Recent Patents on Inflammation & Allergy Drug Discovery - Volume 11, Issue 1, 2017

Background: Cutaneous larva migrans is one of the most common skin diseases reported in travelers returning from tropical regions. Western physicians, however, are often not familiar of this condition. Objective: To review in depth the epidemiology, pathophysiology, clinical manifestations, complications, and treatment of cutaneous larva migrans. Methods: A PubMed search was completed in Clinical Queries using the key term “cutaneous larva migrans'. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. Patents were searched using the key term “cutaneous larva migrans” from www.google.com/patents, www.uspto.gov, and www.freepatentsonline.com. Results: Cutaneous larva migrans is a zoonotic infestation caused by penetration and migration in the epidermis of filariform larva of different kinds of animal hookworms through contact with feces of infected animals. Cutaneous larva migrans is endemic in tropical and subtropical regions. Clinically, cutaneous larva migrans is characterized by an intensely pruritic erythematous migrating tortuous or serpiginous, slightly raised track. The diagnosis is mainly clinical, based on the history of travel to an endemic area and exposure to contaminated soil/sand and the characteristic serpiginous track. Treatment options as well as recent patents related to the management of cutaneous larva migrans are also discussed. Compared with oral antihelminthics, topical treatment over the affected area is less effective. Oral ivermectin is the treatment of choice. Conclusion: The pruritic serpiginous track is pathognomonic. Oral ivermectin is the treatment of choice.

Background: Status asthmaticus is an acute exacerbation of asthma that is persistent and intractable and remains unresponsive to initial treatment with bronchodilators and systemic corticosteroids and that the condition can result in hypoxemia, hypercarbia, and secondary respiratory failure. Objective: To review treatment and recent patents on management of status asthmaticus. Method: A PubMed search was completed in Clinical Queries using the key term status asthmaticus".The search included meta-analyses, randomized controlled trials, clinical trials, reviews and pertinent references. Patents were searched using the key term "status asthmaticus" from www.google.com/patents, www.uspto.gov, and www.freepatentsonline.com. Results: Supplemental oxygen should be given to maintain an oxygen saturation of ≥ 92% in room air. Mainstay of pharmacologic treatment of status asthmaticus includes short-acting, β2 agonists such as salbutamol (albuterol) administered by metered-dose inhaler with spacer or, preferably, by nebulizer and oral corticosteroids. There is no advantage to intravenous corticosteroids unless the child cannot tolerate oral corticosteroids (e.g., protracted vomiting), or unable to take oral corticosteroid (e.g., intubated or unconscious). Inhaled ipratropium bromide and intravenous magnesium sulfate should be considered in children with severe asthma exacerbations not responsive to conventional therapy. Subcutaneous and intramuscular β2 agonists such as terbutaline and epinephrine may be considered for children with severe asthma exacerbation who have poor air entry, are uncooperative with nebulized therapy, or have poor response to nebulized therapy. Monoclonal anti-IgE antibody (omalizumab) and humanized monoclonal antibodies targeting interleukin pathway have shown great promise in severe refractory eosinophilic asthma. Failing therapeutic interventions necessitate non-invasive or invasive ventilation support. Severe exhaustion, deteriorating consciousness, poor air entry, worsening hypoxemia, hypercapnia, and cardiopulmonary arrest are indications for mechanical ventilation and intubation. For chronic treatment of asthma, inhaled corticosteroids, bronchodilator, and oral montelukasts are the mainstay. Some formulations of herbal medicine are efficacious but evidence of other modalities of complementary and alternative medicine are generally lacking. This review also discusses recent patents related to the management of asthma. These recent patents describe a few immunomodulating medications useful for the treatment of chronic severe asthma. There have been no recent patents for the management of status asthmaticus. Conclusion: Inhaled bronchodilators and systematic corticosteroids are the mainstay of therapy in the management of severe and status asthmaticus.

Background: Molluscum contagiosum is a viral cutaneous infection in childhood that occurs worldwide. Physicians should familiarize themselves with this common condition. Objective: To review in depth the epidemiology, pathophysiology, clinical manifestations, complications and, in particular, treatment of molluscum contagiosum. Methods: A PubMed search was completed in Clinical Queries using the key term “molluscum contagiosum”. Patents were searched using the key term “molluscum contagiosum” from www.google.com/patents, http://espacenet.com, and www.freepatentsonline.com. Results: Molluscum contagiosum is caused by a poxvirus of the Molluscipox genus. Preschool and elementary school-aged children are more commonly affected. The virus is transmitted by close physical contact, autoinoculation, and fomites. Typically, molluscum contagiosum presents as asymptomatic, discrete, smooth, flesh-colored, dome-shaped papules with central umbilication from which a plug of cheesy material can be expressed. Some authors suggest watchful waiting of the lesions.Many authors suggest active treatment of lesions for cosmetic reasons or concerns of transmission and autoinoculation. Active treatments may be mechanical (e.g. cryotherapy, curettage, pulsed dye laser therapy), chemical (e.g. cantharidin, potassium hydroxide, podophyllotoxin, benzoyl peroxide, tretinoin, trichloroacetic acid, lactic acid, glycolic acid, salicylic acid), immune-modulating (e.g. imiquimod, interferon-alpha, cimetidine) and anti-viral (e.g. cidofovir). Recent patents related to the management of molluscum contagiosum are also retrieved and discussed. These patents comprise of topical compositions and herbal Chinese medicine with limited documentation of their efficacy. Conclusion: The choice of treatment method should depend on the physician’s comfort level with the various treatment options, the patient's age, the number and severity of lesions, location of lesions, and the preference of the child/parents. In general, physical destruction of the lesion, in particular, cryotherapy with liquid nitrogen and chemical destruction with cantharidin are the methods of choice for the majority of patients.

Background: Acute otitis media is a common childhood infection. Prompt diagnosis and appropriate treatment are very important. Objective: To review in depth the epidemiology, pathophysiology, clinical manifestations, diagnosis, complications and particularly treatment of acute otitis media in children. Methods: A PubMed search was completed in Clinical Queries using the key term “acute otitis media”. Patents were searched using the key term “acute otitis media” from www.google.com/patents, http://espacenet.com, and www.freepatentsonline.com. Results: Acute otitis media affects over 80% of children before their third birthday and 30 to 45% of these children have suffered two or more episodes. Streptococcus pneumoniae, nontypable Haemophilus influenzae, and Moraxella catarrhalis are the most frequently isolated middle-ear pathogens. The diagnosis is based on acute onset of symptoms such as otalgia and fever, middle ear inflammation such as erythema of the tympanic membrane, and middle ear effusion. The choice of treatment method depends on the age of the child, laterality, and the severity of the disease. Recent patents related to the management of acute otitis media are also retrieved and discussed. Conclusion: Antimicrobial treatment is recommended for all children less than two years of age, as well as in children ≥ two years of age who have a temperature ≥ 39oC; are toxic looking; have otalgia > 48 hours; have bilateral otitis media or otorrhea; have craniofacial abnormalities; are immunocompromised; or have uncertain access to follow-up. Amoxicillin is the drug of choice. Observation without antibiotic is an option in immunocompetent children ≥ two years of age who have an acute uncomplicated otitis media and non-severe illness if appropriate follow-up can be arranged.

Background: Inflammatory Bowel Disease (IBD) cannot be controlled easily and the recurrence is the most challenging issue for the physicians. There are various controlled and colon targeted drug delivery systems available for the treatment with limited success rate. Nanoparticles prepared by using the colon targeted polymers such as chitosan may improve the IBD due to their smaller size, unique physico chemical properties and targeting potential. Objective: The aim of this investigation was designed to formulate and develop a colon targeted polysaccharide nanoparticles of rifaximin (RFX) by using linear polysaccharide chitosan, for the improvement of rifaximin solubility, overall therapeutic efficacy and colon targeting. Methods: The research was focused on developing RFX nanoparticles for the treatment of Inflammatory Bowel Disease (IBD) by ionic gelation method. Nanoparticles were subjected to various characterization techniques such as XRD, FTIR and mean particle size (MPS) by Master Sizer and Zeta Sizer. Transmission Electron Microscopy (TEM), drug entrapment efficiency and zeta potential are also determined for the developed formulations. The efficiency of drug release from prepared formulation was studied in vitro by using a dialysis bag diffusion technique in the buffer condition mimicking stomach, intestine and colonic pH conditions. Results: The prepared nanoparticles demonstrated the size in the nano range. The drug release profile was controlled in the upper GI tract and the maximum amount of drug was released in the colonic conditions. The prepared nanoparticles significantly improved the solubility of rifaximin. The zeta potential of the best chitosan preparation was found to be 37.79, which confirms the stability of prepared nanosuspension. Conclusion: Nanoparticles with small particle size found to have high encapsulation efficiency and relatively high loading capacity and predetermined in vitro release profile.

Background: Most of the available antimicrobial drugs have developed resistance, some of them suffer from severe toxicity and side effects. So, there is a need to discover novel compound(s) which should not only be potent, but also less toxic and cost effective. Objectives: The aim of the study is to develop new synthetic antimicrobial agents (Anti-bacterial and anti-fungal) such as 3-substituted flavone/flavanone derivatives, which should be significantly potent with low toxicity. Method: An attempt was made to synthesize a newer series of 3-methyl flavanone derivatives together with the synthesis of a series of 3- hydroxyl flavone analogues. The structures of the test compounds were elucidated and established by UV, IR, 1H-NMR, 13C-NMR and mass spectrometry. The synthesized compounds were subjected for in vitro antimicrobial screening using cup plate methods, followed by the determination of zone of inhibitions. Result: Two series (each 10) of 3-methyl flavanone and 3-hydroxy flavone derivatives were synthesized. The structures of the test compounds were characterized and established by various spectroscopic methods. The synthesized compounds were screened for in vitro antibacterial and antifungal activity against different strains (3-Gram positive, 3-Gram negative and 2- fungal strains). Conclusion: Some of the 3- hydroxyl flavones derivatives (1b, 3b, 4b, and 5b) and 3- methyl flavanone derivatives (3a, 1a, 2a and 4a) were found to elicit potent antimicrobial activity. The study revealed that 3-hydroxy flavone derivatives were found to be most active against Gram negative, while 3-methyl flavanone derivatives were active against Gram positive bacteria.

Objective: To identify the factors influencing the quality of life and professional future of patients suffering from occupational asthma. Method: A cross-sectional study of patients compensated for occupational asthma in Tunisian center during 2004-2011. The study of quality of life was based on the Asthma Quality of Life Questionnaires (AQLQ). Some related patents were also discussed. Results: One hundred twenty-nine patients were compensated and the mean age was 40.8 ± 7.6 years. The global score of quality of life was 3.65 ± 0.75. The group of employees having a "bad quality of life" included 82 patients (77.3%), 73 patients kept the same job (56.6%), 20.9% had an occupational reclassification, 13.9% were dismissed, 6.2% abandoned their job and 2.3% were put in disability. The analytical study of the quality of life showed that: The global score was correlated with the fact of keeping the same job and the application of preventive measures. The score in the "symptoms" area was correlated with working in the textile sector and the association with an occupational rhinitis. The score in the "activity limitation" area was correlated with age. The analytical study of the professional future revealed that maintaining the same job was correlated with low rates of permanent partial disability. Conclusion: Our study revealed the need to implement early preventive measures and to establish a systematic review of the permanent partial disability rate attributed to workers suffering from occupational asthma before the end of the legal period of five years.