Objective: Bacterial extracts have been used for many years to prevent airway infections. Recent findings suggest that immunity can be trained by inducing an immunological memory in both the innate and acquired immune response. This real-life observational study investigated the potential of sublingual bacterial immunotherapy in the prevention of ear, nose, and throat infections. Methods: Patients received sublingual bacterial immunotherapy for 12 months and were followed for 24 months. The number of ear, nose, and throat infection episodes from the previous year was recorded during the initial visit based on the patient’s clinical history. Patients were then followed up with visits every 2 months, and the occurrence of ear, nose, and throat infection episodes was documented at 6, 12, 18, and 24 months after the start of the study. Results: The results demonstrated a strong potential for preventing ear, nose, and throat infections, with a reduction in the number of episodes by 75.68%, 82.27%, 82.78%, and 89.88% at 6, 12, 18, and 24 months, respectively. No adverse effects related to sublingual bacterial immunotherapy administration were reported. Conclusion: The results suggested that long-term sublingual bacterial immunotherapy is safe and effectively prevents ear, nose, and throat infections, even after treatment ends.

Technological innovation, social media and artificial intelligence (AI) have revolutionized doctor-patient interaction and the dissemination of medical information to the population. In the last decade, a large number of digital devices have been developed for the purpose of medical education and patient guidance in the various areas of medicine. Recently, we introduced the AllergyVax app with various educational tools to guide patients and promote increased adherence to AIT. In the present study, we investigated the level of patient satisfaction with the use of the AllergyVax app as an auxiliary tool in the AIT treatment. A digital search was carried out in scientific databases, social media and APP stores to research technological tools used in the area of allergy and immunology. All these tools were analyzed taking into account their qualities and weaknesses. From this analysis, we developed an app with the main objective of educating patients about AIT and promoting adherence to treatment. The evaluation of the usefulness of the APP was carried out by 202 paients (132 and 70 using SLIT and SCIT respectively) who evaluated the level of satisfaction using the following scale: very satisfied, satisfied , little satisfied and not satisfied. The results revealed a high degree of patient satisfaction with AllergyVax app (90% very satisfied, 8% satisfied and 2% little satisfied). Patients' satisfaction was related to some specific tools of the app Educational sessions about treatment were reported as very interesting.

Androgenetic alopecia (AGA) is the most common hair loss disorder, affecting millions of men and women worldwide. Current formulations used to treat this condition often lead to a wide variety of side effects, ranging from allergies to sexual disfunction, especially when those drugs are administered orally. In this study, we developed and tested unique formulations containing nanostructured lipid carriers (NLC) composed of lipids extracted from fruit seeds, carrying finasteride to enhance efficacy of AGA treatment. By stabilizing the hydrophobic compounds in the solid matrix, three formulations of NLC were engineered and successfully prepared. Further an in vivo model of AGA was induced in rats by the administration of testosterone, as a platform to evaluate the efficiency of the formulations. The chosen formulation exhibited high bioavailability, medium size of 124.5 nm and PdI of 0.143, without systemic absorption. In addition, it promoted efficient and significant follicle restoration in AGA induced rats by increasing number of active bulbs and showed to be a safe formulation for topical application. The results of this research indicate that the presented formulation has significant potential to yield improved outcomes in AGA treatment.

Introdução: Mutações do gene da filagrina vêm sendo associadas, classicamente, a alterações da barreira epitelial em doenças alérgicas com comprometimento da pele e das superfícies mucosas.Particularmente na dermatite atópica, a relação entre filagrina, mecanismo fisiopatológico e evolução clínica tem sido demonstrada.Recentemente, alterações da barreira epitelial com redução da expressão da filagrina, também têm sido associadas a mecanismos imunológicos envolvidos na patogênese da esofagite eosinofílica.Devido a disfunções na barreira epitelial, microrganismos e alérgenos são capazes de penetrarem no epitélio da mucosa esofágica, assim como na dermatite atópica

Introduction: Bone healing depends on inflammation control and tissue repair time. Low-level laser therapy (LLLT) has been investigated to accelerate this process. Methylene blue (MB), together with LLLT, has been investigated for its antioxidant and anti-inflammatory potential; however, the effects of photosensitizers (photodynamic therapy, PDT) are controversial. This study aimed to verify whether the combination of MB and LLLT changes the course of the consolidation of experimental bone defects. Methods: Sixteen Wistar rats underwent femoral bone defects. In the control group (n=4), LLLT simulations were performed without MB. The MB group (n=4) received MB and simulation of LLLT. The LLLT group (n=4) was exposed to LLLT. The PDT+LLLT group (n=4) received MB and LLLT. At the end of 7 or 14 days, the animals were euthanized, and samples were collected. Results: PDT and LLLT induced osteogenic formation with cellularity (after seven days) and union of bony edges (14 days). On the seventh day, LLLT combined with PDT induced an increase (P<0.05) of 484% in the area of bone neoformation compared to the control. On the fourteenth day, LLLT combined with PDT or alone increased (P<0.05) the area of bone neoformation by 214% and 240% respectively, compared to the control group. The PDT/LLLT combination was associated with increased radiopacity (P<0.038). Conclusion: The combined use of MB with LLLT initiated during the transoperative phase may stimulate the bone repair process in rats.

ABSTRACT Introduction: Oral mucositis (OM) is considered the most frequent acute side effect of the antineoplasic treatment, with ulcerative lesions resulting from a painful symptomatology, affecting the oral cavity in response to the Antineoplastic treatment. In order to study these side effects, experiments in animal models are necessary, using antineoplastic drugs for the induction of OM and anesthetics, mainly Ketamine and Xylazine, to perform scarification of the cheeks. Objective: The goal is to report an experimental model of induced OM, without the use of anesthetics for the scarification stage of the animal cheeks. Methods: Fourty five male Wistar rats, 7 weeks old and weighting 220g, were used, divided into 2 groups; with OM induced by 5-Fluorouracil intraperitoneal administration. Two days later, Group I was physically contained, in contrast, Group II were anesthetized with Ketamine and Xylazine, focusing on irritating the cheek mucosa using the tip of a sterile needle, in order to potentialize the development of OM. The animals were euthanized with an anesthetic overdose. Results: Concerning the experiment of 5-Fluorouracil chemo-induced of OM, where the irritation was performed by physical containment, without the use of anesthetics (Ketamine and Xylazine), the animals had a longer survivability and a rapid improvement of the side effects induced by chemotherapy. Conclusion: This new model is promising, considering that the use of anesthetics (Ketamine and Xylazine) showed a high mortality rate. In the absence of anesthesia, all the animals survived until the end of the experiment involving chemotherapy model with 5-Fluorouracil and physical restraint.

Sublingual immunotherapy (SLIT) has been used for more than three decades as a therapeutic strategy for the treatment of allergic diseases. Studies have demonstrated its efficacy and safety, and numerous clinical trials have evaluated these parameters. In the present study, through patient perception, we investigated the patient satisfaction with the use of house dust mite SLIT treatment. “Satisfaction Scale for Patients Receiving Allergen Immunotherapy” (ESPIA) questionnaire, a standardized and validated instrument for clinical studies evaluating allergen immunotherapy, was applied to allergic patients (N = 136). Children and adults of both sexes who received SLIT for Dermatophagoides pteronyssinus and/or Blomia tropicalis, according to the results of an immediate reading puncture test, were included. Data analysis showed that the perception of treatment effectiveness was 92%, performance improvement in the daily activities was 91%, a satisfactory cost-benefit balance was 84%, and the perception of general satisfaction was 97%. The results showed a high perception of satisfaction in allergic patients undergoing house dust mite SLIT.

Introdução: O mieloma múltiplo (MM) é uma neoplasia hematológica que cursa com hipogamaglobulinemia e consequente imunodeficiência secundária.Uma das principais causas de morbimortalidade desses pacientes são infecções.Objetivou-se com esse estudo avaliar o impacto da reposição de imunoglobulina endovenosa (IgIV) na taxa de infecções em pacientes portadores de MM.Métodos: Trata-se de um estudo de análise documental, com variáveis qualitativas e quantitativas, com objetivo de realizar análise retrospectiva dos prontuários de pacientes com MM que receberam tratamento com imunoglobulina humana endovenosa em um

The aim of the present study was to investigate the preventive potential of pentoxifylline, atorvastatin and trans-caryophyllene in oral mucositis through histopathological analysis of wounds in the oral mucosa of Wistar rats treated with 5-FU, and to evaluate the immunomodulatory effect of these drugs on serum nitrite production, in situ IFN-γ, TNF-α and TGF-β, and TNF-α in tissues. A total of 32 male Wistar rats with an average age of 9 weeks and an average body weight of 250 g were divided into four treatment groups: Saline, trans-caryophyllene, pentoxifylline and atorvastatin. Oral mucositis was then induced. On days 3 and 4, the mucosa of the mouth of eight pre-treated animals in each group was bilaterally scarified twice with the tip of a sterile needle, with an anesthetic solution. Mucosal samples from animals treated with trans-caryophyllene preserved a thin epithelial lining associated with focal perivascular inflammatory infiltrates. Pentoxifylline-treated animals exhibited total epithelial loss in oral wounds with severe inflammatory infiltrates and mild re-epithelialization associated with mild and diffuse inflammatory infiltrates. Samples from atorvastatin-treated animals exhibited no epithelial dissolution, with preserved thin lining and mild diffuse inflammatory infiltrates. The analysis of TNF-α expression revealed improved results in trans-caryophyllene animals. The analysis of TGF-β expression revealed positive mononuclear cells. Preventive treatment with atorvastatin was demonstrated to modulate the serum expression levels of TNF-α during all stages of the experiment. Treatment with trans-caryophyllene modulated serum IFN-γ levels negatively, whereas treatment with atorvastatin and trans-caryophyllene maintained lower levels of IFN-γ compared with the control group.

Asthma is a chronic inflammatory disease that represents high hospitalizations and deaths in world. Copaiba oil (CO) is popularly used for relieving asthma symptoms and has already been shown to be effective in many inflammation models. This study aimed to investigate the immunomodulatory relationship of CO in ovalbumin (OVA)-induced allergic asthma. The composition of CO sample analyzed by GC and GC MS and the toxicity test was performed in mice at doses of 50 or 100 mg/kg (by gavage). After, the experimental model of allergic asthma was induced with OVA and mice were orally treated with CO in two pre-established doses. The inflammatory infiltrate was evaluated in bronchoalveolar lavage fluid (BALF), while cytokines (IL-4, IL-5, IL-17, IFN-gamma, TNF-alpha), IgE antibody and nitric oxide (NO) production was evaluated in BALF and lung homogenate (LH) of mice, together with the histology and histomorphometry of the lung tissue. CO significantly attenuated the number of inflammatory cells in BALF, suppressing NO production and reducing the response mediated by TH2 and TH17 (T helper) cells in both BALF and LH. Histopathological and histomorphometric analysis confirmed that CO significantly reduced the numbers of inflammatory infiltrate in the lung tissue, including in the parenchyma area. Our results indicate that CO has an effective in vivo antiasthmatic effect.

Selective IgA deficiency is the most common type of primary immunodeficiency, but there is not yet a specific effective treatment. The most prevalent clinical manifestations are infectious diseases of the respiratory system. We report herein the case of an 11-year-old female with selective IgA deficiency and recurring episodes of respiratory infections associated with rhinitis and asthma. We evaluated the efficacy of sublingual immunotherapy combined with inactivated whole-cell bacterial extract and Der p1-specific immunotherapy. After 18 months of clinical follow-up, we observed a significant reduction in the number of episodes of respiratory infections associated with control of atopic diseases. We also observed a 3-fold increase in serum IgA levels compared to treatment initiation. This case demonstrates the potential utility of the concurrent use of sublingual immunotherapy with inactivated whole-cell bacterial extract and Der p1 for successful control of allergy and infection in partial selective IgA deficiency.

Linfocitos T auxiliares sao divididos nas subpopulacoes Th1, Th2, Th17 e Treg, cada uma com funcoes efetoras especificas, segundo um padrao de producao de citocinas. Atualmente, novas subpopulacoes tem sido identificadas como Th22 e Th9, dentre outras. As celulas Th17 foram descritas no ano 2000 por Infante-Duarte et al. e se caracterizam pela sintese das interleucinas 17, 21 e 22. Via liberacao de interleucina 17, as celulas Th17 atuam induzindo inflamacao. Apesar de importante papel na imunidade contra bacterias e fungos, as celulas Th17 participam da patogenese de doencas auto-imunes e de inflamacoes alergicas e, especialmente na asma, o infiltrado neutrofilico observado no tecido das vias aereas em episodios de agudizacao parece ser modulado pelo aumento dos niveis desta interleucina. A hiperoxia, comumente utilizada como terapia complementar em pacientes com asma grave, parece induzir o aumento da IL-17, agravando a condicao clinica do paciente. Apesar de quase um quarto das celulas do infiltrado linfocitario em vias aereas na asma corresponder a linfocitos Th17, o papel desta populacao celular e da IL17 nao e totalmente esclarecido e sua influencia na severidade da asma ainda nao foi bem definida. O presente trabalho busca revisar os principais apectos funcionais das celulas Th17 e de seus produtos, assim como de sua influencia na fisiopatologia e na severidade da asma. PALAVRAS-CHAVE: Th17; asma; hiperoxia

Background The aim of this study was to evaluate the positivity rates of atopy patch tests for Dermatophagoides pteronyssinus , Dermatophagoides farinae and Blomia tropicalis in patients with respiratory diseases such as asthma and allergic rhinitis with or without atopic dermatitis. Methods The patients’ clinical histories were collected, and the patients were subjected to skin prick and patch tests with the three different house dust mites on the same day. The patch tests were examined 48 hours later, and then patients were divided into two groups: I- patients with respiratory diseases, such as asthma and/or rhinitis, and atopic dermatitis and II-patients with only respiratory diseases. A total of 74 patients ranging in age from 2 to 60 years were included in this study; 16 patients were included in group I and 58 were included in group II. This study was approved by the human ethics committee of the Faculty of Medical Science and Health SUPREMA (number 2.007.135), and written informed consent was collected from each patient or their parents prior to enrollment. Results In the skin prick tests, the most prevalent mite that evoked a reaction was Dermatophagoides pteronyssinus , followed by Dermatophagoides farinae and Blomia tropicalis . Regarding the atopy patch tests, the mite that most frequently induced a positive reaction was Dermatophagoides farinae (78.4%), followed by Dermatophagoides pteronyssinus (77%) and Blomia tropicalis (52.7%). A comparison of the skin prick and atopy patch tests revealed that 53 patients (71.6%) were positive on both tests, and 30 (56.6%) patients were positivite for the same mite. We found six patients (8%) who had a positive clinical history of allergy and only exhibited positivity on the atopy patch test. Discussion Most studies have been performed with atopic dermatitis patients, but in this study, most of the patients had respiratory conditions. Blomia tropicalis is a mite that is prevalent in tropical areas, such as Brazil, and only two publications include these three mites, wich are present in Brazil. The APT may produce positive results in concordance with the SPT resuts, but may also be the only positive test ( 8%) as we observed in our study. These results suggest that the mite atopy patch test is relevant and should be considered as an additional test for patients with clinical histories of allergic respiratory disease who have negative prick test results. Conclusion The APT should be considered as an additional test when the SPT and specific serum IgE tests are negative in patients with clinical histories of allergies.

Multiple sclerosis is the most common autoimmune inflammatory and demyelinating disease of the central nervous system. The experimental autoimmune encephalomyelitis (EAE) is an appropriate and a well-establish model for studying the pathogenesis of MS. β-caryophyllene (BCP), a natural sesquiterpene found in many plant species, is a potent anti-inflammatory compound. Herein we investigated the in vitro and in vivo immunomodulatory effects of BCP on C57BL/6 mice induced with EAE. BCP was in vitro evaluated (4, 20, and 40μM) on splenocytes obtained from EAE-induced C57BL/6 mice, and in vivo (25 or 50mg/kg/day) orally administered on EAE-mice. The clinical course, body weight, cytokines and oxygen radicals production were investigated in C57BL/6 EAE-mice. In vitro and in vivo immunological responses were evaluated by ELISA, and CNS sections were stained by hematoxylin and eosin methods The in vitro production of H2O2, NO, IFN-γ, and TNF- α was inhibited by BCP (20 and 40μM) in cultured cells from EAE-mice. BCP (25 and 50mg/kg/day) reduced clinical score and severity of EAE and inhibited H2O2, NO, TNF-α, IFN-γ and, IL-17 production. EAE-mice, orally treated with BCP (mainly at 50mg/kg/day), displayed levels of cytokines and clinical signs similar to animals with no EAE disease, demonstrating the therapeutic action of BCP on EAE animals. Histopathological and histomorphometric analysis confirmed that BCP treatment significantly reduced the numbers of inflammatory infiltrates and attenuated neurological damages in the CNS of EAE-mice.

Evaluate the effect of the extract of Ginkgo biloba in the bone alkaline phosphatase, bone mineral density, in the mechanical properties of the tibia in rats with glucocorticoid-induced-osteoporosis. After osteoporosis induction, the rats were divided into five groups: Osteoporosis; EGb1 (28 mg/Kg); EGb2 (56 mg/Kg); alendronate (0.2 mg/animal) and control. The animals were treated during 20 and 30 days. The control group was compared with the osteoporosis's (Student's t-test), while the other were analyzed by ANOVA test followed by Tukey/Dunnett'T3 (p<0.05). In the osteoporosis group the bone alkaline phosphatase, bone mineral density, the bone stiffness, the maximum load and the resilience were reduced. The bone alkaline phosphatase values increased in the EGb1 and EGb2 groups (30 days). In addition, in the EGb2 and alendronate groups (20 and 30 days) the bone mineral density increased. The extract of Ginkgo biloba restored bone alkaline phosphatase and bone mineral density using dual-energy x-ray absorptiometry.

Objective: to investigate the antimicrobial activity and biocompatibility of the calcium hydroxide [Ca(OH)2] + propylene glycol (PG) + aloe vera (AV) paste in comparison with other pastes used as intracanal medication. Material and Methods: there was evaluated 3 intracanal medication based on calcium hydroxide and propylene glycol, varying only the third component. In group 1, the third component was camphorated paramonochlorophenol (CPMC); in group II, chlorhexidine (CHX); and in group III, aloe vera. The antimicrobial activity was analyzed through the direct contact of the intracanal medication pastes with strains of Enterococcus faecalis; Kocuria rhizophila; Pseudomonas aeruginosa and Candida albicans. The biocompatibility was evaluated in subcutaneous tissue of rats during experimental 7, 21 and 63 days. Results: it was observed that the Group II showed the best results regarding antimicrobial activity, followed by group III and I. The Ca(OH)2 + PG + AV paste was considered biocompatible since it presented discrete fibrosis and suggestive histological characteristics of normal healing after 63 days, approaching the control group. Conclusion: the association of Ca (OH)2 + PG + AV showed antibacterial activity and adequate biocompatibility when compared with commonly pastes used as intracanal medication.

Objetivo: investigar a atividade antimicrobiana e a biocompatibilidade da pasta de hidróxido de cálcio [Ca (OH) 2] + propilenoglicol (PEG) + aloe vera (AV) em comparação com outras pastas utilizadas como medicação intracanal. Material e Métodos: foram avaliadas 3 medicações intracanal à base de hidróxido de cálcio e propilenoglicol, variando apenas o terceiro componente. No grupo 1, o terceiro componente foi paramonoclorofenol canforado (PMCC); no grupo II, clorexidina (CLX); e no grupo III, aloe vera. A atividade antimicrobiana foi analisada através do contato direto das pastas de medicação intracanal com cepas de Enterococcus faecalis; Kocuria rhizophila; Pseudomonas aeruginosa e Candida albicans. A biocompatibilidade foi avaliada em tecido subcutâneo de ratos durante 7, 21 e 63 dias experimentais. Resultados: observou-se que o Grupo II apresentou os melhores resultados quanto à atividade antimicrobiana, seguido pelos grupos III e I. A pasta de Ca (OH) 2 + PEG + AV foi considerada biocompatível por apresentar discreta fibrose e sugestivas características histológicas de cicatrização normal. após 63 dias, aproximando-se do grupo controle. Conclusão: a associação de Ca (OH) 2 + PEG + AV mostrou atividade antibacteriana e biocompatibilidade adequada quando comparada com pastas comumente utilizadas como medicação intracanal.

There are few studies in Latin America about the prevalence of asthma-chronic obstructive pulmonary disease (COPD)-asthma overlap syndrome(ACOS) in elderly patients. An observational cross-sectional study was performed with 202 elderly patients (147 females and 55 males) who were subjected to the asthma module of the International Study of Asthma and Allergies in Childhood (ISAAC) test, which was modified for elderly patients, and evaluated by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) routine in order to assess for COPD. Of the 202 patients, 11.3% had definite asthma, 5.4% had probable asthma, 9.9%had COPD, and 6.4%had ACOS. In the elderly patients with ACOS, the incidence of pulmonary disease was higher in patients who were 60 to 69 years old (10.6%) and in females (6.8%)than it was in males (5.4%). The study group had a significant prevalence of ACOS, which suggested that the methods that are used to diagnose ACOS need to be improved in order to provide a better quality of life to elderly patients with ACOS.

Objective To assess the value of fraction of exhaled nitric oxide (FeNO) measurements in the diagnosis of asthma in elderly patients. Methods The clinical symptoms of 202 elderly patients were assessed with the asthma module of the International Study of Asthma and Allergies in Childhood test, which had been modified for the elderly patients, and the diagnostic routine for chronic obstructive pulmonary disease (COPD), which was based on the Global initiative for chronic Obstructive Lung Disease criteria. Of the 202 patients assessed, 43 were subjected to pulmonary function evaluations (spirometry) and FeNO measurements. Results Of the 202 elderly patients, 34 had asthma (23 definite and eleven probable), 20 met COPD criteria, 13 presented with an overlap of asthma and COPD, and 135 did not fit the criteria for obstructive pulmonary disease. Among the 43 elderly patients who were subjected to FeNO measurements, ten showed altered results (23.2%) and 33 had normal results (76.7%). The average value of FeNO in patients with definite and probable asthma undergoing this procedure was 29.2 parts per billion whereas that in nonasthmatic patients was 17.5 parts per billion (P=0.0002). Conclusion We show a clear relationship between FeNO levels and asthma symptoms and previous asthma diagnoses in elderly patients.

Although the sublingual allergen-specific immunotherapy (SLIT) is a routine treatment in many Latin America countries there are few studies related to the adherence of sublingual immunotherapy (SLIT) with no reports in the Brazilian population. A retrospective cross-sectional study with 218 patients from an Allergy and Immunology Service in Juiz de Fora, MG, Brazil were performed in patients with diagnosis of rhinitis and/or asthma that received SLIT for dust mites based on the results of the Prick Test The participants were divided by sex and into three age groups: A) 2 to 12 years; B) ≥ 12 years to 18 years ; C) ≥ 18. We evaluated adherence after 4 months (the end of the induction phase) and 12 months of treatment. The general adherence of SLIT in four months was 66.1% (70.2% in male group and 61.5% in female group). The analysis of adherence by age, group A showed 70.6% of adherence, B 63.3% and C 61.6% in the fourth month. After 12 months of treatment, the total of adherence was 46.3% (51.8% in male and 40.4% in female) and the adherence of the groups A, B and C were, respectively: 52%, 40% and 41.9%. The SLIT, although it's safety and easier to manage, has limitations in the adherence on the Brazilian population , especially after the induction phase. The results indicate that educational proceedings must be perform to improve the SLIT adhesion.