Oral Mucosal Immunization Recent Advancement and Exploit Dendritic Cell Targeting

Oral mucosal vaccine thrive significant interest in developing vaccines that evoke mucosal moreover systemic immune response i.e. induction of IgA. Oral immunization consistently preferred over conventional immunization because it provides strengthens inpatient acquiescence, needle-free delivery, cost-effective. Thereby strong antibody production at the mucosal site is not refreshing by parenteral administration of the vaccines. Antibodies produced on the mucosal surface instead of it also start common mucosal immune system (CMIS). Vaccines allow particulate delivery protection of antigen. Polylactic-co-glycolic acid, poly lactic acid loaded nanoparticles, liposomes, niosomes, dendrimers; proteosomes are some of the nanocarriers which protect the antigen from their degradation. Authentication concepts of various studies on the mucosal vaccine by using nanotechnology for targeting to dendritic cell presenting on Peyer's patch elicit antibody production. This review sums up current studies on mucosal vaccination by using nanocarrier. More of the studies have been done on mucosal for improvement in methodology. Keywords: Antigen, Nanotechnology, Dendritic cells, Peyer’s patch, Vaccin

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Secondary dentine as a sole parameter for age estimation: Comparison and reliability of qualitative and quantitative methods among North Western adult Indians

The indestructible nature of teeth against most of the environmental abuses makes its use in disaster victim identification (DVI). The present study has been undertaken to examine the reliability of Gustafson’s qualitative method and Kedici’s quantitative method of measuring secondary dentine for age estimation among North Western adult Indians. 196 (M = 85; F = 111) single rooted teeth were collected from the Department of Oral Health Sciences, PGIMER, Chandigarh. Ground sections were prepared and the amount of secondary dentine formed was scored qualitatively according to Gustafson’s (0–3) scoring system (method 1) and quantitatively following Kedici’s micrometric measurement method (method 2). Out of 196 teeth 180 samples (M = 80; F = 100) were found to be suitable for measuring secondary dentine following Kedici’s method. Absolute mean error of age was calculated by both methodologies. Results clearly showed that in pooled data, method 1 gave an error of ±10.4 years whereas method 2 exhibited an error of approximately ±13 years. A statistically significant difference was noted in absolute mean error of age between two methods of measuring secondary dentine for age estimation. Further, it was also revealed that teeth extracted for periodontal reasons severely decreased the accuracy of Kedici’s method however, the disease had no effect while estimating age by Gustafson’s method. No significant gender differences were noted in the absolute mean error of age by both methods which suggest that there is no need to separate data on the basis of gender

Morphology and age-related changes in calcospherites of human teeth: an ultrastructural study

Background: Dentine has been examined extensively for age-related physiological changes, but there are limited data on age-related changes at ultrastructural level of dentine. Aim: The present study aimed to examine age-related ultrastructural changes in calcospherites of human dentine under the scanning electron microscope. Materials and methods: Thirty single rooted teeth of North Western adult Indians (18–75 years) were collected from the Department of Oral Health Sciences, PGIMER, Chandigarh. Labiolingual sections were prepared and morphology of calcospherites was studied at different locations (coronal, cervical, midroot and apical) of the tooth. Results: Morphologically, four types (I [small, unfused and discrete], II [partially fused and globular], III [large, completely fused] and IV [structureless]) of calcospherites were seen in the sample. With advancing age, type I calcospherites approached neighbouring crystals and changed their form to type II, which ultimately coalesced and transformed to type III. Results revealed that among different age groups (young, middle and old), calcospherites of only type I, II and III showed statistically significant differences in their shapes using Pearson’s Chi-square test. Statistically non-significant differences were obtained in the shapes at different locations of the tooth. Conclusions: Results showed that calcospherites get fused as age advances. There is a change in the shape of calcospherites based on the location of the tooth

Characteristics and Outcomes for Secondary Breast Cancer in Childhood, Adolescent, and Young Adult Cancer Survivors Treated with Radiation.

BackgroundRadiotherapy is used to treat many adolescent and young adult (AYA) and childhood cancer patients and is a risk factor for secondary breast cancer. While premenopausal breast cancer is inherently more aggressive, no studies to date have evaluated the characteristics and breast cancer-specific survival (BCSS) of premenopausal secondary breast cancer after radiotherapy in AYA and childhood cancer survivors.MethodsFemale patients ages 12 to 50 diagnosed with primary breast cancer from 1988 to 2014 (n = 107,751) were obtained from the California Cancer Registry and compared with similar aged patients with secondary breast cancer who were treated with radiotherapy for their primary tumor (n = 1,147) from ages 12 to 39. We examined BCSS using multivariable Cox proportional hazards regression.ResultsThe secondary breast cancer cohort was more likely to be Hispanic or Black, be 35 to 45 years of age, have earlier stage tumors, be higher grade, have no lymph node involvement, and be hormone receptor negative. All women showed worse BCSS for large tumor size, lymph node involvement, and hormone receptor-negative status. BCSS was worse for women with secondary breast cancer both overall (hazard ratio, 1.98; 95% confidence interval, 1.77-2.23) and in all subgroups considered. Associations were most pronounced in Hispanics, Asian/Pacific Islanders, and younger women, as well as those with earlier stage, lymph node-negative, and hormone receptor-positive disease.ConclusionsBCSS is significantly decreased among all survivors of childhood and AYA cancer treated with radiotherapy that develop a secondary breast cancer, including women with good prognostic features.ImpactTherefore, we may need to consider alternative and even more aggressive treatment in what were considered low-risk populations previously