Individualized Traditional Chinese Medicine treatment antibiotics for recurrent urinary tract infections: a multicenter, randomized controlled study.

OBJECTIVE: To systematically assess the effects of individualized Chinese medicines on recurrent urinary tract infections (rUTIs). METHODS: This study recruited 230 adult female patients in the remission phase of rUTIs from five hospitals in China. The patients were randomly allocated to two groups: an individualized Chinese medicine group (n = 114) and a control group (n = 116). Patients in the Chinese medicine group received individualized Chinese herbs, which were evaluated for syndrome differentiation. Patients in the control group received antibiotic treatment combined with a Chinese medicine placebo. The duration of treatment was three courses of four weeks each, with a three-month subsequent follow-up. UTI recurrence rate, Traditional Chinese Medicine (TCM) syndrome scores, 36-item Short Form Survey (SF-36) score, and urine secretory immunoglobulin A (SIgA) were measured and analyzed before and after treatment in each group. RESULTS: Patients from the Chinese medicine group exhibited significant decreases in both short- and long-term UTI recurrence rates compared with the control group (P < 0.05). The changes in TCM syndrome scores between the Chinese medicine and control groups were significant (P < 0.05). The changes in the average SF-36 quality-of-life scores in the Chinese medicine group were also significantly higher than those in the control group after treatment (P < 0.05). The Chinese medicine group also demonstrated a significant increase in urine SIgA expression. CONCLUSION: Taken together, compared to the often-used long-term antimicrobial prophylaxis during the remission stage of rUTIs, treating patients with an individualized Chinese medicine decoction by syndrome differentiation could effectively reduce the recurrence rate, improve the patients' TCM syndrome scores and quality of life, and enhance immunity, which in turn helps to prevent antibiotic resistance.

Social support moderates the effect of stress on the cortisol awakening response in dementia family caregivers.

Dementia caregiving has been associated with a range of adverse effects on the physical health of the caregiver. However, the specific mechanisms underlying the relationship between dementia caregiver stress and ill health remain unclear. The aim of this study was to investigate, using available prospective data, the relationship between perceived stress (burden) and pre-clinical indices of ill-health (cortisol awakening response and secretory immunoglobulin A) amongst dementia caregivers. The potential moderating effect of social support on the perceived stress-physiological stress/health relationship was also explored. Participants (N = 31) were caregivers of community-dwelling older adults living with dementia who were enroled in a psychoeducation support program and provided data (study questionnaire and saliva samples) at two timepoints (T1 and T2), 10 weeks apart. Hierarchical regressions were used to determine if changes in stress and social support predicted change in each of the physiological outcomes. Findings indicate that caregivers with more hours of care at T1, or with greater satisfaction with social support, were more likely to exhibit an adaptive cortisol awakening response at T2. Moreover, social support was found to buffer the effect of caregiver stress and hours of caregiving on the cortisol awakening response. Implications for future interventions targeting caregiver health are discussed.

Secretory Immunoglobulin A and Upper Cervical Chiropractic: A Preliminary Prospective, Multicenter, Observational Study.

Objective: The objective of this study was to observe changes in secretory immunoglobulin A (SIgA) after chiropractic care using upper cervical adjusting techniques (UCATs) at the craniocervical junction (CCJ). Methods: Forty-one participants were enrolled from 5 chiropractic offices in North America. Each participant provided a saliva sample at an initial visit before care. A second saliva sample was collected after resting 30 minutes after the first UCAT treatment. A third saliva sample was collected after 2 weeks. Results: There was a significant increase in SIgA observed 30 minutes after the UCAT treatment compared to baseline. After 2 weeks, SIgA levels decreased back to near original levels. Conclusion: Our preliminary findings demonstrate an immediate, temporary increase in SIgA levels after a UCAT treatment at the CCJ.

Influence of short-time pasteurization on essential bioactive components and immune cells in human breast milk / 中华围产医学杂志

Objective:To explore the influence of short-time pasteurization (62.5±0.5℃ for 5 s) on the main bioactive components and immune cells in human breast milk.Methods:Fresh breast milk was collected from 53 women whose premature infants were admitted to the neonatal intensive care unit of the Children's Hospital of Fudan University from May 2020 to October 2020. Each sample (20 ml) was divided into unsterilized, Holder pasteurized (62.5 ℃ for 30 min), or short-time pasteurized groups. The concentration of secretory immunoglobulin A (sIgA), lactoferrin (LTF), lysozyme (LZM), and insulin-like growth factor binding protein-3 (IGFBP-3) in breastmilk whey were detected by enzyme-linked immunosorbent assay and the number of viable immune cells (leukocytes, monocytes, T cells, and B cells) in breastmilk by flow cytometry.Results:(1) A total of 87 breast milk samples were collected. The levels of sIgA, LTF, and LZM were the highest in the unsterilized group, followed by the short-time and Holder pasteurized group [0.42 mg/ml (0.33-0.65 mg/ml) vs 0.40 mg/ml (0.28-0.62 mg/ml) and 0.25 mg/ml (0.17-0.37 mg/ml); (3.57±1.06) vs (3.53±1.11) and (0.85±0.58) mg/ml; 128.60 μg/ml (77.18-203.00 μg/ml) vs 121.70 μg/ml (68.66-188.20 μg/ml) and 83.40 μg/ml (47.40-151.40 μg/ml); all P<0.05]. There was no significant difference in the level of IGFBP-3 among the groups. The median retention rates of sIgA, LTF, and LZM in the Holder pasteurized group were all lower than those in the short-time pasteurized group [55.87% (46.01%-71.41%) vs 96.93% (83.03%-115.90%); 21.72% (12.54%-29.42%) vs 97.88% (88.98%-104.30%); 69.26% (49.42%-89.08%) vs 93.80% (74.85%-110.20%); all P<0.05]. No significant difference in the level of preserved IGFBP-3 was observed between the three groups ( P>0.05). (2) The number of viable leukocytes, monocytes, T cells, and B cells in the Holder pasteurized group were lower than those in the unsterilized group [leukocytes: 185.50 (87.00-356.50) vs 1 271.00 (540.50-2 283.00); monocytes: 12.00 (6.00-16.75) vs 266.00 (137.30-518.80); T cells: 1.00 (0.00-2.00) vs 47.50 (28.50-116.00); B cells: 1.00 (0.00-1.75) vs 21.00(10.00-41.50); all P<0.05]. The percentage of viable leukocyte to the total leukocyte and the viable monocytes, T cells, and B cells to the viable leukocytes were lower in the Holder pasteurized group than those in the unsterilized group [24.80%(16.00%-36.80%) vs 74.20%(63.55%-86.45%); 5.91%(4.09%-8.77%) vs 21.90%(17.40%-29.30%); 0.31%(0.00%-1.31%) vs 4.00%(2.69%-6.43%); 0.30%(0.00%-0.86%) vs 1.27%(0.57%-2.85%); all P<0.05]. A similar trend was observed between short-time pasteurization and unsterilized groups (all P<0.05). (3) The percentages of viable monocytes, T cells, and B cells in their subsets were lower in both Holder and short-time pasteurized groups than those in the unsterilized group [2.94%(1.33%-7.14%) vs 9.72%(5.77%-16.00%) and 52.60%(31.35%-68.75%); 0.00%(0.00%-1.61%) vs 0.49%(0.00%-2.53%) and 28.10%(10.55%-57.00%); 0.00%(0.00%-0.83%) vs 0.24%(0.00%-2.47%) and 13.80%(3.27%-41.00%); all P<0.05].The number and percentage of viable leukocytes in total leukocytes and viable monocytes in total monocytes [leukocytes: 279.50(116.80-548.50), 32.20%(20.70%-45.75%); monocytes: 32.00(21.00- 83.75),15.60%(11.10%-19.15%)] were higher than those in the pasteurized group (all P>0.05). The short-time pasteurized group was noted only for a higher percentage of the viable monocytes to viable leukocytes than the Holder pasteurized group (all P<0.05). Conclusions:Compared with the Holder pasteurization, sIgA, LTF, LZM level, and monocyte activity in breast milk can be better preserved by short-time pasteurization.

Association of secretory IgA with clinical pathological characteristics and complement activation in IgA nephropathy / 中华肾脏病杂志

Objective To further investigate the association among clinical pathology,complement activation and renal secretory IgA (SIgA) deposition in patients with IgA nephropathy (IgAN).Methods The activation of serum complements were detected by immunoturbidimetry and ELISA.Renal deposition of SIgA and activation of complements were detected by immunofluorescence.Then the association among clinical pathology,complement activation and renal SIgA deposition were analyzed in IgAN patients.Results In all 201 patients with IgAN,59 patients had SIgA deposition with higher incidences of mucosal infection history and hematuria (P ＜ 0.05),lower levels of serum cystatin C,β2 microglobulin and lower tubulointerstitial lesion grades and T-grade in the Oxford classification (P ＜ 0.05),when compared with patients without SIgA deposition.Both alternative and mannose binding lectin (MBL) pathways were activated in patients with or without SIgA deposition.Patients with MBL pathway activation had lower estimate glomerular filtration rate (P ＜ 0.01),higher serum creatinine,higher proportion of glomerulosclerosis and S-grade in the Oxford classification,more severe tubulointerstitial lesion (P ＜ 0.05).Conclusions Compared with patients without SIgA deposition,patients with SIgA deposition have a stronger link to mucosal immune.The deposition of SIgA is associated with different clinical and pathological manifestations;however,the complement activation is similar in both groups of patients.Patients with MBL pathway activation show more severe kidney injury.

Effect of military performance stress on sympathetic adrenal medulla in submariners / 军事医学

Objective To evaluate the effect of military performance stress on the changes of concentrations in salivary chromogranin A ( CgA) ,β-endorphin (β-EP) and salivary IgA ( sIgA) of submariners.Methods Twenty-nine submarine soldiers were selected, and their saliva samples were collected separately at the end of a long dive trip and nine months after relaxation ashore.In addition,the saliva samples of twenty-eight graduate students were collected as the normal control.The method of ELISA was used to detect the level of salivary CgA,β-EP and sIgA.Results After long-term dive training, the submariners showed significantly decreased CgA,β-EP and sIgA.Conclusion After a long term dive trip, chronic military performance stress is associated with the decline of salivary CgA,β-EP and sIgA, indicating that the function of sympathet-ic adrenal medulla is suppressed.The biological significance of these changes needs to be assessed in the future.

O Papel da imunoglobulina a secretora no mecanismo de defesa da mucosa bucal / The role of secretory immunoglobulin a in the defense mechanism of the oral mucosa

Introdução: As superficies mucosas mantem contato direto com o meio externo, sendo expostas a uma grande variedade de antigenos. Essas superficies possuem relativa vulnerabilidade e a secreção de anticorpos pelo sistema imune de mucosa constitui sua principal defesa, mantendo os antigenos desconhecidos e/ou potencialmente patogenicos fora do organismo. Entre esses anticorpos, o mais abundante ‚ uma IgA polimerica, denominada IgA secretora, que ‚ produzida por plasmócitos associados as mucosas e glandulas exocrinas. A sIgA possui uma estrutura capaz de resistir adegradação proteolitica de enzimas bacterianas e digestivas, o que a torna ideal para proteção do trato gastrointestinal. Na mucosa bucal a sIgA representa a mais importante barreira imunol¢gica, impedindo a aderencia e a penetração de microorganismos, sendo utilizada como parametro do status imunologico dessa mucosa. Objetivo: Realizar uma revisão de literatura a respeito da imunoglobulina A secretora liberada na saliva, enfocando sua formação, secreção e as principais funções imunológicas na proteção da mucosa bucal. Conclusão: A imunoglobulina A secretora possui ótimas caracteristicas para a proteção da mucosa bucal, atribuidas a sua estrutura e ação especifica e inespecifica. Os resultados de estudos clinico/laboratoriais associados a sua grande quantidade salivar, sugerem uma participação relevante da sIgA nos processos etiológicos e fisiopatológicos de lesões na mucosa bucal, evidenciando a necessidade de uma maior atenção as funções dessa imunoglobulina em estudos posteriores.

Introduction: Mucosa surfaces are in direct contact with the external environment, being exposed to a great variety of antigens. These surfaces have relative vulnerability and the secretion of antibodies by the mucosal immune system is the main defense mechanism, maintaining unknown and/or potentially pathogenic antigens out of the organism. Among these antibodies, the most abundant is a polymeric IgA, denominated secretory immunoglobulin A (sIgA), which is produced by plasmocytes associated with mucosas and exocrine glandules. A sIgA has a structure capable of resisting to the proteolytic degradation of bacterial and digestive enzymes, which makes it ideal for protecting the gastrointestinal tract. In the oral mucosa, sIgA represents the most important immunological barrier, impeding the adherence and penetration of microorganisms and being used as a parameter of immunological status of the mucosa. Objective: This paper presents a literature review on the sIgA released in the saliva, focusing on its formation, secretion and the main immunological functions on the protection of the oral mucosa. Conclusion: sIgA has excellent characteristics for protecting the oral mucosa, which are attributed to its structure and specific and unspecific actions. The results of clinical/laboratorial studies associated with its great amount in the saliva suggest a relevant participation of sIgA in the etiologic and physiopathological processes of oral mucosa injuries, demonstrating the necessity of a greater attention to the functions of this immunoglobulin in further studies.

A intervenção de enfermagem: relaxamento e seus efeitos no sistema imunológico de puérperas / A nursing intervention relaxation, and its effects on the immune system of postpartum women

OBJETIVOS: Avaliar os efeitos da técnica de relaxamento nos níveis de Imunoglobulina A (IgA) salivar em puérperas e a relação com as variáveis: idade, grau de instrução, estado civil, tipo de parto e paridade. MÉTODOS: Estudo experimental randomizado realizado em uma maternidade do Espírito Santo (Brasil). A amostra constituiu-se de 60 puérperas. O grupo experimental composto por 30 puérpuras seguiu a técnica de relaxamento proposta por Benson. As variáveis foram coletadas por meio de formulário específico e o nível de IgA salivar por imunoturbidimetria em dois momentos: até 24 horas pós-parto e 7 dias depois. RESULTADOS: Verificou-se aumento significativo dos níveis de IgA no grupo experimental (p= 0,01) após a prática do relaxamento e ausência de relação entre as variáveis de controle e a IgA. CONCLUSÃO: O relaxamento pode ajudar a aumentar a resistência imunológica de puérperas.

OBJECTIVES: To evaluate the effects of relaxation techniques in the levels of immunoglobulin A (IgA) in saliva of postpartum women, in relationship to the variables: age, education level, marital status, type of delivery and parity. METHODS: This experimental, randomized trial was conducted in a maternity ward of Espirito Santo (Brazil). The sample consisted of 60 postpartum women. The experimental group consisted of 30 postpartum women who received the relaxation technique proposed by Benson. The levels were collected using a specific form and level of salivary IgA by immunoturbidimetry in two stages: up to 24 hours postpartum, and 7 days later. RESULTS: We observed a significant increase of IgA levels in the experimental group (p = 0.01) after the practice of relaxation, and a lack of relationship between the control variables and IgA. CONCLUSIONS: Relaxation can help increase immunological resistance in postpartum women.

OBJETIVOS: Evaluar los efectos de la técnica de relajación en los niveles de Inmunoglobulina A (IgA) salival en puérperas y la relación con las variables: edad, grado de instrucción, estado civil, tipo de parto y paridad. MÉTODOS: Estudio experimental randomizado realizado en una maternidad de Espírito Santo (Brasil).La muestra se constituyó de 60 puérperas. El grupo experimental compuesto por 30 puérperas siguió la técnica de relajación propuesta por Benson. Las variables fueron recolectadas por medio de un formulario específico y el nivel de IgA salival por imunoturbidimetria en dos momentos: hasta 24 horas post-parto y 7 días después. RESULTADOS: Se verificó aumento significativo de los niveles de IgA en el grupo experimental (p= 0,01) después de la práctica de relajación y ausencia de relación entre las variables de control y la IgA. CONCLUSIÓN: La relajación puede ayudar a aumentar la resistencia inmunológica de puérperas.

Study on the role of local immunity in the female genital tract with nongonococcal urethritis / 中华传染病杂志

Objective To study the role of local immunity in the female genital tract with non- gonococcal urethritis(NGU).Methods Forty-four cervical secretions from patients with NGU were collected.After treatment with Azithromycin,22 cases were followed up.One month later,pathogen was eliminated in 15 patients.Another 27 un-infected people were included in our study.The level of secretory immunoglobulin A(SIgA)was detected using the automatic special protein analysor,and interferon-?(IFN-?)was quantified by enzyme-linked immunosorbent assay(ELISA).All data were analyzed with ANOVA.Results The levels of SIgA and IFN-?in NGU infected group were(34.29?15.92)mg/L and(97.13?24.00)ng/L respectively,while those of uninfected group were(47.57?19.61)mg/L and(120.71?33.78)ng/L,respectively(all P0.05).Conclusions SIgA and IFN-?secreted by genital tract mucosa may help pre- vent and resist the local NGU infection.However,the effect is limited,and is insufficient to eliminate infection completely and prevent reinfection.