Progress in the Use of Glucocorticoids and Biological Agents in Non-Infectious Uveitis

One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing promise in the management of this condition. The description of glucocorticoid and biologic usage in non-infectious uveitis is the main topic of this paper.

Effect of biological agents on survival rate and root growth of Scots Pine seedlings

Two-year-old Scots pine (Pinus sylvstris var.mongolica) seedlings were treated with Pt mycorrhiza powder, ABT root-growing powder, HRC water-absorbing agent and high-yield powder, and planted on the sandy land in Balinyouqi, Inner Mongolia (180°12′13″E and 43°13′05″N). The effect and function of these biological agents on survival rate of seedlings were tested and analyzed by measuring the fine root growth and gross root growth. The results showed that the survival rates of the seedlings treated with Pt3, ABT, and HRC biological agents increased by 29.3%, 23.6%, and 16%, respectively. The regression analysis revealed that the length of fine roots (<2 mm) was positively correlated with seedling survival rate, which means that the Pt3 powder, ABT foot-growing powder and HRC water-absorbing powder increased the survival rates of the seedlings by promoting the growth of fine roots. Keywords Biological agents - Pinus sylvstris var.mongolica - Sandy soil - Roots - Survival rate CLC number S723.1 - S791.253 Document code A Foundation item: This article was supported by the National Natural Science Foundation of China (No. 39970627).Biography: TANG Feng-de (1967-), male, Ph. Doctor in Institute of Applied Ecology. Chinese Academy of Sciences, Shenyang 110016, P. R. China.Responsible editor: Zhu Hong

Colitis associated with biological agents

In the past,there has been considerable focus on a host of drugs and chemicals that may produce colonic toxicity.Now,a variety of new biological monoclonal antibody agents,usually administered by infusion,have appeared in the clinical realm over the last decade or so to treat different chronic inflammatory or malignant disorders.For some of these agents,adverse effects have been documented,including apparently new forms of immune-mediated inflammatory bowel disease.In some,only limited symptoms have been recorded,but in others,severe colitis with serious complications,such as bowel perforation has been recorded.In others,adverse effects may have a direct vascular or ischemic basis,while other intestinal effects may be related to a superimposed infection.Some new onset cases of ulcerative colitis or Crohn's disease may also be attributed to the same agents used to treat these diseases,or be responsible for disease exacerbation.Dramatic and well documented side effects have been observed with ipilimumab,a humanized monoclonal antibody developed to reduce and overcome cytotoxic T-lymphocyte antigen 4,a key negative feedback regulator of the T-cell anti-tumor response.This agent has frequently been used in the treatment of different malignancies,notably,malignant melanoma.Side effects with this agent occur in up to 40% and these are believed to be largely immune-mediated.One of these is a form of enterocolitis that may be severe,and occa-sionally,fatal.Other agents include rituximab(an antiCD20 monoclonal antibody),bevacizumab(a monoclonal antibody against the vascular endothelial growth factor) and anti-tumor necrosis factor agents,including infliximab,adalimumab and etanercept.

Control of Lymantria dispar L. by biological agents

The experiment on control of Lymantria dispar L by using different kinds ofbiological measures, including nuclear polyhedrosis virus (NPV) of Lymantria dispar L., BtMP-342,sex-attractant as well as botanical insecticide, was carried out in the forest regions of InnerMongolia in 2003. Two concentrations (2.632x10^6 PIB ? ml^(-1) and 2.632x10^7 PIB ?ml^(-1)) of Lymantria dispar L. NPV were sprayed on the 2rd-instar-larvae of L. dispar and 70% and77.8% control effect were obtained respectively. BtMP0-342 was applied to the 3rd- and 4th-instarlarvae and the control effect was around 80%. The sex-attractant provided by Canada Pacific ForestryResearch Center also showed a good result in trapping L. dispar adults. The self-produced botanicalinsecticide, which was extracted from a kind of poisonous plant distributed in Daxing'an Mountains,China, exhibited a good control result in controlling the larvae of L. dispar, and 82% mortalitywas observed when spraying primary liquid of the botanical insecticide on the 3rd-5th-instar-larvaein lab.

Fire Blight Disease Caused by Erwinia amylovora on Rosaceae Plants in Kyrgyzstan and Biological Agents to Control This Disease

Erwinia amylovora species were isolated from the blossoms, exudates, infected fruits, leaves and bent branches of diseased apple, pear and hawthorn trees, selected in the Chy, Osh and Jalal Abad regions. Biochemical and pathogenicity tests, alongside PCR analyses, were conducted to identify the local isolates of Erwinia amylovora. The alternative antagonistic microorganisms which combat bacterium E. amylovora were tested within in vitro and in vivo conditions. The results revealed the ability of Streptomyces antagonistic bacteria to decrease fire blight severity on pear and apple trees during the first stage of the fire blight disease in leaf tissues. Streptomyces strain C1-4 suppressed E. amylovora disease symptoms in the leaf tissues and excised apple and pear shoots. The incidence of fire blight on leaves was reduced by about 70% with two applications of bacterial antagonists. Further studies at different locations in Kyrgyzstan, using large scale application, would allow for stronger recommendations to be made, including studies and recommendations on their ability to prevent disease and to use them as main components in an integrated pest management program.

Topical biological agents targeting cytokines for the treatment of dry eye disease

Because inflammation plays a key role in the pathogenesis of dry eye disease and Sjogren's syndrome, topical anti-inflammatory agents such as corticosteroids and cyclosporine A have been used to treat inflammation of the ocular surface and lacrimal gland. Systemic biological agents that target specific immune molecules or cells such as tumor necrosis factor(TNF)-α, interferone-α, interleukin(IL)-1, IL-6, or B cells have been used in an attempt to treat Sjogren's syndrome. However, the efficacy of systemic biological agents, other than B-cell targeting agents, has not yet been confirmed in Sjogren's syndrome. Several studies have recently evaluated the efficacy of topical administration of biological agents targeting cytokines in the treatment of dry eye disease. Topical blockade of IL-1 by using IL-1 receptor antagonist could ameliorate clinical signs and inflammation of experimental dry eye. Using a mouse model of desiccating stress-induced dry eye, we have demonstrated that topical application of a TNF-α blocking agent, infliximab, could improve tear production and ocular surface irregularity, decrease inflammatory cytokines and Th-1 CD4+ cells on the ocular surface, and increase gobletcell density in the conjunctiva. Although controversy still remains, the use of topical biological agents targeting inflammatory cytokines may be a promising therapy for human dry eye disease.

Advances in the treatment of IgA nephropathy with biological agents

Immunoglobulin A nephropathy(IgAN)is the most common primary glomerular disease,and the“four-hit”theory represents its currently accepted pathogenic mechanism.Mucosal immunity triggered by infections in the respiratory tract,intestines,or other areas leads to antigen presentation,T cell stimulation,B cell maturation,and the production of IgA-producing plasma cells.The proteins B-lymphocyte stimulator(BLyS)and a proliferation-inducing ligand(APRIL)are involved in this process,and alternative complement and lectin pathway activation are also part of the pathogenic mechanism.Kidney Disease Improving Global Outcomes guidelines indicate that a specific effective treatment for IgAN is lacking,with renin-angiotensin-aldosterone system inhibitors being the primary therapy.Recent research shows that biological agents can significantly reduce proteinuria,stabilize the estimated glomerular filtration rate,and reverse some pathological changes,such as endocapillary proliferation and crescent formation.There are four main categories of biological agents used to treat IgA nephropathy,specifically anti-CD20 monoclonal antibodies,anti-BLyS or APRIL monoclonal antibodies,monoclonal antibodies targeting both BLyS and APRIL(telitacicept and atacicept),and monoclonal antibodies inhibiting complement system activation(narsoplimab and eculizumab).However,further research on the dosages,treatment duration,long-term efficacy,and safety of these biological agents is required.

Expert Consensus on the Treat-to-Target Strategy for Psoriasis With Biological Agents in China(Simplified Edition)

Psoriasis is a chronic,recurrent,inflammatory systemic disease that is not only characterized by skin manifestations but may also be accompanied by various comorbidities,imposing a heavy burden on patients’physical and mental health and affecting their quality of life.Although the continuous approval of various biological agents for clinical use has provided more effective treatment options to patients with psoriasis,no consensus on the evaluation of comprehensive treatment goals has yet been established.The treat-to-target(T2T)strategy requires consideration of multiple dimensions of treatment outcomes,the development of long-term management goals,and regular assessments of treatment conditions,which are often used in the management of chronic diseases.Therefore,based on the latest consensuses and guidelines,research data,and clinical experience as well as the combination of survey results and expert group discussions,the present consensus focuses on 4 dimensions of short-and long-term integrated management goals for biological agents:alleviating skin lesions,improving quality of life,screening and managing psoriasis comorbidities,and ensuring drug safety.The implementation methods,evaluation time,treatment monitoring,and program adjustments are also herein described to achieve comprehensive management of psoriasis to the maximum extent.This consensus provides a reference for clinical practice.

Secondary Metabolites of Entomopathogenic Fungi, Biological Alternative for the Control of Agricultural Pests and Disease: Present and Perspectives

The use of entomopathogenic fungi (EF) in recent years has been highly effective against the different orders of insects considered pests of agricultural importance and their conidia have been commonly applied, but it has been reported that these are sensitive to the environmental conditions. For this reason, biopesticides products have been formulated based on secondary metabolites, recently. These biomolecules participate as biological control agent, such as: cyclic depsipeptides, amino acids, polyketides, polyphenols and terpenoids, affecting their morphology, life cycle and insect behavior. The use of secondary metabolites of entomopathogenic fungi opens the possibility of application in a more efficient way for the control of agricultural pests in a compatible with the environment and human health;therefore, it is important to know, analyzing the type of molecules, their effects, and their different methods of application.

The Use and Exchange of Biological Control Agents for Food and Agriculture

The report sets out to summarize the past and current situation regarding the practice of biologicalcontrol inrelationtothe use and exchange of genetic resources relevant for BCAs.It considers the twomain categories of biological control:classical and augmentative.Allowing access to BCAs for use inanother country imposes no risk of liability to the source country.Local scientific knowledge abouthabitats,fauna andflora,can be

Surgery for Crohn's disease in the era of biologicals:A reduced need or delayed verdict?

Crohn's disease(CD) is a chronic inflammatory bowel disease that can affect the entire gastrointestinal tract.Ultimately,up to 70% of all patients will need surgery,despite optimized medical therapy.Moreover,about half of the patients will need redo-surgery because of disease recurrence.The introduction of anti-tumor necrosis factor(TNF) drugs(Infliximab in 1998) revolutionized the treatment of CD.Different randomized trials assessed the efficacy of anti-TNF treatment not only to induce,but also to maintain,steroid-free remission.Furthermore,these agents can rapidly lead to mucosal healing.This aspect is important,as it is a major predictor for long-term disease control.Subgroup analyses of responding patients seemed to suggest a reduction in the need for surgery at median-term follow up(1-3 years).However if one looks at population surveys,one does not observe any decline in the need for surgery since the introduction of Infliximab in 1998.The short follow-up term and the exclusion of patients with imminent surgical need in the randomized trials could bias the results.Only 60% of patients respond to induction of anti-TNF therapy,moreover,some patients will actually develop resistance to biologicals.Many patients are diagnosed when stenosing disease has already occurred,obviating the need for biological therapy.In a further attempt to change the actual course of the disease,top down strategies have been progressively implemented.Whether this will indeed obviate surgery for a substantial group of patients remains unclear.For the time being,surgery will still play a pivotal role in the treatment of CD.

Technique of Earthworms Restoring Soil in Greenhouse Cultivation

The production environment of greenhouse cultivation is relatively closed,the multiple cropping index is high,the management of fertilizationwatering and pesticideapplication isblindtosomeextent,andthe phenomenonofcontinuous cropping isalsocommonSoilquali-ty affects the sustainable development of greenhouse cultivation.Earthworm is a ubiquitous invertebrate organism in soil,an important part of soil system,a link between terrestrial organisms and soil organisms,an important link in the small cycle of soil material organisms,and plays an important role in maintaining the structure and function of soil ecosystem.Different ecotypes of earthworms are closely related to their habi-tats(soil layers)and food resource preferences,and then affect their ecological functions.The principle of earthworm regulating soil function is essentially the close connection and interaction between earthworm and soil microorganism.Using different ecotypes of earthworms and bio-logical agents to carry out combined remediation of greenhouse cultivation soil is a technical model to realize sustainable development of green-house cultivation.

Accidents at Work from Exposure to Biological Material Contamination of Viral Hepatitis“B”and“C”in a Brazilian Capital

Background: Occupational exposure to biological materials is a serious risk to the health of workers in their workplaces, due to the possibility of transmitting pathogens such as Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV). The aim of this study was to analyze the accidents of exposure to biological material which resulted in contamination of Hepatitis B and C in the municipal health Belo Horizonte. Methods: Epidemiological study with cross-sectional design performed by querying the data on accidents at work involving exposure to biological materials and notification data of Viral Hepatitis in the Information System for Notifiable Diseases (SINAN) for the period of 2007 to June 2011, filed with the municipal government of Belo Horizonte. A descriptive analysis was performed using frequency distribution and percentages. Results: The 45 research records were arranged in professional categories, with 57.77% of incidents being ignored, followed by 24.44% nursing technicians, 6.66% nursing assistants, and 2.22% marketers, housekeeping, administrators, janitors, and builders. The average age was 39 years and 64.44% of the professionals were female. At the notification of the accident, 75.55% of professionals were not registered at CAT, and 92.85% of exposures occurred in the hospital;64.29% in contact with blood;35.71% of the causative agent was without needle lumen, 28.57% during administration of intravenous medication, and 57.14% from percutaneous exposure. In the distribution of occupation, 57.78% were contaminated with viral Hepatitis B and C. With vaccination regimens for Hepatitis B, 66.67% of the cases went to nursing assistants and 42.22% were “ignored”. Conclusion: These data confirm the need for reorientation of working practices during daily activities of health workers and guidance for notification of occupational accidents involving biological material and viral Hepatitis B and C in order to improve the quality of the records.

Physical-biological Collaborative Prevention and Control of Facility Strawberry Continuous Cropping Diseases

The aim was to develop green strawberry varieties,control soil-borne diseases from facility strawberry continuous cropping,improve the safety and quality of strawberries and promote the healthy and stable development of the strawberry industry. Based on the production practices in recent years,we summarized the physical-biological collaborative prevention and control technology for the disease of facility strawberry continuous cropping facilities,established the technical goals,the main types of soil-borne diseases,and the physical-biological collaborative control prevention and control technologies,mainly including the specific methods and technical points of solar high temperature disinfection technology and biological bacterial fertilizer（ agent） treatment technology.

Biologic Agents in Behcet’s Disease:Our Experience and Review of the Literature

Behcet’s disease (BD) is a large vessel vasculitis with a wide range of clinical manifestations. Some of these manifestation may be life threatening and rapid suppression of the inflammation with effective immunosuppressive agent is crucial. There are traditional drugs with different response rates and all have efficacy on different manifestations of the disease. The most frightening manifestations of the disease are ocular, neurologic, intestinal and vascular types of involvement. Besides benign and easily treated manifestations there are also refractory cases with complicated involvement. The novel biologic agents have been used for these resistant patients and favorable response rates have been reported. In this review, we have shared our experience with biologic agents in BD and also reviewed the literature for the efficacy and safety for these novel agents for refractory patients.

Crohn's disease and clinical management today:How it does?

Crohn’s Disease(CD)is an Inflammatory Bowel Disease and is characterized by an immune-mediated nature.Its etiology results from the interaction between genetic,enviromental and microbial factors.Regarding pathophysiology,it involves high levels of interleukin(IL)-12,IL-17,and Th1 profile,along with loss of tolerance mechanisms,an increase in pro-inflammatory interleukins,beyond the possibility to affect any part of the gastrointestinal tract.Its symptoms include abdominal pain,chronic diarrhea,weight loss,anorexia,and fatigue,as well as blood in the stool or rectum.Additionally,conditions comprising musculoskeletal,cutaneous,ocular,hepatic,and hematological alterations may be associated with this scenario and extra-intestinal presentation,such as erythema nodosum,anterior uveitis,osteoporosis,and arthritis can also occur.Today,clinical history,exams as fecal calprotectin,ileocolonocopy,and capsule endoscopy can be performed in the diagnosis investigation,along with treatments to induce and maintain remission.In this sense,anti-inflammatory drugs,such as corticosteroids,immunomodulators,and biological agents,as well as surgery and non-pharmacological interventions plays a role in its therapy.The aim of this review is to bring more current evidence to clinical management of CD,as well as to briefly discuss aspects of its pathophysiology,surveillance,and associated disorders.

Rice(Oryza sativa L.)plant protection using dual biological control and plant growth-promoting agents:Current scenarios and future prospects

Various microorganisms live in association with different parts of plants and can be harmful,neutral,or beneficial to plant health.Some microbial inhabitants of plants can control plant diseases by contesting with,predating on,or antagonizing plant pathogens and by inducing systems for plant defense.A range of methods,including plant growth-promoting microorganisms(PGPMs)as biological control agents(BCAs)(BCA-PGPMs)are used for the biological management and control of plant pathogens.Some BCAs interact with plants by inducing resistance or priming plants without direct interaction with the pathogen.Other BCAs operate via nutrient competition or other mechanisms to modulate the growth conditions for the pathogen.Generally,PGPMs can be applied alone or together with other chemicals or carriers to control various crop diseases.This review highlights the effective types of BCA-PGPMs and their applications,roles,carrier based-formulations,and responses to rice(Oryza sativa L.)pathogens.Future plant disease management prospects are promising,and growers’increasing demand for BCA-PGPM products can be exploited as an effective approach to the management of plant diseases,as well as to improve yield,environmental protection,biological resources,and agricultural system sustainability.

Chronic Refractory Idiopathic Urticaria

Background: Chronic spontaneous urticaria (CSU) is a complex medical condition characterized by substantial morbidity and a negative impact on one’s quality of life. There are several treatment approaches available, tailored to the severity of the condition, which can enhance overall quality of life. Aim: In this article, we outline a systematic approach to managing chronic urticaria, while also elucidating the available treatment strategies for cases that prove resistant to conventional therapies. To illustrate our points, we present a clinical case as a practical example. Case Presentation: Here, we present a patient with CSU since childhood who presented in the context of refractory hives and generalized arthralgia that responded well to omalizumab therapy with no further relapse. Conclusion: Omalizumab is a biological agent that offers a potential treatment option for CSU. It is available for individuals twelve years and older who have not responded well to conventional treatments. It has demonstrated good efficacy with a relatively low rate of clinically significant adverse effects. Nonetheless, there is a dearth of research regarding the optimal method for tapering the dosage and determining the duration of treatment.

New perspectives in the treatment of advanced or metastatic gastric cancer

Metastatic gastric cancer remains an incurable disease,with a relative 5-year survival rate of 7%-27%.Chemotherapy,which improves overall survival(OS) and quality of life,is the main treatment option.Metaanalysis has demonstrated that the best survival results obtained in earlier randomized studies were achieved with three-drug regimens containing a fluoropyrimidine,an anthracycline,and cisplatin(ECF).Although there has been little progress in improving median OS times beyond the 9-mo plateau achievable with the standard regimens,the availability of newer agents has provided some measure of optimism.A number of new combinations incorporating docetaxel,oxaliplatin,capecitabine,and S-1 have been explored in randomized trials.Some combinations,such as epirubicin-oxaliplatin-capecitabine,have been shown to be as effective as(or perhaps more effective than) ECF,and promising early data have been derived for S-1 in combination with cisplatin.One factor that might contribute to extending median OS is the advancement whenever possible to second-line cytotoxic treatments.However,the biggest hope for signif icant survival advances in the near future would be the combination of new targeted biological agents with existing chemotherapy f irst-line regimens.

Hepatitis B and C virus reactivation in immunosuppressed patients with inflammatory bowel disease

In recent years,a number of case reports and clinical studies have highlighted the risk of hepatitis B and C virus reactivation in patients with inflammatory bowel disease who are treated with immunosuppressive drugs.The cases of viral hepatitis reactivation that have been reported are characterized by a wide range of clinical manifestations,from viremia without clinically relevant manifestations to fulminant life-threatening hepatitis.The development and dissemination of biological immunosuppressive drugs have led to a significant increase in the number of reports of interest to physicians in a variety of clinical settings.On this topic,there have been a number of published guidelines and reviews that have collected the available evidence,providing recommendations on prophylactic and therapeutic strategies and methods for monitoring patients at risk.However,it should be noted that,to date,very few clinical studies have been published,and most of the recommendations have been borrowed from otherclinical settings.The published studies are mostly retrospective and are based on very heterogeneous populations,using different therapeutic and prophylactic regimens and obtaining conflicting results.Thus,it seems clear that it is desirable to concentrate our efforts on prospective studies,not conducting further reviews of the literature in the continued absence of new evidence.