Different features in Wegener's granulomatosis: Report of five cases

Wegener's granulomatosis (WG) is an autoimmune inflammatory condition. It is often a rapidly progressive and potentially fatal disease. The clinical presentation of WG can be so diverse that the list of its differential diagnosis is vast, ranging from infectious diseases to other vasculitis (e.g. Behcet's disease), as well as malignancies. The exact aetiology of WG remains unclear. The upper airway diseases including sinusitis, oral lesions and otitis media are the most common presenting features of WG. In this paper, we have described 5 WG cases. They had different presentations and chief complaints. Some of them presented with upper airways diseases, while the others mainly suffered from the manifestations of pulmonary involvement. Although all of them were finally diagnosed as WG cases, the processes of the work up for the diagnosis as well as the outcome of the disease were not the same. So, the diversities in the presentation should be mentioned in the management of the WG suspected patients

The effect of rosa damascena Mill hydro-alcoholic extract on the ileum contraction in rat

Background and purpose: Rosa damascena Mill in Iranian folk medicine is used for treating digestive disorders. We assessed the antispasmodic effects of extract of the leaves of this plant on ileum contractions in Wistar rats; possible mechanisms were investigated, too. Materials and methods: In this experimental study, 48 male Wistar rats (150-200 g) were divided randomly into six groups of eight members, including control group and the groups received extracts of Rosa damascena Mill, propranolol, naloxone, L-nitro-arginine methyl ester (L-NAME), and calcium chloride. To evaluate the effectiveness mechanisms, ileum was placed adjacent to antagonist drugs of β-adrenergic receptors, opioid and inhibitor of the synthesis of nitric oxide, and also under the influence of different doses of calcium chloride. The observed effects were recorded. Then, the percent changes were calculated. Statistical analysis was done using parametric tests of repeated measuring design, ANOVA and t tests. Results: Cumulative extract of Rosa damascena Mill (100, 500 and 1000 mg/k) decreased ileum contractions induced by KCl (P < 0.0001). Propranolol and naloxone significantly decreased the inhibitive effect of the extract on contractions induced by KCl (P < 0.0010), but L-NAME was ineffective. Also, calcium led to the contraction of depolarized tissue through KCI and this contractile effect decreased significantly by the cumulative concentration of Rosa damascena Mill (P < 0.0010). Conclusion: Extract of Rosa damascena Mill probably decreases ileum movements of the rat through stimulating the β-adrenergic and opioid receptors and voltage-dependent channels, and it may be used to treat digestive disorders

A review on promising natural agents effective on hyperlipidemia.

Hyperlipidemia is a prevalent disease and a major component of the metabolic syndrome resulting from various factors. This disease increases morbidity and mortality when combined with other prevalent diseases such as diabetes mellitus, hypertension, and cardiovascular diseases. The side effects of the current lipid-lowering drugs have increased the tendency to move toward traditional and alternative treatments. Epidemiological observations indicate that using alternative treatments, consumption of medicinal plants, diet, and consumption of fruits have had satisfactory results on the effects of hyperlipidemia in many societies. It should be noted that in majority of societies, even developed countries, the tendency toward eating lipid-lowering medicinal plants has increased extensively. Using these plants especially when common remedies cannot control the disease is significant. Although consumption of medicinal plants by hyperlipidemic patients may show improvement in disease state, drug interaction and side effects may cause complications in disease control. Therefore, in this review, apart from introducing some of the reliable plants effective in inhibition and decrease of hyperlipidemia, the possibility of their intoxication and drug interaction is also presented

Targeted Reinforcement of Macrophage Reprogramming Toward M2 Polarization by IL-4-Loaded Hyaluronic Acid Particles

Alteration of macrophage polarization from inflammatory (M1) to anti-inflammatory (M2) phenotype can have striking implications for the regeneration of injured tissues, treatment of inflammatory diseases, and relief of autoimmune disorders. Although certain cytokines like interleukin (IL)-4 and IL-13 are capable of inducing M2 macrophage polarization, their therapeutic potential in vivo is suffering from low efficacy due to their instability and poor access to target cells. Here, we report the synthesis of IL-4-loaded hyaluronic acid (HA) particle for the targeted delivery of cytokines through the high affinity of HA to CD44 receptors of macrophages. HA carriers composed of low, middle, and high molecular weight (MW) polymers were synthesized using divinyl sulfone (DVS) cross-linking. The MW of HA had a negligible effect on the physicochemical properties and biocompatibility of the macrophages, but as an indicative of M2 polarization, a significant change in the arginase-1 (Arg-1) activity, TNF-a release, and IL-10 secretion was observed for the HA particles prepared with high MW polymers. Therefore, these particles were loaded with IL-4 for simultaneous macrophage targeting and M1 to M2 reprogramming, evidenced by a remarkable increase in the Arg-1 to iNOS ratio, as well as CD163 and CD206 upregulation in the M1 macrophages, which were initially triggered by lipopolysaccharide and interferon-y.M.-A.S. acknowledges financial support from Academy of Finland (Decision no. 317316), Iran’s National Elites Foundation and Iran Nanotechnology Initiative Council. T.B.-R. acknowledges financial support from the Fundação para a Ciência e a Tecnologia (Grant no. SFRH/BD/110859/2015). Financial support from the FEDER - Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020 Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through the FCT - Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Inovação in the framework of the project “Institute for Research and Innovation in Health Sciences” (POCI-01-0145-FEDER-007274) is acknowledged. H.A.S. acknowledges financial support from the Sigrid Jusélius Foundation (Decision no. 4704580), the Helsinki Institute of Life Science, and the Academy of Finland (Decision no. 1317042)

Fosfomycin: Mechanisms and the increasing prevalence of resistance

There are challenges regarding increased global rates of microbial resistance and the emergence of new mechanisms that result in microorganisms becoming resistant to antimicrobial drugs. Fosfomycin is a broad-spectrum bactericidal antibiotic effective against Gram-negative and certain Gram-positive bacteria, such as Staphylococci, that interfere with cell wall synthesis. During the last 40 years, fosfomycin has been evaluated in a wide range of applications and fields. Although numerous studies have been done in this area, there remains limited information regarding the prevalence of resistance. Therefore, in this review, we focus on the available data concerning the mechanisms and increasing resistance regarding fosfomycin. © 2019 The Authors