Decrease In White Blood Cells Research Articles

Mentha piperita and Thymus vulgaris ameliorate hematological changes induced by chronic consumption of oxidized palm oil in rats

Objective: The aim of this study was to investigate the effect of Mentha piperita L and/or Thymus vulgaris in ameliorating the hematological changes induced by chronic consumption of oxidized palm oil (OPO) in rats. Methodology: Fifty rats were divided into five groups as follows: rats received a basal diet (control), rats received a basal diet sustained with OPO, rats fed OPO and received Mentha piperita extract, rats fed OPO and received Thymus vulgaris extract, and finally rats fed OPO and received both extracts. After 6 weeks, blood samples were withdrawn and a complete blood count test was done. Results: Rats fed a diet containing OPO showed a significant decrease in red blood cells (RBCs), hematocrit (Hct), mean corpuscular volume (MCV), hemoglobin (Hb), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), lymphocytes (LYM), and platelets (PLTs) accompanied by a significant increase in white blood cells (WBCs), red cell distribution width (RDW), and mean platelet volume (MPV) compared to rats fed a normal diet. In contrast, rats fed on diet containing OPO and the aqueous extract of either Mentha piperita or Thymus vulgaris showed a significant increase in RBCs, Hct, MCV, Hb, MCH, MCHC, LYM, and PLTs accompanied by a significant decrease in RDW, WBCs, and MPV relative to rats fed on diet containing OPO only. Treatment with a combination of both plants showed better improvements. Conclusion: Both Mentha piperita and Thymus vulgaris ameliorate the hematological changes induced by OPO.

Evaluation of the Therapeutic Impact of Probiotic-Enriched Orange and Pomegranate Juices on Some Health Parameters in Diarrhea-Induced Laboratory Rats

This research endeavor was undertaken to craft a functional beverage by blending orange and pomegranate juices, enriched with the inclusion of therapeutic probiotic strains, specifically Lactobacillus acidophilus, Lactobacillus plantarum, and Lactobacillus rhamanous. A comprehensive assessment was conducted to investigate the physicochemical, microbial, and sensory characteristics of the resulting beverage. Furthermore, we explored the potential health benefits of this fortified beverage within a rat model afflicted with E. coli infection, focusing on its influence on blood parameters and lipid profiles in male rats. The research findings revealed the presence of four distinct bacterial strains, namely Staphylococcus hominis, Staphylococcus aureus, E. coli, and Enterococcus gallinarum, in natural juices obtained from local markets in Tikrit. Regarding the physicochemical properties and bacterial counts in the manufactured juices, the results indicated a decline in pH levels and total sugar content over time, coupled with an increase in total acidity during refrigerated storage of functional juices. Additionally, the enumeration and viability of fortifying bacteria surpassed the prescribed probiotic threshold in the tested juice varieties. Sensory evaluation outcomes demonstrated the overall acceptability of the manufactured juices. The research findings demonstrated that E. coli-induced diarrhea led to a significant elevation (P<0.05) in key blood parameters, including white blood cell and platelet counts (12.63 and 747 mm^3/liter), along with a notable reduction in red blood cell counts and hemoglobin concentration (6.0 and 13.1 mm^3/liter, respectively). However, oral administration of functional juices resulted in a decrease in white blood cell and platelet counts and an increase in red blood cell counts and hemoglobin concentration across all measured parameters. Regarding lipid profiles, the diarrheal group exhibited elevated levels of detrimental lipid markers, including cholesterol, triglycerides, and low-density lipids (73.59, 71.61, and 14.8, respectively), accompanied by reduced high-density lipoproteins concentration (31.5). Conversely, treatment with oral doses of functional juices led to a reduction in these adverse lipid indicators for all treatment groups.

The Association between Serum Level of Vitamin D and Inflammatory Biomarkers in Hospitalized Adult Patients: A Cross-Sectional Study Based on Real-World Data.

The association between vitamin D status and inflammation remains unclear in hospitalized patients. We performed the current study based on real-world data from two teaching hospitals. Serum level of vitamin D (assessed by 25-hydroxyvitamin D) was evaluated within 2 days after admission. All the patients were further classified into three groups: deficiency (<12 ng/mL), insufficiency (12-20 ng/mL), and adequate (≥20 ng/mL). White blood cell (WBC) count, serum level of C-reactive protein (CRP), and procalcitonin were also measured and used to evaluate inflammation. Other potential covariates were abstracted from medical records. Charlson comorbidity index (CCI) was calculated to assess the severity of disease. A total number of 35,528 hospitalized adult patients (21,171 men and 14,357 women) were included. The average age and BMI were 57.5 ± 16.2 years and 23.4 ± 3.7 kg/m2, respectively, while medium vitamin D level was 16.1 ng/mL (interquartile range: 11.4 ng/mL, 21.6 ng/mL) and median CCI was one point (interquartile range: 0 point, two points). The prevalence of deficiency and insufficiency was 28.0% and 40.5%. Multivariate linear regression model showed that serum level of vitamin D was significantly associated with WBC and CRP but not associated with procalcitonin. Each standard deviation (≈7.4 ng/mL) increase in vitamin D was associated with a decrease in WBC by 0.13 × 109/mL (95% CI: 0.2 × 109/mL, 0.06 × 109/mL) and 0.62 mg/L (95% CI: 0.88 mg/L, 0.37 mg/L) for CRP. Subgroup analysis and sensitivity analysis (excluding those whose eGFR <60 ml/min/1.73 m2, those whose daily calorie intake <1,000 kcal, and those who were recruited from Xin Hua hospital) generated similar results. The deficiency and insufficiency of vitamin D in the hospitalized adult patients was very common. However, the results should be interpreted with caution for limited representation of the whole inpatients. Low level of vitamin D was associated with inflammatory biomarkers, which provide the evidences to early intervention for lower the risk of infection.

Prophylactic effects of Combretum molle boughs on changes in the hematological, biochemical, and histological parameters in dexamethasone-induced insulin-resistant rats

BackgroundCombretum molle (Combretaceae) is a plant used in Cameroon traditional medicine to treat diabetes mellitus. To our knowledge, no studies have been performed on the preventive effects of C. molle on change in hematological, biochemical, and histological parameters of insulin-resistant rats. The aim of the study was to evaluate the preventive effect of C. molle on changes in the hematological biochemical, and histological parameters of insulin-resistant rats. MethodsInsulin resistance was induced for 10 days by subcutaneous injection of dexamethasone (1 mg/kg), one hour after oral pretreatment of animals with distilled water, metformin (40 mg/kg), and C. molle extract (250 and 500 mg/kg). Hematological profile (red blood cells, white blood cells, platelets and their indices), biomarkers of renal and hepatic function, hepatic glycogen level, activity of hepatic enzymes of carbohydrate metabolism, and histological sections of kidney, liver and pancreas were assessed. ResultsC. molle extract (250 and 500 mg/kg) caused a significant decrease (p < 0.05 to p < 0.001) in white blood cells, platelets count, and the activities of fructose 6-diphosphatase, glucose-6-phosphate dehydrogenase, and transaminases. It also caused significant increase (p < 0.05 to p < 0.001) in red blood cells, hemoglobin, albumin, glycogen, urea, uric acid, and creatinine values, and fructose-1,6-diphospatase and glucokinase activity. Histological examination revealed regeneration of beta-cells of the pancreatic islets and preventive renal and hepatic tissues against damages caused by impact of dexamethasone. ConclusionC. molle extract protected insulin-resistant patients from hematological, biochemical, and histopathological changes, there by validating the merits of the use of this plant in traditional medicine to treat diabetes mellitus and its complications.

Safety and efficacy of non-reduced use of caspofungin in patients with Child-Pugh B or C cirrhosis: a real-world study.

The need for dose adjustment of caspofungin in patients with hepatic impairment is controversial, especially for those with Child-Pugh B or C cirrhosis. The purpose of this study was to investigate the safety and efficacy of standard-dose caspofungin administration in Child-Pugh B and C cirrhotic patients in a real-world clinical setting. The electronic medical records of 258 cirrhotic patients, including 67 Child-Pugh B patients and 191 Child-Pugh C patients, who were treated with standard-dose of caspofungin at the Second Affiliated Hospital of Chongqing Medical University, China, from March 2018 to June 2023 were reviewed retrospectively. The white blood cells (WBC), hepatic, renal and coagulation function results before administration and post administration on days 7, 14 and 21 were collected, and the efficacy was assessed in all patients at the end of caspofungin therapy. Favorable responses were achieved in 137 (53.1%) patients while 34 (13.2%) patients died. We observed that some patients experienced an increase of prothrombin time (PT) or international normalized ratio (INR), or a decrease of WBC, but no exacerbation of hepatic or renal dysfunction were identified and no patient required dose interruption or adjustment because of an adverse drug reaction during treatment with caspofungin. Standard-dose of caspofungin can be safely and effectively used in patients with Child-Pugh B or C cirrhosis, and we appealed to re-assess the most suitable dosing regimen in this population to avoid a potential subtherapeutic exposure.

Efficacy and safety of fruquintinib with nab-paclitaxel in advanced G/GEJ cancer after exposure to immune checkpoint inhibitors: A single-center prospective clinical trial.

327 Background: Immune checkpoint inhibitors (ICIs) expanded choices of early-line therapies in advanced gastric (G)/gastro-esophageal junction (GEJ) cancer. In addition, it’s observed that early-line ICI therapy, compared to chemotherapy, could enhance the efficacy of VEGFR inhibitors with chemotherapy in late lines. This single-center prospective clinical trial was aimed to explore the efficacy and safety of fruquintinib with nab-paclitaxel as second-line in patients (pts) with G/GEJ cancer exposed to ICIs in early lines. Methods: This is a single-center, prospective, open-label clinical trial. Pts with advanced G/GEJ cancer who had been exposed to ICIs before the second line were eligible. 42 pts would receive 100g/m2 nab-paclitaxel on day 1 and day 8 every 3 weeks, and 4mg fruquintinib from day 1 to day 14 every 3 weeks. Progression-free survival (PFS) was set as the primary endpoint. The Kaplan–Meier method would be used to evaluate time-to-event outcomes. Results: Up to Aug 10, 2023, 25 pts had been enrolled, 23 of whom were evaluable. 14 (60.9%) pts in evaluable set were male. All these pts was with stage Ⅳ of TNM staging. The median age was 58 (range: 33-74), and 6 (26.1%) pts were elder than 65 yr. 12 (63.2%) pts were with PD-L1 CPS greater than 1, 9 (47.4%) pts greater than 5, and 4 (17.4%) pts greater than 10. PD-L1 CPS of 4 pts was unknown. The pts had received a median of 5 (range: 1-20) cycles in early-line ICI therapy. 17 (73.9%) pts suffered metastasis in retroperitoneal lymph node and 7 (30.4%) pts in liver. With a median follow up time of 5.6 (range: 2.1-16.6) mo, the PFS achieved 4.8 (95% CI: 4.6-NA) mo. Despite the immatureness of overall survival (OS), the 1-year OS rate was 56.25% (95% CI: 17.27%-95.23%). The ORR was 47.8% (n=11), and DCR was 100% (n=23). As to safety, the most common (≥20%) AEs of all grades were white blood cell decrease, peripheral sensory neuropathy, and neutrophil count decrease, while that of grade≥3 was white blood cell decrease. Conclusions: Fruquintinib with nab-paclitaxel as second-line therapy demonstrated good efficacy and safety in advanced G/GEJ cancer after exposure to ICIs. ICIs might increase benefit from this therapy, which warrants further investigations in a large cohort. Clinical trial information: ChiCTR2200059976 .

Evaluation of the Immunosafety of Cucurbit[n]uril In Vivo.

Cucurbiturils are a family of macrocyclic oligomers capable of forming host-guest complexes with various molecules. Due to noncovalent binding to drug molecules and low toxicity, cucurbiturils has been extensively investigated as potential carriers for drug delivery. However, the immune system's interactions with different drug carriers, including cucurbiturils, are still under investigation. In this study, we focused on cucurbiturils' immunosafety and immunomodulation properties in vivo. We measured blood counts and lymphocyte subpopulations in blood, spleen, and bone marrow, and assessed the in vivo toxicity to spleen and bone marrow cells after intraperitoneal administration to BALB/c mice. When assessing the effect of cucurbit[6]uril on blood parameters after three intraperitoneal injections within a week in laboratory animals, a decrease in white blood cells was found in mice after injections of cucurbit[6]util, but the observed decrease in the number of white blood cells was within the normal range. At the same time, cucurbit[7]uril and cucurbit[8]uril did not affect the leukocyte counts of mice after three injections. Changes in the number of platelets, erythrocytes, and monocytes, as well as in several other indicators, such as hematocrit or erythrocyte volumetric dispersion, were not detected. We show that cucurbiturils do not have immunotoxicity in vivo, with the exception of a cytotoxic effect on spleen cells after сucurbit[7]uril administration at a high dosage. We also evaluated the effect of cucurbiturils on cellular and humoral immune responses. We founded that cucurbiturils in high concentrations affect the immune system in vivo, and the action of various cucurbiturils differs in different homologues, which is apparently associated with different interactions in the internal environment of the body.

Disseminated Talaromyces marneffei infection associated with haemophagocytic syndrome in an HIV-negative patient in northern China: a case report

BackgroundTalaromyces marneffei is endemic to eastern India, Southeast Asia, and Guangdong and Guangxi provinces in China. It is common in immunocompromised individuals, especially in HIV-infected patients.Case presentationA 66-year-old male who had a history of hypertension and resided in Shandong Province (Northern China) was admitted for recurrent fever for one month. The patient had recurrent fever, multiple lymphadenopathies, hepatosplenomegaly, a back rash, and a progressive decrease in white blood cells and platelets. Talaromyces marneffei was isolated from peripheral blood and bone marrow after admission, and suspected fungal cells were found via lymph node pathology. The patient’s infection secondary to haemophagocytic syndrome continued to worsen despite antifungal, anti-inflammatory, and symptomatic treatment, leading to death due to multiple-organ failure.ConclusionAlthough rare, infection due to Talaromyces marneffei in HIV-negative patients has been increasing in recent years, and we should be vigilant about “new” infections in nonendemic areas.

Immunological studies on the effects of toltrazuril and neem extract in broiler chickens suffering from coccidiosis.

The prevalence of avian coccidiosis in the poultry industry has grown, resulting in substantial financial losses from high mortality, stunted growth, reduced productivity, and expensive medical expenses. The purpose of the current study was to assess the immunological effects of neem leaf extract and toltrazuril on broilers that had contracted coccidiosis. In this investigation, 100 one-day-old Cobb broiler chicks without sexes were employed. The chicks were divided into five equal groups, with 20 birds in each. On the 14th day of life, the birds in groups 2, 3, 4, and 5 received an oral inoculation with 1 × 105 sporulated oocysts of Eimeria tenella (E. tenella) (field isolate). The first group (Gp), which consists of 20 healthy broilers, served as a negative control. Gp (2) contains experimentally infected broilers and nontreated (served as a positive control). Gp (3) contains experimentally infected broilers treated with toltrazuril (1 ml/l drinking water) for two consecutive days. Gp (4) contains experimentally infected broilers treated with neem leaf extract 4% (50 ml/l drinking water) for 5 successive days, and Gp (5) contains experimentally infected broilers treated with toltrazuril (1 ml/l drinking water) and a half dose of neem leaves extract 4% (25 ml/l drinking water) for 5 successive days. For the purpose of estimating body weight growth and feed conversion ratio, each broiler was weighed separately at the start of the trial and again on the 1st and 10th day after treatment. In addition to obtaining intestinal samples for immunohistochemistry, blood samples were also obtained for immunological examination. As compared to the negative control group, the experimentally infested broilers with E. tenella showed significant decreases in serum nitric oxide, lysosome, phagocytic percent, and phagocytic index, along with significant increases in white blood cells (WBCs), lymphocyte, heterophilis, eosinophilis, basophilis, monocyte, serum total protein, γ globulin, fibrinogen, and haptoglobin. When compared to the control positive group, experimentally infested broilers treated with either neem or toltrazuril alone or in combination demonstrated significant increases in serum total protein, nitric oxide, lysozyme, phagocytic percent, and phagocytic index, but significant decreases in WBCs, lymphocytes, heterophile, eosinophile, basophile, and monocyte. The intestinal peroxidase stain of broilers infected with E. tenella exhibited a significant positive expression for CD4, but the infected broilers treated with toltrazuril and half a dosage of neem displayed a negative expression for CD4, identical to the negative control. The broiler chickens infested with E. tenella may have a variety of negative impacts on their immune systems and immunohistopathological findings. Nonetheless, toltrazuril and neem extract, either separately or in combination, function as anticoccidial medications that may enhance the broiler chicks' immune state.

Update Results of a Phase II Trial of Venetoclax in Combination with Azacitidine and Chidamide in Relapsed/Refractory Acute Myeloid Leukemia

Background: Therapies for relapsed or refractory (R/R) AML remain limited, with low response rates and short duration of response, especially in patients ineligible for intensive cytotoxic chemotherapy. Combinations of venetoclax (VEN), chidamide (CHI) plus azacytidine (AZA) have shown to be synergistic with low intensity and intensive chemotherapy in preclinical data and in relapsed or refractory (R/R) setting (Phase II, 2022 ASH). Here we present updated results of this Phase II trial. Methods: Eligible patients were &amp;gt;18 yrs old with R/R AML, defined as lack of response rate after at least one cycle of induction or relapsed disease with any prior number of treatments. Patients received AZA 100mg on D1-7, VEN 200mg on D1-14, and CHI 30mg biweekly in 28-day cycles. The primary objective was evaluation of CR/CRi. Secondary objectives included event-free survival (EFS), overall survival (OS) and adverse events (AEs). Clinical responses were determined using the 2017 ELN criteria. Results: Between January 2022 and April 2023, 53 patients with R/R AML were enrolled in the study. The median age was 51 years (range 18-73). This regimen was salvage 1 in 79% (42) of patients, salvage 2 in 11% (6) and salvage 3 in 9% (5). 17%, 36%, and 47% of patients were classified as favorable, intermediate, and adverse ELN risk, respectively ( Table 1). 11% of patients had TP53 mutation, 22% had DNMT3A mutation, 21% had FLT3-ITD mutation, 9% had ASXL1 mutation, 19% had NPM1 mutation, 9% had IDH1 mutation, 11% had IDH2 mutation ( Fig. A). Among the 53 patients, the ORR of these patients was 68% with CRc rate of 53% after one cycle, and 81% with CRc rate of 72% after two cycles ( Fig. B). By ELN risk, ORR and CRc rates were 70% and 50% for favorable risk, 40% and 40% for intermediate risk, and 43% and 30% for adverse risk. Pretreatment IDH1 and IDH2 mutations were associated with higher CRc rates (75% and 50%, respectively). The CRc rate in patients with TP53 mutations was 67%, with response noted among patients with concurrent IDH1/ IDH2 mutations. With a median follow-up of 6.7 months, the median EFS and OS were 6 (95%CI 3.3-8.6) months and not reached (NR), respectively. Among patients with CRc, the 6-month EFS and OS were 64% and 88%, respectively, among those receiving this regimen as first salvage had encouraging outcomes (median EFS, NR) ( Fig. C-D). Of the 8 patients that proceeding with allogeneic hematopoietic stem cell transplant (allo-HSCT), the median EFS and OS were not reached after transplant ( Fig. E-F) No non-hematologic AEs of grade ≥3 were observed. The most common grade 1-2 non-hematologic AEs included nausea (28%), fatigue (28%), hypokalemia (17%), hypoproteinemia (17%), elevated transaminase levels (33%) and hyperbilirubinemia (11%). The occurrence rates of grade 3/4 hematologic adverse events (AEs) were as follows: white blood cell decrease (87%), median time to white blood cell recovery 23 (range 4-29) days; neutropenia (96%), neutropenia with fever (17%), median time to neutrophil recovery 25 (range 10-29) days; platelet decrease (68%), median time to platelet recovery 28.5 (range 7-44) days; anemia (64%), median time to hemoglobin recovery 29 (range 13-56) days. 30-day and 60-day mortality were 0% and 5.7%, respectively. 3 deaths occurred within 60 days in patients with persistent leukemia. Conclusions: Thecombination of VEN and CHI plus AZA (VCA) demonstrated manageable safety and encouraging efficacy in patients with R/R AML. IDH1/ IDH2 mutations were associated with the sensitivity of VCA, even in some patients with concurrent TP53 mutations.

Neutrophil Gelatinase-Associated Lipocalin in Peritoneal Dialysis-Related Peritonitis: Correlation with White Blood Cells over Time and a Possible Role as the Outcome Predictor

Introduction: The present study aimed to monitor peritoneal neutrophil gelatinase-associated lipocalin (pNGAL) during peritonitis episodes and to enhance its diagnostic value by evaluating pNGAL at scheduled times in parallel with white blood cell (WBC) count. In addition, we investigated possible correlations between pNGAL and the etiology of peritonitis, evaluating it as a possible marker of the clinical outcome. Methods: Twenty-two patients with peritoneal dialysis (PD)-related peritonitis were enrolled. Peritonitis was divided into Gram-positive, Gram-negative, polymicrobial, and sterile. WBC count and neutrophil gelatinase-associated lipocalin (NGAL) in PD effluent were measured at different times (days 0, 1, 5, 10, 15, and/or 20 and 10 days after antibiotic therapy discontinuation). NGAL was measured by standard quantitative laboratory-based immunoassay and by colorimetric NGAL dipstick (NGALds) (dipstick test). Results: We found strong correlations between peritoneal WBC, laboratory-based NGAL, and NGALds values, both overall and separated at each time point. On day 1, we observed no significant difference in WBC, both NGALds (p = 0.3, 0.9, and 0.2) between Gram-positive, Gram-negative, polymicrobial, and sterile peritonitis. No significant difference has been found between de novo versus relapsing peritonitis for all markers (p > 0.05). We observed a parallel decrease of WBC and both NGAL in patients with favorable outcomes. WBC count and both pNGAL resulted higher in patients with negative outcomes (defined as relapsing peritonitis, peritonitis-associated catheter removal, peritonitis-associated hemodialysis transfer, peritonitis-associated death) at day 10 (p = 0.04, p = 0.03, and p = 0.05, respectively) and day 15 (p = 0.01, p = 0.04, and tendency for p = 0.005). There was a tendency toward higher levels of WBC and NGAL in patients with a negative outcome at day 5. No significant difference in all parameters was proven at day 1 (p = 0.3, p = 0.9, p = 0.2) between groups. Conclusion: This study confirms pNGAL as a valid and reliable biomarker for the diagnosis of PD-peritonitis and its monitoring. Its trend is parallel to WBC count during peritonitis episodes, in particular, patients with unfavorable outcomes.

RADT-27. BONE MARROW SUPPRESSION AFTER REIRRADIATION THERAPY WITH PROTON VERSUS PHOTON THERAPY FOR RECURRENT GLIOMA

Abstract INTRODUCTION High grade radiation-induced lymphopenia has been implicated to worse prognostic outcomes and overall survival in numerous malignancies. Understanding factors which influence lymphopenia can help optimize radiation delivery and overall patient care. Proton therapy (PRT), due to its distinct dose fall-off, spares tissues and organ-contained blood pools from excess radiation compared to conventional photon radiation (XRT) and may thereby reduce hematologic toxicity. METHODS Patients with confirmed glioma diagnosis who underwent reirradiation with either PRT or XRT were retrospectively analyzed. Complete blood counts (CBCs) within one month of reirradiation start, and CBCs within one month of reirradiation completion were reviewed. Values of interest included total white blood cell (WBC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC). Dosimetric data was collected to assess whole brain mean dose (WBMD), and volume of brain tissue receiving 5-50 Gy (V5-V50). RESULTS 16 patients receiving either PRT (n = 8) or XRT (n = 8) were included. Treatment doses ranged from 35-59.4 Gy. Across all patients there was a decrease in WBC, ANC, and ALC after reirradiation in both PRT and XRT (p &amp;lt; 0.05). Compared to reirradiation with XRT, patients who underwent PRT had significantly lesser reductions in WBC (PRT: 8.60% decrease, XRT: 22.58% decrease; p &amp;lt; 0.05). PRT reirradiation also resulted in lesser ANC and ALC reductions, though did not reach statistical significance. On dosimetric comparison of XRT and PRT plans, PRT demonstrated significant reductions in V5, V10, V20, and V30 (p &amp;lt; 0.05). V5 through V40 and WBMD were significantly correlated with decreased WBC, ANC, and ALC (p &amp;lt; 0.01). CONCLUSION Preliminary results show PRT reirradiation leads to decreased WBMD and volumes of brain tissues receiving 5 to 30 Gy. Given that these parameters are associated with greater reductions in lymphocytic counts, PRT reirradiation may confer reduced hematologic toxicity in patients seeking adjuvant radiation therapy.

CTIM-22. PHASE I STUDY RESULTS OF THE ANTIBODY-CYTOKINE FUSION PROTEIN L19TNF IN COMBINATION WITH LOMUSTINE FOR PATIENTS WITH RECURRENT GLIOBLASTOMA REVEAL PROMISING SAFETY AND DURABLE TUMOR RESPONSES

Abstract Treatment options for recurrent glioblastoma are limited and there is a need for novel effective therapies. Recently, we showed synergistic preclinical anti-tumor activity of the immunocytokine L19TNF in combination with lomustine in orthotopic immunocompetent glioma mouse models. L19TNF is an antibody-cytokine fusion protein, comprising the pro-inflammatory cytokine tumor necrosis factor (TNF) fused to the antibody L19 that binds to a tumor-specific epitope of the extracellular matrix protein fibronectin. This allows a targeted delivery of therapeutically relevant doses of TNF to the tumor site through intravenous administration while sparing healthy tissues. Here, we present results of the completed phase I part of a phase I/II open label, multicenter, randomized study to investigate L19TNF in combination with lomustine for patients with recurrent glioblastoma (NCT04573192). Fifteen patients were enrolled from February 2021 – January 2023 and treated at three different dose levels of L19TNF in combination with lomustine. Overall, the treatment was well tolerated. The most common adverse events were asymptomatic increase of liver function tests and a decrease of white blood cells and platelets. Serial MRI assessments revealed near-complete responses in 3 patients (20%) and stable disease in 8 (53%) patients. The median progression-free survival was 4.2 months, progression-free survival rate at 6 months was 46% (7/15 patients), and median overall survival has not been reached after a median follow-up of 11 months. Serial blood assessments demonstrated a treatment-associated increase in C-reactive protein, a peripheral marker for inflammation, which correlated with progression-free survival. A patient, who showed a near-complete response that lasted 12 months relapsed at a different location. Subsequent re-challenge with L19TNF and lomustine again led to a partial response. These encouraging results justify further investigations within the phase II part of the clinical trial that is recruiting patients in four countries.

Efficacy of Khaya grandifoliola Stem Bark Ethanol Extract in the Treatment of Cerebral Malaria in Swiss albino Mice Using Plasmodium berghei NK65 Strain.

Cerebral malaria is one of the most severe and dangerous forms of malaria and is potentially fatal. This study was aimed at evaluating the anticerebral malaria efficacy of Khaya grandifoliola used by traditional healers. Fifty grams of Khaya grandifoliola stem bark was macerated in 1 L ethanol (95%) for 72 h. The filtrate was dried at 40°C until the obtention of a dry extract. The antimalarial test was evaluated using the Peter 4-day suppressive test and the Rane curative test. Mice were group into 6 groups of 6 mice each. For the antioxidant test, parameters such as malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), catalase (CAT), and nitric oxide (NO) were assessed. The livers of mice were crushed and centrifuged in order to be measured. Aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) using the Dutch Diagnostics Kit and blood were collected for haematological parameters. The ethanol extract showed a suppressive activity of 78.12%, 75.30%, and 68.69% at 500 mg/kg, 250 mg/kg, and 125 mg/kg, respectively. Similarly, the curative activity showed a statistically significant reduction in parasitemia (p < 0.05). Antioxidant parameter assays showed a low value of MDA and a high value of SOD, CAT, NO, and GSH in the negative control group. A statistically significant higher values of ASAT and ALAT were observed in the negative control compared to the other test groups (p < 0.05). Haematological parameters showed a statistically significant decrease in white blood cells, red blood cells, haemoglobin, and platelets in the negative control group (p < 0.05). The results of this study justify the traditional usage of Khaya grandifoliola in the treatment of cerebral malaria. However, in vivo toxicity assessment is still necessary to verify its safeness.

Phospholipid-supplemented diet impacts on growth, blood metrics, reproductive indices, and fatty acid profiles of Pangasianodon hypopthalmus

This study explores the effects of phospholipid inclusions in the diet of Pangasianodon hypopthalmus young adults on growth and physiological parameters. Commercial diet was subdivided into four groups and top coated using phospholipid (food grade Soy Lecithin) at 0%, 2%, 6%, and 10%, of feed dry weight resulting in an equivalent of 5%, 7.39%, 11.93% and 15.88% total crude lipid levels in the experimental diets. After 90 days of the feeding trials, the phospholipid inclusion at 6% (total crude lipid 11%) significantly improved blood parameters, while inclusion of phospholipid at 10% resulted in a decrease in white blood cells (WBCs) and its associated components, suggesting it may have been above the optimal level required by the fish. Reproductive hormones; 11-ketotestorone and 17β-estradiol that were observed showed an increase in direct proportion following the increase of phospholipid inclusion. Fatty acids composition of the muscle, liver, and gonads show a similar trend with the dominance of C16:0, C18:1n-9, and C18:3n-3 in the tissues. Also, the hierarchy of the fatty acids in the tissues were in the order of SFA > MUFA > PUFA. However, the composition of MUFA decreased with increase in the phospholipid inclusion These findings suggest that dietary phospholipid inclusion can enhance growth and physiological parameters of P. hypopthalmus.

Possible Effects of Vitamin D3 and Levofloxacin on Selected Hematology Parameter of Rats

Vitamin D is a fat-soluble vitamin with antioxidant and DNA protecting properties , Levofloxacin is a member of the fluoroquinolone drug class, Its broad-spectrum bactericidal effect affects both Gram-positive and Gram-negative bacteria.&#x0D; The goal of the study is to analyze the haematology analysis in rats received levofloxacin and show the preventive impact of vitamin D3 by analyzing the haematology parameters: packed cell volume (PCV), mean corpuscular hemoglobin concentration(MCHC),haemoglobin (HB), red blood cell (RBC), mean corpuscular volume (MCV),meancorpuscular haemoglobin(MCH), WBC ,differential WBC, and Platelets.&#x0D; The study included 42 rats divided into 6 groups each group 7 rats. group I negative control : healthy animals received normal saline 0.9%, group II: received levofloxacin LFX dose of 50mg/kg/day (IP) for fourteen days, group III : received LFX 100mg/kg/day (IP) for fourteen days, group IV : received vitamin D3 500 IU/day orally by oral gavage for twenty one days, group V received vitamin D3 500 IU/day orally for twenty one days and levofloxacin 50 mg/kg/day IP injected at day 8 for fourteen days, group VI received vitaminD3 500IU/day for twenty one days orally and levofloxacin 100 mg/kg/day IP injected at day 8 for fourteen days.&#x0D; Blood samples taken from rats treated with levofloxacin, showed a decrease in the values of RBC, HB, PCV, MCH, MCHC, as well as a decrease in total white blood cells, then returned approximately to normal levels in the groups IV ,group V and group VI .&#x0D; from the result of the study conclude that some haematological changes caused by levofloxacin ameliorated by vitamin D3 may be due to indirect effect of vitamin D3 on haematology parameters.&#x0D;

Effects of an Eight Week Very Low-Calorie Ketogenic Diet (VLCKD) on White Blood Cell and Platelet Counts in Relation to Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Subjects with Overweight and Obesity.

Obesity and metabolic dysfunction-associated steatotic liver disease (MASLD) are frequently associated conditions characterized by low-grade inflammation. Very low-calorie ketogenic diet (VLCKD) strategies are commonly used to simultaneously obtain weight loss and an improvement of liver steatosis. We evaluated the efficacy of 8 weeks' VLCKD in decreasing the white blood cell (WBC) and platelet (PLT) counts, as well as liver steatosis and fibrosis, diagnosed using transient elastography (FibroScan). Metabolic and anthropometric parameters commonly associated with MASLD were also evaluated. This study included 87 participants; 58 women and 29 men aged between 18 and 64 years with overweight (18%) or obesity (82%), but not taking any medication. Anthropometric measurements, bioimpedance analysis, and biochemical assays were performed before and after the dietary intervention. BMI (kg/m2) (p-value < 0.001), waist circumference (cm) (p-value < 0.001), and fat mass (kg) (p-value < 0.001) were significantly decreased following VLCKD. After VLCKD, the FibroScan parameter CAP (db/m), which measures the accumulation of fatty liver, significantly decreased (p-value < 0.001), as did liver stiffness (kPA), the FibroScan parameter quantifying liver fibrosis (p-value < 0.05). Seemingly, WBC (p-value < 0.001) and PLT (p-value < 0.001) counts were lowered by VLCKD in the whole group; however, the decrease in WBC and platelet counts were significant only in patients with steatosis (CAP ≥ 215 dB/m). Fasting blood glucose (p-value < 0.001), insulin (p-value < 0.001), HbA1c (p-value < 0.001), triglycerides (p-value < 0.001), total cholesterol (p-value < 0.001), LDL-cholesterol (p-value < 0.001), HDL-cholesterol (p-value < 0.001); γGT (p-value < 0.001) blood levels and insulin resistance (as measured by HOMAIR) (p-value < 0.001); and systolic (p-value < 0.001), and diastolic (p-value < 0.001) blood pressure levels, were all significantly lower after VLCKD. In contrast, blood levels of vitamin D were higher following the diet (p-value < 0.001). We conclude that treating subjects with overweight and obesity with VLCKD is followed by a simultaneous reduction in WBCs and platelets, the expression of low-grade inflammation, and of liver steatosis and fibrosis. Therefore, we can hypothesize that VLCKD decreases general and liver low-grade inflammation, thus improving liver health.

Black cardamom (Amomum subulatum) extract improves growth potential, antioxidant status, immune parameters and response to crowding stress in Catla catla.

Natural herbs are excellent alternatives to synthetic compounds to enhance the growth performance and health status of fish. This study was conducted to evaluate the efficacy of black cardamom (Amomum subulatum) extract (BCE) as an herbal supplement in improving the growth, antioxidant status, haematology, and serum biochemistry of Catla catla. The acclimatized fish (N = 900; average initial weight = 14.44 ± 0.33 g) were allocated into five groups (60 fish/group in triplicate) in hapas (4 × 2 × 2.5 ft) and provided with feed containing 0 (control), 0.5, 1, 2and 4 g/kg BCE for 90 days before being subjected to 8 days of crowding stress. After 90 days, significantly higher feed utilization and growth were observed in all BCE-fed treatments compared to the control; however, the maximum values of these parameters were noted in the 2 g/kg BCE-fed treatment. Moreover, the BCE-fed groups exhibited a significant increase in antioxidant indices (glutathione peroxidase, superoxide dismutaseand catalase), with a significant reduction in malondialdehyde levels, indicating a higher antioxidant capacity compared to the control. Significant improvements in haematological parameters, such as an increase in haematocrit, haemoglobinand red blood cells and a decrease in white blood cells, were observed in BCE-fed treatments compared to the control. Furthermore, BCE-fed groups showed a significant decrease in serum glucose, cortisoland triglycerides, while total protein, globulinand albumin levels were significantly higher compared with the control. During the feeding trial of 90 days, no mortality was observed; however, the lowest cumulative mortality was noted in the 2 g/kg BCE group after crowding stress of 8 days. In conclusion, the use of BCE in feed can enhance the growth performance, antioxidant status, haematology, and serum biochemistry of C. catla and improve the resistance against crowding stress. The optimum levels of BCE for C. catla were estimated based on weight gain % (1.78 g/kg; R2 = 0.97), feed conversion ratio (1.65 g/kg; R2 = 0.98), MDA content (1.66 g/kg; R2 = 0.93) and serum lysozyme activity (1.72 g/kg; R2 = 1) using broken-line regression analysis.

Clinical characteristics and risk factors for bronchoscopic airway mucus hypersecretion in childhood pneumonia infected by different pathogens

Objective: To investigate the risk factors for airway mucus hypersecretion in childhood pneumonia infected by different pathogens. Method: A retrospective cohort included 968 children who were hospitalized for Mycoplasma pneumoniae pneumonia (MPP), respiratory syncytial virus (RSV) pneumonia, adenovirus pneumonia and underwent bronchoscopy in Respiratory Department of Children's Hospital of Chongqing Medical University from January 2019 to December 2021 was conducted. The children were divided into two groups distinguished by airway mucus secretion according to the airway mucus hypersecretion score which were scored according to the mucus secretion under the bronchoscope. The demographic characteristics, clinical characteristics, laboratory tests and disease severity of the two groups were compared. And the risk factors for the development of airway mucus hypersecretion in two groups were analyzed. Chi square test, Mann-Whithey U test and Fisher exact test were used to analyze the differences between the two groups, and multivariate Logistic regression was used to analyze the influencing factors. Result: There were 559 males and 409 females in the 968 children, with an age of 4.0 (1.4, 6.0) years. Among the 642 children with MPP, 185 cases were in the hypersecretion group and 457 cases were in the non-hypersecretion group. There were 41 cases in the hypersecretion group and 160 cases in the non-hypersecretion group of 201 children with RSV pneumonia. In the 125 children with adenovirus pneumonia, there were 39 cases in the hypersecretion group and 86 cases in the non-hypersecretion group. In these children, the age of children in the hypersecretion group was older than that in the non-hypersecretion group (6.0 (4.0, 7.0) vs. 5.0 (3.0, 7.0) years old, 1.5 (0.5, 3.6) vs. 0.8 (0.4, 1.6) years old, 2.0 (1.2, 4.5) vs. 1.3 (0.8, 2.0) years old, U=35 295.00, 2 492.00, 1 101.00, all P<0.05). Through multivariate Logistic regression analysis it found that increased risk of airway mucus hypersecretion was present in childhood MPP with increase in peripheral blood white blood cell count (OR=3.30, 95%CI 1.51-7.93, P=0.004) or increase in neutrophil ratio (OR=2.24, 95%CI 1.16-4.33, P=0.016) or decrease in lymphocyte count (OR=3.22, 95%CI 1.66-6.31, P<0.001) or decrease in serum albumin (OR=2.00, 95%CI 1.01-3.98, P=0.047). The risk of airway mucus hypersecretion was increased in children with RSV pneumonia combined with elevated peripheral blood eosinophils (OR=3.04, 95%CI 1.02-8.93, P=0.043). Meanwhile, airway mucus hypersecretion was associated with severe pneumonia (OR=2.46, 95%CI 1.03-6.15, P=0.047) in children with RSV pneumonia. Older age was associated with increased risk of airway mucus hypersecretion in children with adenovirus pneumonia (OR=1.02, 95%CI 1.00-1.04, P=0.026). In these children with occurrence of pulmonary rales, wheezes or sputum sounds (OR=3.65, 95%CI 1.22-12.64, P=0.028) had an increased risk of airway mucus hypersecretion. Neutrophils in bronchoalveolar lavage fluid (BALF) demonstrated higher ratio in hypersecretion group from children with MPP (0.65 (0.43, 0.81) vs. 0.59 (0.34, 0.76), U=24 507.00, P<0.01), while the proportion of macrophages in BALF was lower (0.10 (0.05, 0.20) vs. 0.12 (0.06, 0.24), U=33 043.00, P<0.05). Nucleated cell count and neutrophil ratio in BALF were higher in hypersecretion group of children with RSV pneumonia (1 210 (442, 2 100)×106 vs. 490 (210, 1 510)×106/L, 0.43 (0.26, 0.62) vs. 0.30 (0.13, 0.52), U=2 043.00, 2 064.00, all P<0.05). Conclusions: The increase in peripheral blood white blood cell count, neutrophil ratio and decrease in lymphocyte count, serum albumin in children with MPP is related to the development of airway mucus hypersecretion. In children with RSV pneumonia, the abnormal increase of eosinophils in peripheral blood has relationship with hypersecretion. The appearance of lung rale, wheezing, and sputum rale are associated with airway mucus hypersecretion in children with adenovirus pneumonia. In addition, local neutrophil infiltration in the respiratory tract is closely related to the occurrence of airway mucus hypersecretion caused by Mycoplasma pneumoniae and RSV infection.

Assessment of the acute and subacute toxicity of the aqueous extract of Moroccan Ferula communis fruit in a mouse model

Ferula communis L. is thought to possess a wide range of therapeutic qualities. This plant's safety is critical regarding its potential uses as a medicine. Using the techniques outlined in the OECD recommendations, the present study aimed to assess the acute and subacute toxicity profiles of Ferula communis aqueous extract (FC-Ext) in mice. In the acute study, the FC-Ext was administered to adult male and female Swiss albino mice through oral and intraperitoneal routes at doses of 0–4 g/kg. The general behavioral effects, mortality rates, and latency of mortality were evaluated for a period of 14 days. For the sub-acute dose study, the FC-Ext was administered orally to adult mice at doses of 125, 250, and 500 mg/kg on a daily basis for 28 days. Body weight and selected biochemical and hematological parameters were measured, and histological examinations of the liver, kidney, and spleen were conducted to assess any signs of organ damage at the end of the treatment period. The results of the acute toxicity study demonstrated that the LD50 values for the oral and intraperitoneal administration of FC-Ext were 3.6 g/kg and 2.3 g/kg, respectively. In the subacute toxicity study of FC-Ext, no significant changes in body weight were observed. However, a substantial increase in the weights of the liver, kidney, and spleen was observed in male mice. The administration of FC-Ext to mice at doses higher than 250 mg/kg resulted in a decrease in white blood cells and platelets in both sexes and a reduction in red blood cells and mean corpuscular hemoglobin concentration in males and hemoglobin in females. No changes in biochemical parameters were observed. Microscopic examination of vital organs such as the liver, kidney, and spleen revealed no significant injuries. Based on the current results, the aqueous extract of Ferula communis has low toxicity. These findings provide important information about the toxicity profile of the traditional medicine plant Ferula communis.