Cytokines, inflammation, and pain

Psychosocial stress and associations with inflammation in mid-gestation maternal, fetal, and placental tissue

BACKGROUND

Inflammation has been implicated as an intermediary between psychosocial stress and adverse birth outcomes. However, prior work has mostly relied on maternal inflammation as a proxy for fetal inflammation mid-gestation or measured fetal inflammation in cord blood and placenta obtained at delivery. No studies have examined psychosocial stress in relation to fetal inflammation mid-gestation.

METHODS

Twenty cytokines were measured in matched maternal blood, cord blood, and placenta obtained mid-gestation from a socio-demographically diverse group of pregnant participants undergoing elective second-trimester pregnancy terminations (N = 106). Corticotropin-releasing hormone, a proposed biomarker of gestational length, was measured in maternal blood. Perceived stress, and exposure to stressful life events, job strain, and social support were measured via questionnaires. We used linear regression to estimate associations between individual stressors and inflammatory biomarkers in each biomatrix and principal component analysis to assess groups of inflammatory biomarkers.

RESULTS

We observed many matrix-specific associations between psychosocial stressors and inflammatory biomarkers. For example, low versus high social support was associated with significantly decreased levels of maternal blood CCL3 (β=-0.53; 95 % confidence interval [CI]=-0.98,-0.07), CCL4 (β=-0.26; 95 % CI=-0.47,-0.04), IL8 (β=-0.79; 95 % CI=-1.47,-0.11), CXCL9 (β=-0.47; 95 % CI=-0.89,-0.06), IFNγ (β=-2.28; 95 % CI=-3.60,-0.96), IL4 (β=-1.07; 95 % CI=-1.88,-0.26); and cord blood IFNγ (β=-0.83; 95 % CI=-1.52,-0.14). Social support was not associated with placental inflammation.

CONCLUSIONS

During mid-pregnancy, psychosocial stress─ particularly low social support─ was associated with maternal blood levels of select cytokines, suggesting a potential pathway linking social stress and inflammation. Our results indicate that the placenta may buffer these inflammatory effects on the fetus.

Pain-on-a-Chip: A microfluidic device for neuron differentiation and functional discrimination in animal models of chronic pain

Chronic pain is a global health issue that is poorly understood and challenging to treat. Improving pain classification and treatment requires new strategies that objectively discriminate between pain conditions and minimise subjectivity associated with the perception of pain. To address this, we have developed a microfluidic biosensor - termed 'pain-on-a-chip' - that leverages recent advancements in biocompatible microfluidic technology with on-chip differentiation of nociceptor-like cells, enabling small sample volumes to be used. Following neuronal differentiation, we used on-chip live cell Ca2+ imaging to functionally validate the system. This includes characterising excitation responses in cells challenged with microfluidic perfusion of known nociceptive stimuli and biological fluids collected from different preclinical pain models. Our results demonstrate that this platform has the potential to discriminate between serum samples from distinct chronic pain models. This system has potential as an objective, and minimally invasive method for distinguishing between different subtypes of chronic pain.

Outer Membrane Vesicles from Caulobacter crescentus: A Platform for Recombinant Antigen Presentation

Bacterial outer membrane vesicles (OMVs) are an emerging and attractive technology for the generation of vaccines. Their properties as natural adjuvants, size, acellularity, and comparative cost of production favor their use as vaccines. Two major caveats for the use of OMVs as vaccines are their biological safety, since OMVs can induce a severe and even fatal inflammatory response and that they are naturally produced in low amounts. In this study, we show that a strategy to induce the production of OMVs applied to the nonpathogenic bacterium Caulobacter crescentus results in a strain with good OMV yields. In comparison with the OMVs derived from Escherichia coli K-12, the OMVs from C. crescentus induce a lower inflammatory response in an in vivo murine model of acute inflammation and in a human cell assay. Also, only minor signs of pain in mice were observed even at high doses. The C. crescentus OMVs can be efficiently loaded with a recombinant protein and induce antibody production against it with an adjuvant effect, indicating that these OMVs are viable vehicles for the presentation of recombinant antigens. These results support the use of the OMVs obtained from C. crescentus as a safe and effective platform for the development of low-cost vaccines.

Activation, interaction and intimation of Nrf2 pathway and their mutational studies causing Nrf2 associated cancer

Responses against infection trigger several signaling pathways that lead to the production of cytokines, these cytokines release ROS and RNS, damaging DNA and proteins turn into various diseases including cancer. To combat these harmful cytokines, the Nrf2 pathway is activated. The gene NFE2L2 encodes Nrf2, which is divided into seven conserved domains (Neh1-7). The DLG and ETGE motifs, conserved sequences of amino acid in the Neh2 domain of Nrf2, bind to the BTB domain of Keap1. BTB domain promotes Keap1's homodimerization resulting in Cul3 recruitment providing scaffold formation to E2 ubiquitin ligase to form ubiquitin complex. Under normal conditions, this complex regularly degrades Nrf2. However, once the cell is exposed to oxidative stress by ROS interaction with Keap1 resulting in conformational changes that stabilize the Nrf2. Nrf2 further concentrates on the nucleus where it binds with the transcriptional factor to perform the desired genes transcription for synthesizing SOD, GSH, CAT, and various other proteins which reduce the ROS levels preventing certain diseases. To prevent cells from oxidative stress, molecular hydrogen activates the Nrf2 pathway. To activate the Nrf2 pathway, molecular hydrogen oxidizes the iron porphyrin which acts as an electrophile and interacts with Keap1's cysteine residue.

How variants in inflammatory mediator genes influence symptom severity of psychiatric disorders: Findings from the PsyCourse study

Alterations in glial cell function and cytokine levels in the central nervous system may be influenced by neuroinflammatory processes, which have a pathogenic role in psychiatric disorders. Variability in genes that encode inflammatory mediators is associated with risk of developing mental disorders. Therefore, by analyzing data from the transdiagnostic PsyCourse Study, we aimed to investigate whether variations in inflammatory mediator genes are associated with current symptom severity. We used cross-sectional data from 1320 individuals with a psychiatric disorder and 466 neurotypical individuals. Outcome variables were the psychopathological data from various rating scales and questionnaires that measured depressive, psychotic, and manic symptoms. Furthermore, from a whole-genome SNP array dataset, we extracted single nucleotide polymorphisms (SNPs) in the loci of genes related to inflammatory mediators, and we performed an association analysis by considering covariates. False discovery rate (FDR) was used to adjust the results for multiple comparisons. A total of 1594 individuals and 1336 SNPs were included in the analyses. The results of regression analysis showed a significant positive association of six SNPs located on the interleukin (IL)-1 receptor type 1 (IL-1R1) gene locus with Altman Self-Rating Mania Scale scores (FDR-adjusted p value < 0.05). Our findings show that genetic variations in IL-1R1 may influence the pathophysiology of psychiatric disorders by affecting brain cytokine profiles associated with manic episodes. IL-1R1 encodes a membrane-bound receptor for IL-1. Several physiological functions, including inflammation, are linked to the IL-1/IL-1R1 signaling pathway. Replication of our findings is warranted.

Toll-Like Receptors in Pentachlorophenol- and Dibutyltin-Induced Production of Pro-Inflammatory Cytokines, Interleukin (IL)-1β, and IL-6, by Human Immune Cells

Pentachlorophenol (PCP) and dibutyltin dichloride (DBT) contaminate the environment due to their diverse applications. PCP has been found from 0.26 to 5 μM in the serum of exposed individuals and at an average of 0.15 μM in the unexposed. DBT has been detected in human blood at levels up to 0.3 μM. Exposure to these contaminants is linked to pathological conditions including cancer. Interleukin-1 beta (IL-1β) and IL-6 are pro-inflammatory cytokines that when produced inappropriately can cause chronic inflammation, which is linked to pathologies including autoimmune diseases and cancer. PCP and DBT have been shown to increase the production of IL-1β and IL-6 by immune cells in a MAP kinase (MAPK) dependent process. Toll-like receptors (TLRs) activate the signaling pathways linked to MAPK that lead to production of these cytokines. This study demonstrates that PCP-induced production of IL-1β and IL-6 is dependent on TLR4 and TLR8, and independent of TLR1/2, TLR2, and TLR3. Additionally, DBT-induced IL-6 production depends on TLR1/2, whereas IL-1β production does not. Blocking the TLR-linked adapter protein, MyD88, lead to a loss of both PCP and DBT stimulation of IL-1β and IL-6. These findings indicate that both PCP and DBT interact with selected TLRs as part of their mechanisms of elevating the levels of critical pro-inflammatory cytokines, which may contribute to chronic inflammation and its related pathologies.

The screening assessment of pro-inflammatory, anti-inflammatory, Th1, Th2 and Th17 cytokines in saliva of patients with ischemic stroke

Introduction: Ischemic stroke leads to hypoxia of brain structures, causes inflammation and tissue necrosis. Since the blood-brain barrier is damaged, inflammatory mediators can enter the bloodstream and saliva. This case-control study examines pro-inflammatory, anti-inflammatory, Th1, and Th2 cytokines in the unstimulated saliva of stroke patients and explores the association between these biomarkers and clinical status. Patients and methods: The study group included 22 patients with ischemic stroke, while the control group included 22 healthy individuals that were matched for age, sex, dental, periodontal and oral hygiene status to the study group. Unstimulated saliva was collected from each patient. In each sample, the inflammatory profile was determined using the multiplex ELISA method. Due to the lack of normal distribution, the Mann-Whitney U test was used for comparisons. The research was approved by the Bioethics Committee of the Poznan University of Medical Sciences (59/19, 890/19, 504/21). Results: In the unstimulated saliva of stroke patients, significantly higher levels of pro-inflammatory cytokines (IL-1β (p=0.0003), TNF-α (p≤0.0001), TNF-β; (p≤0.0001)), anti-inflammatory cytokines (IL-1ra (p≤0.0001), TRAIL (p=0.0206)), Th1 cytokines (IFN-γ (p≤0.0001), IL-2Rα (p=0.0021) and IL-12 (p40) (p≤0.0001)) and Th2 cytokines (IL-6 (p=0.0023)) were found compared to healthy participants. Interestingly, Addenbrooke's Cognitive Examination Revised (ACE-R) correlated negatively with TNF-α (p=0.01, r=-0.53), TNF-β (p=0.02, r=-0.60) and IFN-γ (p=0.02, r=-0.50). The Functional Independence Measure (FIM) exhibited a positive association with IL-6 (p=0.003, r=0.62) and BI (p=0.001, r=0.66). The positive correlation was found between Sitting Balance Scale (SBS) and IL-6 (p=0.02, r=0.52). Conclusions: Stroke patients exhibit altered salivary composition characterized by increased secretion of inflammatory mediators. The obtained results do not indicate the dominance of any of the branches of the immune response. The concentration of salivary TNF-α, TNF-β, IFN-γ and IL-12 significantly distinguish patients with ischemic stroke from healthy individuals. Although validation of the results in a larger patient population is necessary, salivary cytokines show potential as diagnostic biomarkers.

Protective Effects of a Probiotic Lacticaseibacillus paracasei MSMC39-1 on Kidney Damage in Aged Mice: Functional Foods Potential

Kidney fibrosis and inflammation are significant contributors to the decline in renal function associated with aging. These processes are characterized by structural changes, such as glomerular sclerosis and interstitial fibrosis, which exacerbate kidney injury and inflammation in aged individuals. Probiotics have gained increasing attention for their potential health-promoting effects. However, further investigation is required to fully understand the mechanisms underlying these benefits. We hypothesize that probiotics could ameliorate fibrosis through the immunomodulatory effects of probiotics and by improving kidney tissue inflammation. Sixteen-month-old aging mice were administered Lacticaseibacillus paracasei MSMC39-1 for four months compared to young mice (six-month-old) and aged mice (twenty-month-old). The research found that following the administration of probiotic MSMC39-1, there were significant improvements in kidney inflammation, as evidenced by reductions in pro-inflammatory cytokines, fibrosis, and inflammatory cells within the tissue. Moreover, the findings demonstrated that probiotic MSMC39-1 significantly normalized levels of malondialdehyde (MDA), and rescued antioxidant superoxide dismutase (SOD) and glutathione peroxidase (Gpx) in kidney tissue which was consistent with a low mitochondria biogenesis. Further investigations revealed that conditioned medium from MSMC39-1 rescued epithelial kidney cells with damage induced by high glucose. This research provides information and insights into the mechanisms underlying the beneficial health effects of probiotics, offering a deeper understanding of how these probiotics contribute to anti-aging processes in the kidney.

Diverse cell types establish a pathogenic immune environment in peripheral neuropathy

Neuroinflammation plays a complex and context-dependent role in many neurodegenerative diseases. We identified a key pathogenic function of macrophages in a mouse model of a rare human congenital neuropathy in which SARM1, the central executioner of axon degeneration, is activated by hypomorphic mutations in the axon survival factor NMNAT2. Macrophage depletion blocked and reversed neuropathic phenotypes in this sarmopathy model, revealing SARM1-dependent neuroimmune mechanisms as key drivers of disease pathogenesis. In this study, we investigated the impact of chronic subacute SARM1 activation on the peripheral nerve milieu using single cell/nucleus RNA-sequencing (sc/snRNA-seq). Our analyses reveal an expansion of immune cells (macrophages and T lymphocytes) and repair Schwann cells, as well as significant transcriptional alterations to a wide range of nerve-resident cell types. Notably, endoneurial fibroblasts show increased expression of chemokines (Ccl9, Cxcl5) and complement components (C3, C4b, C6) in response to chronic SARM1 activation, indicating enhanced immune cell recruitment and immune response regulation by non-immune nerve-resident cells. Analysis of CD45+ immune cells in sciatic nerves revealed an expansion of an Il1b+ macrophage subpopulation with increased expression of markers associated with phagocytosis and T cell activation/proliferation. We also found a significant increase in T cells in sarmopathic nerves. Remarkably, T cell depletion rescued motor phenotypes in the sarmopathy model. These findings delineate the significant changes chronic SARM1 activation induces in peripheral nerves and highlights the potential of immunomodulatory therapies for SARM1-dependent peripheral neurodegenerative disease.

The impact of electronic cigarette smoking on periodontal status and proinflammatory cytokine levels: a cross-sectional study

BACKGROUND

E-cigs(E-cigs) use is increasing worldwide. Recent studies suggest that E-cigs contain harmful elements that could lead to adverse oral health outcomes. Therefore, the aim of this study was to evaluate the impact of E-cigs smoking on periodontal health among current male smokers in Al-Kharj city in Saudi Arabia by assessing periodontal parameters and proinflammatory cytokine levels.

METHODS

Fifty-three male individuals (25 E-smokers and 28 non-smokers) participated in the study. This study compared periodontal parameters, including the plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment loss (CAL), and marginal bone loss (MBL), as well as levels of unstimulated whole saliva (UWS), interleukin IL-1B, and IL-6, between E-smokers and non-smokers.

RESULTS

The E-cigs users consumed approximately 432.6 ± 425.22 puffs on average daily, with a nicotine content of approximately 45.2 ± 11.23 mg on average. There was no statistically significant difference between the groups in terms of BOP and PI. A statistically significant difference was detected in PPD and CAL (p < 0.05) between the two groups, in which the PPD (4.10 ± 1.87) and CAL (2.72 ± 0.89) were greater in E-smokers. The mean MBL was also higher among E-smokers, which was statistically significant (p < 0.05). The mean cytokine IL-1B level was found to be (640.75 ± 138.78) among non-smokers and (889.05 ± 540.56) among E-smokers, and this difference was statistically significant (p < 0.05). However, while IL-1B had shown a significant difference between groups in the bivariate analysis (t-test), its association with E-cigs use became non-significant in the multivariate model (OR = 1.01, 95% CI: 1.00-1.02, p = 0.194). The mean IL-6 level among non-smokers was (19.49 ± 11.90) and among E-smokers, it was (17.07 ± 8.21). And, this difference was not statistically significant (p > 0.05).

CONCLUSIONS

This study revealed that E-cigs smoking had a negative effect on periodontal status (especially PPD, CAL and MBL). These results may contribute to the pathogenesis of periodontal diseases and tissue destruction. Efforts must be made to educate and create awareness among patients and the general community regarding the risks associated with E-cigs usage especially in young populations.

Rapid Reduction of Pro-Inflammatory Cytokines with an Oral Topical Composition Comprising Olive Oil, Trimethylglycine and Xylitol: A Randomized Double-Blind Controlled Trial

An underlying pro-inflammatory status is related to recurrence and persistence of inflammatory susceptibility in obesity and periodontitis, two of the most prevalent chronic inflammatory diseases. Elevated levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), part of the inflammatory network linking these two conditions, persist even after periodontal treatment, with high salivary cytokine levels being linked to overweight and obesity risk. This trial assessed the effect of a novel composition comprising olive oil, trimethylglycine and xylitol, delivered topically to the oral mucosa, on salivary cytokines in periodontally healthy normal and overweight/pre-obese individuals. In a randomized placebo-controlled double-blind clinical trial, adult patients were randomly assigned to use a test toothpaste (intervention group, IG) or a placebo toothpaste (control group, CG) three times a day for 1 month. Primary outcomes were levels of salivary cytokines IL-1β, TNF-α and interleukin-4 (IL-4). Significant differences between IG and CG were observed for IL-1β (p = 0.003; Z = 2.901; r = 0.62) and TNF-α (p = 0.001; Z = 3.23; r = 0.69), but not for IL-4 (p = 0.203; Z = 1.321; r = 0.28). A significant reduction in IL-1β (p = 0.008) and a near significant reduction in TNF-α (p = 0.059) was found in the IG at the end of the trial. Additionally, the effect of body mass index on cytokine levels response was analyzed. A significantly different behavior was shown between IG and CG in the overweight/pre-obesity subgroup for IL-1β (p = 0.014; Z = 2.430; r = 0.63) and TNF-α (p = 0.029; Z = 2.199; r = 0.57). Moreover, a significant decrease in IL-1β in the IG (p = 0.028) was observed. The rapid reduction in IL-1β and TNF-α after 1 month of use of the intervention composition suggests a safe and effective novel strategy for reducing pro-inflammatory cytokines that may offer an opportunity to diminish the inflammatory status in patients with overweight/pre-obesity.

Physical Activity as a Central Pillar of Lifestyle Modification in the Management of Chronic Musculoskeletal Pain: A Narrative Review

Objective: This narrative review aims to analyze physical activity as a central pillar of lifestyle modification in the management of chronic musculoskeletal pain by examining its effects on pain modulation as well as related lifestyle domains, including sleep, stress regulation, dietary habits, and smoking behavior. Methods: A narrative structured review was conducted. We searched MEDLINE/PubMed, Embase, and Cochrane Reviews using terms related to chronic pain and lifestyle. Randomized controlled trials, observational studies, systematic reviews, and narrative reviews reporting on the concepts of interest were included. The results were synthesized and described narratively. Results: Through the release of neuromodulatory compounds such as endorphins, endocannabinoids, dopamine, and serotonin, exercise improves analgesia, promotes emotional resilience, and reduces the reward response associated with addictive behaviors such as smoking. Its effects on the hypothalamic-pituitary-adrenal axis reduce cortisol levels, while melatonin regulation promotes circadian synchronization and deeper sleep stages. In addition, exercise modulates appetite by increasing insulin sensitivity and altering hormones such as leptin and ghrelin, contributing to appetite control and energy balance. These mechanisms support a comprehensive approach to chronic pain management. Conclusions: Physical activity is a core component of lifestyle-based chronic pain management, not only because of its analgesic effects, but also because of its positive influence on sleep, stress regulation, dietary habits, and smoking reduction. Although the available evidence is promising, more randomized controlled trials are needed to examine the effects of exercise on other healthy lifestyle behaviors, such as stress reduction, dietary modification, and smoking cessation, to consolidate its role in the comprehensive prevention and management of chronic pain.

Exploring the dual role of Mangifera indica L. in regulating immune response and pain persistence in inflammatory bowel disease

Inflammatory bowel disease (IBD), encompassing ulcerative colitis and Crohn's disease, is characterized by chronic intestinal inflammation and immune dysregulation, driven mainly by Th1 and Th17 cells and sustained by pro-inflammatory cyto-chemokines. This inflammatory milieu is associated with visceral pain, a key symptom affecting patient quality of life. Addressing both gut inflammation/immunity and visceral pain is crucial for improving IBD therapy. This study assessed the therapeutic potential of Mangifera indica L. extract (MIE), a mangiferin-rich formulation, in a DNBS-induced colitis model in rats. MIE treatment administered either simultaneously or post-DNBS induction, significantly reduced pathogenic Th1 and Th17 cell infiltration, along with pro-inflammatory cytokines (IL-1β, TNF-α) and chemokines (CXCL1, CXCL2), though histopathology showed no significant improvements in tissue healing. Additionally, MIE restored microbiota-derived short-chain fatty acids (acetate and butyrate) in colon and faecal samples. Importantly, MIE alleviated post-inflammatory visceral hypersensitivity, reducing the abdominal withdrawal reflex (AWR) to colorectal distension (CRD), after either acute or repeated treatment. These findings suggest that MIE, in the context of nutraceuticals and functional foods, shows promise as a dual-action therapeutic strategy for complementary and/or adjuvant therapy in IBD.

Implication of system xc- in complete Freund's adjuvant-induced peripheral inflammation and associated nociceptive sensitization

BACKGROUND

Persistent inflammation leading to neuronal sensitization in pain pathways, are key features of chronic inflammatory pain. Alike macrophages in the periphery, glial cells exacerbate hypersensitivity by releasing proalgesic mediators in the central nervous system. Expressed by peripheral and central immune cells, the cystine-glutamate antiporter system xc- plays a significant role in inflammatory responses, but its involvement in chronic inflammatory pain remains underexplored. We herein investigated the contribution of this exchanger in nociceptive hypersensitivity triggered by a peripheral inflammatory insult.

METHODS

Complete Freund's adjuvant (CFA) was injected into the left hind paw of wild-type C57Bl/6 female mice, of xCT-deficient mice (specific subunit of system xc-) and of mice receiving the system xc- inhibitor sulfasalazine. Paw edema was measured over three weeks and pain-associated behaviors were evaluated. Additionally, pro-inflammatory cytokine levels were assessed in blood samples.

RESULTS

CFA injection led to a persistent increase in paw edema and hypersensitivity to mechanical and thermal stimuli, which were less pronounced in xCT-deficient mice. This reduced sensitivity was accompanied by lower systemic pro-inflammatory cytokine levels in xCT-deficient mice. Accordingly, pharmacological inhibition of system xc- with sulfasalazine, either before or after pain induction, efficiently reduced the algesic and inflammatory responses to CFA in wild-type mice.

CONCLUSION

Our findings reveal a critical role for system xc- in the pathophysiology of inflammatory pain. xCT deficiency reduces pain behaviors and peripheral inflammation, positioning system xc- as a promising therapeutic target for alleviating chronic inflammatory pain.

Can Bisphenols Alter the Inflammation Process?

This review's main purpose is to draw attention to the possible influence of widely used bisphenols on the inflammatory process. Bisphenols are endocrine-disrupting chemicals that are produced worldwide in great quantities. From this point of view, it is very important to clarify their influence on innate immune reactions, which protect the integrity of the body against the action of various pathogens on a daily basis. The inflammation process consists of several key factors that are produced at different levels of this reaction. Each of these levels can be affected by endocrine disruptors, from the point of view of modifying either the immune system cells that intervene in this process or the way in which they produce inflammatory mediators. The development of new recommendations for the use of bisphenols is a complex issue given their influence on inflammatory processes. Because the immune system and immune response are so intricate, bisphenols may pose more risk to humans than is presently recognized. This paper discusses the classification of bisphenols, the fundamental mechanism of inflammation, the characterization of inflammatory mediators, and the current knowledge of the molecular mechanisms behind the impact of bisphenols on the inflammatory response.

The role of the endogenous opioid system in modulating orthodontic-induced neurogenic inflammation of the dental pulp: A comprehensive review of the literature

BACKGROUND

Orthodontic forces may lead to neurogenic inflammation in the dental pulp by triggering the release of somatosensory neuropeptides such as Substance P (SP), Calcitonin gene-related peptide (CGRP) and Neurokinin A (NKA). In the vast majority of patients, acute symptoms are not triggered, probably due to the control of the neurogenic inflammatory process exerted by endogenous opioid systems.

OBJECTIVE

This review aimed to assess the cellular and molecular mechanisms through which the endogenous opioid system modulates the orthodontic-induced neurogenic inflammation of the dental pulp and to identify potential mechanisms for endogenous control of pulp pain.

METHODS

A literature search was conducted in the databases Pubmed, ISI Web of Science and Scopus to find relevant studies using the keywords: "orthodontic movement," "opioids" and "neurogenic inflammation." Following the PRISMA and Amstar recommendations, studies were selected for the literature review.

RESULTS

After removing duplicated and irrelevant articles, and those that does not meet the inclusion criteria, 38 articles were selected and classified according to the opioid peptides analysed in relation to orthodontic movement and dental pulp.

DISCUSSION

Both peripheral and central pathways, via endogenous opioid systems such as somatostatin (SST), dynorphin, β-endorphin, methionine enkephalin, endocannabinoids and anti-inflammatory cytokines, modulate the neurogenic inflammation elicited by orthodontic movements. The bradykinin and monoaminergic systems also appear to display regulatory effects on pain response. These control mechanisms, however, may be insufficient in cases where severe orthodontic forces are applied, thus leading to asymptomatic irreversible pulpitis or necrosis.

CONCLUSION

The opioid system regulates neurogenic pulpal inflammation and pain at the level of the central and peripheral nervous systems by releasing endogenous substances, including SST, opioid peptides, endocannabinoids and anti-inflammatory cytokines.

Maternal probiotic supplementation and effects on the fetal placenta

Increasing number of pregnant women are consumi ng probiotics to promote their own health and that of their unborn fetuses. Such supplements are presumed to be safe for pregnant mothers and their unborn offspring. For pregnant mothers, such bioactive compounds might lower the risk of constipation, diarrhea, other gastrointestinal conditions, and pre-term birth, and prevent adverse pregnancy outcomes, including gestational diabetes mellitus and depression/anxiety. More research is needed to examine potential safety of probiotic consumption during pregnancy and long-term health consequences to offspring. The conceptus can also be indirectly affected by maternal probiotic supplementation through microorganism production of bioactive compounds. The placenta is in direct communication with the underlying uterine tissue. Thus, compounds in the maternal blood can easily transfer across the placenta and impact this hormonally sensitive organ. Select studies suggest that disruptions to the maternal microbiome dramatically affect the placenta. In the current review, we will therefore consider the evidence to date of how maternal probiotic supplementation affects the placenta. Three potential mechanisms we will explore include the possibility that maternal probiotic supplementation might impact the putative placenta microbiome. The second potential mechanism we will consider is that maternal probiotic consumption alters bacterial-derived metabolites, including short-chained fatty acids, polyamines, Vitamin B9, and Vitamin B12. The third potential mechanism to be discussed is that such supplements affect maternal and placental immune responses. Before probiotics are promoted for healthy pregnant women and those with gestational disorders, more studies, including those examining the effects on the placenta, are essential.

Hermetia illucens-Derived Chitosan: A Promising Immunomodulatory Agent for Applications in Biomedical Fields

Chitosan, renowned for its important biological properties, is a valuable pharmaceutical excipient for different therapeutic approaches. Currently, the demand for the biopolymer on the market is growing, and, for this reason, it is important to biologically characterize the biopolymer produced from an alternative source to crustaceans, specifically the bioconverter insect Hermetia illucens. In this work, insect chitosan, yielded via heterogeneous and homogeneous deacetylation from larvae, pupal exuviae, and adults, was studied as an immunomodulatory agent. The inflammatory response of immortalized human keratinocyte cells was induced by Salmonella enterica subsp. enterica serovar Typhimurium lipopolysaccharide. After that, the ability of the biopolymer to reduce the expression of the pro-inflammatory cytokines IL-6, IL-8, IL-1α, and TNF-α was tested after 6 and 24 h of treatment. Insect chitosan samples effectively downregulated cytokine expression, with improved activity obtained from heterogeneous chitosan treatments.

Integrative analysis of the microRNA and mRNA response of barramundi (Lates calcarifer) under acute cold stress and Vibrio harveyi challenge

Barramundi (Lates calcarifer) are emerging as a key species in warm-water aquaculture worldwide; however, disease outbreaks caused by Vibrio spp. are impeding industry expansion. Climate change is expected to exacerbate this issue by intensifying extreme weather events, including unusually cold temperatures, thereby increasing the risk of disease. In this study, we investigated the combined effect of cold stress and V. harveyi infection on the early transcriptome (mRNA) and microRNA responses of juvenile barramundi to enhance our understanding of host-pathogen interactions. High levels of differential gene expression were observed in fish subjected to cold stress (22 °C) post-infection with V. harveyi, with 3231 differentially expressed genes and an extensive pro-inflammatory immune response. In contrast, most differentially expressed microRNAs were associated with fish infected with V. harveyi housed under optimal temperature conditions (30 °C). MicroRNAs play a crucial role in regulating gene expression, typically through downregulation of target mRNAs. The significant upregulation of miRNAs in barramundi kept at 30 °C, and the lack of miRNA upregulation in cold stressed fish, suggests that cold stress impaired the immune-regulatory capacity of affected fish, resulting in a hyper-inflammatory response that may account for the increased mortality observed. This study is the first dual study of the transcriptome and microRNA response of barramundi to V. harveyi infection and expands understanding of the innate immune response in barramundi and the regulatory role of microRNAs in teleost fish.

A recent history of immune cell sex differences in the peripheral nervous system in persistent pain states

Pain is entwined with inflammation, and biological sex often influences mechanisms of the immune system. Due to possible differences in inflammatory mechanisms, women are predisposed to autoimmune diseases and chronic pain. Despite sex as a critical variable in clinical cases of autoimmune conditions and its pain comorbidities, fundamental investigations have long underrepresented female subjects in their studies. Fundamental research in the 2010s, however, identified a binary sex specific mechanism for pain in rodents: male pain is microglia-driven while female pain is T cell-driven. Since then, studies have expanded in neuro-immunology to indicate that the sex differences and immune cells involved in these processes take on more elaborate roles when expanded to other causal modalities and anatomical levels of neuropathic and inflammatory pain. In this mini-review, we highlight updated roles for macrophages, T cells, and B cells in the peripheral nervous system during persistent pain conditions: neuropathic pain and inflammatory pain. We discuss sex similarities and sex differences in these cell types. By parsing out the sex specific roles of immune cells in persistent pain states, we may be better positioned to find immune-based therapies that can effectively target chronic pain in sex-biased autoimmune conditions.

Bioaccessible (Poly)phenols of Winery Byproducts Modulate Pathogenic Mediators of Intestinal Bowel Disease: In Vitro Evidence

Intestinal inflammation entails a multifactorial pathophysiology, frequently treated by using anti-inflammatory drugs with severe side effects. At the same time, bioactive compounds present in plant materials and derived residues could contribute to reducing the use of such medications in terms of dosage and treatment length. Thus, the phytochemicals of winery byproducts, mainly represented by (poly)phenols, display significant anti-inflammatory and antioxidant potential. However, the functionality of bioaccessible fractions remains underexplored. This study uncovers the capacity of bioaccessible (poly)phenols of winery byproducts to modulate inflammatory mediators and secondary oxidative stress (OS). After in vitro simulated digestion, bioaccessible (poly)phenols exhibited significant inhibitory capacity of nitric oxide, interleukin (IL)-6, IL-8, and TNF-α production and prevented OS, lowering reactive oxygen species (ROS) resulting from disturbed cell metabolism while preserving the molecular machinery of cells, involving glutathione, catalase, superoxide dismutase, and glutathione peroxidase. The results retrieved suggested the relevance of specific profiles for efficiently preventing inflammation.

Tracking inflammation status for improving patient prognosis: A review of current methods, unmet clinical needs and opportunities

Inflammation is the body's response to infection, trauma or injury and is activated in a coordinated fashion to ensure the restoration of tissue homeostasis and healthy physiology. This process requires communication between stromal cells resident to the tissue compartment and infiltrating immune cells which is dysregulated in disease. Clinical innovations in patient diagnosis and stratification include measures of inflammatory activation that support the assessment of patient prognosis and response to therapy. We propose that (i) the recent advances in fast, dynamic monitoring of inflammatory markers (e.g., cytokines) and (ii) data-dependent theoretical and computational modeling of inflammatory marker dynamics will enable the quantification of the inflammatory response, identification of optimal, disease-specific biomarkers and the design of personalized interventions to improve patient outcomes - multidisciplinary efforts in which biomedical engineers may potentially contribute. To illustrate these ideas, we describe the actions of cytokines, acute phase proteins and hormones in the inflammatory response and discuss their role in local wounds, COVID-19, cancer, autoimmune diseases, neurodegenerative diseases and aging, with a central focus on cardiac surgery. We also discuss the challenges and opportunities involved in tracking and modulating inflammation in clinical settings.

Circulating inflammatory cytokines and risk of aortic stenosis: A Mendelian randomization analysis

BACKGROUND

Observational studies have consistently reported positive associations between inflammatory biomarkers and the risk of developing aortic stenosis (AS). However, it is crucial to acknowledge that conventional observational studies are prone to various forms of bias, including reverse causation and residual confounding. To delve deeper into unraveling the potential causal relationship between inflammatory biomarkers and aortic stenosis, we conducted a comprehensive two-sample Mendelian randomization (MR) analysis.

METHODS

In order to explore the causal effect of exposure to various circulating cytokines on the risk of developing AS, we carefully selected AS datasets as the exposures from the summary statistics of the genome-wide association study (GWAS) conducted by FinnGen. The dataset consisted of a sample size of 3283 for AS cases and 210,463 for controls. To estimate the MR analysis, we primarily adopted the inverse variance weighted (IVW) method. Additionally, we employed complementary methods, including Weighted Median, MR Egger, Weighted Mode, and Simple Mode, to analyze the causal associations comprehensively. In order to assess the presence of heterogeneity, we utilized Cochran's Q statistic and MR-Egger regression. To ensure the robustness and consistency of our findings, we conducted a leave-one-out analysis.

RESULT

We observed a positive association between interleukin-18 (IL-18) levels and AS (odds ratio [OR] per standard deviation [SD] = 1.080; 95 % confidence interval [CI] 1.024 to 1.139), as well as between interferon-gamma levels (IFN-γ) and AS (OR per SD = 1.157; 95 % CI 1.028 to 1.302). Conversely, we found an inverse association between interleukin-13 (IL-13) levels and AS (OR per SD = 0.942; 95 % CI 0.890 to 0.997), as well as between interleukin-5 (IL-5) levels and AS (OR per SD = 0.892; 95 % CI 0.804 to 0.990).

CONCLUSION

Our research enhances the current understanding of the role of specific inflammatory biomarker pathways in aortic stenosis. Nevertheless, further validation is required to assess the viability of targeting these cytokines through pharmacological or lifestyle interventions as potential treatments for aortic stenosis.

Dietary xenobiotics and their role in immunomodulation

Within our daily dietary intake, lies an intriguing and frequently overlooked dimension- the realm of dietary xenobiotics. These chemical compounds originate from different food sources like grilled or processed meat (animal-origin), flavonoids, preservatives, beverages(plant-origin) and so on. Numerous studies have explored the oncogenic properties. Additionally, these compounds also result in interrupting the humoral and cellular immune response. This review specifically concentrates on elucidating the regulatory functions of these dietary xenobiotics within the human immune system. While some, like heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs), are predominantly deemed harmful, certain other compounds, such as specific phenolic compounds and nitrates, have exhibited therapeutic benefits. Furthermore, the review notes the immunomodulatory role of two relatively underexplored compounds, acrylamide and maltol. This underscores the necessity to broaden the scope of investigation surrounding these compounds and this review gives a brief overview of these xenobiotics interfering with the immune system.

Graphical abstract

Effects of rhamnolipids on growth performance, gut barriers, antioxidant capacity, immune function, and gut microbiota in broiler chickens

This study aimed to investigate the effects of dietary supplementation of rhamnolipids (RLS) on growth performance, gut morphology, antioxidant function, lipid metabolism, immune responses, and gut microbiota in Linnan yellow-feathered broilers. A total of 390 one-day-old broilers were randomly assigned to three groups: Control (CON), 250 mg/kg RLS (RLS250), or 500 mg/kg RLS (RLS500). The broilers were fed with basal diet, or basal diet supplemented with 250 or 500 mg/kg RLS for 56 days. Each treatment contained 10 replicates with 13 chickens per replicate. Results showed that diet supplemented with RLS250 and RLS500 markedly improved final BW and ADG on day 56. RLS reduced the CD and increased the VH/CD of jejunum and ileum. RLS significantly increased the levels of total T-AOC and GSH-Px on day 28, while the levels of T-AOC and SOD were higher than CON groups on day 56. RLS treatment also regulated the lipid metabolism in the broilers by increasing the concentration of serum HDL-C and decreased LDL-C. The levels of serum immunoglobulins including IgA, IgM and IgY in RLS250 and RLS500 groups were notably higher than those of CON groups on day 56. Meanwhile, ileum IgA and IgM in RLS500 groups were evidently higher than other two groups. RLS significantly increased the level of IL-10. RLS showed no significant effects on VFA in cecum of broilers. Results of 16S rRNA sequencing showed that RLS optimized the microbiota by lowering the relative abundance of Anaerofilum and DUT089, and regulating g__norank_f__ Ruminococcaceae. This study found that supplemented with RLS in diet improved the growth performance, antioxidant function, and immune function, and regulated intestinal microbiota of broilers, revealing that RLS is potential feed additive for use in animal husbandry.

Paediatric pain and malnutrition in low-income countries: A narrative review

Background: Despite its omnipresence, paediatric pain remains poorly understood and documented, especially in low-income countries. Such pain can be a symptom of long-term subclinical conditions such as systemic chronic inflammation (SCI). The latter can be related to malnutrition. Aim: To explore a potential association between paediatric pain and malnutrition in low-income countries. Methods: Narrative review, including a literature search in the PubMed, EMBASE, Web of Science and Scopus databases (update 24 March 2025). The search query comprised controlled terminology and free text words relating to 'Malnutrition', 'Pain', 'SCI' and 'Paediatric'. Results: To comprehend the complex relation between malnutrition and paediatric pain, associations between (1a) malnutrition, and nociceptive brain development, (1b) malnutrition, the gut microbiome and SCI, and (2) SCI and pain were explored. (1a) Early noxious exposure (e.g. malnutrition-related SCI) can cause long-term alterations in pain perception, brain function and structures. The consequences of malnutrition on the nociceptive brain depend on the life-cycle. (1b) Moderate acute malnutrition causes chronic inflammation and exaggerated inflammatory responses. Such responses could indicate hyper-inflammatory phenotypes. (2) Systemic-induced inflammation causes a widespread increase in musculoskeletal pain sensitivity. Conclusion: Malnutrition could contribute to the development of a nociceptive brain and SCI. Malnutrition-related SCI could induce changes in pain perception/thresholds, and predispose to developing chronic pain. If a relation between malnutrition and SCI predisposes children to develop pain, the prevailing biophysical approach needs revision. A multidimensional interdisciplinary approach seems more relevant. Such approach includes social, cognitive, socioeconomic, lifestyle, nutritional (e.g. integrating nutritional and microbiome-targeted interventions) and environmental dimensions.

The association between vitamin D and restless legs syndrome following acute ischemic stroke

Restless legs syndrome (RLS) and acute ischemic stroke are prevalent conditions in neurology. Several studies have indicated a relationship between RLS, acute ischemic stroke, and vitamin D levels. This study aimed to evaluate vitamin D levels in patients with RLS after acute ischemic stroke, compared to those with only acute ischemic stroke, to determine if there is a significant association. A case-control study included 270 patients with acute ischemic stroke and 53 patients who developed RLS following acute ischemic stroke. The International Restless Legs Syndrome Study Group (IRLSSG) scale was used to assess RLS severity, and vitamin D levels were measured (levels below 20 ng/ml were considered insufficient). Patients with RLS after acute ischemic stroke had significantly lower vitamin D levels (P < 0.001) and a higher incidence of vitamin D insufficiency (P < 0.001) compared to those with only acute ischemic stroke. The multivariate logistic regression model adjusted for the age, female, smoking status, alcohol consumption, history of hypertension, history of diabetes, low density lipoprotein-cholesterol (LDL-C), Homocysteine (HCY), vitamin D, vitamin D (OR = 0.673, 95% CI: 0.610-0.743, P < 0.001) and sex remained (OR = 4.217, 95% CI: 1.390-12.791, P = 0.011) significantly associated with RLS following acute ischemic stroke. Among RLS patients, those with (extremely) severe RLS had lower vitamin D levels than those with mild to moderate RLS (P < 0.001). Vitamin D levels were negatively correlated with IRLSSG scores after adjusting for confounding factors. The area under the curve (AUC) was 0.915 (95% CI 0.873-0.958), and the cut-off value for vitamin D was 18.15 ng/ml, with a sensitivity of 84.4% and specificity of 90.6%. Adults with acute post-ischemic stroke RLS generally have lower vitamin D levels than those with ischemic stroke alone, and lower vitamin D levels are linked to more severe RLS symptoms. Vitamin D levels and sex are important influencing factors for the occurrence of RLS following acute ischemic stroke. Vitamin D level is an independent predictor of RLS after acute ischemic stroke and has high predictive value.

The influence of the gut microbiota on B cells in autoimmune diseases

Mounting evidence shows that gut microbiota communities and the human immune system coexist and influence each other, and there are a number of reports of a correlation between specific changes in gut microbiota and the occurrence of autoimmune diseases. B lymphocytes play a central role in the regulation of both gut microbiota communities and in autoimmune diseases. Here, we summarize evidence of the influence of gut microbiota-B cell pathways on autoimmune diseases and how B cells regulate microorganisms, which provides mechanistic insights with relevance for identification of potential therapeutic targets and related fields.

Neuroprotective potential of hispidulin and diosmin: a review of molecular mechanisms

Flavonoids are an important class of natural products, particularly, belong to a class of plant secondary metabolites having a polyphenolic structure. They are widely found in fruits, vegetables, and certain beverages. Hispidulin and diosmin are naturally occurring flavonoids recognized for their potential health benefits, such as antioxidant, anti-inflammatory, and neuroprotective properties. Hispidulin is present in several plants, including Arnica montana, Salvia officinalis (sage), and Eupatorium arnottianum. Diosmin is mainly extracted from citrus fruits like lemons and oranges and can also be synthesized from hesperidin, another flavonoid found in citrus fruits. Neurodegenerative diseases are characterized by complex signaling pathways that contribute to neuronal deterioration. The JAK/STAT pathway is involved in inflammatory responses, while the NF-κB/NLRP3 pathway is associated with metabolic stress and inflammation, both facilitating neurodegeneration. Conversely, the AMPK/pGSK3β pathway is crucial for neuroprotection, regulating cellular responses to oxidative stress and promoting neuronal survival. Additionally, the BACE/Aβ pathway exacerbates neuronal damage by triggering inflammatory and oxidative stress responses, highlighting critical targets for therapeutic strategies. Hispidulin and diosmin have emerged as promising agents in the modulation of mediators involved in neuroinflammation and neurodegenerative diseases. Oxidative stress and inflammatory pathways, including those driven by Aβ/BACE1 and JAK/STAT signaling, are central to neuronal damage and disease progression. Recent studies highlight that hispidulin and diosmin exhibit notable neuroprotective effects by targeting these mediators. Hispidulin has been shown to impact key inflammatory cytokines and adhesion molecules, while diosmin influences proinflammatory cytokine production and inflammasome activation. Both compounds offer potential therapeutic benefits by modulating crucial mediators linked to neuroinflammation and neurodegeneration. This review article is designed to explore the intricate mechanistic interplay underlying the neuroprotective effects of hispidulin and diosmin.

Immunomodulatory effects of alexidine dihydrochloride on mammalian macrophages through the modulation of the JNK pathway

A plethora of the cancer drugs with high therapeutic potential cannot pass the clinical trials because of their immunotoxic activities. In this study, we tested the immunomodulatory and immunostimulatory effects of the anticancer agent alexidine dihydrochloride on J774.2 macrophage cell lines in vitro. The production levels of the pro-inflammatory cytokines (TNF-α, IL-6, GM-CSF, IL-12p40) were measured and compared by ELISA method. The activated (phosphorylated) JNK protein levels were measured by flow cytometer and the possible related intracellular signaling pathway was examined in this way. According to our results, alexidine dihydrochloride has an anti-inflammatory effect on the LPS-stimulated macrophage cell lines, as evidenced by reduced cytokine production compared to controls. Furthermore, its intracellular mechanism of action was found to be mediated partially through JNK signaling pathways. These findings suggest that alexidine dihydrochloride, while being an effective anticancer agent, may also modulate immune responses by dampening excessive inflammation. In this study, determining the anti-inflammatory effect of alexidine dihydrochloride on the immune system will seriously shed light on the role of this anticancer agent in future clinical studies and will provide a serious basis. In summary, the effects of the most drug-active ingredients on the inflammatory response in immune system cells have not been fully tested, and this creates the problem of many drugs failing in clinical studies or lack of knowledge on their side effects. Our study aimed to determine the effect of alexidine dihydrochloride, used as an anticancer agent, on the inflammatory response in J774.2 macrophage cell lines. Future studies with more immune system cells and a wider analysis of the intracellular signaling pathways will be informative about the immunotoxicity of the drug molecule. Future research involving a broader range of immune cell types and a more comprehensive analysis of intracellular signaling pathways will help clarify the immunotoxicity profile of this anticancer agent.

Prenatal opioid exposure alters pain perception and increases long-term health risks in infants with neonatal opioid withdrawal syndrome

Background

Opioids are often prescribed for pain relief, yet they pose risks such as addiction, dependence, and overdose. Pregnant women have unique vulnerabilities to opioids and infants born to opioid-exposed mothers could develop neonatal opioid withdrawal syndrome (NOWS). The study of opioid-induced epigenetic changes in chronic pain is in its early stages. This study aimed to identify epigenetic changes in genes associated with chronic pain resulting from maternal opioid exposure during pregnancy.

Methods

We analyzed DNA methylation of chronic pain-related genes in 96 placental tissues using Illumina Infinium Methylation EPIC BeadChips. These samples comprised 32 from mothers with infants prenatally exposed to opioids who needed pharmacologic NOWS management (+Opioids/+NOWS), 32 from mothers with prenatally opioid-exposed infants not needing NOWS pharmacologic treatment (+Opioids/-NOWS), and 32 from unexposed control subjects (-Opioids/-NOWS).

Results

The study identified significant methylation changes at 111 CpG sites in pain-related genes among opioid-exposed infants, with 54 CpGs hypomethylated and 57 hypermethylated. These genes play a crucial role in various biological processes, including telomere length regulation (NOS3, ESR1, ESR2, MAPK3); inflammation (TNF, MAPK3, IL1B, IL23R); glucose metabolism (EIF2AK3, CACNA1H, NOTCH3, GJA1); ion channel function (CACNA1C, CACNA1H, CLIC4, KCNQ5); autophagy (CTSS, ULK1, ULK4, ATG5); oxidative stress (NGF, NRG1, OPRM1, ATP1A2); aging (GRIA1, NGFR, PRLR, EIF4E); cytokine activity (TRPV4, RUNX1, CXCL8, IL18R1); and the risk of suicide (ADORA2A, ANKK1, GABRG2, IGSF9B). These epigenetic changes may influence 48 signaling pathways-including cAMP, MAPK, GnRH secretion, estrogen signaling, morphine addiction, circadian rhythms, and insulin secretion-profoundly affecting pain and inflammation-related processes.

Conclusion

The identified methylation alterations may shed light on pain, neurodevelopmental changes, and other biological mechanisms in opioid-exposed infants and mothers with OUD, offering insights into NOWS and maternal-infant health. These findings may also pave the way for targeted interventions and improved pain management, highlighting the potential for integrated care strategies to address the interconnected health of mothers and infants.

Seaweed-derived mixed extracts exhibit immunomodulatory properties on porcine alveolar macrophages

Antimicrobial resistance is a growing global concern, prompting for antibiotic alternatives in animal production. Seaweed, abundant in bioactive compounds with anti-inflammatory properties, offers a natural substitute to synthetic compounds. Considering this, the objective of the present study was to evaluate the anti-inflammatory bioactivity of three seaweeds 1:1 combination of Ascophyllum nodosum, Palmaria palmata, and Ulva lactuca. Initially, polyphenol, flavonoid, and total phlorotannin content of the three seaweed species were assessed through colorimetric assays. Subsequently, the anti-inflammatory bioactivity was first evaluated through an inhibition protein precipitation assay and then confirmed in vitro through gene expression assays in LPS-stimulated porcine alveolar macrophages (PAMs). The evaluation of the bioactive molecules revealed a high content of TPC (1487.67 ± 40.39 and 1763.57 ± 69.01 mg TAE/100 mg of sample, respectively), as well as of TFC (95.68 ± 3.62 and 126.09 ± 7.34 mg CE/100 mg of sample) and TPhC (0.167 ± 0.02 and 0.23 ± 0.01 mg PGE/100 mg) for AN and UL, respectively. The assay for inhibiting protein precipitation disclosed that the extracts combining two algae species (ANUL, ANPP, PPUL) were more effective than the effect exhibited by each single extract. The assessment of anti-inflammatory bioactivity revealed a significant down-regulation of IL-1β and TNF-α in the algae combination extracts. In contrast, TGF-β showed an increasing trend. These findings, along with confirmation of the high content of bioactive molecules, highlight the algae's anti-inflammatory potential, making them suitable as natural alternatives to antibiotics for disease prevention in the livestock sector. Therefore, future research should explore the specific bioactive compounds and validate their efficacy in vivo to confirm their potential use in animal production.

Evaluation of polygenic risk scores for hormones and receptors levels in patients with vestibulodynia: a case-control study

BACKGROUND

Vulvodynia is a multifactorial disease affecting 7%-16% of reproductive-aged women in general population; however, little is still known about the genetics underlying this complex disease.

AIM

To compare polygenic risk scores for hormones and receptors levels in a case-control study to investigate their role in vulvodynia and their correlation with clinical phenotypes.

METHODS

Our case-control study included patients with vestibulodynia (VBD) and healthy women. All participants underwent a vestibular cotton swab test and the assessment of their: pelvic floor, vestibular trophism, ultrasound vestibular mucosa thickness, and current perception threshold levels (Neurometer CPT device). Shallow whole genome sequencing and polygenic risk score calculations were performed. Linear regression models were applied to predict whether genomic predisposition varied significantly between cases and controls, and to investigate the relationship of polygenic risk scores with clinical endophenotypes.

OUTCOMES

The genomic predisposition to hormones and receptors levels, together with clinical endophenotypes, can support VBD diagnosis and personalized treatment of related pain condition.

RESULTS

Thirty women with VBD and 30 controls were recruited. Significant differences between cases and controls were observed for body mass index, vestibular mucosa thickness, vestibular trophic health, pelvic floor hypertone and pain sensitivity (P < .05). Cases showed a genomic predisposition to higher levels of membrane-associated progesterone receptor component 1 compared to controls (P < .05). When considering the clinical endophenotypes, cases showed significant correlations between their polygenic risk scores with several clinical measures: predicted genomic levels of testosterone and estrogen receptor and the vestibular mucosa thickness values (estimates: 9.74E-09 and 9.16E-08, respectively; P < .05); predicted genomic levels of prolactin and Neurometer data at 250 Hz (-2.15E-07; P < .05); predicted genomic levels of prolactin, membrane-associated progesterone receptor component 2 and mineralocorticoid receptor and Neurometer data at 5 Hz (-3.75E-07, -3.43E-07 and -3.06E-07, respectively; P < .05).

CLINICAL IMPLICATIONS

Introduction of polygenic risk scores evaluation in clinical practice can assist early diagnosis and personalized therapeutic treatment of VBD.

STRENGTHS AND LIMITATIONS

Polygenic risk scores and clinical data allowed the identification of disease endophenotypes and highlighted the possibility of a personalized therapeutic approach. As limitations, these data should be confirmed on a larger cohort and polygenic risk score calculation should be adapted to ancestries other than European.

CONCLUSION

Cases showed significant differences compared to controls on both clinical and genetic data and specific endophenotypes necessary to classify disease development and treatment were identified.

The role of autophagy in cancer: from molecular mechanism to therapeutic window

Autophagy is a cellular degradation process that plays a crucial role in maintaining metabolic homeostasis under conditions of stress or nutrient deprivation. This process involves sequestering, breaking down, and recycling intracellular components such as proteins, organelles, and cytoplasmic materials. Autophagy also serves as a mechanism for eliminating pathogens and engulfing apoptotic cells. In the absence of stress, baseline autophagy activity is essential for degrading damaged cellular components and recycling nutrients to maintain cellular vitality. The relationship between autophagy and cancer is well-established; however, the biphasic nature of autophagy, acting as either a tumor growth inhibitor or promoter, has raised concerns regarding the regulation of tumorigenesis without inadvertently activating harmful aspects of autophagy. Consequently, elucidating the mechanisms by which autophagy contributes to cancer pathogenesis and the factors determining its pro- or anti-tumor effects is vital for devising effective therapeutic strategies. Furthermore, precision medicine approaches that tailor interventions to individual patients may enhance the efficacy of autophagy-related cancer treatments. To this end, interventions aimed at modulating the fate of tumor cells by controlling or inducing autophagy substrates necessitate meticulous monitoring of these mediators' functions within the tumor microenvironment to make informed decisions regarding their activation or inactivation. This review provides an updated perspective on the roles of autophagy in cancer, and discusses the potential challenges associated with autophagy-related cancer treatment. The article also highlights currently available strategies and identifies questions that require further investigation in the future.

Genistein in focus: pharmacological effects and immune pathway modulation in cancer

Cancer is a significant global health concern, responsible for mortality and morbidity of individuals. It is characterized by uncontrolled cellular growth, tumor formation, and potential metastasis. The immune system is pivotal in recognizing and eliminating cancerous cells, with immune cells such as T cells, B cells, natural killer cells (NK), and dendritic cells playing critical roles. Dysregulation of immune responses can contribute to cancer progression. Phytochemicals, bioactive compounds derived from plants, have gained attention for their potential roles in cancer prevention and therapy due to their antioxidant, anti-inflammatory, and immunomodulatory properties. Genistein, an isoflavone found in soy products, is of particular interest. In this study, genistein's mechanisms of action at the molecular and cellular levels in cancer were demonstrated, highlighting its impact on T and B lymphocytes, NK cells and dendritic cells. Genistein's ability to influence cytokine production, reducing levels of inflammatory cytokines such as TNF-α, IL-6, and IL-1β, is emphasized. Genistein modulates inflammatory response pathways like Toll-like receptors (TLRs), NF-κB, chemokines, and MAPK, inhibiting tumor growth, promoting apoptosis, and reducing metastasis. It shows promise in overcoming chemoresistance, particularly in ovarian and neuroblastoma cancers, by inhibiting autophagy. Genistein also affects T-cell execution markers, including granzyme B, TNF-α, and FAS ligand in cancer by influencing key proteins involved in immune response and apoptosis. Clinical trials have investigated genistein's therapeutic potential, revealing its promise in enhancing the efficacy of traditional cancer treatments while mitigating associated toxicities. Genistein helps overcome chemoresistance in various cancers by inhibiting autophagy and promoting apoptosis. It also enhances immunotherapy by boosting immune responses and modifying antigens, but careful dosing is needed when combined with anti-PD-1 treatments to avoid reducing effectiveness.

Neuroinflammatory Pathways Associated with Chronic Post-Thoracotomy Pain: A Review of Current Literature

Chronic post-thoracotomy pain (CPTP) is a major clinical problem that affects up to 35-55% of patients undergoing thoracic incisions. Evidence suggests that multiple cellular signaling pathways and neuro-inflammatory mediators may play an essential role in the pathogenesis of CPTP. In this comprehensive review, we present the current evidence on the cellular signaling pathways and inflammatory changes associated with the initiation and maintenance of CPTP, focusing on the potential application of these findings in the clinical setting. An electronic search of Medline, EMBASE, Cochrane, Google Scholar, and ClinicalTrials.gov was performed, and 3652 abstracts were identified. After an initial abstract screening, 131 studies underwent a full-text review, and nine papers were eventually included in this review. Studies were included if they assessed the cellular signaling pathways or inflammatory processes associated with the induction and/or maintenance of CPTP. All the identified studies were pre-clinical studies conducted on animal models. Our search identified seven cellular pathways (NK-1 receptor (NK-1), Glutaminase 1, Toll-like receptor 4 (TLR4), Resolvins, Ror-2, Sonic hedgehog signaling (Shh), and Wnt5a/Wnts) and six cytokines (IL-1β, IL-6, IL-8, IL-10, IFN-γ, and TNF-α) that were investigated in the context of CPTP. Multiple cellular signaling pathways and inflammatory cytokines may play an important role in the neuroinflammatory changes associated with the induction and maintenance of chronic post-thoracotomy pain in animal models. However, the clinical impact and therapeutic utility of these neuroinflammatory changes in routine clinical practice have yet to be demonstrated.

Screening of Sensorial and Inflammatory Changes in Patients Submitted to Orthognathic Surgery

BACKGROUND

Despite the high levels of success after orthognathic surgery, the immediate postoperative pain and edema, besides the neurosensorial deficits, are common complications.

OBJECTIVE

This study aimed to evaluate the pattern of sensory and inflammatory responses in patients undergoing orthognathic surgery.

METHODS

This prospective observational study included 20 patients undergoing bimaxillary orthognathic surgery, who were evaluated in the preoperative period and on Days 1, 2, 3, 4, 5, 6, 7, and 30 after surgery, using a battery of tests to assess sensorial and inflammatory changes.

RESULTS

Subjective and objective evaluations of edema indicated a trend toward edema resolution within 30 days, with a significant decrease in mouth opening on days 1, 7, and 30 after surgery. Regarding nasal obstruction, a significant increase in Nasal Obstruction Symptom Evaluation (NOSE) scores was demonstrated on the first, second, and third days, returning to preoperative levels after 30 days. There was a significant increase in visual analogic scale (VAS) scores from the first to the seventh day after surgery, with a reduction within 30 days. For mechanical and thermal sensitivity tests, the lower lip and chin regions had poorer results, without recovery after 30 days. Positive correlations were observed between painful and inflammatory parameters, as well as between subjective and objective evaluations. Analysis of saliva biomarkers did not show significant differences for pre- and postoperative CCL3 or CCL4 levels.

CONCLUSION

Data provide new evidence about the early inflammatory and sensorial complications after orthognathic surgery.

Amyloid beta-induced signalling in leptomeningeal cells and its impact on astrocyte response

The pathological signature of Alzheimer's disease (AD) includes the accumulation of toxic protein aggregates, mainly consisting of amyloid beta (Aβ). Recent strides in fundamental research underscore the pivotal role of waste clearance mechanisms in the brain suggesting it may be an early indication of early onset AD. This study delves into the involvement of leptomeningeal cells (LMCs), crucial components forming integral barriers within the clearance system, in the context of AD. We examined the inflammatory cytokine responses of LMCs in the presence of Aβ, alongside assessments of LMC growth response, viability, oxidative stress, and changes in vimentin expression. The LMCs showed no changes in growth, viability, oxidative stress, or vimentin expression in the presence of Aβ, indicating that LMCs are less susceptible to Aβ damage compared to other CNS cells. However, LMCs exhibited a unique pro-inflammatory response to Aβ when compared to an LPS inflammatory control, showing an mRNA expression of pro-inflammatory cytokines such IL-6, IL-10 and IL-33 but no changes in IL-1α and IL-1β. Furthermore, LMCs influenced the astrocyte response to Aβ, as conditioned media from Aβ-treated LMCs was observed to downregulate somatic S100β in astrocytes. We also investigated whether the JAK/STAT3 pathway was involved in the Aβ response of the LMCs, as this pathway has been shown to be activated in astrocytes and neurons in the presence of Aβ. JAK/STAT3 activation was assessed through phosphorylated STAT3, revealing that JAK/STAT3 was not active in the cells when in the presence of Aβ. However, when JAK1 and JAK2 were inhibited, cytokine protein levels of IL7, IL10, IL15 and IL33 levels, which had shown alteration when LMCs were treated with Aβ, returned to base levels. This indicates that although JAK1/STAT3 and JAK2/STAT3 are not the direct pathway for Aβ response in LMCs, JAK1 and JAK2 may still play a role in regulating cytokine levels, potentially through indirect means or crosstalk. Overall, our findings reveal that LMCs are resilient to Aβ toxicity and suggest that JAK1/STAT3 and JAK2/STAT3 does not play a central role in the inflammatory response, providing new insights into the cellular mechanisms underlying AD.

Robotics versus open surgery: the impact on cytokine release and patient outcomes

Surgical techniques have witnessed a significant evolution with the advent of robotic surgery. The impact of robotic surgery on the body's immune system, specifically its role in causing cytokine storm has gained interest. The present narrative review explores the association between robotic surgery and cytokine release in the body and attempts to contrast it with open surgical technique consequently, highlighting the impact on patient outcomes. A literature review was conducted using PubMed, Embase, Google Scholar, Web of Science and Cochrane databases. Screening was done using the keywords "Robotic Surgery," "Robot Assisted Surgery," "Conventional Surgery," "Cytokine," "Tissue Injury," "Inflammatory Response," and "IL-6." A total of 5379 articles were identified in the literature search out of which 5172 article records were excluded after the title and abstract screening that was done by two independent reviewers. 207 full text articles were assessed for eligibility and 154 were excluded. Finally, 53 articles were used as a core for this review article. Robotic surgery has been found to have a lower cytokine response and improved clinical outcomes in comparison to the open approach. It is crucial to consider the confounding factors when evaluating the postoperative outcomes that could affect the relationship between the surgical approach, cytokine release and clinical outcomes.

Beneficial Effects of Infiltration of Platelet-Rich Plasma in the Endometrium

Platelet-rich plasma (PRP) is a concentrated product of autologous plasma platelets. It promotes the repair of tissues with low healing potential by providing supraphysiological amounts of essential growth factors and has recently become more popular in endometrial repair, achieving exciting clinical results. PRP treatment has proven to improve fertility outcomes in patients with a poor endometrial environment. However, the mechanism is not yet clear. Previous preclinical models also showed that PRP treatment decreased the expression of inflammatory markers and fibrosis, increased the endometrial proliferation rate and gene expression, and enhanced the pregnancy rate. The modulation of the endometrial immune environment and endometrial microbial community by PRP treatment appeared to be the key mechanism by which it improved endometrial receptivity. This review summarized the potential of adult PRP based on its composition and applications and the biological mechanisms and biological modifications in the endometrium after PRP instillation in preclinical models.

Involvement of virus infections and antiviral agents in schizophrenia

BACKGROUND

Schizophrenia is a chronic and complex mental disorder resulting from interactions between cumulative and synergistic genetic and environmental factors. Viral infection during the prenatal stage constitutes one of the most relevant risk factors for the development of schizophrenia later in adulthood.

METHODS

A narrative review was conducted to explore the link between viral infections and schizophrenia, as well as the neuropsychiatric effects of antiviral drugs, particularly in the context of this specific mental condition. Literature searches were performed using the PubMed, Scopus, and Web of Science databases.

RESULTS

Several viral infections, such as herpesviruses, influenza virus, Borna disease virus, and coronaviruses, can directly or indirectly disrupt normal fetal brain development by modifying gene expression in the maternal immune system, thereby contributing to the pathophysiological symptoms of schizophrenia. In addition, neuropsychiatric effects caused by antiviral drugs are frequent and represent significant adverse outcomes for viral treatment.

CONCLUSIONS

Epidemiological evidence suggests a potential relationship between viruses and schizophrenia. Increases in inflammatory cytokine levels and changes in the expression of key genes observed in several viral infections may constitute potential links between these viral infections and schizophrenia. Furthermore, antivirals may affect the central nervous system, although for most drugs, their mechanisms of action are still unclear, and a strong relationship between antivirals and schizophrenia has not yet been established.

Biomimetic Silk Nanoparticle Manufacture: Calcium Ion-Mediated Assembly

Silk has emerged as an interesting candidate among protein-based nanocarriers due to its favorable properties, including biocompatibility and a broad spectrum of processing options to tune particle critical quality attributes. The silk protein conformation during storage in the middle silk gland of the silkworm is modulated by various factors, including the most abundant metallic ion, calcium ion (Ca2+). Here, we report spiking of liquid silk with calcium ions to modulate the silk nanoparticle size. Conformational and structural analyses of silk demonstrated Ca2+-induced silk assemblies that resulted in a liquid crystalline-like state, with the subsequent generation of β-sheet-enriched silk nanoparticles. Thioflavin T studies demonstrated that Ca2+ effectively induces self-assembly and conformation changes that also increased model drug loading. Ca2+ incorporation in the biopolymer feed significantly increased the nanoparticle production yield from 16 to 89%, while simultaneously enabling Ca2+ concentration-dependent particle-size tuning with a narrow polydispersity index and altered zeta potential. The resulting silk nanoparticles displayed high biocompatibility in macrophages with baseline levels of cytotoxicity and cellular inflammation. Our strategy for manufacturing biomimetic silk nanoparticles enabled overall tuning of particle size and improved yields─features that are critical for particle-based nanomedicines.

Proinflammatory Cytokines in Chronic Respiratory Diseases and Their Management

Pulmonary homeostasis can be agitated either by external environmental insults or endogenous factors produced during respiratory/pulmonary diseases. The lungs counter these insults by initiating mechanisms of inflammation as a localized, non-specific first-line defense response. Cytokines are small signaling glycoprotein molecules that control the immune response. They are formed by numerous categories of cell types and induce the movement, growth, differentiation, and death of cells. During respiratory diseases, multiple proinflammatory cytokines play a crucial role in orchestrating chronic inflammation and structural changes in the respiratory tract by recruiting inflammatory cells and maintaining the release of growth factors to maintain inflammation. The issue aggravates when the inflammatory response is exaggerated and/or cytokine production becomes dysregulated. In such instances, unresolving and chronic inflammatory reactions and cytokine production accelerate airway remodeling and maladaptive outcomes. Pro-inflammatory cytokines generate these deleterious consequences through interactions with receptors, which in turn initiate a signal in the cell, triggering a response. The cytokine profile and inflammatory cascade seen in different pulmonary diseases vary and have become fundamental targets for advancement in new therapeutic strategies for lung diseases. There are considerable therapeutic approaches that target cytokine-mediated inflammation in pulmonary diseases; however, blocking specific cytokines may not contribute to clinical benefit. Alternatively, broad-spectrum anti-inflammatory approaches are more likely to be clinically effective. Herein, this comprehensive review of the literature identifies various cytokines (e.g., interleukins, chemokines, and growth factors) involved in pulmonary inflammation and the pathogenesis of respiratory diseases (e.g., asthma, chronic obstructive pulmonary, lung cancer, pneumonia, and pulmonary fibrosis) and investigates targeted therapeutic treatment approaches.

Role of Galactosylceramide Metabolism in Satellite Glial Cell Dysfunction and Neuron-Glia Interactions in Painful Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy (DPN) is a prevalent and disabling complication of diabetes, with painful diabetic peripheral neuropathy (PDPN) being its most severe subtype due to chronic pain and resistance to treatment. Satellite glial cells (SGCs), critical for maintaining dorsal root ganglion (DRG) homeostasis, undergo significant structural and functional changes under pathological conditions. This study investigated the role of galactosylceramide (GalCer), a key sphingolipid, in SGC dysfunction and neuron-glia interactions during DPN progression. Using a rat model of PDPN, we employed single-cell RNA sequencing (scRNA-seq), targeted mass spectrometry, and immunofluorescence analysis. The PDPN group exhibited transcriptional activation and structural reorganization of SGCs, characterized by increased SGC abundance and glial activation, evidenced by elevated Gfap expression. Functional enrichment analyses revealed disruptions in sphingolipid metabolism, including marked reductions in GalCer levels. Subclustering identified vulnerable SGC subsets, such as Cluster a, with dysregulated lipid metabolism. The depletion of GalCer impaired SGC-neuron communication, destabilizing DRG homeostasis and amplifying neurodegeneration and neuropathic pain. These findings demonstrate that GalCer depletion is a central mediator of SGC dysfunction in PDPN, disrupting neuron-glia interactions and exacerbating neuropathic pain. This study provides novel insights into the molecular mechanisms of DPN progression and identifies GalCer metabolism as a potential therapeutic target.

Platelet rich plasma versus corticosteroids for lateral epicondylitis: a meta-analysis of randomized clinical trials

BACKGROUND

Lateral epicondylitis, colloquially known as tennis elbow, is a common cause of elbow pain and daily task disability. Caused by repetitive movement, it is typically a degenerative rather than inflammatory event and affects mostly middle-aged patients. Despite its good prognostic nature, its economic burden on the healthcare system encourages research on the efficacity of non-operative injection treatments. This article aims to compare the clinical effectiveness of platelet-rich plasma (PRP) and corticosteroid (CS) injections in managing lateral epicondylitis.

METHODS

PubMed, Cochrane, and Google Scholar (pages 1-20) were searched up to March 2024. Only randomized controlled trials were included. The clinical outcomes evaluated were the visual analog scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) score.

RESULTS

Twenty-six randomized controlled trials with 1.877 patients were included in this meta-analysis. In terms of VAS scores, short-term results (<2 months) favored CS over PRP (P=0.03; mean difference [MD], 0.67; 95% CI, 0.05 to 1.28), whereas long-term results (>6 months) favored PRP (P<0.001; MD, -1.60; 95% CI, -2.01 to -1.20]). Intermediate-term results (2-6 months) showed no significant difference between injection treatments. In terms of DASH scores, short- and intermediate-term results showed no significant difference, whereas long-term results favored PRP (P<0.001; MD, -4.87; 95% CI, -7.69 to -2.06).

CONCLUSIONS

CS provides significantly better short-term pain relief, while PRP provides better long-term functional improvement and clinical long-term pain relief. However, future studies should focus on other injection protocols or addition of other non-invasive modalities. Level of evidence: I.

FTY720P-treated macrophages in PEG-4MAL hydrogels promote oral wound healing

BACKGROUND AIMS

Oral wound healing involves hemostasis, inflammation, proliferation and tissue remodeling. The oral cavity is a complex wound healing environment because of the presence of saliva, a high bacterial burden and ongoing physical trauma from eating. The inflammatory component of wound healing balances the polarization of macrophages in healing tissues between M1 inflammatory macrophages and M2 anti-inflammatory macrophages. M2 macrophages secrete anti-inflammatory and pro-regenerative cytokines and chemokines, which aid wound healing. Fingolimod, or FTY720, a Food and Drug Administration-approved sphingosine-1-phosphate modulator, has been implicated in inducing the polarization of macrophages to the M2 phenotype. In this study, we investigated whether macrophage pre-treatment with phosphorylated FTY720 (FTY720P), the bioactive form of the drug, in a PEG-4MAL hydrogel promotes improved oral wound healing in a critically sized oral mucosal defect model.

METHODS AND RESULTS

Using cytokine dot blots and Luminex cytokine assays (MilliporeSigma, Burlington, MA, USA), FTY720P-treated murine RAW 264.7 and human THP1-differentiated macrophages in PEG-4MAL hydrogels secreted chemokines and cytokines known to regulate inflammation (e.g., interleukin [IL] 4, IL-13) and induce M2 macrophage polarization (e.g., CCL6, CCL22), leukocyte migration (e.g., CXCL2, CCL2, CCL12, CCL22), angiogenesis (e.g., vascular endothelial growth factor) and epithelialization (e.g., IL-1, IL-17, IL-22). In vitro, FTY720P-treated cells induced chemotaxis of macrophages and fibroblasts in Transwell assays (Corning, Corning, NY, USA) and oral epithelial scratch wound closure. In a murine oronasal fistula (ONF) model of oral wound healing, the local application of FTY720P-treated macrophages in PEG-4MAL hydrogels significantly increased wound closure (75% closure) relative to non-treated cells (40% closure) and blank hydrogel controls (25% closure) (P < 0.0001). Flow cytometry of mouse palatal tissue showed that application of FTY720P-treated macrophage hydrogels to ONFs significantly increased day 7 percentage of M1 and M2 macrophages, mesenchymal stromal cells and CD19+ B cells. Significantly fewer neutrophils, monocytes, CD4+/CD8+ T cells and endothelial cells were observed in the FTY720P-treated macrophage defects, suggesting that FTY720P-treated macrophages in hydrogels promote oral wound healing via suppression of granulation and resolution of inflammation and promotion of tissue maturation.

CONCLUSIONS

Our data provide new insights into the use of potential FTY720P-treated macrophage therapies for oral wound healing and have clinical implications for cleft palate and oral surgery.

Anti-inflammatory effect of multi-dose tranexamic acid in hip and knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Tranexamic acid (TXA) is considered a potential therapeutic approach to mitigate postoperative inflammatory responses; however, its anti-inflammatory effects remain controversial. This study conducts a systematic review and meta-analysis of randomized controlled trials aiming to investigate the efficacy of multi-dose TXA in exerting anti-inflammatory effects in hip and knee arthroplasty.

METHODS

We identified potential relevant literature evaluating the anti-inflammatory effects of TXA in patients undergoing hip and knee arthroplasty from PubMed, Embase, and the Cochrane Library. Meta-analysis was performed using RevMan 5.3.

RESULTS

Nine randomized controlled studies met the inclusion criteria. Meta-analysis results indicated that, compared with lower doses of TXA, multi-dose TXA significantly reduced the inflammatory markers IL-6 and CRP in patients undergoing hip and knee arthroplasty and shortened the length of hospital stay, with statistically significant results. Nonsignificant differences were found in the incidence of thromboembolic events.

CONCLUSION

Based on the current evidence, our results indicate that multi-dose TXA effectively reduces postoperative inflammatory responses in patients undergoing hip and knee arthroplasty. This anti-inflammatory effect is dose-dependent and is accompanied by a reduction in the length of hospital stay. Nonetheless, further high-quality, multicenter, large-sample-size randomized controlled trials are needed to confirm the anti-inflammatory effects of TXA.

Considerations for defining and diagnosing generalized pustular psoriasis

Generalized pustular psoriasis (GPP) is a rare, chronic skin disease, characterized by widespread pustules and erythema, often accompanied with systemic signs and symptoms. GPP flares occur episodically but may be protracted. Left untreated, GPP can be life-threatening. Despite being first reported over 100 years ago, definitions and diagnostic criteria for GPP have been inconsistent and varied due, in part, to its rarity and a limited understanding of its pathogenesis. As such, many patients with GPP face delays in diagnosis and subsequent treatment. This manuscript aims to increase the recognition of GPP and provide foundational considerations to aid in the definition and diagnosis of this disease.

Potential role of NSAIDs loaded nano-formulations to treat inflammatory diseases

Inflammation is a necessary immunological response that promotes survival and preserves tissue homeostasis, a common characteristic linked to various diseases. However, in some circumstances, the inflammatory response is deleterious and contributes to disease pathogenesis. Anti-inflammatory substances have poor affinity for inflamed tissues, resulting in low concentrations in the target tissue and a higher incidence of severe adverse effects. To address this issue, several potential approaches have been proposed, such as chemical modification of drug molecules and the development of nanocarriers for drug delivery. Since the development of nanotechnology at the beginning of the twenty-first century, researchers have been using the pathophysiological characteristics of inflammation, primarily leaky vasculature, and biomarker overexpression to develop nanomedicines that can deliver therapeutics via passive and active targeting mechanisms to sites of inflammation and produce therapeutic effects. Drug carriers based on nanoparticles can enhance the safety and efficacy of drugs by increasing their capacity, enhancing their solubility, combining several drugs, protecting them from metabolism, and regulating their release. An approach that shows promise in the treatment of various inflammatory diseases is the application of nanomedicines. Nanomedicine involves nanoparticles that have been loaded with a therapeutically active component. Nanomedicines can target inflammation by recognizing molecules highly expressed on endothelial cells or activated macrophage surfaces, enhancing the permeability of vessels, or even by biomimicry. A review of the research findings shows significant potential for the use of nanotechnology to enhance the quality of life for people using NSAIDs for chronic disorders by minimizing drug side effects or the duration of administration. After a brief introduction to inflammation, its various forms- acute and chronic inflammation, and the pathophysiology of inflammation, this review highlights the main innovative nanocarriers utilized for carrying various nonsteroidal anti-inflammatory drugs that have been utilized in treating various inflammatory disorders.

Regulation of miRNA in Cytokine Storm (CS) of COVID-19 and Other Viral Infection: An Exhaustive Review

In the initial stage of the COVID-19 pandemic, high case fatality was noted. The case fatality during this was associated with the cytokine storm (CS) or cytokine storm syndrome (CSS). Sometimes, virus infections are due to the excessive secretion of pro-inflammatory cytokines, leading to cytokine storms, which might be directed to ARDS, multi-organ failure, and death. However, it was noted that several miRNAs are involved in regulating cytokines during SARS-CoV-2 and other viruses such as IFNs, ILs, GM-CSF, TNF, etc. The article spotlighted several miRNAs involved in regulating cytokines associated with the cytokine storm caused by SARS-CoV-2 and other viruses (influenza virus, MERS-CoV, SARS-CoV, dengue virus). Targeting those miRNAs might help in the discovery of novel therapeutics, considering CS or CSS associated with different virus infections.