scholarly journals Peptide-Based Vaccination Therapy for Rheumatic Diseases

2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Bin Wang ◽  
Shiju Chen ◽  
Qing Zheng ◽  
Yuan Liu ◽  
Guixiu Shi
Keyword(s):  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Species Difference ◽  
Experimental Studies ◽  
Treatment Strategies ◽  
Cost Effective ◽  
Disease Heterogeneity ◽  
Safe Delivery ◽  
Cost Effective Treatment ◽  
Vaccination Therapy

Rheumatic diseases are extremely heterogeneous diseases with substantial risks of morbidity and mortality, and there is a pressing need in developing more safe and cost-effective treatment strategies. Peptide-based vaccination is a highly desirable strategy in treating noninfection diseases, such as cancer and autoimmune diseases, and has gained increasing attentions. This review is aimed at providing a brief overview of the recent advances in peptide-based vaccination therapy for rheumatic diseases. Tremendous efforts have been made to develop effective peptide-based vaccinations against rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), while studies in other rheumatic diseases are still limited. Peptide-based active vaccination against pathogenic cytokines such as TNF-α and interferon-α (IFN-α) is shown to be promising in treating RA or SLE. Moreover, peptide-based tolerogenic vaccinations also have encouraging results in treating RA or SLE. However, most studies available now have been mainly based on animal models, while evidence from clinical studies is still lacking. The translation of these advances from experimental studies into clinical therapy remains impeded by some obstacles such as species difference in immunity, disease heterogeneity, and lack of safe delivery carriers or adjuvants. Nevertheless, advances in high-throughput technology, bioinformatics, and nanotechnology may help overcome these impediments and facilitate the successful development of peptide-based vaccination therapy for rheumatic diseases.

Advances in Microbiome Detection Technologies and Application in Antirheumatic Drug Design

2020 ◽  
Vol 26 ◽  
Author(s):  
Xin Wu ◽  
Xiang Chen ◽  
Xiaochen Lyu ◽  
Hao Zheng
Keyword(s):  
Gut Microbiota ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Treatment Strategies ◽  
Taxonomic Assignment ◽  
Drug Induced ◽  
Complex Interactions ◽  
Microbial Profiling ◽  
Control Disease ◽  
And Function

: Rheumatic diseases are a kind of chronic inflammatory and autoimmune disease affecting the connection or supporting structures of the human body, such as the most common diseases Ankylosing spondylitis (AS), gout and Systemic lupus erythematosus (SLE). Although the precise etiology and pathogenesis of the different types of rheumatic diseases remain mostly unknown, it is now commonly believed that these diseases are attributed to some complex interactions between genetics and environmental factors, especially the gut microbiome. Altered microbiome showed clinical improvement in disease symptoms and partially restored to normality after prescribing disease-modifying antirheumatic drugs (DMARDs) or other treatment strategies. Recent advances in next-generation sequencing-based microbial profiling technology, especially metagenomics, have identified alteration of the composition and function of the gut microbiota in patients. Clinical and experimental data suggest dysbiosis may play a pivotal role in the pathogenesis of these diseases. In this paper, we provide a brief review of the advances in the microbial profiling technology and up-todate resources for accurate taxonomic assignment of metagenomic reads, which is a key step for metagenomics studies. In addition, we review the altered gut microbiota signatures that have been reported so far across various studies, upon which diagnostics classification models can be constructed, and the drug-induced regulation of the host microbiota can be used to control disease progression and symptoms.

Clay–starch combination for micropollutants removal from wastewater treatment plant effluent

2016 ◽  
Vol 73 (7) ◽  
pp. 1719-1727 ◽  
Author(s):  
M. F. Mohd Amin ◽  
S. G. J. Heijman ◽  
L. C. Rietveld
Keyword(s):  
Wastewater Treatment ◽  
Wastewater Treatment Plant ◽  
Experimental Studies ◽  
Treatment Plant ◽  
Cost Effective ◽  
Treatment Alternative ◽  
Cationic Starch ◽  
Naturally Occurring ◽  
Cost Effective Treatment ◽  
Wastewater Treatment Plant Effluent

In this study, a new, more effective and cost-effective treatment alternative is investigated for the removal of pharmaceuticals from wastewater treatment plant effluent (WWTP-eff). The potential of combining clay with biodegradable polymeric flocculants is further highlighted. Flocculation is viewed as the best method to get the optimum outcome from clay. In addition, flocculation with cationic starch increases the biodegradability and cost of the treatment. Clay is naturally abundantly available and relatively inexpensive compared to conventional adsorbents. Experimental studies were carried out with existing naturally occurring pharmaceutical concentrations found and measured in WWTP-eff with atrazine spiking for comparison between the demineralised water and WWTP-eff matrix. Around 70% of the total measured pharmaceutical compounds were removable by the clay–starch combination. The effect of clay with and without starch addition was also highlighted.

On the Bioremediation Potential of Inhabitant Microbes of Dredged Marine Soils: A Theoretical Framework

2013 ◽  
Vol 594-595 ◽  
pp. 173-177 ◽  
Author(s):  
Nurasiah Mira Anuar ◽  
Angzzas Sari Mohd Kassim ◽  
Chee Ming Chan
Keyword(s):  
Treatment Strategies ◽  
Cost Effective ◽  
Theoretical Framework ◽  
Peninsular Malaysia ◽  
Rapid Decline ◽  
Contaminant Removal ◽  
Biological Degradation ◽  
Oil And Grease ◽  
Cost Effective Treatment ◽  
Polycyclic Aromatic

Biological degradation is one of the most beneficial and economical methods to clean up contaminated marine soils. Although biodegradation by microorganisms encourages the natural process of contaminant removal and serve as potentially cost-effective treatment, limited facts in microbes and contaminant interactions lead in treatment failure. The present study had identified the existence of potential microbes in marine soils dredged from the coasts of Peninsular Malaysia. These included the genera ofSerratia, Vibrio, Enterobacter, andPseudomonas. Among these,VibrioandSerratiahave potential to degrade oil and grease as well as Polycyclic Aromatic Hydrocarbons (PAHs). Irrespective of any additions of particular nutrients, the existence of these genera whereupon reduces the potential for bioaugmentation treatment. Major problem in bioaugmentation is rapid decline in number of introduce microbes due to abiotic or biotic stress. The first stage needed to develop treatment strategies are by understanding the environmental conditions and factors that limit the ability of microbes to degrade the contaminants. Considering these understanding, biodegradation treatments of contaminated dredged marine soils is ease to design. This theoretical framework therefore aims to assess on the bacteria capability to degrade correlated with the contaminant concentration.

Rhinosinusitis Treatment Protocol: Changing Provider Habits in Primary Care

2002 ◽  
Vol 126 (6) ◽  
pp. 614-622 ◽  
Author(s):  
William C. Kinney
Keyword(s):  
Primary Care ◽  
Chart Review ◽  
Practice Patterns ◽  
Treatment Protocol ◽  
Treatment Strategies ◽  
Primary Caregivers ◽  
Cost Effective ◽  
Clinical Protocols ◽  
Cost Effective Treatment ◽  
Provider Practice

OBJECTIVE: Sinus infections are common and represent a high cost to the health care industry. Clinical protocols can be used to develop cost-effective treatment strategies. Our objective was to show that a protocol for rhinosinusitis can change provider practice patterns in primary care. STUDY DESIGN AND SETTING: We used a literature search, survey of primary caregivers, and chart review from an academic health center to define and document current patterns. A protocol was developed and evaluated using the Rhinosinusitis Disability Index. RESULTS: Survey and chart review identified that primary caregivers do not elicit a detailed history for rhinosinusitis. Protocol use increased this to 100%. First-line antibiotic therapy was used for only 49.4% of the patients before protocol use and for 68.5% after protocol use. Patients felt better after treatment 84.1% of the time; the Rhinosinusitis Disability Index could not measure improvement. CONCLUSION: Provider practice patterns were positively influenced by use of the protocol. SIGNIFICANCE: Clinical protocols should be developed to direct provider treatment practices.

PTSD in Active Combat Soldiers: To Treat or Not to Treat

2014 ◽  
Vol 42 (2) ◽  
pp. 161-170 ◽  
Author(s):  
Bethany C. Wangelin ◽  
Peter W. Tuerk
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Care ◽  
Health Care Services ◽  
Treatment Strategies ◽  
Cost Effective ◽  
Public Health Care ◽  
Care Utilization ◽  
Care Services ◽  
Cost Effective Treatment

Treatment of military-related posttraumatic stress disorder (PTSD) is a major public health care concern. Since 2001 over 2.5 million troops have been deployed to Iraq or Afghanistan, many of whom have experienced direct combat and sustained threat. Estimates of PTSD rates related to these wars range from 8% to over 20%, or 192,000 to 480,000 individuals. Already, nearly 250,000 service members of Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND) have sought VA health care services for PTSD. This recent increased need for mental health services comes in addition to the ongoing needs of Vietnam-era and other veterans who continue to suffer from PTSD. PTSD is related to high co-morbidities of other mental health difficulties, poorer physical health status, and increased medical care utilization. Such high demand for services is an important contributor to the large cost associated with combat-related PTSD. Accordingly, promoting successful, cost-effective treatment strategies for PTSD is a chief public health care priority.

scholarly journals Operative Versus Nonoperative Management of Appendicitis: A Long-Term Cost Effectiveness Analysis

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831986644
Author(s):  
Lindsay A. Sceats ◽  
Seul Ku ◽  
Alanna Coughran ◽  
Britainy Barnes ◽  
Emily Grimm ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Laparoscopic Appendectomy ◽  
Nonoperative Management ◽  
Treatment Strategies ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Life Years ◽  
Cost Effective Treatment ◽  
Uncomplicated Appendicitis

Background. Recent clinical trials suggest that nonoperative management (NOM) of patients with acute, uncomplicated appendicitis is an acceptable alternative to surgery. However, limited data exist comparing the long-term cost-effectiveness of nonoperative treatment strategies. Design. We constructed a Markov model comparing the cost-effectiveness of three treatment strategies for uncomplicated appendicitis: 1) laparoscopic appendectomy, 2) inpatient NOM, and 3) outpatient NOM. The model assessed lifetime costs and outcomes from a third-party payer perspective. The preferred strategy was the one yielding the greatest utility without exceeding a $50,000 willingness-to-pay threshold. Results. Outpatient NOM cost $233,700 over a lifetime; laparoscopic appendectomy cost $2500 more while inpatient NOM cost $7300 more. Outpatient NOM generated 24.9270 quality-adjusted life-years (QALYs), while laparoscopic appendectomy and inpatient NOM yielded 0.0709 and 0.0005 additional QALYs, respectively. Laparoscopic appendectomy was cost-effective compared with outpatient NOM (incremental cost-effectiveness ratio $32,300 per QALY gained); inpatient NOM was dominated by laparoscopic appendectomy. In one-way sensitivity analyses, the preferred strategy changed when varying perioperative mortality, probability of appendiceal malignancy or recurrent appendicitis after NOM, probability of a complicated recurrence, and appendectomy cost. A two-way sensitivity analysis showed that the rates of NOM failure and appendicitis recurrence described in randomized trials exceeded the values required for NOM to be preferred. Limitations. There are limited NOM data to generate long-term model probabilities. Health state utilities were often drawn from single studies and may significantly influence model outcomes. Conclusion. Laparoscopic appendectomy is a cost-effective treatment for acute uncomplicated appendicitis over a lifetime time horizon. Inpatient NOM was never the preferred strategy in the scenarios considered here. These results emphasize the importance of considering long-term costs and outcomes when evaluating NOM.

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