Recent Advances in Inflammation & Allergy Drug Discovery - Volume 17, Issue 1, 2023

Anti-inflammatory therapies currently in use mainly include steroidal and non-steroidal drugs. Contrary to their side effects, the steroid hormones glucocorticoids, which are synthetic versions of natural cortisol, are nevertheless often employed to treat a variety of inflammatory disorders. Other drug class of choice is non-steroidal drugs which mainly target COX-2 and hence the synthesis of prostaglandins, particularly PGE2. To cure both the short-term effects of chronic inflammatory disorders and the long-term symptoms of acute inflammation, pharmaceutical chemists are in continuous search for more potent and less toxic agents. Apart from these two drug classes, phytochemicals are gaining the attention of researchers as source of alternative antiinflammatory agents. However, every drug class has its own advantages or disadvantages thus requiring intervention of newer approaches. Currently, drugs used for anti-inflammatory therapies are costly with low efficacy, high health risk, and socio-economic impact due to the concern issue of their toxicity. Recently, nano-drug delivery system has been experiencing main interest as a new approach for targeting therapeutic agents to the target sites in a controlled, sustained manner and has various advantages as compared to the conventional drug delivery system like, increased solubility, bioavailability, improved pharmacokinetic profile of drugs, surface area and rate of dissolution and additionally, overcomes the problems related to hydrophobicity, toxicity. Present review summarized the intervention of nanotechnology to overcome the limitations/ risk associated with current anti-inflammatory drugs of different classes.

Owing to the enhanced toxicity as well as consequences of allopathic medication, the research on herbal therapies is developing progressively. As a result, medicinal herbs are beginning to play a substantial role in the advancement of the dominant therapeutic medications. Since ancient times, the use of herbs has performed a vital part in human well-being as well in the invention of cutting-edge pharmaceuticals. Inflammation and related illnesses are a major health concern for the entire human population. Pain-inducing drugs including opiates, non-steroidal anti-inflammatory drugs, glucocorticoids, and corticosteroids have severe side effects and these therapies suffer from the recurrence of symptoms too after discontinuing the treatment. As a result, the diagnosis along with the advancement of medications with anti-inflammatory properties is the priority to conquer the drawbacks of the existing therapies. The present review article provides insight into the literature comprising promising phytochemicals from various medicinal plants tested through different model systems and employed for alleviating inflammation in several inflammatory disorders as well as clinical status of the herbal products.

Inflammation is a defense mechanism of the body against harmful stimuli/organisms. Even if it is the body’s defense mechanism, these mediators may affect different ways in the human body and can lead to chronic disorders. The most common treatment strategy for the acute type of inflammation mainly includes synthetic chemical drugs; Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and immunosuppressant drugs whereas these synthetic drugs have many side effects, adverse effects, and limitations. Herbal drugs can be a promising alternative to these synthetic drugs but they too have limitations. Recent advances in the nanotechnology field can be combined with herbal drugs to overcome the limitations. Research works done on topical nanophyto pharmaceuticals for anti-inflammatory activity were compiled and in all the studies, clear evidence is indicated for the increased penetration, distribution, and increased efficacy of phytopharmaceuticals when formulated into nano dosage forms. Considering the adverse effects and limitations of most widely used synthetic drugs, topical nano Phyto pharmaceuticals can play a pivotal role in the local and systemic delivery of promising phytoconstituents to a specific site of the body.

Inflammatory bowel disease (IBD) is a chronic and relapsing disease caused by a dysregulated immune response to host intestinal microbiota that occurs in genetically predisposed individuals. IBD encompasses two major clinical entities: ulcerative colitis (UC), limited to the colonic mucosa, and Crohn's disease (CD), which might affect any segment of the gastrointestinal tract. Despite the prevalence of IBD increasing worldwide, therapy remains suboptimal, largely because of the variability of causative mechanisms, raising the need to develop individualized therapeutic approaches targeted to each individual patient. In this context, patients-derived intestinal organoids represent an effective tool for advancing our understanding of IBD’s pathogenesis. Organoid 3D culture systems offer a unique model for dissecting epithelial mechanisms involved IBDs and testing individualized therapy, although the lack of a functional immune system and a microbiota, two driving components of the IBD pathogenesis, represent a major barrier to their exploitation in clinical medicine. In this review, we have examined how to improve the translational utility of intestinal organoids in IBD and how co-cultures of 3D or 2D organoids and immune cells and/or intestinal microbiota might help to overcome these limitations.

Hepatitis E is viral hepatitis caused by infection with the hepatitis E virus (HEV). This article aims to review HEV disease and recent advances in the management of hepatitis E. We used PubMed Clinical Queries and keywords of “hepatitis E”, “hepatitis E virus” AND “zoonosis” as the search engine. “Therapy”, “Clinical Prediction Guides”, “Diagnosis”, “Etiology” and “Prognosis” were used as filters, and “Narrow” scope was used. The search was conducted in April 2022. The information retrieved from the above search was used in the compilation of the present article. Hepatitis E is viral hepatitis caused by infection with the hepatitis E virus (HEV). Hepatitis E has mainly a fecal-oral transmission route. Hepatitis E infection usually follows an acute and self-limiting course of illness with low death rates in resource-rich areas; however, it can be more severe in pregnant women and immunocompromised people. The mortality rates in these groups are substantially higher. A vaccine for HEV is available but is not universally approved. Ribavirin remains the most efficacious medication for the treatment of HEV but is contraindicated in pregnancy. Sofosbuvir and pegylated interferon, with or without ribavirin, have not been shown in the latest literature reviews to provide reliable additional benefits to the treatment of hepatitis. Sofosbuvir should not be used as monotherapy for HEV. Food is an important source of infection in many countries while rats are the primary vector in developing nations. Management must include an understanding of the rat habitats for this zoonotic disease. Hepatitis E remains an important cause of hepatitis and a zoonotic disease globally. Public health policies are key to containing this viral infectious disease, including policy in the transfusion of blood products.

Background and Objective: Type 1 diabetes mellitus is a complex disease defined by the loss of pancreatic cells, which leads to complete insulin insufficiency. The Diabetes Control and Problems Trial defines the aims of Type 1 diabetes therapy as achieving adequate glycaemic control, and preventing and avoiding recurrent bouts of hypoglycaemia. Despite ongoing efforts to improve insulin therapy regimens, the actual hormone substitute therapy treats just the symptoms of the disease, with no influence on disease pathology or etiopathogenesis. In recent decades, there has been a lot of interest in preventative techniques in high-risk patients, based on the theory that if a therapeutic intervention is adopted early in the disease, it can help maintain endogenous cell function by protecting the remaining cell reservoir from autoimmune attack. Methods: Based on preclinical and clinical data, we have discussed some immunotherapeutic in this meta-analysis. We referred to the preclinical and clinical studies for teplizumab and rituximab from authentic databases and compiled the data. We used statistical analysis to do a meta-analysis. Results: In two immunotherapeutic anti-CD3 antibodies and anti-CD20 antibodies examples, teplizumab and rituximab, respectively, shows better efficacy as well as fewer side effects. We have discussed this drug briefly based on their mechanism of action and meta-analysis, which compare clinical efficacy. Conclusion: Immunotherapeutic can be a better option for preventing and protecting type one diabetes. Since, the existing literature does not have enough data to support any single drug concluding the same will not be appropriate. Hence further studies are required wherein different drugs can be compared with similar sample sizes for each group of drugs.

Background: SARS-CoV-2 infection has mild and asymptomatic to critical clinical course affecting mainly the lungs. Few case reports of COVID-19-associated pancytopenia are reported, but a series of 18 cases is not described in the literature to date. Aims and Objectives: This study aimed to investigate pancytopenia in COVID-19 and its correlation with severity and to explore the detailed clinical and biochemical information in COVID-19- associated pancytopenia. This study also highlights pancytopenia's rarity and prognostic value among COVID-19 patients. Materials and Methods: This was a retrospective observational study conducted in a tertiary care centre at a level 3 COVID care facility that included adults of either sex having positive RT PCR for COVID-19 from October 2020 to May 2021. Data were collected from the online outpatient department and hospitalized patients. Results: A total of 18 cases were included in the study; 13 were males (72.2%). The mean age was calculated as 48.56 years. Cases were categorized as severe 13 (72.2%) and non-severe 5 (27.8%) disease on the first day of pancytopenia. The most common presentations were fever 18 (100%) and cough 18 (100%), followed by generalized weakness 16 (88.9%), breathlessness 15 (83.3%), and diarrhoea 10 (55.6%). One case died in the severe disease group. The mean of haemoglobin, leukocyte count, and platelets in severe vs non-severe disease were calculated as 8.59 vs 8.74, 2339 vs 2578, and 77769 vs 88600, respectively. Conclusion: Pancytopenia was more prevalent in severe disease and age group 40-60 years. CAP was most likely due to secondary bone marrow suppression. It has no prognostic value for disease outcomes.

Background: Lymphocytic esophagitis (LE) is a poorly understood clinical finding that has been increasingly identified in the last decade. Previous studies proposed increased frequency of LE in elderly females, as well as associations with smoking and pediatric Crohn’s disease. Objective: We aimed to determine the patient characteristics and clinical features of our adult LE patients. As inflammation in the esophagus has been linked to cancer, this review also describes this association. However, there are no reported cases of malignant transformation in those with underlying lymphocytic esophagitis. Methods: We retrospectively reviewed records for patients at the University of Missouri Hospital- Columbia (located in the USA) who had a histopathological diagnosis of LE. Cases of LE were identified using the pathology reporting system at the University of Missouri Hospital for esophageal biopsy specimens for the above-mentioned period. Results: The data of a total of 20 adult cases with esophageal biopsy specimens consistent with LE were included. Conclusion:LE seems to be a benign but disturbing clinical problem and should be remembered in elderly females complaining of dysphagia or refractory reflux symptoms. It has similar endoscopic findings of eosinophilic esophagitis with rings and esophagitis. Smoking and hiatal hernia are common risk factors. The majority of LE patients can respond to proton pump inhibitor (PPI) therapy. Endoscopic dilations and steroid therapy should be considered for PPI nonresponder LE patients.