Search

Introduction: Exemestane was approved in 2005 for adjuvant treatment of breast cancer. In this study, we aimed to assess whether it is cost-effective in comparison to available alternatives., Material and Methods: To evaluate the efficacy of exemestane, a systematic review was conducted by searching electronic databases. The outcomes of interest were "clinical benefit", "overall response" and "disease-free survival rate". To evaluate the cost of treatments, costs of both domestic generic and imported brand medicines were taken into account, and the incremental cost-effectiveness ratio (ICER) was calculated for each comparison., Results: Regarding primary breast cancer, based upon available evidence, exemestane could not be considered as a cost-effective medicine either in generic or brand form compared with placebo (ICER: 119,100 and 215,525), with tamoxifen after 2-3 years of therapy (ICER: 35,150 and 82,400) and with sequential treatment by tamoxifen and exemestane (dominated because of lower effectiveness and higher cost). In metastatic breast cancer, exemestane was not considered a cost-effective treatment compared with both anastrozole and megestrol acetate (dominated) and was highly cost-effective compared with tamoxifen (ICERs: 2,208 and 4,326 dollars per one more patient with an overall response for generic and brand medicines) although even in this case it was not cost-effective in terms of the 1-year survival rates (dominated)., Conclusions: Regarding current evidence and related costs in terms of Iranian pharmaceutical market prices, exemestane could not be considered a cost-effective treatment in primary and advanced breast cancer compared with available alternatives. However, more evidence is still needed for more certain decisions.

Background: Astrocytes, which comprise ~90% of overall brain mass, are involved in brain immunity. These cells represent the non-professional class of CNS-resident APCs and may promote or inhibit CNS inflammation depending on the cytokines they secrete. IL-10 family of cytokines and their receptors, IL-20R1 and IL-20R2, may have a role in shifting astrocytes to a neuroprotective or neurodegenerative function., Objective: To address the expression of IL-20R1 and IL-20R2 cytokine receptors in astrocytes and brain cortex of C57BL/6 mice., Methods: We investigated the expression of IL-20R1 and IL-20R2 in C57BL/6 mice astroglial cells and brain cortex in response to lipopolysaccharide (LPS), using reverse-transcription polymerase chain reaction (RT-PCR) method., Results: Astrocytes were able to express IL-20R1 and IL-20R2 mRNA not only in response to LPS stimulation but also in the absence of LPS. Furthermore, we found the expression of IL-20R1 and IL-20R2 mRNA in the cortex of adult C57BL/6 mice., Conclusions: IL-20R1 and IL-20R2 are constitutively express in the brain. Since most neuropathological processes involve astrocytes and inflammatory cytokines, these findings have important implications for future therapeutic strategies.

Objective: There have been various reports on the roles of CXC receptors (CXCR) in modulation of hematopoiesis. In the present study, we investigated the effects of CXCR1 and/or CXCR2 inhibition on expansion and differentiation of umbilical cord blood (UCB) CD133(+) cells into megakaryocytic progenitors., Materials and Methods: Purified UCB CD133(+) cells were cultured in a serum-free liquid culture either in the presence or absence of neutralizing anti-CXCR1 and/or anti-CXCR2 antibodies in combination with a conventional cytokine cocktail for up to 14days. Expression of megakaryocytic lineage markers (CD41 and CD61) and determination of ploidy level were determined by flowcytometry. In addition, colony-forming unit assay was performed using CD133(+) cultures in serum-free collagen-based medium containing the cytokine cocktail plus neutralizing CXCR1 and -R2 antibodies. Colony forming unit-megakaryocyte (CFU-MKs) and non-MKs were counted after immunocytochemistry staining on day 12., Results: We show that while simultaneous inhibition of both CXCR1 and -R2 causes a significant reduction in the fold expansion of UCB CD133(+) cells, it also leads to an increase in percentages of CD61(+), CD41(+), and CFU-MK populations., Conclusion: CXCR1 and CXCR2 play significant roles in the suppression of megakaryopoiesis. We demonstrate that blocking of this suppressive effect by a simultaneous inhibition of both receptors can enhance the differentiation of UCB CD133(+) cells into megakayocytic progenitors., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Background: Vaccines capable of controlling tumor virus based infections are found difficult to develop due to the consistence latent infection in the host. DNA vaccines are attractive tools for the development of HPV vaccines and inducing antigen-specific immunity owing to the stability, simplicity of delivery, safety and cost effectiveness. However, there is a need to increase their potency by procedures such as using HSP70 gene as an adjuvant., Objective: To evaluate a DNA vaccine containing HPV16 truncated E7 C-terminal cytotoxic T-lymphocyte epitopes linked to HSP70 gene (HSP70-tE7) in an animal model., Methods: Mice were immunized with the plasmid DNA after pre-treatment with cardiotoxin. The splenocytes of immunized mice were then tested for CTL activity by detecting the apoptosis and necrosis in target cells, cytokine production by ELISA, CD4 and CD8 frequencies by flow cytometry, and lymphocyte stimulation by MTT assay., Results: The recombinant expression vector was able to elicit immune responses close to that of full length E7 complete gene. Although the use of a small part of a target antigen can induce immune responses equivalent to the full length antigen, it fails to elicit statistically significant stronger immune responses when fused with HSP70 compared to the complete E7 gene alone., Conclusion: The potent immunogenicity of HPV16 E7 was preserved in the HSP70-tE7 vaccine and may represent a target of choice for the therapeutic vaccination strategies. However, to improve the immunogenicity polytope DNA vaccines which elicit multiple effector and memory CTL responses should be considered in future studies of DNA-based cancer vaccines.

Modulation of adhesion molecules expression on the surface of cord blood (CB) CD34(+) cells may assist in overcoming the delay in cord blood engraftment. Likewise, utilization of diverse growth factors such as neuropeptides could also be helpful. Therefore, we aimed to assess the role of Substance P (SP) along with a cytokine cocktail on CB CD34(+) adhesion molecule expression. CB CD34(+) cells were cultured in a serum-free media containing different concentrations of SP in combination with a cytokine cocktail (SCF, FL, TPO, IL-3, and IL-6). Expression of adhesion molecules CXCR4, CD44, CD49e, and CD62L was analyzed after 7 and/or 11 days of cell cultivation. Additionally, the colonogenic capacity of cells was analyzed by colony formation unit assay. Our results show an enhanced percentage of CD34(+)cells with CXCR4, CD44, and CD62L on day 7, as compared with control. Furthermore, an increase in frequency was observed for CD49e(+) CD34(+)cells by day 7 in both test and control groups compared with day 0. Colonogenic assays show occurrence of more total colony formation and immature progenitor cells in SP-treated cells. Our study indicates that SP could act as an effective modulator for expression of cell adhesion molecules.

Background and Objectives: Umbilical cord blood (UCB) is a rich source of hematopoietic cells. Here, for the first time, we surveyed the effects of different concentrations of platelet growth factors and cytokine cocktail (CC) on the expansion and differentiation of UCB CD133(+) stem cells into megakaryocyte progenitors., Materials and Methods: UCB CD133(+) cells were separated by magnetic cell sorting and cultured in different concentrations of platelet growth factors in combination with a CC containing interleukins 3 and 6, stem cell factor, and thrombopoietin. Cell expansion and differentiation were assessed using mononuclear cell count and flow cytometry., Results: The results show that either activated platelet-rich plasma or the platelet supernatant, when added in the first day of culture, significantly suppress the expansion of CD133(+) cells after 7 days in culture (p < 0.05). By contrast, the expression of CD41, CD61, and CD42b markers in the presence of all platelet growth factors increased compared with that of the control (p < 0.05)., Conclusion: Taken together, platelet growth factors in the presence of CC suppress ex vivo expansion of UCB CD133(+) cells and enhance their differentiation into megakaryocytic progenitor cells in a dose- and time-dependent manner.

Background: Modulation of the expression of CXCR4 as a critical adhesion molecule on cord blood (CB) CD34+ cells could overcome delay following cord blood transplantation. Identification of beneficial effects of growth factors including cytokines and neuropeptides on CXCR4 expression would enable our understanding of this complicated network. Therefore, we aimed to assess the role of substance P (SP) and Calcitonin gene related peptide (CGRP) on CXCR4 levels., Material and Methods: CD34+cells purified from CB were cultured in a serum-free liquid culture system. Different concentrations of SP and CGRP were used in combination with cytokine cocktail. Expression of CXCR4 at protein and genomic levels was assessed by flow cytometry and real time RT-PCR., Results: Our results indicate increased CXCR4+ CD34+ cells after 7 days cultivation with SP and/or CGRP. Increased gene expression of the CXCR4 molecule was observed at 10(-9) M either SP or CGRP individually, by day 11 as compared to control group., Conclusions: Our study indicates that SP and CGRP induce CXCR4 protein expression in short term culture, and stimulate its expression. Consequently, the increased expression of CXCR4 could improve engraftment of CB CD34+ cells., (2010 Elsevier Ltd. All rights reserved.)

Many approaches have so far been tried to enhance the immunogenicity of DNA vaccine. These include the use of various factors that induce apoptosis or anti-apoptosis effects when co-delivered with DNA vaccine. In the present study, the effects of pro-apoptotic Bax encoding plasmid (pBax) and anti-apoptotic Bcl-X(L) encoding plasmid (pBcl-xl), intradermally co-injected with glycoprotein B (gB) of Herpes Simplex Virus (HSV)-1 encoding plasmid (pgB) into the C57BL/6 mice were evaluated. Immune responses of the mice to the antigen were assessed by antibody assay, lymphoproliferative responses as well as cytokine and cytotoxic T-lymphocyte (CTL) assay. Analysis of the humoral and cellular responses showed that the mice immunized with pBax and pgB induced higher levels of antibody and Interleukin-4 as well as stronger lymphocyte proliferative responses and cytotoxic activity compared to those mice received pgB alone. pBcl-xl when intradermally co-injected with pgB showed no significant enhancement in immune responses comparing to pgB., (Copyright (c) 2009 Elsevier B.V. All rights reserved.)

There is little evidence on roles of growth factors other than cytokines in expansion of cord blood (CB) stem cells. We aimed to explore a novel approach for expansion, using Substance P (SP) and calcitonin gene-related peptide (CGRP) neuropeptides. CB CD34(+) cells were cultured in different concentrations of SP and/or CGRP in combination with a cytokine cocktail. Phenotypic and functional analysis was performed by flowcytometry and colonogenic assay. Our results show a significant improvement of total expansion of neuropeptide treated cells. There was a selective effect of CGRP on CD34(+) CD133(+) cells, SP on CD34(+) CD45(dim) cells, and 10(- 9) M SP and/or CGRP on expansion of CD34(+) CD38(- ) cells. There was also a tendency for erythroid and granulocyte-myeloid colony formation in SP and CGRP treated cultures, respectively. Supplementation of cytokines with other growth factors, such as neuropeptides, might enable us to overcome the difficulties of ex vivo expansion of CB cells.

Aim: To describe the involvement in relatives of keratoconus (KCN) patients with corneal topography map., Methods: A total of 150 siblings of 300 eyes of 75 KCN patients referred to corneal clinic were studied and experienced complete slit-lamp, refraction examinations and topographic cornea maps provided by videophotoker-atography. ANOVA, Fisher exact and Chi-square tests performed to compare of results., Results: Of 150 siblings, 56% were female and 44% were male with average age of 21 (range 15-39) years. KCN and suspect KCN diagnosed in 12.3% and 6.6% respectively. The central keratometry (CK) was 46.5±4.51 dioptr (D) in KCN and 45.66±1.52D in suspect KCN. Inferior-superior value (I-S) was 3.51±2.5D in KCN and 1.56±1.22D in suspect KCN. In KCN condition the oval pattern was 67.6% (n=25) and Round pattern detected 32.4% (n=12). In suspect KCN these patterns detected 90% and 10% respectively. Refractive errors in KCN were -7.5 to +1.25 dioptr (-1.25±1.83), in suspect KCN 0.45 to -4.2 dioptr (-0.68±0.76) and in healthy group 2.75 to -7.5 dioptr (-0.6±1.12). Astigmatism was mild in 22.7%, moderate and sever astigmatism in 18.3% in KCN and suspect KCN CONCLUSION: Increasing KCN condition in healthy siblings of KCN patients shows require to screening plan to early diagnose and cautionly treatment of contact lens in these individuals.

Background: Cervical cancer is the most prevalent tumor in developing countries and the second most frequent cancer among female population worldwide. Specific human papillomaviruses and, most notably, HPV types 16 and 18 are recognized as being causally associated with cervical carcinomas. The early HPV type 16 genes, E6 and E7, directly participate in the in vitro transformation of primary human keratinocytes and represent an excellent target for immune therapy of HPV related disease., Objective: The aim of this study was the evaluation of the efficacy of a DNA vaccine containing human papillomaviruse type 16 E7 gene (Iranian isolate) in induction of CTL responses in an animal model., Methods: In this study, the expression vector containing HPV type 16 E7 gene was constructed and chosen as a model antigen in the development of a therapeutic DNA vaccine in an animal model. CTL responses, cytokine assay, lymphocyte stimulation test, CD4 and CD8 staining and flowcytometry were done for evaluating of the immune responses., Results: Our findings indicate that the target DNA vaccine can induce an E7-specific CTL response, which is important in the lysis of infected tumor cells, compared to negative control (p<0.005) after in vivo immunization in the mouse system., Conclusion: The developed vaccine may be promising as an anti-cancer vaccine.

Opsonophagocytosis mediated by antibody and complement is the major defense mechanism for clearing Neisseria meningitidis from the host. Therefore, a newly developed phagocytosis assay based on flow cytometry (flow assay) was using sera obtained from rabbit postvaccination with outer membrane vesicle of N. meningitidis serogroup B, was done in order to evaluation of the potential efficacy of (experimental) meningococcal vaccines. The Outer Membrane Vesicles (OMVs) and control were injected intramuscularly into groups of five rabbit with boosters on 14, 28 and 42 days after the primary immunization. The serum on 0, 14, 28, 42 and 56 days were collected and stored at -20 degrees C for next analysis. Phagocytic function of and intracellular oxidative burst generation by rabbit polymorphonuclear (PMN), against N. meningitidis serogroup B, was measured with flow cytometer, using dihydrorhodamine-123 as probes, respectively. We use a Coulter Epics XL-profile (USA) with an argon laser operating at 488 nm. The results of quantitative flow cytometric analysis of rabbit PMN function in hyperimmun sera with OMVs revealed a highly significant increase in opsonophagocytic responses against serogroup B meningococci after 56 day in comparison with the control group (p < 0.05). Present results indicated that OMVs could be as a candidate for vaccine toward serogroup B meningococci and a new standard flow cytometric method to measure the opsonophagocytosis activity by rabbit PMNs was shown by this study.

The cytosolic members of the heat shock protein 70 (HSP-70) family have been shown to elicit protective cell mediated immunity in animal tumor models. The aim of this study was to investigate the effect of the HSP-70 enriched lysate of heated tumor cells as vaccines in cancer immunotherapy in the mouse model for WEHI-164 fibrosarcoma. Three animal bearing tumor groups were investigated: test group; vaccinated with enriched HSP-70 tumor lysate, control group I; vaccinated with tumor lysate only and control group II; received PBS. The results indicated that vaccinated mice in the test group had resulted in a significant reduction in tumor size and longer survival. To find the mechanism of these results, we measured the splenocytes proliferation, tumor infiltrated lymphocytes and cytotoxic activity of the splenocytes. The results indicated a significant increase in the proliferation of mouse splenocytes, a significant increase in the CD8+ lymphocytes as well as significant increase in the cytotoxic activity of splenocytes against the target cells in the test group. In addition, we analyzed the shifting of Th1/Th2 in all the groups. The results indicated a significant increase in the IFN-gamma production in the test group. These findings provided a useful therapeutic model for development of approaches to cancer treatments.

Objective: To estimate and report the prevalence of gestational diabetes mellitus (GDM) in pregnant women of Bandar Abbas, a city in southern Iran., Methods: From March 2002 to March 2004, 800 pregnant women underwent assessment for GDM in obstetrics clinics in Bandar Abbas. The medical history and risk factors for GDM were recorded, and the weight, height, and blood pressure were measured. All the women were screened for GDM by a 1-hour, 50-g oral glucose tolerance test (OGTT), with a cutoff point of 130 mg/dL. All patients with a "positive" screening test result underwent a 3-hour OGTT with 100 g of glucose., Results: The prevalence rate of GDM in our study was 6.3% (95% confidence interval, 4.7% to 8.4%) and 8.9% (95% confidence interval, 6.9% to 11.3%) with use of the National Diabetes Data Group and the Carpenter and Coustan criteria, respectively. The patients with GDM were significantly older than the normal group of pregnant women (28.2 +/- 5.6 years versus 24.6 +/- 5.2 years, respectively) (P<0.001). The mean number of pregnancies, systolic blood pressure, and body mass index (BMI) were significantly higher in the GDM group than in the normal pregnant women (P<0.05). Among the recorded risk factors, only age (3)25 years, history of macrosomia in previous newborns, and BMI (3)25 kg/m2 were significantly more prevalent in the GDM group than in the normal group (P<0.05). If selective screening criteria for GDM had been applied, 11.3% of patients with GDM would have been missed., Conclusion: This study showed a higher prevalence of GDM in Bandar Abbas in comparison with other parts of Iran. Screening for GDM in all pregnant women in Bandar Abbas seems necessary, regardless of the presence of risk factors for GDM.