فصلنامه آزمایشگاه و تشخیص
پیاپی 59 (بهار 1402)

Rheumatoid arthritis (RA) is a multi-faceted inflammatory disease which affects joints and other organs. The pathophysiology of RA is not completely clear and no gold standard test exists to confirm disease diagnosis. Regarding the presence of non-specific clinical manifestations in the course of the disease, it is important to be able to identify the RA phenotype at an early stage of the disease development to delay or prevent the disease from becoming chronic and reduce the possibility of erosive changes to the joints. There are some laboratory tests including rheumatoid factor (RF), anti- cyclic citrullinated peptides (anti-CCP), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) helping the RA diagnosis along with joints involvement. It is aimed to present the last classification criteria to diagnose RA disease in patients at risk of developing persistent and erosive arthritis. These criteria for RA have been presented by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) in 2010. Along with the above mentioned tests, measurement of 14-3-3ƞ protein complementary to RF and anti –CCP is recommended by some researchers for increasing sensitivity of RA diagnosis.

In the late of 20th century DNA fingerprinting has revolutionized forensic science either in criminal investigation or family disputes. Although the DNA in the our cells has more than 99.5% homology in Homo Sapience (the species from which all modern humans have diverged), the remaining (less than 0.5%) shows variation between individuals. On the basis of this assumption, Alec Jeffreys, the British scientist, introduced the DNA fingerprinting in 1984. In this method some regions of DNA with tandem repeated sequence, are used as a marker to produce individual specific-fingerprints. Of course, it should be noted that finally the result are interpreted on the basis of average match probability. It means to what extent the test result could be obtained by chance. For example, the probability that two people have the same genomic content is estimated to be one in 594.1 trillion. The cut-off value of these probabilities is determined by political decision. In this review, after a brief description of the history, we will explain the types of markers and their use in related issues.

While fungal infections of the CNS are relatively rare, they have become more common with the increasing number of individuals who are immunocompromised due to HIV/AIDS, immunosuppressive therapies, invasive diagnosis and treatment methods, and organ transplants. CNS fungal infections present many diagnostic and therapeutic challenges and are associated with a high mortality rate. While immunocompromised patients are the most susceptible to CNS fungal infections, they can also occur in immunocompetent patients undergoing invasive procedures such as neurosurgery and in patients exposed to contaminated devices or drugs. In addition, heavy exposure to fungi in endemic regions can lead to infection in immunocompetent individuals. CNS infections caused by dimorphic fungi are diverse and their signs and symptoms might be associated with the characteristics of both the host and the infectious fungi, including variations in neurotropism and immunosuppression. Infection with these species is frequently caused by spore inhalation in endemic regions. Predominant clinical characteristics include meningitis, brain or epidural abscesses, spinal cord lesions, meningoencephalitis, and primary lung infection. Aspergillus infections of the CNS are typically caused by Aspergillus fumigatus and arise through hematogenous spread from the primary sites of infection which is mostly pulmonary, or from contiguous anatomical sites, such as the paranasal sinuses. While symptoms are largely nonspecific, the most common signs include fever, focal neurologic defects, seizures, alterered mental status, and lack of response to broad-spectrum antibiotics. Predominant findings include focal lesions or brain abscesses. CNS infection with non-aspergillus molds most commonly involve zygomycetes, which typically affect the airways. Other non-aspergillus molds, such as Scedosporium apiospermum, Fusarium, and some phaeo- hyphomycetes are less frequent causes of CNS infection. The predominant clinical characteristics of CNS infection due to non-aspergillus molds include brain abscesses and, less commonly, meningitis and primary infection. Diagnosis of fungal CNS infection involves microscopic and histopathologic examination, and serologic testing such as: Galactomannan antigen testing in CSF showed a sensitivity of 88% and a specificity of 96% for CNS aspergillosis CSF antigen testing was found to have a sensitivity of 93% and specificity of 100% for coccidioidal meningitis β-D-glucan testing of CSF demonstrated 100% sensitivity and 98% specificity for meningitis caused by Exserohilum rostratum Molecular tests such as polymerase chain reaction may help to confirm the diagnosis, although most are not standardised and the fast-growing genomic knowledge about fungi requires regular curation of sequence data. The preferred diagnostic imaging tests for CNS fungal infections are computed tomography (CT) and magnetic resonance imaging (MRI), which facilitate detection of infectious lesions and associated complications and can inform the selection of interventions.

Gestational diabetes mellitus (GDM) is defined as a glucose intolerance that is diagnosed first during pregnancy. GDM is associated with an increased risk of short-term and long-term disorders for both mothers and their offspring. Therefore, early prediction and diagnosis of GDM are very crucial. The oral glucose tolerance test (OGGT) at 24–28 weeks of gestation is the gold standard method for diagnosing GDM. Because pathological changes that trigger GDM development occur before GDM, identifying biomarkers with the ability to predict GDM is pivotal. In this review article, we reviewed current literature regarding methods that are routinely used for diagnosis of GDM. Furthermore, we discussed about the possible benefits and challenges of using adipokines, inflammatory biomarkers, metabolomic findings, and molecular biomarkers for the early prediction of GDM.

The liver, as the largest organ of the body, plays a vital role in metabolism, detoxification, maintenance of homeostasis, food synthesis and storage, and defense against invading macromolecules. Liver diseases can be caused by exogenous factors, such as alcohol consumption, drug toxicity, induction of toxins and infections, or endogenous factors, such as metabolic syndromes, autoimmune and genetic diseases. By applying damages, the liver enters the first stage of the disease, non-alcoholic fatty liver disease (NAFLD), which has problems in lysis and breakdown of fat, which, if accompanied by inflammation, leads to non-alcoholic steatohepatitis (NASH). If the disease process continues and there is no treatment, (persistent and chronic damage) the liver enters a more advanced stage of the disease, i.e., fibrosis. The amount of extracellular matrix accumulation and type I, III, and IV collagen production increases up to ten times during fibrosis, and over time, it leads to cirrhosis, hepatocellular carcinoma (HCC), and death due to liver dysfunction. Several cells and inflammatory pathways are involved in the development of liver fibrosis Probable and pre-clinical treatment methods have been reported for the treatment of liver fibrosis, but definitive methods for the treatment and reversibility of the disease in humans have not yet been proven.

Crocins, as a type of water-soluble carotenoid, are a set of ester compounds that are formed from crostin and glucose and are mainly found in saffron. Crocin has been reported to have a wide range of biological activities such as cardiovascular protection. Saffron has long been used as a folk medicine to treat various diseases and conditions including neurological diseases, memory disorders, arteriosclerosis, blood lipids, diabetes, high blood pressure, ulcers and fatty liver disease. Clinical studies have shown the effectiveness of crocins in the treatment of various diseases, including metabolic syndrome, depression and coronary artery diseases. Crocins, which are compounds derived from saffron, have protective effects against cerebral ischemia and ischemic stroke; They exert various biological activities including neuroprotection, anti-neuro-inflammation, antioxidant and cardiovascular protection and anti-apoptotic by inhibiting inflammatory biochemical markers and oxidative stress. In fact, there is a clear relationship between oxidative stress and disruption of the blood-brain barrier during ischemia, and crocins protect the brain against excessive oxidative stress and are therefore a potential candidate in the treatment of cerebral ischemia.