Immune System In Patients Research Articles

Identification of clonally expanded γδ T-cell populations during CAR-Tcell therapy.

Anti-CD19 Chimeric Antigen Receptor (CAR)-Tcell therapies have shown promise for treating B cell malignancies, but the clinical outcome is influenced by both the CAR-T product and the patient's immune system. The role of γδ Tcells in the context of CAR-T cell therapy remains poorly understood. This study investigates the transcriptional heterogeneity, clonal expansion and dynamics of γδ Tcells in patients undergoing anti-CD19 CAR-T cell therapy. Longitudinal single cell multi-omics analysis was performed on γδ Tcells from four patients receiving anti-CD19 CAR-T cell therapy. Single cell RNA-seq, antibody-based protein profiling (AbSeq) and full-length TCRγδ sequences revealed clonally expanded populations displaying plasticity in Tcell differentiation, and temporal dynamics of large clones, suggesting ongoing expansion and differentiation. Clonally expanded γδ Tcells had heterogeneous gene expression profiles, occupying seven transcriptionally distinct clusters. Analysis of chemokine markers indicated cluster-specific homing tendencies of circulating γδ Tcells to peripheral tissues. We found unexpectedly high frequencies of Vδ1 and Vδ3 cells in the blood with distinct gene and protein expression profiles. This analysis provides insights into the dynamic and heterogeneous nature of γδ Tcells following anti-CD19 CAR-T cell therapy, contributing valuable information for optimizing CAR-T cell therapies in B cell malignancies.

Myeloid subsets impede the efficacy of anti-PD1 therapy in patients with advanced gastric cancer (WJOG10417GTR study).

Gastric cancer (GC) is one of the most common and deadly malignant diseases worldwide. Despite revolutionary advances, the therapeutic efficacy of anti-PD1/PDL1 monoclonal antibodies in advanced GC is still low due to the emergence of innate and acquired resistance to treatment. Myeloid cells represent the majority of human immune cells. Therefore, their increase, decrease, and abnormality could have a significant impact on the patient's immune system and the progression of cancer, and reprogramming, inhibiting, and eliminating the tumor-supportive types may improve the immunological situation and efficacy of immunotherapy. However, the significance of myeloid cells in anti-PD1/PDL1 therapy remains unclear in GC. In the WJOG10417GTR study on GC, we sought to identify myeloid determinants that could predict anti-PD1 therapeutic efficacy and also serve as potential therapeutic targets. We collected tumor tissues and peripheral blood from 96 patients with advanced GC before and 1 month after anti-PD1 nivolumab monotherapy, and the isolated whole leucocytes were analyzed by flow cytometry for various immune cell populations, including many myeloid subsets. Then, the relationship between the cellular levels and progression-free survival (PFS) or overall survival (OS) was statistically analyzed. We found that high levels of several myeloid subsets expressing molecules that have been targeted in drug discovery but not yet approved for clinical use were significantly associated with shorter PFS/OS as compared with low levels: PDL1+ and CTLA4+ myeloid subsets within tumors at baseline, PDL1+, B7H3+ and CD115+ myeloid subsets in peripheral blood at baseline, and LAG3+, CD155+ and CD115+ myeloid subsets in peripheral blood at post-treatment. This study revealed that these myeloid subsets are significant risk factors in nivolumab therapy for advanced GC. Targeting them may be useful as diagnostic biomarkers to predict potential anti-PD1 therapeutic efficacy, and also as therapeutic targets for accelerating the development of new drugs to improve clinical outcomes in immunotherapy for GC.

Survey on Breast Cancer analysis

Breast cancer constitutes 12% of all newly diagnosed cases globally, making it the most predominant type of cancer as a whole. Histopathology images, among all the medical image modalities, maintain the cancer's path and provide richer phenotypic relevant information. The patient's immune system is progressively predictable as a critical feature in defining the suitable treatment. Tumor-infiltrating lymphocytes (TILs), immune cells found within tumors, are emerging as key biomarkers in breast cancer. The detection of lymph node metastasis affects the management of patients with primary breast cancer significantly in terms of staging, treatment, and prognosis.Tumoour infiltrating lymphocytes score and lymph node metastasis identification plays a very important role in staging of breast cancer.This review aims to provide a comprehensive overview on how deep learning-based method is used to compute the Tumour-Infiltrating Lymphocytes (TILs) score and lymph node metastasis from breast cancer histopathological images.

STATE OF CELLULAR IMMUNITY IN PURULENT CHOLANGITIS

Abstract. Objective: To study the state of the cellular link of immunity in acute and chronic cholangitis. Materials and methods. Cholangitis always worsens the condition of the biliary system. Depending on the magnitude of the pathological changes in the bile ducts, we distinguished three groups of patients. Group I – cholangitis caused by obstruction of the main extrahepatic bile ducts due to choledocholithiasis, group II – cholangitis in conditions of cicatricial strictures of the main bile ducts, and group III – cholangitis in conditions of already performed reconstruction of the duct system. The indicators of the cellular link of immunity were studied separately in each group. The results. The conducted studies indicate an imbalance of the immune system in patients with different courses of cholangitis. The presence of inflammation of a mild degree of severity causes stimulation of almost all links of the immune system, while the cellular branch reacts first. Conclusions. Long-term cholangitis was accompanied by suppression of the main markers of T-lymphocyte differentiation — CD2+, CD3+, CD4+ and CD8+, which take part in antigen presentation, signal transmission to other cells and affect their adhesive properties.

Revolutionizing cancer treatment: an in-depth exploration of CAR-T cell therapies.

Cancer is a leading cause of fatality worldwide. Due to the heterogeneity of cancer cells the effectiveness of various conventional cancer treatment techniques is constrained. Thus, researchers are diligently investigating therapeutic approaches like immunotherapy for effective tumor managements. Immunotherapy harnesses the inherent potential of patient's immune system to achieve desired outcomes. Within the realm of immunotherapy, CAR-T (Chimeric Antigen Receptor T) cells, emerges as a revolutionary innovation for cancer therapy. The process of CAR-T cell therapy entails extracting the patient's T cells, altering them with customized receptors designed to specifically recognize and eradicate the tumor cells, and then reinfusing the altered cells into the patient's body. Although there has been significant progress with CAR-T cell therapy in certain cases of specific B-cell leukemia and lymphoma, its effectiveness is hindered in hematological and solid tumors due to the challenges such as severe toxicities, restricted tumor infiltration, cytokine release syndrome and antigen escape. Overcoming these obstacles requires innovative approaches to design more effective CAR-T cells, which require a competent and diverse team to develop and implement. This comprehensive review addresses numerous therapeutic issues and provides a strategic solution while providing a deep understanding of the structural intricacies and production processes of CAR-T cells. In addition, this review explores the practical aspects of CAR-T cell therapy in clinical settings.

Features of immune status in patients with pulmonary tuberculosis after the COVID-19

BACKGROUND. Identification of immunological changes in patients with pulmonary tuberculosis after coronavirus infection will contribute to the prediction of its course and correction of therapeutic protocols. OBJECTIVE. The aim of the work is to determine the nature of immuno-mediated disorders caused by coronavirus disease (COVID-19) in patients with pulmonary sensitive tuberculosis (STB). MATERIALS AND METHODS. The results of a comprehensive immunological clinical and laboratory examination with subsequent computer processing of the data of 72 patients with STB of the lungs were analyzed. RESULTS. In the immune system of patients with pulmonary STB after COVID-19 the multidirectional changes are manifested by: a lower degree of increase of the blood leukocytes number (mainly due to a decrease in the absolute lymphocytes number), activation of the immune T-cells with an increase in the percent number and functional activity of pan-T-cells and T-helpers, an increase in the functional activity of T-suppressors, natural killers and killer T-cells (with the absolute and percent decrease of the latter), a higher level of the absolute and relative number of double positive (CD4+8+) cells and the functional activity of B-cells. A decrease in the level of IgA and an increase in the concentration of IgG with an decrease in the level of the medium and small circulating immune complexes, depression of the phagocytes link of immunity by reducing phagocyte number of phagocytes are observed in the blood of the patients with pulmonary STB after COVID-19. CONCLUSIONS. In the patients with pulmonary tuberculosis after COVID-19, the immune response is complex, with the crossing of immune reactions of pulmonary tuberculosis and post-COVID changes in immunity: on the one hand, previous COVID-19 promote compensatory activation of immune cells – T- and B-lymphocytes, natural killers; on the other hand, it causes suppression of antibacterial protection of mucous membranes (due to a decrease in the blood level of IgA) and reduces the body’s resistance (due to suppression of the phagocytes link of immunity).

Application of Nanomaterials in the Repair and Regeneration of Lymphatic Organs and Corresponding Biophysical Simulation Strategies

Immune system diseases, malignant tumors, and traumatic injuries can directly damage the structure and function of lymphoid organs, while subsequent radiotherapy, chemotherapy, and lymph node dissection further damage the patient's immune system, leading to immune dysfunction, metabolic disorders, and increased susceptibility to infection, which seriously affect the patient's prognosis and quality of life. In this context, nanotechnology plays a key role in lymphoid organ regeneration and immune function recovery, including improving the therapeutic effect through targeted drug delivery systems, using targeted imaging probes to achieve tumor prediction and early detection, combining nanoplatforms with immunotherapy and photodynamic therapy to achieve synergistic therapeutic effects, and using nanomaterials to regulate the tumor microenvironment to enhance the sensitivity of traditional treatments. In addition, biophysical simulation strategies that simulate the microenvironment of lymphoid organs have also attracted widespread attention, aiming to construct a native cell environment to support the regeneration and functional recovery of damaged lymphoid tissues, or to simulate immune cells to regulate lymphocytes and induce specific immune responses. The multifaceted application of nanotechnology provides promising prospects for lymphoid organ regeneration and immune system repair.

Laporan Pendidikan Kesehatan Kebutuhan Nutrisi Untuk Proses Penyembuhan Luka Post OP di Bangsal Mawar RSUD Dr Soehadi Prijonegoro Sragen

: Background: Nutrients are obtained from food and fluids which are then assimilated by the body. Nutrition itself is one of the factors that can support the wound healing process, there are things that are no less important that must be considered as well, namely the nutrients from the food we eat during the wound healing process. Objective: The purpose of postoperative diet is to strive for the patient's nutritional status to return to normal immediately to accelerate the healing process and increase the patient's immune system, by providing basic needs (fluids, energy, protein), replacing the loss of protein, glycogen, iron, and other nutrients, correcting electrolyte and fluid imbalances, preventing and stopping bleeding. Methods: The media used in health education activities is leaflets. Through leaflets we hope that the delivery of material can be understood by participants and can be delivered well.Results: The results of observations from this health education activity, that the majority of participants are active in asking questions and answering questions given by the health education team and can explain the essence of the material that has been delivered by the speaker Conclusion: Of the 20 patient families who attended 15 people had understood the fulfillment of nutritional needs for the correct post op wound healing process.

BCMA-CD19 compound CAR T cells for systemic lupus erythematosus: a phase 1 open-label clinical trial

ObjectivesThis study aims to evaluate the safety and efficacy of BCMA-CD19 compound chimeric antigen receptor T cells (cCAR) to dual reset the humoral and B cell immune system in patients...

Etiology of Leukemoid Reaction in Patients Undergoing Extracorporeal Membrane Oxygenation.

Nosocomial infections are frequent in patients receiving extracorporeal membrane oxygenation (ECMO). Leukemoid reaction, defined as >50,000 white blood cells (WBCs) per microliter, has been associated with infections in some populations. As ECMO is associated with significant inflammation activation between the patient's immune system and the circuit components, it is hypothesized that leukemoid reactions may have low specificity for identifying new infections in patients receiving ECMO. A retrospective cohort study was performed on all adult patients admitted to the Brooke Army Medical Center who received ECMO for greater than 72 hours between 2018 and 2022. Maximum WBCs were obtained for all charts. For those with leukemoid reaction, demographic information and clinical management was obtained. This study was determined to be exempt by Brooke Army Medical Center Institutional Review Board. Among 182 patients receiving ECMO for greater than 72 hours, 15 (8%) developed a leukemoid reaction while on ECMO. The median (Interquartile range, IQR) WBC was 53.94 (50.98 to 62.55). Fourteen (93%) patients underwent an infectious evaluation. Patients had a median of 2 (IQR: 2 to 3) etiologies contributing to their leukemoid reaction. At the time of leukemoid reaction, 11 (73%) patients were receiving treatment for a known infection, 6 (40%) were found to have a new thrombus, and 4 (27%) were receiving glucocorticoids. Only 1 (7%) patient was found to have a new infection, an Acinetobacter baumannii bacteremia. Leukemoid reactions occur infrequently in patients receiving ECMO and are generally multifactorial. In this cohort, leukemoid reactions rarely occurred in the setting of a new infection and suggest low utility to starting or broadening antimicrobials for these patients. Future studies identifying useful infectious markers are needed for patients receiving ECMO.

The future of immunotherapy for diffuse large B-cell lymphoma.

With the introduction of anti-CD19 chimeric antigen receptor (CAR) T-cell (CAR T) therapies, bispecific CD3/CD20 antibodies and anti-CD19 antibodies, immunotherapy continues to transform the treatment of diffuse large B-cell lymphoma (DLBCL). A number of novel immunotherapeutic strategies are under investigation to build upon current clinical benefit and offer further options to those patients who cannot tolerate conventional intensive therapies due to their age and/or state of health. Alongside immunotherapies that leverage the adaptive immune response, natural killer (NK) cell and myeloid cell-engaging therapies can utilize the innate immune system. Monoclonal antibodies engineered for greater recognition by the patient's immune system can enhance antitumor cytotoxic mechanisms mediated by NK cells and macrophages. In addition, CAR technology is extending into NK cells and macrophages and investigational immune checkpoint inhibitors targeting macrophage/myeloid cell checkpoints via the CD47/SIRPα axis are in development. Regimens that engage both innate and adaptive immune responses may help to overcome resistance to current immunotherapies. Furthermore, combinations of immunotherapy and oncogenic pathway inhibitors to reprogram the immunosuppressive tumor microenvironment of DLBCL may also potentiate antitumor responses. As immunotherapy treatment options continue to expand, both in the first-line setting and further lines of therapy, understanding how to harness these immunotherapies and the potential for combination approaches will be important for the development of future DLBCL treatment approaches.

Increased neutrophil counts are associated with poor overall survival in patients with colorectal cancer: a five-year retrospective analysis.

Colorectal cancer (CRC) continues to be a major health concern in today's world. Despite conflictive findings, evidence supports systemic inflammation's impact on CRC patients' survival rates. Therefore, this study aims to assess the prognostic role of the innate immune system in patients with CRC. A total of 449 patients were included, with a 5-year follow-up period, and absolute neutrophil counts and their related ratios were measured. The non-survival group had increased levels of white blood cells, neutrophils (both p<0.001), and monocytes (p=0.038), compared to the survival group, along with other neutrophil-related ratios. We observed increased mortality risk in patients in the highest tertile of white blood cells [HR=1.85 (1.09-3.13), p<0.05], neutrophils [HR=1.78 (95% CI: 1.07-2.96), p<0.05], and monocytes [HR=2.11 (95% CI: 1.22-3.63)], compared to the lowest tertile, after adjusting for all clinicopathological variables. Random forest analysis identified neutrophils as the most crucial variable in predicting survival rates, having an AUC of 0.712, considering all clinicopathological variables. A positive relationship between neutrophil counts and metastasis was observed when neutrophil counts are considered continuous (β=0.92 (0.41), p<0.05) and tumor size (width) when neutrophils were considered as logistic variable (T1 vs T3) [OR=1.42, (95% CI: 1.05-1.98), p<0.05]. This study offers comprehensive insights into the immune factors that impact the prognosis of CRC, emphasizing the need for personalized prognostic tools.

Anti-Tumor Immunity to Patient-Derived Breast Cancer Cells by Vaccination with Interferon-Alpha-Conditioned Dendritic Cells (IFN-DC).

Breast cancer represents one of the leading causes of death among women. Surgery can be effective, but once breast cancer has metastasized, it becomes extremely difficult to treat. Conventional therapies are associated with substantial toxicity and poor efficacy due to tumor heterogeneity, treatment resistance and disease relapse. Moreover, immune checkpoint blockade appears to offer limited benefit in breast cancer. The poor tumor immunogenicity and the immunosuppressive tumor microenvironment result in scarce T-cell infiltration, leading to a low response rate. Thus, there is considerable interest in the development of improved active immunotherapies capable of sensitizing a patient's immune system against tumor cells. We evaluated the in vitro anti-tumor activity of a personalized vaccine based on dendritic cells generated in the presence of interferon (IFN)-α and granulocyte-macrophage colony-stimulating factor (IFN-DC) and loaded with an oxidized lysate from autologous tumor cells expanded as 3D organoid culture maintaining faithful tumor antigenic profiles. Our findings demonstrate that stimulation of breast cancer patients' lymphocytes with autologous IFN-DC led to efficient Th1-biased response and the generation in vitro of potent cytotoxic activity toward the patients' own tumor cells. This approach can be potentially applied in association with checkpoint blockade and chemotherapy in the design of new combinatorial therapies for breast cancer.

Cell Immunotherapy: Principles, Progress, and Challenges

Cellular immunotherapy refers to a therapeutic strategy that harnesses the patient's immune system for the purpose of recognizing and eliminating malignant cells. This article provides an overview of the fundamental principles, primary classifications, advancements in clinical implementation, obstacles encountered in practice, as well as potential directions for future development in cellular immunotherapy. Through in-depth analysis, our goal is to delve deeper into the comprehensive knowledge of cellular immunotherapy and look forward to its potential applications in the field of cancer therapy in the future, with a view to opening up new therapeutic avenues.

Diagnostic tests for primary immunodeficiency disorders: Classic and genetic testing.

Primary immunodeficiency diseases encompass a variety of genetic conditions characterized by a compromised immune system and typically results in increased susceptibility to infection. In fact, they also manifest as autoimmunity, autoinflammation, atopic diseases, and malignancy. Currently, the number of recognized monogenic primary immunodeficiency disorders is set at ∼500 different entities, owing to the exponential use of unbiased genetic testing for disease discovery. In addition, the prevalence of secondary immunodeficiency has also been on the rise due to the increased use of immunosuppressive drugs to treat diseases based on immune dysregulation, an increase in the number of individuals undergoing hematopoietic stem cell transplantation, and other chronic medical conditions, including autoimmunity. Although the clinical symptoms of immunodeficiency disorders are broad, an early diagnosis and tailored management strategies are essential to mitigate the risk of infections and prevent disease-associated morbidity. Generally, the medical history and physical examination can provide useful information that can help delineate the possibility of immune defects. In turn, this makes it feasible to select focused laboratory tests that identify immunodeficiency disorders based on the specific immune cells and their functions or products that are affected. Laboratory evaluation involves quantitative and functional classic testing (e.g., leukocyte counts, serum immunoglobulin levels, specific antibody titers in response to vaccines, and enumeration of lymphocyte subsets) as well as genetic testing (e.g., individual gene evaluation via Sanger sequencing or unbiased evaluation based on next-generation sequencing). However, in many cases, a diagnosis also requires additional advanced research techniques to validate genetic or other findings. This article updates clinicians about available laboratory tests for evaluating the immune system in patients with primary immunodeficiency disorders. It also provides a comprehensive list of testing options, organized based on different components of host defense.

Analysis of Factors Affecting the Incidence of Hais (Healthcare Associated Infections) in the Inpatient of Dr. Iskak Hospital Tulungagung

One of the efforts to prevent and stop the incidence of infection in health care facilities is to break or eliminate the chain of transmission of infection consisting of 6 components (infectious agent, reservoir, portal of exit, transmission method, portal of entry, suscptible host). Prevention can also be done by observing the risk factors and characteristics of the patient. The purpose of the study was to analyze factors that affect the incidence of HAIs (healthcare associated infections) in the inpatient of RSUD dr Iskak Tulungagung. The research design is in the form of quantitative research with case control analytical observational research methods with a retrospective approach. The research samples were some employees at RSUD dr. Iskak Tulunggung Regency as many as 83 case groups and 83 control groups with sampling techniques using the simple random sampling method. The results showed that the factors that influence the incidence of HAIs at RSUD dr. Iskak Tulungagung is an invasive action, a type of microorganism germ and the length of the day of treatment. While the most dominant factor affects the incidence of HAIs at RSUD dr. Iskak is the length of days of treatment with an OR of 5.256, meaning that the factor of length of days of care is 5 times more influential on the increase in the incidence of HAIs at RSUD dr. Iskak Tulungagung. Providing appropriate prophylactic antibiotics, balanced nutrition and vaccination to patients are steps that must be taken to help the patient's immune system remain in a state of being able to fight infection.

Combination certainty factor method and fuzzy expert system module to determine the dose of leukemia drugs

Leukemia is a type of blood cancer. Treatment for leukemia patients can last for years because the dose of medication given is adjusted to the patient's immune system. The aim of this research is the use of information technology through a combination of certainty factors and the development of a fuzzy expert system (FES) module to determine the therapeutic schedule for administering leukemia drugs. The urgency of this research is to help medical personnel in measuring the dose of leukemia medication to be given to patients so as to increase the cure rate for leukemia patients. The method used is certainty factor and fuzzy logic. The combination of the certainty factor method and the FES module which is carried out using input variables in the form of the severity of the leukemia suffered by the patient is to produce an appropriate therapeutic schedule for administering leukemia drugs. The result of this research is a combination of the factor certainty method and the FES module which has been tested and the accuracy level is 95.17%, the same as recommendations from experts.

Total pain, opioids, and immune checkpoint inhibitors in the survival of patients with cancer

Experimental and observational studies have shown that opioid analgesics may increase tumor growth, potentially reduce immunotherapy efficacy, and shorten survival. As a result of the lack of clinical data, the current rationale for continuing opioid analgesic treatment is based on animal models, which suggests that physical pain itself may potentially influence cancer growth and exert immunosuppressive effects. Total pain encompasses the various factors that patients may experience during their cancer journey: physical symptoms, social isolation/loneliness, psychological, spiritual/existential, and financial distress. These need to be screened and discussed with patients to help them cope with the treatment and disease. As each issue may affect survival, it is essential to identify them to understand how they might affect the patient's immune system, influence immunotherapy outcomes, and ultimately, survival. The question arises whether a single factor, such as the combination of opioids and immune checkpoint inhibitors, negatively affects treatment outcomes. While there is a risk of fostering opioid phobia, the complex interplay between total pain, quality of life, and the immune system must be considered. Thus, in studies that appropriately investigate the interactions between opioid analgesics and the immune system, it is essential to consider all the distress factors that patients may experience at each stage of their illness.

Single-cell RNA Sequencing Analysis Reveals Cancer-associated Fibroblast Signature for Prediction of Clinical Outcomes and Immunotherapy in Gastric Cancer.

Gastric cancer (GC) is a significant worldwide health concern and is a leading cause of cancer-related mortality. Immunotherapy has arisen as a promising strategy to stimulate the patient's immune system in combating cancer cells. Nevertheless, the effectiveness of immunotherapy in individuals with gastric cancer (GC) is not yet optimal. Thus, it is crucial to discover biomarkers capable appof predicting the advantages of immunotherapy for tailored treatment. The tumor microenvironment (TME) and its constituents, including cancer-associated fibroblasts (CAFs), exert a substantial influence on immune responses and treatment outcomes. In this investigation, we utilized single-cell RNA sequencing to profile CAFs in GC and established a scoring method, referred to as the CAF score (CAFS), for the prediction of patient prognosis and response to immunotherapy. Through our analysis, we successfully identified distinct subgroups within CAFs based on CAF score (CAFS), namely CAFS-high and CAFS-low subgroups. Notably, we noted that individuals within the CAFS-high subgroup experienced a lessF favorable prognosis and displayed diminished responsiveness to immunotherapy in contrast to the CAFS low subgroup. Furthermore, we analyzed the mutation and immune characteristics of these subgroups, identifying differentially mutated genes and immune cell compositions. We established that CAFS could forecast treatment advantages in patients with gastric cancer, both for chemotherapy and immunotherapy. Its efficacy was additionally confirmed in contrast to other biomarkers, including Tumor Immune Dysfunction and Exclusion (TIDE) and Immunophenotypic Score (IPS). These findings emphasize the clinical relevance and potential utility of CAFS in guiding personalized treatment strategies for gastric cancer.

A Comparative Study of the Efficacy of Intralesional Measles Mumps Rubella (MMR) Vaccine and Auto Implantation for the Treatment of Periungual and Palmoplantar Warts: A Randomized Controlled Trial.

Warts are benign epidermal proliferations, caused by infection of keratinocytes with human papillomavirus (HPV). Auto implantation and intralesional mumps, measles, and rubella (MMR) vaccine are novel methods of immunotherapy for treating periungual and palmoplantar warts. They act by stimulating the patient's immune system; this clears not only the local warts but also distant warts with lesser side effects. We conducted this study to compare the efficacy and safety of both methods in treating periungual and palmoplantar warts. A total of 160 patients were randomly allocated into two groups of 80 patients. Group A was treated with 0.3 mL of intralesional MMR vaccine at an interval of 3 weeks or for a maximum of three sittings, and Group B was treated with auto implantation. At the end of therapy, the result was better in group A (MMR vaccine) as 86% of cases yielded an excellent response as compared to 71% in group B (auto implantation). The recurrence rate was 5% in group A and 4% in group B. There were no serious side effects in both groups with pain during injection (70%) in group A and swelling at the recipient site (8%) in group B being the most common side effect. Both MMR and auto implantation had significant response rates. But MMR was faster and better.