Infectious disorders drug targets最新文献

Background: Both tuberculosis and Methicillin-Resistant Staphylococcus Aureus (MRSA) are known to be notorious for causing fistulas due to their characteristics of persis-tent, difficult-to-treat infections that lead to chronic inflammation, abscess formation, and tissue necrosis. There are several case reports highlighting the invasiveness and potential for fistula formation associated with both tuberculosis and MRSA infections independently, but to the best of our knowledge, this is the first case of a utero-cutaneous fistula caused by chronic infection due to MRSA, superadded on genital tuberculosis.

Case presentation: A 35-year-old female, P3L3, visited the gynaecology outpatient depart-ment nine months after her last caesarean section with the complaint of severe pain and blood discharge from the transverse supra-pubic scar during menstruation. On evaluation, she was found to be chronically infected with MRSA and have genital tuberculosis only after histo-pathologic examination of the fistulous tract and tubo-ovarian abscess.

Conclusion: This case highlights the importance of considering genital tuberculosis in pa-tients with atypical or refractory post-surgical complications and emphasizes the need for a thorough and multidisciplinary approach to its management.

Objective: This study aimed to assess the safety and efficacy of tissue Plasminogen Activator (tPA) in patients with COVID-19-induced severe Acute Respiratory Distress Syndrome (ARDS).

Methods: The intervention group consisted of eligible patients with severe ARDS due to COVID-19 admitted to the Intensive Care Unit (ICU) of a university hospital. We selected the control group from admitted patients treated in the same ICU within the same period. The intervention group received intravenous tPA as 10 mg stat, 40 mg over the first 2 hours, and 25-50 mg over the next 10 hours, followed by a therapeutic dose of enoxaparin. The control group only received the therapeutic dose of enoxaparin. The main outcomes were the rise of SpO2 within 24 hours of tPA administration, critical bleeding during tPA administration, 28-day in-hospital mortality following admission to the ICU, and length of stay in the ICU.

Results: We analyzed two sets of 15 patients in the intervention (mean age: 45 years, 69% male) and the control (mean age: 50 years, 50% male) groups. There was rapid relief of dyspnea and SpO2 rising within 24 hours in seven cases (45%) only in the intervention group with no significant organ-threatening bleeding. Death was observed in 5 of the tPA-treated patients (33.3%) versus 10 (66.7%) of the controls [adjusted OR (95%CI): 0.17 (0.03, 0.98), P value =0.068].

Conclusion: The administration of intravenous tPA as 10mg stat, 40 mg during 2 hours, and 50mg during the next 10 hours is safe, can cause a rapid relief of dyspnea, and be lifesaving.

Background: In this article, we present the results of a multicenter clinical trial of IFN-γ in patients with drug-susceptible and drug-resistant pulmonary Tuberculosis (TB) in routine clinical practice.

Objective: This study aimed to confirm the efficacy and safety of IFN-γ administered to patients with TB.

Methods: All patients were diagnosed with TB after being tested by bacterioscopic and molecular genetic methods and had no contraindications to standard chemotherapy.

Results: Recombinant human IFN-γ proved high efficacy in multi-center clinical trials in routine TB practice.

Conclusion: The results show that IFN-γ is efficient and safe in the treatment of pulmonary tuberculosis.

The COVID-19 epidemic in recent years has been produced by various coronavirus strains that nearly destroyed world health policies and economics. Emerging viral strains exac-erbated the pandemic. Huge investments have been made in preventative vaccines to combat the disease, but the genetic instability of these viruses has hampered their usefulness. However, in addition to traditional therapeutic approaches, nutraceuticals have been considered effica-cious in preventing and or treating COVID-19 and post-COVID syndrome. In this context, nutraceuticals such as vitamins or dietary supplements including multiple vitamins and miner-als and propolis have been widely studied for their significant impact on viral respiratory dis-eases like SARS-CoV-2 and COVID-19. Some of these nutraceuticals having antioxidant, anti-inflammatory, and immune-modulatory properties have been highly recommended for use as an adjunct option to moderate the adverse effects associated with the COVID-19 pandemic. In this review, we intend to present the recent understanding and converse scientific implications for the use of nutraceutical antioxidants such as vitamins, minerals, probiotics, and polyphenols like bee propolis, in the management of viral respiratory diseases and post-COVID-19 syn-drome. Future challenges and limitations regarding the use and bioavailability of these ingre-dients, and dose-response studies are further emphasized.

Multicellular surface-attached populations of bacteria embedded in the extracellular matrix are known as biofilms. Bacteria generally preferred to grow as biofilms. Quorum sensing (QS), detection of density of cell population through gene regulation, has been found to play an important role in the production of biofilms. Biofilm formation can increase the severity of infections that can lead to morbidity or mortality. Bacteria living within biofilms have a higher pattern of adaptive resistance to antibiotics. Antibiotic resistance is a barrier in the treatment of biofilmsinduced acute to chronic infections such as post-surgery infections, surgery-associated wound infections, endocarditis, joint infections, burn-related wound infections occurred, ventilator-associated pneumonia, etc. So it is urgent to discover or find out potent new drugs in fight against infectious diseases such as biofilms-associated infections. Medicinal plants or herbs are a rich source for fighting with biofilms-mediated infections. Phytochemicals have exhibited significant effects in the prevention of biofilms formation against different bacteria that are causing infections. Purified compounds such as berberine, tetrandrine, embelin, xanthorrhizol, bakuchiol, etc., exhibited promising biofilm inhibition actions against different pathogenic bacteria. Plant extracts that contain several phytochemicals are evaluated for its biofilm's inhibition property, and have shown significant potential in biofilm formation. Antibiofilm agents act by distinct mechanisms such as inhibiting the adherence of biofilms in a surface, preventing the biofilm formations, disrupting the matured biofilms, etc. This study is intended to reiterate about possibilities of plant extracts and purified compounds in the treatment of the prevention of bacterial biofilms-related infections.

Introduction: Withania somnifera (Ashwagandha) is a traditional herb that is cur-rently commercially available for treating a variety of illnesses. By evaluating and verifying docking affinity scores, it is possible to explore the potential of the plant for treating leprosy and lepra-reaction as off-label use.

Methods: The sitoindosides were used as ligands along with thalidomide in docking against targets, such as M. leprae, TNF-Alpha, and Interleukin-6 in order to determine the potential for inhibitory concentration and docking affinity.

Results: According to the study, good binding energy values varied from -7 to -11 Kcal/mol. Sitoindoside IX had the highest binding affinity and important binding interactions, such as hydrogen bonding, when compared to Thalidomide and Sitoindoside X against all three re-ceptors.

Conclusion: The present study confirmed that the Sitoindoside IX and X are a better fit for treating patients with leprosy. These findings are highly intriguing and suggest that this herb should be investigated further to validate these findings in leprosy.

Background: Cuts and wounds are unfortunate yet inevitable events. Traditional remedies have historically harnessed various plants for wound healing, undergoing clinical and pre-clinical scrutiny. Hence, this systematic review focuses on clinically researched herbal formulations for wound healing.

Methodology: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, databases like Google Scholar, Web of Science, PubMed, Scopus, J-gate, and Ayush Research Portal were meticulously searched for clinical trials in-volving wound-targeting herbal formulations, alongside a comprehensive hunt for preclini-cal plant data.

Results: Among 623 screened documents, 26 published clinical trials spotlighting herbal wound healing formulations were identified. All studies showcased significant wound heal-ing progress, with some surpassing standard betadine treatment. Only one study reported an adverse effect. Within the 26 formulations, 45 distinct plant species were employed, with 35 exhibiting wound healing attributes like antimicrobial, anti-inflammatory, and antioxidant activities scientifically. Enhanced collagen content, stabilized fibers, activated fibroblast cells, increased total protein, elevated growth factors, hydroxyproline, hexosamine, and tis-sue protein demonstrate the efficacy of plants, such as Hypericum perforatum, Centella asi-atica, and Calendula officinalis in wound healing.

Conclusion: The findings of the current study indicated that medicinal plants are effective and safe agents for the treatment of wounds, though larger, well-designed trials are needed for definitive role confirmation.

Introduction: Biosurfactants are naturally occurring compounds with various ap-plications, biodegradable, non-toxic, and effective in different conditions. This study fo-cuses on the extraction and evaluation of biosurfactants produced by five strains of lactic acid bacteria [LAB] for their potential to inhibit biofilm formation and adhesion by Strep-tococcus mutans.

Methods: The strains of LAB-producing biosurfactants such as Lactobacillus salivarius, L. acidophilus, L. plantarum, L. casei, and L. rhamnosus were confirmed by the hemolysis test. The presence of biosurfactants derived from LAB strains and their molecular compo-sition were confirmed, and their cellular toxicity, minimum inhibitory concentration [MIC], and minimum bactericidal concentration [MBC] were investigated. Ultimately, the anti-biofilm and anti-adhesive activities of LAB-derived biosurfactants against S. mutans were determined. Eventually, the effect of biosurfactants on the changes in gene expression associated with biofilm formation of S. mutans was assessed. All the LAB strains used in this study were biosurfactant producers. The LAB-derived bi-osurfactants exhibited no cytotoxicity towards the human gingival fibroblast [HGF] cell line. According to the results, the lowest and highest MIC values were observed in the biosurfactants derived from L. rhamnosus and L. plantarum at 0.78 mg/mL and 6.25 mg/mL, respectively. The MBC values for the biosurfactants derived from L. rhamnosus, L. casei, L. salivarius, L. acidophilus, and L. plantarum were 3.12, 3.12, 6.25, 12.5, and 12.5 mg/mL, respectively. The LAB-derived biosurfactants at MBC concentrations exhib-ited significant inhibitory effects on biofilm formation and adhesion of S. mutans [P<0.05]. The highest anti-biofilm and anti-adhesion activities were attributed to the biosurfactants derived from L. plantarum, which were not significantly different from the 0.2% chlorhex-idine as a positive control group [P>0.05]. Moreover, all biosurfactants could significantly decrease the gene expression level of gtfB [P>0.05].

Results: The study found that LAB-derived biosurfactants exhibit significant anti-adhesion and anti-biofilm activities against S. mutans without any observed cellular toxicity towards HGF cells.

Conclusion: These promising bioactive compounds can be utilized as natural antimicrobial agents and biofilm inhibitors to prevent microbial biofilm formation and adhesion in vari-ous dental applications, offering a safe and effective alternative for controlling dental bio-films and improving oral health outcomes.

Invasive fungal infections (IFIs) pose a significant global health threat, particularly among immunocompromised individuals. These infections can lead to severe illness and death, placing a significant financial burden on healthcare systems. Fungi were not previously considered a substantial risk to human health, but this perception changed with the rise of the HIV epidemic. The emergence of drug-resistant fungal strains further complicates the man-agement of these infections, highlighting the urgent need for effective antifungal therapies. Addressing this challenge requires innovative approaches and antifungal drug delivery for-mulations as promising strategies. This article explores the role of effective antifungal drug delivery formulations in combating the rise of IFIs. These formulations, ranging from lipid-based systems like liposomes and lipid emulsions to polymeric nanoparticles and micropar-ticles, offer several advantages over conventional drug delivery methods. Optimizing these formulations may improve drug efficacy, reduce the risk of drug resistance, and enhance pa-tient outcomes. Furthermore, advancements in nanotechnology and targeted drug delivery systems hold promise in overcoming existing limitations and expanding the scope of antifun-gal therapies.