Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 3 2017 06 17 171 182 EN Masoomeh Jannesar Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran AND Department of Biology, Faculty of Sciences, Tehran University, Tehran, Iran Maryam Sharif Shoushtari Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran AND Department of Biology, Faculty of Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran Ahmad Majd Department of Biology, Faculty of Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran Zahra Pourpak Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran 2016 10 08 2017 01 25 Bee pollen grains, as the male reproductive part of seed-bearing plants contain considerable concentrations of various phytochemicals and nutrients. Since antiquity, people throughout the world used pollens to cure colds, flu, ulcers, premature aging, anemia and colitis. It is now well-documented that some bee pollen secondary metabolites (e.g. flavonoid) may have positive health effects. In recent years, the flavonoids have attracted much interest because of their wide range of biological properties and their beneficial effects on human health. The current review, points out potential therapeutic effects of bee pollen flavonoids as one of the main bee pollen bioactive compounds in allergic and immunological diseases. Due to the fact that some types of flavonoid components in bee pollen have anti-allergic, anti-oxidant and anti-inflammatory properties, bee pollen flavonoids can be excellent candidates for future studies including phytotherapy, molecular pharmacology and substitutes for chemicals used in treating allergic and immunological disorders. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/1092 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/1092/740

Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 3 2017 06 17 183 192 EN Mohsen Ebrahimi Neonatal and Children's Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran AND Department of Allergy and Clinical Immunology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran Mohammad Gharagozlou Department of Allergy and Clinical Immunology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran Ali Mohebbi Growth and Development Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran Nasim Hafezi Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Gholamreza Azizi Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; AND Department of Laboratory Medicine, Imam Hassan Mojtaba Hospital, Alborz University of Medical Sciences, Karaj, Iran Masoud Movahedi Department of Allergy and Clinical Immunology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran 2016 04 28 2016 09 05 Cow's milk allergy is the most common type of food allergy that decrease the quality of life of patients and their families. The aim of this study was to evaluate the efficacy of oral immunotherapy in patients with cow's milk allergy. 14 patients above 3 years of age with a history of cow's milk allergy confirmed by positive double blind placebo controlled food challenge (DBPCFC) test, presence of serum IgE against cow's milk and positive SPT (skin prick test) were enrolled in this study. During the immunotherapy all patients received increasing amounts of cow's milk during three phases. The type and severity of allergic reactions were recorded after each dose. The serum IgE and SPT were measured at the beginning and at the end of study. Since February 2014 to March 2015, 14 patients with the median age of 4.75 (3.7-7) years were studied. 13 patients (92.9%) completed the build up and maintenance phase successfully and became desensitized to cow's milk. During the build up and maintenance phase, 24 (2.0%) and 11 (0.9%) episodes of allergic reactions occurred, respectively. The median serum IgE level against cow's milk proteins and casein decreased from 39.3 to 10.4 and 7.72 to 2.83 (ku/L), respectively. The median of the difference of the wheal diameter in SPT with the control, decreased from 10 to 6 mm during the immunotherapy protocol. Oral immunotherapy is effective to decrease the frequency and the severity of allergic reactions but due to high rate of allergic reactions and possible anaphylaxis, it must be done under strict supervision of both clinicians and caregivers. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/898 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/898/741

Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 3 2017 06 17 193 197 EN Fuat Erel Department of Pulmonary Medicine, Faculty of Medicine, Balikesir University, Balikesir, Turkey Nurhan Sarioglu Department of Pulmonary Medicine, Faculty of Medicine, Balikesir University, Balikesir, Turkey Mehmet Kose Department of Pulmonary Medicine, Faculty of Medicine, Balikesir University, Balikesir, Turkey Mustafa Kaymakci Department of Ear, Nose and Throat, Faculty of Medicine, Balikesir University, Balikesir, Turkey Mucahide Gokcen Department of Pulmonary Medicine, Faculty of Medicine, Balikesir University, Balikesir, Turkey Ahmet Kepekci Department of Ear, Nose and Throat, Meltem Hospital, Istanbul, Turkey Mehmet Arslan Department of Health Public, Faculty of Medicine, Balikesir University, Balikesir, Turkey 2016 04 22 2016 09 13 Taking medical history, physical examination, and performing some in vivo and in vitro tests are necessary for the diagnosis of allergy. Skin prick test (SPT) is considered as the standard method and first-line approach for the detection of allergic sensitization. Although mainly SPT is used for the detection of allergic sensitization, intradermal skin test (IDST) may be necessary, especially in patients with a negative SPT result. IDST is quite safe; however, is nowadays seldom used for detection of inhalant allergy and its value remains controversial. We aimed to investigate whether IDST is useful and necessary in diagnosis of respiratory allergies or not. This study involved 4223 patients with allergic rhinitis (AR) and/or bronchial asthma (BA). SPT results were positive in 2419 patients (57%) and negative in 1804 (43%). IDST was applied to 344 patients with marked allergic symptoms and with negative SPT results. Out of 344 patients, 152 (44%) showed allergic sensitization to IDST. The most commonly encountered allergic response was against the house dust mite (HDM) (32.6%). Allergic response against fungal spores was also relatively high (22%), while the pollen allergy rate (4.3%) was quite low. In BA patients with negative prick test, IDST made a significant contribution to the diagnosis of HDM allergy (p=0.003). To avoid missed diagnosis of AR and BA, particularly regarding  the HDM allergy, application of IDST may be beneficial; therefore, IDST should be considered as the next step after SPT for diagnosis of allergy prior to in vitro or provocation tests.  https://ijaai.tums.ac.ir/index.php/ijaai/article/view/889 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/889/734

Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 3 2017 06 17 198 204 EN Saeideh Mazloomzadeh Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran Niousha Bakhshi Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran Akefeh Ahmadiafshar Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran AND Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran AND Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran Mehdi Gholami Zanjan Cultural Heritage Department, Zanjan, Iran 2016 09 28 2017 01 31 The asthma treatment and control might be associated with significant burden on family and community‚ thus exploring other therapeutic plans could be desirable. The aim of this study was to investigate the effect of salt space on clinical findings and peak expiratory flow rate among children with asthma. In this randomized crossover trial, 34 patients aged 6-14 years old with mild to moderate asthma were selected and randomly divided into two groups. The first group went through a period of salt therapy by staying in the salt room for one hour, three times a week for 3 consecutive weeks and then was under observation for three weeks. This process was reversed for the second group (three weeks under observation followed by salt therapy). The wash-out period was one week. During the study, the morning and evening peak expiratory flow (PEF), the frequency of coughing, wheezing, dyspnea and use of rescue medications were measured. Salt therapy had a significant effect on raising the morning and evening PEF in the second week in both groups (p=0.028 and p=0.032, respectively). However, there was no significant effect on PEF variabilities‚ cough‚ wheezing, dyspnea, and the frequency of rescue medication (p>0.05). No side effect was observed during salt therapy. This study showed the significant effect of salt therapy on PEF rate of the patients in the second week. However, further studies with different frequency and time of salt therapy on respiratory disorders are recommended.  https://ijaai.tums.ac.ir/index.php/ijaai/article/view/1079 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/1079/739

Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 3 2017 06 17 205 218 EN Sakine Işık Department of Pediatric Allergy and Immunology, Dokuz Eylul University, İzmir, Turkey Nevin Uzuner Department of Pediatric Allergy and Immunology, Dokuz Eylul University, İzmir, Turkey Meral Karaman Department of Microbiology, Dokuz Eylul University, İzmir, Turkey Özkan Karaman Department of Pediatric Allergy and Immunology, Dokuz Eylul University, İzmir, Turkey Müge Kıray Department of Histology, Dokuz Eylul University, İzmir, Turkey İlknur Kozanoğlu Department of Hematology, Başkent University, Adana, Turkey Hüsnü Alper Bağrıyanık Department of Histology, Dokuz Eylul University, İzmir, Turkey Zeynep Arıkan-Ayyıldız Department of Pediatric Allergy and Immunology, Dokuz Eylul University, İzmir, Turkey Melis Kartal Yandım Department of Molecular Biology and Genetics, İzmir Institute of Technology, İzmir, Turkey Yusuf Baran Department of Molecular Biology and Genetics, İzmir Institute of Technology, İzmir, Turkey 2016 07 22 2017 03 15 Bone marrow-derived mesenchymal stem cells (BMSCs) can ameliorate a variety of lung diseases such as asthma, lung fibrosis, and acute lung injury by its anti-inflammatory and immunmodulatory effects. In this study, we developed a mouse model of bronchiolitis obliterans (BO) and evaluated the effects of the intraperitoneal administration of BMSCs on lung histopathology and cytokine levels. 25 BALB/c mice were divided into four groups; control group (Group I), BO developed and 1x106 BMSCs-injected group (Group II), non-BO, 1x106 BMSCs-injected group (Group III), and BO developed and saline-injected group (Group IV). Histological and immunohistochemical findings of the lung tissue and the migration of BMSCs to the lung were evaluated using light and confocal microscopy techniques. Confocal microscopy evaluations showed that there was no noteworthy amount of BMSCs in the lung tissue of group III while significant amount of BMSCs was detected in group II. Wall thicknesses of terminal bronchiole and periterminal bronchiolar collagen deposition were significantly lower in group II compared to the group IV (p<0.05). Furthermore, according to the immunohistochemical staining results, CD3, CD4, CD8, CD20, CD68 and neutrophil elastase positive immune cells of group II were stained more positive than group IV cells (p<0.05). IFN-γ IL-2 and TNF-α levels in bronchoalveolar lavage fluid (BALF) were significantly lower in group II compared to group IV (p<0.05). The findings of this study indicate that intraperitoneally administered BMSCs have potent effects on histopatological changes of the lung tissue and cytokine levels in the murine model of BO. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/1012 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/1012/736

Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 3 2017 06 17 219 227 EN Mousalreza Hosseini Department of Gasteroenterology and Hepatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Payman Shalchiantabrizi Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Maliheh Dadgarmoghaddam Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Saeideh Ahmady-Simab The Vice Chancellor of Research, Mashhad University of Medical Sciences, Mashhad, Iran Azizollah Behjati Immonology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Masoumeh Salari Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2016 04 09 2017 02 22ROR-γt and those of the cytokines IL-4, IL-5, IL-13, and IL-17, representing both T helper (Th)2 and Th17 responses, were lower in the IL-37 group in comparison with the Der f group. However, the Th1 responsewas not suppressed after administration of IL-37. IL-37 increased the IL-10 level; however, Real-Time PCR, western blotting, and flow cytometry results showed the limited action of IL-37 on CD4+CD25+Foxp3+T cells. This study demonstrates that intranasal IL-37 can suppress Th2 and Th17 responses in an AR murine model. Furthermore, these data suggest that IL-10 is increased, but CD4+CD25+Foxp3+T cells are not correlated with the IL-37-induced mechanism.   https://ijaai.tums.ac.ir/index.php/ijaai/article/view/1104 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/1104/762

Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 5 2017 10 28 418 424 EN Mohammad Taghi Palizgir Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran Maryam Akhtari Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Department of Cell and Molecular Biology, University of Tehran, Tehran, Iran Mahdi Mahmoudi Rheumatology Research Center, Tehran University of Medical Sceinces, Tehran, Iran Shayan Mostafaei Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran Alireza Rezaeimanesh Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Massoomeh Akhlaghi Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran Farhad Shahram Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran 2017 03 07 2017 05 16 Aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor, connecting environmental stimulators with the immune system. M1 macrophages are a part of immune system that contribute to the inflammatory events in the pathogenesis of Behcet's disease (BD). The effect of AHR on the macrophages in BD patients is still unclear. In this study, we investigated the mRNA expression of AHR in the monocyte-derived and M1 macrophages in active BD patients in comparison to healthy controls. Isolated monocytes from 10 healthy controls and 10 active BD patients were differentiated to macrophages by macrophage-colony stimulating factor (M-CSF) for 7 days. Cells were then polarized to M1 macrophages by lipopolysaccharide (LPS) and interferon-γ (IFNγ) for 24h. Monocyte purity and macrophage markers expression were analyzed by flow cytometry. Analysis of AHR mRNA expression was performed by SYBR Green real-time PCR. Our results showed that AHR expression is significantly down-regulated in M1 macrophages compare to monocyte-derived macrophages. It was shown that both monocyte-derived macrophages and M1 macrophages from BD patients significantly express lower level of AHR mRNA compared to healthy individuals. Our results demonstrate an anti-inflammatory role for AHR in macrophages, which suggest that decreased AHR expression is associated with pro-inflammatory M1 macrophage and BD susceptibility. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/1350 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/1350/774

Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 5 2017 10 28 425 432 EN Tahereh Khamehchian Department of Pathology, Kashan University of Medical Sciences, Kashan, Iran Eqlim Nemati Internal Medicine Department, Baqiyatallah University of Medical Sciences, Tehran, Iran Marziyeh Jazayeri Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran shirin Azimi Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran Hassan Nikoueinejad Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran Hossein Akbari Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran Behnaz Irandoust Department of Pathology, Kashan University of Medical Sciences, Kashan, Iran 2017 03 04 2017 05 13 Type 1 diabetes (T1D) is the result of the autoimmune destruction of insulin-producing beta cells. Regulatory T cells (Tregs) and plasmacytoid dendritic cells (PDCs) act as mediators of peripheral tolerance. We investigated the possible alterations of such cells in peripheral blood of patients with T1D compared to normal individuals. This comparison may lead to a better understanding of the immunopathogenesis processes involved in T1D. 92 participants, including 49 patients with T1D and 43 healthy controls were studied. 3 mL of blood was taken from all participants. After isolating peripheral blood mononuclear cells (PBMCs), PDCs as well as 2 subtypes of Tregs, CD4+CD25+FoxP3+ and CD8+CD28- cells were counted by 3-colorflow cytometry. The association between such enumeration and T1D was studied by multivariate regression and discriminate function models. The frequency of CD4+CD25+FoxP3+Tregs (p=0.038) and PDCs (p=0.039) in the peripheral blood of diabetic patients was less than that in healthy subjects. Having compared some models consisting different cells as well as their combinations, we did not find any profound explanation of each subset or their combinations to identify T1D. The decrease of CD4+CD25+FoxP3+cells and PDCs in diabetic patients may suggest their role in the onset or development of the disease. Therefore, it is likely that their pharmacologic stimulation may direct immune responses towards tolerance and prevent the development or even the onset of diabetes in susceptible individuals. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/1343 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/1343/768

Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 5 2017 10 28 433 442 EN Hossein Ahmadi Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ahmad Reza Jamshidi Rheumatology Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahdi Mahmoudi Rheumatology Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Farhad Gharibdoost Rheumatology Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahdi Vojdanian Rheumatology Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Javad Fattahi Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Institute for Cancer Research (ICR), School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Noushin Rastkari Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran Zahra Aghazadeh Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Abbas Mirshafiey Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2017 01 23 2017 03 12 The aim of this study was to investigate the effect of β-D-mannuronic acid (M2000) on hematological parameters in patients with active rheumatoid arthritis. This study was conducted on 25 patients with active rheumatoid arthritis (RA) (identifier: IRCT2014011213739N2). M2000 was administered orally for anemic and non-anemic RA patients at a dose of 500 mg twice daily for 12 weeks. The patients were permitted to continue the conventional treatments excluding NSAIDs. Blood samples were collected at baseline, 4 and 12 weeks after drug administration and were tested for hematological parameters. Moreover, serum levels of TNF-α and IL-6 were analysed before and after M2000 therapy compared to healthy controls using enzyme linked immunosorbent assay method. We found a significant increase in the count of red blood cells and also hemoglobin (Hb) concentration (0.9 g/dL) in anemic patients after 12 weeks of M2000 therapy (p<0.02 and p<0.01, respectively). Furthermore, our results showed an improvement in Hb level (0.45 g/dL) even in non-anemic patients who were treated by M2000 (p<0.04). The leukocytosis in RA patients, significantly decreased in both anemic and non-anemic patients after 12 weeks of M2000 therapy (p<0.02 and p<0.03, respectively). The percent of neutrophils significantly increased in anemic patients (p<0.01) while in non-anemic patients it significantly decreased after 12 weeks of M2000 therapy (p<0.01). The serum levels of IL-6 and TNF-α significantly decreased after 12 weeks of M2000 therapy (p<0.01 and p<0.04, respectively). M2000 improves hematological parameters in RA patients by its potent inhibitory effect on serum levels of TNF-α and IL-6. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/1275 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/1275/761

Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 5 2017 10 28 443 451 EN Mohadese M. Farahani Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Elahe Motevaseli Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Faezeh Maghsood Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Maryam Heidari-Kharaji Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran Abbas Mirshafiey Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2016 11 16 2017 04 05 The aim of this study was to evaluate the effects of M2000, a novel non-steroidal anti-inflammatory drug (NSAID) with immunosuppressive property and without gastro-nephrotoxicitic effects on matrix metalloproteinases (MMP)-2 and (MMP)-9 in phorbol myristate acetate (PMA)-differentiated THP-1 cells. Gene expression and activity of MMP-2 and MMP-9 are inhibited respectively by the tissue inhibitor of matrix metalloproteinase (TIMP)-2 and (TIMP)-1 and are induced by extracellular matrix metalloproteinase inducer (CD147/EMMPRIN). In this study, real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) was used to determine gene expression of MMP-2, MMP-9, TIMP-1, and TIMP-2. Flow cytometry and zymography were applied to determine cellular surface expression of CD147 and activity of MMP-2 and MMP-9, respectively. Our results showed that treatment of THP-1 cells with high concentration (25 µg/mL) of M2000 significantly decreased the cellular surface expression of CD147 (p<0.05) and the gene expression of MMP-2, MMP-9 and TIMP-1 (p<0.05), and inhibited the gelatinolytic activity of MMP-2 and MMP-9 (p<0.05). According to our results, M2000 can reduce inflammation through inhibition of the cellular surface expression of CD147 and decrease the gene expression and gelatinolytic activity of MMP-2 and MMP-9 in PMA-differentiated THP-1 cells. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/1148 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/1148/773

Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 5 2017 10 28 452 456 EN Demeke Geremew Department  of  Immunology,  School  of  Medicine,  International  Campus,  Tehran  University  of  Medical  Sciences, Tehran, Iran AND Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar (UoG), Gondar, Ethiopia Ania Rahimi-Golkhandan Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran Khosro Sadeghniiat-Haghighi Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran Yadollah Shakiba Department of Immunology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran Ahmad khajeh-Mehrizi Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran AND Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Bita Ansaripour Department  of  Immunology,  School  of  Medicine,  International  Campus,  Tehran  University  of  Medical  Sciences, Tehran, Iran Maryam Izad Department  of  Immunology,  School  of  Medicine,  International  Campus,  Tehran  University  of  Medical  Sciences, Tehran, Iran 2016 11 11 2017 04 18 Narcolepsy is a rare, disabling disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations and sleep paralysis. Several studies demonstrated its association with HLA-DQB1*0602 in various ethnic groups. Our study aimed to determine the prevalence of HLA-DQB1*0602 allele in Iranian patients with narcolepsy and assess its predictive parameters for diagnosing narcolepsy. In addition, car accidents and job problems were assessed among narcoleptic patients. We studied 44 narcoleptic patients, 30 patients with other types of excessive daytime sleepiness (EDS)  and 50 healthy age and sex matched individuals in this case-control study. Patients and controls filled out a questionnaire including items about car accidents due to sleepiness and job problems. International classification of sleep disorders-2 criteria was used as the gold standard for diagnosis of narcolepsy. The DNAs isolated from whole blood samples were collected from the patients and controls to assess the presence of HLA-DQB1*0602. The results showed that HLA DQB1*0602 was present in 4 (8%) individual of controls and 20 (45.5%) patients with higher prevalence in patients with cataplexy (78.9%) than patients without cataplexy (p<0.001). The sensitivities of the DQB1*0602 for diagnosing narcolepsy with cataplexy and narcolepsy without cataplexy were 78.9 and 20; specificities were 88 and 72.4, respectively. 18.2% of patients had car accidents due to sleepiness and 68.2% suffered from job problems. Our study shows that evaluation of DQB1*0602 in patients suspected to narcolepsy could be helpful especially in complex cases with atypical cataplexy and indistinguishable multiple sleep latency test MSLT results. Moreover, high rates of car accidents and job problems are found among narcoleptic patients. https://ijaai.tums.ac.ir/index.php/ijaai/art