Current status of the acquired immune system of Iranian patients with long-term complications of sulfur mustard poisoning

  • Mahdi Balali-Mood
  • Bamdad Riahi-Zanjani
  • Mahmoud Mahmoudi
  • Mahmood SadeghiEmail author
Research Article



Sulfur mustard (SM) is a powerful blistering chemical warfare agent that has genotoxic effects. Cells with excessive proliferation such as lymphocytes may inherit this cellular toxicity which can lead to their malfunctions in the long-term. This study was designed to evaluate the status of acquired immunity among SM poisoned veterans around three decades after exposure.


Thirty five male Iranian veterans having at least 25% disability due to SM poisoning with long-term complications in the respiratory system, skin or eyes were investigated. Non-functional/functional tests including hematological parameters, immunostaining analysis, lymphocyte proliferation assay, cytokine profile, and levels of total serum IgM, IgG and IgA were performed.


The results showed that most of the parameters of adaptive immune system of the veterans were currently within the normal ranges. However, changes in the proliferation index (PI) of lymphocytes showed problems with the lymphocytes which cannot be proliferated appropriately. PI values for PBMCs (peripheral blood mononuclear cells) in presence of PHA (Phytohemagglutinin-A) and LPS (lipopolysaccharide) mitogens were 1.16 ± 0.14 and 1.13 ± 0.07, respectively which are less than expected.


Based on the results gathered in this study, most of the parameters of acquired immunity were normal. However, the observed failure of lymphocyte functions may disrupt physiological activity of whole immune system leading to long-term complications; including recurrent respiratory tract infections. Indeed, further cellular and molecular studies with regard to lymphocytes function are required to better understand the status of adaptive immunity in these patients.

Graphical abstract


Sulfur mustard Acquired immunity Veterans Adaptive immune system Lymphocytes 



The authors are thankful to the Vice Chancellor of Research of Mashhad University of Medical Sciences and Organization for the Prohibition of Chemical Weapons for their financial supports. The authors are also grateful to Mehran Sadeghi for his contribution to the preparation of graphical abstract. The results of the present study are part of a PhD thesis of Mahmood Sadeghi.

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mahdi Balali-Mood
    • 1
  • Bamdad Riahi-Zanjani
    • 2
  • Mahmoud Mahmoudi
    • 3
  • Mahmood Sadeghi
    • 2
    Email author
  1. 1.Medical Toxicology and Drug Abuse Research CenterBirjand University of Medical SciencesBirjandIran
  2. 2.Medical Toxicology Research CenterMashhad University of Medical SciencesMashhadIran
  3. 3.Immunology Research CenterMashhad University of Medical SciencesMashhadIran

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