Drug-Resistant Bacterial Infections in HIV Patients

The human immunodeficiency virus (HIV) was first detected in 1982 among homosexual men, and subsequently, it was further detected in various regions of world. In 2016, WHO estimated that 36.7 million people were living with HIV, 1.9 million were newly infected HIV patients and approximately 1 million people died worldwide. HIV attacks CD4 T cells and causes immunodeficiency. Weakened immune system of HIV patients increases the opportunity to acquire various infections caused by fungi, bacteria, parasites and other viruses. Bacterial infections that cause huge threats to HIV patients are tuberculosis, syphilis, bacterial enteric diseases and bacterial pneumonia. Important bacterial etiologies are Streptococcus pneumoniae, Salmonella spp. Haemophilus influenzae, Staphylococcus aureus, Citrobacter freundii, Escherichia coli, Klebsiella pneumoniae, Morganella morganii, Pseudomonas aeruginosa and Mycobacterium tuberculosis. Frequent bacterial infections in HIV patients increase the usage and also highly expose bacteria to antibiotics. Most problematic multidrug-resistant bacteria are extended-spectrum β-lactamases producing P. aeruginosa, Acinetobacter baumannii, E. coli and K. pneumoniae; vancomycin-resistant enterococci; methicillin-resistant S. aureus and multidrug-resistant and extensively drug-resistant M. tuberculosis. These antibiotic-resistant bacteria complicate the treatment of infections in HIV patients with available antibiotics and sometimes cause death. It also causes higher medical costs, prolonged hospital stays, increased mortality and economic burden on families and societies

TUMOR NECROSIS FACTOR-ALPHA LEVEL IN SERA OF SOUTH INDIAN PATIENTS WITH RHEUMATOID ARTHRITIS: CORRELATION WITH ANTICYCLIC CITRULLINATED PEPTIDE ANTIBODY LEVEL

Objective: The present study was aimed to find out the anticyclic citrullinated peptide (CCP) antibody level and expression level Th2 cytokine-liketumor necrosis factor-alpha (TNF-α) in patients with rheumatoid arthritis (RA) from South India.Methods: The patients attending the Arthritis and Rheumatism Care Centre, Vadapalani, Chennai and healthy individuals from the Presidency College, Chennai, were enrolled for this study. The study group included 74 patients with RA and 50 healthy individuals without history of RA. 3-5 ml of blood samples was aseptically collected using Vacutainer, and the separated serum samples were transported to the Department of Microbiology, Presidency College, Chennai, Tamil Nadu, in cold chain. Anti-CCP antibodies were detected by enzyme-linked immunosorbent assay (ELISA). Serum concentrations of TNF-α were studied in patients with RA and in healthy controls, using an ELISA method.Results: The results of anti-CCP enzyme immunoassay revealed that out of 74 patients, all were anti-CCP positive, which included 65 females and 9 males. Higher levels of anti-CCP (456 IU/ml) were present in the age group between 41 and 50 followed by 21-30 years age group which shows 335.28 IU/ml of anti-CCP antibody level. The level of serum TNF-α was measured in the range of 4.6-1082.84 pg/ml for RA patients and6.630-459.74 pg/ml for the healthy control group.Conclusion: TNF-α levels were significantly increased in RA patients compared to healthy individuals. A negative correlation was found between anti- CCP antibody and TNF-α level in RA patients.Keywords: Rheumatoid arthritis, Tumor necrosis factor-alpha, Enzyme-linked immunosorbent assay, Anticyclic citrullinated peptide antibodie

NITRIC OXIDE PRODUCTION AND ANTIOXIDANT ACTIVITY OF DRIED FRUIT EXTRACTS OF TERMINALIA CHEBULA

 Objective: The dried ripe fruits of Terminalia chebula have traditionally been used to treat various ailments as it has a wide spectrum of pharmacological activities. Hence, in the present study, we aimed to explore the antioxidant activity, nitric oxide production, cytotoxicity, and phytocompounds present in the aqueous and methanol extract of T. chebula. Methods: The dry fruits of T. chebula were extracted using water and methanol, and the extracts were concentrated by lyophilization method. Phytochemical analysis was done by gas chromatography and mass spectrometry and Fourier-transform infrared spectroscopy. The free radical scavenging activity of T. chebula was estimated by 1,1diphenyl 2, picrylhydrazyl method. RAW 264.7 cells were stimulated with aqueous and methanol extracts, and the production of nitric oxide was estimated by spectrophotometric method using Griess reagent. Cytotoxicity assay was performed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method and percentage of cell viability was calculated.Results: Aqueous and methanolic extracts of the dry fruit of T. chebula showed non-toxic to RAW 264.7 cells at the concentration of 2 mg and 1.5 mg, respectively. These concentrations showed high free radical scavenging activity and production of optimum concentration of nitric oxide in RAW 264.7 cells.Conclusion: Fruit extracts of T. chebula possess properties of nitric oxide production and high free radical scavenging activity; these properties could be useful in the development of immunomodulatory drugs as well as protection against various human diseases associated with oxidative stress.</jats:p

NITRIC OXIDE PRODUCTION AND ANTIOXIDANT ACTIVITY OF DRIED FRUIT EXTRACTS OF TERMINALIA CHEBULA

 Objective: The dried ripe fruits of Terminalia chebula have traditionally been used to treat various ailments as it has a wide spectrum of pharmacological activities. Hence, in the present study, we aimed to explore the antioxidant activity, nitric oxide production, cytotoxicity, and phytocompounds present in the aqueous and methanol extract of T. chebula. Methods: The dry fruits of T. chebula were extracted using water and methanol, and the extracts were concentrated by lyophilization method. Phytochemical analysis was done by gas chromatography and mass spectrometry and Fourier-transform infrared spectroscopy. The free radical scavenging activity of T. chebula was estimated by 1,1diphenyl 2, picrylhydrazyl method. RAW 264.7 cells were stimulated with aqueous and methanol extracts, and the production of nitric oxide was estimated by spectrophotometric method using Griess reagent. Cytotoxicity assay was performed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method and percentage of cell viability was calculated.Results: Aqueous and methanolic extracts of the dry fruit of T. chebula showed non-toxic to RAW 264.7 cells at the concentration of 2 mg and 1.5 mg, respectively. These concentrations showed high free radical scavenging activity and production of optimum concentration of nitric oxide in RAW 264.7 cells.Conclusion: Fruit extracts of T. chebula possess properties of nitric oxide production and high free radical scavenging activity; these properties could be useful in the development of immunomodulatory drugs as well as protection against various human diseases associated with oxidative stress

ASSOCIATION OF ANTI-DOUBLE STRANDED DNA ANTIBODIES, C-REACTIVE PROTEIN, AND ERYTHROCYTE SEDIMENTATION RATE FROM PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS IN TAMIL NADU.

 Objective: To determine the serum levels of anti-double stranded DNA (anti-dsDNA) antibodies, serum C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in patients with systemic lupus erythematosus (SLE) from Tamil Nadu, and elucidate their correlation level.Methods: Blood samples were collected from 100 SLE patients (mean age 39 years) attended to the Rheumatology Care Centre, Rajiv Gandhi Government General Hospital, Chennai. Anti-dsDNA antibodies IgG in SLE patients were analyzed by Enzyme-linked Immunosorbent Assay, and CRP was measured by turbidimetry. ESR was measured by Westergren method.Results: In a total of 100 SLE patients, 72 cases were positive for anti-dsDNA antibody. The mean level of anti-dsDNA antibodies in 72 SLE patients was 102 IU/ml. Among the 100 SLE cases, 92 cases (92%) had elevated levels of CRP and their mean level was 11 ± 4 mg/L. The mean ESR levels were high in SLE patients (56 ± 20 mm/hr). Significant association of anti-dsDNA antibodies with ESR (r = 0.357; p &lt; 0.001) and CRP (r = 0.81; p = 0.023) was found.Conclusion: Anti-dsDNA antibodies had a significant association with CRP and ESR. The result of our study suggests an association of anti-dsDNA antibodies with ESR and CRP and was linked with SLE disease progression. </jats:p