1. 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.
		                        		
		                        		
		                        		
		                        	
2.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.
		                        		
		                        		
		                        		
		                        	
3.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. 
		                        		
		                        		
		                        		
		                        	
4.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.
		                        		
		                        		
		                        		
		                        	
5.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.
		                        		
		                        		
		                        		
		                        	
6.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.
		                        		
		                        		
		                        		
		                        	
7.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. 
		                        		
		                        		
		                        		
		                        	
8.Inhibitory action of Lipopolysaccharide-induced signal transductions by Valproic acid
Ulziisaikhan J ; Tsogtsaikhan S ; Yokochi T ; Enkhsaikhan L ; Jambaldorj J ; Javkhlan B ; Baigalmaa B ; Tsevelmaa N ; Galindev B ; Sodnomtsogt L ; Munkhtuvshin N ; Munkhbat B ; Bilegtsaikhan Ts
Health Laboratory 2019;9(1):12-20
		                        		
		                        			Introduction:
		                        			Valproic acid (VPA) has been used in the treatment of seizures and bipolar disorders. In the present 
study, we examined how VPA affected PI3K-Akt pathway in response to LPS by using mouse 
RAW 264.7 macrophage cells.
		                        		
		                        			Material and methods:
		                        			Mouse RAW 264.7 macrophage-like cells cultured and the cell viability 
checked by MTT and TUNEL assay. In addition, protein expression and protein interaction were
detected by immune blotting and immune precipitation, respectively. TLR4 expression on cell 
surface studied by FACS analysis.
		                        		
		                        			Results:
		                        			The MTT and TUNEL assays demonstrated no significant difference between VPA at 2 
mM treated and untreated control cells. VPA attenuated LPS-induced phosphorylation of 
phosphatidylinositol 3-kinase (PI3K) and Akt, but not nuclear factor (NF)-κB and mitogen activated protein kinases (MAPKs). There was no significant difference in the TLR4 expression on 
the cell surface between cells treated with or without VPA. VPA inhibited LPS-induced PI3K/Akt 
signal transduction in a dose dependent manner.
		                        		
		                        			Conclusion
		                        			VPA at 2mM exhibits nontoxic effect in the RAW 264.7 cells. VPA down regulates 
LPS-induced phosphorylation of Akt via inhibition of PI3K activation. 
		                        		
		                        		
		                        		
		                        	
9. Role of MAPK signaling on human mast cell activation induced by Trichomonas vaginalis
Giimaa N ; Arim MIN ; Myeong Heon Shin ; Gurbadam A ; Tsogtsaikhan S ; Temuulen D
Innovation 2016;10(1):38-42
		                        		
		                        			
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
10. Clinical and pathological analysis of rejection cases after kidney transplantation
Enkhtamir E ; Galtsog L ; Ulzii-Orshikh N ; Bayambadash B ; Munkhjargal B ; Od-Erdene L ; Uranchimeg B ; Saruultuvshin A ; Chimidtseren S ; Tsogtsaikhan S ; Batbaatar G ; Munkhzol M
Innovation 2016;10(2):48-51
		                        		
		                        			
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
            
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