Dengue Shock Syndrome: Its Similarity with Anaphylaxis and with the Homeopathic Medicine Apis mellifica (European Honeybee)

Dengue, with four viral serotypes, causes epidemics in tropical and sub-tropical regions. Allopathic antiviral therapies and a vaccine of general use are lacking. The homeopathic medicine Apis mellifica, advised in anaphylaxis from honeybee sting, is proposed to address the life-threatening dengue shock syndrome, which develops from dengue hemorrhagic fever and has features of anaphylaxis. In both dengue and anaphylaxis, immunoglobulin E activates, and released vasoactive mediators (importantly histamine, tryptase and platelet-activating factor) cause, a vascular permeability enabling shock. In dengue, another mechanism, namely antibody-dependent enhancement, due to secondary infection with a heterologous dengue serotype, is associated with release of vasoactive mediators. The homeopathic medicine Apis mellifica indicates plasma leak, shock, and the serous effusion that is noted in dengue patients, and is a suggested prophylactic and therapeutic medicine for dengue shock syndrome.

Knowledge, attitude and behaviour study on urticaria patients towards urticaria and diet

<p class="abstract"><strong>Background:</strong> Urticaria (‘hives’ or ‘nettle rash’) consists of blanchable, erythematous, edematous papules or wheals. These wheals vary in size from 1 mm to many centimetres, and are usually very itchy. They are caused by vasoactive mediators, predominantly histamine, released from mast cells. In majority of cases, the wheals are transient, lasting for only a few hours in any one place, but with new wheals appearing in other places. The aim of the study was to assess the knowledge, attitude and behaviour towards urticaria and diet among patients.</p><p class="abstract"><strong>Methods:</strong> A cross sectional study was done among urticarial patients visiting DVL OPD at Sree Balaji medical college and hospital using self-reported questionnaire from January to February 2021. Questionnaire was designed in manner that general population can understand and was distributed randomly irrespective of gender. Sample size of 50 was taken.<strong></strong></p><p class="abstract"><strong>Results:</strong> The results of the study revealed that most of the patient had the knowledge about urticaria and were aware about their trigger factors. Regarding behaviour most of the patients were ready to do lifestyle modifications. Regarding attitude urticarial patient had no problems mingling with the normal people.</p><p class="abstract"><strong>Conclusions:</strong> Urticaria is a relapsing condition with impact on quality of life. Specific elimination diets have observed high rates of response after a duration of 3 weeks. It has been confirmed that some patients experience worsening of symptoms after ingestion of foods including food additives as well as foods such as tomatoes, herbs, seafood, alcohol, and others.</p>

26. Chronic periodontitis and endothelial dysfunction In patients with arterial hypertension

The work offers a view at the data obtained through an examination of 120 patients with chronic generalized periodontitis (CP) and arterial hypertension (AH). The check-up included clinical examination, immunohistochemical, morphometric studies, as well as evaluation of the endothelium vasodilating function. CP in patients with hypertension features more significant changes in the quantitative density of gum cells positive to ET-1, endothelial NO-synthase, if compared to the CP values in patients with no background somatic pathology. Changes affecting vasoactive mediators in the gum are associated with a systemic inflammatory response and a violation of the endothelium vasodilating function. Periodontitis remission can be achieved with the therapy of the neurotransmitter imbalance.

Roles of Immune Cells in Hereditary Angioedema

Hereditary angioedema (HAE) is a rare genetic disease, characterized by recurrent and unexpected potentially life-threatening mucosal swelling. HAE may be further classified into HAE with C1‐inhibitor deficiency (C1‐INH‐HAE) and HAE with normal C1‐INH activity (nlC1‐INH‐HAE), mostly due to mutations leading to increased vascular permeability. Recent evidence implicates also the innate and adaptive immune responses in several aspects of angioedema pathophysiology. Monocytes/macrophages, granulocytes, lymphocytes, and mast cells contribute directly or indirectly to the pathophysiology of angioedema. Immune cells are a source of vasoactive mediators, including bradykinin, histamine, complement components, or vasoactive mediators, whose concentrations or activities are altered in both attacks and remissions of HAE. In turn, through the expression of various receptors, these cells are also activated by a plethora of molecules. Thereby, activated immune cells are the source of molecules in the context of HAE, and on the other hand, increased levels of certain mediators can, in turn, activate immune cells through the engagement of specific surface receptors and contribute to vascular endothelial processes that lead to hyperpemeability and tissue edema. In this review, we summarize recent developments in the putative involvement of the innate and adaptive immune system of angioedema.

Th1-Polarized, Dengue Virus-Activated Human Mast Cells Induce Endothelial Transcriptional Activation and Permeability

Dengue virus (DENV), an arbovirus, strongly activates mast cells (MCs), which are key immune cells for pathogen immune surveillance. In animal models, MCs promote clearance of local peripheral DENV infections but, conversely, also promote pathological vascular leakage when widely activated during systemic DENV infection. Since DENV is a human pathogen, we sought to ascertain whether a similar phenomenon could occur in humans by characterizing the products released by human MCs (huMCs) upon direct (antibody-independent) DENV exposure, using the phenotypically mature huMC line, ROSA. DENV did not productively infect huMCs but prompted huMC release of proteases and eicosanoids and induced a Th1-polarized transcriptional profile. In co-culture and trans-well systems, huMC products activated human microvascular endothelial cells, involving transcription of vasoactive mediators and increased monolayer permeability. This permeability was blocked by MC-stabilizing drugs, or limited by drugs targeting certain MC products. Thus, MC stabilizers are a viable strategy to limit MC-promoted vascular leakage during DENV infection in humans.

Pathophysiology of Thrombosis in Peripheral Artery Disease

<P>Under physiological conditions, peripheral arteries release endogenous vascular-protective and antithrombotic agents. Endothelial cells actively synthesize vasoactive mediators, which regulate vascular tone and platelet reactivity thus preventing thrombosis. Atherosclerosis disrupts homeostasis and favours thrombosis by triggering pro-thrombotic responses in the vessels, platelet activation, aggregation as well as vasoconstriction, phenomena that ultimately lead to symptomatic lumen restriction or complete occlusion. <P> In the present review, we will discuss the homeostatic role of arterial vessels in releasing vascular-protective agents, such as nitric oxide and prostacyclin, the role of pro- and anti-thrombotic vascular receptors as well as the contribution of circulating platelets and coagulation factors in triggering the pro-thrombotic response(s). We will discuss the pathological consequences of disrupting the protective pathways in the arteries and the pharmacological interventions along these pathways.</P>