Publications by authors named "Neda Khalili"

28 Publications

  • Page 1 of 1

Current and Future Perspectives of PD-1/PDL-1 Blockade in Cancer Immunotherapy.

J Immunol Res 2021 22;2021:6661406. Epub 2021 Feb 22.

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

Cancer immunotherapy, which reactivates weakened immune cells of cancer patients, has yielded great success in recent years. Among immunotherapeutic agents, immune checkpoint inhibitors have been of particular interest and have gained approval by the FDA for treatment of cancers. Immune checkpoint blockade through targeting programmed cell death protein-1 (PD-1) has demonstrated promising antitumor effects in cancer immunotherapy of many different solid and hematologic malignancies. However, despite promising results, a favorable response is observed only in a fraction of patients, and there is still lack of a single therapy modality with curative ability. In this paper, we review the current and future perspectives of PD-1/L1 blockade in cancer immunotherapy, with a particular focus on predictive biomarkers of response to therapy. We also discuss the adverse events associated with PD-1/L1/2 inhibitors, ranging from severe life-threatening conditions such as autoimmune myocarditis to mild and moderate reactions such as skin rashes, and explore the potential strategies for improving the efficacy of immunotherapy with PD-1/L1 checkpoint inhibitors.
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http://dx.doi.org/10.1155/2021/6661406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925068PMC
February 2021

Association of PTPN22 single nucleotide polymorphisms with chronic spontaneous urticaria.

Allergol Immunopathol (Madr) 2021 1;49(2):40-45. Epub 2021 Mar 1.

Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Introduction And Objectives: Chronic spontaneous urticaria (CSU) is thought to be an autoimmune disease in a subpopulation of patients. Protein tyrosine phosphatase-22 (PTPN22) polymorphisms are considered to be one of the strongest contributing factors to autoimmune diseases. In this study, we aimed to investigate the potential association of several PTPN22 single nucleotide polymorphisms (SNPs) with CSU in an Iranian population.

Material And Methods: A total of 93 CSU patients and 100 healthy individuals were included in this study. Five SNPs within the PTPN22 gene were analyzed using TaqMan genotyping assays. The frequency of alleles, genotypes, and haplotypes of PTPN22 SNPs (rs12760457, rs2476601, rs1310182, rs1217414, and rs33996649) was investigated.

Results: A significantly higher prevalence of the rs1310182 T allele was observed among patients compared with controls [OR = 1.75 (95% CI: 1.17-2.63); P = 0.007]. In addition, the rs1310182 CC genotype and TT genotype were 0.47 and 2.06 times more common in patients, respectively (P = 0.03). Moreover, haplotype analysis demonstrated that CGCGC, CGTGC, and TGCGC (P < 0.001) were significantly associated with CSU. No significant differences were observed between the patients and controls in the other analyzed PTPN22 SNPs.

Conclusions: Polymorphisms of the PTPN22 gene are associated with an increased susceptibility to CSU in the studied Iranian population.
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http://dx.doi.org/10.15586/aei.v49i2.53DOI Listing
March 2021

Pelvic Pain and Adnexal Mass: Be Aware of Accessory and Cavitated Uterine Mass.

Case Rep Med 2021 11;2021:6649663. Epub 2021 Feb 11.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Accessory and cavitated uterine mass (ACUM) is a rare form of Mullerian anomaly that usually presents in young females with chronic cyclic pelvic pain and/or dysmenorrhea. This clinical entity is often underdiagnosed as it may be mistaken for other differential diagnoses, such as pedunculated myoma or adnexal lesions. Imaging modalities, including ultrasonography and magnetic resonance imaging (MRI), accompanied with relevant and suspicious clinical findings are important tools in making acorrect diagnosis. To date, surgical excision of the mass remains the mainstay of treatment,which provides significant symptom relief. In this study, we present a female adolescent with chronic pelvic pain since menarche who underwent laparotomy with the presumed diagnosis of a left-sided ovarian mass. Retrospective evaluation of pelvic MR images demonstrated that the lesion was in fact an ACUM, which was further confirmed by histopathological examination.
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http://dx.doi.org/10.1155/2021/6649663DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892247PMC
February 2021

Prevalence, Risk Factors and Outcomes Associated with Acute Kidney Injury in Patients Hospitalized for COVID-19: A Comparative Study between Diabetic and Nondiabetic Patients.

J Diabetes Res 2021 6;2021:6666086. Epub 2021 Jan 6.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Background: The risk factors for acute kidney injury (AKI) development in patients with diabetes hospitalized for COVID-19 have not been fully studied yet. In this study, we aimed to estimate the rate of AKI among the hospitalized population with COVID-19 and to identify the risk factors associated with AKI among patients with diabetes. This retrospective cohort study included 254 patients (127 with diabetes and 127 without diabetes) who were admitted for COVID-19 to a tertiary hospital in Tehran, Iran, between February and May 2020. Clinical characteristics and outcomes, radiological findings, and laboratory data, including data on AKI, hematuria, and proteinuria were recorded and analyzed.

Results: Of 254 patients, 142 (55.9%) were male and the mean (± SD) age was 65.7 years (±12.5). In total, 58 patients (22.8%) developed AKI during hospitalization, of whom 36 patients had diabetes ( = 0.04); most patients (74.1%) had stage 1 or 2 AKI. Also, 8 patients (13.8%) required renal replacement therapy (RRT) after developing AKI. Regardless of diabetes status, patients who developed AKI had significantly higher mortality rates compared with patients who did not develop AKI ( = 0.02). Hematuria and proteinuria were observed in 38.1% and 55% of patients, respectively. Multivariate analysis showed that invasive mechanical ventilation, proteinuria, HBA1c level, history of cardiovascular disease, and use of statins were independent risk factors for AKI development in patients with diabetes.

Conclusion: Results of this study showed that AKI develops in a considerable percentage of patients with COVID-19, especially in those with diabetes, and is significantly associated with mortality.
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http://dx.doi.org/10.1155/2021/6666086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808817PMC
February 2021

Implementation of an algorithm for chest imaging in blunt trauma decreases use of CT-scan: Resource management in a middle-income country.

Injury 2021 Feb 6;52(2):219-224. Epub 2021 Jan 6.

Associate Professor, Surgery Department, Ravandi Street, Shahid-Beheshti Hospital, Kashan, Iran. Electronic address:

Purpose: Due to the low sensitivity of chest radiography, chest CT-scan is usually recommended for the evaluation of high-risk blunt trauma patients. Considering the radiation exposure and costs accompanying routine CT-scan, the aim of this study was to design and implement an evidence-based institutional algorithm for selective chest imaging in high energy blunt trauma patients and evaluate its effect on patient outcome and resource utilization.

Methods: For this field trial, an institutional evidence-based algorithm for chest trauma imaging was designed according to existing data and expert panel. After final consent and ethic committee approval, the algorithm was integrated in the diagnostic flow sheet in the emergency department and patient data were collected from the pre- and post-implementation period.

Results: One-hundred and sixty-five patients before algorithm implementation and 158 patients after that were included. Chest CT-scan was requested for 93% of patients in the pre-implementation group and for 73% in the post-implementation group (P<0.001). Length of stay in hospital was slightly shorter in the post-implementation group (p = 0.036), however, duration of stay in emergency room and ICU, pulmonary complications and mortality showed no significant difference.

Conclusion: Implementation of an algorithm for limiting chest CT-scan to a subgroup of patients with a higher risk of chest injuries can reduce radiation exposure and more useful distribution of resources without harming the patients. Each institution should use institutional guidelines and algorithms with respect to patient load, available resources and desired sensitivity for injury detection.
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http://dx.doi.org/10.1016/j.injury.2020.12.040DOI Listing
February 2021

BCGitis as the primary manifestation of chronic granulomatous disease.

IDCases 2021 29;23:e01038. Epub 2020 Dec 29.

Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Patients with primary immunodeficiency disease (PID) are not only vulnerable to mycobacterial disease, but are also more likely to develop adverse events following BCG vaccination. These events can range from regional disease (BCGitis) to disseminated disease (BCGosis). Chronic granulomatous disease (CGD), which is characterized by impaired leukocyte phagocytic function, is one of the many inherited PIDs that increase the body's susceptibility to recurrent bacterial and fungal infections. Here, we report a 6-year-old boy with no significant past medical history who presented with progressive lymphadenopathy six years after BCG vaccination. He was later diagnosed with CGD on further evaluation.
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http://dx.doi.org/10.1016/j.idcr.2020.e01038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7785948PMC
December 2020

Pulmonary embolism and COVID-19 pneumonia: the role of non-enhanced chest computed tomography.

Rev Cardiovasc Med 2020 12;21(4):493-495

School of Medicine, Tehran University of Medical Sciences, 14155-6559, Tehran, Iran.

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http://dx.doi.org/10.31083/j.rcm.2020.04.246DOI Listing
December 2020

Transient FDG-avid hilar lymph node on PET/CT imaging in asymptomatic COVID-19.

IDCases 2020 6;22:e00981. Epub 2020 Nov 6.

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

The most common features of coronavirus disease-2019 (COVID-19) pneumonia on chest computed tomography imaging are ground glass opacity and consolidation. Mediastinal and hilar lymph node enlargement are less frequently observed. Herein, we present an unexpected finding of fluorodeoxyglucose (FDG)-avid hilar lymph node in an asymptomatic patient with COVID-19, and show that this is a transient phenomenon, subsiding on a follow-up FDG-PET/CT within 10 days.
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http://dx.doi.org/10.1016/j.idcr.2020.e00981DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7644432PMC
November 2020

Circulating glucagon-like peptide-1 level in patients with liver cirrhosis.

Arch Physiol Biochem 2020 Oct 12:1-6. Epub 2020 Oct 12.

Center for Mitochondrial and Epigenomic Medicine, Children's Hospital of Philadelphia, Philadelphia, USA.

Background: Glucagon-like peptide-1 (GLP-1), a gut-derived incretin hormone, plays a pivotal role in glucose-induced insulin secretion. Currently, the role of incretin hormones in the pathogenesis of cirrhosis is not clearly defined. This study aimed to investigate circulating levels of GLP-1 in liver cirrhosis and its association with the severity of liver disease.

Methods: A total of 80 participants including 39 patients with a definite diagnosis of liver cirrhosis and 41 healthy controls recruited in this cross-sectional study. Circulating levels of GLP-1 were determined using the ELISA method. The severity of liver cirrhosis was assessed according to the Child-Pugh, MELD (i), MELD-Na, MELD New, and UK end-stage liver disease score (UKELD) criteria.

Results: The mean age of patients and healthy subjects was 42.51 ± 12.80 and 42.07 ± 10.92 years, respectively ( value = .869). The mean MELD (i), MELD-Na, MELD New, UKELD, and Child-Pugh scores were 14.36 ± 4.26, 15.26 ± 4.81, 14.74 ± 4.66, 52.33 ± 3.82, and 7.28 ± 1.50, respectively. In this study, circulating levels of GLP-1 were statistically lower in cirrhotic patients compared with healthy controls (95.26 ± 17.15 vs 111.84 ± 38.14 pg/mL; value = .017).

Conclusion: Larger prospective studies are needed to explore the incretin effect in cirrhosis patients compared with healthy individuals.
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http://dx.doi.org/10.1080/13813455.2020.1828479DOI Listing
October 2020

Incidence patterns of gynecological sarcomas in Iran analysis of National Cancer Registry data between 2009 and 2014.

J Obstet Gynaecol Res 2020 Oct 7. Epub 2020 Oct 7.

Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Aim: Gynecological sarcomas (GS) are rare malignant tumors arising in the female genital organs. Due to the low incidence and diverse histology, information on the epidemiology of these tumors is sparse. We aimed to investigate the incidence rates of GS in Iran that in our knowledge is the first report from Eastern Mediterranean Region.

Methods: In this retrospective study, all malignant tumors with a sarcoma morphology arising in the female genital organs diagnosed between 2009 and 2014 were extracted from the Iran National Cancer Registry dataset. All the cancer cases were categorized according to ICD-O-3 morphologic and topographic codes. Age-standardized incidence rates, age-specific incidence rates, morphologic and geographic distribution of all cases were analyzed and compared with other parts of the world.

Results: A total of 1174 cases were diagnosed over the period 2009-2014. The overall age-standardized incidence rate for all sites combined was 6.13 per million females. Analysis of trends in incidence did not show a significant change over time according to annual average percent change analysis (P-value = 0.300). The most common anatomical site was the uterus, accounting for 77% of all cases. The mean (±SD) age at diagnosis, irrespective of tumor site, was 52.3 (±15) years. In terms of morphology, leiomyosarcoma was the most frequently observed subtype, constituting 34% of all GS. Also, the highest ASIR was observed in women aged 60-64 years.

Conclusion: Based on the findings, GS are relatively rare tumors that occur more in old women. The results of this study provide a comprehensive picture of GS incidence patterns in Iran for more investigation.
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http://dx.doi.org/10.1111/jog.14514DOI Listing
October 2020

Short-course versus long-course neoadjuvant chemoradiotherapy in patients with rectal cancer: preliminary results of a randomized controlled trial.

Radiat Oncol J 2020 Jun 5;38(2):119-128. Epub 2020 Jun 5.

Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: Colorectal cancer is becoming an increasing concern in the middle-aged population of Iran. This study aimed to compare the preliminary results of short-course and long-course neoadjuvant chemoradiotherapy treatment for rectal cancer patients.

Materials And Methods: Patients in group I received three-dimensional conformational radiotherapy with a dose of 25 Gy/5 fractions in 1 week plus concurrent XELOX regimen (capecitabine 625 mg/m2 from day 1-5 twice daily and oxaliplatin 50 mg/m2 on day 1 once daily). Patients in group II received a total dose of 50-50.4 Gy/25-28 fractions for 5 to 5.5 weeks plus capecitabine 825 mg/m2 twice daily. Both groups underwent delayed surgery at least 8 weeks after radiotherapy completion. The pathological response was assessed with tumor regression grade.

Results: In this preliminary report on complications and pathological response, 66 patients were randomized into study groups. Mean duration of radiotherapy in the two groups was 5 ± 1 days (range, 5 to 8 days) and 38 ± 6 days (range, 30 to 58 days). The median follow-up was 18 months. Pathological complete response was achieved in 32.3% and 23.1% of patients in the short-course and long-course groups, respectively (p = 0.558). Overall, acute grade 3 or higher treatment-related toxicities occurred in 24.2% and 22.2% of patients in group I and II, respectively (p = 0.551). No acute grade 4 or 5 adverse events were observed in either group. Within one month of surgery, no significant difference was seen regarding grade ≥3 postoperative complications (p = 0.333).

Conclusion: For patients with rectal cancer located 5 cm above the anal verge, short-course radiotherapy with concurrent and consolidation chemotherapy and delayed surgery is not different in terms of acute toxicity, postoperative morbidity, complete resection, and pathological response compared to long-course chemoradiotherapy.
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http://dx.doi.org/10.3857/roj.2020.00115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533412PMC
June 2020

Diffuse alveolar damage and thrombotic microangiopathy are the main histopathological findings in lung tissue biopsy samples of COVID-19 patients.

Pathol Res Pract 2020 Oct 19;216(10):153228. Epub 2020 Sep 19.

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Since the outbreak of the novel coronavirus disease-2019 (COVID-19) in December 2019, limited studies have investigated the histopathologic findings of patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

Material And Methods: This study was conducted on 31 deceased patients who were hospitalized for COVID-19 in a tertiary hospital in Tehran, Iran. A total of 52 postmortem tissue biopsy samples were obtained from the lungs and liver of decedents. Clinical characteristics, laboratory data, and microscopic features were evaluated. Reverse transcription polymerase chain reaction (RT-PCR) assay for SARS-CoV-2 was performed on specimens obtained from nasopharyngeal swabs and tissue biopsies.

Results: The median age of deceased patients was 66 years (range, 30-87 years) and 25 decedents (81 %) were male. The average interval from symptom onset to death was 13 days (range, 6-34 days). On histopathologic examination of the lung specimens, diffuse alveolar damage and thrombotic microangiopathy were the most common findings (80 % and 60 %, respectively). Liver specimens mainly showed macrovesicular steatosis, portal lymphoplasmacytic inflammation and passive congestion. No definitive viral inclusions were observed in any of the specimens. In addition, 92 % of lung tissue samples tested positive for SARS-CoV-2 by RT-PCR.

Conclusions: Further studies are needed to investigate whether SARS-CoV-2 causes direct cytopathic changes in various organs of the human body.
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http://dx.doi.org/10.1016/j.prp.2020.153228DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837112PMC
October 2020

Dyspneic and non-dyspneic (silent) hypoxemia in COVID-19: Possible neurological mechanism.

Clin Neurol Neurosurg 2020 11 9;198:106217. Epub 2020 Sep 9.

Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

SARS-CoV-2 mainly invades respiratory epithelial cells by adhesion to angiotensin-converting enzyme 2 (ACE-2) and thus, infected patients may develop mild to severe inflammatory responses and acute lung injury. Afferent impulses that result from the stimulation of pulmonary mechano-chemoreceptors, peripheral and central chemoreceptors by inflammatory cytokines are conducted to the brainstem. Integration and processing of these input signals occur within the central nervous system, especially in the limbic system and sensorimotor cortex, and importantly feedback regulation exists between O, CO and blood pH. Despite the intensity of hypoxemia in COVID-19, the intensity of dyspnea sensation is inappropriate to the degree of hypoxemia in some patients (silent hypoxemia). We hypothesize that SARS-CoV-2 may cause neuronal damage in the corticolimbic network and subsequently alter the perception of dyspnea and the control of respiration. SARS-CoV-2 neuronal infection may change the secretion of numerous endogenous neuropeptides or neurotransmitters that distribute through large areas of the nervous system to produce cellular and perceptual effects. SARS-CoV-2 mainly enter to CNS via direct (neuronal and hematologic route) and indirect route. We theorize that SARS-CoV-2 infection-induced neuronal cell damage and may change the balance of endogenous neuropeptides or neurotransmitters that distribute through large areas of the nervous system to produce cellular and perceptual effects. Thus, SARS-CoV-2-associated neuronal damage may influence the control of respiration by interacting in neuromodulation. This would open up possible lines of study for the progress in the central mechanism of COVID-19-induced hypoxia. Future research is desirable to confirm or disprove such a hypothesis.
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http://dx.doi.org/10.1016/j.clineuro.2020.106217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480672PMC
November 2020

Portal vein thrombosis associated with COVID-19: points to consider.

BJR Case Rep 2020 Sep 24;6(3):20200089. Epub 2020 Jul 24.

Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

The rapid global spread as well as the mortality and morbidity associated with COVID-19 has raised increasing concern around the globe. Studies have reported that patients infected with the novel coronavirus are prone to coagulopathy. However, information on portal vein thrombosis in patients with COVID-19 is scarce. In this case report, we depict the abdominal CT findings of a 26-year-old male patient with COVID-19 who developed severe abdominal pain during hospitalization and was later diagnosed with portal vein thrombosis. We also demonstrate the chest CT findings of the same patient, which revealed bilateral pleural effusion, a less common imaging finding, and multifocal patchy consolidations. This paper emphasizes that physicians, particularly radiologists, should be aware of thromboembolic events when examining any suspected patient during the current outbreak.
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http://dx.doi.org/10.1259/bjrcr.20200089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465749PMC
September 2020

Well-controlled vs poorly-controlled diabetes in patients with COVID-19: Are there any differences in outcomes and imaging findings?

Diabetes Res Clin Pract 2020 Aug 25;166:108286. Epub 2020 Jun 25.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. Electronic address:

Aims: We aimed to compare the clinical outcomes and imaging findings between COVID-19 patients with well-controlled diabetes and those with poorly-controlled diabetes.

Methods: In this retrospective single-center study, 117 patients with coexistent COVID-19 and type 2 diabetes mellitus were included. Patients were divided into two groups based on HbA1c values. Clinical data and laboratory parameters were collected from patients' medical records. Also, the chest computed tomography (CT) score was defined by the summation of individual scores from 5 lung lobes: scores of 0, 1, 2, 3, 4 and 5 were respectively assigned for each lobe if pulmonary involvement was 0%, less than 5%, 5%-25%, 26%-49%, 50%-75%, or more than 75% of each region.

Results: Among all patients with diabetes, 93 (79.5%) patients had poorly-controlled diabetes and 24 (20.5%) had well-controlled diabetes; 66 (56.4%) patients were male and the median age was 66 years (IQR, 55-75 years). The chest CT severity scores were not significantly different between patients with well-controlled diabetes and those with poorly-controlled diabetes (p = 0.33). Also, the mortality and recovery rates were similar between the two groups (p = 0.54 and p = 0.85, respectively).

Conclusion: Based on the results, clinical outcomes and chest CT severity scores are similar between patients with well-controlled and poorly-controlled diabetes among the Iranian population with COVID-19.
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http://dx.doi.org/10.1016/j.diabres.2020.108286DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314673PMC
August 2020

Diagnostic, prognostic, and therapeutic significance of miR-139-5p in cancers.

Life Sci 2020 Sep 2;256:117865. Epub 2020 Jun 2.

Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

miRNAs are a group of non-coding RNAs that have regulatory functions in post-transcriptional gene expression. These molecules play a fundamental role in cellular processes, for instance cell proliferation, apoptosis, migration, and invasion. Scientific investigations have previously established that miRNAs can either promote or suppress tumor development by mediating different signaling pathways. miR-139-5p, located on chromosome 11q13.4, has been examined extensively in cancers. Studies have demonstrated that miR-139-5p might be an attractive cancer biomarker. Herein, we will review how miR-139-5p acts in cancer diagnosis, prognosis, and therapy, as well as elucidating its major target genes and associated signaling pathways.
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http://dx.doi.org/10.1016/j.lfs.2020.117865DOI Listing
September 2020

Lung Ultrasound in COVID-19 Pneumonia: Prospects and Limitations.

Acad Radiol 2020 07 3;27(7):1044-1045. Epub 2020 May 3.

Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.acra.2020.04.032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196391PMC
July 2020

Neurologic Involvement in COVID-19: Radiologists' Perspective.

Acad Radiol 2020 07 5;27(7):1051-1053. Epub 2020 May 5.

Shahid Beheshti University of Medical sciences, Shohada Tajrish Hospital, Tehran, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.acra.2020.04.035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7200135PMC
July 2020

Effects of lead and cadmium on the immune system and cancer progression.

J Environ Health Sci Eng 2020 Jun 17;18(1):335-343. Epub 2020 Feb 17.

5Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

In our daily life, we are surrounded by harmful pollutants, including heavy metals that are not visible in the macroscopic view easily. Heavy metals can disrupt different aspects of human health, such as the immune system which has gained a lot of attention in recent decades. This had led to its rapid progression and new insights into its alterations in different diseases especially cancer. Heavy metals are non-biodegradable materials that exist in different parts of the food cycle, such as fruits and vegetables as commonly consumed foods and also unexpected sources such as street dust, that exists in the streets that we pass every day, soil, air, and water. These heavy metals can enter the human body through respiratory, cutaneous, and gastrointestinal pathways and then accumulate in different organs, leading to their encountering with various parts of the body. These sources and natural characteristics of heavy metals facilitate their interaction with the immune system. In this review, we investigated the effect of lead and cadmium, as pollutants that exist in many different parts of the human environment, on the immune system which is known to have a key role in the pathophysiology of cancer.
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http://dx.doi.org/10.1007/s40201-020-00455-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203386PMC
June 2020

Saving the Breast Saves the Lives of Breast Cancer Patients.

Int J Surg Oncol 2020 27;2020:8709231. Epub 2020 Feb 27.

Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

. Surgery has been known as the procedure of choice for breast cancer management since 1700 years before Christ. Nowadays, breast-conserving surgery and mastectomy are performed in selected cases with specific clinical criteria. Here, we compare these two procedures for breast cancer patients with variable features in Cancer Research Center, Tehran, as a single institution experience.

Methods: In this 25-year follow-up retrospective cohort study, we identified breast cancer patients who had undergone breast-conserving therapy or mastectomy. Disease-free survival and overall survival were evaluated using Kaplan-Meier survival analysis and the log-rank test between the two groups. A value less than 0.05 was considered statistically significant.

Results: A total of 3358 breast cancer patients, including 61% breast-conserving therapy and 39% mastectomy cases were identified, with a mean follow-up time of 94 months. The overall survival and disease-free survival of all cases were significantly better in breast-conserved patients, particularly in early-stage breast cancer with favorable clinical, pathological, and biological features. Ten-year disease-free survival and overall survival in breast-conserving therapy and mastectomy cases were 74%, 88% and 58%, 80%, respectively.

Conclusion: Breast-conserving surgery and radiation therapy prove to be an appropriate treatment option for breast cancer patients in terms of overall survival and disease-free survival when indicated.
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http://dx.doi.org/10.1155/2020/8709231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063187PMC
December 2020

Seroprevalence of anti- antibody among multiple sclerosis patients: a case-control study.

J Parasit Dis 2020 Mar 29;44(1):145-150. Epub 2019 Oct 29.

3Department of Parasitology, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.

Although previous studies have shown an association between parasitic infections and multiple sclerosis, the possible role of infection on the etiology of multiple sclerosis has been overlooked. The present study aimed to investigate the seroprevalence of anti- IgG antibodies among patients with multiple sclerosis compared to healthy controls. Seventy patients with prior diagnosis of multiple sclerosis were selected as cases and 70 healthy matched individuals as controls. The presence of serum anti- IgG antibody was investigated by ELISA technique. The Chi square test was used to test statistically significant differences for parametric data. A total of 140 serum samples were collected and analyzed. In the case and control groups, 20 (28.6%) and 8 (11.4%) participants had positive serum anti- IgG antibodies, respectively, indicating a statistically significant difference (OR 3.1; 95% CI 1.26-7.63; value = 0.02). The seroprevalence rate was also higher among individuals with a history of contact with dogs (OR 2.7; 95% CI 1.17-6.37; value = 0.03).The results declare that a protective role of against the development of multiple sclerosis is unlikely.
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http://dx.doi.org/10.1007/s12639-019-01174-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046906PMC
March 2020

The elimination of measles in Iran.

Lancet Glob Health 2020 02;8(2):e173-e174

Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1989934148, Iran. Electronic address:

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http://dx.doi.org/10.1016/S2214-109X(20)30002-4DOI Listing
February 2020

The NLRP3 inflammasome: a therapeutic target for inflammation-associated cancers.

Expert Rev Clin Immunol 2020 02 22;16(2):175-187. Epub 2020 Jan 22.

Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

: Inflammasomes are large multimeric intracellular complexes that are capable of maturation and secretion of pro-inflammatory cytokines, IL-1β and IL-18, in response to danger signal molecules. As a member of the inflammasome family, the NLRP3 inflammasome has recently been under intense investigation revealing its possible role in several human diseases especially cancers.: In this review, we will discuss the biology and mechanism of NLRP3 inflammasome activation, its role in specific types of tumors and the novel therapeutic modalities targeting this complex.: The NLRP3 inflammasome and its components including the adapter apoptosis-associated speck-like (ASC) protein and caspase-1 impose different and sometimes contrasting effects in tumorigenesis depending on various contexts. Considering the novel role of this complex in the initiation and progression of neoplasia, the NLRP3 inflammasome and its pathways provide desirable therapeutic targets for prevention, treatment, and prognosis of certain types of cancer. To date, several agents have been introduced for this purpose, some of which have shown promising results in the clinic.
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http://dx.doi.org/10.1080/1744666X.2020.1713755DOI Listing
February 2020

Passive-specific immunotherapy with monoclonal antibodies for prostate cancer: A systematic review.

J Oncol Pharm Pract 2019 Jun 22;25(4):903-917. Epub 2018 Oct 22.

4 Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Treatment of metastatic castration-resistant prostate cancer with conventional therapies is still not successful. Therefore, application of novel biological approaches such as immunotherapy, which appears to be more effective and less toxic, is necessary. Monoclonal antibodies against cancer specific antigens are a kind of immunotherapy that have been approved for specific types of cancer and are being investigated for prostate cancer as well. The aim of this review was to assess the effectiveness and safety of monoclonal antibodies for treatment of advanced prostate cancer.

Method: According to the search strategy stated in our systematic review protocol, Scopus, Medline, TRIP, CENTRAL, ProQuest, DART and OpenGrey databases were searched. Data collection and quality assessment were done independently by two authors and any disagreements between the collected data were resolved by a third author. A meta-analysis was not feasible as there was a considerable statistical heterogeneity among the trials. Hence, this review was limited to a narrative analysis of the included studies.

Results: We found 9756 references by applying search strategy in 4 databases of journal articles and 3 databases of grey literature. We then discarded 3957 duplicate citations using Endnote software and 5143 articles due to obvious irrelevancy of their topics in primary screening. In secondary screening of 656 fulltexts, we excluded 538 articles, and finally included 12 trials in this systematic review, updated on 23 June 2017. The overall quality of the studies was fair. In general, results of this systematic review show promising advances in the treatment of prostate cancer patients with monoclonal antibodies against prostate-specific antigens with regard to PSA/disease response. Some of the studies reported pain relief after treatment as well.

Conclusion: Currently, the role of immunotherapy in the treatment of advanced prostate cancer still remains debated. Although passive specific immunotherapy could be offered as a novel therapeutic option in the coming years, patients should be informed about the risks and benefits of this therapy. One of the obstacles in this review was the lack of adequate assessment of survival-related endpoints reported in the included studies. Our study provides support for further research in this field.
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http://dx.doi.org/10.1177/1078155218808080DOI Listing
June 2019

Reference values of lymphocyte sub-populations in healthy human immunodeficiency virus-negative Iranian adults.

Iran J Immunol 2014 Dec;11(4):221-32

Molecular Immunology Research Center and Department of Immunology, Tehran University of Medical Sciences, Tehran, Iran.

Background: Lymphocyte subsets enumeration is considered prominent in the management of primary and acquired immunodeficiency disorders. Because of local variations due to race, age, gender, and environmental conditions on lymphocyte subsets, and to improve the accuracy of interpretation of laboratory findings, reference intervals must be determined in every population.

Objective: To establish a normal reference range for CD3+, CD4+, CD8+, CD19+ and CD56+ lymphocytes in a healthy Iranian adult population using flowcytometry.

Method: Blood samples were collected from 221 HIV seronegative individuals, including 112 females and 109 males, with ages ranging from 20 to 40 years old. The percentage of lymphocytes expressing either of CD3, CD4, CD8, CD19 and CD56 surface markers were determined by flowcytometry assay.

Result: Total mean percentage and absolute count of lymphocyte subsets were as follows: CD3+: 70.90 ± 7.54%, 1800.87 ± 471.09 cells/µl; CD4+: 41.04 ± 7.86%, 1039.99 ± 338.02 cells/µl; CD8+: 31.11 ± 6.60%, 783.95 ± 234.87 cells/µl; CD19+: 12.77 ± 4.56%, 328.37 ± 153.17 cells/µl; CD56+: 15.53 ± 6.34%, 388.62 ± 176.17 cells/µl, respectively. The ratio of CD4+/CD8+ lymphocytes for the studied population was 1.39 ± 0.48. Significant differences were observed between male and female subjects indicating that the average percentage of CD3+ cells (p=0.017) and CD4+ T cells (p=0.003) were higher in the female population, whereas the average percentage of CD19+ cells (p=0.02) tended to be higher among males. However, investigations on the CD56+ NK cell and CD8+ T cell sub-populations did not show any statistical differences between the two genders. In comparison with reports of other populations, we were confronted with different results.

Conclusion: Establishing reference values of lymphocyte subsets for each population is helpful in achieving standard criteria for the prognosis of HIV infection. Therefore, normal ranges established by this survey can be used as a reference for decisions made in clinical practice.
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http://dx.doi.org/IJIv11i4A1DOI Listing
December 2014

Arterial blood gas and spirometry parameters affect the length of stay in hospitalized asthmatic patients.

Med J Islam Repub Iran 2014 16;28. Epub 2014 Feb 16.

4. MD, Resident of Orthopedics, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Asthma is a common condition in general medical practice, and it accounts for about 1% of all ambulatory hospital visits. Nowadays, hospitalization rates for asthma have actually been increased in some demographic subgroups despite recent advances in treatment. Understanding the underlying factors that contribute to hospitalization and especially duration of the hospitalization of asthmatics could help elucidate the recent rise in morbidity and also reduce the high demand on health care systems of the disease. The aim of this study was to evaluate factors affecting the duration of hospitalization for Iranian patients with asthma.

Methods: This study was conducted on 55 asthmatic patients (diagnosis of asthma was in accordance with the criteria of the American Thoracic Society). The study was performed on patients hospitalized in Rasoul-e-Akram hospital in Tehran, Iran during the period 2005-2006. During hospitalization, the patients' most common complaints were recorded as the symptoms and signs of the medical condition, results of physical examinations, spirometry, arterial blood gas analysis (ABG), and ICU admission.

Results: There were 18(32.7%) male and 37(67.3%) female patients with a mean age of 54.96 (SD=17.54) years. The mean duration of hospitalization was 8.31(SD=4.69) days that ranged between 2 and 23 days. The mean baseline arterial PH (p=0.039, RPearso = -0.362), baseline arterial [HCO3] (p=0.042, RPearson = 0.361), changes of FEV1 after bronchodilator (p=0.041, RPearson= -0.363) and patient's age (p=0.002, RPearson=0.0433) were determined as factors affecting duration of hospitalization.

Conclusion: Our results showed that more attention needs to be given to the findings of arterial blood gas and spirometry which can potentially affect the duration of hospitalization of asthmatic patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154272PMC
September 2014

Combination of calcium hydroxyapatite and autologous blood for endoscopic treatment of vesicoureteral reflux in children.

Int Urol Nephrol 2014 Jul 20;46(7):1263-8. Epub 2014 Feb 20.

Pediatric Urology Research Center, Section of Tissue Engineering and Stem Cell Therapy, Department of Pediatric Urology, Children's Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, No. 62 Dr. Qarib's St, Keshavarz Blvd, Tehran, 1419433151, Iran (IRI).

Objective: To report the results of endoscopic correction of vesicoureteral reflux (VUR) with concomitant injection of pure calcium hydroxyapatite (CaHA) and autologous blood.

Patients And Methods: Records of patients who underwent endoscopic correction of VUR using concomitant injection of CaHA and autologous blood from 2008 through 2010 were retrospectively reviewed. Data regarding patients' demographics, preoperative VUR grades, febrile urinary tract infections, complications of procedure, postoperative VUR grades and cure rates were collected. Voiding cystourethrography was performed 3 months postoperatively.

Results: Total number of 23 children (9 girls and 14 boys) with 40 refluxing ureters were included. The mean age of children was 1.9 ± 0.97 (SD) years. Reflux grades were II to IV in 14, 11 and 15 renal refluxing units (RRUs), respectively. The mean follow-up period was 44 months. VUR was successfully treated in 87.5% of RRUs after three injections. Significant statistical difference was found between VUR grades before and after the first, second and third injections (p < 0.001, p = 0.001 and p = 0.011, respectively). Moreover, there was a significant difference between primary reflux grade and treatment success (p = 0.031). Febrile UTI was resolved in 85% of patients (17 of 20 patients with febrile UTI) after endoscopic treatment which shows significant improvement (p < 0.001). The procedure was uneventful in all patients, and no obstruction was reported during the follow-up period.

Conclusion: Concomitant injection of pure CaHA without any additives (hyaluronic acid, etc.) and autologous blood can be an effective, repeatable and cost-benefit approach for the management of children suffering VUR with a success rate of 87.5% after three injections.
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http://dx.doi.org/10.1007/s11255-014-0659-4DOI Listing
July 2014

Comparison of metformin and insulin in the control of hyperglycaemia in non-diabetic critically ill patients.

Endokrynol Pol 2012 ;63(3):206-11

Faculty of Pharmacy and Pharmaceutical Sciences Research Centre, Teheran University of Medical Sciences, Teheran, Iran.

Introduction: It is accepted that preventing hyperglycaemia during critical illness while assuring adequate caloric intake can reduce mortality and morbidity. The aim of this study was to compare the metabolic effects of metformin and insulin on hyperglycaemia in ICU patients.

Methods: This double-blind randomised clinical trial was performed on 24 patients who were admitted to the intensive care unit (ICU) from 20 March to 20 September 2007. All patients with serious injuries or with major non-abdominal surgeries were included if they met the inclusion criteria, and were assigned randomly to one of the study groups. Patients in Group 1 received intensive insulin therapy, and patients in Group 2 were treated with metformin. Moreover, the Acute Physiology And Chronic Health Evaluation (APACHE) II scoring system was used to grade disease severity.

Results: Both glycaemic management protocols led to significantly improved glucose levels without any report of hypoglycaemia. The mean initial glucose levels for the insulin group decreased significantly after the intravenous infusion of insulin (p < 0.001). Additionally, the blood glucose concentration was significantly lower after two weeks of metformin administration compared to baseline measurements (p < 0.001). Moreover, the blood glucose concentration decrease during these two weeks was significantly higher in the insulin group (p = 0.01). Besides, APACHE II score was lower than baseline at the end of the study for both therapeutic groups (score of 10 vs. 15 [insulin] and 16 [metformin]). Finally, new renal dysfunction (maximum serum creatinine level at least double the initial value) was observed in three of the patients (two patients from the metformin group and one from the insulin group) in the last days of the protocol, although none of the patients showed lactic acidosis after ICU admission.

Conclusions: Both metformin and intensive insulin therapy significantly decreased hyperglycaemia in ICU patients. Insulin caused a greater reduction in blood glucose concentration but required more attention and trained personnel.
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November 2012