mohammadreza javan

Exosomes are a group of extracellular vesicles that are produced by various cells and are abundantly found in body fluids such as plasma. Due to their special structure, these small particles are able to carry and contain various compounds and establish cellular communication. Also, much attention has been paid to the ability of exosomes as new treatment option in various fields of regenerative medicine. One of the most abundant exosomes in plasma is platelet derived exosomes, which are rich in compounds found in platelet granules, such as growth factors. Since the use of platelets and platelet-rich plasma has been very effective in regenerative medicine, in recent years the use of platelet exosomes in regenerative medicine has received much attention and investigation. This review briefly examines the role of platelet exosomes in various fields of regenerative medicine, such as hair repair, wound healing, orthopedic injuries, angiogenesis, and drug delivery. The results of this study show that these microparticles have low immunogenicity, low thrombogenicity, and they are very useful and efficient in regenerative medicine.

Cardiovascular disease (CVD) is one of the principal causes of mortality in the world. Various factors have been identified in the pathogenesis of CVD. Leukemia inhibitory factor (LIF) as a secretory cytokine is one of these factors. The LIF receptor is located on endothelial cells and plays a role in the expression of specific genes in these cells. Endothelial cells are the innermost cells of blood vessels, and defects in these cells cause endothelial dysfunction and eventually CVD.

The present study is based on PubMed database information (1982–2022) using the following words: “cardiovascular disease,” “endothelial cells,” “leukemia inhibitory factor,” and “angiogenesis.”

LIF can cause arteriosclerotic plaques by activating inflammatory mechanisms in monocytes through the induction of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 expression. LIF can also induce vascular endothelial growth factor expression by activating signaling pathways, eventually leading to angiogenesis. Additionally, it can activate the coagulation cascade by factor VII production promotion within endothelial cells.

Understanding the interplay between LIF and the inflammation pathways, coagulation, and angiogenesis as key factors in CVD occurrence raises the possibility of targeting this factor as a potential strategy to mitigate CVD risk.

platelet count errors such as PU flag, could cause misdiagnosis.

Case report:

 a 36-year-old thalassemia minor male with fever and myalgia presented. Petechiae and purpura in the lower extremities of patients were observed in physical examination. The platelet count was assessed by Nihon Kohden’s Celltac G cell and Sysmex XP-300 cell counter and the platelet count was reported 10,000/μL and 129,000/μL respectively. But peripheral blood smear assessment confirms that the result of the Sysmex XP-300 cell counter was wrong and a platelet flag was seen. This situation can be corrected by the CBC histogram and peripheral blood smear evaluation.

Sysmex XP-300 cell counter inability to differentiate severely microcytic cells from platelets can cause the PU error, which means the severe microcytic RBCs were counted as platelets that cause the platelet count falsely higher than the actual number in this patient. The PU flag means the platelet histogram intersects the PU line and does not touch the zero baseline, that occur in conditions such as platelet clumps, giant platelet, microcytic and fragmented or dysplastic RBCs in hemolytic anemia. In Nihon Kohden’s Celltac G cell counter, due to the change in the PU line this error was prevented and the actual platelet count of the patient was reported. By the way, to avoid such errors, abnormal platelet counts should always be confirmed with the findings of PBS. ConclusionPoikilocytosis such as microcytic RBCs can cause the PU flag, so platelet and erythrocytes histograms and PBS evaluation should be assessed.

Acute lymphoblastic leukemia (ALL) causes uncontrolled cell proliferation and prevents normal cell differentiation at any stage of hematopoiesis. Therefore, timely diagnosis and treatment are very important. Complete blood count (CBC) can be a simple, but valuable initial test to diagnose ALL. In this study, we investigated the diagnostic value of hematological parameters, including Platelet to lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and hemoglobin to Platelet ratio (HPR) indices in ALL.

In this study, 54 ALL patients (Mean ages: 5.29) and 58 healthy controls (Mean ages: 5.53) were evaluated. They were compared in terms of hematological parameters, including PLR, NLR, and HPR; cytogenetic and immunophenotypes were also analyzed.

In the analysis of hematological factors between the studied groups, all indices except lymphocytes showed a statistically significant relationship (P-Value ˂0.05). In terms of hematological factors, only WBC and ESR were statistically significant between the B-ALL and T-ALL groups (P-Value ˂0.05). The ROC curve was generated to select the appropriate cut-off values for NLR, PLR, and HPR based on analysis. NLR and PLR have cut-off values of 0.50 and 62.24, respectively; they are good biomarkers to distinguish ALL individuals from normal people. HPR value was significant between case and control groups, but it was not a suitable indicator for distinguishing patients from the control group.

CBC is a simple and valuable test for early detection of ALL, and the new PLR and NLR markers are good hematologic markers for ALL diagnoses.

Background &  Recurrent pregnancy loss (RPL) is the occurrence of three or more miscarriages before the 20th week of pregnancy. Thrombophilia factors are one of the common causes of RPL.Materials &  This retrospective study was performed on women with miscarriages. 620 patients’ documents with pregnancy loss were investigated. Based on the number of pregnancy loss, the women were divided into a control group with less than three miscarriages (212) and RPL group (180). Cytogenetics analysis and thrombophilia factors polymorphism tests were performed for all patients. In the analysis, none of the studied polymorphisms (MTHFR 677 C⁄T /Factor V Leiden /Prothrombin G20210A/ ACE I/D/ PAI-1) showed a significant relationship between Control and RPL groups (P-value ˃ 0.05). Cytogenetic analysis showed 2 numerical and 9 structural abnormalities among both groups. Statistical analysis indicated a significant association between the number of abortions and age (P value= 0.005, r= 0.139). We even realized that there was a significant relationship between polymorphism number and recurrent number of miscarriages (P value= 0.018, r= 0.6). We showed that polymorphisms analysis for thrombophilia factors is a more precious test than cytogenetics analysis (study of the banded pattern of chromosomes during metaphase of the cell cycle). We even indicated that no association was found between thrombophilia polymorphisms in the control and RPL groups. This means that screening for Factor V Leiden, prothrombin G20210A, MTHFR C677T, ACE I/D, and PAI-1 and cytogenetic analysis in patients with a history of RPL is not recommended.

Interaction between cancer cells and the coagulation system could have reciprocal effects on both groups. Coagulation-fibrinolytic cascade is a process that regulates the homeostasis of the body, and this process can be disrupted by several factors; one of the most important factor is cancer. In contrast, the coagulation-fibrinolytic system can also act as a factor in cancer growth and metastasis. Our aim in this study is to investigate this relationship.

The present study is based on Pubmed database information (2010- 2023) using the words “Cancer”, “Coagulation”, “Platelet “, “Tissue factor” and “ VTE “.

Cancer cells disrupt the coagulation process by activating prooncogenic factors or inhibiting tumor suppressors, thereby inducing changes in platelets and coagulation factors, and increasing proteins involved in coagulation. These aberrations in the coagulation system result in coagulation abnormalities such as venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC). In various cancers, the activity of the coagulation and fibrinolytic systems increases, leading to an increase in coagulation and fibrinolysis factors. These factors are closely related to tumor size, tumor stage, cancer progression and metastasis.

The coagulation-fibrinolytic system is closely related to cancers.Cancer cells can disrupt the coagulation-fibrinolysis process. Also, coagulation-fibrinolytic agents can both lead to cancer progression and can be used as a marker for the prognosis of some cancers.

Fanconi anemia (FA) is an autosomal recessive disorder that usually manifest in forms of pancytopenia, hyperpigmentation, and skeletal complications. Mutation in the DNA repair regulatory genes is associated with the development of FA. Examination of chromosomal breakages when chromosomes are exposed to cross-linking agents is a common method of FA diagnosis. This study aimed to evaluate the prevalence and characteristics of patients with FA in Mashhad, northeast of Iran.

In this study, we evaluated 312 suspected FA patients who had been referred to the laboratory of Ghaem Hospital during 2014-2020. The mitomycin C method was used to identify FA-positive subjects.

After the examinations, 84 patients (26.9%) were cytogenetically positive for FA. Of 84 patients, 48 (57.1%) were male and 36 (42.9%) were female. Thumb abnormality was the most common congenital anomaly (43.2%).

Based on the findings, males are more susceptible to FA, and thumb abnormality is the most common congenital anomaly associated with FA. Combination of clinical manifestations and genetic susceptibility in patients may contribute to a more accurate diagnosis.

Given the role of chronic inflammation in developing GDM (gestational diabetes mellitus), investigating hematological inflammatory indicators such as platelet-to-lymphocyte ratio (PLR), hemoglobin-to-platelet ratio (HPR), and other blood biomarkers can be helpful in GDM patients. The present study was conducted aimed to evaluate the hematological inflammatory indicators of women with GDM compared to the control group.

In this retrospective study, the profiles of 300 pregnant women with a definite diagnosis of GDM admitted to Mohebbe Yas Hospital (Tehran) from 2019 to 2021 were investigated. In this study, the absolute number of blood cells and other hematological parameters were evaluated in separate groups of diabetic and normal pregnant mothers. The sensitivity and specificity of each statistically significant variable were determined by ROC curve analysis. Data were analyzed by SPSS (version 22) and Mann-Whitney U, Independent t-test, Wilcoxon, and Chi-square tests. P˂0.05 was considered statistically significant.

In terms of absolute lymphocyte count (ALC), the results of comparison between GDM and normal groups showed that this index had a sensitivity of 84.07% and a specificity of 37.98% in the diagnosis of GDM patients, and it was statistically significant (p= 0.022). The absolute neutrophil count (ANC) index had a sensitivity of 66.78% and a specificity of 53.49%, which was statistically significant (p= 0.012). The PLR index had a sensitivity of 54.08% and a specificity of 66.67% (p<0.001). However, HPR and NLR indices were not statistically significant (p>0.05).

This study showed that in GDM patients, ALC and ANC indices decrease and PLR increases. To improve the screening process of high-risk pregnant women for GDM, the predictive value of each of these indices in the incidence of GDM can be investigated in future studies.

Today, young women infertility through chemotherapy has become a global challenge. Chemotherapy destructs the malignant cells by reactive oxygen species (ROS)productionand inflammatory factorssecretion; these factors can also destructthe ovarian and uterine cells. Infertility usuallyhappens as a result of ovarian and uterine cellsapoptosis, as well as dysfunctionin these organs. Signaling pathways activated by chemotherapy lead to increased activation of follicles and depletion of the follicular pool. In addition, excessive secretion of sex hormones leads to follicles activation and infertility in women. Mesenchymal stem cells(MSC) use havebeen reported to be a great help inrestoringthe function of ovarian and uterine cells.On the other hand, theycanregulate sex hormonesecretion. Finally, the use of MSCsas a suitable treatment strategy can help restore the function of reproductive cells and treat infertility.

Multiple sclerosis (MS) has not been comprehensively characterized in the 21th century yet. MS is an autoimmune neurodegenerative disease of the central nervous system (CNS) with unknown etiology. It is a heterogeneous disease both in the course and clinical symptoms and in the clinical response to treatment. Pharmacogenomics has potential to impress the treatment strategies of the diseases. It is related to the targeted populations that are genetically identifiable with the therapeutic interventions and it permits to elicit quick and optimized curative outcomes alongside the least possible side effects. In the case of successful manipulation of the personalized medicine, the trial-and-error approach for the treatment of diseases such as MS would no longer be mandatory. Moreover, pharmacogenetic and pharmacogenomic investigations contribute to the determination of genetic background of individual patients and may open new horizons to the personalized medicine. By identifying the various biological and social determinants of MS outcomes, personalized medicine could be applied in medical interventions and psychosocial manifestations, exercise and nutrition. Application of this highly personalized approach is promising and hopefully would culminate in cost-effective care.

Context: As a globally major health problem, tuberculosis (TB) causes almost two million cases of death annually. Epidemiological studies demonstrate that a third of the world’s individuals is infected with Mycobacterium tuberculosis.
Evidence Acquisition: Approximately 10% of infected patients with M. tuberculosis develop chronic manifestation as TB. Due to HIV coinfection and emerging the drug-resistant TB, the disease has been increasing and its control has been frustrated in several parts of the world.
Current diagnostic techniques and therapeutic tools for TB are not satisfactory. Consequently, it is urgently essential to establish new therapies concerning vaccines, immunotherapeutic agents to provide prosperous attempts for TB controlling. To achieve this goal, it is required to be armed with comprehensive understanding of immunobiology and immunopathogenesis of TB. This would be beneficial in designing new immune-based protections, drug discoveries, personalized medicine by choosing highly-effective immunotherapeutic interventions, identification and development of novel drug candidates.
Hopefully, immunotherapies could be advantageous in modulating the immune system in patients with TB, providing efficient control of M. tuberculosis infection perpetuation and, therefore, its pathogenesis. This review herein attempts to describe the function of immune system in response to TB that is of the therapeutical and clinical importance. Moreover, new insights based on therapeutics to resolve TB with immunological orientation will be discussed.

To address the continuously increasing demand for high data rates, beside air interface technologies, there are requirements to introduce new and effective ways to design architecture of networks. This paper proposes several technologies which can be used as promising candidates to change the future of wireless communication architecture especially in Fifth generation (5G) wireless network. In this article, we discuss various promising cellular architectures such as full duplex communication, device-to-device communication, mobile femtocell, visible light communication and visualization in 5G.

Due to the influence of Internet and mobile service in every part of our lives in addition to pervasive demand for them, next generation wireless networks should be able to address different kind of objectives or demands. New generation of cellular networks must achieve high user quality of experience (QoE) in order to satisfy the user demands and survive in market. To meet this demands, drastic revision need to be made in previous network architecture. This paper reviews some of the key technologies which are emerged to improve future network architecture and meet the demands of users, especially in Fifth generation (5G) cellular network. In this paper, the prime focus is on the air interface of 5G which includes millimeter wave communication, multiple access technologies, carrier aggregation (CA), and massive Multiple-Input Multiple-Output (MIMO).

Programmed cell death-1 (PD-1) and its ligands, PD-L1 and PD-L2, have been regarded as important immune system regulatory molecules. The aberrant expression of the molecules has been related to several autoimmune disorders. This study is aimed to assess the mRNA expression level of PD-1, PD-L1, and PD-L2 molecules in the peripheral blood mononuclear mells (PBMCs) from multiple sclerosis (MS) patients. PBMCs were isolated from the whole blood of 50 MS and 50 healthy individuals. Total RNA content of the leukocytes was extracted. Then, cDNA was synthesized from the extracted RNA. Afterwards, quantitative analysis of PD-1, PD-L1 and PD-L2 was carried out through Real Time PCR using the TaqMan gene expression assays. Relative expression of PD-1 and PD-L1 in PBMCs from MS patients was significantly lower compared with the healthy control group (p=0.003 and 0.012, respectively). However, no significant difference was observed in the expression level of PD-L2 between patients and healthy individuals. Relative expression of PD-1 correlated with expanded disability status scale score (EDSS) of the patients (r=-0.763, p=0.008). Downregulation of the immunosuppressive molecules, PD-1 and PD-L1, may imply that over-activation of immune cells in multiple sclerosis occurs through signaling dysfunction of these molecules and PD-L2 plays no important role in this context.