Recent patents on inflammation & allergy drug discovery最新文献

Background: The CD44 receptor is a cell surface glycoprotein, which mediates many physiological and pathological activities. Its key role is to provide defence against inflammatory reactions by cellular transmigration and cell signalling. In pathological conditions, it gives destructive outcomes by mediating migration of pathogenic cells to vital organs resulting in tissue and organ damage. It binds to several ligands principally the hyaluronan.

Objective: This review explores CD44 structure, functions, and its potential as a disease indicator and therapeutic target.

Method: From a thorough literature review on the CD44 receptor, several patents of targeting approaches have been identified and herewith reviewed which recommend CD44-binding proteins, CD44-binding antibodies, antibody fragments, pharmaceutical compositions, as well as nucleic acids as a targeting moiety.

Result: Applicability of CD44 overexpression and its targeting has now been extensively utilized in the disease diagnosis and real-time bio imaging of pathologic cells.

Conclusion: A thorough understanding of CD44-receptor structure, expression and diverse functions towards different cell types would offer an opportunity to develop better therapeutic approaches in the near future by overcoming all the shortcomings of toxicity and efficacy. The present review includes recent patents of CD44 receptor targeting approaches that have been presented in the different agencies: European (EP), US, and World Intellectual Property Organization (WIPO) and a general analysis of the future developments and trends in this emerging area.

Background: Atopic Dermatitis (AD) is a chronic relapsing dermatosis associated with itch, sleep disturbance and poor quality of life. Treatment of AD includes the use of emollients, and topical and systemic immunomodulating agents. Many patients also use complementary and alternative medicine (CAM).

Objective: This article reviews the pathophysiology of AD, clinical trials and recent patents involving various modalities of CAM in the treatment of AD.

Methods: A Medline/Pubmed search was conducted using Clinical Queries with the key terms "Chinese Medicine OR Complementary and Alternative medicine" AND "Eczema OR Atopic dermatitis". The search strategy included meta-analyses, Randomized Controlled Trials (RCTs), clinical trials, reviews and pertinent references. Patents were searched using the key term "atopic dermatitis" from www.google.com/patents, www.uspto.gov, and www.freepatentsonline.com.

Results: Only a few RCTs evaluated the efficacy of Chinese medicinal herbs in treating AD. There was some evidence for other modalities of CAM. Integrative Medicine (IM) usually refers to the various forms of CAM that combine conventional western medicine and Chinese medicine. Supporting evidence for the efficacy of IM in the treatment of AD is presently lacking. Integration is difficult. Western medicine practitioners are often ignorant about CAM and IM. Parents are concerned about the potential side effects of Western medicine and will tend to be non-compliant with the conventional Western component of IM. Recent patents on CAM and IM are reviewed. Most CAM patents are herbal compositions, evidence on their efficacy is generally lacking.

Conclusion: AD is a complex disease. The psychodynamics of the child and his/her family is the reason for the often suboptimal outcomes. Both Western and CAM practitioners should collaborate to create a mutually encouraging environment for the advances of IM. CAM and IM publications and patents are reviewed. Evidence of their efficacy is generally lacking. Further research is needed.

Background: Acute otitis media is a common childhood infection. Prompt diagnosis and appropriate treatment are very important.

Objective: To review in depth the epidemiology, pathophysiology, clinical manifestations, diagnosis, complications and particularly treatment of acute otitis media in children.

Methods: A PubMed search was completed in Clinical Queries using the key term "acute otitis media". Patents were searched using the key term "acute otitis media" from www.google.com/patents, http://espacenet.com, and www.freepatentsonline.com.

Results: Acute otitis media affects over 80% of children before their third birthday and 30 to 45% of these children have suffered two or more episodes. Streptococcus pneumoniae, nontypable Haemophilus influenzae, and Moraxella catarrhalis are the most frequently isolated middle-ear pathogens. The diagnosis is based on acute onset of symptoms such as otalgia and fever, middle ear inflammation such as erythema of the tympanic membrane, and middle ear effusion. The choice of treatment method depends on the age of the child, laterality, and the severity of the disease. Recent patents related to the management of acute otitis media are also retrieved and discussed.

Conclusion: Antimicrobial treatment is recommended for all children less than two years of age, as well as in children ≥ two years of age who have a temperature ≥ 39oC; are toxic looking; have otalgia > 48 hours; have bilateral otitis media or otorrhea; have craniofacial abnormalities; are immunocompromised; or have uncertain access to follow-up. Amoxicillin is the drug of choice. Observation without antibiotic is an option in immunocompetent children ≥ two years of age who have an acute uncomplicated otitis media and non-severe illness if appropriate follow-up can be arranged.

Background: HIV positive patients can suffer many complications due to infectious diseases. A sever drug reaction to some of the drugs involved in the treatment can overlap the symptoms of the infections, making the diagnosis very difficult. We present the case of a 28-year-old-man, HIV positive, with secondary syphilis, who developed a Stevens Johnson Syndrome (SJS) caused by one of the many drugs he received. The SJS was overlapped with a possible Jarisch Herxheimer Reaction, which complicated the diagnosis of the skin reaction.

Objective: In HIV+ patients, the overlapping of severe drug reactions and infectious diseases could be fatal, thus an accurate diagnosis is mandatory.

Material and methods: A Rapid Plasma Reagin Test (RPR), an ELISA test, a blood laboratory test, chest radiography and a skin biopsy were realized in order to diagnose the infectious disease and the cause of skin lesions. Intradermal tests and double blind challenge tests were realized in the allergy study.

Results: The laboratory tests confirmed the diagnosis of syphilis; the skin biopsy confirmed the cause of lesions, a severe allergic reaction as a SJS. The allergy study discharged all the drugs involved, except dypirone which wasn't proved in the study because of the severity of reaction, the high possibility to be the causative drug and the alternative of other similar drugs available. For the inflammatory response, HIV+ patients are especially susceptible to severe reaction, both infectious and allergic, as in this case. Thus, recent patents emphasize the interest in inflammatory molecules that cause inflammatory symptoms.

Conclusions: Although the diagnose of SJS has established criteria, the possibility of overlapping with infectious illness and/or with its treatment, may complicate the diagnosis.

Background: Major effects of shift schedule are related to sleep alertness and performance, but also to long term health outcomes. For nurses, these negative effects have consequences not only on the individual, but also on the workplace, as decreased alertness and reduced job performance could endanger human lives.

Objective: The specific aim of our study is to assess the influence of shift schedule on nurses´ cognitive ability and rapidity of execution.

Method: Our survey is a cross sectional study which had been conducted for 15 months; it involved a sample of 293 participants representative of 1118 nurses working in two Tunisian university hospitals. It included an evaluation of the rapidity of execution performance through the manual dexterity test and the reaction time test. The study was completed by an assessment of the workability Index through a 7- item survey.

Results: No association was found between the groups of work schedules and the cognitive ability of execution speed. However, we found a significant decrease in cognitive performance in the nurses exceeding 10 years of job seniority for both schedules.

Conclusion: We concluded to an impaired cognitive performance speed in the over 10-year seniority groups in both schedules. Recommendations should be focused on implementing periodic assessment of cognitive performance based on O'Connor finger dexterity test and time reaction test and on implementing effective preventive measures in hospitals after ten years of seniority at work.