Interventions to Improve Adherence to Medication on Multidrug-Resistant Tuberculosis Patients: A Scoping Review.

INTRODUCTION: Inappropriate treatment and non-adherence use of anti-tuberculosis (TB) drugs trigger the spread of multidrug-resistant tuberculosis (MDR-TB) strains and causes an emerging public health threat worldwide. Therefore, non-adherence to MDR-TB treatment leading to prolonged medication period, increase incidence of adverse event and financial burden, thus it requires interventions to achieve a therapeutic outcome. OBJECTIVE: This scoping review aims to provide an overview of interventions to improve the adherence level to medication of MDR-TB patients. MATERIALS AND METHODS: A review of observational studies was conducted to discuss the accuracy, tolerability and ease of use of tonometers in measuring IOP in children with glaucoma. Three databases (PubMed, Web of Science, Scopus) were used in a scoping review. The data were synthesised using Rayyan AI. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to guide this review. RESULTS: A total of 11 articles were included in this review to describe the various interventions in MDR-TB treatment adherence. Psychological counselling or education intervention was the most popular intervention, and it significantly increased adherence levels among MDR-TB patients. Increased adherence level patients also reported by interventions with Medication Event Reminder Monitor (MERM), Video Directly Observed Therapy (VDOT), 30-day recall and Visual Analogue Scale (VAS), Financial Support, mHealth Application and directly observed therapy, short course (DOTS) and DOTS-Plus programs. However, we found that Electronic Dose Monitoring (EDM) device intervention has less effect on MDR-TB patients' adherence. CONCLUSION: The recovery of patients can be facilitated through MDR-TB treatment adherence interventions. It is acknowledged that the studies included in this review exhibit heterogeneity, with a majority showing significant improvement. Therefore, further study was required to investigate the specific on developing highly personalised interventions tailored to specific population or context, as well as to assess the cost-effectiveness of such interventions.

The lack of compound 48/80-induced contraction in isolated trachea of mast cell-deficient Ws/Ws rats in vitro: the role of connective tissue mast cells.

In the rat trachea, two types of mast cells have been identified, connective tissue mast cells and mucosal mast cells. Their different characteristics may account for their different biological functions. The role of connective tissue mast cells in tracheal contraction as one feature of the immediate reaction of asthma was studied in vitro in isolated trachea, using tissue derived from mast cell-deficient (Ws/Ws) rats, heterozygous (Ws/+) rats and control (+/+) rats, and compound 48/80 as a potent inducer of mast cell degranulation. The contractile response of tracheas from the three types of rats was also studied upon exposure to the following spasmogens: histamine, 5-hydroxytryptamine (5-HT), and carbachol. Histamine content in tissues reflected the differing mast cell numbers in strips from the three rat types. It was found that carbachol and 5-HT elicited tracheal contraction in a similar manner in strips from the three types of rats. Histamine had no contractile effect. Compound 48/80, at a dose of 25 microg/ml, elicited contraction in tracheas from both control (+/+) and heterozygous (Ws/+), but not in trachea from Ws/Ws rats. Compound 48/80-induced contractions in tracheas from +/+ rats were inhibited by 0.1 microM ketanserin and 0.1 microM nedocromil, but not by 0.1 microM mepyramine. Enzyme histochemistry confirmed that the degranulation occurred in connective tissue mast cells, but not in mucosal mast cells. We concluded that connective tissue mast cells play an important role in rat tracheal contraction via 5-HT release induced by compound 48/80. In addition, the specific mast cell-deficient (Ws/Ws) rats provide a good tool for studying the roles of mast cells in airway system.

Screening of several Indonesian medicinal plants for their inhibitory effect on histamine release from RBL-2H3 cells.

Twelve alcoholic extracts and 12 hexane extracts of plant materials selected on the basis of medicinal folklore for asthma treatment in Indonesia were studied for their activity in inhibiting histamine release from RBL-2H3 cells (rat basophilic leukemia cell line), a tumor analog of mast cells. The results of screening indicated that five alcoholic extracts (Plantago major leaves, Eucalyptus globulus leaves and fruit, Cinnamomum massoiae cortex, Vitex trifolia leaves) and two hexane extracts (Eucalyptus globulus leaves, Vitex trifolia leaves) inhibited IgE-dependent histamine release from RBL-2H3 cells. The inhibitory effects were found to be more than 80% for extract concentrations of 0.5 mg/ml. The results indicate that the extracts contain active compounds that inhibit mast-cell degranulation, and provide insight into the development of new drugs for treating asthma and/or allergic disease.

Do mucosal mast cells contribute to the immediate asthma response?

In rat trachea, two types of mast cells have been identified, connective tissue mast cells (CTMCs) and mucosal mast cells (MMCs). We previously reported that CTMCs play an important role in tracheal contraction in vitro via 5-hydroxytryptamine (5-HT) release in a rat model. In this study, we investigated whether MMCs also play a role in tracheal contraction by employing mast cell-deficient (Ws/Ws) rats and their congenic (+/+) rats. Rats were actively sensitized with ovalbumin and challenged with it 2 weeks later. To exclude the influence of CTMCs, rats were pretreated for 7 days with compound 48/80 injected i.p. in increasing doses. Histological study confirmed that degranulation occurred in CTMCs, but MMCs still remained. Histamine levels in trachea decreased to 9.31% of control levels. Ovalbumin-specific IgE production showed a time-dependent increase in both Ws/Ws and +/+ rats after sensitization with no significantly different values between the two groups. Ovalbumin challenge caused contraction of the trachea in sensitized control (+/+) rats, but not in sensitized Ws/Ws and compound 48/80-pretreated +/+ rats. Ketanserin inhibited the contraction, but leukotriene antagonist ONO-1078 did not, indicating that the contraction was due to 5-HT, whereas leukotriene, a mediator specific derived from MMCs, has no significant effect. The results suggest that MMCs has minimal, if any, contribution to tracheal contraction and might have another function. Furthermore, Ws/Ws and the congenic rats provide a good model for studying the role of mast cells in the immunologic response in airways.