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.

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.

Background: Kidney transplantation has being performed in Mongolia since 2006. However there is currently no published data available on long-term graft and patient survival. Objective: Our aim was to assess the long-term graft and patient survival rate correlation with HLA-A-B-DR matching. Methods: We retrospectively analyzed data from 70 adult kidney transplants performed at our hospital from August 2006 through January 2014. The data was retrospectively collected from patient files, including characteristics of the recipient and donor, post transplant features and HLA-A-B-DR DNA based typing results. The Kaplan-Meier method was used to analyze graft and patient survival. Results: The mean patient follow-up period after kidney transplantation was 39,6±25.9 months, and the mean kidney graft follow-up period was 36.6±23.7 months for 70 cases. Overall graft and patient survivals were 52 (74.3%) and 60 (85.7%) respectively in 70 cases. Five-year graft and patient survivals were 23 (67.6%) and 29 (85.3%) respectively in 34 cases. The group with four to six mismatched were found to have a significantly lower 3 and 5-year graft and patient survival (71%; 35%); (80%; 40%) compared to 0 to 1 mismatched group (100%) (p=.030; p=.015). Furthermore we analyzed the association of HLA matching, immunosuppressive therapy and long-term graft survival. We selected CNI mono-therapy group for long-term survival analysis and observed a similar pattern. In mono-therapy group, the group with four to six mismatched were found to have a significantly lower 3 and 5-year graft and patient survival (75%; 30%); (65%; 30%) compared to 0 to 1 mismatched group (100%) (p=.037; p=.001). Conclusion The results showed that graft and patient survival rates were lower compared with results from established centers. Statistically highly significant effect of HLA matching on kidney graft and patient survival rates was found in our analysis. Five years after transplantation the graft survival rate of first adult kidney transplant with 4-6MM was 65-70% lower than that of grafts with 0-1MM. Longitudinal cohort study needed in the future to exhibit an improved transplantation outcome.

Background: However kidney transplantation has being performed in Mongolia since 2006, because of pre-transplant sensitization, ABO incompatibility, hepatitis B and C virus activation many patients are taken kidney transplantation in abroad. The transplantation centers use own immunosuppressive regimens. Objective: Our aim was to assess the immunosuppressive regimens efficacy and toxicity in kidney transplant Mongolian recipients. Methods: We analyzed data from 96 adult kidney transplant recipients who had taken kidney transplantation in different transplant centers from August 2006 through January 2014. There were 3 kinds of regimens Group I Simulect induction with standard triple /FK506/CyA+MMF/AZA+steroid/, Group II Campath-1H induction with CNI monotherapy and Group III Campath-1H induction with standard triple /FK506/CyA+MMF/AZA+steroid/. We retrospectively collected the post-transplant first two years serum creatinine. The study was performed in 2014. The questionnaire was taken and blood samples collected for determination of tacrolimus through level and for other laboratory tests. The primary end point was the first two years serum creatinine, the secondary end points included rejection episodes, blood through level of tacrolimus and some laboratory findings. Results: The post-transplant first two years serum creatinine levels were significantly different in 3 groups. Group III showed similar results compared to Group I. There was not enough data of biopsy proven acute rejection episodes however group II said more rejections occurred. However participants said that rejection occurred in 15 (15.6%) biopsy was done only 3 (3.1%) cases. Blood through level of tacrolimus was significantly different in three groups. Some laboratory findings showed different between three groups. Conclusions A regimen of Campath-1H induction with CNI monotherapy (Group II) may be advantageous for short-term renal function and cost effective but there were more rejection complications and increased creatinine. The regimen of Campath-1H induction 11 with standard triple (Group III) may be advantageous for long-term renal function, allograft survival, but there should consider about infection complications and polycythemia. Simulect induction with standard triple could be best choice but transplantations were performed in experienced centers. The study enrolled few cases and cases which were performed at the beginning of transplant program so many things could influence on the result. The study was compared beginner transplant center with experienced centers. Longitudinal cohort study needed in the future.

Background: De-novo donor and non-donor specific antibodies could be detrimental to the kidney allograft. Kidney transplantation has being performed in Mongolia since 2006. However there is currently no published data available on post-transplant de-novo antibodies and long-term graft survival. Our aim was to determine immunosuppressive drug through level, its combination, de-novo HLA antibodies and its influence on graft survival in different immunosuppressive protocols. Methods: We analyzed data from 56 adult first kidney transplant recipients at our hospital from August 2006 to May 2013. We determined the level of tacrolimus, cyclosporine A, and the presence of pre and post-transplant anti-HLA antibodies. Results: Post-transplant follow up period was 1-8 years. Mean recipient age on transplantation was 33.9±9.1 years. Male 45 (80.4%). Cadaver donor kidney was 5 (8.9%). Mean donor age on transplantation was 39.98±11.13 years. Rejection occurrence was 12(21.4%). Tacrolimus and cyclosporine A through levels were 3-12.8ng/ml and 65- 324ng/ml respectively. Anti-HLA class I antibodies were detected in 17.9% of pretransplantation (n=10) and in 23.2% of post-transplantation (n=13) cases respectively (p=0.607). On the other hand, anti-HLA class II antibodies were detected in 5.4% of pretransplantation (n=3) and in 33.9% of post-transplantation (n=19) cases (p=0,001). We determined anti-HLA class II antibody specificity. Anti-DQ, DR, DP antibodies were 25% ( n=14), 14.3% ( n=8) and 7.1% ( n=4) respectively on all 56 cases. Two (3.6%) patients’ samples were positive on three loci of HLA class II. Six patient samples (10.7%) were positive on two loci. Nine (64.3%) of anti-DQ positive patients have rejected their grafts and begun hemodialysis treatment. All 9 graft rejected recipients were anti-HLA DQ positive and had taken cyclosporine mono-therapy for the first year after transplantation. Conclusion The presence of de-novo anti-HLA class II antibodies, especially de-novo anti-DQ were significantly increased on cyclosporine mono-therapy group following transplantation and negatively affected kidney graft survival. The blood through level of cyclosporine was very variable. The graft survival was better in standard triple regimen. Therefore, it is essential to monitor immunosuppressive drug combinations with drug blood level and anti-DSA antibodies as well as to manage antibody removal therapies such as therapeutic plasma exchange, intravenous immunoglobulin and Rituximab therapy on time. HLA –DQ-DP antigen determination is important for the kidney transplantation.

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.

Introduction: When human body encounters external pathogens primary/innate immunity cells are activated by recognizing them and secondary/adaptive immunity is activated consecutively. Immune cell surface receptors, called Toll-like receptors (TLRs) recognize and bind pathogens. In our previous study, we revealed that there is a synergistic action between TLR9 and IFN-γ signaling in the endothelial cells. Purpose: To determine the role of negative and positive regulatory proteins on the IFN-γ/TLR9 synergistic signaling pathway Materials and Methods: This study was held in the Core Laboratory, Science Technology Center, Mongolian National University of Medical Sciences (MNUMS). In this study, murine endothelial cell (END-D) culture was used. The negative and positive regulator protein expression was detected by Western blotting. Result: Result of immunoblotting assay indicated that CpG DNA enhanced IFN-γ positive regulator protein p38 phosphorylation in the endothelial cells. Treatment by TLR9 ligand CpG DNA and IFN-γ increased p38 activation in 0.5 hour and 1 hour. CpG DNA inhibited IFN-γ negative regulator SOCS1 protein expression in 4 hr and 8 hr. Therefore, TLR9 ligand CpG DNA increased IFN-γ signal transduction in the endothelial cell line. Conclusion TLR9 ligand CpG DNA has decreased IFN-γ negative regulator protein SOCS1 expression. CpG DNA has increased IFN-γ positive regulator protein p38 phosphorylation.

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.

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: 70-80% of the world’s population uses herbal therapy and drug preparations of traditional medicine for health and first aid treatment [1]. SDS is used for relieving fever and also used as an anti-inflammatory medicine.1-2 It is also used in the treatment of cancer and infectious disease in Eastern and Chinese medicine. It is important to study the pharmacological actions and do a genome study in order to use natural resources wisely and to access biological effects on the plant. AIM: The study of the herbal preparation Saposhnikovia Divaricata on joint inflammation MATERIALS AND METHODS: All the experimental procedures and protocols used in the study were reviewed and approved by the Bio-Medical Ethical Committee of Mongolian National University of Mongolia. A dry extract of SDS is root was prepared by the lyophilization method and used in the study. CIA pathology model were determined by the David D Brand (2005) method. Statistical Analysis: Statistical analysis of data was performed by SPSS 16.0 program and analyzed statistically using criteria of Student t test. RESULTS: As a result the treatment group of mice with the use of the drug Saposhnikovia divaricata and groups of mice were treated with sodium salicylate, the body weight of mice increased significantly, and histological signs of inflammation were pronounced. In the mice of the control group who did not receive treatment, body weight decreased significantly, and histological signs of inflammation of the joints were expressed significantly. CONCLUSION: Preparation of Saposhnikovia divaricata decreased inflammation of arthritis.