Inflammation & allergy drug targets最新文献

Multidrug antituberculosis regimen is associated with diverse clinical patterns of cutaneous adverse drug reactions (CADR), ranging from mild and moderate such as pruritus, maculopapular exanthems, lichenoid eruptions, fixed drug eruptions and urticaria to severe and even life threatening ones like acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These adverse reactions to antituberculosis drugs are commonly observed adverse events. This is of particular importance for high HIV prevalence settings and developing countries where tuberculosis is common infection resulting in higher occurrence rate of these reactions. There is still significant heterogenity in definition and classification of CADR, as well as diversity in treatment modalities following adverse reactions and rechallenge management. The aim of this review is to discuss clinical presentation, occurrence of CADR caused by antituberculosis drugs, to identify risk factors for intolerance of the standard therapy as well as to draw attention to importance of multi-disciplinary approach, early detection, prompt diagnosis and in time management of antituberculosis drugs associated CADR. CADR can cause significant treatment interruption and alteration, resulting in increased risk of treatment failure, drug resistance, relapses and increased risk of complications including even lethal outcome. Finally, it can be concluded that it is of great importance to identify the best possible treatment and preventive regimens in order to enable continuity of the antituberculosis therapy to the full extent.

Disease modifying antirheumatic drugs (DMARDs) is a category of drugs which is used as medication in various arthritic conditions to arrest the progression of disease along with relief from pain. About 83% of population worldwide uses DMARDs. Withdrawal of COX-2 inhibitors because of cardiovascular side effects and short-term action associated with glucocorticoids provided a motivation for development of newer DMARDs. Currently non- biological DMARDs like methotrexate, sulfasalazine, hydroxychloroquine and azathioprine serve the purpose of relieving pain and inhibiting the progression of disease. Biological DMARDs like toclizumab, adalimumab, infliximab, golimumab and abatacept have shown more efficacy and lesser side effects as compared to non- biological DMARDs but their access to patient is less because of higher cost. DMARDs act by different mechanisms against inflammation like inhibition of tumor necrosis factor, suppression of IL-1 and TNF-α, induction of apoptosis of inflammatory cells, by increasing chemotactic factors, inhibition of purine synthesis, pyrimidine metabolism or purine embolism. DMARDs have important applications in diseases like rheumatoid arthritis, Crohn's disease, juvenile idiopathic arthritis, psoriatic arthritis and myasthenia gravis. Present review mainly focuses on DMARDs and their clinical applications giving an overview of their mechanism of action, pharmacokinetic properties, advantages over conventional therapies, shortcomings and recent trends.

The intricate relationship between stress and skin conditions has been documented since ancient times. Recent clinical observations also link psychological stress to the onset or aggravation of multiple skin diseases. However, the exact underlying mechanisms have only been studied and partially revealed in the past 20 years or so. In this review, the authors will discuss the recent discoveries in the field of "Brain-Skin Connection", summarizing findings from the overlapping fields of psychology, endocrinology, skin neurobiology, skin inflammation, immunology, and pharmacology.

Multiple sclerosis (MS) is a complex autoimmune disease of the central nervous system. It is characterized by a proinflammatory and neurodegenerative process that results in neuroaxonal damage. Over the last two decades, a wide range of immunomodulatory and immunosuppressive treatments have been used for the management of MS. Several treatments have been developed or are under evaluation for reducing relapses, disease progression and long-term MS-related disability. Recently, a growing interest has emerged for therapeutics with very selective actions, particularly monoclonal antibodies, to target several biological pathways involved in MS. To date, only Natalizumab (Tysabri(®)) has been approved for the treatment of active MS forms. Its therapeutic mechanism is the blockade of the a4-integrin molecule of many leukocytes, which leads to a decrease of immune cells migration, in particular of lymphocytes, across the blood-brain barrier. Furthermore, other promising molecules are under study in clinical trials. In this review, we summarize and discuss the history, pharmacodynamics and safety of monoclonal antibodies that have been approved or are under evaluation for the selective treatment of MS.

The manifestation of sensitive skin occurs as a consequence of increased permeability of the Stratum corneum, besides the involvement of neuro-immune-endocrine system. In this study, we evaluated the effects of an active ingredient SensC on the production of neuropeptides substance P (SP), enkephalin and β-endorphin; eicosanoids prostaglandin E2 (PGE2) and leukotriene B4 (LTB4); histamine, transient receptor potential vanilloid subfamily member 1 (TRPV1), and envelope proteins filaggrin and involucrin, using an in vitro model of human cell culture. Our results demonstrated that treatment of keratinocyte cultures with SensC prevented the increase of all evaluated inflammatory mediators induced by interleukin-1 alpha (IL-1α). As the same way, SensC provides decrease in the synthesis of TRPV1. Regarding the synthesis of envelope proteins, SensC promoted increases for filaggrin and involucrin levels, when compared to control group. Considering the absence of appropriate treatment, the availability of ingredients, such as SensC, with antiinflammatory and protective barrier properties can be a significant tool for preventing neurosensorial symptoms associated with sensitive skin.

The role of air pollution in exacerbation of allergic symptoms is well known. Several studies have shown the effect of air pollution on serotonergic system. The changes in serotonergic system could trigger several allergic symptoms. 5-HT(3A) is among serotonin receptors on the peripheral Blood Mononuclear Cells (PBMCs) as well as other cells. In the present study we compared the 5-HT(3A) gene expression in PBMCs of the asthmatic patients as well as individuals who had been exposed to the air pollution. Normal individuals were also included in the study as control for comparison of 5-HT(3A) gene expression. Following the synthesis of the cDNA using mRNA extracted from PBMCs the level of 5- HT(3A) gene expression was measured using real-time PCR. The results showed t a significant increase in the relative expression level of 5-HT(3A) receptor in PBMCs from asthmatic patients and individuals exposed to the air pollutants compared to normal controls. Our result indicates that significant increase in 5-HT(3A) receptor may contribute to the pathogenesis as well as allergic symptoms which resulted from air pollution.

Azo prodrugs of aminosalicylates viz: 5-aminosalicylic acid and 4-aminosalicylic acid were synthesised using phenols as colon- targeting carriers for management of inflammatory bowel disease. The structures were confirmed by spectral and elemental analysis. These azo- linked prodrugs showed increased hydrophilicity which prevented their absorption from the upper GIT thus delivering them intact to the colon. They were also seen to be stable in stomach and intestinal homogenates, showing minimal release. Activation of prodrugs was faster in cecal matter showing upto 96-98% release with prolonged half lives. Amongst the azo series; 5-Aβ and 4-Ares significantly attenuated the symptoms of colitis induced by TNBS but their overall efficacy was less than SLZ. Safety assessment revealed absence of any abnormalities in hepatic and pancreas morphology with significantly low ulcerogenic propensity.

The prevalence of allergic diseases among infants is increasing particularly in developed countries. Although, the exact reason is not clear yet, one of the most probable explanations is reducing microbial exposure during early life and consequent alteration of gut microbiota. Various factors including delivery mode, infant`s diet, environment and antibiotics administration by mothers are involved in microbial colonization of infant`s intestine. Since the content of infant`gut microbiota plays a critical role in the maturation and development of the immune system, it determines the risk of immune diseases. Different studies confirmed the important role of vaginal delivery, due to transferring of useful bacteria to the neonatal's intestine, and breastfeeding, owing to the presence of exosomes and different kind of mediators in the milk which modify the pattern of intestinal microflora. As a result, it was proposed that both factors have remarkable effects on reducing allergic diseases. Furthermore, the consumption of probiotic productions by the mother during and after pregnancy possibly induces beneficial impacts on attenuating the allergic diseases.

CD163 is a scavenger receptor for the endocytosis of hemoglobin and hemoglobin/haptoglobin complexes and is nearly exclusively expressed on monocytes and macrophages. CD163 is induced by IL-10 and glucocorticoids while proinflammatory cytokines like TNF reduce its expression. The cytokine IL-6 which exerts pro- and anti-inflammatory effects depending on the signaling pathway activated strongly upregulates CD163. Anti-inflammatory cells involved in the down-modulation of inflammation express high CD163 which controls immune response. Ligands of the toll-like receptors 2, 4 and 5 stimulate ectodomain shedding of CD163 thereby releasing soluble CD163 (sCD163) which mediates cellular uptake of free hemoglobin. Soluble CD163 circulates in blood and is increased in serum of critically ill patients, in chronic inflammatory and infectious diseases. Serum concentrations of sCD163 are related to disease severity and are suitable biomarkers for diagnosis, prognosis and therapeutic drug monitoring in several inflammatory disorders. Raised sCD163 even predicts comorbidity and mortality in some diseases. Relationship of CD163/sCD163 and disease severity demonstrates a fundamental role of monocytes/macrophages in various diseases. CD163 is a target to specifically deliver drugs to macrophages intending advanced therapeutic efficiency and minimization of adverse reactions. In this review article factors regulating CD163 expression and shedding, current knowledge on the function of CD163 and sCD163, and inflammatory diseases where CD163 and/or sCD163 are mostly increased are summarized.

Objective: to demonstrate the possible effectiveness of a long-term multimodal medical therapy in patients with Peyronie's disease (PD) we carried out a controlled study on 82 patients diagnosed with PD, whereas in the scientific literature the conservative treatment of this disease is much discussed.

Methods: 82 patients (mean age=53.6±10.1 years-range 23-68) diagnosed with PD were selected for this study. Of these 41 patients (group A) were treated for 18 months as follows: Verapamil penile injections (12 total injections for six months and subsequently every month for twelve months: total 24 injections) + Iontophoresis with Verapamil/daily + blueberries 160mg/daily + propolis 600mg/daily + Vitamin E 600mg/daily + topical Diclofenac/daily. The other 41 patients spontaneously decided not to receive treatment for several motives and then were introduced as a control group B. All patients were controlled at 6- and 18-month follow up with the same diagnostic tests completed before the therapy (penile ultrasound, photograph documentation, pain scale etc.).

Results: In group A, after treatment of 6 and 18 months, the change in plaque volume consisted in volume reduction= - 47.6% and -73.6% respectively, while in group B, the change consisted of an increase in plaque volume= +55.7% and +118.7% respectively (p=0.000). In group A, after treatment of 6 and 18 months, improvement of curvature occurred in 76.3% and 81.5% of the cases respectively, while in group B it occurred in 2.7% and 8.1%, respectively (p<0.0001).

Conclusion: Our results showed that a long-term multimodal medical therapy (Verapamil associated with Antioxidants and local Diclofenac) is statistically effective to treat PD patients, if we consider that lower therapeutic outcomes were achieved after 6 months treatment (medium-term treatment). Furthermore, this study confirms that the best treatment modality for PD is a combination therapy.