Iranian Journal of Allergy, Asthma and Immunology https://publish.kne-publishing.com/index.php/IJAAI <p class="text">The Iranian Journal of Allergy, Asthma and Immunology (IJAAI), a scientific and research journal, seeks to publish original papers, selected review articles, case reports, and other articles of special interest related to the fields of asthma, allergy and immunology. The Journal is an official publication of the Iranian Society of Asthma and Allergy (ISAA), which is supported by Immunology, Asthma and Allergy Research Institute (IAARI) and published by Tehran University of Medical Sciences (TUMS). The Journal seeks to provide its readers with the highest quality materials published through a process of careful peer reviews and editorial comments. All papers are published in English.</p> <p class="text"><strong data-stringify-type="bold">All the manuscripts should be submitted through the Journal Primary Website at <a href="https://ijaai.tums.ac.ir/index.php/ijaai">https://ijaai.tums.ac.ir/index.php/ijaai</a></strong></p> Knowledge E en-US Iranian Journal of Allergy, Asthma and Immunology 1735-1502 Immunotherapeutic Potential of Echinococcus granulosus Hydatid Cyst Antigens in Autoimmune Disease and Allergy https://publish.kne-publishing.com/index.php/IJAAI/article/view/18676 <p>This study explores recent advances in harnessing the immunotherapeutic potential of hydatid cyst antigens for the treatment of allergies and autoimmunity. The aim is to elucidate the immunotherapeutic mechanisms employed by these parasite antigens. The hydatid cyst is considered the larval stage of <em>Echinococcus granulosus</em>, a parasitic helminth with life cycles involving a carnivorous definitive host (usually dogs) and an intermediate herbivore host (human, ungulate, or rodent). The two major species of this parasite with human public health importance are <em>E</em> <em>granulosus </em>and <em>E multilocularis. E granulosus</em> is a highly immunogenic organism that stimulates proinflammatory responses, significant antibody production, and T cell-mediated responses. Host adaptive immune responses to the parasite are T<sub>H</sub>2 dominant, but responses are absent in one-fifth of patients. Diagnostic antigens from cyst fluid are well-known, and the high abundance of hydatid cysts in the lungs and livers of slaughtered farm animals has made it easy to access the source of cyst antigens. Emerging from current preclinical studies, antigens derived from hydatid cyst cells and fluid show potential for suppressing and regulating immune responses associated with allergic and autoimmune conditions, disorders which increase with Western-type human development.</p> Azam Samei Mostafa Khedri Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18676 Effect of Montelukast and Budesonide Aerosol Inhalation in the Treatment of Allergic Rhinitis and asthma in Children and Its Effect on the Inflammatory Response of Children https://publish.kne-publishing.com/index.php/IJAAI/article/view/18677 <p>Studies have investigated montelukast and budesonide aerosol inhalation for treating allergic rhinitis (AR) and bronchial asthma (BA) in children. However, there are significant variations in dosage and duration of administration. This research evaluated the efficacy in children with AR and BA and analyzed montelukast's impact on the inflammatory response.</p> <p>This retrospective cohort study involved 100 children with AR and BA who were admitted to “Baoding Hospital, Beijing Children's Hospital Affiliated with the Capital Medical University” from October 2022 to September 2023. They were divided into a budesonide group (budesonide <em>n=</em>50) and a combination group (montelukast and budesonide, <em>n=</em>50). Comparisons were made between the two groups in terms of clinical efficacy, severity scores of AR and BA before and after treatment, inflammatory indicators (interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)), pulmonary function indicators (forced expiratory volume in the first second (FEV<sub>1</sub>), peak expiratory flow rate (PEF)), and adverse reactions.</p> <p>After treatment, the severity scores of AR and BA in the combination group were 4.00±0.93 points and 2.64±0.56 points, which were lower than those in the budesonide group (5.14±0.66 points and 3.31±0.65 points, respectively). The total response rate of the combination group (96.00%) was higher than that of the budesonide group (80.00%). The levels of IL-6 and TNF-α in the combination group were lower than those in the budesonide group, and the levels of FEV<sub>1</sub> and PEF in the combination group were higher than those in the budesonide group.</p> <p>Mometasone combined with budesonide shows good treatment effects in children with AR and BA.</p> Hui Li Tiecheng Zhang Ziwei Chen Shipei Gao Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18677 A Comparison of Spirometry Versus Impulse Oscillometry in Patients with Asthma Based on Asthma Severity https://publish.kne-publishing.com/index.php/IJAAI/article/view/18678 <p>Measuring the performance of small airways dysfunction is challenging due to their relative inaccessibility with conventional methods. In recent years, spirometry and impulse oscillometry (IOS) methods have been widely used for their evaluation. The aim of this study was to investigate the relationship between spirometric parameters and IOS in newly diagnosed asthma (NDA) patients.</p> <p>In this cross-sectional study, 100 NDA patients who referred to the allergy Clinic of Masih Daneshvari Hospital between 2021 and 2023 were enrolled. IOS and spirometry tests were performed for all patients. Spirometry measures included forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, and forced expiratory flow (FEF25-75). IOS criteria included R5%, R20%, R5-R20%, X5%, Ax% and FRES. The relationship between spirometry and IOS parameters was evaluated.</p> <p>The mean age was 22.6±9.5 years. None of the 2 techniques had a significant relationship with disease severity. FVC, FEV1/FVC and FEF25-75 indices had a significant positive correlation with all other IOS indices except for Ax. In the comparison of FEF25-75 parameter in spirometry, 4 IOS indices including R5, R20, R5-R20 and X5 had appropriate sensitivity and specificity for predicting asthma. In the comparison of FEF25-75 parameter in spirometry, 4 IOS indices including R5, R20, R5-R20 and X5 had appropriate sensitivity and specificity for predicting asthma. The sensitivity and specificity of R5 for asthma diagnosis were 0.85 and 0.73, respectively.</p> <p>Further multicenter studies with larger sample sizes are recommended to confirm these results.</p> Maryam Heydarazad zadeh Seyed Alireza Mahdaviani Alireza Eslaminejad Mahsa Rekabi Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18678 Chronic Spontaneous Urticaria: A Closer Look at Antinuclear Antibodies and Their Autoimmune Implications https://publish.kne-publishing.com/index.php/IJAAI/article/view/18679 <p>Autoimmune activities in chronic spontaneous urticaria (CSU) are claimed to be one of the most common causes of disease pathogenesis. This study aims to evaluate the prevalence and patterns of antinuclear antibodies (ANA) in patients with CSU, investigate the relationship between ANA positivity and autologous serum skin test (ASST) results, and explore the implications of these findings for understanding the potential autoimmune nature of CSU, particularly in relation to immunoglobulin E (IgE) levels.</p> <p>We analyzed data from 60 patients with CSU at Jahad Daneshgahi Clinic, Tehran, Iran. Patients were categorized based on ASST results (30 positive and 30 negative). Laboratory evaluations included ANAs via indirect immunofluorescence using the HEp-20-10 biochip kit. Data analysis was performed using chi-square and Mann-Whitney U tests.</p> <p>Among the 60 CSU patients, 37 were ANA-positive, with common patterns being nuclear fine-speckled and nucleolar. A decrease in IgE levels among ANA-positive patients compared to ANA-negative ones was also observed.</p> <p>Our study uncovered a notable 61.6% prevalence of ANA positivity among CSU patients, exceeding previously reported rates. The identification of nuclear fine-speckled and punctate nucleolar patterns may indicate associations with specific autoimmune conditions that warrant further investigation. Additionally, the observed lower IgE levels in ANA-positive patients suggest a distinct immunological profile, potentially reflecting type IIb autoimmunity.</p> Haniyeh Shahabi Maryam Mahlooji Rad Habib Soheili Tooba Ghazanfari Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18679 The Effect of Probiotic Yogurt Containing Lactobacillus rhamnosus and Bifidobacterium bifidum on Disease Activity and Disability in Patients with Systemic Lupus Erythematosus: A Randomized Controlled Trial https://publish.kne-publishing.com/index.php/IJAAI/article/view/18680 <p>Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease with relapsing and remitting periods. It has been reported that alterations of gut microbiota can affect disease activity in SLE. Probiotics which can modify the gut microbiota may be useful to control disease activity. Therefore, the effect of probiotic yogurt was evaluated on SLE disease activity.</p> <p>In this triple-blind, randomized, controlled trial, the patients were randomized and divided into 2 groups. The patients had Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) ≤6 and were on a stable dose of immunosuppressant in the last 3 months. The intervention group was given 200 g of probiotic yogurt containing <em>Lactobacillus rhamnosus</em> and <em>Bifidobacterium bifidum</em> for 13 weeks. The control group was given 200 g of yogurt without bacteria for 13 weeks. Demographic measurements, SLEDAI, and Health Assessment Questionnaire (HAQ) were analyzed before and after the intervention. The probiotic group (19 patients) and the control group (14 individuals) were compared. At the beginning and baseline of the trial, the probiotic and control groups’ average energy intake, micronutrients, and macronutrients did not differ significantly.</p> <p>In the probiotic group, the amount of protein, cholesterol, magnesium, zinc, selenium, and iron intake increased significantly after intervention. There are no significant changes in SLEDAI score and disability (HAQ) between case and control groups at the end of the study.</p> <p>Consumption of probiotic yogurt containing <em>L. rhamnosus</em> and <em>B. bifidum</em> did not have a significant short-term effect on SLEDAI and disability in SLE patients.</p> Razieh Banaki Seyedeh Tahereh Faezi Ahmad Esmaeilzadeh Mahdi Mahmoudi Elham Farhadi Majid Alikhani Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18680 Evaluation of T-cell Function after Blood Transfusion in Patients Undergoing Coronary Artery Bypass Grafting https://publish.kne-publishing.com/index.php/IJAAI/article/view/18681 <p>Blood transfusion is associated with increased mortality and morbidity. This study aimed to determine the effect of blood transfusion on T-helper 1 (T<sub>H</sub>1), T<sub>H</sub>2, and T<sub>H</sub>17 function in patients undergoing coronary artery bypass grafting (CABG).</p> <p>Two blood samples were obtained from patients undergoing CABG, before and 14 days after surgery. Production of interleukin (IL)-2, IL-4, interferon (IFN)-γ, IL-17A, and IL-10 by CD4<sup>+</sup> T cells was measured using enzyme-linked immunosorbent assay (ELISA). mRNA expression of T-box expressed in T cells (<em>T-bet)</em>, GATA binding protein 3 (<em>GATA3)</em>, RAR-related orphan receptor-γ (<em>ROR-</em>γ<em>t), </em>signal transducer and activator of transcription 3<em> (STAT3), STAT4</em>, and <em>STAT6</em> were measured using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR).</p> <p>mRNA expression of T-bet and <em>STAT4</em> showed a significant decrease after blood transfusion. However, the concentration of IFN-γ in the culture supernatant showed no significant difference after blood transfusion. mRNA expression of <em>GATA3</em> and <em>STAT6</em> showed a significant decrease after blood transfusion. However, the concentration of IL-4 in the culture supernatant showed no significant difference after blood transfusion. mRNA expression of <em>ROR-γt</em> showed no significant decrease after blood transfusion; however, the expression of <em>STAT3</em> and the concentration of IL-4 in the culture supernatant did significantly decrease following blood transfusion. IL-10 production increased significantly postoperatively.</p> <p>Decreased T<sub>H</sub>1, T<sub>H</sub>2, and T<sub>H</sub>17 signaling pathway activity and increased IL-10 concentration indicate an immunomodulatory effect on the immune system after blood transfusion.</p> Nasim Golafshani Narges Golafshani Ali Reza Mohseni Mahboubeh Mohseni Shervin Ziabakhsh-Tabari Hossein Asgarian-Omran Mohsen Tehrani Ali Akbar Pourfathollah Ahmad Najafi Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18681 A Novel Nanodrug Suppresses Lung Cancer Growth and Metastasis in C57BL/6 Mouse Model by Altering CD8+ Cell Infiltration and Oxidative Stress https://publish.kne-publishing.com/index.php/IJAAI/article/view/18682 <p>Lung cancer is a leading cause of cancer deaths worldwide and new therapeutic approaches are needed. This study investigates the efficacy of a new zinc oxide-based nanomedicine in a mouse model of heterotopic lung cancer.</p> <p>C57BL/6 mouse model with Lewis lung carcinoma (LL2) cells was used. The mice were treated with different doses of nanodrug, cisplatin, or phosphate-buffered saline. Tumor growth, metastasis, markers for oxidative stress, and immune responses, in particular the infiltration of CD8<sup>+</sup> T cells, were examined.</p> <p>The nanodrug significantly reduced tumor size, inhibited metastasis, and improved survival compared to the control group. Moreover, no significant toxic effect was observed in hematological, biochemical and histopathological analyses. Furthermore, the nanodrug altered the tumor microenvironment in favor of immune system activation by modulating the level of oxidative stress and increasing CD8<sup>+</sup> cell infiltration.</p> <p>The results show that this new nanomedicine may be a candidate for an effective treatment for lung cancer.</p> Sajjad Shekarchian Marzieh Eghtedardoost Hannaneh Golshahi Helia Behrouzfar Zahra Fakhroueian Roya Yaraee Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18682 Role of USP10/METTL3/CXCR4 Axis in Immunotherapy of Castration-Resistant Prostate Cancer https://publish.kne-publishing.com/index.php/IJAAI/article/view/18683 <p>The aim of this study was to investigate the role of the ubiquitin specific peptidase 10 (USP10/methyltransferase like 3 (METTL3)/C-X-C chemokine receptor type 4 (CXCR4) axis in immunotherapy of castration-resistant prostate cancer (CRPC).</p> <p>Knockdown experiments were conducted in CRPC cell lines to assess the effect of targeting CXCR4 on cell proliferation invasion and migration. Coculture experiments of <em>CXCR4</em> knockdown CRPC cells with THP1-M0 were performed to evaluate their impact on macrophage polarization and migration ability. With CD8<sup>+</sup> T cells was conducted to assess their effects on CD8<sup>+ </sup>T cell proliferation and apoptosis. <em>CXCR4</em>-overexpressing CRPC cells were treated with the JAK-2 specific inhibitor AG490 to assess the effect of <em>CXCR4</em> through the JAK2/STAT3 pathway on CRPC. The mechanisms by which USP10 regulates <em>CXCR4</em> expression through targeting METTL3 were explored through dataset analysis, bioinformatics prediction, and Western blot.</p> <p>In CRPC tissues and cells, there was an observed increase in <em>CXCR4</em> expression. Suppressing <em>CXCR4</em> through knockdown methods resulted in the inhibition of CRPC cell growth, movement, and infiltration. Additionally, it led to a reduction in M2 polarization and the recruitment of Tohoku Hospital Pediatrics-1 (THP1) M0 macrophages, along with a mitigation of CD8<sup>+</sup> T cell exhaustion. Dataset analysis, bioinformatics prediction, and Western blot validation indicated that CXCR4 activates the JAK2/STAT3 pathway to promote the expression of CCL2 and PD-L1, while USP10 promotes <em>CXCR4</em> expression through METTL3.</p> <p>Our study underscores the significance of the USP10/METTL3/CXCR4 axis in immunotherapy for CRPC and CXCR4 as a potential target for therapeutic intervention in CRPC treatment.</p> Wu Chen Lijun Xu Haibo Deng Zhenyan Zhu Dongrong Yang Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18683 Luteolin Ameliorates Allergic Rhinitis in Mice through Modulating T Cell Subset Imbalance, Endoplasmic Reticulum Stress, and NLRP3 Inflammasome Axes https://publish.kne-publishing.com/index.php/IJAAI/article/view/18684 <p>Luteolin (LO) possesses pharmacological benefits like anti-inflammatory, antioxidant, and immune-boosting properties. This study aims to clarify the effect of LO on allergic rhinitis (AR) and its mechanisms and provide new insights for the clinical application of LO.</p> <p>A mouse model for AR was developed through ovalbumin (OVA) stimulation. AR mice were gavaged with saline, low, medium, and high concentrations of LO, and montelukast. Nasal symptoms and scores were evaluated. The levels of OVA-specific immunoglobulins (OVA-sIgs), T helper cells (Th1, Th2, Th17), regulatory T cells (Tregs) cytokines, along with proinflammatory cytokines were measured using enzyme-linked immunosorbent assay (ELISA). Histopathological alterations were observed utilizing hematoxylin-eosin staining. Interleukin (IL)-1β and IL-18 levels were assessed through immunohistochemistry. Flow cytometry measured the percentage of T lymphocytes. The levels of endoplasmic reticulum stress (ERS)-related and NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome-related mRNAs and proteins were analyzed through reverse transcription-polymerase chain reaction (RT-PCR) and Western blot.</p> <p>LO reduced nasal symptom scores in AR mice, upregulated OVE-sIgG2a levels, and downregulated OVE-sIgE, OVE-sIgG1, and histamine levels. After the administration of LO, AR mice showed an increase in Th1 and Treg cytokines levels, while Th2 and Th17 cytokines levels were reduced. LO ameliorated the splenic T cell subset imbalance and attenuated inflammatory cell infiltration. LO reduced the levels of ERS-related and NLRP3 inflammasome activation-related mRNAs and proteins in the nasal mucosa.</p> <p>LO ameliorated AR symptoms by regulating T cell subset imbalance, hindering ERS and NLRP3 inflammasome activation.</p> Xiangdong Guo Yamin Liu Xiaoning Chen Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18684 Inhibition of LTBP2 Suppresses High Glucose-Induced Proliferation, Fibrosis, and Inflammation in Glomerular Mesangial Cells by Disrupting the PI3K/Akt/NF-κB Pathway https://publish.kne-publishing.com/index.php/IJAAI/article/view/18685 <p>Latent transforming growth factor-β binding protein-2 (LTBP2) plays a significant role in tissue fibrosis. This research aimed to elucidate whether LTBP2 influences the progression of diabetic nephropathy (DN) through the phosphatidylinositol 3-kinases/protein kinase B (PI3K/Akt)/nuclear factor kappa-B (NF-κB) pathway.</p> <p>The HBZY-1 cells were exposed to high glucose to create diabetic nephropathy cell model. LTBP2 levels were examined by Western blot and immunofluorescence. After verifying the transfection efficiency of si-LTBP2, cell counting kit-8, 5-ethynyl-2-deoxyuridine staining, Western blot, flow cytometry and immunofluorescence were utilized to assess the proliferation, apoptosis and fibrosis of HBZY-1 cells, respectively. Collagen deposition was also detected by Sirius red staining, and inflammatory factors levels were determined by Elisa. PI3K/Akt/NF-κB pathway activators were applied to explore whether LTBP2 silencing could play a role in DN by modulating this pathway.</p> <p>After treatment with high glucose, the expression of LTBP2 was elevated in HBZY-1 cells. LTBP2 silencing hindered the aberrant proliferation of HBZY-1 cells, with no significant effect on apoptosis; meanwhile, it reduced fibrosis, decreased collagen content, and decreased inflammatory factors levels in HBZY-1 cells. Following treatment with high glucose, the PI3K, Akt, and p65 phosphorylation levels were increased, whereas silencing LTBP2 reduced them. Activators of the PI3K/Akt/NF-κB pathway weakened the inhibition of LTBP2 silencing on cell proliferation, fibrosis, and inflammation.</p> <p>In conclusion, silencing of LTBP2 weakened the proliferation, fibrosis, and inflammation of HBZY-1 cells treated with high glucose by hindering the PI3K/Akt/NF-κB pathway. This research offers a new reference for the targeted therapy of DN.</p> <p>&nbsp;</p> You Wang Pei Pi Manli Hu Dan Luo Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18685 Pan-cancer Analysis Predicts PDCD4 as a Potential Diagnostic, Prognostic and Immune Infiltration-related Biomarker https://publish.kne-publishing.com/index.php/IJAAI/article/view/18686 <p>Programmed cell death protein 4 (<em>PDCD4</em>) is an oncogene involved in the cell cycle and apoptosis, enhancing drug sensitivity in tumor cells and inhibiting tumor development. However, the relationship between <em>PDCD4</em> and tumor immune microenvironment remains unclear.</p> <p>The Cancer Genome Atlas (TCGA) database was used to collect <em>PDCD4</em> data and somatic mutation data for 33 cancer types. Gene Expression Profiling Interactive Analysis (GEPIA) database was used to obtain the distribution map of <em>PDCD4</em> gene in human tissues and the prognostic expression heat map of cancer. Human Protein Atlas (HPA) database was used to explore the expression differences of <em>PDCD4</em> RNA in different cell lines, and <em>PDCD4</em> expression and clinical data were obtained from Gene Expression Omnibus (GEO) database.</p> <p>We found significant differences in the expression of <em>PDCD4</em> in different cancers and associated with patient prognosis. <em>PDCD4</em> is closely related to the tumor microenvironment, sensitive to immunomodulators, and involved in immune regulation. Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed that <em>PDCD4</em> plays a crucial role in tumor metastasis, affecting the survival and prognosis of tumor patients. The differential expression of <em>PDCD4</em> in various tumor tissues and its involvement in immunomodulatory mechanisms suggest its potential as a biomarker for prognosis and immunotherapy.</p> <p><em>PDCD4</em> was closely related to tumor immune microenvironment and immune efficacy indexes. It is suggested that it may be used as a biomarker to predict immune efficacy.</p> Haili Jiang Anni Xie Ting Wang Wenjing Shi Die Hu Rui Sheng Chaozheng Gao Tian Xie Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18686 Serum Levels of IL-21 and IL-27 do not Reflect differential Avidity of Anti-SARS-CoV-2 IgG Antibodies in Symptomatic and Asymptomatic COVID-19 Patients https://publish.kne-publishing.com/index.php/IJAAI/article/view/18687 <p>The quantity and quality of anti-Spike (anti-S) antibodies, rapidly elicited by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are necessary for understanding the immune response induced by infection. Antibody avidity is a good indicator of the quality of antibody response. Interleukin (IL)-21 and IL-27 are two cytokines that play vital roles in the affinity maturation process. Therefore, we decided to investigate whether there are any relationships between the avidities of antibodies against spike and nucleocapsid (N) antigens of SARS-CoV-2 and serum levels of these cytokines in symptomatic and asymptomatic coronavirus disease 2019 (COVID-19) patients.</p> <p>Forty symptomatic COVID-19 patients and 40 asymptomatic carriers were enrolled. Anti-S and anti-N IgG avidity indices (AIs) were determined using a modified enzyme-linked immunosorbent assay (ELISA). Serum levels of IL-21 and IL-27 were quantified by specific ELISA kits.</p> <p>AI values of both anti-S and anti-N IgG were lower in the symptomatic group compared to asymptomatic cases, while only that of anti-N IgG was statistically significant. For IL-21 and IL-27 serum levels, no significant difference between the two groups was shown. Also, we could not find any correlations between cytokine levels and antibody AI values. However, an inverse correlation between anti-S AI value and IL-27 serum level was found in asymptomatic patients.</p> <p>Our study suggests that serum levels of IL-21 and IL-27 cannot predict differences in anti-S and anti-N IgG avidity between symptomatic and asymptomatic COVID-19 patients.</p> Mozhdeh Ebrahimpour Mehrdad Hajilooi Ghasem Solgi Mohsen Rastegari-Pouyani Copyright (c) 2025 Iranian Journal of Allergy, Asthma and Immunology 2025-05-13 2025-05-13 10.18502/ijaai.v24i3.18687