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Respiratory viral infections are common respiratory diseases. Influenza viruses, RSV and SARS-COV2 have the potential to cause severe respiratory infections. Numerous studies have shown that unregulated immune response to these viruses can cause excessive inflammation and tissue damage. Therefore, regulating the antiviral immune response in the respiratory tract is of importance. In this regard, recent years studies have emphasized the importance of vitamin D in respiratory viral infections. Although, the most well-known role of vitamin D is to regulate the metabolism of phosphorus and calcium, it has been shown that this vitamin has other important functions. One of these functions is immune regulation. Vitamin D can regulate the antiviral immune response in the respiratory tract in order to provide an effective defense against respiratory viral infections and prevention from excessive inflammatory response and tissue damage. In addition, this vitamin has preventive effects against respiratory viral infections. Some studies during the COVID-19 pandemic have shown that vitamin D deficiency may be associated with a higher risk of mortality and sever disease in patients with COVID-19. Since, more attention has recently been focused on vitamin D. In this article, after a brief overview of the antiviral immune response in the respiratory system, we will review the role of vitamin D in regulating the antiviral immune response comprehensively. Then we will discuss the importance of this vitamin in influenza, RSV, and COVID-19. [ABSTRACT FROM AUTHOR]

Background and Objective: Despite the self-limiting nature of bronchiolitis, its severe forms require hospitalization. Electrolyte imbalance during bronchiolitis is common, however, the relationship between bronchiolitis severity and serum sodium (Na) levels has not been well studied. The purpose of this study was to investigate the relationship between serum Na level and bronchiolitis severity. Methods: This cross-sectional study included hospitalized children with bronchiolitis at Amirkola Children's Hospital, Babol, Iran, from May 2020 to May 2021. Diarrhea, underlying disease, glucocorticoid intake, and intravenous fluid therapy before admission were considered exclusion criteria. The Bierman-Pierson scale was used to evaluate the severity of the disease, and hyponatremia was divided into mild, moderate, and severe groups. Variables were analyzed using Statistical Packages for Social Sciences (SPSS) 26. A value of P<0.05 was considered significant. Findings: Sixty-one children (55.7% male) with a mean age of 5.19 ± 4.36 months were enrolled in the study, with most (50.8%) belonging to the mild form of the disease. The mean serum Na levels based on the severity of bronchiolitis were 136.22 (SD: 2.99), 133.76 (SD: 3.88), and 130.50 (SD: 11.45) in the mild, moderate, and severe groups, respectively. There was a statistically significant relationship between serum sodium level and severity of bronchiolitis (P-value = 0.013). Conclusion: The results showed that higher severity of bronchiolitis was associated with an increased risk of hyponatremia. Therefore, periodic monitoring and correction of hyponatremia in children with bronchiolitis, especially at younger ages, is necessary to improve the outcome of the disease. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the transverse and vertical dimensions of the palate of children with allergic rhinitis (AR). There was no significant difference for intermolar and intercanine distances between two groups in primary and mixed dentitions. Palate depth in children with allergic rhinitis was statistically more than in children without any respiratory disease. Cross bite was more prevalent in study group. It seems that the main influence of alteration of breathing pattern from nasal to mouth occurs on the vertical plane.

Hereditary Angioedema (HAE) is a rare autosomal dominant immunodeficiency disease with mutation in C1 inhibitor gene (SERPING1) which deficient and dysfunction of C1-INH protein result in HAE type I or type II, respectively. The present study aimed to define the genetic spectrum of HAE type I and type II among Iranian patients. Thirty-four patients with clinical phenotype of recurrent edematous attacks in face, upper and lower limbs, hands, and upper airway entered the study. Mutations in SERPING1 were analyzed using PCR and Sanger Sequencing. In addition, Multiplex Ligation-dependent Probe Amplification (MLPA) was performed to discover large deletions or duplications in negative screening samples by Sanger. Twenty-three patients were diagnosed with HAE type I and 11 with HAE type II. Fourteen distinctive pathogenic variations including five frameshift (p.G217Vfs*, p.V454Gfs*18, p.S422Lfs*9, p.S36Ffs*21, p.L243Cfs*9), seven missense (p.A2V, p.G493R, p.V147E, p.G143R, p.L481P, p.P399H, p.R466C), one nonsense (p.R494*), and one splicing defect (C.51 + 2 T˃C), which three of these mutations were identified novel. However, no mutation was found in seven patients by Sanger sequencing and MLPA. Final diagnosis with mutation analysis of HAE after clinical evaluation and assessment of C1INH level and function can prevent potential risks and life-threatening manifestations of the disorder. In addition, genetic diagnosis can play a significant role in facilitating early diagnosis, pre-symptomatic diagnosis, early diagnosis of children, asymptomatic cases, and those patients who have the borderline biochemical results of C1-INH deficiency and/or C4. [ABSTRACT FROM AUTHOR]

CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/CRISPR‐associated protein9) may be viewed as an adaptive bacterial immune system. When a virus infects a bacterium, a fragment of the virus genome is inserted into the CRISPR sequence of the bacterial genome as a memory. When the bacterium becomes infected again with the same virus, an RNA molecule that is a transcript of the memory sequence, directs Cas9, an endonuclease, to the complementary region of the virus genome, and Cas9 disables the virus by a double‐strand break. In recent years, studies have shown that by designing synthetic RNA molecules and delivering them along with Cas9 into eukaryotic cells, different regions of the cell's genome can be targeted and manipulated. These findings have drawn much attention to this new technology and it has been shown that CRISPR/Cas9 gene editing can be used to treat some human diseases. These include infectious diseases and autoimmune diseases. In this review article, in addition to a brief overview of the biology of the CRISPR/Cas9 system, we collected the most recent findings on the applications of CRISPR/Cas9 technology for better investigation of the pathogenesis and treatment of viral infections (human immunodeficiency virus infection, hepatitis virus infections, and onco‐virus infections), non‐viral infections (parasitic, fungal, and bacterial infections), and autoimmune diseases. [ABSTRACT FROM AUTHOR]

Background: Pediatric asthma is a prevalent disease and has a significant immunologic and inflammatory nature. In recent years, the role of vitamin D3 in immunologic processes has been studied, and many aspects of this role have been clarified in some human diseases. Objective: The aim of this study was to evaluate the relationship among the vitamin D3 status, Pediatric Asthma Severity Score (PASS), and inflammatory indicators of pediatric asthma. Methods: Among all of the pediatric patients with asthma and with asthma exacerbation, 100 patients were randomly enrolled in the study and subdivided into three groups according to serum levels of 25-OH vitamin D3. The control group consisted of 100 sex- and age-matched healthy subjects. Asthma exacerbation severity was evaluated based on the PASS before starting the medical care. The count of the white blood cells, eosinophil count, and serum levels of total immunoglobulin E (IgE) plus 25-OH vitamin D3 were measured in all the subjects. The obtained data were then compared via proper statistical tests. A p value of <0.05 was considered as statistically significant. Results: The median level of serum IgE was increased in patients with vitamin D3 deficiency compared with other groups. There was a significant inverse correlation between serum levels of 25-OH vitamin D3 and IgE in pediatric patients with asthma (r = -0.483, p = 0.001). Furthermore, the serum levels of 25-OH vitamin D3 also significantly inversely correlated with the PASS (r = -0.285, p = 0.004). Conclusion: Vitamin D3 deficiency is associated with exacerbation severity and serum IgE levels in patients with pediatric asthma; hence, it can have an important role in pediatric asthma pathogenesis, possibly through IgE. [ABSTRACT FROM AUTHOR]

Objective: Hereditary Angioedema (HAE) is a rare autosomal dominant disorder that is caused by improper quantitative level or C1-inhibitor function and these lead to the HAE type I and type II, respectively. C1-inhibitor is a serine protease inhibitor, which controls the activation of complement system and regulation of the fibrinolytic, contact and coagulation systems. C1-inhibitor gene (SERPING1) is located in the q12-q13.1 sub-region of chromosome 11 and consists of eight exons. The aim of this study is genetic diagnosis of HAE type I patients. Material and Methods: The patients who referred to Immunology, Asthma & Allergy Research institute (IAARI) between Jan 2006 to Jan 2014 with clinical phenotype of HAE (subcutaneous angioedema, abdominal pain, laryngeal edema), were entered this study. Twenty HAE type I patients were evaluated for genetic analysis of SERPING1 gene based on low levels of C4 and C1-inhibitor. Blood samples were obtained from these patients and after the DNA extraction from EDTA treated blood samples, polymerase chain reaction (PCR) was accomplished for coding exons (exon 2 to 8) of SERPING1 gene and PCR products were sequenced and the results were analyzed by Finch TV program. Results: Among twenty patients from 15 families with HAE type I, 9 mutations in SERPING1 gene were identified in 12 patients. All mutations were in heterozygous state except one new homozygous missense mutation (c.440T>A) in a patient. The others including one splicing defect (c.51+2T>C) in intron 2, three frame shift mutations in exon four (c.650delG) and exon 8 (c.1356_1357delTG, c.1264delT), three missense mutations in exon 2 (c.5C>T), and exon 8 (c.1477G>A, c.1442T>C), and one nonsense (c.1480C>T) mutation in exon 8 which are previously reported. Conclusion: HAE is a life-threatening disease, and if laryngeal edema occurs possibly leads to death. Therefore, early genetic diagnosis in the families who carries the mutation with symptomatic or asymptomatic phenotype of disease could be helpful for prevention of acute edema and proper treatment in HAE patients and other family members. [ABSTRACT FROM AUTHOR]

Background: Urticaria is a common dermatologic disease. About 20 per cent of the population experiences it in a life-time period. The aim of this study was to compare the various laboratory examinations of chronic urticaria patients and healthy individuals and to determine the necessity of laboratory tests in such patients. Materials and Methods: In this study 78 patients suffering from chronic urticaria and 67 healthy individuals (2-50 year-old) with analogous demographic features underwent ALT, AST, S/E, ESR, CBC, TSH, T4, C4, C3, CH50, ANA, anti-thyroglobulin, anti-peroxidase, and anti H. pylori antibodies testing. Results: Forty-one per cent of patients had increased IgE in comparison to 14.92% in normal subjects. Anti-thyroid antibodies were positive in 17.94% of cases while only 9% of normal individuals were positive (p<0.05). Anti H. pylori antibodies were positive in 69.23 % of patients (all above 18-year-old) and 61.19 per cent of normal population (p>0.05). No significant difference found in other variables. Conclusion: Urticaria is often diagnosed based on clinical grounds and no routine laboratory examination is required. [ABSTRACT FROM AUTHOR]

Objective: Hereditary Angioedema (HAE) is a rare autosomal dominant disorder caused by low serum levels (type I) or dysfunction (type II) of C1 Inhibitor (C1INH), which is characterized by subcutaneous and/ or submucosal edema attacks involving face, limbs, genitalia, gastrointestinal and respiratory system. HAE could give rise to fatal laryngeal edema, acute abdominal pain leading to unnecessary emergency surgeries, and reduced quality of life. Therefore, the aim of this study was to investigate and report the demographic, clinical and laboratory findings of patients registered in Iranian HAE registry (IHAER). Material and Methods: The patients referred (2006-2016) to Immunology, Asthma and Allergy Research Institute (IAARI) with symptoms suggestive of HAE were investigated (after signing informed consent form) using a questionnaire and laboratory tests. The patients with a definite diagnosis of HAE (type I, II) based on low serum levels of C4 and C1INH quantity/quality accompanying with suggestive clinical findings (after ruling out other possible etiologies) were enrolled into this study. Moreover, in some cases genetic analysis reconfirmed laboratory results. Results: Among 80 patients registered in IHAER with definite diagnosis of HAE (Type I, II; 48.8%, 51.3%) 30 patients belonged to children and adolescents group (aged ≤ 21). The median symptoms age-onset and median diagnostic delay were 11 (min, max; 1, 72) and seven (min, max; 0, 39) years, respectively. Physical trauma (69.7%) and emotional stress (57.6%) were found to be the most common triggers of attacks; however, 82% of patients reported spontaneous attacks as well. The most commonly involved sites were face and limbs. Moreover, laryngeal edema was reported in 56.1% of patients leading to death in three patients during this study. Conclusion: HAE is a life-threatening disease diagnosed with significant delay possibly due to mistaking it for other disorders causing similar symptoms such as acute face and limbs edema. On the other hand, complete avoidance of emotional and physical stress as common HAE triggers could not be easily achieved. Thus, the outcomes of IHEAR in the form of scientific papers/reports is meant to inform health care providers, and policy makers about this rare disease, which would in turns, help with an earlier diagnosis, and improvement in patient care and quality of life. [ABSTRACT FROM AUTHOR]

Objective: Chronic cough is one of the most common causes of absence from school, education and disturbances in ordinary works. According to its high prevalence in our population and lack of study (ies) about this in our country, this study has been performed to estimate chronic cough preformed, to estimate chronic cough prevalence and determinate its relations to variables such as age, sex, location, parent's education and smoking. Materials and methods: This descriptive analytic cross- sectional study has been performed on 3222 students of primary school during 1379-80. Date was acquired by interview, completion of questionaries' and sanitary service records. Then information became analyzed and tested by person chi-square test if needed. Results: Findings showed that the prevalence of chronic cough in our population was 3.6% (3.5% male and 3.8% female). Among 3222 students, 1748 (962 male and 786 female) subjects were from urban and 1474 (719 male and 755 female) rural population. 118 cases had chronic cough in urban population the prevalence was 4 percent (3.2% male and 4.7% female) and in rural population 3.2% (3.6% male and 2.9% female). Among 118 involved students, 60 cases had a smoker father (50.8%) and among 3104 others, 1438 cases had a non-smoker father (46.3%). Conclusion: Our finding showed that sex, age location smoking and parent's education had relation to chronic cough of students. So we decide that for reducing the chronic cough prevalence in our society especially primary school ones. Health and sanity education planned and distributed in a wide array to diagnostic modalities and appropriate therapeutic plans for reduction of chronic cough complication. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the recognition of asthmatic students by their elementary school teachers in Babol, Iran.

Background: Hereditary angioedema (HAE) is a rare autosomal dominant disorder characterized by Cl-INH (Cl esterase inhibitor), low serum levels (type I), dysfunction (type II) or normal serum levels and function (type III), which lead to subcutaneous and submucosal edema attacks. The aim of this study was to investigate the demographic, clinical and laboratory findings of Iranian patients with HAE. Methods: The patients with a history or symptoms of angioedema who were referred to Immunology, Asthma and Allergy Research Institute (IAARI) between Jan 2006 and Jan 2014, were assessed based on a specific questionnaire and laboratory evaluation. The patients with a definite diagnosis of HAE type I and type II were entered into this study. Results: Among 51 patients, 63.3% were diagnosed with HAE type I and 36.7% with HAE type II. Fifteen patients were under 18 years and 36 were adults. The mean age of symptoms onset and diagnosis were 12.33 ± 10.20 years and 24.48 ± 14.64 years, respectively. The mean delay of diagnosis was 11.02 ± 11.60 years. The most commonly involved locations of edema were hands, face and genitalia. Moreover, laryngeal edema was observed in 61.2% of patients, which led to death in two patients during this study. Conclusion: Hereditary angioedema is a life threatening disease with considerable morbidity and mortality. The outcomes of this study can be used to inform clinicians and health care providers about HAE, which can help earlier diagnosis and better management of the patients, specifically in life threatening attacks. [ABSTRACT FROM AUTHOR]