Can Mandated BCG Vaccine Promote herd Immunity against Novel Coronavirus? A Potential Solution at Hand to Tackle Covid-19 Pandemic

The 2019 novel coronavirus (2019-nCoV) infection is an emerging pandemic that poses a severe threat to global public health. This pandemic started from the Wuhan City of Hubei Province in China, and is speculated to have originated from bats and spread among humans with an unknown intermediate transmitter. The virus binds to angiotensin-converting enzyme 2 (ACE2), which is abundantly expressed on various human cells, including lung epithelial and intestinal cells, thereby entering into these cells and causing infection. It is transmitted to other humans through airborne droplets from infected patients. Presently there are no specific treatments or vaccines that are available to curtail the spread of this disease. There are few indirect reports that explain the potential importance of the mandated BCG vaccine as a protective factor against COVID-19. There is a speculation that a live attenuated vaccine (BCG vaccine) can be beneficial against COVID-19 to develop the initial immune response, and can also spread in the community, thereby boosting herd immunity to fight against COVID-19. This review summarizes the conclusions of various reports on the BCG vaccine, and is an attempt to establish BCG-vaccination mediated herd immunity as an effective instant intermediate approach in curbing COVID-19 spread in highly populous countries.

COVID-19: Update on Pathogenesis and Treatment Strategies

COVID-19 (Coronavirus disease) is the most contagious virus, which has been characterized as a global pandemic by WHO. The pathological cycle of COVID-19 virus can be specified as RNAaemia, severe pneumonia, along with the Ground-glass opacity (GGO), and acute cardiac injury. The S protein of Coronavirus has been reported to be involved in the entry of the virus into the host cell, which can be accomplished by direct membrane fusion between the virus and plasma membrane. In the endoplasmic reticulum or Golgi membrane, the newly formed enveloped glycoproteins are introduced. The spread of disease occurs due to contact and droplets unleashed by the vesicles holding the virus particles combined with the plasma membrane to the virus released by the host. The present manuscript describes the pathogenesis of COVID-19 and various treatment strategies that include drugs such as chloroquine and hydroxychloroquine, an anti-malarial drug, antibodies: SARS-CoV-specific human monoclonal antibody CR3022 and plasma treatment facilitate the therapeutic effect.

Immunomodulation in Multiple Sclerosis by Phytotherapy

Multiple sclerosis is a chronic inflammatory and demyelinating disorder of the central nervous system (CNS) that can cause cognition, mobility, and sensory impairments. Studies have shown that the immune system through inflammation and autoreactive T cells are involved in the progression of MS. The present article aimed to review the potent anti-inflammatory, antioxidant, and immunomodulatory agents that could modulate the immune response in MS. In herbal medicine, various medicinal plants including Olive, Silybum marianum, Grape, Pomegranate peel extract, Nigella sativa, Turmeric, Green tea, Aloysia citrodora, Boswellia papyrifera, Boswellia serrata, Ruta graveolens, and Andrographis paniculata are known with therapeutic benefits in MS patients through immunoregulation and reduction of major symptoms.

Is Immune Response Relevant in Interstitial Lung Disease?

Interstitial lung disease, a term for a group of disorders, causes lung fibrosis, is mostly refractory to treatments and has a high death rate. After diagnosis the survival is up to 3 years but in some cases the patients live much longer. It involves a heterogenous group of lung diseases that exhibit progressive and irreversible destruction of the lung due to the formation of scars. This results in lung malfunction, disruption of gas exchange, and eventual death because of respiratory failure. The etiology of lung fibrosis is mostly unknown with a few exceptions. The major characteristics of the disease are comprised of injury of epithelial type II cells, increased apoptosis, chronic inflammation, monocytic and lymphocytic infiltration, accumulation of myofibroblasts, and inability to repair damaged tissue properly. These events result in abnormal collagen deposition and scarring. The inflammation process is mild, and the disease is primarily fibrotic driven. Immunosuppressants do not treat the disease but the evidence is evolving that both innate and acquired immune responses a well as the cytokines contribute to at least early progression of the disease. Furthermore, mediators of inflammation including cytokines are involved throughout the process of lung fibrosis. The diverse clinical outcome of the disease is due to different pattern of inflammatory markers. Nonetheless, the development of novel therapeutic strategies requires better understanding of the role of the immune response. This review highlights the role of the immune response in interstitial lung disease and considers the therapeutic strategies based on these observations. For this review several literature data sources were used to assess the role of the immune response in interstitial lung disease and to evaluate the possible therapeutic strategies for the disease.

Thymosin α1; Potential Therapeutic Implications of an Immunoregulatory Drug in the Treatment of Lymphocytopenia Associated with COVID-19

It is not unbeknownst to us that since the very onset of the COVID-19 outbreak, many patients from different age groups have suffered greatly, and in a remarkable number of cases, succumbed to their untimely demise as a result of infection with the novel coronavirus or SARS-CoV- -2. The elderly are perhaps the most vulnerable community, who stand at the pinnacle of morbidity and mortality rates due to contracting severe forms of COVID-19. Hopefully, based on the recent findings and the present evidence, there might be a number of medications that would possibly be of great prophylactic and therapeutic value to the elderly patients diagnosed with COVID-19. According to an interventional study, Thymosin α1 is arguably one such medication that has recently been indicated to be an effective therapeutic agent for inpatient management of lymphocytopenia and T cell exhaustion caused by COVID-19.

Seroprevalence of Hepatitis B, Hepatitis C, and Human Immunodeficiency Viruses in End-Stage Renal Disease Patients, Southern Iran

Background: Hemodialysis [HD] patients are more prone to blood-borne viruses, such as hepatitis B virus [HBV], hepatitis C virus [HCV], and, to a lesser extent, Human Immunodeficiency Virus [HIV]. Chronic HBV and HCV infections are associated with liver cirrhosis, hepatocellular carcinoma, and early graft failure after kidney transplantation. As there was no recent information, this study aimed to evaluate the prevalence of HBV, HCV, and HIV infection in HD patients in Fars province, southern Iran. This could help health policymakers to run more effective infection control practices for reducing such blood-borne virus infections, if necessary. Methods: This cross-sectional study was performed on 906 HD patients in Fars province, southern Iran. A total of 906 blood samples were obtained from patients and diagnostic tests of HBV, HCV, and HIV were done. Demographic data and some other information, such as duration of dialysis, were extracted from the patients’ medical records. Data were analyzed in SPSS, version 18. Results: Out of the patients enrolled in the study, 547 [60.4%] were male and 359 [39.6%] female. The mean ± SD age of the patients was 58.0 ± 15.8 years. The prevalence of HBV, HCV, and HIV infection was 0.88%, 0.55% and 0.44%, respectively. HIV-infected subjects were significantly younger than the HIV-negative group [P <0.017]. Conclusion: It seems that Fars is among the provinces with low HBV and HCV prevalence in HD patients in comparison to other provinces of Iran. On the other hand, HIV prevalence here is higher than other provincial studies. Strict adherence to preventive infection control measures is recommended in HD centers.

The Potential Prognostic Performance of Neutrophil CD64 and Monocyte HLA-DR in Patients with Complicated Intra-abdominal Infections

Background: Complicated intra-abdominal infections are still associated with a high risk of an unfavorable outcome. Despite the equal treatment, the mortality rates in some patients’ populations remain significant, especially when the impaired immune response is present. Aim: The object of this research is to analyze the impact of pro-inflammatory neutrophil CD64 and anti-inflammatory monocyte HLA-DR on the final outcome. Methods: We have searched in the PubMed database, the literature relating the prognostic value of two biomarkers - nCD64 and mHLA-DR in patients with complicated intra-abdominal infections and/or sepsis. Results: Eighteen original studies with 2960 patients fulfilled our inclusion criteria. The data about nCD64 that we found was contradictory, whereas low mHLA-DR expression showed good prognostic value. Conclusion : Our review showed heterogeneous data about nCD64 survival prediction. Further investigations with surgical patients exclusively are needed to evaluate its prognostic value in cIAIs. However, we observed a good prognostic performance of low mHLA-DR expression. After a validation in larger multicentre studies, mHLA-DR could be used as promising prognostic biomarker in cIAIs.

Forecasting of COVID-19 Cases in India: A Predictive Study

An outbreak of new coronavirus (COVID-19) originated by SARS-CoV has reached 212 countries throughout the world. India is the second-highest populated country, so it is critical to forecasting the confirmed cases and deaths due to pandemic. To fulfil the purpose, three machine learning models Linear Regression, Multilayer Perceptron, and Sequential Minimal Optimization Regression are used. The predictive data of three geographic regions (India, Maharashtra, and Tamil Nadu) are compared with the data considered to be adequate in practice. The analysis concluded that Sequential Minimal Optimization Regression can be adopted for possible pandemic predictions such as COVID-19.

Interleukin-10 in Oral Lichen Planus – Review and Meta-Analysis

Background: Interleukin 10 (IL-10) is a powerful anti-inflammatory cytokine capable of preventing inflammatory and autoimmune diseases. Oral lichen planus (OLP) is an autoimmune, chronic, inflammatory disease with relapsing nature involving oral mucous membranes. It was prevsiouly assumed that like other autoimmune diseases, IL-10 may have a role in OLP pathogenesis, and many studies focused on that. But there are obvious controversies among IL-10 levels in OLP patients. Objective: In this review with Meta-Analysis, we attempt to assess IL-10 expression in OLP patients. Methods: The search was conducted via Pubmed, Ovid, and Google Scholar, to identify articles published up to Jun 2020. A meta-Analysis by Revman 5.3 was conducted based on serum levels of IL-10 in 313 OLPs and 203 controls. Results: With Meta-Analysis in 313 OLPs and 203 controls, the Mean difference between IL-10 in OLPs and controls was obtained as 0.26 (95% CI: -0.51-1.03), demonstrating no statistically significant difference. Conclusion: IL-10, in concert with its receptors, has a crucial role in the pathogenesis of various diseases, including inflammatory, infectious, and autoimmune diseases. Both over-expression, as well as IL-10 deficiency, have been described in oral lichen planus. With Meta-Analysis on serum IL-10 levels, it is speculated that no significant relationship exists between IL-10 and OLP pathogenesis. With respect to the importance of cytokines in the autoimmunity process, performing additional studies is of necessity to understand the association of other cytokines with OLP predisposition and its underlying pathological processes.