Allergy & Immunology
Assessment of Interleukin 17 in Egyptian Systemic Lupus Erythematosus Patients as a Biomarker in Disease Activity
Introduction: Systemic lupus erythematosus (SLE) is a chronic idiopathic systemic autoimmune disorder with dysregulation of adaptive and innate immune systems. Interleukin (IL)-17 is the prototypical pro-inflammatory cytokine of T helper 17 (Th17) cells. Therefore it contributes to the pathogenesis of human SLE. Aim: The aim of the research paper was the evaluation of IL-17 level as a biomarker in the SLE cohort and its relation to disease activity and analysis of IL-17 concentration in patients with lupus nephritis and non-lupus nephritis. Methods: The research enrolled 45 SLE patients according to Systemic Lupus International Collaborating Clinics Classification Criteria (SLICC) and age and sex-matched. The patients underwent full history clinical examination laboratory investigation and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) calculation. Results: The mean age ± SD of the participants equaled 32 ± 11 years and serum IL-17 in SLE cases was statistically significantly high (p < 0.001). No statistically significant correlations were reported between disease activity according to SLEDAI and IL-17. In addition a statistically significant positive correlation was reported between IL-17 and ESR and a high statistically significant negative correlation was reported between IL-17 and C3 and C4 (P < 0.001). A statistically significant positive correlation was reported between IL-17 and 24-hour urinary proteins with a Pvalue of 0.01. Conclusion: SLE cases demonstrated higher levels of serum IL-17 contributing to SLE pathogenesis. However no statistically significant difference was reported between IL-17 and Lupus nephritis. IL-17 and SLE activity (SLEDAI) did not correlate. A statistically significant positive relation was reported between IL-17 and 24-hour urinary proteins. Additionally a high statistically significant negative correlation was reported between IL-17 and C3 and C4.
Hypoparathyroidism: Musculoskeletal Manifestations Related to Parathormone Deficiency
Background: Hypoparathyroidism is a rare metabolic disorder that can be responsible for musculoskeletal manifestations. Aim: We present a systematic review of musculoskeletal manifestations of adult-onset nonsurgical nongenetic hypoparathyroidism. Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline using the MEDLINE database including manuscripts describing musculoskeletal manifestations of adult-onset nonsurgical nongenetic hypoparathyroidism. Results: Musculoskeletal manifestations included myopathy shoulder disorder immune-negative non-erosive peripheral arthritis axial involvement simulating spondylarthritis and diffuse ligamentous ossifications. An association between hypoparathyroidism and spondyloarthritis or autoimmune diseases is possible. T-cell activation seen in patients with hypoparathyroidism may explain the co-occurrence of hypoparathyroidism with other autoimmune diseases. The treatment of these manifestations is based on calcium and active vitamin D supplementation. Parathyroid hormone may have an anabolic effect on muscle atrophy and muscle weakness. Parathyroid hormone can also promote bone formation and bone resorption by stimulating osteoclast differentiation by increasing RANKL (receptor activator for nuclear factor kappa-B ligand) expression. Therefore hypoparathyroidism can be responsible for an increase in bone mineral density. However the risk of fractures does not appear to be reduced due to changes in bone microarchitecture and the high risk of falls. Treatment with parathyroid hormone has been shown to improve bone microarchitecture. Conclusion: Our review showed that musculoskeletal manifestations are frequent in patients with hypoparathyroidism including muscular axial peripheral articular and entheseal manifestations.
Low Frequency of Upper Gastrointestinal Bleeding Despite Non-Steroidal Anti-Inflammatory Drugs and Corticosteroids in Patients with Rheumatoid Arthritis
Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease. It has been identified that non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids can be essential risk factors for developing complications such as upper gastrointestinal bleeding (UGIB). Objective: This study aimed to describe the safety profile of drugs used to treat RA focused in UGIB. Methods: A cross-sectional study of patients with RA between 2015 and 2021 a description of the population and an evaluation of the relationship with UGIB through bivariate analysis and logistic regression. Results: Of 405 individuals 16 presented UGIB (93.8% women mean age was 65±13.6 years). No statistically significant differences were found regarding UGIB and medication use except for the mean dose of corticosteroids. In the multivariate analysis it was found that the presence of anemia in the last three months had an adjusted OR (AOR) of 16.1 (95% CI 2.74- 24.23) and higher HAQ values during the previous three months had an AOR of 6.17 (95% CI 1.79- 21.24). Conclusion: This study found a low frequency of UGIB in patients with RA. More significant disability and anemia in the previous months were independently associated with UGIB. The low frequency of NSAID use in this population is noteworthy. In general reasonable medication use related to this complication is recommended.
Exploring the Promising Role of Guggulipid in Rheumatoid Arthritis Management: An In-depth Analysis
Background: Guggulipid an oleo-gum resin extracted from the bark of Commiphora wightii of the Burseraceae family holds a significant place in Ayurvedic medicine due to its historical use in treating various disorders including inflammation gout rheumatism obesity and lipid metabolism imbalances. Objective: This comprehensive review aims to elucidate the molecular targets of guggulipids and explore their cellular responses. Furthermore it summarizes the findings from in-vitro in-vivo and clinical investigations related to arthritis and various inflammatory conditions. Methods: A comprehensive survey encompassing in-vitro in-vivo and clinical studies has been conducted to explore the therapeutic capacity of guggulipid in the management of rheumatoid arthritis. Various molecular pathways such as cyclooxygenase-2 (COX-2) vascular endothelial growth factor (VEGF) PI3-kinase/AKT JAK/STAT nitric oxide synthase (iNOS) and NFΚB signaling pathways have been targeted to assess the antiarthritic and anti-inflammatory effects of this compound. Results: The research findings reveal that guggulipid demonstrates notable antiarthritic and anti-inflammatory effects by targeting key molecular pathways involved in inflammatory responses. These pathways include COX-2 VEGF PI3-kinase/AKT JAK/STAT iNOS and NFΚB signaling pathways. in-vitro in-vivo and clinical studies collectively support the therapeutic potential of guggulipid in managing rheumatoid arthritis and related inflammatory conditions. Conclusion: This review provides a deeper understanding of the therapeutic mechanisms and potential of guggulipid in the management of rheumatoid arthritis. The collective evidence strongly supports the promising role of guggulipid as a therapeutic agent encouraging further research and development in guggulipid-based treatments for these conditions.
Reaction Time in Fibromyalgia Patients
Background: Fibromyalgia has unknown aetiology and is associated with reduced information processing speed and therefore prolonged reaction time. However the processes underlying this are unknown. Objectives: First to compare the reaction time in a cohort of fibromyalgia patients and a matched group of normal controls. Second to assess whether detailed symptoms of pain and autonomic function as well as measures of tinnitus fatigue daytime sleepiness and Mycoplasma pneumoniae infection are predictors of reaction time in fibromyalgia. Methods: The between-groups mean serial five-choice reaction time difference was assessed in a cohort of fibromyalgia patients and in a matched group of normal controls in an analytical casecontrolled study. With the mean serial five-choice reaction time as the dependent variable for the fibromyalgia group a mixed stepwise multiple linear regression was performed with inputs relating to pain dysautonomia tinnitus fatigue daytime sleepiness and Mycoplasma pneumoniae infection. Results: The mean (standard error) serial five-choice reaction time for the fibromyalgia group was 448.4 (23.0) ms compared with 386.3 (8.3) ms for the control group (p = 0.007). The final multiple linear regression model (p < 0.001; adjusted R2 = 0.772) contained 13 predictors: eight sensory pain and three affective pain parameters and Mycoplasma pneumoniae IgG and IgA assay results. Conclusion: Certain sensory and affective pain parameters as well as Mycoplasma pneumoniae infection appear to be predictors of reaction time in fibromyalgia. Further research into the pathophysiological mechanisms by which they affect information processing is warranted and may shed light on the aetiology of fibromyalgia.
Severe Acro-osteolysis Mimicking Arthritis Mutilans in a Patient with Primary Hyperparathyroidism: A Case Report
Background: Primary hyperparathyroidism (PHPT) should be considered in the differential diagnosis of a patient with suspected secondary osteoporosis and severe osteoporosis with multiple fractures is frequently the first clinical manifestation of the disease. Case Presentation: Mutilating arthritis (arthritis mutilans) can be part of the clinical presentation of a number of rheumatic diseases most commonly seen in psoriatic arthritis rheumatoid arthritis and juvenile idiopathic arthritis but also in systemic lupus systemic sclerosis and multicentric reticulohistiocytosis. Evidence exists that subperiosteal and subchondral bone resorption seen in PHPT could induce the so-called ‘osteogenic synovitis’ which could eventually lead to the development of a secondary osteoarthritis with bone deformities. Conclusion: Here we present a case report of a patient initially diagnosed with PHPT who presented with mutilating arthritis of the finger joints and discuss whether the severe acro-osteolysis is a manifestation of the endocrinopathy or whether there is a co-existing undiagnosed inflammatory joint disease.
Insight into the Epidemiology of the Adult-onset Systemic Autoimmune Rheumatic Diseases in Egypt: A Descriptive Study of 8690 Patients
Background/Objective: Although systemic autoimmune rheumatic diseases (SARDs) seem to be ubiquitous Africa and the Middle East seem to be a remarkable exception with scarcity of data compared with the developed countries. Furthermore most of the studies addressed a particular disease. This work aimed to shed light on the relative frequency and epidemiology of the different adult-onset SARDs in Egypt. Methods: This is a retrospective hospital-based study including six university hospitals providing free health care services: Cairo Alexandria Tanta Suez Canal Beni-Suef and Assiut University Hospitals. All available files for patients attending the outpatient clinics or admitted to the inpatient departments between January 2000 and December 2021 were retrospectively reviewed. Data about the patient’s diagnosis gender age at disease onset year of disease onset and residence were collected. Results: The study included 8690 patients. Rheumatoid arthritis (RA) systemic lupus erythematosus (SLE) Behçet’s disease (BD) and spondyloarthropathies (SPA) represented the main SARDs in Egypt. They mainly affect young patients below the age of 40 years. RA and SLE mainly affect females; males are mainly affected by axial SPA and BD. There is an increasing incidence of SARDs during the study period. Conclusion: The study revealed the high burden of SARDs in Egypt helping better allocation of economic resources for the management of diseases of the highest prevalence and those affecting the young reproductive age groups. Increased public and medical staff awareness about SARDs is recommended to help early referral of patients to rheumatologists and hence better estimation of their epidemiology.
Study on the Expression and Potential Function of LncRNA in Peripheral Blood of Patients with Ankylosing Spondylitis
Background: Ankylosing spondylitis (AS) is an autoimmune disease that has the characteristics of difficult early diagnosis and a high disability rate. Objective: The objective of this study was to further explore the possible mechanism and potential function of lncRNA in AS. Methods: We used lncRNA microarray technology to detect the expression of lncRNA and mRNA in patients with active AS stable patients and healthy controls (HC). Afterward bioinformatics analysis was conducted on differentially expressed genes. Seven differentially expressed lncRNAs were screened out for real-time fluorescent quantitative PCR (RT-qPCR) combined with various clinical indicators for correlation analysis and the receiver operating characteristic (ROC) curve was used to analyze the potential of lncRNA as a diagnostic marker for AS. Results: The results showed that the expression levels of NR-037662 and ENST00000599316 in the AS subgroups were significantly higher than those in the HC group while the expression levels of ENST00000577914 and ENST00000579003 were lower than those in the HC group. The expression levels of NR-003542 and ENST00000512051 in the ASA group were significantly higher than those in the ASS and HC groups while NR-026756 was just the opposite. Spearman’s correlation analysis showed that the expression level of NR-003542 was positively correlated with Bath Ankylosing Spondylitis Functional Index (BASFI) Erythrocyte Sedimentation Rate (ESR) and high sensitivity C-Reactive Protein (hsCRP). The expression level of NR-026756 was negatively correlated with the Bath Ankylosing Spine Inflammatory Disease Activity Index (BASDAI) BASFI ESR hsCRP and globulin (GLOB). In addition it was also found that the ROC curve analysis of the 4 lncRNAs between the AS group (ASA group and ASS group) and the HC group were statistically significant and the area under the curve (AUC) of NR-037662 ENST00000599316 ENST00000577914 and ENST00000579003 was 0.804 0.812 0.706 and 0.698 respectively. Conclusion: It was found that these differentially expressed lncRNAs of AS may be involved in the occurrence and development of the disease. Among them NR-037662 ENST00000599316 ENST00000577914 and ENST00000579003 might have the potential to become AS diagnostic molecular markers. Moreover NR -003542 ENST00000512051 and NR-026756 might have the potential to be indicators of disease activity.
An Overview of Adalimumab Therapy for Ankylosing Spondylitis
Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease known for causing pain stiffness and reduced mobility in the axial skeleton. Adalimumab a tumor necrosis factor (TNF) inhibitor has emerged as a promising therapeutic option for AS. Methods: This systematic review involved a comprehensive search of randomized controlled trials related to AS treatment conducted in major databases such as MEDLINE Google Scholar and PubMed. The search terms encompassed ankylosing spondylitis adalimumab methotrexate other non-biologic DMARDs glucocorticoids NSAIDs and analgesics. A total of 14 randomized controlled trials with 4500 participants were included in the review. Results: The review's results revealed that adalimumab demonstrated notable superiority when compared to a placebo. It effectively reduced disease activity improved physical function and lowered inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate. Adalimumab demonstrated a favorable safety profile with adverse events comparable to those observed with placebo. Conclusion: Based on the results adalimumab is deemed an effective treatment for AS showcasing its potential as a first-line therapeutic option. Notably no significant increase in adverse events was observed compared to placebo. However the conclusion emphasizes the need for further studies with extended follow-up durations to ascertain the long-term efficacy and safety of adalimumab in AS management. This systematic review provides valuable insights supporting the use of adalimumab in the treatment of AS and underscores the importance of ongoing investigations into its long-term effects to optimize its clinical utilization in AS patients.
Correlation between Quality of Life and Erythrocyte Sedimentation Rate with Disease Activity in Rheumatoid Arthritis
Background: Inflammatory markers are crucial in diagnosing and monitoring rheumatoid arthritis. Patients with rheumatoid arthritis (RA) live with constant pain that limits their daily activities. Our study highlights the effects of disease activity on the quality of life in patients with rheumatoid arthritis. Methods: Swollen joint count (SJC) tender joint count (TJC) and visual activity scale (VAS) were utilized to acquire patients' subjective feelings of wellness and their performance of routine daily activities to determine the disease activity. The patient's erythrocyte sedimentation rate (ESR) was measured at the clinical hematology laboratory using the Westergren method. The Quality of Life was rated on a scale of 1 to 10. Results: Our study found that disease activity is inversely proportional to the quality of life. Out of 111 patients 3 (2.7%) were in remission 1 (0.9%) had mild disease 51 (45.9%) had moderate disease and 56 (50.5%) had high disease activity. The ESR was normal (<20) in 11 patients (9.9%) moderately elevated (20-50) in 56 (50.5%) patients and very high (>50) in 44 (39.6%) patients. The study revealed that 66% of patients in remission had normal while 33% had moderately elevated ESR. 12.5% of patients with moderate disease activity had normal ESR and none with high disease activity had normal ESR. Of 44 patients with high ESR 7 had moderate disease activity and 37 had high disease activity. In our study 60% of patients had a less than 50% quality of life compared to patients with pre-arthritis. Conclusion: High disease activity affects the productivity and quality of life in patients with rheumatoid arthritis. Assessing the impact of different interventions on the QOL should be an essential task that can help define a holistic and integrative treatment and rehabilitation model for RA patients.
Mixed Connective Tissue Disease: The Two Cases Representing the Range of this Illness
Introduction: Mixed connective tissue disease (MCTD) is defined as a systemic rheumatic disease characterized by the presence of high titer anti-U1 ribonucleoprotein (U1 RNP) antibodies in combination with clinical features commonly seen in systemic lupus erythematosus (SLE) systemic sclerosis (SSc) rheumatoid arthritis (RA) and polymyositis (PM). Case Presentation: The annual incidence of MCTD is 1.9 per 100000 adults. Any organ system can be involved in MCTD however four clinical features that suggest the presence of MCTD rather than another systemic rheumatic disease are Raynaud phenomenon with swollen hands or puffy fingers absence of severe kidney disease and central nervous system (CNS) disease at first presentation generally insidious onset of pulmonary hypertension and presence of autoantibodies anti-U1 ribonucleoprotein (U1 RNP) especially antibodies to the 68 kD protein. MCTD although initially thought to be a disease with a benign course is not considered a valid argument at present. This connective tissue disorder can present with life-threating organ involvement with rapid progression of disease. Conclusion: We report two cases of MCTD one with mild disease and another with life-threatening illness describing the range of severity at presentation of this disorder.
Randomised Clinical Trial Study: The Combination of Vitamin D and Curcumin Piperine Attenuates Disease Activity and Pro-inflammatory Cytokines Levels Insystemic Lupus Erythematosus Patients
Background: Curcumin-piperine might synergise with vitamin D to induce clinical remission in patients with systemic lupus erythematosus (SLE). Objective: To observe the improvement of patients with SLE clinically and the levels of inflammatory cytokines after receiving supplements of curcumin-piperine and cholecalciferol (Vitamin D3). Methods: Forty-five female SLE patients were included in a three-month double-blind randomized controlled trial. Participants were classified into: Group I (400 IU cholecalciferol + placebo three times daily n = 15) Group II (600 mg curcumin + 15800 m piperine once daily and three times daily placebo n = 15) and Group III (cholecalciferol 400 IU three times and 600 mg curcumin + 15800 mg piperine once a day n = 15). Mexican SLE disease activity score (Mex- SLEDAI) fatigue severity scale (FSS) TGF-β and IL-6 levels were measured from all patients before and after the treatments. Results: Mex-SLEDAI FSS and IL-6 were reduced significantly while TGF-β serum levels were increased in all groups after the treatments (p <0.05). Changes in Mex-SLEDAI score (p = 0.003 and p = 0.008) FSS (p = 0.001 and p <0.001) and TGF-β (p = 0.003 and p = 0.004) serum levels were significantly higher in group III compared to the group I or group II. On the other hand changes in Mex-SLEDAI FSS IL-6 and TGF-β serum levels were similar between groups I and II. Conclusion: Although vitamin D or curcumin-piperine alone could improve the clinical outcome and cytokines levels in SLE curcumin-piperine combined with vitamin D had the best outcome in improving the disease activity and cytokines levels among patients with SLE. (ClinicalTrials.gov number NCT05430087).
Synergistic Structural Inhibition of MMP-9 by Natural Flavonoids: A Natural Combinatorial Therapy against Cancer
Cancer is the uncontrolled proliferation of cells leading to metastasis due to genetic alterations resulting in oncogenes activation and tumor suppressor genes deactivation. It is the 2nd leading cause of death across the world. MMP-9 or gelatinase B plays an effective role in ECM degradation normal tissue turnover and tissue remodelling.
Overexpression of MMP-9 has been studied in almost all types of cancers proving the effective role of MMP-9 in accelerating malignant conditions. Thus targeting MMP-9 to treat cancer seems to be a potential strategy to deal with adverse pathologies of cancer. Methods: Chemotherapy and radiotherapy are frequently utilized for the treatment of cancer but are associated with diverse side effects. Flavonoids are natural compounds frequently found in plants and have been analyzed for the structural inhibition potential against MMP-9 by several researchers to develop natural treatments against cancer but none of the flavonoids have landed into clinical use. In the present study in-depth in-silico analysis to investigate the synergistic effects of flavonoids for structural inhibition of MMP-9 was done. The ADMET and bioactive properties analysis revealed effective drug-like properties of the considered flavonoids. Principal component analysis of ADMET and bioactive properties revealed high similarity in the chemical nature of luteolin and quercetin. Molecular docking analysis of MMP-9 with the considered flavonoids individually revealed the highest effective binding energy of luteolin.
Combination docking analysis of MMP-9 with different combinations of flavonoids led to the identification of two combinations including Quercetin with Genistein and Luteolin and Genistein revealing high negative binding energies of -15.48kcal/mol and -15.31kcal/mol which was significantly greater than the binding energies identified for respective ligands in individual dockings.
Thus the present study put forward synergistic natural flavonoid combinations against cancer via the MMP-9 inhibition approach that can be further evaluated to develop high-efficacy treatments.
Mapping the Landscape of Obesity Effects on Male Reproductive Function: A Bibliometric Study
Background: Due to changes in lifestyle and dietary habits the global population with obesity is increasing gradually resulting in a significant rise in the number of individuals having obesity. Obesity is caused by an imbalance between energy intake and consumption leading to excessive fat accumulation which interferes with normal human metabolism. It is also associated with cardiovascular disease metabolic syndrome male reproductive endocrine regulation disorders systemic and local inflammatory reactions excessive oxidative stress and apoptosis. All these factors can damage the internal environment for sperm generation and maturation resulting in male sexual dysfunction a decline in sperm quality and lower fertility. This study analyzes the trends and priorities of the effects of obesity on male reproductive disorders from a bibliometric perspective. Methods: This study uses the Web of Science as the statistical source covering all time spans. Tools like Web of Science VOSviewer and CiteSpace are used to analyze countries institutions authors journals and keywords in the field. Total publications total citations and average number of citations are selected for statistics. Results: The results show that the research on the impact of obesity on male reproductive function can be roughly divided into three stages: the initial stage the slow development stage and the rapid development stage. Our statistical scope includes 463 highly relevant articles that we have screened. We found that the journal with the most publications in this field is Andrologia and the institution with the highest total citations is the University of Utah. The most influential countries institutions and authors in this field are the United States the University of Utah and Carrell Douglas. Currently research related to the impact of obesity on male reproduction focuses mainly on three aspects: biochemistry molecular biology and reproductive biology. The keyword explosion results indicate that sperm obesity and male reproduction are at the forefront and trends of future research in this field. There has been a shift from basic biochemical and molecular research to research on molecular mechanisms relying on omics technologies. However we have observed that the number of papers published in 2022 is lower than in 2021 indicating a growth interruption during this period. Considering that this deviation may be due to the impact of the COVID-19 pandemic it may hinder the progress of certain experiments in 2022. In recent years China has rapidly developed research in this field. However the average citation rate is relatively low indicating the need for Chinese scholars to improve the quality of their articles further. Based on our research and in the context of global obesity men are at risk of increased infertility. Addressing this issue relies on our continued research into the mechanisms of obesity-related male reproductive disorders. Over the past forty-three years with the contributions of scientists worldwide research in this field has flourished. Conclusion: The impact of obesity on male reproductive disorders has been extensively studied. Currently research in this field primarily focuses on male sperm function sperm quality and the effects or mechanisms of cells on male reproduction. Future trends in this field should concentrate on the relationship between male fertility and energy metabolism as well as the endocrine function of adipose tissue. This study comprehensively analyzes the current research status and global trends in obesity and male reproductive disorders. We also discuss the future developments in this field making it easier for researchers to understand its developmental history current status and trends providing valuable reference for effective exploration in this area.
The Antidiabetic Drug Metformin Attenuated Depressive and Anxiety-like Behaviors and Oxidative Stress in the Brain in a Rodent Model of Inflammation Induced by Lipopolysaccharide in Male Rats
Background: Inflammation is considered to be a link between diabetes and central nervous system (CNS) disorders including depression and anxiety. Metformin is suggested to have antioxidant anti-inflammatory and mood-improving effects. The aim of the current research was to investigate the effects of the antidiabetic drug metformin on depressive- and anxiety- like behaviors and oxidative stress in the brain in a rodent model of inflammation induced by lipopolysaccharide (LPS) in male rats. Materials and Methods: The rats were treated as follows: (1) Vehicle instead of metformin and lipopolysaccharide (2) Lipopolysaccharide (1 mg/ kg) + vehicle instead of metformin (3-5) Lipopolysaccharide + 50 100 or 150 mg/ kg of metformin. After the behavioral tests including open field (OF) elevated pulse maze (EPM) and force swimming (FS) tests the brains were removed and malondialdehyde (MDA) nitric oxide (NO) metabolites total thiol catalase (CAT) activity interleukin-6 (IL-6) and superoxide dismutase (SOD) activity were determined. Results: In the EPM metformin increased the open arm time and entry and decreased closed arm time and entry. In the FS test metformin lowered the immobility and increased active time compared to lipopolysaccharide. In the OF test metformin increased total crossing and total distance time spent traveled distance and crossing number in the central zone. As a result of metformin administration IL-6 MDA and NO metabolites were decreased while thiol content SOD and CAT activity were increased. Conclusion: The results indicated that the well-known antidiabetic drug metformin attenuated depressive- and anxiety-like behaviors induced by inflammation in rats. These beneficial effects are suggested to be due to their attenuating effects on neuroinflammation oxidative stress and NO in the brain.
A Review on Role of Inflammation in Coronavirus Disease
The respiratory illness known as COVID-19 is caused by the novel coronavirus SARS-CoV-2. While the precise pathogenic mechanism of COVID-19 remains unclear the occurrence of a cytokine storm subsequent to viral infection plays a pivotal role in the initiation and advancement of the disease. The infection of SARS-CoV-2 induces a state of immune system hyperactivity leading to an excessive production of inflammatory cytokines. Consequently the identification of the various signaling pathways implicated in the inflammation induced by COVID-19 will enable researchers to investigate new targets for therapeutic intervention.
Anti-viral Effects of Pavetta indica Methanolic Extract and Acyclovir on Behavioral and Biochemical Parameters in Streptozotocin-induced Alzheimer's Disease in Rats
Background: Alzheimer's disease is a neurological dysfunction of the brain caused by neurodegeneration and oxidative stress. Some viruses such as herpes viruses HSV-1 and HSV-2 are causative agents of Alzheimer's disease and result in β-amyloid peptide and tau protein accumulation in the brain. Some antiviral drugs such as valacyclovir acyclovir and foscarnet reduce amyloid-beta and P-tau. Pavetta indica leaves are also reported for their antiviral properties. The current study aimed to find out the significance of using Pavetta indica methanolic extract and acyclovir against Alzheimer's disease induced by streptozotocin. Methods: Wistar rats received acyclovir and Pavetta indica methanolic extract orally at different dose ranges (50 150 450 mg/kg) and (125 250 500 mg/kg) respectively. The standard therapy Rivastigmine (2 mg/kg) was given orally. Results: Intracerebroventricular-streptozotocin produced significant alternations in behavioral assessments including locomotor activity test Morris water maze test and elevated plus maze test. Moreover intracerebroventricular-streptozotocin ameliorated the antioxidant defense activity by decreasing levels of catalase superoxide dismutase and reduced glutathione while enhancing the oxidative stress markers including malondialdehyde and total nitrite levels. Finally the main findings showed that intracerebroventricular-streptozotocin significantly increased the inflammatory marker tumor necrosis factor-α and disturbed neurotransmitter mediators including levels of acetylcholinesterase glutamate and γ-amino butyric acid. Conclusion: In a dose-dependent manner acyclovir and Pavetta indica methanolic extract treatments abrogated the streptozotocin-induced behavioral and neurological abnormalities in rats. The potential therapeutic effects of PIME and acyclovir administration in intracerebroventricular-streptozotocin-treated rats may be attributed to its potential antiviral antioxidant and anti-inflammatory effects. The current study suggests that Pavetta indica methanolic extract and acyclovir are promising therapeutic targets against Alzheimer's disease.
Electronic Method (Pro-Kin) for Improving and Speeding Up the Recovery After Ankle Sprain
Background and Objective: Ankle sprains very common injuries occurred especially during sports activities are mainly caused by indirect trauma which influences exaggerated stress exceeding the strength of stabilization mechanisms. Up to 85% of such injuries result from a sudden flexion and inversion of the foot. In this study we analyzed the effectiveness of the platform Pro-kin an innovative system that has given us the possibility to combine the functionality of the older proprioceptive boards with very accurate software in order to improve and accelerate the recovery after ankle injuries. Methods: 30 patients with moderate ankle sprain outcomes in two groups (A and B) were included in this study. Group A was only treated with proprioceptive exercises for 3 weeks while the group B was trained with the innovative Pro-kin. In both groups we evaluated VAS scale the ratio between the number of circumductions performed by the injured foot and the time spent on doing them and the percentage of load among the injured and the healthy foot in statics and dynamics with electronic baropodometry. Our data has been collected at t0 (beginning of study) t1 (one week later) t2 (two weeks later) t3 (one month later) t4 (two months later) and then analyzed by the two-way analysis of variance (2-way ANOVA) test. Results: At t0 no statistical differences of pain in the 2 groups (3.3 and 3.4); the values were similar as well as at time t1 t2 t3 and t4. Therefore we deduce that Pro-kin treatment is not painful. The number of circumductions performed was definitely better in B group since the first week; for the A group the values considerably increased only at t3 (one month later). Comparing the load percentages on two feet detected by the electronic baropodometer in statics and in dynamics we deduced that the patients of A group tend to lean mostly on the healthy foot than B group. Conclusion: This study demonstrates that new technological resources (such as Pro-kin) may be helpful to improve and speed up the recovery of ankle sprain in athletes.
An Overlooked Disease: Minimal Autonomous Cortisol Secretion (MACS). A Narrative Review
Background: A far more common disease than Cushing's syndrome is subclinical hypercortisolism or mild autonomous cortisol secretion (MACS) with an overall prevalence of 0.2-2%. Objective: This review aims to shed light on the prevalence screening and diagnostic criteria comorbidities and management of Mild Autonomous Cortisol Secretion (MACS). Methods: Studies eligible targeted MACS regarding prevalence screening comorbidities management and clinical outcome. This is a narrative-review. IRB approval was not needed. Results: The 1 mg Dexamethasone suppression test (DST) remains the first screening test. MACS is associated with adverse cardiometabolic and renal outcomes osteoporosis and osteopenia immunodeficiency depression coagulopathy and sarcopenia. Surgery is the gold standard treatment. Medical therapy is recommended when surgery is contraindicated or not feasible. Clinically silent hypercortisolism is a frequent entity that necessitates early detection and treatment. The production of cortisol should be looked at as a spectrum where subtle undetectable levels can still be produced. They know its association with adverse health outcomes. Conclusion: MACS is no longer considered an asymptomatic disorder; repeated hormonal and functional tests are crucial to prevent multiorgan damage.