Tehran University Medical Journal

Background: Although significant advances have been made in scientific and medical technology, but the rate of medical complaints has also risen. The purpose of this study was to investigate the effect of handling of medical malpractice cases in the hospital complaints committee on the reduction of patient complaints to law enforcement authorities.
Methods: In this descriptive study, patients complained about ophthalmology from April 2005 to December 2005 at Farabi Hospital, Tehran, were evaluated. The complainant's patients, if confirmed by the trusted doctors, were invited to complaints committee, and the subject of the complaint was examined and tried to obtain patient satisfaction.
Results: A total of 87 patients complained to ophthalmologists completed a complaint form 71 (81.7%) of the cases were male. Statistically, the number of complaints was significantly lower in those with lower education (P=0.02). The prevalence of primary disease, 52 cases (59.8%) was cataract and 14 cases (16%) due to refractive errors and refractory surgery. In the examination of complaints by trusted doctors in the hospital, 11 cases of ophthalmologic error were identified, with a mantle rate of 12.6%, and the cases were reviewed by the complaints committee. Of the cases of complained that confirmed by the committee, only one person sued the law enforcement, which represented 9% of the defaulted item. These statistics showed a significant decline compared to the past year at the same center, and the percentage of defaults to law enforcement was 37.5% (P<0.05).
Conclusion: Establishing committees to handle complaints of ophthalmologic failures in hospitals and providing a clear and honest atmosphere to hear the subject of complaints by patients and their companions, and then trying to get patients' satisfaction and helping them continue their treatment can lead to reduced complaints of patients to the authorities Legal, like forensics medicine department and medical council. 

Background: Determination of mortality causes precisely, is very important in developing countries. Mortality rate is a helpful index for evaluating the quality of health in every society. However, recording of life events as well as mortality rates are difficult and conducted only in a few developing countries which account for a large percentage of the world’s mortality. Thus, it was attempted to conduct a study on mortality cases of under 18 year’s old corpses referred to the dissection laboratory of forensic medicine in Tehran from 2014 to 2015.
Methods: In this cross-sectional descriptive study, all cases of accidental deaths less than 18 years old which were referred to forensic medicine in Tehran have examined. All mortality data between April 2014 and April 2015 was completed by a questionnaire. This data were classified by age, sex, cause of referral, type of death, underlying disease, and cause of death based on autopsy results and positive findings of autopsy, pathology, and toxicology.
Results: In 2014 and 2015, 495 and 508 cases of under 18 years old were sent to the dissection laboratory of forensic medicine in Tehran, consequently. The mortality rate of 520 males and 483 females was recorded and it has risen from 2014 to 2015. The most common mortality causes are accidents, suspicious death, suicide, and car accidents.
Conclusion: The results showed that the mortality rate in males was higher than females, which is in line with the global findings. This may be due to cultural issues or the vulnerability of males. Study on causes of deaths, which recorded over two years showed that deaths in Tehran province are due to accidents, falls, strangulation, life-threatening poisoning and electrocution, birth disorders and suicides, which requires more studies on these subjects.

Background: Medical malpractice is one of the most important legal issues in medicine committed more or less by physicians. The medical staff has inadequate or deficient awareness of medical errors and their importance. Therefore, this study investigated the frequency of medical malpractices/errors resulting in death in files referred to the Iranian Legal Medicine Organization.
Methods: The study population in this descriptive cross-sectional research consisted of all doctors who had been sued in Tehran's Legal Medicine Organization (Forensic Committees of Tehran Province) from the first day of July 2018 to the end of December 2018. The study was carried out in and under supervision and support of the Legal Medicine Research Center. Data were collected using a checklist of the files from Tehran's Legal Medicine Organization.
Results: The results showed that most medical errors are of organizational types. Major medical failures occur in university-affiliated hospitals among the male technical staff aged 41-50 years with a work experience less than 6 years. Most complaints were recorded against general practitioners, general surgeons, and anesthesiologists, respectively. The smallest percentage of the complaints related to orthopedics, urologists, and ear, nose, and throat (ENT) specialists.
Conclusion: The results of the study indicated that most of medical failures have of an organizational nature and occur in university hospitals among male technical officials who are in the fifth decade of life with a low work experience. So, paying attention to these issues can help the better selection of technical officials. The technical authorities of the hospitals must be careful about the responsibilities given to them. In order to reduce the failure of the technical authorities of the hospitals, doctors with a high standard of service should be appointed as technical officers. These doctors ought to possess legal knowledge and be familiar with the course of complaints filed in the judiciary.

Background: Potency evaluation of rabies vaccine is a cheap, fast, high precision and consistent with ethical values is critical, so researchers have modified a variety of methods such as: National Institute of Health (NIH) method, Single Radial Immunodiffusion (SRID) and so on. The purpose of the present study was to replace an in vitro method consistent with medical ethics criteria instead of an in vivo method. By recognizing that the potency of the rabies vaccine depends on the amount of glycoprotein antigen content and the monoclonal antibody detect the correct folding of antigen of the rabies virus, then the glycoprotein content could be represent of vaccine potency.
Methods: In this study, we designed an immune-capture enzyme-linked immunosorbent assay (ELISA) with three antibodies (capture, primary and secondary) to determine the existent amount of viral glycoprotein in different rabies vaccines, and compared the results at the same time with measuring potency of those vaccines using the NIH method. This applied study was conducted from September 2016 to September 2018 at the Research Laboratory of the World Health Organization Collaborating Center for reference and research on rabies at the Pasteur Institute of Iran in Tehran.
Results: The slope of the standard line was calculated to R2=0.98 (P=0.0013). In the humans’ vaccines, the mean lied between 5.554-7.336 (SD=0.0463-0.1039) and the coefficient of variation was 0.778-2.436 (SD=0.0041-0.2724), at the same time in the animals’ vaccines the mean were 2.293-5.993 (SD=0.0041-0.2724) and the coefficient of variation was calculated 0.182-4.546. For animal vaccines the Pearson correlation coefficient is 0.99 and for the human vaccines this coefficient was 0.95. Also, the concordance correlation coefficient for animal vaccines was 0.98 and for human vaccines is 0.95, indicating a moderate to high concordance in both animals and humans vaccines.
Conclusion: The designed Immuno-capture ELISA kit had a proper acceptance criterion, intermediate precision, good linearity and robustness for measuring the glycoprotein level of the vaccine, which was directly related to the vaccine potency.

Background: Amphotericin B is one of the most useful therapeutic modalities for the treatment of patients with invasive fungal infections, in spite of serious side effects, namely kidney injury, electrolyte imbalances, and infusion-related reactions. The goal of this study was to assess the different aspects of premedication practice and the incidence and types of infusion-related reactions in patients receiving amphotericin B.
Methods: This observational study was performed on 70 hospitalized patients who received amphotericin B in different departments of two university hospitals, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, from January 2017 to February 2018. Information on physicians’ performance regarding premedication administration for amphotericin B, including the types and doses of medications administered prior to amphotericin B infusion, as well as patients’ clinical data including infusion-related side effects were collected and then analyzed in comparison with the standard practice guidelines.
Results: The study population consisted of 70 patients with the mean age of 51.6±18.3 years, who received amphotericin B for 8.2±3.5 days. From 70 evaluated patients, 21 patients (30%) had encountered the infusion-related reactions, including chills, fever, urticaria, headache, and hypotension. These side effects were evident in 19 patients (27%) who received no premedication and 2 patients (3%) who received only one drug as premedication, before amphotericin B administration. Twenty patients (28%) experienced chills, fever and headache, while 7 patients (10%) had nausea and vomiting during amphotericin B infusion. Hydrocortisone 50-200 mg, was the most prescribed agent for premedication (in 67% of patients), while chlorpheniramine 10 mg (in 50% of patients) and promethazine 10 mg (in 35% of patients) were the second and third prescribed ones, respectively.
Conclusion: In this study, the patients who received no or only one drug as premedication experienced infusion-related side effects. This emphasizes the necessity for standard premedication practices to prevent this type of adverse reactions. Considering the higher price of liposomal form of Amphotericin-B, if prescribed correctly, even the conventional form would be an effective and tolerable treatment for invasive fungal infections.

Background: It is difficult to treat infections caused by Acinetobacter baumannii due to multiple drug resistance. The aim of this study was to determine the efficacy of combination therapy with two broad-spectrum antibiotics colistin and rifampin on clinical and para clinical indexes of the patients with ventilator-dependent pneumonia due to imipenem-resistant to A. baumannii in intensive care units of a tertiary hospital.

Methods: In a descriptive cross-sectional study, fifty patients admitted to the intensive care units in Vali-Asr Hospital, Arak, Iran, from October 2014 to May 2015, with established ventilator-associated pneumonia were subjected to this study and were treated with standard dosage of colistin and rifampin daily. Once the minimum inhibitory concentration (MIC) of the A. baumannii isolates were susceptible to colistin (MIC˂2 µg/ml) and rifampin (MIC˂2 µg/ml) they were treated with three million international units of colistin in 100 ml of normal saline three times a day and 600 mg of rifampin daily. Side effects of combination therapy and variables of patients like fever, blood pressure, white blood cell count, differential count and, mortality were documented and statistically analyzed.
Results: 31(62%) patients were improved after combined treatment with colistin and rifampin, 4(8%) patients were died due to bloodstream infection with A. baumannii and 15(30%) passed away in effect of other reasons. The mean of BUN (P=0.07) and creatinine significantly increased (P=0.02). Clinical variables such as fever, white blood cell count, white blood cell percentage and red blood cell sedimentation rate significantly decreased (P≤0.05).
Conclusion: Colistin and rifampicin appear to be an effective and safe combination therapy for treatment of ventilator-dependent pneumonia due to imipenem-resistant to A. baumannii 

Primary immunodeficiency diseases (PIDs) is a diverse group of diseases, characterized by a defect in the immune system. These patients are susceptible to recurrent respiratory infections, gastrointestinal problems, autoimmune diseases, and malignancies. In most cases, patients with primary immunodeficiency disorders have genetic defects and are monogenic disorders that follow a simple Mendelian inheritance, however, some PIDs recognize a more complex polygenic origin. Overall, almost 70 to 90 percent of patients with primary immunodeficiency are undiagnosed. Given that these patients are exposing to respiratory infectious agents and some live-attenuated vaccines, thus they have a high risk to some clinical complications. The administration of oral polio vaccine in patients with PIDs especially can increase the possibility of acute flaccid paralysis. These patients will excrete the poliovirus for a long time through their feces, even though they are not paralyzed. Long-term virus proliferation in the vaccinated individuals causes a mutation in the poliovirus and creates a vaccine-derived polioviruses (VDPVs), which is a major challenge to the final stages of the worldwide eradication of polio. 
To increase the diagnosis and identification of patients with immunodeficiency and carrying out a national plan for screening patients with immunodeficiency from the fecal excretion of the poliovirus, a possible polio epidemic can be prevented during post-eradication. Development of laboratory facilities in provincial and city centers, improvement of communications among physicians regarding medical consultation and establishment of referring systems for patients by national network lead to improve status of diagnosis and treatment of patients with primary immunodefiicencies. In this context, launching and activating the national network of immunodeficiency diseases is essential for improving the health of children and reducing the cost of the health system of the country. A national network of immunodeficiency can lead to increase awareness of physicians regarding primary immunodeficiency disorders, improve collaboration among physicians about genetic consultation and establish a practical referral system in Iran that results in increased diagnosis and improve treatment of patients with primary immunodeficiency disorders.

Chick embryos are a great historical research model in basic and applied sciences. Along with other animal models, avian and specifically chicken embryo has been attended, as well. Avian fertilized eggs as a natural bioreactor are an efficient tool for producing recombinant proteins and vaccines manufacturing. Due to the limitations of birds' eggs for viral replication, avian stem cells culture technologies access to safe methods as well as large-scale production of a variety of human and animal vaccines. Chicken pluripotent stem cells present the unique property of self-renewal and the ability to generate differentiated progeny in all embryonic lineages such as ectoderm, mesoderm, and endoderm in vitro. For the first time, chicken embryonic stem cells (cESCs) derived from the blastodermal cells of stage X embryos in vitro. Chicken ESC provides a great model of early embryo and they are useful for gene manipulation, virus proliferation, and the generation of transgenic birds. In addition to blastodermal cells, pluripotent cell lines can be produced by reprogramming of chicken fibroblasts into induced pluripotent stem cells (iPSCs) with transcription factors such as OCT4, NANOG, SOX2, KLF4, LIN28, and C-MYC that are well known to contribute to the reprogramming of somatic cells into an iPSCs. Similar to chicken ESCs, iPSCs have properties of unlimited self-renewal in vitro and the capacity for differentiation to all three embryonic germ layers. Chicken iPSCs have been a useful tool for the production of transgenic birds and viral vaccines. Despite the benefits and multiple applications of chicken pluripotent stem cells, the propagation of these cells is limited and some important challenges should be eliminated before their use in vaccine manufacturing. It is necessary to define the appropriate culture conditions for chicken pluripotent stem cells. For example, the presence of endogenous viruses in the avian species should be evaluated for human vaccine production. Currently, primary chicken fibroblast cells are still mainly used for vaccine production. This review covers the resources to achieve chicken derived cell lines for vaccine manufacturing.

The highly contagious new coronavirus virus, SARS-CoV-2, was first appeared in Wuhan, China in late 2019. The virus has spread to 216 countries, including Iran, until 7 September 2020. So far, the number of people infected by the new corona virus and died from the disease is 27032617 and 881464 worldwide, respectively. Therefore, it is necessary to introduce the available treatments for this virus, as a global dilemma. Articles for this review study were selected from Embase, Medline and Google Scholar. Published full articles in English, English full articles published from 1st December 2019 to 23rd July 2020, were included. The search terms included combinations of COVID-19, SARS-COV-2, chloroquine, convalescent plasma, antiviral, antibacterial, Remidesivir, hydroxychloroquine, chloroquine phosphate, vaccines and monoclonal antibodies. There were no restrictions on the types of study eligible for inclusion. Different available therapies generally can be divided into small molecules and biological products. Among the small molecule drugs used for COVID-19 patients Remdesivir, Favilavir, and hydroxychloroquine have been associated with considerable success in disease control. Separation and transfusion of plasma from blood of improved COVID-19 patients to new patients and the use of recombinant Angiotensin converting enzyme 2 (ACE2) have been two very successful biological therapies in the treatment of COVID-19 disease. However, many efforts are being made by researchers around the world to make other effective and promising biological products. The development of a safe and effective vaccine can lead to great success in eradicating the disease. Also, the production of anti-SARS-CoV-2 monoclonal antibodies and using of stem cell-based therapeutics can be a great success in treating the disease. In addition, according to the miRNA properties, many efforts have been made to inhibit the production of viral proteins using natural miRNAs or artificial siRNAs. It has been proposed that aptamers derived from SELEX can be used for the diagnosis and treatment of COVID-19. Subsequently, since the size of miRNAs is at the nanometer level, they can easily incorporate to the targeted exosomes and be delivered via circulation in human blood to the infected cells such as lung cells. Interestingly, miRNAs can be delivered into the lung by inhalation.

Background: The bronchopulmonary carcinoid tumor accounts for 1-2% of all adult malignancies of the lung and 20-30% of all carcinoid tumors. Cushing’s syndrome is the result of chronic exposure to increased concentration of exogenous or endo-genus cortisol hormone, and it is generally associated with central obesity, metabolic syndrome, and hypertension. Treatment is based on decreasing cortisol levels in the blood, through medical or surgical approaches. Surgery is considered the main treatment for ectopic ACTH-secreting tumors. Paraneoplastic Cushing’s syndrome due to bronchopulmonary carcinoid tumor is a rare clinical occurrence, which has been reported in only a few case reports and case series. An average of 71% of typical carcinoid tumors were found to be central. 79% of patients with a peripheral carcinoid tumor and evidence of mediastinal node enlargement are likely to have an atypical carcinoid.
Case Presentation: A 45 Years old male with a history of ectopic Cushing’s syndrome over the last two years was admitted to our department (Department of thoracic surgery, Teahran, Iran). He had a positive Octreotide scan of the hilar lymph nodes of the left lung at last evaluations. During the surgery, in the left lower lobe was resected (because a small nodule with tumoral appearance was seen in left lower lobe) with hilar and mediastinal lymph node dissection. Pathology indicated a typical carcinoid tumor with mediastinal lymph node metastasis. Plasma cortisol and ACTH were normalized following the surgery.

Background: One of the main causes of maternal death in developing countries is postpartum hemorrhage. Cesarean section is one of the most common surgeries all around the world. In comparison with normal vaginal delivery, cesarean section is a greater risk factor for postpartum hemorrhage and need for blood transfusion. The risk of postpartum hemorrhage will increase when other risk factors such as multiple pregnancies, polyhydramnios, severe preeclampsia, peripartum hemorrhage, protracted labor, labor induction, and obesity are present. Oxytocin is conventionally used for the prevention of uterine atony during the cesarean section. The aim of this study was the evaluation of the effect of sublingual misoprostol in combination with oxytocin in reducing blood loss during and after cesarean delivery.
Methods: This randomized clinical trial was performed in Ommolbanin hospital; an academic hospital that is affiliated to Mashhad University of medical sciences from September 2016 to January 2018. The subjects were 90 pregnant women with a term pregnancies who were candidates for emergent cesarean delivery under spinal anesthesia and were at high risk for postpartum hemorrhage. All participants received 40 IU oxytocin in 1 liter of normal saline after delivery, and then they were randomly assigned to the intervention group who received 400 μg sublingual misoprostol in combination with oxytocin infusion, and the control group who received only oxytocin infusion without adding misoprostol.

Background: CNS infection can be focal or generalized. Meningitis, besides other etiologies, can occur after a viral infection or viral vaccine. Although meningitis can occur in at any age but it is more common in children less than five years old. Aseptic meningitis and meningoencephalitis are two of the most common complications of mumps (wild type or vaccine). As a result of their serious complication, we decided to obtain more information about clinical manifestations and laboratory findings after the injection of the Hoshino MMR vaccine in a group of children in an Iranian referral hospital.
Methods: In this cross-sectional study, performed from March 2013 to February 2015 on 73 children with meningochemical symptoms of meningitis, children who have been diagnosed with aseptic meningitis followed by an MMR vaccine in an infectious ward or emergency department of the Children’s Medical Center were enrolled in the study and their information was recorded from their files. A questionnaire was provided for children with diagnostic criteria of aseptic meningitis and their data were collected.

Background: Even after surgery, as the most effective treatment for colorectal cancer, about 30-40% of cases are recurring. Since growth inhibition is an important strategy in cancer treatment, many attempts are in the program to find new agents, so in this study, the cytotoxic and antimicrobial effects of Lactobacillus sakei on colon cancer cell line (HT-29) and some pathogenic microorganisms have been evaluated. Lactobacillus sakei is a probiotic that, when consumed affects the intestinal flora, causes beneficial effects on host health. Probiotics due to their anti-cancer effects, modulation of the differentiation process in tumor cells, changes in tumor gene expression and lack of immunological responses have attracted a lot of attention as a new and effective treatment for colorectal adenocarcinoma.

Background: At present, in nuclear medicine to calculate the cumulative activity of various organs, different techniques are being used to correct the background radiations in the conjugate view method. Each of these techniques considers the effect and weight of background radiations to a different extent. These background radiations can cause errors in cumulative activity calculations. The purpose of this study was to evaluate and compare different techniques of correcting background radiations to each other in calculating kidney cumulative activity during the nuclear scan of the bladder in children.
Methods: This study was Cross-sectional and performed for patients who were referred to Isfahan Shahid Chamran Hospital between December 2019 and June 2020. In this study using Foley, 1 mCi of TC-DTPA radio-pharmaceutical that was diluted with normal saline was injected into the patient's bladder, then images recorded by gamma cameras were extracted at 2, 5, 10, and 20 minutes, Finally with ROI drawing around kidney with having vesicoureteral reflux, Cumulative renal activity was calculated with four correcting background radiations techniques such as without correction of background radiation, conventional method, Buijs method, and Kojima method Eventually, the data was Eventually, the data was compared to each other to determine how much weight each of these techniques consider for background radiations.

Background: Nicolau syndrome is a rare condition that happens after intramuscular injection. All the intramuscular injections may have mild to moderate complications such as pain, focal abscess, nerve complication and anaphylactic reactions. Among these complications, wide necrosis of the skin like Nicolau syndrome happens very rarely. In this condition, Patients typically report acute, intense pain, immediately after drug injection and it is followed by an erythematous macular evolving after 24 hours into a livedoid violaceous patch with dendritic extensions. The study has been reported a case report of a 6-month-old infant who suffered from Nicolau syndrome after the injection of pentavalent vaccine.
Methods: A 6-month-old girl infant without a history of any disease was referred to the emergency department with the signs of erythema, edema and purple like discoloration in the vaccine injection site at the left tight, after vaccination. One hour after admission, in the lower limb severe edema along with an extension of a dark red to purple discoloration happened on different parts of foot and after 5 days they turned necrotic. The infant suffered from Nicolau syndrome after the injection of the pentavalent vaccine.

Background: Cholangiocarcinoma is a cancer of the bile duct epithelium that originates from the bile ducts inside or outside the liver. Although this tumor is not common, its mortality rate is high. This tumor accounts for about 3% of all gastrointestinal malignancies. Many patients are being detected when the disease has spread. Evaluating risk factors affecting the incidence of cholangiocarcinoma is very important to avoid exposure to them. Therefore, this study was performed to evaluate the risk factors for cholangiocarcinoma in a population in Iran.
Methods: This was a descriptive cross-sectional study. It was performed on 276 patients with cholangiocarcinoma who had been referred to Firoozgar Hospital affiliated with the Iran University of Medical Sciences in Tehran from March 2020 to February 2021. Demographic information, family and personal history, social history (tobacco or drug use) and blood group of patients were extracted from their files. SPSS version 16 was used for data analysis. A P-value below 0.05 was considered statistically significant.

Background: Primary intraosseous squamous cell carcinoma (PIOC) of the mouth is a very rare but well-known carcinoma. It is locally invasive and its prognosis is quite poor. It may originate from the walls of an odontogenic cyst or de novo from the remnant epithelium at this region. Because the early symptoms of such malignancies are sometimes similar to those of inflammatory or periodontal diseases, early diagnosis is the most important step toward appropriate treatment.
Case Presentation: The case was a 46-year-old female with a sudden luxation of two posterior mandibular molars referred to a general dentist in May 2019. With diagnosis of periodontitis, the teeth were extracted without finding the cause of the tooth luxation. After four months, because of pain, swelling and non-healing socket of extracted teeth she referred to the department of Oral medicine in Mashhad Faculty of Dentistry. The patient was healthy with no systemic disease, drug history or familial history of cancer and no history of trauma, habits, tobacco, alcohol, and smoking. ln clinical examination, a nodular swelling with extensive ulcer and rolled borders along with hyperkeratosis and erythema on the posterior part of the right mandibular ridge was observed. The Extraoral examination revealed a tender mobile lymph node in the right submandibular region. After radiographic evaluation, with an initial diagnosis of SCC originated from the socket of extracted mandibular molars, incisional biopsy was performed, and histopathological analysis of the specimen revealed a primary intraosseous squamous cell carcinoma (grade II) and then necessary treatments (surgery, radiotherapy, chemotherapy) were performed.

Background: Today, despite the efforts of the medical community and health staff, the rate of dissatisfaction and complaints among patients is increasing and this highlights the importance of evaluating its related factors. The aim of this study was to analytically investigate complaints against ophthalmologists which were referred to the Legal Medicine Organization of Iran in Tehran during 2017-2019.
Methods: In this cross-sectional (analytical-descriptive) study, the demographic data of patients and physicians including age, gender, marital status and academic degree, type of treatment measures leading to complaints, last decision of the medical commission, characteristics of protesting of patients and vote of revision commissions for all the complaints of ophthalmology were recorded and analyzed.
Results: During 3 years, 176 complaints were recorded in the field of ophthalmology. Of these, 90(51.1%) complaints were from medical interventions which took place in university or government hospitals and clinics. Also, 27(15.3%) cases of malpractice were reported, among which negligent was the most common type, with 22 cases (81.5%). The highest number of complaints was for cataract surgery and the most frequent treatments with malpractice of the physicians were cornea transplantation. Although the most protests to the first decision were from the patients, the effectiveness of physicians’ protest was significantly higher (P<0.001).

Background: Influenza vaccines based on conserved proteins are being developed persistently. The conserved protein vaccines based on Nucleoprotein (NP) are highly protected vaccines against influenza viruses that can be used as a Universal vaccine. Aluminum hydroxide (Alum) is the most common adjuvant used in vaccine formulation to improve immunization by altering the epitopes’ folds. However, due to its toxic effects on the nervous system, especially in infants and young children exposed to multiple vaccine injections during brain development, it is better to use more desirable options such as carbohydrate-based adjuvants. Sucrose ester (SE) is a carbohydrate and non-ionic surfactant that is compatible with the human body and environmentally friendly. This study evaluated the immunogenicity of recombinant NP molecule prepared in a prokaryotic with the accompaniment of sucrose ester adjuvant against lethal influenza virus challenge in a Balb/c mice model.
Methods: The recombinant vector of PET-28a-NP was used to produce NP molecule. The vaccines containing an NP with or without Alum or sucrose ester adjuvants were injected into the mice. The Effectiveness and immunogenicity were examined by evaluating the humeral immunity induction by Immunoglobulin G (IgG), and its subunits production, and cellular immunity induction by Interferon-Gamma (IFN-γ) and Interleukin-4 (IL-4) production by ELISA Method and also animal’s surveillance was documented. The study took part at the Influenza and other respiratory viruses department of Pasteur institute of Iran in November 2018.
Results: The animals’ surveillance in the Np group was 57.1%, NP+SE was (71.4%), and NP+SE was 64.28%. Also, IgG and its subunits, IL4, and IFN-γ production in both Alum and SE combined vaccines compared to NP alone were significant.