Use of veterinary medicinal products in the Philippines: regulations, impact, challenges, and recommendations.

Agricultural production is a major driver of the Philippine economy. Mass production of animal products, such as livestock and poultry farming, is one of the most prominent players in the field. Filipino farmers use veterinary medicinal products (VMPs) when raising agricultural animals to improve animal growth and prevent diseases. Unfortunately, the extensive use of VMPs, particularly antibiotics, has been linked to drug resistance in animals, particularly antibiotics. Antimicrobial gene products produced in animals due to the prolonged use of VMPs can passed on to humans when they consume animal products. This paper reviews information on the use of VMPs in the Philippines, including the regulations, their impact, challenges, and potential recommendations. The Philippines has existing legislation regulating VMP use. Several agencies were tasked to regulate the use of VMPs, such as the Department of Agriculture, the Department of Health, and the Philippine National Action Plan. Unfortunately, there is a challenge to implementing these regulations, which affects consumers. The unregulated use of VMPs influences the transmission of antibiotic residues from animals to crops to humans. This challenge should be addressed, with more focus on stricter regulation.

ADIPOQ gene (T45G and G276T) single nucleotide polymorphisms and their association with gestational diabetes mellitus in a Filipino population.

Several studies have associated the presence of ADIPOQ gene polymorphisms with insulin resistance, adiponectin levels, and metabolic diseases such as diabetes, although with varying degrees of correlation depending on ethnicity. Here we aim to identify individual's susceptibility to gestational diabetes mellitus (GDM) in the presence of T45G and G276T single nucleotide polymorphisms (SNPs) within the ADIPOQ gene among Filipino pregnant women. A total of 285 pregnant women (95 GDM cases and 190 controls) were included in this study. Two ADIPOQ gene polymorphisms were genotyped using TaqMan assay. Results of SNP genotyping showed no significant differences in the frequencies of TT, TG and GG genotypes of T45G SNP between the GDM and control group [p = 1.0000, 0.6179, 0.5797; OR (95%CI) = 1.030 (0.582-1.874), 1.135 (0.683-1.828), 0.833 (0.481-1.420)]. Similarly, the frequencies of GG, GT, and TT genotypes of G276T SNP were comparable in both groups [p = 0.8002, 1.0000, 0.3466; OR (95%CI) = 1.090 (0.654-1.785), 1.022 (0.616-1.665), 0.433 (0.092-1.698)]. Moreover, although adiponectin levels were significantly decreased in GDM group (p = 0.0196) and have shown substantial negative correlations with FBS, 1-hour OGTT, 2-hour OGTT, and HOMA-IR (p < 0.05), they were not significantly different according to genotypes of T45G and G276T polymorphisms both in GDM and control group. Our results suggest that neither of the two ADIPOQ gene polymorphisms influence adiponectin levels and development of GDM in a Filipino population.

Biotherapeutic Applications of Platelet-Rich Plasma in Regenerative Medicine.

BACKGROUND: Platelet-rich plasma (PRP), a blood-based product containing platelets and growth factors, is being utilized to treat numerous non-hemostatic disorders. Studies have explored the use of PRP to provide rapid repair, healing, and recovery from various injuries; some studies mentioned the effectiveness of PRP as compared with other forms of treatment like the use of hyaluronic acid. Commercially available PRP systems are available now, and each varies from one another depending on how it is prepared, thus causing variations in platelet concentration and growth factor content. These variations also implicated different therapeutic applications. METHODS: The paper reviews the various applications of PRP, including factors to consider before using PRP therapy, and provides an extensive list of PRP applications. RESULTS: The administration of PRP as a standalone treatment or as a co-therapy results in observed positive outcomes. However, there is a lack of standardization for PRP preparation, increasing the risks for heterogeneity and bias amongst results. CONCLUSION: The use of PRP is indeed an option for regenerative therapy, but more research is needed before it can fully be recommended as a primary treatment modality.

Evaluating immunochromatographic test kits for diagnosis of acute human leptospirosis: A systematic review.

Background: Leptospirosis, a common zoonotic infection in developing countries, usually progresses to severe conditions and poor outcomes when not detected early. Microscopic agglutination test (MAT) and culture are available but are not accessible in all areas and are usually confined to specialized laboratories. There are several available immunochromatographic test kits (ICT) that offer ease of use, access, and affordability, but diagnostic accuracy is not yet well established. In this paper, we aim to review published literature on the use of ICTs for the detection of leptospirosis and evaluate their diagnostic efficiency. Materials and methods: We systematically searched multiple databases (PubMed, Cochrane Library, and Google Scholar), including gray literature sources for published research articles as of April 13, 2022, on the diagnosis of acute leptospirosis using ICT. We assessed the methodological quality of each article using the revised QUADAS-2. Results: From a total of 41 articles, 30 (73.2%) were identified as potentially relevant after reviewing the title and abstract and eliminating duplicate articles; then, 22 (53.7%) articles were included after scrutinizing and applying the inclusion/exclusion criteria to the full text. Almost all test kits detect IgM antibodies against the Leptospira species except for one which used IgG as a marker for diagnosis of acute leptospirosis. A wide range of sensitivity (15.8%-100.0%) and specificity (37.3%-100.0%) were recorded. Lipopolysaccharide (LPS)-specific Immunochromatographic Lateral Flow Assay presented the highest sensitivity (∼93-100%) and specificity (∼99.19-100%). Conclusion: Rapid diagnosis of acute leptospirosis is highly warranted; however, available test kits present a wide range of diagnostic accuracy. We found that LPS-specific ICT kit has the highest diagnostic efficiency; however, our analysis was limited by the included studies' heterogeneity in design and reporting; thus, we recommend standardization in the conduct and reporting of diagnostic accuracy of test kits as it is vital to evaluate the reliability of the test kit.

Differential gene expression and network-based analyses of the placental transcriptome reveal distinct potential biomarkers for gestationaldiabetes mellitus.

AIMS: Gestational diabetes mellitus (GDM) is a common complication during pregnancy affecting the mother and fetus. With the problems encountered with the oral glucose tolerance test (OGTT), we aim to identify potential early biomarkers of GDM. METHODS: A cross-sectional study was conducted among 80 pregnant women. Blood samples were collected every trimester, and total RNA was isolated. After quality control and library preparation, next-generation sequencing was performed. Differential expression analysis was done. Enriched Gene Ontology: Biological Processes (GO: BP) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were identified. Gene co-expression networks were constructed. Protein-protein Interaction (PPI) networks were then built from modules significantly correlated with Hemoglobin A1c. Genes with the highest degree of interaction were identified as hub genes. RESULTS: IGKV2D-28 and PTPRG were consistently differentially expressed among the three comparisons. Top enriched GO: BP terms and KEGG pathways are linked to immune responses. Orange (r = 0.59, p = 0.02) and purple modules (r = 0.41, p = 0.02) of the GDM cohorts in the first and second trimesters, respectively, significantly correlated with Hemoglobin A1c. HDAC8 of the orange module and MPO and CRISP3 of the purple module were identified as hub genes. CONCLUSIONS: In this study, potential biomarkers of GDM were identified, namely, IGKV2D-28, PTPRG, HDAC8, MPO, and CRISP3.

Placental mTOR complex 1 regulates fetal programming of obesity and insulin resistance in mice.

Fetal growth restriction, or low birth weight, is a strong determinant for eventual obesity and type 2 diabetes. Clinical studies suggest placental mechanistic target of rapamycin (mTOR) signaling regulates fetal birth weight and the metabolic health trajectory of the offspring. In the current study, we used a genetic model with loss of placental mTOR function (mTOR-KOPlacenta) to test the direct role of mTOR signaling on birth weight and metabolic health in the adult offspring. mTOR-KOPlacenta animals displayed reduced placental area and total weight, as well as fetal body weight at embryonic day (E) 17.5. Birth weight and serum insulin levels were reduced; however, ß cell mass was normal in mTOR-KOPlacenta newborns. Adult mTOR-KOPlacenta offspring, under a metabolic high-fat challenge, displayed exacerbated obesity and metabolic dysfunction compared with littermate controls. Subsequently, we tested whether enhancing placental mTOR complex 1 (mTORC1) signaling, via genetic ablation of TSC2, in utero would improve glucose homeostasis in the offspring. Indeed, increased placental mTORC1 conferred protection from diet-induced obesity in the offspring. In conclusion, placental mTORC1 serves as a mechanistic link between placental function and programming of obesity and insulin resistance in the adult offspring.

Time-series modelling of dengue incidence in the Mekong Delta region of Viet Nam using remote sensing data.

OBJECTIVE: This study aims to enhance the capacity of dengue prediction by investigating the relationship of dengue incidence with climate and environmental factors in the Mekong Delta region (MDR) of Viet Nam by using remote sensing data. METHODS: To produce monthly data sets for each province, we extracted and aggregated precipitation data from the Global Satellite Mapping of Precipitation project and land surface temperatures and normalized difference vegetation indexes from the Moderate Resolution Imaging Spectroradiometer satellite observations. Monthly data sets from 2000 to 2016 were used to construct autoregressive integrated moving average (ARIMA) models to predict dengue incidence for 12 provinces across the study region. RESULTS: The final models were able to predict dengue incidence from January to December 2016 that concurred with the observation that dengue epidemics occur mostly in rainy seasons. As a result, the obtained model presents a good fit at a regional level with the correlation value of 0.65 between predicted and reported dengue cases; nevertheless, its performance declines at the subregional scale. CONCLUSION: We demonstrated the use of remote sensing data in time-series to develop a model of dengue incidence in the MDR of Viet Nam. Results indicated that this approach could be an effective method to predict regional dengue incidence and its trends.

Gestational Diabetes Mellitus: A Harbinger of the Vicious Cycle of Diabetes.

Gestational diabetes mellitus (GDM), characterized by a transitory form of diabetes induced by insulin resistance and pancreatic ß-cell dysfunction during pregnancy, has been identified as one of the major obstacles in achieving improved maternal and child health. Approximately 9-25% of pregnancies worldwide are impacted by the acute, long-term, and transgenerational health complications of this disease. Here, we discuss how GDM affects longstanding maternal and neonatal outcomes, as well as health risks that likely persist into future generations. In addition to the current challenges in the management and diagnosis of and the complications associated with GDM, we discuss current preclinical models of GDM to better understand the underlying pathophysiology of the disease and the timely need to increase our scientific toolbox to identify strategies to prevent and treat GDM, thereby advancing clinical care.

Serum ferritin as a candidate diagnostic biomarker of polycystic ovarian syndrome: a meta-analysis.

Objective: In this study, we investigated about the potential of serum ferritin as a complementary diagnostic biomarker of polycystic ovarian syndrome (PCOS) by performing a meta-analysis of existing literature. Materials and methods: Eleven studies written in English were retrieved up to 30 June 2018. Data were extracted from the selected studies by two of the authors and was subjected to statistical analysis. Levels of serum ferritin were compared between women with PCOS and controls using the standardized mean difference (SMD) and 95% confidence interval (CI). Subgroup analysis was also performed and stratified by ethnicity (Asians versus Caucasians). Results: Overall post-outlier outcomes indicated that elevated serum ferritin is strongly associated with PCOS (SMD: 0.52; 95% CI: 0.40-0.64; PA = 10-5). Subgroup analysis by ethnicity showed no significant difference between Asian and Caucasian population. Post-outlier receiving operations characteristics curve were plotted and showed that values for serum ferritin showed good potential in discriminating patients with and without PCOS (AUC = 0.827, p = 0.006). Conclusion: Our findings suggest that high serum ferritin level is significantly associated with PCOS and its potential as a biomarker is evident in its high diagnostic accuracy. However, additional studies are needed to confirm our claims.

G276T polymorphism in the ADIPOQ gene is associated with a reduced risk of polycystic ovarian syndrome: A meta-analysis of Asian population.

OBJECTIVE: The etiology of polycystic ovarian syndrome (PCOS) has not yet been fully explained. Several studies suggested an association between two single nucleotide polymorphisms (T45G and G276T) of the ADIPOQ gene that encodes for the hormone adiponectin and PCOS susceptibility. Hence, we performed a meta-analysis to investigate the relationship of the two further. MATERIALS AND METHODS: Literature search was conducted in PubMed up to June 22, 2018, for related publications written in English. Selected data were extracted from the included studies and was subjected to analysis using Review Manager 5.3. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed and pooled from the resulting studies. Subgroup analysis by ethnicity was also performed. RESULTS: Overall analysis showed that women with the G276T polymorphism have reduced susceptibility to PCOS (OR: 0.68; 95% CI: 0.60-0.78; PA < 0.001). While no significant association was observed for the T45G polymorphism (OR: 1.07; 95% CI: 0.93-1.24; PA = 0.34). Subgroup analysis, on the other hand, showed significant associations among East Asians (OR: 0.69; 95% CI: 0.57-0.82; PA < 0.001) for the G276T association. CONCLUSION: Results of this meta-analysis suggests that women with the G276T polymorphism are less likely to develop PCOS. However, more studies are needed to confirm the claims of this meta-analysis.

Larvicidal and ovicidal activities of Artocarpus blancoi extracts against Aedes aegypti.

CONTEXT: Dengue control may be done by targeting its vector. In this study, we used Artocarpus blancoi (Elm.) Merr. (Moraceae) leaves, an endemic hematophagous insect repellent as a larvicide and ovicide. OBJECTIVE: We investigated the larvicidal and ovicidal activities of its soluble crude ethanol extract and the hexane, aqueous, and ethyl acetate fractions against Aedes aegypti. MATERIALS AND METHODS: Third to early fourth instar A. aegypti larvae were exposed to 200, 400, 600, 800 and 1000 ppm of crude ethanol; to 10, 20, 40, 60 and 80 ppm of ethyl acetate; and to 500, 750, 1000, 1250 and 1500 ppm of hexane fractions of A. blancoi; 48 h LC50 and LC90 values were determined. For the ovicidal assay, an average of 25 eggs/paper strip was used; inhibition of egg hatchability was counted 72 h after exposure. Fractions were screened qualitatively for phytochemicals. RESULTS: Ethyl acetate soluble fraction gave the lowest LC50 value (18.59 ppm) followed by the crude ethanol (411 ppm), hexane (685 ppm) and aqueous (20,158 ppm) fractions. Similarly, ethyl acetate soluble fraction appeared to be the most ovicidal (80 ppm). Larvicidal and ovicidal activities of the fractions were dose dependent. Qualitative phytochemical screening revealed moderate presence of glycosides and sterols and trace amounts of triterpenes, flavonoids, saponins and tannins. DISCUSSION AND CONCLUSIONS: A. blancoi is a potential larvicide and ovicide against A. aegypti, and future studies isolating the specific components responsible for such actions would be significant.

Association of maternal iron deficiency anemia with the risk of gestational diabetes mellitus: a meta-analysis.

PURPOSE: The aim of the study was to conduct a meta-analysis investigating the association of maternal iron deficiency anemia (IDA) and risk of gestational diabetes mellitus (GDM). METHODS: Literature search was conducted in various database websites such as PubMed, Cochrane Library, and Web of Science up to 17 June 2018 for related publications written in English. Selected data were extracted from the included studies and were subjected to statistical analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed, pooled, and interpreted. Subgroup analysis by ethnicity (Asians vs. Caucasians) was also performed. RESULTS: Six studies with a total sample size of 15,157 from various countries were included in this meta-analysis. Pooled ORs of all publications included show that pregnant women with IDA have a reduced risk of developing GDM (OR 0.61; 95% CI 0.47-0.80; PA = 0.0003). Subgroup analysis, on the other hand, showed significant associations among Asians (OR 0.60; 95% CI 0.45-0.79; PA = 0.0003) than Caucasians (OR 0.76; 95% CI 0.32-1.76; PA = 0.52). CONCLUSION: Results of this meta-analysis suggests that pregnant women with IDA are 39% less likely to develop GDM. However, more studies are needed to confirm the claims of our results.

Association and biomarker potential of elevated serum adiponectin with nephropathy among type 1 and type 2 diabetics: A meta-analysis.

BACKGROUND: Managing nephropathy associated with diabetes mellitus warrant investigation of relevant biomarkers in predicting this condition. Adiponectin (ADP) may hold promise as a biomarker for diabetic nephropathy (DN). In this study, we examine associations of ADP with DN by meta-analyzing relevant literature. We also examined the predictive potential of ADP and estimate progression of DN. METHODS: Multi-database literature searches and serial omissions of articles yielded 13 studies for inclusion in the meta-analysis. We compared ADP levels between controls/ normoalbuminuria and cases with micro- and macroalbuminuria (MI and MA, respectively) as well as MI versus MA using standardized mean differences (SMD). Associations of ADP with DN were indicated with the P-value considered significant at ≤ 0.05. Subgrouping was based on diabetes type (1 and 2). Predictive potential of ADP was explored with AUC (area under the curve) derived from Receiver Operating Characteristic curve analysis. RESULTS AND CONCLUSION: At high P-values of <10-5, overall and subgroup outcomes indicated ADP associations with DN (up to SMD = 1.89-2.26, respectively). However, heterogeneity of the initial SMD effects (up to I2 = 99%) warranted examination of their sources which with the Galbraith plot method, either eliminated or reduced their heterogeneity, signifying combinability of the studies. This feature along with consistency of significant associations, robust outcomes and significant AUC values provide good evidence of the associative and predictive roles of ADP in DN.

Clinical enzymes as possible immunological biomarkers in the diagnosis of malaria, human African and American trypanosomiasis.

Peripheral blood smear microscopy still remains the gold standard for diagnosing malaria and trypanosomiasis. Microscopy is a labor-intensive process and requires great amount of skill to accomplish. Even though cheap and easy to perform, it still has several limitations. This hinders the microscopist in identifying protozoan structure or differentiating species from one another. Considering these factors in the performance of microscopic examination, it is crucial to identify new strategies for parasite identification and species differentiation. Innovations in clinical enzymology, immunodiagnostics, and molecular technology would be of help in resolving the problem. This study mainly focused on the possible role of clinical enzymes in malaria and trypanosomiasis diagnosis. Enzymes play a vital role in parasite physiology and metabolism. They enable the parasite to survive inside the living host by initiating different metabolic cycles. These enzymes can either be expressed on the surface of the protozoa or excreted in the extracellular environment. Lactate dehydrogenase, aldolase, and glutamate dehydrogenase were the significant enzymes associated with pathogenic Plasmodium spp. Other malarial enzymes were also identified but further validation is still required to establish their use as diagnostic biomarkers. Whereas, the enzyme matrix metalloproteinase was identified as significant for diagnosing and differentiating Trypanosoma spp. Analysis of these enzymes can be used as alternative means for microscopy in parasite identification and differentiation. Application of these enzymes as immunologic markers in various diagnostic test kits should be further evaluated.