The Effect of Grapex on Wounds Healing in Patients with Scleroderma: A Randomized Controlled Clinical Trial

Background and Aim: Scleroderma (SC) is a connective tissue disease, characterized by diffuse microangiopathy and excessive production of collagen. The current study aimed to investigate the effectiveness of Grapex extract in improving the wound of patients with scleroderma. Methods: This randomized controlled double-blind clinical trial was performed from 2018 to 2019 on patients with scleroderma referred to Golestan Hospital in Ahvaz, Iran. Forty patients with active SC were selected and randomly divided into two groups. Patients applied the ointment twice a day for 4 weeks on the surface of their wounds. After four weeks of using the cream, the rate of wound healing was determined by clinical examination of the wounds. Results: 6 people were excluded from the study due to the lack of referral and final analyzes were performed on 34 patients (16 patients in the control group and 18 patients in the case group). The results of this study showed that there was a significant difference between the two groups in terms of response to treatment (p <0.0001). At the end of the fourth week, 88.89% of the patients in the case group (16 of the 18 patients) achieved complete healing of the wounds in comparison with 18.75% of the control group (3 of the 16 patients). Neither the control group nor the case group had a significant association between response to treatment with age and gender of patients, type of scleroderma, duration of illness, and symptoms. Conclusion: This study showed the effectiveness of Grapex cream ointment in healing scleroderma wounds. Therefore, Grapex cream is an effective, inexpensive, safe, and available medicine that can be used to accelerate wound healing in patients with scleroderma. *Corresponding Authors: Elham Rajaei, Email: [email protected] Please cite this article as: Hemmati AA, Deris Zayeri Z, Rajaei E, Ghanavati M. The Effect of Grapex on Wounds Healing in Patients with Scleroderma: A Randomized Controlled Clinical Trial. Arch Med Lab Sci. 2021;7:1-10 (e1). https://doi.org/10.22037/amls.v7.3105

Implications of Complement Imbalance in COVID-19: A Molecular Mechanistic Discussion on the Importance of Complement Balance

Two central questions in COVID-19 treatment which should be considered are: “How does the imbalance of the complement system affect the therapeutic approaches?” and “Do we consider complement inhibitors in therapeutic protocols?”. The complement system is a double-edged sword since it may either promote immune responses against COVID-19 or contribute to destructive inflammation in the host. Therefore, it is crucial to regulate this system with complement inhibitors. In this manuscript, we discuss the molecular mechanisms of complement and complement inhibitors in COVID-19 patients. We searched the terms “COVID-19”, “Complement”, “Complement inhibitor”, “SARS-CoV-2”, and all complement fragments and inhibitors from 2000 to 2022 in PubMed and google scholar and checked the pathways in “KEGG pathway database”. Complement is not well-appreciated in the treatment protocols despite its multiple roles in the disease, and most of the preventive anti-inflammatory therapeutic approaches did not include a complement inhibitor in COVID-19 therapeutic protocols. In this review article, we discussed the most recent studies regarding complement components mediated interventions and the mechanism of these interventions in COVID-19 patients. Since the control of the complement system overactivation is associated with a better prognosis in the initial stages of COVID-19, heparin, anti-thrombin, C1-inhibitor, montelukast, and hydralazine can be effective in the initial stages of this viral infection. Recombinant complement activation (RCA) proteins are more effective in regulating complement compared to terminal pathway therapeutic approaches such as the C3a and C5a inhibitors

An Update on the Tissue Renin Angiotensin System and Its Role in Physiology and Pathology

In its classical view, the renin angiotensin system (RAS) was defined as an endocrine system involved in blood pressure regulation and body electrolyte balance. However, the emerging concept of tissue RAS, along with the discovery of new RAS components, increased the physiological and clinical relevance of the system. Indeed, RAS has been shown to be expressed in various tissues where alterations in its expression were shown to be involved in multiple diseases including atherosclerosis, cardiac hypertrophy, type 2 diabetes (T2D) and renal fibrosis. In this chapter, we describe the new components of RAS, their tissue-specific expression, and their alterations under pathological conditions, which will help achieve more tissue- and condition-specific treatments

Comparison of zinc, copper, selenium, magnesium, aluminium and lead blood concentrations in end-stage renal disease patients and healthy volunteers in Ahvaz, southwest of Iran

Introduction ― Heavy metal storage and essential elements deficiency are two important issues in dialysis patients. Geographic region and dietary habits might affect essential trace elements concentration in body. Trace elements (TEs) status has not been studied previously in dialyzed patients in Ahvaz city. The aim of this study is to compare blood concentrations of six TEs between dialysis patients and normal group in Ahvaz, the center of Khuzestan province, in southwest of Iran. Material and Methods ― We studied 33 end-stage renal disease (ESRD) patients and 33 normal cases. TEs assayed in serum samples, except lead, which assessed in whole blood. We used atomic absorption spectroscopy in this pressure. We used ANOVA and Tukey-HSD statistical analysis as well as binary logistic regression for calculating Odds ratio. Results ― There was a significant difference between case and control groups for magnesium (Mg), aluminium (Al) and lead (Pb) (P0.05). Zinc (Zn) level change was not significant. Al and Pb level increased after dialysis but Mg level decreased. All calculated Odds ratios were weak for all investigated trace elements. Different results published about TEs level in ESRD patients. Increase in TEs level in case group may be as a result of chronic poisoning through dialysis and after dialysis hemoconcentration, respectively. In order to understand the exact reason of this observation we need comprehensive and monitored studies. TEs disturbances in Ahvaz ESRD patients imply the importance of periodically studies. Conclusion ― The most important interpretations and suggestions of this study is that the TEs level is different among different population. Then, Iranian health-providers should consider to TEs assessment in both healthy and patient cases. Periodical measurement of TEs is essential for ESRD patients and it can be helpful in preventing TEs deleterious effects

A Review of SARS-CoV-2 Genetic and Structure: Hot Cellular Targets for Virus Entry: Genetic and structure of COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses several molecules such as angiotensin-converting enzyme 2 (ACE2), cluster of differentiation 26 (CD26), Ezrin, and Neuropilin-1 (NRP-1) for viral entry. In this review, the entire structural and genomic combination and the mechanism of virus entry, are discussed. This study might be useful for further drug design studies. SARS-CoV-2 neutralization allows the immune system to fight the virus before its entry. COVID-19 enters the host bloodstream by infecting endothelial cells via a cluster of differentiation 147 (CD147). SARS-CoV-2 not only uses ACE2 for its entry but also affects ACE-2 and its enzymatic activity on Ang II and bradykinin, it also imbalances the RAAS and bradykinin system and elevates the inflammation. High levels of bradykinin, cause nonproductive cough as the result of fluid extravasation and leukocyte recruitment to the lung. Accordingly, we suggest replicase transcriptase complex (RTC) and specific non-structural proteins (Nsps) such as Nsp7,8, Nsp10, Nsp12, and Nsp16 are perfect targets of study because RTC and Nsps are the golden elements in the maintenance of COVID-19 appearance and masking. Base on this evidence COVID-19 uses various receptors for its entry and it might block these receptors' activity to evade the immune system and spread to other cells. *Corresponding Authors: Elham Rajaei, Email: [email protected]; ORCID: https://orcid.org/0000-0002-8231-0138 Please cite this article as: Torabizadeh M, Ghobadi Dana V, Aghapour SA, Zibara K, Deris Zayeri Z, Rajaei E. A Review of SARS-CoV-2 Genetic and Structure: Hot Cellular Targets for Virus Entry. Arch Med Lab Sci. 2021;7:1-9 (e15). https://doi.org/10.22037/amls.v7.3421

Association of erythrocyte sedimentation rate and C-reactive protein and clinical findings with HLA-DQ8 allele in Rheumatoid Arthritis patients

Background ― Rheumatoid arthritis (RA) is an inflammatory, autoimmune disease induced by certain auto-antigens. HLA-DRB1*0401 allele has a significant relationship with RA incident. Additionally, DQβ1*0301, *302(DQ8), *303, and *304 can increase RA risk especially in DQA1*0301 and *302 coincident. Recent studies suggest that distribution of this allele is different in various populations Material and Methods ― 70 patients and 70 healthy controls were analyzed for human leukocyte antigen (HLA) allele by specific primer-polymerase chain reaction (SSP-PCR) method. Patients were evaluated in terms of ESR and CRP. Data analysis was performed in SPSS V.17. Results ― HLA-DQ8 allele was significantly more frequent in RA patients compared to control (P<0.0001). However, no significant relationship was observed between increased ESR (P=0.527), CRP (P=0.505), and mean counts of arthritic (P=0.691) and tender joints (P=0.669) among the patients who were carriers of HLA-DQ8. Conclusion ― There is a significant association between RA and HLA-DQ8 allele, this allele can increase susceptibility to RA. These findings might relate to the ethnical variations of RA patients but we couldn’t find a significant association between CRP and ESR with HLA-DQ8. We recommend to add specific inflammatory markers to CRP as well as assess ESR in larger sample sizes to obtain accurate results