Liver and renal function profile of mucormycosis cases receiving amphotericin B - A retrospective study

Background: Mucormycosis is a serious infection that needs to be treated with prescription antifungal medicine, usually amphotericin B. In the study, we have analyzed the side effects of amphotericin B because studies have revealed that the drug has toxic effects both on the liver and the kidneys. Methodology: This is a retrospective study and was conducted using a record of mucormycotic patients who were admitted at GMERS Gotri Medical College and Hospital, Vadodara. We included the patients who were admitted to the hospital from June 1, 2021, to August 31, 2021. Three reports each of liver and renal function tests (LFT and RFT) were collected. These reports were entered into the excel sheet and a result was framed. Results: A total of 64 patients were reviewed with the infection of mucormycosis. Increase in bilirubin levels and serum glutamic pyruvic transaminase (significant rise) levels and decrease in albumin levels and albumin/globulin ratio were observed in LFT 2 and LFT 3 after initiating amphotericin B therapy. Similarly, a rise in serum urea and creatinine levels was observed in RFT 2 and RFT 3. The number of patients with altered serum sodium and potassium levels did not vary much in the three consecutive RFT reports. Conclusion: Amphotericin B drug does have adverse effects on the liver and kidneys. The three consecutive RFT and LFT reports revealed liver and kidney dysfunction due to damage induced by the drug. These led to altered levels of the factors included in the respective LFT and RFT reports

In vivo antiviral efficacy of LCTG-002, a pooled, purified human milk secretory IgA product, against SARS-CoV-2 in a murine model of COVID-19

ABSTRACTImmunoglobulin A (IgA) is the most abundant antibody (Ab) in human mucosae, with secretory form (sIgA) being dominant and uniquely stable. sIgA is challenging to produce recombinantly but is naturally found in human milk, which could be considered a global resource for this biologic, justifying its development as a mucosal therapeutic. Presently, SARS-CoV-2 was utilized as a model mucosal pathogen, and methods were developed to efficiently extract human milk sIgA from donors who were naïve to SARS-CoV-2 or had recovered from infection that elicited high-titer anti-SARS-CoV-2 Spike sIgA in their milk (pooled to make LCTG-002). Mass spectrometry determined that proteins with a relative abundance of 1% or greater were all associated with sIgA. Western blot demonstrated that all batches consisted predominantly of sIgA. Compared to control IgA, LCTG-002 demonstrated significantly higher Spike binding (mean endpoint of 0.87 versus 5.87). LCTG-002 was capable of blocking the Spike receptor-binding domain – angiotensin-converting enzyme 2 (ACE2) interaction with significantly greater potency compared to control (mean LCTG-002 IC50 154ug/mL versus 50% inhibition not achieved for control), and exhibited significant neutralization activity against Spike-pseudotyped virus infection (mean LCTG-002 IC50 49.8ug/mL versus 114.5ug/mL for control). LCTG-002 was tested for its capacity to reduce viral lung burden in K18+hACE2 transgenic mice inoculated with SARS-CoV-2. LCTG-002 significantly reduced SARS-CoV-2 titers compared to control when administered at 0.25 mg/day or 1 mg/day, with a maximum TCID50 reduction of 4.9 logs. This innovative study demonstrates that LCTG-002 is highly pure and efficacious in vivo, supporting further development of milk-derived, polyclonal sIgA therapeutics