Background. When the coronary atherosclerotic plaque becomes vulnerable, a thrombus develops on that ruptured plaque and then occludes the coronary artery, which causes an acute blood defi ciency in the downstream myocardium. Furthermore oxLDL (oxidized Low Density Lipoprotein) is involved in the coronary atherosclerotic plaque pathogenesis, MMP-9 (Matrix Metalloproteinase-9) enzymes plays role during the plaque rupture and CPR (C Reactive Protein) has a prognostic value in myocardial infarction. Objective. To determine the involvement of oxLDL, MMP-9, CRP markers in the pathogenesis of myocardial infarction, to study their involvement in the injury of the myocardium and to evaluate the complications. Material and Methods. The study was conducted using case-control design. The main inclusion criteria of the 40 case groups are that the patient should have a ruptured coronary atherosclerotic plaque, confi rmed by clinical symptom, ECG, serum troponin I, and coronary angiography. Also 40 patients with coronary stenosis or chronic occlusion without ruptured plague were included in the control group. Serum MMP-9 enzyme and oxLDL titers were determined by ELISA according to the manufacturer’s recommended protocol. Additionally CRP was measured by full-automated analyzater. We used CIIS (cardiac infarction injury score) by ECG and Gensini score system (Coronary Angiographic Scoring System) for assessing the severity of coronary heart disease. Results. Serum MMP-9, oxLDL levels (p<0.001) in the case group (ÌÌÐ-9 0.396±0.155 ng/ml; oxLDL 1.411±0.099 μg/ml) were more than in the control group (ÌÌÐ-9 0.223±0.087 ng/ml; oxLDL 1.332±0.163 μg/ml). The logistic analysis shows that ÌÌÐ-9, oxLDL, CRP (MMP-9 OR=0.985, p<0.001; oxLDLOR=0.011, p<0.05; CRP OR=0.041, p<0.005) may play a role in the pathogenesis of the plaque rupture. Serum MMP-9 enzyme level was directly correlated with Gensini score (r=0.552, p<0.01), CIIS (r=0.340, p<0.01) and CRP (r=0.321, p<0.01) titers. Furthermore, serum MMP-9 enzyme increases with accordance of severity of the myocardium injury with the statistical signifi cance (p<0.01): the borderline abnormality group (CIIS<10, 0.227±0.099 ng/ ml), possible injury (CIIS 10-15, 0.317±0.132 ng/ml), probable injury (CIIS >15, 0.376±0.132 ng/ ml) groups. MMP-9 levels were signifi cantly higher in the probable injury group patients (CIIS >15) compared to the possible injury group patients (CIIS 10-15) (p<0.001). ROC Curve analysis shows that MMP-9 enzyme levels variance (area=0.87, p<0.001) are more than other biomarkers making it a diagnostically benefi cial for the coronary atherosclerotic plaque rupture (CRP area=0,733, p<0.001, oxLDL area=0.635, p<0.05). Conclusion: Serum MMP-9, oxLDL and CRP are signifi cantly involved in the pathogenesis of coronary atherosclerotic plaque rupture in the myocardial infarction.

IntroductionAlthough systemic lupus erythematosus (SLE) is a relatively common autoimmune disorder, thebroad range of associated clinical symptoms means that its diagnosis can be diffi cult. Anti-ds-DNAautoantibodies are also considered to play a pathogenic role in inducing renal symptoms in SLE, anda strong correlation has been seen in lupus nephritis (LN) between disease activity and anti-ds-DNAautoantibody levels.GoalThe aim of the study was to compare the prevalence and levels of autoantibodies in the serum ofpatients with Systemic lupus erythematosus.Materials and MethodsThis patient-based descriptive study involved 39 patients with LN and 74 controls with primaryglomerulonephritis (GN). Face to face interview was used to obtain necessary information followed bythe physical examination and autoantibodies (anti-ds-DNA, anti-SS-A/Ro, anti-SS-B/La, c/p-ANCA, anti-Sm) measured by Enzyme-Linked Immunosorbent Assay (Germany, ORGENTEC Diagnostic GmbH).ResultsThe prevalence of anti-ds-DNA 48.7%, anti-SS-A/Ro 56.4%, anti-Smith 38.5%, anti-SS-B/La 12.8%were positive in lupus nephritis group (secondary GN), the prevalence of anti-ds-DNA 6.76%, anti-SS-A/Ro 6.76%, anti-Smith 2.7%, anti-SS-B/La 2.7% were positive in primary GN group.Conclusions: SLE associated with several autoantibodies (anti-ds-DNA, anti-SS-A/Ro, anti-Smith,and anti-SS-B/La) and each of which are very useful in distinguishing patients with SLE from otherautoimmune diseases and GN.

Background: Glomerulonephritis (GN) remains a common cause of end stage kidney failure worldwide. The auto antibodies are useful in the patients prognosing, diagnose and treatment of GN. The aim of the study was to compare the prevalence and levels of auto antibodies in the sera of patients with GN in relation to the clinical activity of disease and auto antibodiesMethods: From a hospital-based population, 90 patients with GN (mean age 37.9±12.7) were recruited. Autoantibodies (C/P-ANCA, anti-dsDNA, anti-Sm, anti-SS-A/Ro, anti-SS-B/La, anti-Scl-70, anti-GBM) measured by Enzyme Immuno Assay (Germany, ORGENTEC Diagnostika GmbH). Renal function was evaluated by the eGFR using the Cockcroft-Gault formula.Results: Patients with GN was significantly younger and primary GN was more common in the male, but frequency of LN was 4 times higher among female. The prevalence of cANCA 2.9%, Sm 4.2%, dsDNA 5.7%, SSA 7.1%, SSB 1.4% were positive in primary GN group, the prevalence of Sm 16.7%, dsDNA 8.3%, SSA 25%, SSB 16.7% were positive in secondary GN group. A higher frequency of anti Sm 25%, anti-dsDNA 25%, anti-SS-A/Ro 75%, anti-SS-B/La 25% was observed in the lupus nephritis group. Conclusion: Lupus nephritis associated with several auto antibodies (anti Sm, anti-dsDNA, anti-SS-A/ Ro, anti-SS-B/La) and each of which are very useful in distinguishing patients with lupus nephritis from other secondary GN.

INTRODUCTION: In the modern medical practice of Mongolia, autoimmune diseases have notbeen diagnosed in its early stage. The autoantibodies are useful in the patient’s early diagnosis,prognosing, and treatment of autoimmune diseases.GOAL: The aim of the study was to compare the prevalence and levels of autoantibodies in theserum of patients with autoimmune diseases.MATERIALS AND METHODS: This patient-based descriptive study involved 144 participants, withconfirmed diagnosis of autoimmune disease and glomerulonephritis (GN). Face to face interviewwas used to obtain necessary information followed by the physical examination and autoantibodies(anti-SS-A/Ro, anti-SS-B/La, anti-SCL-70, c/p-ANCA, anti-GBM, anti-Sm) measured by Enzyme-Linked Immunosorbent Assay (ELISA).RESULTS: The prevalence of anti-SS-A/Ro 38.6%, anti-Sm 25.7%, anti-SS-B/La 8.6%, c-ANCA7.14%, anti-SCL-70 1.4% were positive in autoimmune disease group (secondary GN), theprevalence of anti-SS-A/Ro 6.8%, anti-Sm 2.7%, anti-SS-B/La 2.7%, c-ANCA 1.4% were positivein primary GN group. A higher frequency of anti-SS-A/Ro 66.4%, anti-SS-B/La 22.8%, and anti-Sm38.4% was observed in the SLE group.CONCLUSIONS: Patients with autoimmune disease was significantly higherly younger and female.SLE associated with several auto antibodies (anti-SS-A/Ro, anti-SS-B/La, and anti-Sm) and eachof which are very useful in distinguishing patients with SLE from other autoimmune diseases.

Background Systemic Lupus Erythematous (SLE) is a multi-systemic autoimmune disease with numerous patterns of clinical and immunological manifestations. Renal disease in SLE occurs in 40–75% of patients, most often within five years of disease onset, and is one of the strongest predictors of a poor outcome. Anti-dsDNA antibodies are reported to be more prevalent in patients with SLE who have renal disease. Anti-Sm, anti SSA and anti SSB antibodies are also considered to play a pathogenic role in inducing renal symptoms in SLE, and a strong correlation has been seen in lupus nephritis (LN) between disease activity and anti-dsDNA antibody levels. Objective The aim of our study is to highlight the clinical and laboratory features in SLE patients. Methods This is a three year hospital based case-control study of patients with renal diseases, who were admitted to the nephrology and rheumatology units of the 1st central Hospital and 3rd central hospital, Mongolia. Standard methods were used for laboratory testing. Autoantibodies (C/P-ANCA, anti-dsDNA, anti-Sm, anti-SS-A/Ro, anti-SS-B/La, anti-Scl-70, anti-GBM) measured by Enzyme Immuno Assay (Germany, ORGENTEC Diagnostika GmbH). Renal function was evaluated by the eGFR (estimated glomerular filtration rate) using the Cockcroft-Gault formula. Result The study included 27 patients with lupus nephritis and 78 controls with other types of GN. There were 85.2% of female patients in the lupus nephritis group. Patients with LN were significantly younger than the controls (mean (SD) 31.9 (10.1) years vs. 37.1 (11.9) years; p=0.036). For the serology, a higher proportion of anti dsDNA (46.1%), anti Sm (29.6%), anti SSA (63%) and anti SSB (11.1%) were seen in the group with lupus nephritis (p=0.001; p=0.043; p<0.0001; p=0.096, respectively). The Pearson’s correlation analysis indicated that the level of anti-dsDNA (r=-0.249, p=0.021) and anti SSA (r=-0.195, p=0.048) were significantly correlated with the renal function (eGFR). All had dipstick proteinuria 1+/2+/3+, more than 10 red blood cells/hpf hematuria (n-12, 44.4%) in lupus nephritis group and renal function (mean eGFR (SD) 88.1 (51.3) ml/min vs. 112.3 (67) ml/min; p=0.05) was more decreased in lupus nephritis patients than controls. Conclusion Notably, rising titers of antibodies to dsDNA, SSA may indicate exacerbations of glomerulonephritis.

Trichomonas vaginalis is a flagellated protozoan parasite that causes vaginitis and cervicitis in women and asymptomatic urethritis and prostatitis in men. Mast cells have been reported to be predominant in the vaginal smears and vaginal walls of patients infected with T. vaginalis. Mitogen activated protein kinase (MAPK) activated by various stimuli also regulate the transcriptional activity of various cytokine genes in the mast cells. Because of their essential role in intracellular signaling network, also appropriate targets for pharmacological treatment of inflammatory disorders.Cultivation of T.vaginalis and HMC-1 line, preparation of TvSP, to check intracellular ROS level and degranulation by FACS, to determine phosphorylation of MAPK and p47phox by immunobloting.In this study, we investigated whether MAPK were involved ROS generation and exocytotic degranulation in HMC-1 induced by T. vaginalis-derived secretory products (TvSP). We first examined that TvSP could induce activation of MAPK and NADPH oxidase in HMC-1 cells. Stimulation with TvSP induced phosphorylation of MAPK and p47phox in HMC-1 cells. Phosphorylation of p47phox is main source of ROS generation. Next, to determine involvement activation of MAPK in ROS generation and degranulation in HMC-1 cells induced by TvSP. ROS generation is required for exocytotic degranulation of mast cells induced by TvSP. Stimulation with TvSP induced phosphorylation of p47phox, ROSgeneration, and surface up-regulation of CD63 in human mast cells. CD63 is a marker for exocytosis. Pretreatment with MAPK inhibitors strongly inhibited TvSP-induced ROS generation and exocytotic degranulation.Our results suggest that TvSP could induce intracellular ROS generation and exocytotic degranulation in HMC-1 via MAPK signaling pathway.

Background: Natural protection against Mycobacterium tuberculosis is based on cell-mediated immunity, which most importantly involves CD4+ and CD8+ T-cell subsets. Therefore, the evaluation of CD4+ and CD8+ T-cell profi les are important to evaluate cell-mediated immunity. Immuno-regulating therapy is important in increase of T cell subsets. Objective: To determine some T-cell subsets in active pulmonary tuberculosis patients following immunoregulating treatment in intensive phase of antituberculosis treatment, so to evaluate the treatment effect. Method: This study was conducted in TB clinic of National Center for Communicable Diseases (NCCD) between Aug 2008 and Mar 2009. CD4+ and CD8+-T cells were evaluated in 50 active pulmonary tuberculosis (infi ltrative form) cases before antituberculosis treatment (25 cases with Salimon-Study group, 25 cases without SalimonControl group) Patients with chronic disease, pregnant and alcohol users are excluded. The T cell subsets count was performed by FACSCount fl ow cytometer at the Immunology Laboratory of the NCCD,Mongolia.The monoclonal antibodies to CD3, CD4 and CD8 (Becton Dickinson) were used for the analysis. Result: CD4 count was 605,1242,7 cells/microL, CD8 count-470,92235,7 cells/microL, CD3 count-1130,7425,6 cells/microL, CD4/CD8 ratio was-1,480,67. CD4, CD8, CD3 cells were signifi cantly lower (P=0.05) in active pulmonary TB patients than in healthy Mongolian. And these subsets were signifi cantly lower in older patients (>50 age).There was no statistical signifi cance in sex and other age groups (p>0, 05). There were statistical signifi cances such as CD4 count, CD4/CD8 ratio (CD4-733,95314,38 cells/micro, CD4/CD8 ratio-1.870,7 in treatment group, CD4-570,54213.07 cells/micro, CD4/CD8 ratio-1.260.45 in control group) between TB and control group at the end of intensive phase of antituberculosis treatment (=0,05, =0,001). However, there were not any signifi cance CD8 count and CD3 count between two groups (CD8-423,68174,28 cells/microL, CD3-1212,27453,98 cells/microL in treatment group, CD8-500,67203,74cells/microL, CD3 -1139,33 386,47 cells/ microL in control group) (=0,05). Conclusion: 1. T cell subsets were signifi cantly lower in active,new,smear positive, pulmonary TB patients than in healthy Mongolians (p=0.05). 2. The statistical signifi cance is observed in 50 years and older TB patients (p=0.05). 3. CD4, CD4/CD8 were signifi cantly higher in patients treated with immuno-regulating treatment than in patients of control group (=0,05, =0,001).

Kidney transplantation is the best alternative treatment for end-stage renal disease and health-related quality of life and survival of the patients are improved compared with dialysis. Worldwide, more than 1.4 million patients with CKD receive renal replacement therapy with incidence growing by approximately 8% annually.1 Unfortunately, despite significant improvement in graft function, kidney transplants can still fail due to acute rejection and chronic allograft nephropathy.2 Kidney biopsy after transplantation, which has evaluated by Banff 09 classification is usefull method for diagnose of transplanted kidney disease.3,4Kidney graft rejection was diagnosed in 10 renal allograft biopsy specimens (bs) obtained from transplant patients followed up at our institute between 2015 and 2016. All specimens were evaluated as satisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissue was divided into two tips: one piece for routine H&E stain and special stains, including Masson’s trichrome, and PAS stain; another piece for immunofluorescence by frozen section, which were stained with IgA, IgM, IgG and complement component (C3, C4, C1q, C4d). All the renal biopsies were examined by the same pathologist.Out of 117 transplantations, 10 episodes of rejection selected. Among the 10 patients, 30% had an acute T cell rejection and 70% had a chronic allograft nephropathy. Interstitial inflammation (i1-7) was present in 7 bs (70%), tubulitis (t1-4,t2-2) in 6 bs (60%), transplant glomerulitis (g1-1, g2-2, g3-1) in 4 bs (40%), transplant interstitial fibrosis (ci1-2, ci2-2, ci3-2) in 6 bs (60%), tubular atrophy (ct1-6, ct2-2, ct3-1) in 9 bs (90%), mesangial matrix increase (mm1-5) in 5 bs (50%), vascular fibrosis intimal thickeness (cv1-3) in 3 bs (30%), arteriolar hyaline thickening (ah1-5) in 5 bs (50%), tubulitis (ti1-6, ti2-3, ti3-1) in 10 bs (100%) and peritubular capillaritis (ptc1-1, ptc2-2, ptc3-1) in 4 bs (40%). C4d deposition was present very mild in wall of the vessels and peritubular capillaries. Because of not good working Methenamin silver stain, we couldn’t demostrate glomerular basement membrane changes (cg) fully.We suggest that histopathological changes of transplant glomerulopathy might be accompanied by inflammation of the microvasculature, such as transplant glomerulitis and peritubular capillaritis. C4d deposition in the wall of the vessels and peritubular capillaritis is not always present in biopsy specimens of transplant glomerulopathy.

Introduction: In Mongolia, diagnostic tests for the detection of the sexually transmitted congenital virus and human papilloma virus are currently not routinely used in clinical settings and the frequency of these STIs is enigmatic. Goal: The prevalence of this virus were prospectively evaluated among 200 Mongolian pregnant women and their newborns and correlated with pregnancy outcome. Materials and Methods: Taq Man PCRs were used to detect some virus in pre-birth vaginal swabs of the pregnant women and in oral swabs of their newborns. A standardized questionnaire concerning former and present pregnancies was developed and regression analysis was used to correlate virus detection with pregnancy outcome. Result: Cytomegalovirus was the most prevalent of the tested pathogens (46.5% positive women and 10.5% newborns), human papilloma virus (31.5% and 4.5%) and herpes simplex virus-2 (1% and 0%). Statistical analysis: The statistical analysis was conducted using the software program RStudio, version 0.99.896. Multiple regression analysis was used to assess the association between pathogen loads of mothers or newborns and the outcome variables (gestational age, neonatal length, weight, head circumferences and bacterial vaginosis). Conclusions Multiple regression analyses indicate that colonization of the mothers with cytomegalovirus is associated with transmission to newborns and that transmission is associated with reduced neonatal length and gestational age. Thus, diagnostic tests for their detection should be implemented in the clinical settings in Mongolia.

Background: Establishment of quantitative reference intervals of white blood cells and its subpopulations using a high accuracy analytic system is essential for clinical medicine, public health, and anthropology. We are unable to identify peer-reviewed literature sources describing white blood cell counts and their subpopulations using monoclonal antibodies to specific surface antigens in healthy Mongolians. This study aimed to measure the counts of white blood cells and their subpopulations in healthy Mongolians using flowcytometry. Materials and Methods: The absolute number (cell/L) of leukocytes (CD45+), granulocytes, monocytes and lymphocytes were measured by Magnetic Activated Cell Sorting Assay (MACSQuant Analyzer 10) in 287 blood donors (158 males and 129 females) 17-64 years of age (mean age 33.1±12.4). Peripheral blood samples were collected at the time of blood donation at the National Center for Transfusion Medicine. Results The mean values of leukocytes and granulocytes were lower in donors over 30 years of age (ANOVA: F=4.408, p=0.002 and F=5.685, p=0.001) and regression analysis demonstrated indirect correlation between counts of these cells and age of donors (r= - 0.198, p=0.001 and r=-0.221, p=0.001, respectively). Gender-related differences in white blood cell counts were not found.
Mean value of lymphocyte count in donors investigated in spring (May and March, n = 87; 2224.6±775.3) was significantly higher than those in winter (December – February, n=180; 1613.2±454.3, p=0.001) and autumn (October, n=20; 1576.1±438.6, p= 0.001).
Comparing of our findings with the data from available literature shown that healthy Mongolians have lower leukocyte count compared with Koreans, Chinese Han population and lower mean value of lymphocyte count comparing with Korean, Chinese Han population, and Arabian (Saudi Arabia) populations.