@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2014;6(4):177-181
ISSN: 2008-2630 Iranian Journal of War & Public Health 2014;6(4):177-181
Association between IL-18 and IL-18bp Levels and Chronic Urticaria in Sulfur Mustard Exposed Veterans
ARTICLE INFO
Article Type
Original ResearchAuthors
Askary N. (1 )Ghazanfari T. (* )
Jalayi Sh. (2 )
Soroush M.R. (3 )
Davoudi S.M. (4 )
(* ) “Immunoregulation Research Center” and “Immunology Department, Medicine Faculty”, Shahed University, Tehran, Iran
(1 ) Biology Department, Sciences Faculty, Shahid Bahonar University of Kerman, Kerman, Iran
(2 ) Biostatistics Department, Rehabilitation Faculty, Tehran University of Medical Sciences, Tehran, Iran
(3 ) Janbazan Medical and Engineering Research Center(JMERC), Tehran, Iran
(4 ) Dermatology Department, Medicine Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
Correspondence
Article History
Received: June 21, 2014Accepted: October 3, 2014
ePublished: September 20, 2014
ABSTRACT
Aims
Exposure to mustard gas leads to acute and chronic toxic effects on the skin. Results from
several studies have been suggested the role of immune mediators, including Interleukin-18,
in the pathogenesis of diseases associated with the urticaria appearance. The aim of present
study was to investigate the association between Interleukin-18 and its binding protein and
chronic urticaria in veterans.
Materials & Methods In this historical cohort study, 372 Sardasht veterans exposed to mustard gas and 128 healthy people (residents of the Rabat City, Iran) were studied. The both “exposed” and “control” groups were homogeneous in terms of gender, age, body mass index, and marital status. All subjects were studied and divided by an experienced skin specialist for skin disorders such as urticaria. Interleukin-18 serum levels and its binding protein were measured by sandwich ELISA methods. Mann-Whitney test was performed to compare cytokines serum levels of in the studied groups.
Findings 8 (2.1%) of exposed group and 1 (0.8%) of control group had chronic urticaria. There was no significant difference in Interleukin-18 level mean in exposed group with urticaria compared to control group mean without urticaria (p=0.17). The difference of Interleukin-18 level between the samples with and without urticaria of the exposed group was significant (p=0.025) and higher in the persons with urticaria. No significant difference was observed in Il-18bp level mean in exposed group with urticaria compared to control group without urticaria (p=0.784).
Conclusion IL-18 may be involved in the occurrence of urticaria induced by mustard gas.
Materials & Methods In this historical cohort study, 372 Sardasht veterans exposed to mustard gas and 128 healthy people (residents of the Rabat City, Iran) were studied. The both “exposed” and “control” groups were homogeneous in terms of gender, age, body mass index, and marital status. All subjects were studied and divided by an experienced skin specialist for skin disorders such as urticaria. Interleukin-18 serum levels and its binding protein were measured by sandwich ELISA methods. Mann-Whitney test was performed to compare cytokines serum levels of in the studied groups.
Findings 8 (2.1%) of exposed group and 1 (0.8%) of control group had chronic urticaria. There was no significant difference in Interleukin-18 level mean in exposed group with urticaria compared to control group mean without urticaria (p=0.17). The difference of Interleukin-18 level between the samples with and without urticaria of the exposed group was significant (p=0.025) and higher in the persons with urticaria. No significant difference was observed in Il-18bp level mean in exposed group with urticaria compared to control group without urticaria (p=0.784).
Conclusion IL-18 may be involved in the occurrence of urticaria induced by mustard gas.
CITATION LINKS
[1]Ghazanfari T, Faghihzadeh S, Aragizadeh H, Soroush MR, Yaraee R, Mohammad Hassan Z, et al. Sardasht-Iran cohort study of chemical warfare victims: design and methods. Arch Iran Med. 2009;12(1):5-14.
[2]Balali-Mood M, Hefazi M. Comparison of early and late toxic effects of sulfur mustard in Iranian veterans. Basic Clin Pharmacol Toxicol. 2006;99(4):273-82.
[3]Paromov V, Suntres Z, Smith M, Stone WL. Sulfur mustard toxicity following dermal exposure. J Burns Wounds. 2007;7:e7.
[4]Institute of Medicine; Committee on the Institute of Medicine; Rall DP (Editor). Veterans at Risk: The Health Effects of Mustard Gas and Lewisite. 1st ed. Washington: National Academy Press. 1993.
[5]Mortazavi H, Raziee M, Emadi SN, Nakhai MJ, Soroush MR, Noormohammad pour P, et al. Skin lesions in 800 Iranian victims of mustard gas 14-20 years after exposure. Iran J Dermatol. 2005;8(31):177-89.
[6]Moin A, Ghazanfari T, Davoudi SM, Emadi SN, Panahi Y, Mohammad Hassan Z, et al. Long-term skin findings of sulfur mustard exposure on the civilians of Sardasht, Iran. Toxin Rev. 2009;28(1):24-9.
[7]Momeni AZ, Enshaeih S, Meghdadi M, Amindjavaheri M. Skin manifestations of mustard gas. A clinical study of 535 patients exposed to mustard gas. Arch Dermatol. 1992;128(6):775-80.
[8]Naraghi ZS, Mansouri P, Mortazavi M. A clinicopathological study on acute cutaneous lesions induced by sulfur mustard gas (yperite). Eur J Dermatol. 2005;15(3):140-5.
[9]Hefazi M, Maleki M, Mahmoudi M, Tabatabaee A, Balali-Mood M. Delayed complications of sulfur mustard poisoning in the skin and the immune system of Iranian veterans 16-20 years after exposure. Int J Dermatol. 2006;45(9):1025-31.
[10]Emadi SN, Mortazavi M, Mortazavi H. Late cutaneous manifestations 14 to 20 years after wartime exposure to sulfur mustard gas: a long-term investigation. Arch Dermatol. 2008;144(8):1059-61.
[11]James WD, Berger T, Elston D. Andrews' Diseases of the Skin: Clinical Dermatology.11th ed. Philadelphia: Elsevier Health Sciences; 2011.
[12]Altman K, Chang C. Pathogenic intracellular and autoimmune mechanisms in urticaria and angioedema. Clin Rev Allergy Immunol. 2013;45(1):47-62.
[13]Rezvani SM, Mahmoudi Pour A, Bijani A. Clinical symptoms and complications in Iranian troops wounded by chemical weapons, Babol Shahid Yahyanejad Hospital, 2001-03. J Babol Univ Med Sci. 2006;8(1):74-7.
[14]Fekri AR, Janghorbani M. Late cutaneous complication in chemical warfare victims in Kerman province. J Kerman Univ Med Sci. 1995;2(3):108-19.
[15]Emad A, Emad Y. Levels of cytokine in bronchoalveolar lavage (BAL) fluid in patients with pulmonary fibrosis due to sulfur mustard gas inhalation. J Interferom Cytokine Res. 2007;27(1):39-43.
[16]Javadi MA, Yazdani S, Sajjadi H, Jadidi K, Karimian F, Einollahi B, et al. Chronic and delayed-onset mustard gas keratitis: report of 48 patients and review of literature. Ophthalmology. 2005;112(4):617-25.
[17]Askari N, Vaez-Mahdavi MR, Moaiedmohseni S, Khamesipour A, Soroush MR, et al. Association of chemokines and prolactin with cherry angioma in a sulfur mustard exposed population-Sardasht-Iran cohort study. Int Immunopharmacol .2013;17(3):991-5.
[18]Moin A, Khamesipour A, Hassan ZM, Ebtekar M, Davoudi SM, Vaez-Mahdavi MR, et al. Pro-inflammatory cytokines among individuals with skin findings long-term after sulfur mustard exposure: Sardasht-Iran Cohort Study. Int Immunopharmacol. 2013;17(3):986-90.
[19]Atwa MA, Emara AS, Youssef N, Bayoumy NM. Serum concentration of IL-17, IL-23 and TNF-α among patients with chronic spontaneous urticaria: Association with disease activity and autologous serum skin test. J Eur Acad Dermatol Venereol. 2014;28(4):469-74.
[20]Santos JC, de Brito CA, Futata EA, Azor MH, Orii NM, Maruta CW, et al. Up-regulation of chemokine C-C ligand 2 (CCL2) and C-X-C chemokine 8 (CXCL8) expression by monocytes in chronic idiopathic urticaria. Clin Exp Immunol. 2012;167(1):129-36.
[21]Puxeddu I, Panza F, Pratesi F, Bartaloni D, Casigliani Rabl S, Rocchi V, et al. CCL5/RANTES, sVCAM-1, and sICAM-1 in chronic spontaneous urticaria. Int Arch Allergy Immunol. 2013;162(4):330-4.
[22]Tedeschi A, Lorini M, Suli C, Asero R. Serum interleukin-18 in patients with chronic ordinary urticaria: association with disease activity. Clin Exp Dermatol. 2007;32(5):568-70.
[23]Smith DE. The biological paths of IL-1 family members IL-18 and IL-33. J Leukoc Biol. 2011; 89(3):383-92.
[24]Kawayama T, Okamoto M, Imaoka H, Kato S, Young H A, Hoshino T. Interleukin-18 in pulmonary inflammatory diseases. J Interferon Cytokine Res. 2012; 32(10):443-9.
[25]Stoll S, Mueller G, Kurimoto M, Saloga J, Tanimoto T, Yamauchi H, et al. Production of IL-18 (IFN-g inducing factor) messenger RNA and functional protein by murine keratinocytes. J Immunol. 1997;159(1):298-302.
[26]Nakanishi K, Yoshimoto T, Tsutsui H, Okamura H. Interleukin- 18 regulates both Th1 and Th2 responses. Annu Rev Immunol. 2001;19:423-74.
[27]Izakovicova Holla L. Interleukin-18 in asthma and other allergies. Clin Exp Allergy. 2003;33(8):1023-5.
[28]Novick D, Kim SH, Fantuzzi G, Reznikov LL, Dinarello CA, Rubinstein M. Interleukin-18 binding protein: a novel modulator of the Th1 cytokine response. Immunity. 1999;10(1):127-36.
[29]Puxeddu I, Italiani P, Giungato P, Pratesi F, Panza F, Bartaloni D, et al. Free IL-18 and IL-33 cytokines in chronic spontaneous urticaria. Cytokine. 2013;61(3):741-3.
[30]Kim SH, Son JK, Yang EM, Kim JE, Park HS. A functional promoter polymorphism of the human IL18 gene is associated with aspirin-induced urticaria. Br J Dermatol. 2011;165(5):976-84.
[31]Krause K, Metz M, Makris M, Zuberbier T, Maurer M. The role of interleukin-1 in allergy-related disorders. Curr Opin Allerg Clin Immunol. 2012;12(5):477-84.
[32]Kurt E, Aktas A, Aksu K, Keren M, Dokumacioglu A, Goss CH, et al. Autologous serum skin test response in chronic spontaneous urticaria and respiratory diseases and its relationship with serum interleukin-18 level. Arch Dermatol Res. 2011;303(9):643-9.
[2]Balali-Mood M, Hefazi M. Comparison of early and late toxic effects of sulfur mustard in Iranian veterans. Basic Clin Pharmacol Toxicol. 2006;99(4):273-82.
[3]Paromov V, Suntres Z, Smith M, Stone WL. Sulfur mustard toxicity following dermal exposure. J Burns Wounds. 2007;7:e7.
[4]Institute of Medicine; Committee on the Institute of Medicine; Rall DP (Editor). Veterans at Risk: The Health Effects of Mustard Gas and Lewisite. 1st ed. Washington: National Academy Press. 1993.
[5]Mortazavi H, Raziee M, Emadi SN, Nakhai MJ, Soroush MR, Noormohammad pour P, et al. Skin lesions in 800 Iranian victims of mustard gas 14-20 years after exposure. Iran J Dermatol. 2005;8(31):177-89.
[6]Moin A, Ghazanfari T, Davoudi SM, Emadi SN, Panahi Y, Mohammad Hassan Z, et al. Long-term skin findings of sulfur mustard exposure on the civilians of Sardasht, Iran. Toxin Rev. 2009;28(1):24-9.
[7]Momeni AZ, Enshaeih S, Meghdadi M, Amindjavaheri M. Skin manifestations of mustard gas. A clinical study of 535 patients exposed to mustard gas. Arch Dermatol. 1992;128(6):775-80.
[8]Naraghi ZS, Mansouri P, Mortazavi M. A clinicopathological study on acute cutaneous lesions induced by sulfur mustard gas (yperite). Eur J Dermatol. 2005;15(3):140-5.
[9]Hefazi M, Maleki M, Mahmoudi M, Tabatabaee A, Balali-Mood M. Delayed complications of sulfur mustard poisoning in the skin and the immune system of Iranian veterans 16-20 years after exposure. Int J Dermatol. 2006;45(9):1025-31.
[10]Emadi SN, Mortazavi M, Mortazavi H. Late cutaneous manifestations 14 to 20 years after wartime exposure to sulfur mustard gas: a long-term investigation. Arch Dermatol. 2008;144(8):1059-61.
[11]James WD, Berger T, Elston D. Andrews' Diseases of the Skin: Clinical Dermatology.11th ed. Philadelphia: Elsevier Health Sciences; 2011.
[12]Altman K, Chang C. Pathogenic intracellular and autoimmune mechanisms in urticaria and angioedema. Clin Rev Allergy Immunol. 2013;45(1):47-62.
[13]Rezvani SM, Mahmoudi Pour A, Bijani A. Clinical symptoms and complications in Iranian troops wounded by chemical weapons, Babol Shahid Yahyanejad Hospital, 2001-03. J Babol Univ Med Sci. 2006;8(1):74-7.
[14]Fekri AR, Janghorbani M. Late cutaneous complication in chemical warfare victims in Kerman province. J Kerman Univ Med Sci. 1995;2(3):108-19.
[15]Emad A, Emad Y. Levels of cytokine in bronchoalveolar lavage (BAL) fluid in patients with pulmonary fibrosis due to sulfur mustard gas inhalation. J Interferom Cytokine Res. 2007;27(1):39-43.
[16]Javadi MA, Yazdani S, Sajjadi H, Jadidi K, Karimian F, Einollahi B, et al. Chronic and delayed-onset mustard gas keratitis: report of 48 patients and review of literature. Ophthalmology. 2005;112(4):617-25.
[17]Askari N, Vaez-Mahdavi MR, Moaiedmohseni S, Khamesipour A, Soroush MR, et al. Association of chemokines and prolactin with cherry angioma in a sulfur mustard exposed population-Sardasht-Iran cohort study. Int Immunopharmacol .2013;17(3):991-5.
[18]Moin A, Khamesipour A, Hassan ZM, Ebtekar M, Davoudi SM, Vaez-Mahdavi MR, et al. Pro-inflammatory cytokines among individuals with skin findings long-term after sulfur mustard exposure: Sardasht-Iran Cohort Study. Int Immunopharmacol. 2013;17(3):986-90.
[19]Atwa MA, Emara AS, Youssef N, Bayoumy NM. Serum concentration of IL-17, IL-23 and TNF-α among patients with chronic spontaneous urticaria: Association with disease activity and autologous serum skin test. J Eur Acad Dermatol Venereol. 2014;28(4):469-74.
[20]Santos JC, de Brito CA, Futata EA, Azor MH, Orii NM, Maruta CW, et al. Up-regulation of chemokine C-C ligand 2 (CCL2) and C-X-C chemokine 8 (CXCL8) expression by monocytes in chronic idiopathic urticaria. Clin Exp Immunol. 2012;167(1):129-36.
[21]Puxeddu I, Panza F, Pratesi F, Bartaloni D, Casigliani Rabl S, Rocchi V, et al. CCL5/RANTES, sVCAM-1, and sICAM-1 in chronic spontaneous urticaria. Int Arch Allergy Immunol. 2013;162(4):330-4.
[22]Tedeschi A, Lorini M, Suli C, Asero R. Serum interleukin-18 in patients with chronic ordinary urticaria: association with disease activity. Clin Exp Dermatol. 2007;32(5):568-70.
[23]Smith DE. The biological paths of IL-1 family members IL-18 and IL-33. J Leukoc Biol. 2011; 89(3):383-92.
[24]Kawayama T, Okamoto M, Imaoka H, Kato S, Young H A, Hoshino T. Interleukin-18 in pulmonary inflammatory diseases. J Interferon Cytokine Res. 2012; 32(10):443-9.
[25]Stoll S, Mueller G, Kurimoto M, Saloga J, Tanimoto T, Yamauchi H, et al. Production of IL-18 (IFN-g inducing factor) messenger RNA and functional protein by murine keratinocytes. J Immunol. 1997;159(1):298-302.
[26]Nakanishi K, Yoshimoto T, Tsutsui H, Okamura H. Interleukin- 18 regulates both Th1 and Th2 responses. Annu Rev Immunol. 2001;19:423-74.
[27]Izakovicova Holla L. Interleukin-18 in asthma and other allergies. Clin Exp Allergy. 2003;33(8):1023-5.
[28]Novick D, Kim SH, Fantuzzi G, Reznikov LL, Dinarello CA, Rubinstein M. Interleukin-18 binding protein: a novel modulator of the Th1 cytokine response. Immunity. 1999;10(1):127-36.
[29]Puxeddu I, Italiani P, Giungato P, Pratesi F, Panza F, Bartaloni D, et al. Free IL-18 and IL-33 cytokines in chronic spontaneous urticaria. Cytokine. 2013;61(3):741-3.
[30]Kim SH, Son JK, Yang EM, Kim JE, Park HS. A functional promoter polymorphism of the human IL18 gene is associated with aspirin-induced urticaria. Br J Dermatol. 2011;165(5):976-84.
[31]Krause K, Metz M, Makris M, Zuberbier T, Maurer M. The role of interleukin-1 in allergy-related disorders. Curr Opin Allerg Clin Immunol. 2012;12(5):477-84.
[32]Kurt E, Aktas A, Aksu K, Keren M, Dokumacioglu A, Goss CH, et al. Autologous serum skin test response in chronic spontaneous urticaria and respiratory diseases and its relationship with serum interleukin-18 level. Arch Dermatol Res. 2011;303(9):643-9.