Publications by authors named "Hamed Fouladseresht"

8 Publications

  • Page 1 of 1

The Neutrophil-to-Lymphocyte Ratio at the Time of Admission: A New Prognostic Indicator for Hospital Mortality of Trauma Patients.

Iran J Allergy Asthma Immunol 2021 Jan 30;20(1):33-45. Epub 2021 Jan 30.

Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

The elevated neutrophil-to-lymphocyte ratio (NLR) is associated with poor clinical outcomes, especially in pro-inflammatory states such as surgical injuries and severe hemorrhages. Therefore, it was hypothesized whether NLR value at the time of admission could be a prognostic indicator of hospital mortality in trauma patients. This retrospective cohort study was conducted on 865 trauma patients referred to Rajaee Hospital between April 2016 and July 2019. The NLR value was calculated at the time of admission, and receiver operating characteristics (ROC) curve analysis was used to determine the cut-off point value of admission NLR related to hospital mortality of trauma patients. Furthermore, Kaplan-Meier survival analysis and Cox regression models have been applied to determine the effectiveness and prognostic potential of the admission NLR in the hospital mortality of trauma patients. The median age of the trauma patients was 32 years with an interquartile range (IQR) of 23 to 48 years, and most of them were male (83.9%). Also, trauma patients had a median injury severity score (ISS) of 9 (IQR=4-16) and a median Glasgow coma scale (GCS) of 14 (IQR=9-15). The cut-off value for admission NLR was 5.27 (area under the curve: 0.642, 95%CI: 0.559-0.726, p=0.001). In Kaplan-Meier survival analysis, the admission NLR>5.27 was an indicator of hospital mortality in trauma patients (p=0.001). Multivariate Cox regression models demonstrated that trauma patients with an admission NLR>5.27 had a 2.33-fold risk of hospital mortality (hazard ratio=2.33, 95%CI: 1.02-5.38, p=0.041). Furthermore, the admission NLR>5.27 was associated with a higher risk of hospital mortality in trauma patients with age≥65 years, systolic blood pressure≤90 mmHg, blood potassium>4.5 mmol/L, blood sodium>144 mEq/L, blood potential hydrogen (pH)≤7.28, GCS≤8, ISS>24 and blood base excess≤-6.1 mEq/L. The NLR value greater than 5.27 at the time of admission was associated with poorer outcomes, and it can be considered an independent prognostic indicator of hospital mortality in trauma patients.
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http://dx.doi.org/10.18502/ijaai.v20i1.5411DOI Listing
January 2021

Predictive monitoring and therapeutic immune biomarkers in the management of clinical complications of COVID-19.

Cytokine Growth Factor Rev 2021 04 9;58:32-48. Epub 2020 Oct 9.

Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

The coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), appears with a wide spectrum of mild-to-critical clinical complications. Many clinical and experimental findings suggest the role of inflammatory mechanisms in the immunopathology of COVID-19. Hence, cellular and molecular mediators of the immune system can be potential targets for predicting, monitoring, and treating the progressive complications of COVID-19. In this review, we assess the latest cellular and molecular data on the immunopathology of COVID-19 according to the pathological evidence (e.g., mucus and surfactants), dysregulations of pro- and anti-inflammatory mediators (e.g., cytokines and chemokines), and impairments of innate and acquired immune system functions (e.g., mononuclear cells, neutrophils and antibodies). Furthermore, we determine the significance of immune biomarkers for predicting, monitoring, and treating the progressive complications of COVID-19. We also discuss the clinical importance of recent immune biomarkers in COVID-19, and at the end of each section, recent clinical trials in immune biomarkers for COVID-19 are mentioned.
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http://dx.doi.org/10.1016/j.cytogfr.2020.10.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544568PMC
April 2021

T Cell Proliferative Responses and IgG Antibodies to β2GPI in Patients with Diabetes and Atherosclerosis.

Endocr Metab Immune Disord Drug Targets 2021 ;21(3):495-503

Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Diabetes increases the risk of myocardial infarction (MI) by 2 to 3 folds. Tlymphocytes play a role in atherosclerosis, which is the main pathology behind MI. Cellular immune responses to beta-2 glycoprotein I (β2GPI) are shown in carotid atherosclerosis.

Objective: To investigate the self-reactive, β2GPI-specific T-lymphocytes in patients with and without diabetes and atherosclerosis.

Methods: Collectively, 164 subjects with and without diabetes that underwent coronary angiography were divided into four groups based on their diabetes status and coronary stenosis. Group I=Diabetic with ≥50% stenosis: A+D+ (n=66); Group II=Non-diabetic with ≥50% stenosis, A+D- (n=39); Group III=Diabetic with <50% stenosis: A-D+ (n=28); and Group IV=Non-diabetic with <50% stenosis: AD- (n=31). All groups were evaluated for anti-β2GPI IgG antibody by ELISA method. Then, PBMCs were isolated from 18 subjects and were stimulated with β2GPI-derived peptides to assess their proliferation in accordance with their HLA-DRB1 alleles.

Results: Mean β2GPI IgG levels were higher in groups with ≥50% stenosis (A+) compared to those with <50% stenosis (A-), (P=0.02). The co-presence of diabetes in A+ individuals increased mean β2GPI-specific IgG. Auto-reactive β2GPI-specific T cells were detected in the repertoire of T-lymphocytes in all groups. β2GPI-peptides showed promiscuous restriction by various HLADRB1.

Conclusion: β2GPI is the target of cellular and humoral immune responses in patients with atherosclerosis. Since the T cell responses but not antibodies were detectable in A-D+ and A-D- groups, it is reasonable to assume that cellular responses preceded the humoral responses. Post-translation modifications of β2GPI under oxidative and glycemic stresses may have increased the IgG levels in patients with diabetes. Finally, identification of antigens that trigger immuno-pathogenesis in atherosclerosis and diabetes may help the development of immunomodulation methods to prevent or treat these debilitating diseases.
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http://dx.doi.org/10.2174/1871530320666200505115850DOI Listing
January 2021

Anti-varicella Zoster Virus IgG and hsCRP Levels Correlate with Progression of Coronary Artery Atherosclerosis.

Iran J Allergy Asthma Immunol 2019 Oct 23;18(5):543-553. Epub 2019 Oct 23.

Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

The relationship between high levels of anti-Varicella Zoster Virus (VZV) IgG in cerebrospinal fluid (CSF) and cerebrovascular atherosclerosis commends a possible similar association in other vessels. We aimed to investigate the association of VZV-seropositivity with coronary artery atherosclerosis. We recruited 88 newly diagnosed patients with more than 50% stenosis in at least one of the main coronary arteries. As the control group, 99 age-matched individuals with normal/insignificant coronary artery findings were included. Clinical, paraclinical, and demographical data were gathered at the time of sampling. High-sensitivity C-reactive protein (hsCRP) levels were measured by nephelometry. VZV-seropositivity was determined by measuring of anti-VZV IgG level in plasma. Multivariable logistic regression was used to evaluate the correlation of data with coronary vascular atherosclerosis. The frequency of VZV-seropositivity was significantly higher in the atherosclerosis group compared to the controls (OR=1.88; 95%CI=1.03-3.44). The plasma levels of anti-VZV IgG were significantly higher in patients with atherosclerosis (Median=2.70, IQR=1.53-4.30 AU/mL) than in the controls (Median=2.10, IQR=1.70-3.10 AU/mL, p=0.034). The hsCRP levels in patients and controls were 5.19±2.00 and 1.51±1.07 mg/L, respectively. The correlation between hsCRP and anti-VZV IgG level in plasma was observed (r=0.40, p<0.001). The levels of hsCRP and anti-VZV IgG increased based on the number of diseased vessels but only the difference in hsCRP levels reached a significant level (p<0.001 and p=0.168, respectively). Our data suggest that VZV-seropositivity and hsCRP elevation jointly increase the risk of atherosclerosis. The multifactorial nature of atherosclerosis; however, leaves more options for the inflammatory milieu to be generated.
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http://dx.doi.org/10.18502/ijaai.v18i5.1924DOI Listing
October 2019

Immune-Inflammation in Atherosclerosis: A New Twist in an Old Tale.

Endocr Metab Immune Disord Drug Targets 2020 ;20(4):525-545

Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background And Objective: Atherosclerosis, a chronic and progressive inflammatory disease, is triggered by the activation of endothelial cells followed by infiltration of innate and adaptive immune cells including monocytes and T cells in arterial walls. Major populations of T cells found in human atherosclerotic lesions are antigen-specific activated CD4+ effectors and/or memory T cells from Th1, Th17, Th2 and Treg subsets. In this review, we will discuss the significance of T cell orchestrated immune inflammation in the development and progression of atherosclerosis.

Discussion: Pathogen/oxidative stress/lipid induced primary endothelial wound cannot develop to a full-blown atherosclerotic lesion in the absence of chronically induced inflammation. While the primary inflammatory response might be viewed as a lone innate response, the persistence of such a profound response over time must be (and is) associated with diverse local and systemic T cell responses. The interplay between T cells and innate cells contributes to a phenomenon called immuneinflammation and has an impact on the progression and outcome of the lesion. In recent years immuneinflammation, an old term, has had a comeback in connecting the puzzle pieces of chronic inflammatory diseases.

Conclusion: Taking one-step back and looking from afar at the players of immune-inflammation may help us provide a broader perspective of these complicated interactions. This may lead to the identification of new drug targets and the development of new therapies as well as preventative measures.
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http://dx.doi.org/10.2174/1871530319666191016095725DOI Listing
March 2021

Increased frequency of HLA-A*02 in patients with atherosclerosis is associated with VZV seropositivity.

Arch Physiol Biochem 2019 Jul 15:1-8. Epub 2019 Jul 15.

a Department of Immunology, School of Medicine , Shiraz University of Medical Sciences , Shiraz , Iran.

HLA molecules are inherited key molecules in the immune inflammation and specific responses to environmental pathogens. We investigated the association of HLA-A alleles with virus (VZV) seropositivity in patients with atherosclerosis (AS). Plasma Anti-VZV IgG and molecular HLA type were detected in 203 (100 AS and 103 AS) individuals. Of 100 AS individuals, 66 were anti-VZV and 34 were anti-VZV. Of 103 age/sex-matched AS individuals, 59 were anti-VZV and 44 were anti-VZV. Anti-VZV-IgG in AS cases was higher than AS controls ( = .034). The mean anti-VZV IgG in HLA-A*02AS individuals was higher than HLA-A*02AS controls ( < .001). HLA-A*02 was associated with VZV-seropositivity ( = .01) in AS patients. A higher frequency of HLA-A*02-allele in AS patients compared to AS controls ( = .015) and an accumulation of HLA-A*02-allele in AS anti-VZV group (33.3%,  = .004) was observed. HLA-A alleles and immune responses to VZV are associated with clinical atherosclerosis.
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http://dx.doi.org/10.1080/13813455.2019.1640253DOI Listing
July 2019

Association of ABCA1 Haplotypes with Coronary Artery Disease.

Lab Med 2020 Mar;51(2):157-168

Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Adenosine triphosphate (ATP)-binding-cassette-transporter-A1 (ABCA1) transports cholesterol from cells into apolipoprotein A1 to form high-density lipoprotein (HDL) cholesterol.

Methods: We investigated the frequencies of ABCA1 functional variants in 273 patients with coronary artery disease (CAD) and 261 age-matched, healthy blood donors in southwest Iran. Sequence-specific primer polymerase-chain reaction (SSP-PCR) and polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) were used for genotyping.

Results: Frequencies of the rs2422493-TT genotype and T-allele, rs1800976-GG genotype, and G-allele in the promoter and rs2230806-GG genotype and G allele in the exon of the ABCA1 gene were higher in the patients. Abnormal left ventricular size and left-artery disease correlated with rs2422493-T and rs1800976-G alleles, respectively. Wall-motion abnormalities correlated with the rs1883025-G allele and rs2230806-A allele. Regarding the rs2422493/rs1800976/rs2230806/rs1883025 haplotype, T-G-G-A and T-G-A-A were more frequent in case individuals, whereas C-C-G-G was more frequent in control individuals.

Conclusions: The rs2422493-T allele and the rs1800976-G allele increase the risk of disease, as single polymorphisms and in the haplotype. The effect of the rs1883025-G allele is prominent in the haplotype, rather than individually. Considering that G allele of rs2230806 in the third place is present in both susceptible and protective haplotypes, the susceptibility haplotype can be defined as T-G-X-A.
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http://dx.doi.org/10.1093/labmed/lmz031DOI Listing
March 2020

Serum Levels of APRIL Increase in Patients with Glioma, Meningioma and Schwannoma

Asian Pac J Cancer Prev 2019 Mar 26;20(3):751-756. Epub 2019 Mar 26.

Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Email:

Objective: Brain tumors are of high mortality and morbidity for which there is still no cure. The TNF family cytokine, A Proliferation Inducing Ligand (APRIL), is shown to help proliferation and development of tumor cells. We assessed serum levels of APRIL in patients with glioma, meningioma and schwannoma in comparison to healthy individuals. Methods: Peripheral blood samples of 68 patients with brain tumors, divided into three groups of gliomas (n=25), meningiomas (n=30) and schwannomas (n=13), as well as 45 healthy individuals were obtained. Serum samples were prepared and stored in -40°C until usage. Using a commercial ELISA method, APRIL concentration was measured in each serum sample. The obtained data were then analyzed using SPSS software. Results: APRIL serum levels were higher in all patients compared to the controls (P<0.001). Moreover, APRIL serum levels were higher in each of the tumor bearing groups (gliomas, meningiomas and schwannomas) in comparison to the controls (P<0.001, <0.001 and =0.001, respectively). Comparing APRIL between the patients groups showed no significant difference. Age and gender showed no significant correlation with serum APRIL levels, although the age of patients in glioma group was significantly lower than controls (P=0.017). The serum APRIL levels in gliomas with histological grade showed no difference, but in meningiomas, it was lower in tumors with higher grades (P= 0.011). Conclusion: Increased serum levels of APRIL in patients with meningioma and schwannoma as well as glioma may indicate a common role of this cytokine in brain tumors.
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http://dx.doi.org/10.31557/APJCP.2019.20.3.751DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825795PMC
March 2019