1.Determination of serum IL-4 and IFN-γ levels in allergic model-induced C57BL/6 mice using in-house ELISA
Dulguunuu M ; Nyam-Ochir G ; Oyun-Erdene Ch ; Ariunzaya B ; Tsogtsaikhan S ; Enkhtushig G ; Khuselt-Od T ; Enkhtuya S ; Sarantuya L ; Suvd O ; Nyamdorj D ; Batbaatar G ; Gansukh Ch ; Enkhsaikhan L ; Enkh-Amar B
Mongolian Journal of Health Sciences 2026;92(2):134-138
Background:
Type I hypersensitivity, commonly known as an allergic reaction, is characterised by an IgE-mediated immune response triggered when foreign proteins enter the body. During allergic reactions, cytokines such as IL-4, IL-5, IL-9, and IL-13, secreted by T-helper 2 (Th2) cells, play a crucial role in activating immune effector cells like eosinophils and mast cells, which contribute significantly to airway inflammation and obstruction. Conversely, interferon-gamma (IFN-γ), produced by Th1 cells, suppresses Th2-mediated responses and plays an essential role in regulating allergic inflammation. Therefore, determining the balance of cytokines produced by Th1 and Th2 cells is crucial for understanding the mechanisms underlying allergic responses.
Aim:
We aimed to induce an allergic response in experimental animals using ovalbumin and to determine the levels of IL-4 and IFN-γ cytokines using an in-house enzyme-linked immunosorbent assay (ELISA).
Materials and Methods:
A total of 20 female C57BL/6 mice aged 6–8 weeks were selected for the experiment and randomly divided into two groups: control and experimental groups. The concentrations of IL-4 and IFN-γ cytokines in mouse serum were determined using an in-house enzyme-linked immunosorbent assay (ELISA).
Result:
Compared to the control group, the levels of IL-4 and IFN-γ cytokines in the serum of allergic model-induced C57BL/6 mice were determined to be 513.7 pg/mL and 193.2 pg/mL, respectively. A statistically significant difference was observed in IL-4 cytokine levels between the two groups (p < 0.001).
Conclusion
In the allergic model group, serum levels of IL-4 cytokine were elevated, while IFN-γ cytokine levels were decreased, suggesting a predominant Th2-type immune response.
2.Determination of miRNA-21 as a Marker in Primary Brain Tumors
Enkhtuya S ; ; Orkhontuul Sh ; ; Ariunzaya B ; Batbaatar G ; Tsogtsaikhan S ; Gansukh Ch ; Enkhsaikhan L ;
Mongolian Journal of Health Sciences 2026;96(6):121-126
Background:
Globally, approximately 322,000 new cases of brain and central nervous system (CNS) tumors were reported in 2022, accounting for 1.6% of all newly diagnosed cancers. Primary brain tumors represent 85–90% of all CNS tumors, and survival varies substantially by tumor type and stage. Malignant brain tumors have a 5-year survival rate of approximately 35.7%, while meningioma, the most common benign brain tumor, has a 5-year survival rate of 88.2%. Furthermore, survival outcomes are substantially poorer in low- and middle-income countries (LMICs). For example, the median survival of patients with glioblastoma (GBM) is 12–15 months in high-income countries but only 6–9 months in LMICs. In Mongolia, 93 new cases of brain and CNS tumors were reported in 2024. Although the incidence is lower than that of other common cancers, the mortality rate remains high (80.4%). Because brain tissue biopsy is invasive and repeated sampling is often impractical, in Mongolia, brain and CNS tumors continue to be associated with high mortality, underscoring the need for minimally invasive biomarkers for early diagnosis and disease monitoring MicroRNAs (miRNAs) are small non-coding RNAs (18–22 nucleotides) that regulate gene expression at the post-transcriptional level and remain stable in body fluids, making them promising biomarkers. Among them, miR-21 is a well-characterized oncogenic miRNA that is overexpressed in glioma and glioblastoma. However, evidence regarding its clinical utility in LMICs, particularly in Mongolia, remains limited.
Aim:
To evaluate plasma miRNA-21 expression in patients with primary brain tumors and evaluate its diagnostic performance.
Materials and Methods:
This study enrolled 120 participants, including patients with primary brain tumors, patients with other neurological disorders (non-tumor), and healthy controls. Peripheral blood samples were collected, and plasma miRNA-21 expression was quantified using quantitative real-time polymerase chain reaction. Relative expression was calculated using the 2^-ΔΔCt method. Descriptive statistics and one-way analysis of variance (ANOVA) were performed to evaluate differences among groups. Receiver operating characteristic curve analysis was performed to assess diagnostic performance, with statistical significance set at p < 0.05.
Result:
Plasma miRNA-21 expression was significantly higher in patients with primary brain tumors than in healthy individuals, showing a 3.81-fold increase (p<0.001), and was 1.53-fold higher than in patients with neurological disorders (p<0.001). miRNA-21 expression was significantly elevated in patients with glioma, meningioma, and adenoma compared with both healthy individuals and patients with neurological disorders (p<0.001). Similarly, miRNA-21 expression was significantly higher in both glial and non-glial tumors than in the healthy and neurological disorder groups (p<0.001) and showed an increasing trend according to tumor stage/grade (p<0.001). ROC curve analysis demonstrated that miRNA-21 had a sensitivity of 92.3% and a specificity of 80.5% for distinguishing patients with primary brain tumors from the comparison groups.
Conclusion
Plasma miRNA-21 has the potential to distinguish patients with primary brain tumors from healthy individuals and patients with neurological disorders and may serve as a minimally invasive diagnostic biomarker for primary brain tumors.
3. Impact of Individual Temperament on the Immune Response After COVID-19 Vaccination
Burenjargal B ; Dashpagam O ; Shatar Sh ; Khongorzul T ; Ariunzaya B ; Zolmunkh N ; Gansukh Ch ; Ulziisaikhan B ; Chimidtseren S ; Baasanjargal B ; Enkh-Amar B ; Nomin-Erdene Ts ; Davaalkham D ; Tsogtsaikhan S ; Batbaatar G
Mongolian Journal of Health Sciences 2025;88(4):47-51
Background:
The first confirmed case of COVID-19 in Mongolia was reported on November 11, 2020. In response, the
government imposed a nationwide lockdown, which significantly impacted the population’s mental health. Heightened
levels of stress, anxiety, loneliness, and depression during the pandemic altered individuals’ psychological stability and
behavior. Personality traits—defined as relatively stable patterns of emotion, cognition, and behavior—play a key role in
stress responses and emotional regulation under pressure. Emerging evidence suggests that these psychological factors
may influence the immune system’s responsiveness, including vaccine-induced antibody production.
Aim:
To evaluate the association between post-vaccination antibody responses and personality types following two doses
of COVID-19 vaccines.
Materials and Methods:
A total of 738 participants who received two doses of COVID-19 vaccines (AstraZeneca
ChAdOx1, n=29; Pfizer-BioNTech, n=119; Sinopharm BBIBP, n=590) and had no prior SARS-CoV-2 infection were enrolled. Serum samples were collected 21–28 days after the second dose, and SARS-CoV-2 RBD (S) IgG antibodies
were measured using ELISA (Proteintech Inc., USA). Personality types were assessed using a 56-item temperament
questionnaire developed by A. Belov, categorizing individuals into classical temperament types (choleric, phlegmatic,
sanguine, melancholic). Logistic regression and ROC analysis were used to examine associations between personality
types and antibody response.
Results:
The presence of an antibody response was significantly higher among individuals with a melancholic temperament, and significantly lower among those with a phlegmatic temperament. Furthermore, antibody titers were higher in
participants with melancholic and sanguine temperaments and lower in those with a phlegmatic type.
Conclusions
1. During the early period following the second dose of COVID-19 vaccination, the antibody response was higher
in individuals with a pure melancholic temperament, while it was lower in those with a phlegmatic temperament.
2. After the second dose of the Sinopharm BBIBP COVID-19 vaccine, antibody titers were higher in individuals with
pure melancholic and sanguine temperaments, and lower in those with a phlegmatic temperament.
4.Outcomes of COVID-19 Immunization Among Healthcare Workers
Dashpagam O ; Davaalkham D ; Burenjargal B ; Tselkhaasuren B ; Baigal V ; Shatar Sh ; Khorolsuren L ; Tsogtsaikhan S
Mongolian Journal of Health Sciences 2025;87(3):191-198
Background:
The first case of COVID-19 was reported in our country on November
11, 2020. As of 2023, a total of 869,385 cases and 2,128 deaths have been
recorded nationwide. The World Health Organization (WHO) has recommended
that countries use 15 vaccines from 11 manufacturers listed for emergency use.
The WHO has advised low-income member states to prioritize vaccinating healthcare
workers and other high-risk populations vulnerable to severe illness and
death from COVID-19. The main goal of the coronavirus vaccination program is to
prevent infection, complications, and death among priority target groups, such as
healthcare workers and other populations at high risk of severe illness. The effectiveness
of the vaccination is measured by its ability to reduce the risk of illness,
hospitalization, and death from COVID-19-related complications among vaccinated
individuals. While extensive research is being conducted globally to develop,
evaluate, and assess the effectiveness and outcomes of COVID-19 vaccines,
there has been limited research focused on these outcomes within our country.
This gap highlights the need for and serves as the basis of the present study.
Аim:
To assess the risk of infection, hospitalization, and associated risk factors among
healthcare workers vaccinated against COVID-19, and to examine the factors that
influence these risks.
Materials and Methods:
A This follow-up study was conducted over an 80-week
period—at weeks 12, 24, and 48—from February 23, 2021, to December 31, 2022.
The study involved healthcare workers from Ulaanbaatar city and the aimags of
Bayankhongor, Orkhon, Bulgan, Dundgovi, Darkhan-Uul, and Dornod. The study
was conducted over a period of 1.5 years (80 weeks) following the administration
of the first two doses of the COVID-19 vaccine. Data were collected from participants
at three time points: before vaccination, after the second dose, and after
each booster dose. A structured questionnaire comprising 7 sections and 49 questions
was used for data collection, and the results were analyzed using SPSS version
26.0.
Results:
Of the total respondents, 574 (60%) worked in direct contact
with infected individuals in the 'red zone,' while 370 (40%) worked in the 'yellow
zone.' Additionally, 250 participants (27.1%) were healthcare workers from Ulaanbaatar
city, and 674 (72.9%) were from rural areas. In our observational study, the
risk of new infections among healthcare workers increased over time, rising from
38.4% at week 24 to 59.6% by week 80. Hospitalizations also increased during the
follow-up period: 24 cases (2.6%) were recorded at week 12, 160 (17.3%) at week
24, 202 (21.9%) at week 48, and 204 (22.1%) by week 80. Among frontline workers
in rural areas, those in Bayankhongor and Orkhon aimags exhibited a lower
risk of infection compared to their counterparts in other aimags.
Conclusion
In
our follow up study, an increase in the duration since primary immunization was
associated with a higher risk of new infection among workers, rising from 38.4%
at 24 weeks to 59.6% at 80 weeks post-vaccination. Administration of additional
(booster) immunizations was associated with a reduced risk of subsequent infection.
COVID-19 vaccination was associated with a reduced risk of complications
necessitating hospitalization. Employment in rural settings and designated red
zones was identified as a risk factor for incident infections, hospitalizations, and
reinfections.
5.Results of inflammatory cytokines after kidney transplantation
Ariunaa A ; Gansukh Ch ; Ulziikhuu T ; Enkh-Amar B ; Batbaatar G ; Tsogtsaikhan S ; Sarantsetseg J ; Khongorzul T
Mongolian Journal of Health Sciences 2025;85(1):14-18
Background:
Organ transplantation has been rapidly advancing in Mongolia in recent years. The number of successful
kidney, liver, and bone marrow transplants performed in national central hospitals has been increasing annually. While the
number of successful kidney transplants is increasing, post-transplant immune monitoring remains insufficiently studied.
Aim:
To assess post-transplant immune status by analyzing inflammatory cytokine levels in kidney transplant recipients
Materials and Methods:
A prospective cohort study was conducted at the First Central Hospital of Mongolia. Serum
samples from kidney transplant recipients were analyzed using flow cytometry to measure the levels of 13 inflammatory
cytokines, including TGF-β1, PAI-1, sTREM-1, PTX3, sCD40L, sCD25 (IL-2Ra), CXCL12 (SDF-1), sST2, sTNF-RI,
sTNF-RII, sRAGE, CX3CL1 (Fractalkine), and sCD130 (gp130). Statistical analysis was performed to assess the results.
Results:
The mean creatinine level significantly decreased on post-transplant days 7 and 30 compared to pre-transplant
levels (p<0.001, ANOVA). No statistically significant difference was found in the 13 cytokine levels between the high
risk and low-risk groups based on creatinine levels on post-transplant day 30 (p>0.05). However, the levels of TGF-β1,
CX3CL1, sTREM-1, and sTNF-RI showed statistically significant differences between post-transplant days 7 and 30
(p<0.05). No significant correlation was found between the measured cytokine levels and CRP (p > 0.05). On post-transplant day 7, sTREM-1 had a weak correlation with TGF-β1 (r=0.40, p=0.02) and sTNF-RI (r=0.36, p=0.05) but showed a
strong correlation with CX3CL1 (r=0.65, p=0.0001). On post-transplant day 30, sTREM-1 remained strongly correlated
with CX3CL1 (r=0.73, p=0.0001) and moderately correlated with sTNF-RI and TGF-β1 (r=0.45, p=0.01).
Conclusions
1. The levels of TGF-β1, CX3CL1, sTREM-1, and sTNF-RI significantly varied between post-transplant days 7 and
30 (p< 0.05, T-test).
2. On post-transplant day 30, these cytokines were not correlated with CRP but were interrelated among themselves.
6.The In vitro study on the effect of the bioactive fraction of Rhododendron adamsii on the end products of TLR4 signaling
Otgontuya N ; Badmaarag B ; Khashchuluun S ; Onon Ch ; Oyun S ; Tsogtsaikhan S ; Erdenezaya O ; Chimidtseren S
Mongolian Journal of Health Sciences 2025;85(1):239-243
Background:
Rhododendron adamsii (Sagaan Dalya) is a medical plant widely distributed in the Altai region, Mongolia,
and Russia. It is traditionally used for its calming, restorative, and immune-boosting properties. Inflammation is a complex immune response against pathogens such as bacteria, viruses, and fungi, involving macrophages, fibroblasts, mast
cells, and neutrophils. These cells release inflammatory mediators such as nitric oxide (NO), TNF-α, and IL-1β.
In collaboration with the Russian Foundation for Basic Research, a project was initiated to investigate the bioactive fractions of Rh. rosea (L.) and Rh. adamsii and their effects on the production of TLR4 signaling end products
and associated protein activation. Previous studies within this project have shown that certain bioactive fractions exhibit
anti-inflammatory activity. Specifically, fraction 7.11 suppressed NO production and inflammatory signaling molecules
in LPS-stimulated RAW 264.7 macrophages, while fractions 7.46 and 7.52 influenced the phosphorylation of proteins
such as ERK1/2, JNK, and IRF3. These findings suggest the need for further investigation into the effects of Rh. adamsii
bioactive fractions on inflammatory signaling pathways.
Aim:
This study aims to evaluate the effects of bioactive fractions derived from Rhododendron adamsii on the production
of TLR4 signaling end products in RAW264.7 macrophage cell cultures.
Materials and Methods:
The study was conducted using RAW264.7 macrophage cell cultures and bioactive fractions
extracted from Rh. adamsii, dividing the experiments into three groups. After stabilization, RAW264.7 cells were stimulated with 100 ng/mL LPS. Based on previous studies, non-toxic concentrations of bioactive fractions (10 µg/mL) were
applied. NO production was measured using the Griess assay, while TNF-α and IFN-β cytokine levels were evaluated
using ELISA. Each experiment were repeated three times, and data were statistically analyzed using SPSS 25.0, applying
One-way ANOVA and Independent Samples T-test.
Results:
The NO production in the positive control group was significantly higher compared to the negative control. In
contrast, the experimental groups showed a statistically significant reduction in NO production, suggesting a potential inhibitory effect on TLR4 signaling in macrophages. However, fraction 7.48 reduced TNF-α levels while increasing IFN-β
production, but these changes were not statistically significant. Similarly, fraction 7.55 slightly reduced TNF-α and IFN-β
levels, but the effect was also statistically unsignificant.
Conclusion
The bioactive fractions 7.48 and 7.55 of Rh. Adamsii reduced nitric oxide (NO) production in LPS-stimulated macrophage cell line cultures, suggesting that they may inhibit TLR4 signaling. However, their lack of effect on
TNF-α and IFN-β production indicates that they do not influence TLR4 signaling mediated by these cytokines. Instead,
they may affect the final product output through other pathways or different stages of signal transduction.
7.Serum levels of Aquaporin-4, IL-6, and TNF-α in Patients with Primary Brain Tumors
Baigalmaa D ; Orkhontuul Sh ; Enkhtuya S ; Tsogtsaikhan S ; Gansukh Ch ; Enkhsaikhan L ; ; Ariunzaya B ;
Mongolian Journal of Health Sciences 2025;89(5):79-84
Background:
Gliomas are common primary brain tumors of glial origin in adults with a poor prognosis. Tumor-related
inflammatory cytokines such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and aquaporin-4 (AQP-4)
water channel protein have been reported to be expressed in gliomas
Aim:
This study aimed to determine their serum levels in patients with primary brain tumors compared to healthy controls
and to evaluate their potential diagnostic value.
Materials and Methods:
Serum AQP-4 levels were measured by ELISA in 28 patients with primary brain tumors (PBT)
and 26 healthy controls. IL-6 and TNF-α were assessed by flow cytometry in 59 PBT patients and 52 controls.
Results:
Among the primary brain tumor cases, 45.61% were meningiomas, 26.32% anaplastic astrocytomas, 8.77%
glioblastomas, and 12.28% other tumors (including chondroma, ependymoma, schwannoma, craniopharyngioma). Serum
IL-6, TNF-α, and AQP-4 levels were significantly higher in the PBT group compared with healthy controls.
Conclusion
Elevated serum levels of AQP-4, IL-6, and TNF-α in patients with primary brain tumors suggest that these
biomarkers molecules could represent valuable non-invasive biomarkers for the early detection of PBT.
8.Peripheral blood differential count of white blood cells in blood donor
Tsendsuren S ; Gansukh Ch ; Khongorzul T ; Enkhsaikhan L ; Erdenebayar N ; Nyambayar D ; Tsogtsaikhan S ;
Mongolian Medical Sciences 2020;193(3):3-10
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.
9.The key role of transcription factors on the innate immunity reaction
Ulziisaikhan J ; Gandolgor Ts ; Tsogtsaikhan S ; Yokochi T ; Enkhsaikhan L ; Jambaldorj J ; Munkhbayar S ; Munkhtuvshin N ; Munkhbat B ; Bilegtsaikhan Ts
Health Laboratory 2019;10(2):23-33
Background:
The effect of lipopolysaccharide (LPS) on valproic acid (VPA)-induced cell death was examined by using mouse RAW 264.7 macrophage cells.
Materials and methods, results:
LPS inhibited the activation of caspase 3 and poly (ADP-ribose) polymerase (PARP) and prevented VPA-induced apoptosis. LPS inhibited VPA-induced p53 activation and pifithrin-α as a p53 inhibitor as well as LPS prevented VPA-induced apoptosis. LPS abolished the increase of Bax/Bcl-2 ratio, which is a critical indicator of p53-mediated mitochondrial damage, in response to VPA. The nuclear factor (NF)-κB inhibitors, Bay 11-7082 and parthenolide, abolished the preventive action of LPS on VPA-induced apoptosis. A series of toll-like receptor (TLR) ligands, Pam3CSK4, poly I:C, and CpG DNA as well as LPS prevented VPA-induced apoptosis.
Conclusion
Taken together, LPS was suggested to prevent VPA-induced apoptosis via activation of anti-apoptotic NF-κB and inhibition of pro-apoptotic p53 activation.
10.Result of detection sexually transmitted some viral infections among pregnant women and newborns
Otgonjargal B ; Batbaatar G ; Tsogtsaikhan S ; Klaus P ; Birgit H ; Enkhtsetseg J ; Battogtokh Ch
Mongolian Medical Sciences 2019;187(1):11-16
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.
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