• Afshineh Latifynia
  • Mohammad Vojgani
  • Mohammad Javad Gharagozlou
  • R Sharifian


Background: Fasting during the month of Ramadan is one of the essential religious practices ofMuslims. The aim of this study was to evaluate opsonisation, phagocytosis, and nitrobluetetrazolium (NBT) reduction by white blood cells in normal, healthy, male subjects under nonfasting (before Ramadan) and fasting (after Ramadan) conditions. Methods: In this study, 13Muslim men, aged 28-54 years, whose health was confirmed by health application forms, gaveblood samples one week before the beginning of the holy month of Ramadan and during the lastweek of Ramadan. Blood samples were tested for neutrophil phagocytosis, serum opsonisationpower, and NBT reduction. Results: Despite a decline in the neutrophil phagocytic index andserum opsonisation index, the percentage of neutrophils participating in phagocytosis increasedwith fasting. In addition, there was an increase in the percentage of neutrophils demonstratingNBT reduction. Although there was a decrease in opsonisation of the serum, the increasedpercentage of opsonisation compensated for this defect. Conclusion: This study demonstrates thebeneficial effect of fasting during Ramadan on neutrophil phagocytic function.Keywords: Neutrophil, Ramadan, Nitroblue tetrazolium, Phagocytosis, Opsonisation


Aadil N, Houti IE, Moussamih S. Drug intake during

Ramadan. BMJ 2004;329:778–82.

Alam M, Ranadive NS, Pruzanski W. Influence of neutrophil

cationic proteins on generation of superoxide by human

polymorphonuclear cells during phagocytosis. Inflammation


Gharbi M, Akrout M, Zouari B. Food intake during and out

side Ramadan. East Meditrr Health J 2003;1-2:131–40.

Hellum KB. Nitroblue tetrazolium test in bacterial and viral

infections. Scand J Infect Dis 1977;9:269–76.

Ku HP. Increased production of hydrogen peroxide and

expression of CD11/CD18 on alveolar macrophages in

patients with active pulmonary tuberculosis. Tube Lung Dis


Nakagawara A, Kayashima K, Tamada R. Sensitive and rapid

method and determination of superoxide generating activity

of blood monocytes and its use as a probe for monocyte

function in cancer patients. Gann 1989;70:829–33.

Schluger NW, Wiliam NR. The host immune response to

tuberculosis. Am J Respir Crit Care Med 1998;157:679–91.

Schlesinger LS. Role of mononuclear phagocytesin

M.tuberculosis pathogenesis. Invest Med 1996;44:312–23.

Dubaniewicz A, Dubaniewicz A, Hoppe A. The spontaneous

and stimulated nitroblue tetrazolium (NBT) tests in

mononuclear cells of patients with tuberculosis. Ann Acade

Med Biaiost 2004;49:252–5.

Mathews SE, Warinner JE, Weeks BA. Assays of immune

function in fish macrophages. In: Stolen JS, Fletcher TC,

Anderson DP, editors. Techniques in fish immunology. Vol-

New Jersey: Fair Haven;1990. p.155–63.

Garondahi G, Jahannisson A, Demmers S. Influence of age

and plasma treatment on neutrophil phagocytosis and CD18

expression in foals. Vet Microbiol 1991;62:241–54.

Levinsky RJ, Harvey BAM, Rodeck CH F Soothill. Phorbol

myrestate acetate stimulated NBT test: a sample method

suitable for antenatal diagnosis of chronic granulomatous

disease. Clin Exp Immunol 1983;54:595–8.

Gabig TG, Babior BM. The killing of pathogens by

phagocytes. Ann Rev Med 1981;32:313–26.

Peveri P, Walz A, Dewald B, Baggiolini M. A novel

neutrophil-activating factor produced by human mononuclear

phagocytes. J Exp Med 1988;167:1547–59.

Uysal AR, Erdogan MF, Sahin G Kamel N, Erdoğan G.

Clinical and metabolic effects of fasting in 41 type-2.

Diabetic patients during Ramadan. Diabetes Care


Lopez AF, Williamson DJ, Gamble JR, Begley CG, Harlan

JM, Klebanoff SJ, et al. Recombinant human granulocytemacrophage colony-stimulating factor stimulates in vitro

mature human neutrophil and eosinophil function, surface

receptor expression, and survival. J Clin Invest


Naccache PH, Faucher N, Borgeat P, Gasson JC, DiPersio

JF, et al. Granulocyte-macrophage colony-stimulating factor

modulates the excitation-response coupling sequence in

human neutrophils. J Immunol 1988;140:3541–6.

Weisbart RH, Kwan L, Golde DW, Gasson JC., Human GMCSF primes neutrophils for enhanced oxidative metabolism

in response to the major physiological chemoattractants.

Blood 1987;69:18–21.

Kowanko IC, Ferrante A. Stimulation of neutrophil

respiratory burst and lysosomal enzyme release by human

interferon-gamma. Immunology 1987;62:149–51.

J Ayub Med Coll Abbottabad 2009;21(4) 115

Taetle R, Honeysett JM. Gamma-interferon modulates

human monocyte/macrophage transferrin receptor

expression. Blood 1988;71:1590–5.

Zagroski-kiprokowicz D. Nitroblue tetrazolium test in course

of ulcerative olictis. Rocz Akad Med Bialymst 1997;42:69–74.

Fries LF, Siwik SA, Malbran A, Frank MM.. Phagocytosis of

target particles bearing C3b-IgG covalent complexes by

human monocytes and polymorphonuclear leucocytes.

Immunology 1987;62:45–51.

Willis HE, Browder B, Feister AJ Mohanakumar T, Ruddy S.

Monoclonal antibody to human IgG Fc receptors. Crosslinking of receptors induces lysosomal enzyme release and

superoxide generation by neutrophils. J Immunol


Curnutte JT, Babior BM. Chronic granulomatous disease.

Adv Hum Genet 1987;16:229–97.

Repo H. Defects in phagocytic functions. Ann Clin Res


Rossi F. The O2-forming NADPH oxidase of the phagocytes:

nature, mechanisms of activation and function. Biochim.

Biophys Acta 1986;853:65–89.

Steele RW. Clinical applications of chemiluminescence of

granulocytes. Rev Infect Dis 191;13:918–25.