Promising phytopharmacology, nutritional potential, health benefits, and traditional usage of Tribulus terrestris L. herb.

Traditional medicines are becoming more popular as people become more aware of the dangers of synthetic pharmaceuticals. Tribulus terrestris L., (Gokharu) an annual herbaceous plant, has been extensively utilized by herbalists for numerous medicinal purposes. T. terrestris has been studied for its multiple therapeutic effects, including immunomodulatory, aphrodisiac, anti-urolithic, absorption enhancer, cardioprotective, antidiabetic, anti-inflammatory, hypolipidemic, neuro-protective, anticancer, and analgesic properties. Saponins and flavonoids are two examples of beneficial substances that have recently been found in T. terrestris. These chemicals are very important for a variety of therapeutic effects. Numerous studies have shown that T. terrestris products and various parts may have antioxidant, anti-inflammatory, anti-cancer, anti-diabetic, testosterone-boosting, and liver protective effects. According to the published evidence, T. terrestris boosts testosterone secretion, regulates blood pressure, and protects the human body against injuries. The cardiovascular, reproductive, and urinary systems are all severely impacted. Due to its potent bioactive compounds, the literature evaluated from a wide range of sources including books, reports, PubMed, ScienceDirect, Wiley, Springer, and other databases demonstrated the extraordinary potential to treat numerous human and animal ailments. Our review is different from other published articles because we explored its importance for humans and especially in veterinary like poultry health. It could also be used as an aphrodisiac to treat different fertility-related disorders in human and animal science. More research into the pharmacodynamics of herbs like T. terrestris is needed so that it can be used in a wider variety of nutraceutical products for humans and poultry.

Nutraceutical and Health-Promoting Potential of Lactoferrin, an Iron-Binding Protein in Human and Animal: Current Knowledge.

Lactoferrin is a natural cationic iron-binding glycoprotein of the transferrin family found in bovine milk and other exocrine secretions, including lacrimal fluid, saliva, and bile. Lactoferrin has been investigated for its numerous powerful influences, including anticancer, anti-inflammatory, anti-oxidant, anti-osteoporotic, antifungal, antibacterial, antiviral, immunomodulatory, hepatoprotective, and other beneficial health effects. Lactoferrin demonstrated several nutraceutical and pharmaceutical potentials and have a significant impact on improving the health of humans and animals. Lactoferrin plays a critical role in keeping the normal physiological homeostasis associated with the development of pathological disorders. The current review highlights the medicinal value, nutraceutical role, therapeutic application, and outstanding favorable health sides of lactoferrin, which would benefit from more exploration of this glycoprotein for the design of effective medicines, drugs, and pharmaceuticals for safeguarding different health issues in animals and humans.

PGE2 mediates hemocyte-spreading behavior by activating aquaporin via cAMP and rearranging actin cytoskeleton via Ca2.

Spreading behavior of hemocytes (= insect blood cells) is essential for cellular immune responses against various microbial pathogens. It is activated by prostaglandin E2 (PGE2) via its membrane receptor associated with secondary messenger, cAMP, in insects. This study observed an increase of calcium ion (Ca2+) level after an acute increase of cAMP induced by PGE2 treatment and clarified the intracellular signals underlying the hemocyte-spreading behavior. Inhibition of Ca2+ flux significantly impaired the hemocyte-spreading and subsequent cellular immune response, phagocytosis. The up-regulation of intracellular Ca2+ in response to PGE2 was dependent on cAMP because RNA interference (RNAi) of PGE2 receptor expression or inhibiting adenylate cyclase prevented Ca2+ mobilization. The up-regulation of Ca2+ was induced by inositol triphosphate (IP3) via its specific IP3 receptor. Furthermore, inhibition of ryanodine receptor impaired Ca2+ mobilization, suggesting Ca2+-induced Ca2+ release. However, the effective spreading behavior of hemocytes was dependent on both secondary messengers. Ca2+ signal stimulated by cAMP was required for activating small G proteins because RNAi treatments of small G proteins such as Rac1, RhoA, and Cdc42 failed to stimulate hemocyte-spreading. In contrast, aquaporin was activated by cAMP. Its activity was necessary for changing cell volume during hemocyte-spreading. These results indicate that PGE2 mediates hemocyte-spreading via cAMP signal to activate aquaporin and via Ca2+ signal to activate actin cytoskeletal rearrangement.

Maintained Complete Response and Long-Term Survival in Epidermal Growth Factor Receptor Mutated Metastatic Non-Small Cell Lung Cancer with Erlotinib.

The prognosis of advanced non-small cell lung cancer (NSCLC) has significantly improved for certain patients with the development of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). However, metastatic NSCLC patients with long-term survival are still rare. Our 66-year-old male patient was admitted to the hospital for treatment of pneumonia. A chest CT scan done revealed a left upper lobe mass; computed tomography (CT)-guided fine-needle aspiration (FNA) was done in 2010 revealing adenocarcinoma. A staging positron emission tomography (PET) scan did not reveal evidence of metastatic disease. He underwent left upper lobectomy and the pathologic stage was IB, moderately differentiated adenocarcinoma with positive angiolymphatic invasion. He was offered adjuvant systemic therapy, but he opted for surveillance. In 2012, a CT scan showed disease recurrence in the left upper lobe, which was confirmed with a biopsy. He was deemed non-surgical by thoracic oncology. Systemic therapy was initiated with carboplatin/pemetrexed and Avastin; after four cycles of treatment, the CT scan showed stable disease. Mutation analysis sent before chemotherapy revealed EGFR mutation for which chemotherapy was stopped and he was started on switch maintenance with erlotinib 150 mg in October 2012, then the dose was reduced to 100 mg secondary to grades 2-3 acneiform rash. Follow-up CT scans in January 2016 showed complete remission, which is maintained with no evidence of disease as of today. Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related mortality in the United States. Surgical excision is the standard treatment for stage I disease. Despite the long-term survival without adjuvant therapy, the disease recurrence rate ranges between 27% and 38% after resection. Different histologic subtypes vary in pathologic and molecular features, leading to differences in treatment and prognosis. In the adenocarcinoma subtype, five-year progression-free survival in patients with EGFR mutation treated with an EGFR-TKI is 14.6% as compared to less than 5% in unselected patients with distant-stage NSCLC. The association between exon 19 deletions, which represent about 45% of overall EGFR mutations and half of the sensitizing ones, and prolonged survival in patients with advanced NSCLC treated with EGFR-TKIs has been reported by several groups. Our case reports long-term survival in a patient with EGFR mutation-positive NSCLC with no evidence of disease for eight years since he started erlotinib treatment. Is there an option to discontinue maintenance erlotinib at this point? The answer to this question is not known, but this is a remarkably maintained response that is a good area to study patient's characteristics leading to differences in response.

Deletion mutant of PGE2 receptor using CRISPR-Cas9 exhibits larval immunosuppression and adult infertility in a lepidopteran insect, Spodoptera exigua.

Prostaglandins (PGs) mediate various physiological processes in insects and other invertebrates, but there is very little information on PG receptors. This study identified a PGE2 receptor (SePGE2R) in the lepidopteran insect, Spodoptera exigua, and addressed its functional association with cellular immunity, development, and reproduction. SePGE2R is expressed in most developmental stages and tissues. After SePGR2R expression knock down by RNA interference (RNAi), larval nodule formation (clears bacterial infections from circulating hemolymph) was severely suppressed coupled with reduced F-actin growth in hemocytes. Treating female adults with RNAi prevented nurse cell dumping in follicles and interfered with oocyte development. SePGE2R was heterologously expressed in Sf9 cells, in which the endogenous S. frugiperda PGE2R was knocked down by small interfering RNA. This transiently expressed SePGE2R responded to PGE2, but not other PGs, with dose-dependent up-regulation of intracellular cAMP concentrations. Treating S. exigua larvae with PGE2 led to activation of a trimeric Gαs subunit, protein kinase A (PKA), and Rho family small intracellular G proteins in hemocytes. A deletion mutant of SePGE2R was generated using CRISPR/Cas9 which exhibited severely retarded larval development and adult reproduction. We infer that PGE2R mediates insect immune and reproductive processes via a PKA signal pathway.

Effect of Exposure to Agent Orange on the Risk of Monoclonal Gammopathy and Subsequent Transformation to Multiple Myeloma: A Single-Center Experience From the Veterans Affairs Hospital, Detroit.

BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) is an indolent, premalignant plasma cell disorder with the potential of transforming into symptomatic multiple myeloma (MM). There are multiple risk factors that contribute to transformation. Agent Orange (AO) has been linked with multiple malignant and nonmalignant conditions. PATIENTS AND METHODS: We conducted a retrospective chart review of patients with monoclonal gammopathy who were seen at John D. Dingell Veterans Affairs Medical Center (Detroit, Michigan) between 2005 and 2015 with MGUS, smoldering multiple myeloma, and MM. We explored baseline patient characteristics and explored AO exposure. Dates of diagnosis, dates of progression, and expiration dates were recorded to time to progression and overall survival (OS). RESULTS: We identified 211 patients with monoclonal gammopathy; 96% were male and 122 were African American. Eleven patients had reported AO exposure. Cumulative risk of progression in the overall population was 1.4% at 1 year. Risk of transformation in the population exposed to AO was significantly higher with a hazard ratio (HR) of 11.19 (95% confidence interval [CI], 2.10-59.47; P = .005). OS was numerically shorter in AO-exposed patients with a median OS of 7 years compared with 11.1 years in those not exposed. However, AO exposure was not associated with OS in multivariable analysis (HR, 0.50; 95% CI, 0.07-3.83; P = .508). CONCLUSION: Monoclonal gammopathy is a premalignant condition with the risk of progressing to MM. Exposure to AO has been implicated in multiple conditions including MM. Our study demonstrates an increased risk of progression in exposed patients.

A 2-week wait referral diagnosed with post-sternotomy liver herniation in a background of adrenal myelolipoma.

Herniation of the liver through the anterior abdominal wall is a rare post-sternotomy complication. A 32-year-old woman had a 2-week wait referral due to abdominal pain, weight loss and upper abdominal swelling. She was known to have a left adrenal myelolipoma and had a mitral valve replacement 3 years prior to presentation with the postoperative period complicated by sepsis and poor wound healing. She had recently been started on metformin for type 2 diabetes mellitus and she had long-standing lower abdominal symptoms known to the gynaecology team. Investigations revealed hepatic herniation of liver segments II & III through the anterior abdominal wall while there was no underlying malignancy a benign left adrenal myelolipoma was noted.

An ultra-sensitive monoclonal antibody-based enzyme-linked immunosobent assay for dibutyl phthalate in human urinary.

Dibutyl phthalate (DBP) has been extensively used as a plasticizer in many daily products, which is highly toxic to human, notably affecting the reproductive and developmental function. As the previous method is expensive, time-consuming, low sensitivity and just focused on the environment. Present study was aimed to establish an ultra-sensitive and simple method based on good quality monoclonal antibody, applying to evaluate excretion level of DBP in urine samples of Chinese population directly. A monoclonal antibody was generated and characterized after fusion of myeloma cells with spleen cells isolated from BALB/c mouse. The mouse was previously immunized using a specially designed amino derivative of DBP conjugated with bovine serum albumin (BSA) as immunogen. Cross-reactivity values of the monoclonal antibody against DBP, di-isobutyl phthalate (DIBP) were observed 100% and 1.25%, while for dimethyl phthalate (DMP), butyl benzyl phthalate (BBP) and didecyl phthalate (DDP) the values were <0.06%. The standard curve was constructed at 0-50 ng mL(-1) and good linearity (R(2)=0.994) was achieved. The observed IC50 (7.34 ng mL(-1)) and LOD (0.06 ng mL(-1)) values was improved 1000-fold to polyclonal antibody and 5-fold to other monoclonal antibodies. A total 1246 urine samples were analyzed and the detection frequency of DBP was observed 72.87% by ic-ELISA. The 95th percentile and mean concentration of DBP were 12.07 and 3.00 ng mL(-1). Acceptable recovery rates of DBP were 97.8-114.3% and coefficients variation 5.93-11.09%. The concentrations of DBP in females were found significantly higher (p<0.05) than males. Similarly, the DBP in middle aged and low educated individuals was found higher (p<0.001) than the others. Considering the adverse health effects, DBP internal exposure in the Chinese population should be reduced. The ic-ELISA method has been proved as a cost effective, specific, and highly sensitive screening tool to detect DBP in urinary samples.

Bowel obstruction caused by intestinal tuberculosis: an update.

Tuberculosis is one of the most important communicable diseases worldwide, with an increasing incidence within the UK. The abdomen is involved in 11% of patients with extra-pulmonary tuberculosis, and can provide a diagnostic challenge if not suspected. The authors report the case of a 31-year-old Sudanese female who presented with intestinal obstruction due to a mass caused by abdominal tuberculosis. Imaging revealed evidence of multifocal tuberculosis involving the ileo-caecal region with abdominal and mediastinal lymphadenopathy. She went on to have a limited right hemicolectomy and completed antitubercular therapy. It is important to consider abdominal tuberculosis when conditions such as Crohn's disease or gastrointestinal malignancy are being entertained in those from a high-risk background. Since diagnosis can be difficult, if clinical suspicion is strong, surgery is a safe option. Recommended management combines up to 12 months of antitubercular therapy with conservative surgery.