Dietary Immunomodulators - An Organic Boom in the Management of Chronic Diseases

Immunology involves all the defence mechanisms occurring in the body after the invasion of any infectious agent and the ability to resist this infection. The micronutrients like essential proteins, essential amino acids, vitamins (A, B6, B12, C, D, E and folic acid), fatty acids, minerals (iron, selenium, zinc and copper) and certain phytochemicals are of prime importance towards healthy immune system. In addition to these nutritional components, intestinal microflora and certain bacteria (probiotic bacteria) also play an important role in the modulation of healthy immune system. There is an ongoing trend of usage of immunomodulators to combat various chronic diseases like viral diseases, cancers, inflammatory and autoimmune diseases. This review focuses on various immunomodulators available in daily dietary meals, its positive and negative effects on immune system and its role in management of chronic illness as an adjunct to other modalities to achieve positive health benefits with minimal side effects.

Versatile Use of Mycobacterium indicus pranii (MIP) Vaccine

Mycobacterium indicus pranii (MIP) earlier known as Mw is a soil-borne, non-pathogenic, saprophytic and rapidly growing strain of mycobacteria. MIP is approved as a vaccine/ immunomodulator for various indications including mycobacterium infections like leprosy in humans. Its administration has resulted in satisfactory clinical improvement, accelerated bacillary clearance, and increased immune responses to Mycobacterium leprae antigens, thereby shortening the full recovery time of the patients. It also shares its antigens with M.tuberculosis. In the last decade, RCTs have been done establishing immunotherapeutic properties of MIP in the treatment of leprosy, tuberculosis, warts and experimently in leishmaniasis. Through its immune inducing and cytotoxic property, it has also proved beneficial for human use especially in treating lung cancer. The beneficial role of it is also being explored in breast, cervical, oral, liver, and bladder cancers. Various studies on MIP have shown that it has immune-modulating properties in humans. The curiosity of the human mind has led to it being tried in Covid treatment trials. The results have shown that administering MIP has lowered inflammatory markers in Covid 19 patients, promising us for it to be a potential treatment option. More RCTs with a larger sample size should be done to establish this. Cytokine storm seen in bacterial sepsis is also decreased with MIP administration. Considering the encouraging results in hastening recovery in various diseases it appears that MIP is perhaps not being exploited to its fullest potential

Effect of continuous blood purification on immunity and endothelial cell function in patients with sepsis / 中华危重病急救医学

Objective:To explore the effect of continuous blood purification (CBP) on the immunity and endothelial cell function of patients with sepsis.Methods:A prospective study was conducted. The patients aged ≥18 years old and meeting the diagnostic criteria of sepsis admitted to the department of critical care medicine of Binzhou Medical University Hospital from March 2019 to October 2020 were selected as the research subjects, and the patients were divided into standard treatment group and CBP treatment group according to random number table method. Both groups were given standard treatment including initial fluid resuscitation, infection source control and antibiotics according to the 2016 international guidelines for the management of sepsis and septic shock. CBP treatment group was additionally given continuous veno-venous hemofiltration (CVVH) at a dose of 25-30 mL·kg -1·h -1 and blood flow rate of 150-200 mL/min for more than 20 hours a day for 3 days. The clinical data of patients including blood lactic acid (Lac), procalcitonin (PCT), lymphocyte count (LYM), acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, sequential organ failure assessment (SOFA) score were recorded before treatment and 1 day and 3 days after treatment. At the same time, the venous blood was collected, and the immune function related indexes [interleukins (IL-4, IL-7), programmed death receptor-1 (PD-1), programmed death ligand-1 (PD-L1), interferon-γ (IFN-γ)] and endothelial cell injury related markers [soluble thrombomodulin (sTM), angiopoietin-2 (Ang-2), von Willebrand factor (vWF), heparan sulfate (HS), syndecan-1 (SDC-1)] levels in serum were determined by enzyme-linked immunosorbent assay (ELISA). The length of intensive care unit (ICU) stay of patients in the two groups was recorded, and the outcomes of patients in the two groups were followed up for 28 days. Results:Finally, 20 patients were enrolled in the standard treatment group, and 19 patients were enrolled in the CBP treatment group. There were no significant differences in gender, age and infection site between the two groups. The length of ICU stay in the standard treatment group was (10±5) days, and 5 patients died and 15 patients survived after 28 days. The length of ICU stay in the CBP treatment group was (9±4) days, and 8 patients died and 11 patients survived after 28 days. There were no significant differences in the length of ICU stay and number of patients who died within 28 days between the two groups (both P > 0.05). There were no significant differences in the Lac, PCT, LYM, APACHEⅡ score, SOFA score and immune function and endothelial cell injury related indexes before treatment and 1 day after treatment between the two groups. After 3 days of treatment, the Lac, PCT, APACHEⅡ score and SOFA score of the CBP treatment group were significantly lower than those before treatment, and pro-inflammatory and anti-inflammatory cytokines such as IFN-γ and IL-4, apoptosis-related indicators such as PD-1 and IL-7, and endothelial injury related factors such as sTM, SDC-1 and HS were significantly improved compared with the pre-treatment, the improvement degree of the above indicators was more obvious than that of the standard treatment group, and LYM was significantly higher than that of the standard treatment group (×10 9/L: 1.3±0.3 vs. 0.9±0.4, P < 0.05), IL-4, IFN-γ, IFN-γ/IL-4 ratio, IL-7, PD-1, sTM, SDC-1, HS, and Ang-2 were significantly lower than those of the standard treatment group [IL-4 (ng/L): 2.8 (1.5, 3.2) vs. 3.3 (2.7, 5.2), IFN-γ (ng/L): 6.3 (5.4, 106.5) vs. 217.9 (71.4, 517.1), IFN-γ/IL-4 ratio: 3.7 (1.8, 70.3) vs. 59.1 (18.3, 124.9), IL-7 (ng/L): 4.6 (3.2, 5.1) vs. 6.3 (5.2, 8.0), PD-1 (μg/L): 0.04 (0.03, 0.06) vs. 0.08 (0.05, 0.12), sTM (μg/L): 4.9 (4.3, 7.4) vs. 8.7 (6.0, 10.8), SDC-1 (μg/L): 0.6 (0.3, 1.1) vs. 0.9 (0.8, 2.5), HS (ng/L): 434.8 (256.2, 805.0) vs. 887.9 (620.1, 957.3), Ang-2 (ng/L): 934.0 (673.3, 1 502.1) vs. 2 233.9 (1 472.5, 3 808.4)], the differences were statistically significant (all P < 0.05). Conclusion:CBP treatment can eliminate the patient's immunosuppressive state, reduce a variety of endothelial injury markers and the degradation of glycocalyx, but cannot decrease the 28-day death risk or shorten the length of ICU stay.

Advances in the Treatment of Glucocorticoid Resistance and Relapsed Immune Thrombocytopenia --Review / 中国实验血液学杂志

Immune thrombocytopenia (ITP) is an immune-mediated acquired hemorrhagic autoimmune disease. At present, the first-line therapeutic drugs for ITP include glucocorticoids and intravenous immunoglobulins. However, about 1/3 of the patients had no response to the first-line treatment, or relapsed after dose reduction or withdrawal of glucocorticoids. In recent years, with the gradual deepening of the understanding on the pathogenesis of ITP, the drugs targeting different pathogenesis continually emerge, including immunomodulators, demethylating agents, spleen tyrosine kinase (SYK) inhibitors and neonatal Fc receptor (FcRn) antagonist. However, most of these drugs are in clinical trials. This review summarized briefly the recent advances in the treatment of glucocorticoids resistance and relapsed ITP, so as to provide reference for the clinical treatments.

Influência do açafrão (Curcuma longa) na melhoria dos parâmetros biológicos e comportamentais: uma revisão narrativa / Influence of turmeric (Curcuma longa) on the improvementof biological and behavioral parameters: a narrative review

O papel dos produtos naturais, em especial os nutracêuticos, vem ganhando destaque nos últimos anos devido aos efeitos positivos em parâmetros relacionados à saúde. O açafrão é uma espécie originária do sudeste da Ásia e considerado uma preciosa especiaria. Além da principal utilização como condimento, possui substâncias com atividades antioxidante, antimicrobiana e corante, que lhe conferem possibilidade de emprego nas áreas de cosméticos, têxtil e alimentícia, sendo também muito utilizado nas medicinas tradicionais chinesa e indiana. Seu principal composto fenólico, a curcumina, tem sido amplamente estudado, por apresentar uma variedade de propriedades para a saúde, como efeitos antioxidantes, anti-inflamatórios, antivirais, antibacterianos, antidepressivos e anticancerígenos e, assim, potencial de ação contra várias doenças crônicas. Portanto, o objetivo do presente estudo foi revisar os efeitos do açafrão nos parâmetros biológicos e comportamentais, bem como sua utilização na manutenção da saúde e qualidade de vida dos indivíduos.

The role of natural products, especially nutraceuticals, has been gaining prominence in recent years due to their positive effects on health-related parameters. Turmeric is a species native to Southeast Asia and considered a precious spice. In addition to its main use as a condiment, it has substances with antioxidant, antimicrobial, and coloring activity, which give it the possibility of being used in the areas of cosmetics, textiles, and food; It is also widely used in traditional Chinese and Indian medicine. Its main phenolic compound, curcumin, has been widely studied, as it has a variety of health properties, such as antioxidant, anti-inflammatory, antiviral, antibacterial, antidepressant and anticancer effects and, thus, potential for action against various chronic diseases. Therefore, the objective of the present study was to review the effects of saffron on biological and behavioral parameters, as well as its use in maintaining the health and quality of life of individuals.

Management of COVID-19 patients, with emphasis on limited resource setting:is less optimum?

Background:There is scarcity of essential medications, medical talent and health care facilities to treat covid-19, at remote places. This studyexplores various modalities in resource-limited settings for the management of COVID-19 patients.Methods: We retrospectively analysed data of 266 consecutive discharged and death Covid-19 patients from 26December 2020 to 29May 2021. All patients were admitted and received appropriate supportive care, regular clinical and laboratory monitoring.Results: Of total 266 patients the mean age of patients was 49.19 (SD 14.1) years and 185(69.54%) of them were males. 99(37%)cases were moderate, 83(31%)were severe cases remaining 84(32%)were mild cases. 16 (6.01%) patients expired and remaining 250 patients were subsequently discharged.Median duration of stay in the hospital was 9 (37) days. Of total 266 admitted patients� mortality rate was only 6.01%.Conclusions: We emphasize that even in healthcare facilities with limited resource, poor infrastructure and lack of ICU facilities, clinical observation-based managementt can help to reduce mortality considerably. Unique features of our study include; use of progesterone as an immunomodulator, use of dual antiviral agents, use of age-related lower limit of oxygen saturation.

CCS e amiloide A do leite de quartos mamários tratados na secagem com plasma rico em plaquetas autólogo, associado ou não a antibiótico / [CCS and Amyloid A of milk from breast quarters treated in drying with autologous platelet-rich plasma, with or without antibiotics]

Este estudo teve como objetivo avaliar biomarcadores de mastite após terapia da secagem com plasma rico em plaquetas (PRP), associado ou não a antibiótico. Trinta e seis quartos mamários foram utilizados em três tratamentos (T): T1 - antibiótico (ATB), T2 - PRP e T3 - PRP + ATB. Amostras de leite foram coletadas antes da secagem (A1), no parto (D0) e 14, 30 e 60 dias pós-parto (D14, D30 e D60), para determinar contagem de células somáticas (CCS) e amiloide A (AA). O delineamento foi inteiramente ao acaso, com arranjo em parcelas subdivididas (SigmaPlot®). Dados de CCS foram transformados (log 10). As médias foram comparadas utilizando-se testes de Tukey ou Holm-Sidak (P<0,05). A CCS em A1 foi elevada em todos os grupos (P>0,05). No D30, CCS foi maior em T2 (P<0,05), igualando-se no D60. Não houve diferença na AA entre Ts em qualquer dia de coleta (P>0,05). Houve diferença nos momentos de coleta (P<0,05), A1 maior que D14 e D30. Houve uma correlação positiva fraca com CCS (0,280). Os tratamentos foram semelhantes em manter a saúde da glândula mamária na lactação subsequente. O PRP intramamário pode ser usado para terapia de vaca seca em casos de mastite subclínica.(AU)

This study aimed to evaluate biomarkers of mastitis after autologous platelet rich plasma (PRP) dry cow therapy, associated or not with antibiotic, compared to conventional treatment. Thirty-six mammary quarters were used in three treatments (T): T1 - antibiotic, T2 - PRP and T3 - PRP + ATB. Milk samples were collected before drying (A1), on calving (D0) and at 14, 30 and 60 days postpartum (D14, D30 and D60), for Somatic Cell Count (CCS) and amyloid dosage A (AA). The design was completely randomized with arrangement in subdivided plots (SigmaPlot ®). Data from CCS were transformed in log10. Means were compared using the Tukey or Holm-Sidak tests, at a 95% confidence level (P<0.05). CCS in A1 was elevated in allgroups (P>0.05). On D30 CCS was higher in T2 (P<0.05), matching D60. There was no difference in AA among T on any day of collection (P>0.05). There was difference in collection moments (P<0.05), A1 different from D14 and D30. There was a weak positive correlation with CCS (0.280). Three treatments were similar in maintaining the health of the mammary gland at subsequent lactation. PRP intramammary can be used for dry cow therapy in subclinical mastitis.(AU)

Immunomodulatory Effects of Zinc as a Supportive Strategies for COVID-19

Coronaviruses 2019 (Covid-19) is a massive family of viruses that causes respiratory illnesses ranging from the common cold to the most severe conditions such as Middle East Respiratory Syndrome and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that represents the humanitarian crisis on a global scale. Currently, there are no therapeutic strategies approved by the U.S.Food and Drug Administration (FDA) to cure or prevent COVID-19. Global researchefforts from around the world extrapolate the updates focusing specifically on the biphasic nature of Covid-19 that involve both innate and acquired immunity. Even though researchers around the globe are racing to invent a life-saving therapeutics and vaccines to tackle COVID-19, the only available venture is a supportive approach in rendering treatment to patients with severe and non-severe cases of COVID-19. Supplementation of several vitamins and trace elements showed the expected favorable impact on enhancing immunity in viral infection. Numerous studies prompted the value of zinc (Zn) supplementation that prevents the virus from entering cells by binding with protein in potentiating antiviral immunity, which is realized through different mechanisms, including the improvement in markers of immune function. Zinc is also an associated factor for several enzymes (needed for the activity for over 300 enzymes), transcription factors, and replication factors. Interestingly, low-level zinc results in dysfunction of all immune cells, subjects with altered zinc state have a high risk for infectious disorders, autoimmune disorders, and cancer. Several assumptions regarding immunomodulators of zinc remain unresolved. This review aimed to explore the hypothetical association of Zinc supplementation (the key immunomodulator) in association with a preventive and therapeutic role of treating patients with COVID-19

Antioxidant and immunomodulatory properties of Spilanthes oleracea with potential effect in chronic fatigue syndrome infirmity

Background: Chronic fatigue syndrome (CFS) holds a mystery for researchers due to its multifactorialnature; hence, its diagnosis is still based on symptoms and aetiology remains obscured. Number ofscientific evidences regarding the role of oxidative stress, immune dysfunction in CFS and alleviation ofsymptoms with the help of nutritional supplements guided us to study effect of ethanolic extract ofSpilanthes oleracea (SPE) in CFS.Objectives: Present study was designed to evaluate antioxidant, immunomodulatory properties of S.oleracea flower to ameliorate CFS infirmity in mice.Materials and method: In order to induce fatigue, experimental animals were stressed by chronic water eimmersion stress model. Meanwhile, parameters like immobility period and tail withdrawal latencywere assessed. On the 21st day, mice blood was collected and they were immediately sacrificed forbiochemical estimations.Results: Biochemical analysis results revealed that CFS elevates lipid peroxidation, nitrite level and diminishes the endogenous antioxidant enzyme like catalase level in stressed animal’s brain homogenate.Stressful condition developed muscle fatigue leading in alteration of lactate dehydrogenase level (LDH),Blood urea nitrogen (BUN) and Triglycerides (TG) levels. Concurrent and chronic treatment of SPE for 21days restored all these behavioural despairs and associated biochemical adaptation in mice in dosedependent manner.Conclusion: The outcome of this study indicates ability of SPE in amelioration of CFS by mitigating theoxidative stress and thus provide a powerful combat against CFS which may be due to its antioxidant andimmunomodulatory properties.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V

Progress in the treatment of multiple myeloma / 中国临床药理学与治疗学

Multiple myeloma is a malignant tumor that occurs in plasma cells. Clonal plasma cells in bone marrow proliferate abnormally and secrete monoclonal immunoglobulin or its fragment (M protein), resulting in damage to related organs or tissues. At present, with the development of new drugs, the development of cellular immunotherapy and the improvement of hematopoietic stem cell transplantation technology, the depth of remission and survival of multiple myeloma are significantly prolonged. This article reviews the latest advances in the treatment of multiple myeloma in recent years.

A prospective randomized controlled trial showing efficacy of luteal phase low molecular weight heparin in fresh non-donor IVF/ICSI cycles in women with previous implantation failures

Background: Implantation failure is a major challenge in in-vitro fertilization (IVF) cycles. The present study was undertaken to determine the immunomodulatory effects of heparin in patients with previous implantation failures undergoing assisted reproductive techniques (ART).Methods: This was a prospective randomized controlled trial with sample size of 100 patients who had history of at least one previously failed IVF/ICSI. Study group of 50 patients received heparin and 50 patients in control group received routine luteal phase support.Results: Primary outcome of the study was implantation rate (IR) which was 11.03% in the study group was and 5.48% in the control group (p=0.08). Biochemical pregnancy rate and clinical pregnancy rate in the study group was 18% and 12% in the control group (p=0.401). Calculated live birth was 5.15% and 3.42% in the study and control groups respectively (p=0.562). 11 babies were taken home from the study group and 6 from the control group (p=0.18).Conclusions: The result of this pilot study showed relative increase in implantation rates (IR) suggesting beneficial effects of heparin in patients with repeated implantation failures. Although these changes are not statistically significant, the presence of an increasing trend in all the outcome parameters signify the possible benefits of heparin proving for the present study hypothesis.

Lentigo maligno tratado con imiquimod 5%. Presentación de un caso y revisión del tema / Malignant Lentigo treated with imiquimod 5%. Presentation of a case and review of the subject

Resumen El lentigo maligno (LM) es una variante de melanoma in situ que se desarrolla principalmente en áreas de exposición solar crónica en pacientes de etnia blanca, de edad media-avanzada. Sin tratamiento, del 5% hasta el35% de los LM pueden progresar a un melanoma lentigo maligno (LMM). Aunque el tratamiento de elección es quirúrgico, el imiquimod aparece como una opción no invasiva viable. Suele indicarseen pacientes con tumores de gran tamaño, personas de edad avanzada o con patología de base, o que simplemente rechazan la extirpación quirúrgica de la lesión, especialmente por ser desfigurante. Se presenta una paciente con LM tratada satisfactoriamente con imiquimod tópico.

Abstract Malignant lentigo (LM) is a variant of in situ melanoma that develops mainly in areas of chronic sun exposure in middle-aged patients. Without treatment, 5% to 50% of the LM can progress to a lentigo maligna melanoma (LMM). Although the treatment of choice is surgical, imiquimod seems to be a viable and non-invasive option in patients with large tumors, elderly or people with underlying disease, or who simply reject the surgical removal of the lesion. We present a case of LM satisfactorily treated with topical imiquimod.

Progress in lactic acid-mediated maintenance of healthy vaginal microecology / 中华微生物学和免疫学杂志

Lactic acid is the main substance produced by Lactobacillus and plays an important role in maintaining a healthy vaginal microecology. Recent studies indicates that both L- and D-chiral isomers of lactic acid can be protonated and destroy the cell membranes of pathogens, thereby inhibiting bacterial vagi-nosis- and aerobic vaginitis-related pathogens. Lactic acid also can inhibit the pathogens of sexually transmit-ted diseases such as Chlamydia trachomatis and human immunodeficiency virus. Moreover, lactic acid acts as an immunomodulator to inhibit the inflammatory responses caused by pathogenic microorganisms and as an epigenetic regulator regulating gene expression in vaginal epithelial cells. In this paper, we reviewed the pro-gress in lactic acid-mediated maintenance of a healthy vaginal microbiology in recent years for providing ref-erence for further research.

Antagonistic Effect of Biosynthesized AgNPs from Garcinia Atroviridis Extract on Anti-inflammatory Properties of CD4+ILRhigh Cells from Non Obese Resistance (NOR) Mouse Model

@#Introduction: CD4+CD25+ Foxp3+ T regulatory cell (Tregs) represents approximately 8-10% of the total CD4+ T cell population and are important for immune homeostasis and preventing autoimmune development. Thus, harnessing their functions as immune modulator may be coupled with the rapid advancement of nanotechnology development. Plant-mediated biosynthesis of silver nanoparticle (AgNP) is noteworthy due to simplicity, rapid rate and potentially render more biocompatibility with biomolecules. This study identified the effect of biosynthesized-AgNPs from Garcinia atroviridis (GA) in modulating inflammatory properties of Treg cells in Non-Obese Resistant (NOR). GA extract was used to biosynthesized AgNPs and was tested on the effect of inducing inflammatory properties in CD4+IL17Rhigh cells following 72hr in vitro treatment. Methods: Conventional CD4+CD25-Foxp3- cells from female NOR mice were sorted using magnetic separation and cultured in RPMI in the presence of anti-CD3/CD28 antibodies, TGF-β and IL-2 cytokines. Cells were then treated with or without GA-AgNPs for 48hr of iTreg cell induction and then re-cultured with new media treated with respective treatments received. After 72hr in vitro culture, cells were stained with fluorochrome-conjugated antibodies for flow cytometry. Results: Current result showed that AgNPs suppress CD4 expression in CD4+IL17Rhigh population. MAPK pathway proteins remain unchanged in both control and AgNP-treated groups. Conclusions: The preliminary findings may suggest the properties of GA-AgNPs in modulating CD4+ T cell population in normal condition. Further studies are necessary to elucidate the molecular mechanisms involve in such interaction. Current findings serve as basis in further identifying the immunomodulatory profile of nanoparticle for potential therapeutic use.

Maintenance therapy of multiple myeloma: is there a best drug or combinations ? / 白血病·淋巴瘤

Multiple myeloma (MM) is a kind of common hematologic neoplasms. The application of new drugs and autologous hemopoietic stem cell transplantation can significantly improve the response rate of MM. However, as it is impossible to eradicate the minimal residual disease, recurrence is unavoidable. Maintenance therapy has the potential to increase remission degree, thus lengthening the progression-free survival and overall survival time of MM patients.

Theories and clinical applications of biochemotherapy for malignant carcinomas / 中国肿瘤临床

Chemoimmunotherapy or biochemotherapy, the combination of chemotherapy with immunotherapy, is a novel compre-hensive treatment model for malignant carcinoma. In recent years, many clinical trials have shown that biochemotherapy is associated with an improved response rate. Such biological agents include tumor vaccines, monoclonal antibodies, cytokines, and immunocompe-tent cells. In this article, we review the theories, sort the clinical applications of novel treatments, and discuss some of the problems existing in this field.

Investigation of Convaren’s stimulating effect on immune organs of mice.

Background: Investigation of Convaren’s immunostimulating action on white mice used to prove its effectiveness as a new immunomodulatory drug that then may be used by humans for treatment of infectious, tumor, systemic, and other diseases followed by decrease of immune system function. Methods: In this investigation were observed immunomodulating effects of Convaren on immune organs of mice (spleen, thymus, mesenteric lymph nodes, bone medulla). All effects were estimated due to the amount of antibody producing cells (APC) in their spleen, amount of APC calculated on whole organ and on 106 spleen cells, amount of nucleus containing spleen cells, common amount of nucleus containing cells in thymus, mesenteric lymph nodes, and bone medulla. Results: Convaren in doses 50 and 100 mg/kg significantly increases amount of cells in thymus and bone medulla, but significant increase of cell amount in lymph nodes was observed just with dose 50 mg/kg. It shows that dose 50 mg/kg is optimum, with which the cell proliferation processes in central and peripheral immune organs are expressed maximally. Smaller dose of Convaren has a little better stimulating effect than the higher one. Conclusions: New drug Convaren has a high immunostimulating activity in mice’s organisms. Due to its low toxicity, availability of raw materials and not hard production and transportation Convaren may be a cost-effective drug for the Asian region.

Methotrexate in type 1 diabetes mellitus:advances research / 军事医学

Type 1 diabetes mellitus(T1DM),also known as insulin dependent diabetes mellitus (IDDM), is classified as an autoimmune disease.Academia currently define it as one of the important autoimmune diseases(IAIDs).The most significant pathophysiological characteristics of T1DM are the pathological humoral and cellular autoimmune response which results in damage to pancreaticβ-cell and absolute reduction insulin.Thus, the mainstream traditional therapy for T1DM has been to chronically replenish insulin or substitutes.Nevertheless, this approach may generate a number of side effects, especially hypoglycemia reaction, hypoglycemic coma and insulin resistance.In recent years, the clinical use of methotrex-ate(MTX) as an immunity inhibitor or regulator aiming at pathogenesis of T1DM has received increasing attention and will become another significant case where an old drug is used for new purposes.The advances in research on MTX in T1DM are discussed in this paper.

Research development and effect of immunomodulator in the treatment of asthma / 中国小儿急救医学

Bronchial asthma is the most common chronic disease in children.In recent years,the inci-dence of bronchial asthma is rising and seriously harmed to the public health,has been gained comprehensive attention in community and scholars.With the in-depth study of the pathogenesis of asthma,the immunologi-cal dysfunction caused by disordered Th1 /Th2 cell play a major role in the pathogenesis of asthma,and im-munotherapy for its pathogenesis has also made great progress,which is expected to become the safer,more effective and more specific treatment.Currently immunomodulator for the treatment of asthma can be divided into four categories according to the source:microbial agents,biological agents,herbal or plant origin and syn-thetic agents.Microbial agents which include BCG,Pan Fu Shu,biologics including Th2 receptor antagonist, Th1 cytokines,anti-IgE antibody,immunoglobulin,thymosin,synthetic agents include pidotimod,transfer fac-tor,traditional Chinese medicine or plant.The main source of Gin kgo biloba extract,Huaiqihuang etc.We make a summary on the research progress and immunomodulator in the treatment of asthma in this review.