Recent Advances in Inflammation & Allergy Drug Discovery最新文献

Introduction: The sole approved treatment for egg allergy is abstaining from consuming eggs. We assessed the effectiveness of oral immunotherapy (OIT) utilizing egg-white powder to treat egg allergy in children.

Methods: This is a randomized clinical trial on patients with egg white allergy. A desensitization protocol for egg allergies involves a modify rush desensitization method with a build-up and maintenance phase. During the build-up phase, patients consume increasing doses of egg white powder mixed with mashed potatoes for 5-7 days until they can tolerate a whole egg white. During the maintenance phase, patients consume a daily intake of whole cooked egg whites for six months. After two weeks of abstinence, a food challenge test is administered to determine if the patient has developed tolerance.

Results: Thirty-two patients aged 4-7 years with egg white hypersensitivity were recruited. Sixteen participants were in the intervention group, and 16 were in the control group. The intervention group had the highest number of anaphylaxis reactions on day one. During the build-up phase, all patients in the intervention group experienced 60 responses, with skin reactions being the most common. In the maintenance phase, patients were prescribed medications to ensure the success of desensitization. After six months, the intervention group demonstrated a higher tolerance rate for egg whites compared to the control group. Before OIT, the levels of total immunoglobulin E (IgE), serum immunoglobulin G4 (IgG4), and Radioallergosorbent Test (ImmunoCAP RAST) were similar between the intervention and control groups. After OIT, the level of IgG4 increased in the intervention group and decreased in the control group. ImmunoCap RAST increased in both groups, but significantly more in the intervention group. Skin Prick Test (SPT) wheal decreased significantly in the intervention group but not in the control group. The size of the SPT flare significantly decreased in the intervention group but remained the same in the control group.

Conclusion: OIT is adequate for most children with egg allergies. It is a promising intervention for food allergies, but the mechanism underlying its efficacy remains unclear. A better understanding of risks and effective dosing schedules is needed for it to become a recommended standard of care. Long-term immune tolerance strategies are also critical.

Clinical trial number: (No. IRCT20190116038387N1).

Background: Leptospirosis is a globally important zoonotic disease with substantial morbidity and mortality, yet it remains underreported in Northern India. This study aimed to evaluate the seroprevalence, clinical characteristics, and severity determinants of acute leptospirosis in a tertiary care setting.

Methods: We conducted a retrospective cross-sectional analysis of 174 hospitalized leptospirosis patients from 20,162 admissions between 2019 and 2023. The diagnosis was established using Leptospira IgM ELISA testing. Clinical, haematological, and imaging parameters were systematically evaluated.

Results: The incidence of leptospirosis was 0.9%, peaking at 38.5% post-monsoon. Rural residents (64.9%), males (59.2%), and individuals involved in agricultural work (62.6%) were predominantly affected. Common presentations were fever (100%), headache (70.7%), myalgia (62%), and calf pain (50%), followed by jaundice (39.7%), and reduced urine output (33.3%).. The mortality rate was 20.1%. Severity correlated significantly with nausea/vomiting, abdominal pain, cough, and complications, including diffuse alveolar haemorrhage (DAH), disseminated intravascular coagulation (DIC), multiorgan dysfunction syndrome (MODS), hepatic dysfunction, acute renal injury, and leukocytosis.

Discussion: The findings emphasize the critical need for early risk stratification and timely intervention to improve clinical outcomes. Identifying clinical and laboratory predictors of severity can significantly guide early management strategies in endemic areas.

Conclusion: Several clinical and laboratory parameters are significant predictors of leptospirosis severity. Early recognition and risk stratification based on these indicators are crucial to improving patient outcomes. Enhanced surveillance, preventive measures, and clinician awareness are urgently needed to address this neglected tropical disease.

Introduction: Interleukin-6 (IL-6) is a pleiotropic cytokine produced by several immunologic cells during inflammatory processes, showing an increased serum value in several autoimmune diseases and infections. Recently, it has been used to evaluate lung involvement in COVID-19 infection, and a specific laboratory test has been developed for such a purpose. We used IL-6 to monitor the evolution of Stevens Johnson Syndrome/Toxic Epidermal Necrolysis in two patients.

Case summary: We observed two cases of generalized allopurinol-induced adverse cutaneous reactions, including severe hypersensitivity. Serum IL-6 measurement allowed us to evaluate the magnitude of the immune and inflammatory status of patients better than C Reactive Protein (CRP) or White Blood Cell (WBC) count and to evaluate the response to the treatment.

Conclusion: Although different cytokines and serum markers have been proposed for the diagnosis of severe cutaneous adverse reactions (SCAR) like SJS/TEN, they are still experimental. We were the first to use IL-6 measurement as a helpful biomarker in the diagnosis and therapeutic management.

Allergic rhinitis (AR) is a common, chronic inflammatory disorder of the upper respiratory tract, primarily caused by exposure to environmental allergens such as pollen, dust mites, and mold. It has a substantial impact on daily life, often leading to sleep disruption, decreased productivity, and a heightened risk of asthma and other related conditions. The underlying mechanism of AR involves an IgE-mediated immune reaction, with both immediate and delayed inflammatory responses contributing to ongoing symptoms. AR can be classified into several types-seasonal, perennial, occupational, and drug-induced-which aids in its diagnosis and personalized management. Key risk factors include hereditary susceptibility, environmental pollution, and modern lifestyle factors. Diagnosis is typically based on a detailed medical history, skin prick testing, and serum IgE measurements. Treatment strategies involve the use of antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists, complemented by allergen-specific immunotherapy and lifestyle modifications such as allergen avoidance. In recent years, advanced therapies like targeted biologics (e.g., dupilumab) and probiotic-based treatments have emerged, offering promising new avenues for patients with persistent or severe symptoms.

Introduction: Gingivitis is the initial manifestation of periodontal disease, characterized by bacteria and inflammatory mediators, such as IL-32. This study aimed to determine whether the rs45499297 genetic variant of the IL32 gene and its serum and salivary levels are associated with gingivitis. In addition, we investigated whether transcription factors bind differentially in the presence of this genetic variant.

Methods: The study was conducted with 147 subjects. The rs45499297 variant was analyzed using the PCR-RFLP technique, while cytokine levels were measured using the ELISA assay. The affinity of the transcription factors in the presence of the gene variant was analyzed using bioinformatics methods. The results suggest that schooling, salivary flow, lipids, and salivary IL-32 levels were associated with gingivitis. Furthermore, the TC genotype, in the presence of obesity, conferred an increased risk of gingivitis, which was associated with lower serum IL-32 levels. Bioinformatics analysis revealed that the transcriptional factor LRH1 binds with a higher affinity to the C allele than to the T allele of the studied genetic variant.

Results: The findings of this study demonstrate the multifactorial nature of gingivitis, wherein the interplay between genetics and obesity serves as a regulatory factor in inflammation and periodontal risk. The preferential binding of LRH1 to the C allele suggests a molecular link between the genetic variant, inflammatory dysregulation, and the altered metabolic environment in obesity.

Conclusion: Our data show that the rs45499297 gene variant is only associated with gingivitis in the presence of obesity and affects serum cytokine levels. Additionally, we identified the potential involvement of LRH1 in regulating the IL-32 gene expression.

Psoriasis is an immune-mediated skin disease manifested in more than 3% of Americans and over 125 million people worldwide. The inflammatory skin condition with an increased rate of keratinocyte turnover involves every level of the skin and exhibits various forms of the disease, including plaque, guttate, inverse, pustular, and erythrodermic psoriasis, as well as disease-associated conditions, such as psoriatic arthritis and nail psoriasis. Innovative treatment has highlighted the importance of Apremilast, an oral drug that belongs to the phosphodiesterase- 4 (PDE4) class, which was approved by the FDA in 2014. Apremilast works by increasing the presence of cyclic adenosine monophosphate (cAMP) within cells, thereby affecting inflammatory processes and reducing the production of pathological cytokines. Randomized controlled trials have shown that it effectively treats moderately to severely affected plaque psoriasis and psoriatic arthritis, and it is safer than traditional systemic agents. The new perspective on the usage of ethosomes, niosomes, liposomes, and nanostructured lipid carriers in psoriasis treatment is based on emerging nanotechnology in drug delivery systems. These new formulations are designed to enhance the solubility and targeted release of Apremilast, thus providing an enhanced therapeutic effect. This review will discuss the basic mechanisms of the disease known as psoriasis, as well as the mode of operation, pharmacological properties, clinical trials, and pharmacokinetics of apremilast, particularly in relation to nanocarrier modification of this promising drug.

Vanillin is a naturally occurring compound found in numerous plant species and is commonly utilized in food, beverages, cosmetics, and pharmaceuticals. It is the main ingredient in vanilla pods, and numerous studies have indicated that it has a variety of pharmacological properties, including anti-inflammatory, antioxidant, and anticancer properties. Vanillin is extensively utilized in modern drug research for the treatment of many diseases, including cancer, due to its anti-inflammatory properties. Besides its application in food and flavoring, vanillin acts as a precursor in the production of other valuable petroleum-derived chemicals. This review provides a thorough explanation of the impact of this phytochemical on many signalling pathways, which are interconnected with the root cause of disease. This review also discusses its pharmacokinetic characteristics and clinical trial studies.

Introduction: Cognitive impairment linked to neurodegenerative diseases poses a considerable challenge, requiring the exploration of plant-derived therapeutic alternatives. Ruellia tuberosa, a medicinal plant recognized for its anti-oxidant and anti-inflammatory properties, was examined for its therapeutic potential in a rodent model of memory impairment.

Method: The present study aimed to evaluate the effects of Ruellia tuberosa ethanolic extract (RTEE) on aluminium chloride (AlCl3)-induced Alzheimer's disease (AD) in adult Wistar rats. In-vitro cell line study showed decreased formation of reactive oxygen species (ROS), decreased levels of IL-6 (Interleukin-6), and suppressed NF-κB (Nuclear factor kappa-B) translocation, which further confirmed RTEE's antioxidant and anti-inflammatory characteristics. Following the objective, thirty adult Wistar rats were taken and divided into five groups (n=6). They were treated with Normal saline, AlCl3 (100 mg/kg), DPZ (Donepezil- 3 mg/kg), and RTEE (100 and 200 mg/kg), respectively, for 35 days.

Results: Various behavioral and biochemical parameters, along with the oxidative and inflammatory biomarkers, were assessed to determine the effects of RTEE. The plant extract at both the doses (100 and 200 mg/kg) demonstrated increased body weight, improved motor coordination as demonstrated by an increase in fall-off time on the Rota rod apparatus, decreased escape latency in the Morris water maze test, reduced transfer latency (TL) in the elevated plus maze test, increased time spent in the target quadrant, and increased exploration time in the novel object recognition test. Furthermore, RTEE treatment exhibited decreased levels of malondialdehyde (MDA) and acetylcholinesterase (AChE) activity and increased levels of glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and total protein. Additionally, RTEE reduced levels of inflammatory cytokines, such as TNF-α and IL-1β, which decreased neuroinflammation and amyloid-beta levels. Additionally, the extract exhibited cholinergic system modulation, as observed by improved acetylcholinesterase activity, suggesting its potential role in neurotransmitter regulation. Histopathological study further confirmed its neuroprotective potential by reducing neuronal degeneration in brain regions (hippocampus and cortex).

Conclusion: According to the study's findings, memory impairment in the AlCl3-induced rat model of AD was ameliorated by both doses of RTEE. However, further studies need to be conducted to establish its therapeutic effects in neurodegenerative diseases.

Introduction/objective: Alzheimer's disease is a neurodegenerative disorder characterized by progressive cognitive decline and memory loss. In recent years, inflammation has gained recognition as a key contributor to both the onset and progression of Alzheimer's disease, acting through complex pathways that include neuroinflammation and immune system dysregulation. This study aims to systematically review the relationship between Alzheimer's disease and inflammation, focusing on publication trends from 2000 to 2023.

Methods: Using the Scopus database, a bibliometric analysis was conducted through Microsoft Excel, Harzing's Publish or Perish, and VOSviewer, examining publication trends, citation metrics, and co-network visualization.

Results: A total of 1,205 relevant publications were identified, revealing a steady increase in research output. The majority of contributions came from the United States (33.1%), China (16.8%), and the United Kingdom (8.8%). Key terms such as "neuroinflammation", "cytokine", "microglia", "amyloid beta", and "oxidative stress" dominated the literature, while emerging keywords included "neuroprotection", "BDNF", "inflammasome", and "mitochondria".

Conclusion: These findings underscore the growing focus on the role of inflammatory processes in the etiopathology of Alzheimer's disease, as well as efforts to identify biomarkers and neuroprotective therapeutic targets. This study provides a detailed mapping of the research landscape, offering insights into the evolving knowledge structure and highlighting prominent countries, institutions, authors, journals, and highly cited articles. By identifying key trends, this review advances our understanding of the interplay between inflammation and Alzheimer's disease, paving the way for future research and clinical strategies.