Mohammad Reza Fazlollahi

Tehran University of Medical Sciences

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Zahra Pourpak

Tehran University of Medical Sciences

Mostafa Moin

Tehran University of Medical Sciences

Masoud Movahedi

Tehran University of Medical Sciences

Mohsen Badalzadeh

Tehran University of Medical Sciences

Raheleh Shokouhi Shoormasti

Tehran University of Medical Sciences

Amir Ali Hamidieh

Tehran University of Medical Sciences

Zahra Alizadeh

Amirkabir University of Technology

Massoud Houshmand

National Institute of Genetic Engineering and Biotechnology

Anoshirvan Kazemnejad

Tarbiat Modares University

Shaghayegh Tajik

Children's Medical Center

Cooperative Institutions

Tehran University of Medical Sciences

272

Children's Medical Center

101

University of Tehran

Shahid Beheshti University of Medical Sciences

Iran University of Medical Sciences

Semmelweis University

Odense University Hospital

Ahvaz Jundishapur University of Medical Sciences

Charité - Universitätsmedizin Berlin

Rasool Akram Hospital

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Antibody Production after COVID-19 Vaccination in Patients with Inborn Errors of Immunity.

PubMed (2023)

Maryam Nourizadeh Elham Feizabadi Milad Mirmoghtadaei Ashraf Mohammadi Mohammad Reza Fazlollahi

Few studies have evaluated COVID-19 vaccine efficacy in patients with inborn errors of immunity (IEI).

Humoral immunity

10.22034/iji.2023.97759.2525

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Citations (4)

A New IL-2RG Gene Mutation in an X-linked SCID Identified through TREC/KREC Screening: a Case Report.

DOAJ (DOAJ: Directory of Open Access Journals) (2015)

Maryam Nourizadeh Stephan Borte Mohammad Reza Fazlollahi Lennart Hammarström Zahra Pourpak

Severe combined immunodeficiency (SCID) represents a rare group of primary immunodeficiency disorders (PIDs), with known or unknown genetic alterations. Here, we report a new interleukin 2 receptor, gamma chain (IL-2RG) mutation in an Iranian SCID newborn. The patient was a 6-day old boy with a family history of PID. The child was screened using a molecular-based analysis for the assessment of T cell receptor excision circles (TRECs) and kappa-deleting recombination excision circles (KRECs). Moreover, a complete immunological evaluation and gene sequencing was performed. Results showed undetectable TREC but a high level of KREC copy numbers. Flow cytometric data indicated low numbers of T and NK cells, but elevated number of B cells. A novel substitution in IL2RG: c.675 C>A, leading to p.225 Ser>Arg was found. Based on the functional analysis, the mutation is predicted to be damaging. The patient was diagnosed as a T B+ NK X-linked SCID.

Primary Immunodeficiency

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Fresh frozen plasma for on-demand hereditary angioedema treatment in South Africa and Iran

World Allergy Organization Journal (2019)

Nicole Wentzel Angelica Panieri Maryam Ayazi S D Ntshalintshali Zahra Pourpak

International guideline-recommended on-demand treatments for hereditary angioedema (HAE) include: C1-esterase inhibitor (plasma-derived or recombinant), or bradykinin-receptor antagonists. In most low- and middle-income countries (LMIC) these products are not registered or are unaffordable. Solvent-detergent, fresh or freeze-dried plasma therapy is thus the only available on-demand treatment in these settings; but published data on efficacy and safety are limited. This study evaluated the efficacy and safety of on-demand plasma treatment of acute HAE in two LMICs.A retrospective folder or patient registry review of acute swelling episodes necessitating emergency room attendance amongst known HAE patients was conducted at treatment centers in South Africa and Iran. Data collected included the site of angioedema, timing and amount of fresh frozen plasma (FFP) administered, time-to-resolution, hospital length of stay and adverse events.There were 176 acute swelling episodes amongst 43 HAE patients; 98 were treated with FFP. The face, upper airway, and abdomen were involved in 15.3% (15/98), 53.1% (52/98) and 29.6% (29/98) of episodes treated with FFP respectively. Median (interquartile range ([IQR]) of FFP administered was 400 (280-560) mLs. In all episodes except two, FFP led to resolution, with median (IQR) hours to resolution 4 (2-12). Five transfusion reactions occurred, with one case of anaphylaxis and no deaths; giving an adverse reaction rate of 5%. Differences between South Africa and Iran included: (1) proportion of HAE type II(2) median (IQR) hours to FFP administration and hospitalization, (3) number of intubations after FFP infusion. Healthcare cost for FFP treatment was USD369- 791 in South Africa and USD275-550 in Iran, largely influenced by hospital length of stay.Plasma (fresh-frozen) remains the only available effective on-demand treatment for acute HAE in many countries. FFP is effective and safe, but time-to-resolution is slower and adverse events are more frequent than published data on targeted therapies. Overall healthcare cost of FFP approaches that of targeted therapies - now available through global access programs - when hospitalization is prolonged.

Hereditary Angioedema

Fresh frozen plasma

Interquartile range

Icatibant

10.1016/j.waojou.2019.100049

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Citations (34)

The Prevalence of Allergic Rhinitis, Allergic Conjunctivitis, Atopic Dermatitis and Asthma among Adults of Tehran.

DOAJ (DOAJ: Directory of Open Access Journals) (2018)

Raheleh Shokouhi Shoormasti Zahra Pourpak Mohammad Reza Fazlollahi Anoshirvan Kazemnejad Fatemeh Nadali

Alteration of environmental factors and air pollution affects the trend of allergic diseases especially in cities such as Tehran. This study aimed to determine the prevalence of allergic rhinitis, conjunctivitis, atopic dermatitis and asthma among adults in the capital city of Iran.This cross-sectional study was performed between 2013 and 2016 in Tehran, Iran. The participants were adults between 18 and 45 yr of age. A specific questionnaire including demographic data and clinical symptoms was filled out by a trained interviewer. The diagnosis of allergic diseases was performed based on standard questionnaires and criteria.The prevalence of allergic rhinitis, conjunctivitis, asthma and atopic dermatitis were 28.3%, 15.9%, 7.6% and 3.9%, respectively. Allergic rhinitis and conjunctivitis together were reported in 12.3% of the participants. Among patients with asthma, 47.4% had AR. Additionally, 25.7% of atopic dermatitis subjects were reported to have asthma. The subjects with at least one of these allergic diseases were 36.3%. Women showed a higher prevalence of allergic symptoms than men. There was a significant relationship between allergic symptoms and family history of atopic diseases.The most common allergic disease was allergic rhinitis. Regarding the comorbidity of asthma and allergic rhinitis, paying more attention to controlling these allergic diseases is deemed necessary.

Allergic conjunctivitis

Atopy

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Citations (37)

Determining reference ranges for lymphocyte proliferation responses to phytohemagglutinin and Bacillus Calmette–Guérin in Iranian children

Clinical Immunology (2024)

Maryam Nourizadeh Shokouh Azam Sarrafzadeh Raheleh Shokouhi Shoormasti Mohammad Reza Fazlollahi Shiva Saghafi

Primary Immunodeficiency

Reference range

10.1016/j.clim.2024.109937

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Citations (1)

Impact of maternal mental health on pediatric asthma control.

PubMed (2013)

Zeinab Ghaempanah Mohammad Reza Fazlollahi Ahmad Ali Noorbala Masoud Movahedi Anoshirvan Kazemnejad

Asthma like other chronic diseases is a stressful condition not only for children but also for their parents. Caring for a child with asthma combines the demands of parenting with the emotional and physical burdens of the child's chronic illness. Some studies have assessed the relations between parental mental health and asthma severity in children. This study aims to evaluate the mental health of mothers of asthmatic children and associations between maternal mental health and childhood levels of asthma control.Eighty mothers with asthmatic children aged 7-12 yrs. completed a General Health Questionnaire (GHQ.28) containing questions about somatic symptoms, anxiety, social dysfunction, and severe depression. Level of asthma control in children was classified as "well controlled"," partly controlled" and "uncontrolled" by an asthma specialist.The results showed that mothers of asthmatic children reported the depression symptoms significantly more than the community cut-off point (p<0.001); also GHQ scores were not significantly different in three levels of asthma control in children (i.e. well controlled, partly controlled and uncontrolled). The results revealed that caring for a child with asthma had an impact on the mother's mental health and depression was prevalent among mothers of asthmatic children. In addition, improving asthma control level did not promote maternal mental health.Inclusion of mental health and quality of life of parents in the classification of pediatric asthma control may be helpful. Our findings suggest that the physician's awareness of maternal depression and the presence of a psychotherapist for diagnosing and treating depression in mothers of children with asthma may be important for guiding effective interventions.

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Glucocorticoid Receptor Nuclear Translocation in CD4 T Cells from Severe and Moderate Asthmatic Patients Treated with Fluticasone/Vilanterol.

DOAJ (DOAJ: Directory of Open Access Journals) (2018)

Zahra Alizadeh Marzieh Mazinani Esmaeil Mortaz Mohammad Reza Fazlollahi Ian M. Adcock

Different phenotypes of asthma from mild to severe are categorized based on diverse clinical features. A guideline for the recognition and treatment of asthma has been provided by Global Initiative for Asthma (GINA). To control symptoms and prevent asthma exacerbation in most patients combinational therapy with inhaled corticosteroids (ICS) and a long acting B2-adrenreceptor agonist (LABA) are recommended. Understanding asthma phenotypes would be helpful to improve asthma diagnosis and treatment. The aim of this study was to verify glucocorticoid receptor glcococorticoid receptor (GR) nuclear translocation in CD4 T cells treated with fluticasone furoate (FF), vilanterol (V) and FF/V combination in severe asthmatic patients compare to patients with moderate asthma and healthy controls using Immunocytochemistry (ICC). After taking blood and separating PBMCs from each subject, CD4 T cells were isolated from PBMCs using CD4+ T cell isolation kit. Isolated CD4 T cells were cultured in presence of FF, V and FF/V combination for 1 hour and after cytocentrifugation, cells were incubated with anti GR-antibody and subsequently stained with FITC bound secondary antibody and GR nuclear translocation was observed under microscope. The results showed significant increasing in GR nuclear translocation in treated CD4 T cells from patients with moderate asthma and controls compare to those severe asthmatic patients, along with treating cells with FF/V combination no significant GR nuclear translocation was observed compare to that of using mono treatment of cells with FF and V. Based on our findings, it can be concluded different mechanisms are responsible for severe asthma and moderate asthma.

Fluticasone propionate

Fluticasone

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Citations (3)

Clinical manifestations and severity of cow’s milk anaphylaxis in children

Clinical and Translational Allergy (2011)

Zahra Pourpak Pegah Teymourpour Saeideh Barzegar Raheleh Shokouhi Mohammad Reza Fazlollahi

In this study all children(<18 years old) with suspicious history of cow’s milk anaphylaxis who had been referred to IAARI(Immunology,Asthma and Allergy Research Institute)during 2005(JAN)—2010(SEP) were considered. A detailed questionnaire was fulfilled for each patient. A specific severity grading for anaphylaxis with five levels was also used. Skin Prick Test(SPT) with allergen extract(cow’s milk) was performed at least 4—6 weeks after patient’s last anaphylaxis attack. Cow’s milk specific IgE and total IgE level were measured by Immunocap system.Patients with clear history and one positive laboratory test and patients with both positive laboratory tests(SPT and cow’s milk specific IgE)were included.

Clinical history

10.1186/2045-7022-1-s1-p47

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Confirmation of Hyperimmunoglobulin E Syndrome in Two Patients with an Ocular Problem: Detection of Two New DOCK8 Mutations

Iranian Journal of Allergy Asthma and Immunology (2022)

Shiva Saghafi Fariborz Zandieh Mohammad Reza Fazlollahi Cristina Glocker Natalie Frede

Early diagnosis of primary immunodeficiencies is crucial for timely treatment and preventing unwanted complications. Next-generation sequencing (NGS) and detailed clinical and immunological evaluation can help early detect such disorders. This study aimed to confirm the diagnosis of two cases of autosomal recessive hyper-immunoglobulin E (IgE) syndrome (AR-HIES), presenting with irreversible eye involvement. Two unrelated patients with suspected AR-HIES were referred to the Immunology, Asthma and Allergy Research Institute (IAARI), Tehran, Iran. Immunological screening tests were performed for AR-HIES, which showed elevated serum IgE levels, eosinophilia, and low T-lymphocyte responses. NGS was performed, and the results were confirmed by Sanger sequencing. Sequence analysis showed a mutation in intron 17 of the dedicator of cytokinesis 8 (DOCK8) gene in the first patient, and a homozygous three base-pair deletion in exon 45 of DOCK8 in the second patient. This is the first time such mutations are reported and these variants are predicted to be damaging. Both patients suffered from persistent viral infections along with cytomegalovirus (CMV) retinitis. Suspicion of these two novel DOCK8 mutations can benefit patients presenting with recalcitrant ophthalmic viral involvements and relevant immunological test results. This would lead to earlier referrals for immunologic and genetic confirmation and thus, a more timely intervention with hematopoietic stem cell transplantation (HSCT).

Sanger sequencing

Primary Immunodeficiency

Cytomegalovirus

10.18502/ijaai.v21i3.9809

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Citations (2)

Asthma Economic Costs in Adult Asthmatic Patients in Tehran, Iran.

PubMed (2015)

Laleh Sharifi Zahra Pourpak Mohammad Reza Fazlollahi Saied Bokaie Hamid Reza Moezzi

High prevalence and increasing rate of asthmatic patients around the word witnesses the high burden of asthma. We have limited data on asthma burden and economic costs in Iran. This study aimed to find direct and indirect economic costs of asthma and their association with some background factors in one of the referral tertiary centers for adult patients with asthma.We surveyed asthma related economic costs of 197 adult patients who referred to Milad Hospital, Tehran, Iran from Jun 2007 to January 2010. The patients were followed up for a period of one-year ±1 month and asthma related costs and its control status were registered.Patients were consisted of 125 (64.1%) females and 70 (35.9%) males. Total cost of asthma was 590.22 ±32.18 USD for one patient per one year, the cost of drug, paraclinic, doctor visit, hospitalization, emergency, transportation, and absent days were 327.02, 4.76, 35.44, 3.82, 0.26, 113.03, 105.89 USD respectively. Men showed a significant elevation in their total (P=0.009) and drug costs (P=0.028). In addition, we found significant differences between total asthma costs and asthma control status (P=0.002).According to the high proportion of asthma, related cost compare to Total Income of an Iranian family, the necessity of public coverage of health assurance is quite clear. We suggest that improving asthma management and accessibility to specialized treatment centers can result in decreasing asthma medication and transportation costs as major direct and indirect asthma related costs.

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Citations (6)