Background
Bullous pemphigoid (BP) is the most common autoimmune subepidermal bullous disease of the skin. First-line treatment of systemic corticosteroids may cause serious adverse events. ...Rituximab, omalizumab, and dupilumab should be explored as alternative treatment options to improve outcomes.
Objective
To systematically review the rituximab, omalizumab, and dupilumab treatment outcomes in bullous pemphigoid.
Methods
A PubMed, Embase, Web of Science, and Cochrane library search were conducted on March 10, 2022. A total of 75 studies were included using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.
Results
Use of rituximab (n=122), omalizumab (n=53) and dupilumab (n=36) were reported in 211 patients with BP. Rituximab led to complete remission in 70.5% (n=86/122) and partial remission in 23.8% (n=29/122) of patients within 5.7 months, with a recurrence rate of 20.5% (n=25/122). 9.0% (n=11/122) of patients died and infection (6.6%, n=8/122) was the most common adverse event. Omalizumab led to complete remission in 67.9% (n=36/53) and partial remission in 20.8% (n=11/53) of patients within 6.6 months, with a recurrence rate of 5.7% (n=3/53). 1.9% (n=1/53) of patients died and thrombocytopenia (1.9%, n=1/53) was observed as the most common adverse event. Dupilumab led to complete remission in 66.7% (n=24/36) and partial remission in 19.4% (n=7/36) of patients within 4.5 months of treatment without any reported adverse events, with a recurrence rate of 5.6% (n=2/36).
Conclusions
Rituximab, omalizumab, and dupilumab have similar clinical benefits for BP patients. However, rituximab resulted in higher recurrence rates, adverse events, and mortality rates.
Systematic Review Registration
https://www.crd.york.ac.uk/PROSPERO/
, identifier CRD42022316454.
The Hopf–Hopf bifurcations of an aircraft nose landing gear model are investigated in this paper based on two pairs of continuation parameters. It is shown that due to the effect of higher-order ...terms, there exists a deviation between the bifurcation curve of the original system and the bifurcation curve of its truncated amplitude system, which results in a contraction in the bistable region compared with the previous work. Two codimension 3 strong resonant points can be detected on the Neimark–Sacker bifurcation curve. Period-3 and period-4 limit cycles with torsional-lateral shimmy can emerge when the vertical force and the taxiing velocity are chosen near the resonant points. The occurrence of 1:3 and 1:4 resonant Hopf–Hopf bifurcations can induce tire-ground vibrations in torsional and lateral direction, which can greatly degrade the performance and safety and possibly destroy the airstrip. So it is of significance to investigate the resonate behaviors of the aircraft nose landing gear to ensure the safe landing.
A prey–predator model with constant-effort harvesting on the prey and predators is investigated in this paper. First, we discuss the number and type of the equilibria by analyzing the equations of ...equilibria and the distribution of eigenvalues. Second, with the rescaled harvesting efforts as bifurcation parameters, a subcritical Hopf bifurcation is exhibited near the multiple focus and a Bogdanov–Takens bifurcation is also displayed near the
BT
singularity by analyzing the versal unfolding of the model. With the variation of bifurcation parameters, the system shows multi-stable structure, and the attractive domains for different attractors are constituted by the stable and unstable manifolds of saddles and the limit cycles bifurcated from Hopf and Bogdanov–Takens bifurcations. Finally, a cusp point and two generalized Hopf points are found on the saddle-node bifurcation curve and the Hopf bifurcation curves, respectively. Several phase diagrams for parameters near one of the generalized Hopf points are exhibited through the generalized Hopf bifurcation.
This work designs a two-thresholds policy for a Filippov model in combating influenza, so as to estimate when and whether to take control strategies, including the media coverage, antiviral treatment ...of infected individuals and vaccination of susceptible population. By introducing two tolerance thresholds
S
c
and
I
c
of susceptible and infected individuals, the two-thresholds policy is designed as: a vaccination program is implemented when the number of susceptible individuals is above
S
c
; an antiviral treatment strategy is taken and the mass media begins to report information about influenza when the infection number is larger than
I
c
; no control strategies are required in other cases. Furthermore, the global dynamics of the model are analyzed by varying these two thresholds, including the existence and dynamics of sliding mode, and the existence and global stability of equilibrium. It is shown that the model solutions ultimately converge to a pseudoequilibrium or a pseudoattractor on the switching surface, or a real equilibrium. The obtained results indicate that, by choosing susceptible and infected thresholds properly, the infection number can be remained below or at an acceptable level.
Stress corrosion crack growth tests of a cold worked nuclear grade 316L stainless steel were conducted in simulated pressurized water reactor (PWR) primary water environment containing various ...dissolved oxygen (DO) contents but no dissolved hydrogen. The crack growth rate (CGR) increased with increasing DO content in the simulated PWR primary water. The fracture surface exhibited typical intergranular stress corrosion cracking (IGSCC) characteristics.
We study the non-existence of global classical solutions to 1D compressible heat-conducting micropolar fluid without viscosity. We first show that the life span of the classical solutions with decay ...at far fields must be finite for the 1D Cauchy problem if the initial momentum weight is positive. Then, we present several sufficient conditions for the non-existence of global classical solutions to the 1D initial-boundary value problem on 0, 1. To prove these results, some new average quantities are introduced.
Rotifer contamination, as a severe constraint in mass cultures, impedes industrial-scale cultivation of microalgae. Once contamination occurred, the rotifers released something that inhibited ...microalgal cell growth in addition to algal reduction due to predation. With the aim of further identifying the type and effects of the inhibitor released from rotifers,
Chlorella
sp. was cultured in fresh modified F/2 medium and in media containing various proportions of boiled rotifer culture-medium filtrate (RCF), as well as in media containing water-soluble or lipid-soluble fractions isolated from RCF. Then, the growth and photosynthesis of
Chlorella
sp. were measured. The rotifer inhibition of
Chlorella
growth could not be eliminated by boiling the RCF, indicating that the inhibitor was not likely a protein. The growth and photosynthesis of
Chlorella
sp. was not inhibited by the water-soluble RCF fraction, but they were significantly inhibited by the lipid-soluble RCF fraction, in a dose-dependent manner. Further, the lipid-soluble fraction decreased energy conservation and photosynthetic electron transport, which induced a severe decrease in PSII activity and a decrease in the net photosynthetic O
2
evolution rate. Based on these physiological responses of
Chlorella
cells, the lipid-soluble fraction rather than the protein or water-soluble fractions was determined to contain the responsible inhibitor, suggesting the direction of further studies
.
Conventional treatment techniques have limited efficacy and more side effects in the treatment of prurigo nodularis. The better alternative treatment option for better outcomes of the disease is ...dupilumab.
The objective of this study was to systematically review dupilumab-related treatment outcomes in prurigo nodularis.
Several databases like Embase, PubMed, Web of Science, and Cochrane library were searched for data acquisition on October 8, 2022. Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, 24 publications were included in this study.
After 4,12,16 and more than 16 weeks of dupilumab treatment, 8.3% (n=5/60), 34.4% (n=11/32), 3.6% (n=2/56), and 45.3% (n=29/64) of patients had complete remission, respectively. In addition, 85.0% (n=51/60), 59.4% (n=19/32), 83.9% (n=47/56), and 43.8% (n=28/64) had partial remission, respectively. Moreover, 6.7% (n=4/60), 6.3% (n=2/32), 12.5% (n=7/56), and 10.9% (n=7/64) showed no remission, respectively, and significant reduction of numeric rating scale itch intensity (from 9.0 to 4.9, 2.1, 2.8, 0.9) was attained. There were no serious adverse events observed during treatment, but the most common event observed was conjunctivitis (12.6%, n=15/119).
Dupilumab has definite effectiveness and safety in prurigo nodularis treatment.
https://www.crd.york.ac.uk/PROSPERO, identifier (CRD42022365802).
Accumulated evidences support the fetus's intestinal flora unbalance is associated with the development of allergic diseases. Probiotic supplements in pregnancy and childhood might prevent atopic ...diseases. The aim of this systematic review and meta-analysis was to evaluate the effect of probiotic supplementation during pregnancy and early infancy in preventing eczema, atopic eczema, and other allergic diseases. We also explored whether different probiotic strains or intervention objects affected the antiallergic effect of probiotics and the prevention atopy effect of the long-term period. Fixed-effect models were used, and random-effects models where significant heterogeneity was present. Results were expressed as odds ratios (ORs) with a 95% confidence interval (CI). Twenty-one studies were included in the meta-analysis. The probiotics group had a significantly lower risk of eczema and atopic eczema compared to controls, especially those treated with probiotic combinations. Mothers' probiotics intake significantly contributed to reducing the risk of eczema as well as atopic eczema. What's more, probiotics seemed effective on eczema prevention ≤2 years of age, but against atopic eczema after 1 of age year. No significant difference in terms of prevention of asthma, rhinitis, wheeze, allergic diseases and sensation. In brief, a probiotic supplement is expected to become a novel potential strategy for infant eczema and atopic eczema.
Introduction: Pycnogenol (PYC), a standardized extract from French maritime pine, has traditionally been used to treat inflammation. However, its primary active components and their mechanisms of ...action have not yet been determined. Methods: This study employed UPLC-MS/MS (Ultra-high performance liquid chromatography-tandem mass spectrometry) and network pharmacology to identify the potential active components of PYC and elucidate their anti-inflammatory mechanisms by cell experiments. Results: 768 PYC compounds were identified and 19 anti-inflammatory compounds were screened with 85 target proteins directly involved in the inflammation. PPI (protein-protein interaction) analysis identified IL6, TNF, MMP9, IL1B, AKT1, IFNG, CXCL8, NFKB1, CCL2, IL10, and PTGS2 as core targets. KEGG (Kyoto Encyclopedia of Genes and Genomes) enrichment analysis suggested that the compound in PYC might exert anti-inflammatory effects through the IL17 and TNF signal pathways. Cell experiments determined that PYC treatment can reduce the expression of IL6 and IL1β to relieve inflammation in LPS (lipopolysaccharide)-induced BV2 cells. Conclusion: PYC could affect inflammation via multi-components, -targets, and -mechanisms.
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