Optimized gravity-driven intranasal drop administration delivers significant doses to the ostiomeatal complex and maxillary sinus

Chronic and allergic rhinosinusitis impacts approximately 12% of the global population. Challenges in rhinosinusitis treatment include paranasal sinus inaccessibility and variability in delivery efficiency among individuals. This study addresses these challenges of drug delivery by developing a high-efficiency, low-variability protocol for nasal drop delivery to the ostiomeatal complex (OMC) and maxillary sinus. Patient-specific nasal casts were dissected to reveal the configurations of conchae and meatus, providing insights into anatomical features amendable for sinus delivery. Fluorescent dye-enhanced videos visualized the dynamic liquid translocation in transparent nasal casts, allowing real-time assessment and quick adjustment to delivery parameters. Dosimetry to the OMC and maxillary sinus were quantified as drop count and mass using a precision scale. Key delivery factors, including the device type, formulation, and head-chin orientation, were systematically investigated in a cohort of ten nasal casts. Results show that both the squeeze bottle and soft-mist nasal pump yielded notably low doses to the OMC with high variability, and no dose from these two devices was detected within the maxillary sinuses. In contrast, the proposed approach, which included a curved nozzle surpassing the nasal valve and leveraged gravity-driven liquid translocation along the lateral nasal wall, delivered significant doses to the OMC and maxillary sinus. Iterative experimentations identified the optimal head tilt to be 40° and chin tilt to be° from the lateral recumbent position. Statistical analyses established the drop count required for effective OMC/sinus delivery. The proposed delivery protocol holds the potential to enhance chronic rhinosinusitis treatment outcomes with low variability. The dual role of nasal anatomy in posing challenges and offering opportunities highlights the need for future investigations using diverse formulations in a larger cohort of nasal models. Optimized gravity-driven intranasal drop administration delivers significant doses to the ostiomeatal complex and maxillary sinus.

Targeted drug delivery to the inferior meatus cavity of the nasal airway using a nasal spray device with angled tip

BACKGROUND AND OBJECTIVE

Nowadays, by advancement in computational tools, Computational Fluid and Particle Dynamics (CFPD) technique can be used more than ever. The main aim of this study is using a nasal spray device with angled tip to deliver drug particles to the inferior meatus cavity for treatment purposes. In the present study, the drug delivery to the lower regions of the nasal cavity will be improved that has been considered less in the literature.

METHODS

For this purpose, a spray with an angled tip was used, and the deposition of sprayed particles was compared with a spray with a straight tip. Based on the objectives presented above, a realistic model of the nasal route, including facial geometry, and paranasal sinuses obtained from a series of Computed tomography (CT) scan images, as well as the geometry of a nasal spray with two types of tip were developed.

RESULTS

It is observed that by using the spray with the straight tip, particles were mainly deposited in the middle and superior regions of the nasal cavity and no particles entered the inferior meatus airway. The results proved that the spray with the angled tip improved the regional deposition percentage in the inferior meatus cavity up to 2.4% of the total sprayed particles and 1 mg drug mass delivered to this region. The majority of these particles had a diameter between 15-55 µm and that could be considered by spray designers to produce more compatible sprays with the targeted region. Also, most particles were deposited near the inferior meatus cavity and so there is a strong chance to be absorbed and delivered to this region.

CONCLUSION

The deposition pattern and particle size contour due to the spray with the angled tip can give sight to the designers and producers of nasal sprays to build more efficient types for better targeted drug delivery purposes. With this spray type, deposited particles were observed in the inferior meatus that never happened with the straight type. Also, the angled tip of the nasal spray shows the benefit of the ease of use for the user.

Development of a novel platform of virus-like particle (VLP)-based vaccine against COVID-19 by exposing epitopes: an immunoinformatics approach

The emergence of a rapidly spreading and highly infectious coronavirus disease 2019 (COVID-19) outbreak by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a global pandemic with unprecedented social and economic dimensions. Therefore, the development of effective strategies is urgent to control the COVID-19 outbreak. According to recent investigations, cell entry of coronaviruses relies on binding of the viral spike glycoprotein to the host cellular receptors. Therefore, the present study aimed to predict immunogenic epitopes in silico by analysing the spike protein. In parallel, by screening the immunogenic SARS-CoV-2 spike-derived epitopes provided in the literature, we chose a set of epitopes that we believed would induce immunogenic response. Next, provided with the epitopes selected by using both approaches, we performed immunoinformatic analysis that mapped identically to the antigen regions and antigenic properties. Finally, after selecting a screened set of epitopes, we designed a novel virus-like particle vaccine optimized to be produced in plants by using molecular farming biotechnology techniques. Our assay may be used as a starting point for guiding experimental efforts towards the development of a vaccine against SARS-CoV-2.

Photobiomodulation therapy improves the growth factor and cytokine secretory profile in human type 2 diabetic fibroblasts

Impaired wound healing is a common complication of diabetes mellitus (DM) and the underlying mechanism of this impairment is still unclear. Fibroblast, as the main reconstructing cell, secretes some critical growth factors and cytokine contributing to wound healing. It is well known that DM alters the behavior of these cells and photobiomodulation therapy (PBMT) compensates some impairments in diabetic fibroblasts. Therefore, the aim of the present study was to demonstrate the impact of diabetes and the role of PBMT through low level laser irradiation on secretory profile of human diabetic fibroblasts. Primary human dermal fibroblasts from normal (HDFs) and diabetic (DHDFs) donors were harvested. For PBMT, the DHDFs were irradiated with a Helium-Neon laser at 632.8 nm wavelength and energy density of 0.5 J/cm², as laser treated group (LT-DHDFs). Next, some cellular behaviors and secretory profiling array for 60 growth factors/cytokines were investigated in LT-DHDFs and then compared with those of controls. The data showed that the PBMT could compensate such impairments occurred in DHDFs in terms of viability, proliferation, and migration. Furthermore, considering our novel findings, out of those 20 growth factors/cytokines involved in cell proliferation, immune system regulation, and cell-cell communication pathways, which significantly decreased in DHDF as compared with HDFs, the PBMT could compensate seven in LT-DHDFs as compared with DHDFs. The seven growth factor/cytokines, which are mainly involved in cell-cell communication, positive regulation of cell proliferation, and chemokine mediated pathway included BDNF, Eotaxin-3, FGF6, FGF7, Fractalkine, fit-3ligand, and GCP-2. Therefore, it is suggested that scrutinizing these differentially secreted molecules and the impaired pathways in DHDFs, in combination with those compensated in LT-DHDFs, could raise our knowledge to manage diabetic ulcer through a feasible and cost effective intervention, specifically PBMT.

The basic reproduction number and prediction of the epidemic size of the novel coronavirus (COVID-19) in Shahroud, Iran

The aim of this study was to estimate the basic reproduction number (R0) of COVID-19 in the early stage of the epidemic and predict the expected number of new cases in Shahroud in Northeastern Iran. The R0 of COVID-19 was estimated using the serial interval distribution and the number of incidence cases. The 30-day probable incidence and cumulative incidence were predicted using the assumption that daily incidence follows a Poisson distribution determined by daily infectiousness. Data analysis was done using 'earlyR' and 'projections' packages in R software. The maximum-likelihood value of R0 was 2.7 (95% confidence interval (CI): 2.1-3.4) for the COVID-19 epidemic in the early 14 days and decreased to 1.13 (95% CI 1.03-1.25) by the end of day 42. The expected average number of new cases in Shahroud was 9.0 ± 3.8 cases/day, which means an estimated total of 271 (95% CI: 178-383) new cases for the period between 02 April to 03 May 2020. By day 67 (27 April), the effective reproduction number (Rt), which had a descending trend and was around 1, reduced to 0.70. Based on the Rt for the last 21 days (days 46-67 of the epidemic), the prediction for 27 April to 26 May is a mean daily cases of 2.9 ± 2.0 with 87 (48-136) new cases. In order to maintain R below 1, we strongly recommend enforcing and continuing the current preventive measures, restricting travel and providing screening tests for a larger proportion of the population.

The signal transducer and activator of transcription factors lodge in immunopathogenesis of rheumatoid arthritis

Rheumatoid arthritisis (RA) is a chronic autoimmune disorder that affects ~1-2% of the world’s population and damages synovial joints. RA is characterized by inflammation, autoantibody production, cartilage and bone destruction and synovial hyperplasia. Inflammation induces systemic and articular synthesis of pro-inflammatory cytokines, such as tumor necrosis factor alpha and interleukin-6 that play essential roles in joint and other organ damage in this disease. Considering the role of signal transducer and activator of transcription factors (STATs) in signaling of these cytokines, these proteins may be involved in the pathogenesis of RA. The expression and activity of STATs can contribute to the onset, progression and severity of RA. All STAT family members (STAT1, STAT2, STAT3, STAT4, STAT5a, STAT5b, and STAT6) have been associated with autoimmune diseases, as highlighted in several studies. In this review we aim to describe the immunobiology of STATs and its family members and the role of these proteins in the immunopathogenesis of RA.

Assessment of antibody titers and immunity to Hepatitis B in children receiving chemotherapy

BACKGROUND

There is a decrease in vaccine-specific antibody to certain vaccine-preventable diseases in children after chemotherapy, but the frequency of non-immune patients is not clear. In the present case-control study, was taken under investigation protection level to Hepatitis B infection in children 6 months after completing chemotherapy.

MATERIALS AND METHODS

In this study 68 patients with cancer and 68 healthy children were enrolled. Patients were 1.5 -12 years old with completed standard chemotherapy at least for 6 months. All the patients and healthy children were negative for HBsAg and HBeAg and had received Hepatitis B vaccination. IgG antibody concentrations against Hepatitis B Virus (HBV) were determined in the patients receiving chemotrapy and healthy subjects serum by ELISA method. IgG antibody titer > 10 mIU/ml was considered as baseline protective titer for preventing HBV infection.

RESULTS

Anti-HBs antibody titer in 19.12% of patients was less than 10 mIU/ml and 11.76% of the patients had borderline antibody titer (10-20 mIU/ml). In healthy subjects, 2.94% and 5.88% had antibody titer < 10 mIU/ml and 10-20 mIU/ml, respectively. According to statistical analysis, frequency of non immune subjects in children with cancer was significantly higher than those in healthy children (P-value=0.024).

CONCLUSION

HBV vaccination post-intensive chemotherapy in the children with cancer is strongly recommended.

Saffron in the treatment of patients with mild to moderate Alzheimer's disease: a 16-week, randomized and placebo-controlled trial

WHAT IS KNOWN

Herbal medicines have been used in the treatment of behavioural and psychological symptoms of dementia but with variable response. Crocus sativus (saffron) may inhibit the aggregation and deposition of amyloid β in the human brain and may therefore be useful in Alzheimer's disease (AD).

OBJECTIVE

The goal of this study was to assess the efficacy of saffron in the treatment of mild to moderate AD.

METHODS

Forty-six patients with probable AD were screened for a 16-week, double-blind study of parallel groups of patients with mild to moderate AD. The psychometric measures, which included AD assessment scale-cognitive subscale (ADAS-cog), and clinical dementia rating scale-sums of boxes, were performed to monitor the global cognitive and clinical profiles of the patients. Patients were randomly assigned to receive capsule saffron 30 mg/day (15 mg twice per day) (Group A) or capsule placebo (two capsules per day) for a 16-week study.

RESULTS

After 16 weeks, saffron produced a significantly better outcome on cognitive function than placebo (ADAS-cog: F=4·12, d.f.=1, P=0·04; CDR: F=4·12, d.f.=1, P=0·04). There were no significant differences in the two groups in terms of observed adverse events.

WHAT IS NEW AND CONCLUSION

This double-blind, placebo-controlled study suggests that at least in the short-term, saffron is both safe and effective in mild to moderate AD. Larger confirmatory randomized controlled trials are called for.

A 22-week, multicenter, randomized, double-blind controlled trial of Crocus sativus in the treatment of mild-to-moderate Alzheimer's disease

RATIONALE

There is increasing evidence to suggest the possible efficacy of Crocus sativus (saffron) in the management of Alzheimer's disease (AD).

OBJECTIVE

The purpose of the present investigation was to assess the efficacy of C. sativus in the treatment of patients with mild-to-moderate AD.

METHODS

Fifty-four Persian-speaking adults 55 years of age or older who were living in the community were eligible to participate in a 22-week, double-blind study of parallel groups of patients with AD. The main efficacy measures were the change in the Alzheimer's Disease Assessment Scale-cognitive subscale and Clinical Dementia Rating Scale-Sums of Boxes scores compared with baseline. Adverse events (AEs) were systematically recorded. Participants were randomly assigned to receive a capsule saffron 30 mg/day (15 mg twice per day) or donepezil 10 mg/day (5 mg twice per day).

RESULTS

Saffron at this dose was found to be effective similar to donepezil in the treatment of mild-to-moderate AD after 22 weeks. The frequency of AEs was similar between saffron extract and donepezil groups with the exception of vomiting, which occurred significantly more frequently in the donepezil group.

CONCLUSION

This phase II study provides preliminary evidence of a possible therapeutic effect of saffron extract in the treatment of patients with mild-to-moderate Alzheimer's disease. This trial is registered with the Iranian Clinical Trials Registry (IRCT138711051556N1).