Immunotherapies application in active stage of systemic lupus erythematosus in pregnancy:A case report and review of literature

BACKGROUND Pregnancy in the setting of systemic lupus erythematosus can worsen thecondition from the stable to active stage, with quality of life and fertility desirebeing particular concerns. Pregnancy in the active stage of systemic lupuserythematosus (ASLE), although rare and complicated to manage, can be treatedfavorably with immunotherapies ifs used properly. Here we report such a successcase.CASE SUMMARY A 31-year-old primigravida patient, diagnosed with SLE seven years ago, wasinduced ASLE after a cold at 21 + weeks. The patient’s vital signs on presentationwere normal. Her laboratory exam was remarkable for significant proteinuria,liver and renal dysfunction, and low C3 and C4 levels. Infectious work-up wasnegative. The patient was diagnosed with ASLE. She was given immunosuppressiveagents (methylprednisolone, gamma globulin and azathioprine etc.)and plasma adsorption therapy, monitoring blood pressure every 8 h, fetal heartrate twice a day, and liver and renal function at least twice a week. Successfulmaternal and fetal outcomes are presented here.CONCLUSION Child-bearing in ASLE has become more promising, even for this difficult case ofASLE with multiple organ damage. Thorough antepartum counseling, cautiousmaternal-fetal monitoring, and multi-organ function monitoring bymultidisciplinary specialties are keys to favorable pregnancy outcomes.

Milestones in the discovery of hepatitis C

The discovery of hepatitis C has been a landmark in public health as it brought the opportunity to save millions of lives through the diagnosis,prevention and cure of the disease.The combined work of three researchers,Alter H,Houghton M and Rice C,which set the basis for the diagnosis,treatment and prevention of hepatitis C apart from laying the ground work for a new approach to study infections in general and developing new antiviral agents.This is a story of a transfusion-associated infection.A series of clinical studies demonstrated the existence of an infectious agent associated with hepatitis.That was followed by the identification of what was later known to be the hepatitis C virus(HCV)and the development of diagnostic tests.It all preceded the full molecular identification and demonstration of a causal effect.Finally it ended up with the development and discovery of a new class of therapeutic drugs,the direct acting antivirals,which are now used not only to cure the disease but most probably,to eliminate the problem.This work started with Dr Alter H who demonstrated that a new virus was responsible for the majority of post-transfusion hepatitis followed by Houghton M who cloned the virus and developed the blood test to identify those cases that carried the virus.Finally,the work of Rice C demonstrated that a cloned HCV produced after applying molecular biology techniques could cause long-standing infection and cause the same disease as the one observed in humans.

Regulation of transforming growth factor-β signaling as a therapeutic approach to treating colorectal cancer

According to data from 2020,Slovakia has long been among the top five countries with the highest incidence rate of colorectal cancer(CRC)worldwide,and the rate is continuing to rise every year.In approximately 80%of CRC cases,allelic loss(loss of heterozygosity,LOH)occurs in the long arm of chromosome 18q.The most important genes that can be silenced by 18q LOH or mutations are small mothers against decapentaplegic homolog(SMAD)2 and SMAD4,which are intracellular mediators of transforming growth factor(TGF)-βsuperfamily signals.TGF-βplays an important role in the pro-oncogenic processes,including such properties as invasion,epithelial-mesenchymal transition(commonly known as EMT),promotion of angiogenesis,and immunomodulatory effects.Several recent studies have reported that activation of TGF-βsignaling is related to drug resistance in CRC.Because the mechanisms of drug resistance are different between patients in different stages of CRC,personalized treatment is more effective.Therefore,knowledge of the activation and inhibition of factors that affect the TGF-βsignaling pathway is very important.

Effect of Photoactivated Hypericin on Growth and Antibiotic Susceptibility of Hospital-Related Staphylococcus aureus and Enterococcus sp. Clinical Strains

Resistance against commonly used antibiotics is a serious clinical problem in recent medical practice. There exist several bacterial strains in which the possibilities of their inhibition are very limited due to multidrug resistance. Antimicrobial photodynamic therapy (aPDT) represents an option how to effectively suppress the growth of resistant pathogens. In this work we have studied interactions of potent photosensitizer hypericin (Hyp) with hospital-related gram positive (Gram+) and gram negative (Gram-) bacterial strains and the effects of photodynamic activated Hyp on bacterial susceptibility and/or resistance of these strains to antibiotics. We demonstrated a significant influence of photoactivated Hyp on growth of Staphylococcus aureus and Enterococcus sp. We have also shown that it is extremely important to use the effective concentrations of Hyp for aPDT, which completely inhibit the growth of microorganisms. Otherwise, there appears an increase in resistance, probably due to the activation of efflux mechanisms, which are involved in the efflux of Hyp and antibiotics as well.

Monitoring of Heart Ischemia in Blood Serum

Our aim was to study the selected cases of the patients with ischemic heart disease and to analyze the structure of blood serum of patients in comparison with control serum of healthy subjects by methods: synchronous fluorescence fingerprint and atomic force microscopy that are still not used in clinical practice. Our results of fluorescence analysis showed that blood serum of all patients with ischemic heart disease decreased intensity of fluorescence in comparison with control blood serum. Endogenous fluorescence of synchronous fluorescence fingerprint of blood serum of patients with unstable angina pectoris state after non ST elevation myocardial infarction;angina pectoris and arterial hypertension 3 was similar, but atomic force microscopy revealed differences in the structure of blood serum of patients with the angina pectoris. Blood serum of patients with angina pectoris exhibited disappearance of fluorescence peak with maximum fluorescence and showed lower fluorescence intensity than control blood serum and blood serum of patients with arterial hypertension 2. Profiles of synchronous fluorescence fingerprint of blood serum of patients with arterial hypertension stage 2 showed formation of the new fluorescent peak with maximum fluorescence, similar shape of synchronous fluorescence fingerprint and higher fluorescence intensity than blood serum of healthy subjects. Blood serum sensitively revealed changes in the body by using untraditional novel techniques which enable the analysis of the mixture of blood serum and might be a new possibility in study of heart ischemia diseases.

Effects of primovaccination and booster vaccination on serum cortisol and humoral immune response in cattle

The objective of this study was to evaluate the effect of one or two doses of the anti-rabies vaccination on the serum concentration of cortisol and the humoral immune response in cattle as well as the correlation between serum cortisol concentrations and the titers of rabies-neutralizing antibodies. Nelore cattle were randomly assigned to one of three groups, which were vaccinated with one dose of rabies vaccine (group GVSR, N = 15), two doses of rabies vaccine (group GVR, N = 15) or were not vaccinated (group Gc, N = 15). A commercial liquid inactivated rabies vaccine was used. The stressors imposed on the cattle were vaccination, corral handling and the presence of people. Blood samples were collected on days 0, 30 and 60 post-vaccination. Serum cortisol concentrations were determined using a solid-phase radioimmunoassay, and rabies antibody titers were determined using a serum neutralization test with BHK21 cells (RFFIT). Both serum cortisol concentrations and antibody titers increased after the second (booster) vaccination (P < 0.05). In all the groups, the serum cortisol concentrations increased after the cattle were handled in the corral (P < 0.05). No correlation was observed between the serum cortisol concentrations and the antibody titers with any treatment or on any observation day. In conclusion, booster vaccination is indispensable for primovaccinated cattle in achieving high and protective levels of rabies antibodies. Although booster vaccination and frequent cattle handling in corrals are stressors, the response is not strong enough to cause immunosuppression in cattle.

The Effect of Different Diet on Saliva

The aim of this scientific research was to study the influence of various diets (ketogenic, low carb, mixed) on teeth and saliva structure of healthy individuals. The health condition of teeth and the influence of diet (sweets, water intake) were investigated using the questionnaires which were statistically processed by descriptive and inductive statistics. Saliva was examined using synchronous fluorescent fingerprint (SFF) and atomic force microscopy (AFM). The statistical evaluation of answers of respondents using the questionnaires about intake of sweets in their diet showed significant influence of sugars on formation of tooth decay of diet. The intake of water (volume and frequency) did not show significant influence on formation of tooth decay. Endogenous fluorescence and surface structure of saliva differed in healthy subjects with different diet. The most organized surface structure showed low carb diet (without crystals). The least organized surface structure showed ketogenic diet with the big crystals (1 - 2 μm). Untraditional methods (SFF and AFM) enable the new, sensitive and quick analysis of the mixture of saliva. Saliva of individuals with low carb diet showed the most organized structure. Low content of sugar in diet is important possibility of the prevention before dental carries.

New Screening Approach for Ocular Diseases

Objective: Present a new screening approach for ocular diseases. Method: Transversal, retrospective, single center study that analyzed medical records of patients from a social project on the prevention of blindness and amblyopia, which aimed at: 1) Detect the main ocular disorders such as amblyopia, primary angle-closure suspect (PACS);glaucoma suspect (GS);predisposing retinal detachment lesions (PRDL);age-related macular degeneration (AMD), and diabetic retinopathy (DR);2) Perform cataract diagnosis;3) Provide guidance and treatment for allergic conjunctivitis. 4) Prescribe glasses for children until 14 years of age. Participants were examined by a single specialist, holder of a post-doctoral degree in ophthalmology, with 36 years of experience and a sub-specialization in retina and vitreous. All data were analyzed in 2022. Results: The examiner diagnosed 42 cases of PACS, 21 of GS, 8 of PRDL, 14 of AMD, 3 of DR, 40 of cataract and 31 cases of allergic conjunctivitis. Thirty-three participants younger than 14 were prescribed glasses. Other pathologies included retinal detachment, papilledema, corneal ulcer, suspected conjunctival squamous cell carcinoma, retinal vasculitis, strabismus, uveitis, bilateral papilla paleness and lacrimal duct obstruction. Out of the 297 cases examined, 168 participants presented some type of alteration that could compromise their vision. Conclusion: The examiner’s experience and knowledge were decisive factors for the quick diagnosis, advice, screening and/or treatment of several ocular diseases. The social project results reveal that the primary care and/or the screening performed by a specialist are likely to reduce blindness cases.

Vitamin D receptor gene polymorphisms and hepatocellular carcinoma in alcoholic cirrhosis

AIM: To assess the relationship between vitamin D re-ceptor (VDR) gene polymorphisms and the presence of hepatocellular carcinoma (HCC). METHODS: Two-hundred forty patients who underwent liver transplantation were studied. The etiologies of liver disease were hepatitis C (100 patients), hepatitis B (37) and alcoholic liver disease (103). A group of 236 healthy subjects served as controls. HCC in the explanted liver was detected in 80 patients. The following single nucle-otide gene polymorphisms of the VDR were investigatedby polymerase chain reaction and restriction fragment length polymorphism: FokI C>T (F/f), BsmI A>G (B/b), ApaI T>G (A/a) and TaqI T>C (T/t) (BAT). RESULTS: The frequencies of genotypes in patients without and with HCC were for FokI F/F = 69, F/f = 73, f/f = 18 and F/F = 36, F/f = 36, f/f = 8; BsmI b/b = 45, B/b = 87, B/B = 28 and b/b = 33, B/b = 35, B/B = 12; for ApaI A/A = 53, A/a = 85, a/a = 22 and A/A = 27, A/a = 38, a/a = 15; for TaqI T/T = 44, T/t = 88, t/t = 28 and T/T = 32, T/t = 38, t/t = 10. Carriage of the b/b genotype of BsmI and the T/T genotype of TaqI was signif icantly associated with HCC (45/160 vs 33/80, P < 0.05 and 44/160 vs 32/80, P < 0.05, respectively). The absence of the A-T-C protective allele of BAT was signif i-cantly associated with the presence of HCC (46/80 vs 68/160, P < 0.05). A strong association was observed between carriage of the BAT A-T-C and G-T-T haplotypes and HCC only in alcoholic liver disease (7/46 vs 12/36 vs 11/21, P < 0.002, respectively).CONCLUSION: VDR genetic polymorphisms are sig-nificantly associated with the occurrence of HCC in patients with liver cirrhosis. This relationship is more specific for patients with an alcoholic etiology.

Factors associated with tobacco, alcohol, and other drug use among youth living in West Central Mexico

AIM To determine the prevalence of drug and substance abuse among high school students in Jalisco and its association with the severity of health, behavior and psychosocial problems in order to provide evidence for possible prevention and treatment needs. METHODS A multi-stage random sample of Jalisco high school students was given a paper-and-pencil survey based upon an adapted version of the drug use screening inventory(DUSI)(n = 24699; n = 2832). The DUSI showed adequate psychometric characteristics in this population. The statistical analyses accommodated the complex survey design with attention to unequal probability of selection and clustering of participants within schools and regions. RESULTS An estimated 44% of the students had smoked tobacco, one in five students was a current smoker, and one in four students used to smoke but had not smoked for one year or more. By contrast, 6.8% of the students reported having used marijuana, cocaine, or both. Behavioral problems, deviant peer affiliation, and troubled families were independently associated with drug use. One in two students who used tobacco or alcohol had used these drugs in the past year(46% and 54%, respectively), and one in four students who used marijuana or cocaine in their lifetime had used those drugs in the past year(28% in both cases). CONCLUSION The rates of cocaine use as well as the proportion of current users were higher than expected among high school students and indicate changing patterns of drug use in Mexico. These results corroborate that the general trend of drug use by youth in Mexico is increasing. Results from this study help us better understand the needs of at-risk youth and the need for new treatment and prevention strategies.

左西替利嗪治疗慢性特发性荨麻疹:一项随机、双盲、安慰剂对照研究

Background: Chronic urticaria is a common skin condition. It is frequently a disabling disease because of the persistence of clinical symptoms, the unpredictable course and its negative influence on the quality of life. Objectives: To determine whether levocetirizine is efficacious in the treatment of chronic idiopathic urticaria. Methods: A randomized, double-blind,placebo-controlled study was conducted in 106 patients with a diagnosis of chronic idiopathic urticaria. A 1-week singleblind placebo run-in period (baseline) was followed by a 6-week double blind active treatment period. The patients were randomized to receive one of the following treatments once daily: (a) oral levocetirizine 5 mg, or (b) oral placebo. The study ended after another 1-week single blind placebo washout period. Results: The evaluable population consisted of 100 patients. Levocetirizine administered once daily is effective and well tolerated in the treatment of the symptoms of chronic idiopathic urticaria and in improving the patient’s quality of life. Levocetirizine was superior to placebo in reducing the mean total symptoms score as well as individual symptoms, then umber of daily episodes and the number of weals, the overall severity of symptoms and the quality of life. The significant beneficial effects of levocetirizine lasted only during the active trial, while at follow-up there was a significant worsening of all the variables evaluated in this study, after the end of the active trial (week 7). Conclusions: A global assessment indicates that levocetirizine 5 mg once daily is an effective agent in patients with chronic idiopathic urticaria, as its action provides a rapid and satisfactory control of the symptoms and measures of subjective disease, although this is limited to the duration of treatment.

Comparative effect of electroacupuncture and moxibustion on the expression of substance P and vasoactive intestinal peptide in patients with irritable bowel syndrome

OBJECTIVE: To compare the impacts of electroacupuncture(EA) and moxibustion(Mox) on the primary gastrointestinal symptoms and the expressions of colonic mucosa-associated neuropeptide substance P(SP) and vasoactive intestinal peptide(VIP)in patients with either diarrhea-predominant or constipation-predominant irritable bowel syndrome(IBS-D and IBS-C,respectively).METHODS: Eighty-five IBS patients were randomly allocated to the EA and Mox groups. Zusanli(ST 36)and Shangjuxu(ST 37) were selected as acupoints for electroacupuncture or warm moxibustion treatment once a day for 14 consecutive days. Before and after the treatment sessions,a Visual Analog Pain Scale and the Bristol Stool Form Scale were used to evaluate gastrointestinal symptoms. There were four dropout cases,leaving 81 participants(41 with IBS-D and 40 with IBS-C) who volunteered to undergo colonoscopy before and after the treatment sessions. During colonoscopy,sigmoid mucosa were collected to detect SP and VIP expression using immunohistochemistry assay.RESULTS: Both EA and Mox treatments were effective at relieving abdominal pain in IBS-D and IBS-C patients. However,Mox was more effective at reducing diarrhea in IBS-D patients,whereas EA was more effective at improving constipation in IBS-C patients. EA and Mox treatments both down-regulated the abnormally increased SP and VIP expression in the colonic mucosa,with no significant difference shown between the two treatments.CONCLUSION: Both EA and Mox treatments are effective at ameliorating gastrointestinal symptoms by reducing SP and VIP expression in the colonic mucosa of IBS patients.

Effects of electroacupuncture and Chinese kidney-nourishing medicine on polycystic ovary syndrome in obese patients

OBJECTIVE: To explore the effect of electroacupuncture and Chinese kidney-nourishing medicine on insulin (INS), adiponectin (APN), leptin (LEP), and glucolipid metabolism of obese patients with polycystic ovary syndrome (PCOS). METHODS: Sixty-seven obese PCOS patients were randomly divided into two groups. Thirty-three patients in the acupuncture-medicine group were treated three times a week with electroacupuncture at the Tianshu (ST 25), Zhongwan (CV 12), Qihai (CV 6), Sanyinjiao (SP 6), Geshu (BL 17), and Cil-iao (BL 32) acupoints. They also took the Chinese drug, Tiankui capsule, for 3 months as a course of treatment. Point-taking and treatment in the electroacupuncture group of 34 patients was the same as those in the acupuncture-medicine group. We observed and compared the changes in the obesity-related indexes of body weight (BW), body mass index (BMI), and waist-hip ratio (WHR), as well as fasting plasma glucose (FPG), fasting insulin (FINS), APN, and LEP. RESULTS: BW, BMI, WHR, and FINS decreased and insulin sensitivity index (ISI) and APN were higher in the acupuncture-medicine group than in the electroacupuncture group (P<0.01). There was no obvious difference in LEP between the two groups (P>0.05). CONCLUSION: Acupuncture combined with medicine is better than just electroacupuncture for obese PCOS patients by improving obesity-related indexes, insulin sensitivity, and APN level. This indicates that acupuncture-medicine therapy is worth clinical popularization.

Effect of metallic nanoparticles on amyloid fibrils and their influence to neural cell toxicity

The modification of amyloid fibrils cytotoxicity through exogenous nanomaterials is crucial to understand the processes controlling the role of protein aggregation in the related diseases.The influence of nanoparticles on amyloid stability yields great interest due to the small size and high surface area-to-volume ratio of nanoparticles.Various physico-chemical parameters play a role in the interaction of proteins and nanoparticles in solution,thus influencing the disaggregation of preformed fibrils.We have examined the influence of two kinds of metallic nanoparticles on lysozyme amyloid fibrils using a multi-technique approach and focalized their impact on cytotoxicity on human neuroblastoma cells(SH-SY5Y).In particular,fluorescence,infrared and circular dichroism spectroscopies,optical and atomic force microscopy experiments have been carried out;the results are analyzed to rationalize the effects of these complexes on neural cell viability.It is remarkable,that the fibrils in the presence of AuNPs,unlike fibrils alone or with AgNPs,do not generate a significant cytotoxic effect even at high concentration and an amyloid degradation effect is visible.