Compelling Impacts of Natural Polymer-Centered Drug Delivery Systems as Prophylactic and Therapeutic Approaches in Various Pulmonary Disorders/Lung Diseases

Pulmonary disorders are common illness that affects people of all ages world­wide. Common pulmonary disorders include pulmonary hypertension, CF (cystic fibrosis), asthma, chronic obstructive pulmonary disorder, emphysema, chronic bronchitis, lung cancer, and COVID-19. Treatments of these disorders vary but can be broadly categorized into pharmacological (medicinal), non-pharmacological, rehabilitation, and surgical techniques. Often, a combina­tion of these approaches is used, both for symptomatic relief and treatment. Regarding these prophylactic and therapeutic approaches, advances are rapidly being made, and scientists are currently investigating modern and unique theranostic methods. However, there is a lacuna in drug delivery, pharmacokinetic aspects, and drug-induced adverse effects. One particular area for improvement that needs to be immediately addressed is the drug delivery system to significantly improve healthcare associated with pulmonary disorders. Natural polymer-based drug delivery systems are widely adopted for their ease of production, lack of biotoxicity, and strong bioaffinity. Of the natural polymer­based drug delivery systems, chitosan, sodium alginates, albumin, hydroxyapa­tite, and hyaluronic acid are the most common natural polymers. Each of these natural polymers has its preferred use, either due to tissue-specific delivery or medical property packaging. The current scientific article discusses the common pulmonary disorders, their pathophysiology, and the current therapeutic approaches. Additionally, we discuss the major natural polymer drug delivery systems, including their properties and common uses. © The Author (s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

Radiotherapy in COVID-19: a review

The World Health Organization (WHO) stated the novel coronavirus (COVID-19) a global pandemic on 11th March 2020. The virus-infected patients suffered from a respiratory disease called Severe Acute Respiratory Syndrome Coronavirus 2 (SAR-CoV-2). A proteinaceous exudate, alveolar edema, and hyperplasia associated with monocytes and lymphocytes alveolar inflammatory infiltration was observed in the affected patient's lungs. Virus broadens a systemic inflammatory reaction with a cytokine release syndrome which is characterized with the aid of using unexpected growth in many pro-inflammatory cytokines especially IL-6, IL-1, and TNF-a through activated M1 macrophage phenotype. Virus block IL-6 with tocilizumab and the usage of respirator device appears to be very vital. Radioactivity is the process by which unstable atomic nucleus losses energy by radiation, mainly using alpha, beta, and gamma rays. SARS-CoV-2 affected lungs can be treated by a low dose of radiotherapy. It was found that minute dose chest radiation therapy can be able to wean patients off a ventilator as it can reduce inflammation inside the lungs of severely infected COVID-19 patients. Numerous such clinical trials are underway and researchers may work to cure the COVID-19 lung infections by radiotherapy.

Therapeutic Options for the SARS-CoV-2 Virus: Is There a Key in Herbal Medicine?

SARS-CoV-2 has been responsible for over 500 million cumulative cases all over the world since December 2019 and has marked the third introduction of a highly pathogenic virus after SARS-CoV and MERS-CoV. This virus is in a winning situation because scientists are still racing to explore effective therapeutics, vaccines, and event treatment regimens. In view of progress in current disease management, until now none of the preventive/treatment measures can be considered entirely effective to treat SARS-CoV-2 infection. Therefore, it is required to look up substitute ways for the management of this disease. In this context, herbal medicines could be a good choice. This article emphasizes the antiviral potential of some herbal constituents which further can be a drug of choice in SARS-CoV-2 treatment. This article may be a ready reference for discovering natural lead compounds and targets in SARS-CoV-2 associated works.

OUTCOMES AND MANAGEMENT OF ACUTE NECROTIZING PANCREATITIS DURING THE COVID-19 PANDEMIC

Introduction: The clinical care of patients with acute necrotizing pancreatitis (ANP) is resource-intensive. Patients with ANP often have severe illness which may require intensive care unit (ICU) admission, invasive drainage procedures, and other high-level multidisciplinary care. The Covid-19 pandemic has put an enormous strain on hospitals and ICUs around the world. The resulting impact of the pandemic, on the ability for hospitals to care for patients with ANP has not been studied. We aimed to analyze the outcomes and management of patients admitted with ANP before and during the pandemic using a large population dataset. Methods: TriNetX is a large international research network. This dataset comprises electronic health record (EHR)-derived disparate data from 57 healthcare networks and over 80,000,000 patient lives. We queried the dataset to find two cohorts of patients: those admitted to a hospital with ANP from April 1, 2018-April 1, 2019, and those admitted to a hospital with ANP from April 1, 2020-April 1, 2021. The two cohorts were propensity matched using a 1:1 greedy nearest-neighbor algorithm based on age, sex, race, ethnicity, BMI, alcohol, and tobacco use. The primary outcome was 30-day all cause mortality. Secondary outcomes included rates of ICU admission, mechanical ventilation, antibiotic usage, endoscopic, and percutaneous drainage. Results: The incidences of ANP in the pre-Covid and post-Covid study years were 10.2 per 100,000 and 9.9 per 100,000 persons, respectively. The pre-Covid cohort contained 2,113 patients and the post-Covid cohort contained 2,083 patients. After matching, two cohorts of 1,943 remained (Table 1). In the post-Covid cohort, 29 patients (1.5%) tested positive for SARS-CoV-2 during the 30 days after hospital admission for ANP. Overall, there was no significant difference in the primary outcome of 30-day allcause mortality (4.4% vs 4.9%, p=0.49). Additionally, there were no significant differences in ICU admission, mechanical ventilation, endoscopic or percutaneous drainage, or antibiotic usage between the two groups. Conclusion: The Covid-19 pandemic has resulted in bed and staffing shortages both in ICU and general medical/surgical floors around the world. Despite this, the clinical management, and outcomes of patients with ANP did not significantly change for the worse compared with outcomes from 2018-2019. These data suggest that despite the strain induced by the Covid-19 pandemic, the care of patients with ANP, including those with critical care needs, was not compromised. (Table Presented)

Synergism of CD28 Immune Molecule in Late Immunosuppressive Phase of COVID-19: Effectiveness in Vaccinated Individuals

CONTEXT: Lymphopenia has been frequently documented and linked to coronavirus disease 2019 (COVID-19) in a severe acute respiratory syndrome (SARS)-coronavirus 2 (CoV-2) attack. A decrease in the T-lymphocyte count has shown promise as a clinical indicator and predictor of COVID-19 severity. OBJECTIVE: The review intended to examine the relationship of COVID-19 infections in individuals to lost expression of CD28 on naive CD4+/CD8+-mediated, vaccine-specific, neutralizing antibody responses. DESIGN: The research team performed a narrative review by searching eight databases: Medline, Elsevier, Cochrane, PubMed, Google Scholar, Mendeley, and Springer Nature. The search used the following key terms: SARS CoV-2, clinical aspects and pathology of SARS CoV-2, involvement of viral spike (S) protein in SARS CoV-2, immunological changes in COVID-19 infection, basic overview of CD28 immuno-molecule ligand, reduction of vaccine therapeutic efficacy in COVID-19 infection, and immunomodulatory response of lost CD28 ligand. SETTING: This study was done in a Maharishi Arvind College of Pharmacy, Jaipur, India. RESULTS: In COVID-19 patients, particularly those with severe disease, had increased levels of IL-2 or IL-2R. Given IL-2's supportive role in the expansion and differentiation of T cells, the authors exhibiting that lymphopenia, particularly in severe COVID-19, could be attributed to nonfunctional and dysfunctional differentiation of CD4+ and CD8+ T cells as a result of low CD28 immuno-molecule expression on naive T cells. CONCLUSIONS: The literature review found that independent, early immunological prognostic markers for a poor prognosis, in addition to higher levels of IL-6, include a substantial proportion of large inflammatory monocytes and a small proportion of chronic CD28+ CD4+T cells. The current findings suggest that a combination of COVID-19 vaccination with SARS CoV-2-reactive naive T cells with the CD28 immune-molecule may be a viable method for establishing T-cell-based, adaptive cellular immunotherapy against COVID-19 infection. Further research is needed, especially larger studies to confirm the current findings, to improve early clinical treatment.

Radiotherapy in covid-19: A review

The World Health Organization (WHO) stated the novel coronavirus (COVID-19) a global pandemic on 11th March 2020. The virus-infected patients suffered from a respiratory disease called Severe Acute Respiratory Syndrome Coronavirus 2 (SAR-CoV-2). A proteinaceous exudate, alveolar edema, and hyperplasia associated with monocytes and lymphocytes alveolar inflammatory infiltration was observed in the affected patient’s lungs. Virus broadens a systemic inflammatory reaction with a cytokine release syndrome which is characterized with the aid of using unexpected growth in many pro-inflammatory cytokines especially IL-6, IL-1, and TNF-α through activated M1 macrophage phenotype. Virus block IL-6 with tocilizumab and the usage of respirator device appears to be very vital. Radioactivity is the process by which unstable atomic nucleus losses energy by radiation, mainly using alpha, beta, and gamma rays. SARS-CoV-2 affected lungs can be treated by a low dose of radiotherapy. It was found that minute dose chest radiation therapy can be able to wean patients off a ventilator as it can reduce inflammation inside the lungs of severely infected COVID-19 patients. Numerous such clinical trials are underway and researchers may work to cure the COVID-19 lung infections by radiotherapy. © 2021, SILAE (Italo-Latin American Society of Ethnomedicine). All rights reserved.

In silico screening of phytochemicals as potential inhibitors of sars-cov-2 mpro and human ace-2

Background and Objective: An enzyme that inhibits the receptor could make it more difficult for coronavirus to reach cells. The key protease necessary for coronavirus proteolytic maturation is the recognized coronavirus 3-chymotrypsin-like protease 3CLpro, also known as Mpro. This Mpro is needed for immune control and the cleavage of the polyproteins pp1a and pp1ab, making it a promising target for anti-COVID-19 drugs. As a result, inhibiting the Mpro enzyme inhibits viral maturation. Bioactive constituents obtained from some selected indigenous plants of India, which have been reported to have antiviral potential, were subjected to virtual screening against ACE-2 and Mpro in the current study. Materials and Methods: Cresset's Flare 4.0 was used to establish the 3-D structure of all the compounds. Complete optimizations of these constructed structures were carried out. While performing the minimization, the spin state of the wave function was set to the singlet and standard SCF convergence was used for optimization, all other parameters were left at their default values. The Protein Data Bank (https://www.rcsb.org) was used to download the 3-D structures of Mpro from COVID-19 (PDB ID 6LU7) and ACE-2 receptor from Human (PDB ID 1R4L). Results: The findings show that these phytochemicals can bind to ACE-2 and Mpro more effectively as compared to reference compounds and act as inhibitors. Conclusion: The findings of virtual screening of these bioactive constituents revealed that most of them are more active than the reference compounds. Therefore, they could be used to produce antiviral drugs against Coronavirus in the future.

Gender and Age Differences Reveal Risk Patterns in COVID-19 Outbreak

By April 28th 2020, the global number of people that were viciously infected with the newfound novel corona virus (COVID-19) stood at a staggering 3 077 133 cases, as per the confirmed data released by the WHO. It has been reported that women from the Chinese Han population are associated with essential hypertension due to their relation with the 5 SNPs, namely, rs1514283, rs4646155, rs4646176, rs2285666, and rs879922, which belong to the ACE2 gene. The level of ACE2 activity was very low in normal healthy younger persons, and was reported to be increased in patients with cardiovascular diseases. Thus, there might be severe myocarditis, that may result in acute heart failure and cardiac complexities in the elderly subjects.

The Impact of COVID-19 Pandemic Infection in Patients Admitted to the Hospital for Reasons Other Than COVID-19 Infection

COVID-19 or SARS CoV-2 is a worldwide public health emergency. The first case of COVID-19 was described in Wuhan, China in December, 2019 and within a short time the infection had spread quickly to the rest of China and then the world. The COVID-19 pandemic has had a huge impact on patients who do not have COVID-19 but other diseases like cancer, diabetes, and many more non-communicable diseases;their care is compromised because of the pandemic. COVID-19 also poses a work-related health risk for healthcare workers who are treating patients with COVID-19, and many have themselves become infected. Healthcare workers involved in diagnosing and treating patients with COVID-19 should be evaluated for stress, anxiety and depression.

Letter to the Editor: Integrating the Roles of Pharmacy Practice and Drug Delivery in Mitigating COVID-19

No Abstract Available.