Effects of neutrophil extracellular traps during human respiratory syncytial virus infection in vitro

The human respiratory syncytial virus (hRSV) is the most common cause of severe lower respiratory tract diseases in young children worldwide, leading to a high number of hospitalizations and significant expenditures for health systems. Neutrophils are massively recruited to the lung tissue of patients with acute respiratory diseases. At the infection site, they release neutrophil extracellular traps (NETs) that can capture and/or inactivate different types of microorganisms, including viruses. Evidence has shown that the accumulation of NETs results in direct cytotoxic effects on endothelial and epithelial cells. Neutrophils stimulated by the hRSV-F protein generate NETs that are able to capture hRSV particles, thus reducing their transmission. However, the massive production of NETs obstructs the airways and increases disease severity. Therefore, further knowledge about the effects of NETs during hRSV infections is essential for the development of new specific and effective treatments. This study evaluated the effects of NETs on the previous or posterior contact with hRSV-infected Hep-2 cells. Hep-2 cells were infected with different hRSV multiplicity of infection (MOI 0.5 or 1.0), either before or after incubation with NETs (0.5–16 μg/mL). Infected and untreated cells showed decreased cellular viability and intense staining with trypan blue, which was accompanied by the formation of many large syncytia. Previous contact between NETs and cells did not result in a protective effect. Cells in monolayers showed a reduced number and area of syncytia, but cell death was similar in infected and non-treated cells. The addition of NETs to infected tissues maintained a similar virus-induced cell death rate and an increased syncytial area, indicating cytotoxic and deleterious damages. Our results corroborate previously reported findings that NETs contribute to the immunopathology developed by patients infected with hRSV.

Probiotics: relevant during the coronavirus (COVID-19) infection pandemic?

The review presents modern views on the role of probiotics in the treatment and prevention of complications of the novel coronavirus COVID-19 infection. This infection can be complicated, for example, by the development of diarrhea after the use of antibacterial drugs in case of secondary bacterial infection, extrapulmonary viral infections, viremia, and the so-called «cytokine storm». The emphasis has been placed on such potentially beneficial effects of probiotics as а prevention of antibioticassociated diarrhea, prevention of intestinal damage induced directly by viral replication, prevention of leaky gut syndrome and immunomodulation in case of coronavirus COVID-19 infection. It has been shown that the use of probiotics alongside antibiotic therapy significantly reduces the risk of developing antibiotic-associated diarrhea, including such a severe variant as pseudomembranous colitis. The use of a probiotic during a viral respiratory disease reduces the risk of a severe disease course due to the positive modulation of inflammation and direct antiviral effects. Selected data showed the positive effect of probiotics on the tight junction stability of the intestine, which potentially protects against viremia and the penetration of immunogenic molecules into the internal environment of the body. In order to address the challenges adequately, a probiotic should meet certain requirements in terms of product quality, safety, evidence of efficacy, composition and understanding of the strains. The article presents data on the successful use of a multi-strain immuno-probiotic as an example demonstrating the therapeutic potential of modern multi-strain probiotics as a nonspecific immunomodulatory agent for the prevention of acute respiratory diseases.

Bupleurum turcicum: A Rich Source of Saikosaponin A and D with Potential Use as Adjunct for the Management of Acute Respiratory Diseases: A Meta Review

COVID-19 pandemic caused by SARS-CoV-2 has resulted in unprecedented havoc worldwide with significant morbidity and mortality. Till now, no effective antivirals are at disposal prompting researchers to explore potential lead molecules including from bioactive phytochemicals. An extensive literature search was carried out utilizing online resources; Google Scholar and PubMed to collect published reports on pharmacological potential of saikosaponin particularly in underexplored Bupleurum species. A number of molecular docking studies have reported promising antiviral effects of saikosaponins particularly of saikosaponin A, D, U and V with tremendous potential to be developed as anti-SARS-CoV-2 therapy. The search for potential sources of saikosaponin A and D led to the identification of Bupleurum turcicum; an unexplored, underutilized and endemic Bupleurum species. The observation that B. turcicum root extract contains highest amount of SSa and SSd among endemic Bupleurum species found in Turkey (Bupleurum sulphureum, Bupleurum lycaonicum, Bupleurum turcicum, Bupleurum heldreichii, Bupleurum pauciradiatum) and presence of significant amounts of antioxidant compounds led to the proposition of using B. turcicum extracts as adjust therapy in the management of COVID-19. The proposal also relies on the evidence of SSa and SSd being effective against a number of viruses including SARS-CoV. This review discusses phytochemical composition of B. turcicum root, antiviral, immunomodulatory and anti-inflammatory potential of saikosaponins in view of its plausible usefulness in the management of COVID-19. B. turcicum is an underutilized species rich in saikosaponin A and D with potential antiviral properties which could be effective alternative therapy in COVID-19 management.

Study of clinical features of patients with chronic eczema

Objective — s to study the clinical features of chronic eczema (CE) in 96 patients aged 18 to 78 years. Materials and methods. The study was carried out in the city clinical dermatovenerological dispensary No. 5 in Kharkov. All patients gave written informed consent to participate in the study.The majority of them (66.7 %) were between 31 and 50 years old. The duration of dermatosis in 6.3 % of the surveyed persons ranged from 6 months to 1 year, in 33.3 % — from 1 year to 5 years, in 42.7 % — from 5 to 10 years, in 17.7 % — over 10 years. The most frequent causes of exacerbation in 51.1 % were neuropsychiatric trauma and stress, in 15.6 % — dise­ases of internal organs and acute respiratory diseases, in 13.5 % — contact with chemicals. In all patients, dermatosis was recurrent. Most often, the surveyed patients complained of moderate intensity itching (51 %) and severe sleep disturbances (66.7 %). Moderate leukocytosis and accelerated ESR were found in 21.9 % of patients, eosinophilia — in 5.1 %. Results and discussion. 96 patients with chronic eczema aged 18 to 78 years were under observation. The diagnosis of chronic eczema was based on anamnestic data, patients’ complaints of itchy skin of varying intensity, objective examination of the patient, as well as recurrences of dermatosis for more than 1 year. The largest number of patients had dermatosis from 5 to 10 years. Chronic eczema in the observed patients was recurrent. The duration of remission was (4.9 ± 0.2) months. The duration of exacerbation was (6.1 ± 0.2) weeks. To characterize the severity of chronic eczema, a scoring system was used, according to which the average severity was (2.63 ± 0.08) points.According to the degree of skin lesions, the forms of dermatosis were limited and widespread. Patients complained of skin itching of varying intensity: more often itching of moderate intensity, periodic; painful, persistent, with an insurmountable need to scratch; short-term; no itching.Also, patients noted sleep disturbance in the form of difficulty falling asleep, sudden awakening at night and lack of a feeling of rest after waking up in the morning. 39 patients had bad habits (smoking, alcohol abuse).Сlinical analysis of blood revealed moderate leukocytosis, accelerated ESR, eosinophilia, signs of secondary infection. Conclusions. The average age of the patients ranged from 31 to 50 years. All examined patients had recurrent dermatosis. The average degree of its severity was (2.63 ± 0.08) points. Most often, patients complained of moderate intensity itching (51 %) and severe sleep disturbances (66.7 %). In 21.9 % of the examined patients moderate leukocytosis and accelerated ESR were revealed, in 5.1 % — eosinophilia.

The Impact of Haze on Healthcare Utilizations for Acute Respiratory Diseases: Evidence From Malaysia

Haze imposes a substantial disease burden on the human population especially in the Southeast Asia region due to the high frequency of haze episodes. The reduction of air quality levels by haze has resulted in a substantial disease burden and an increase in healthcare utilization (HU). This study aims to determine the association between haze and HU of haze-related respiratory illnesses with a focus given on the acute exacerbation of bronchial asthma (AEBA) and chronic obstructive pulmonary disease (AECOPD). A cross-sectional study was conducted through secondary data collection of haze/non-haze episodes as the study exposures and HU related to the exacerbation of bronchial asthma and COPD as the study outcomes. Data on haze/non-haze episodes and HU for four consecutive years (2012–2015) were retrieved from the Department of Environment and Ministry of Health Malaysia, respectively. In the four consecutive years, the percentage of haze episodes recorded in all stations was higher (67%) as compared to non-haze (33%) episodes. Means (SD) of patients diagnosed with AEBA and AECOPD were also significantly higher (p < 0.05) for inpatient 74 (62.1) and outpatient 320 (650.1) cases during haze episodes as compared to inpatient 34 (16.5) and outpatient 146 (170.5) cases during non-haze episodes. Findings from this study indicated that haze episodes incurred a significant healthcare burden due to an increase in HU. The evidence from this study will help the policymakers to prepare and allocate resources to control future implications of haze-related illnesses.

The systemic pro- and antioxidant processes in preschool children with recurrent acute respiratory diseases

Background. The imbalance of innate defense early mechanisms in children from pathogens — peroxidation and antioxidant system, can lead to a decrease in the efficiency of the entire immune system. The study of the lipid peroxidation (LPO) and antioxidant protection (AOP) status in children with recurrent acute respiratory diseases will complement the scientific data on the antimicrobial immunity formation processes. The study was aimed to increase the information value of timely detected pro- and antioxidant processes disorders in children with recurrent acute respiratory diseases by studying the primary, secondary, tertiary, and quaternary compounds of LPO and AOP in the serum. Materials and methods. Sixty children aged from 2 to 5 years were examined. Two groups were formed: group 1 — children with respiratory acute infectious more than six times per year (n = 30); group 2 — children with respiratory acute infectious six or fewer times per year (n = 30). Results. The children in group 1 more often presented with high serum levels of lipid hydroperoxides (by 80.0 %; p < 0.05), diene conjugates (by 80.0 %; p < 0.05), malonic dialdehyde (76.7 %; p < 0.05), diene ketones (76.7 %; p < 0.05), Schiff bases (76.7 %; p < 0.05). ceruloplasmin (80.0 %; p < 0.05), superoxide dismutase (80.0 %; p < 0.05), glutathione peroxidase (86.7 %; p < 0.05), catalase activity (86.7 %; p < 0.05). The values of retinol, tocopherol, ascorbic acid in children in the observation groups did not differ statistically significantly. Conclusions. The children aged from 2 to 5 years old with recurrent acute respiratory diseases have an imbalance of the LPO and AOP systems. It was characterized by a simultaneous increase in the serum content of the primary, secondary, and end-products of LPO, enzymes of anti-peroxide and anti-oxygen protection against the background of the lack of adaptive increase in the content of anti-radical compounds.

Energy lost in endothermic reactions in the production of clay blocks in a continuous kiln

In Ocaña, Norte de Santander, Colombia, the production of ceramic materials is done in a traditional and empirical manner, generating heat losses, low productivity and product quality, and increased emissions of polluting gases into the environment. A virtual instrument for temperature data acquisition was developed and the firing process was monitored in two loading doors of a Hoffman kiln. 29040 blocks were produced, and 1370.76 kg of pulverized charcoal were consumed. The firing process lasted sixty-two hours and the virtual instrument was programmed to record data every 5 minutes. The energy supplied to the brick kiln was 340.16x106 kJ and the heat due to loading of the products and heat lost in the endothermic reactions of the clay was 107.71x106 kJ and 105.71x106 kJ respectively, representing 31.66% and 31.08% of the energy supplied. The results have made it possible to establish trends in the temperatures and energy consumed in the endothermic reactions in the clay. This will allow the implementation of coal quality and grinding procedures, increasing energy efficiency, and reducing gas emissions into the environment, thus avoiding acute respiratory diseases.

Dysbiosis and structural disruption of the respiratory microbiota in COVID-19 patients with severe and fatal outcomes

The COVID-19 outbreak has caused over three million deaths worldwide. Understanding the pathology of the disease and the factors that drive severe and fatal clinical outcomes is of special relevance. Studying the role of the respiratory microbiota in COVID-19 is especially important as the respiratory microbiota is known to interact with the host immune system, contributing to clinical outcomes in chronic and acute respiratory diseases. Here, we characterized the microbiota in the respiratory tract of patients with mild, severe, or fatal COVID-19, and compared it to healthy controls and patients with non-COVID-19-pneumonia. We comparatively studied the microbial composition, diversity, and microbiota structure between the study groups and correlated the results with clinical data. We found differences in the microbial composition for COVID-19 patients, healthy controls, and non-COVID-19 pneumonia controls. In particular, we detected a high number of potentially opportunistic pathogens associated with severe and fatal levels of the disease. Also, we found higher levels of dysbiosis in the respiratory microbiota of patients with COVID-19 compared to the healthy controls. In addition, we detected differences in diversity structure between the microbiota of patients with mild, severe, and fatal COVID-19, as well as the presence of specific bacteria that correlated with clinical variables associated with increased risk of mortality. In summary, our results demonstrate that increased dysbiosis of the respiratory tract microbiota in patients with COVID-19 along with a continuous loss of microbial complexity structure found in mild to fatal COVID-19 cases may potentially alter clinical outcomes in patients. Taken together, our findings identify the respiratory microbiota as a factor potentially associated with the severity of COVID-19.

Organization of research activity in a polyclinic using medical information system

Introduction. The article considers an approach to organization of research activity using medical information system. Materials and methods. Authors carried out retrospective analytical cohort study of adults with temporary incapacity to work based on the data from the State Medical Institution Galichskaya District Hospital (Kostroma Region of the Russian Federation) for a period 2014–2019. Sampling was done using the medical information system. Results. As the medical information system has been operating for many years and is designed in the way that the key information gaps should be filled, we consider the results of our study on research activity in a polyclinic using medical information system successful. Discussion. The organization of research activity is discussed using results of an epidemiological study aimed at identifying the correlation between the incidence of acute respiratory diseases and further development of circulatory system diseases carried out in Galichskaya District Hospital.

Mineral metabolism and COVID-19: is there a connection?

Due to global spread of COVID-19, the search for new factors that could influence its clinical course becomes highly important. This review summarize the relevant publications on the association between immune system and the main regulators of mineral homeostasis including. In addition, we have highlighted the various aspects of phosphorus-calcium metabolism related to the acute respiratory diseases and in particular to COVID-19. The data about the calcium-phosphorus metabolism in SARS-CoV-2 infection is required to understand the possible clinical implications and to develop new therapeutic and preventive interventions.