reza Shiri
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran. ; Ilam University of Medical Sciences, Ilam, Iran
| | - Fatemeh Yari
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Minoo Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Shahram Vaeli
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Mohammad Reza Tabatabaei
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| |
Collapse
|
24
|
Faranoush M, Abolghasemi H, Toogeh G, Karimi M, Eshghi P, Managhchi M, Hoorfar H, Dehdezi BK, Mehrvar A, Khoeiny B, Kamyar K, Heshmat R, Baghaeipour MR, Mirbehbahani NB, Fayazfar R, Ahmadinejad M, Naderi M. A Comparison Between Recombinant Activated Factor VII (Aryoseven) and Novoseven in Patients With Congenital Factor VII Deficiency. Clin Appl Thromb Hemost 2014; 21:724-8. [DOI: 10.1177/1076029614522545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In order to establish the efficacy and biosimilar nature of AryoSeven to NovoSeven in the treatment of congenital factor VII (FVII) deficiency, patients received either agent at 30 μg/kg, intravenously per week for 4 weeks, in a randomized fashion. The primary aim was to compare FVII:coagulation activity (FVII:C), 20 minutes after recombinant activated FVII (rFVIIa) injection, in the 2 groups. A secondary measure was self-reported bleeding. The median interquartile baseline range of the plasma level of activated FVII (FVIIa) activity in the 2 groups was 1.6 (1.1-14.0) IU/dL and 5.0 (1.1-25.5) IU/dL. All patients achieved levels of FVIIa (FVII:C) >30 IU/dL, 20 minutes after the injection of rFVIIa. Bleeding was similar between the 2 groups, with a comparable decrease in severity and frequency compared to the last month prior to treatment. AryoSeven is similar to NovoSeven in increasing postinjection FVIIa activity as well as in clinical safety and efficacy.
Collapse
Affiliation(s)
- M. Faranoush
- High Institute of Research, Iranian Blood Transfusion Organization, Iran University of Medical Sciences, Rasool Akram Hospital, Tehran, Iran
| | | | - Gh. Toogeh
- Tehran University of Medical Sciences, Thrombosis and Hemostasis Research Center, Tehran, Iran
| | - M. Karimi
- Shiraz University of Medical Sciences, Shiraz, Iran
| | - P. Eshghi
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M. Managhchi
- Tehran University of Medical Sciences, Thrombosis and Hemostasis Research Center, Tehran, Iran
| | - H. Hoorfar
- Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | | | - K. Kamyar
- Aryogen Zist Darou Company, Karaj, Iran
| | - R. Heshmat
- Tehran University of Medical Sciences, Thrombosis and Hemostasis Research Center, Tehran, Iran
| | | | | | - R. Fayazfar
- Kerman University of Medical Sciences, Kerman, Iran
| | | | - M. Naderi
- Zahedan University of Medical Sciences, Ahwaz, Iran
| |
Collapse
|
25
|
Hakeshzadeh F, Tabibi H, Ahmadinejad M, Malakoutian T, Hedayati M. Effects Of L-Carnitine Supplement On Plasma Coagulation And Anticoagulation Factors In Hemodialysis Patients. Kidney Res Clin Pract 2012. [DOI: 10.1016/j.krcp.2012.04.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
26
|
Sadr SM, Ahmadinejad M, Saedi B, Razaghian F, Rafiee M. Anatomical variations in sinus imaging in sinusitis: a case control study. B-ENT 2012; 8:185-189. [PMID: 23113381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE To compare anatomical variations in sinusitis patients and control subjects. SUBJECTS AND METHODS We reviewed and compared the computed tomography (CT) scans of 87 sinusitis patients after adequate medical treatment and scans of 103 healthy subjects. All images were scored for sinusitis severity using the Lund-Mackay scoring system. Anatomical variations such as septal deviation, concha bullosa, presence of the Haller's cell, paradoxical middle turbinate, prominent agger nasi cell, and Onodi cell were also recorded. RESULTS Of the 190 evaluated CT images, 55.2% of the cases and 47.6% of the controls had septal deviation (p > 0.05). The prevalence of concha bullosa was 68% in patients and 61% in controls (p > 0.05). CONCLUSION There were no significant differences in the evaluated anatomical variations between cases and controls in this study. Mucosal inflammation may play a more essential role than anatomical variation in the development of sinusitis.
Collapse
Affiliation(s)
- S M Sadr
- Otolaryngology Research Center, Tehran University of Medical Sciences
| | | | | | | | | |
Collapse
|
27
|
Vahabi S, Heidari M, Ahmadinejad M, Akhlaghi J, Birjandi M. Comparison of local anesthetic effects of tramadol and lidocaine used subcutaneously in minor surgeries with local anesthesia. Middle East J Anaesthesiol 2011; 21:9-14. [PMID: 21991727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES In this study, the local anesthetic and post-operative analgesic effects of tramadol were compared to those of lidocaine in minor surgeries under local anesthesia. METHODS This double-blind clinical trial study included 70 patients in ASA physical status I and II, aging between 20 and 50 years, undergoing minor surgery (lipoma excision and revision of scars less than 4 cm within 30 minutes or less) under local anesthesia. The patients were randomly assigned to receive either 2 mg/kg tramadol (group T, n = 35) or 1 mg/kg lidocaine 2% (group L, n = 35) subcutaneously. Scores of the pain sensation were recorded as VAS (visual analogue scale 0-10) during injection, incision and 15, 30 and 45 minutes after incision, and then 2, 4 and 6 hours post-operatively at the ward. RESULTS There was no significant difference between pain scores of the two groups during injection, incision and surgery or in the post-operative period at the ward (p = 0.181). Incidence of nausea was 0% and 22.8% in group L and group T, respectively. The difference was statistically significant (p = 0.002). Furthermore, 82.9% of subjects in group L and 60% of subjects in group T needed acetaminophen to control their pain and the difference was significant (p = 0.004). CONCLUSION Tramadol 2 mg/kg has local anesthetic and post-operative analgesic effect equal to lidocaine 1 mg/kg in minor surgeries performed subcutaneously. Therefore, we concluded that tramadol can be used as an alternative drug to lidocaine in local anesthesia and has the ability to decrease the demand for post operative analgesics.
Collapse
Affiliation(s)
- S Vahabi
- Anesthesiology Department, Faculty of Medicine, Lorestan University of Medical Sciences, Pardis Educational Institute, Kamalvand Street, Khorram Abad, P.O. Box 13185-1678, Tehran, Iran.
| | | | | | | | | |
Collapse
|
28
|
Hakeshzadeh F, Tabibi H, Ahmadinejad M, Malakoutian T, Hedayati M. Effects ofL-Carnitine supplement on plasma coagulation and anticoagulation factors in hemodialysis patients. Ren Fail 2010; 32:1109-14. [DOI: 10.3109/0886022x.2010.510617] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
29
|
Imani H, Tabibi H, Atabak S, Rahmani L, Ahmadinejad M, Hedayati M. Effects of soy consumption on oxidative stress, blood homocysteine, coagulation factors, and phosphorus in peritoneal dialysis patients. J Ren Nutr 2009; 19:389-95. [PMID: 19577483 DOI: 10.1053/j.jrn.2009.01.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE We studied the effects of soy consumption on oxidative stress, blood homocysteine, coagulation factors, and phosphorus in peritoneal dialysis patients. DESIGN This was an unblinded, randomized clinical trial. SETTING This study involved peritoneal dialysis centers in Tehran, Iran. PATIENTS We included 40 peritoneal dialysis patients (20 males and 20 females). INTERVENTION Peritoneal dialysis patients were randomly assigned to either a soy or control group. Patients in the soy group received 28 g/day textured soy flour (containing 14 g of soy protein) for 8 weeks, whereas patients in the control group received their usual diet, without any soy. MAIN OUTCOME MEASURES Blood oxidized low-density lipoprotein (ox-LDL), homocysteine, phosphorus, fibrinogen concentrations, and the activities of coagulation factors VII, IX, and X were measured at baseline and at the end of week 8 of the study. RESULTS The percentage of plasma coagulation factor IX activity decreased significantly by 17% in the soy group at the end of week 8 compared with baseline (P < .01), and the reduction was significant compared with the control group (P < .05). There were no significant differences between the two groups in mean changes of blood ox-LDL, homocysteine, phosphorus, fibrinogen concentrations, and the activities of coagulation factors VII and X. CONCLUSION Soy consumption reduces plasma coagulation factor IX activity, which is a risk factor for thrombosis in peritoneal dialysis patients.
Collapse
Affiliation(s)
- H Imani
- Department of Human Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shaheed Beheshti University of Medical Sciences and Health Services, Tehran, Islamic Republic of Iran
| | | | | | | | | | | |
Collapse
|
30
|
Tabatabaei S, Azarkeyvan A, Ahmadinejad M, Tavasoli F, Sajadi S, Far MJ. HIGH PREVALENCE OF ELEVATED FACTOR VIII IN IRANIAN PATIENT WITH IDIOPATHIC VENOUS THROMBOEMBOLISM. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb03024.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
31
|
Ahmadinejad M, Snyder JW, Perlin MH. A combined molecular approach to screen for mec gene variants from methicillin-resistant Staphylococcus aureus. Diagn Microbiol Infect Dis 1998; 30:17-20. [PMID: 9488825 DOI: 10.1016/s0732-8893(97)00165-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Previous reports have suggested a common origin for all methicillin resistance (mec) genes from methicillin-resistant Staphylococcus aureus (MRSA) isolates examined so far. The purpose of this study was to explore several molecular methods for screening MRSA isolates from different sources and, in some cases, with varying phenotypes. Eighty MRSA isolates from three teaching hospitals in the University of Louisville Medical Center were compared with MRSAs from a hospital in southern California and with methicillin-sensitive S. aureus isolates. The methods were used to detect the presence of mec gene and to screen for any polymorphisms in these genes for the respective strains. The mec gene for each isolate was amplified via the polymerase chain reaction, and each polymerase chain reaction product was compared to the others by restriction enzyme digestion, denaturing-gradient gel electrophoresis, and mutation detection enhancement. By these criteria, the mec genes from the 80 MRSA strains in this study seemed to be identical. Such a finding was not unexpected and supported the existing hypothesis of a common ancestor for all mec genes isolated in MRSA isolates. However, the combination of methods used in this study may facilitate screening of MRSA strains in population studies as mec gene variants begin to emerge.
Collapse
Affiliation(s)
- M Ahmadinejad
- Department of Pathology, University of Louisville Hospital, Kentucky 40292, USA
| | | | | |
Collapse
|
32
|
Abstract
OBJECTIVE To test the possible inhibitory effect of allopurinol on reperfusion injury, caused by oxygen-derived free radicals, of sheep large intestine. DESIGN An ultrastructural study on caecal tissues from control and treated groups. ANIMALS Fifty sheep in four ischaemic and reperfused (treatment) groups and one control group. Three of the treatment groups were subdivided for half to be injected with allopurinol and the other half with its solvent, potassium hydroxide (KOH). PROCEDURE Ischaemia of the caecum was induced in the four treatment groups for 60 minutes by clamping the apex. Allopurinol and its KOH solvent were injected intravenously in three treatment groups prior to ischaemia. Samples were collected before and 1 hour after induction of ischaemia and 1 min, 1 h and 8 h after reperfusion. Tissues were processed and examined with an electron microscope. RESULTS Untreated and solvent injected sheep showed minor ultrastructural changes following ischaemia. With reperfusion, there was severe mitochondrial, goblet cell and basement membrane damage. Tissues from allopurinol-treated sheep were preserved and appeared similar to tissues from the control group. CONCLUSION Pre-treatment with allopurinol prevented damage to tissues whereas untreated or allopurinol solvent-treated showed severe damage following reperfusion. It is believed that allopurinol, an analogue of hypoxanthine and xanthine, prevents reperfusion injury by competitively binding with xanthine oxidase. This reduces or inhibits the xanthine oxidase mediated conversion of hypoxanthine to xanthine thereby preventing the formation of oxygen-derived free radicals.
Collapse
Affiliation(s)
- M Ahmadinejad
- Department of Companion Animal Medicine and Surgery, University of Queensland
| | | | | | | | | |
Collapse
|
33
|
May K, Eghbal B, Ahmadinejad M, Ensslin HD, Weiss M. Evaluation of effectiveness and tolerability of isosorbide mononitrate during a three-year period in patients with angina pectoris. Cardiology 1991; 79 Suppl 2:46-50. [PMID: 1760829 DOI: 10.1159/000174924] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The antianginal effect and tolerability of isosorbide mononitrate (ISMN), 20 mg 2-3 times daily, orally were investigated in an open study in 28 patients, suffering from coronary heart disease and stable angina pectoris. Ergometric exercise tests were carried out before treatment and 2 h after drug intake, every 3 months during the first year and at 6-month intervals during the following 2 years. At the conclusion of the 3-year study the reduction of ST-segment depression, which had amounted to 58% after 1 year, could be improved to 78% (p less than 0.01). The frequency of angina was markedly reduced during the treatment with ISMN. While 14 of the patients had more than 3 episodes per day prior to the study, 16 patients were symptom-free at the end of the three years' therapy, and none of the patients had more than 1 or 2 attacks per day. The consumption of sublingual nitroglycerin diminished by 94% after one year and by 98% after 3 years of therapy (p less than 0.01). Headache was the only adverse effect observed in some of the patients (at the initiation of the treatment only). In conclusion this study demonstrated (1) the good tolerability of ISMN, at the doses used, and (2) the fact that the antianginal efficacy may be enhanced during the course of the therapy.
Collapse
Affiliation(s)
- K May
- International Medical Affairs, Schwarz Pharma AG, Monheim, FRG
| | | | | | | | | |
Collapse
|
34
|
Ahmadinejad M, Eghbal B, Sorgenicht W, Schneeweiss A, Weiss M. Slow-release isosorbide-5-mononitrate--a new once daily therapeutic modality for angina pectoris. Eur Heart J 1988; 9 Suppl A:135-9. [PMID: 3137063 DOI: 10.1093/eurheartj/9.suppl_a.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The acute and chronic efficacy of slow-release isosorbide-5-mononitrate (IS-5-MN) in the form of Elantan long capsules (50 mg) and the tolerability to this agent were evaluated in an open study of 45 patients with chronic stable angina pectoris, treated for one year. After 3 days of replacement of previous antianginal treatment with placebo, an Elantan long capsule (50 mg) was given once daily in the morning. Exercise test was performed 6 hours after ingestion of the capsule, on placebo (after wash-out of 3 days), in the first day of treatment, and after 3 and 6 months of treatment as well as 6 and 24 hours after 12 months of treatment compared to the exercise test at the same time after discontinuation of treatment (three days on placebo). At comparable work load the drug was associated with a 26.6% reduction in ST-segment depression after 6 hours of acute treatment, 46.7% after 3 months of treatment, 52.2% after 6 months, and 66% at the end of treatment (12 months) (P less than 0.001). Even 24 hours after intake of the last capsule of Elantan long the ST-segment reduction was still 49.5%. Exercise test 24 hours after ingestion of the drug revealed that the effect still exists. In the post-treatment placebo period all values returned to pretreatment levels. The sublingual nitroglycerin consumption was reduced by 90% and the frequency of anginal attacks was reduced from 19 +/- 15 to 1.1 +/- 4.2 weekly (P less than 0.001). The drug was well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- M Ahmadinejad
- Research Foundation for Geriatric Cardiology, Tel Aviv, Israel
| | | | | | | | | |
Collapse
|