Asian Journal of Immunology

An Inter Mammalian Microbiome-Immune-Axis MIA

Ibrahim M S SHNAWA — 2025-03-25

There is a mutual bidirectional cross-talk between mammalian microbiomes MM and their respective immune systems during the host homeostatic and disease states, the microbiome- immune axis. The objective of the present opinion paper was to map the current status of the microbiome-immune axis updates. Human gut microbiome diversity decreases rapidly after autologous stem cell transfer. Myelopoiesis in human is regulated by signals from microbiome reaching the bone marrow. Some animal heat treated gut bacterial antigens induces proinflammatory cytokines in rabbits ileal and villus cultures while other animal heat treated gut bacterial antigens initiated anti-inflammatory cytokines using same test culture systems. Rabbits gut microbiome modulates brain development and function with coordinative helping role of the immune system. Rabbit models for rhino-sinusitis and cystic fibrosis were found associated with microbiome dysbioses in nose and gut microbiomes respectively and simulating that of man. When the development of mice microbiome became arrested the immune system undergoes stunting growth and development. Obese mice have shown dysbiotic microbiome. Thus, the paradigm of microbiome-immune axis MIA have shown that the potentials of the monkeys, rabbit and mice microbiomes can be translated to human welfare providing some limitations.

An Alum Loaded Macrophage Driven Autoimmune Myopathy

IBRAHIM M S SHNAWA — 2025-05-03

Immune mediated diseases and syndromes are rare and attributed at most to genetic and environmental interactions. Macrophagic Myofasciitis MMF is one of these syndromes sub-entities. In the present opinion the immunobiology of MMF was being reviewed. The molecular autoimmune mechanisms can be as follows; concurrent release of alum nano-molecules are taken up by macrophage persist in, combine with cellular proteins forming metalloprotein. It is now modified cellular protein in a modified macrophage which have DC marker, but still of macrophage morphology. Metalloprotein, when being extracellular on cellular burst or on diffusion to extracellular space will reach immune cells, in presence of; chronic induction, pathogenic allele, the HLA DR1 01 and the affected tissue microenvironment. Molecular mimicry, antigen bystander and/or epitope spreading response may operate and autoimmune tissue changes happened within continuum of granulomatous lesion developed in skeletal muscle at the injection site. Modified macrophage may migrate to regional lymph node and spleen the finally reach the brain. As a result, disturbance occurs in skeletal muscle functions and in brain cognition function.

Anti-N Antibody Reacting at 37°C: An Unusual Reaction in Antibody Screening in a 20-Year-Old Male Liver Donor

Muhammad Shayan Ashfaq — 2025-04-29

Anti-N antibodies usually possess cold-reactive properties which make them clinically insignificant and are mostly classified as naturally occurring IgM antibodies. These antibodies sometimes trigger reactions at body temperature (37°C) or in the anti-human globulin phase resulting in serious medical outcomes such as delayed hemolytic transfusion reactions or hemolytic disease of the newborn. This case shows an extraordinary naturally occurring anti-N antibody which was detected in a 20-year-old male liver donor during standard antibody testing because of its unexpected reactivity at 37°C. The absence of any previous blood transfusions or medication use in the patient made this case stand out as particularly intriguing. The antibody identification was successful following the 'pre-warm' technique implementation while antigen phenotyping validated it as an IgG-type anti-N antibody. This medical case demonstrates the critical importance of recognizing unusual antibody responses during blood transfusions and organ transplants because uncommon reactions may lead to serious consequences.

Symptomatic Multiple Myeloma in the Second Trimester of Pregnancy: A Case Report

Hacene Meriche — 2025-09-15

Multiple myeloma (MM) in pregnant women is a rare disease characterized by clonal proliferation of plasma cells producing monoclonal immunoglobulin, which suppresses the normal production of other antibodies and weakens the maternal immune response. Plasma cells release inflammatory cytokines (IL-6, TNF-α, IL-1β) that promote their survival and bone destruction. During pregnancy, maternal immunity shifts towards complex tolerance with decreased Th1 inflammatory responses, Th2 predominance, and increased regulatory T cells, which often masks MM and complicates its management. Treatment is generally deferred until after delivery to protect the fetus, with the VTD protocol then used to control the disease by reducing plasma cell proliferation and inflammation. This case illustrates the importance of simple tests such as serum protein electrophoresis in diagnosing unexplained anemia during pregnancy, and highlights the need for immunological monitoring and a multidisciplinary approach to optimize maternal and fetal prognosis.

Preclinical Immunogenicity of Capsule and Outermembrane Proteins of a Local Neurotropic Isolate of Hemophilus Infleunzae B in a Lapin Model

Ibrahim M S Shnawa — 2025-02-06

The preclinical immunogenicity of capsule C and outer membrane protein OMP of human neurotropic isolate of Hemophilus influenzae b HIB in a lapin model is being reported. Hemophilus influenzae b is gram negative, short rods, encapsulated bacterium, microaerophilic, fastidious, need X and V factor for growth with six capsular serotypes. Among which serotype b was the dominant. Itis associated with human pyogenic respiratory and meningeal infections. The C and OMP were separated, purified, and characterized. Then, quantfied to the rate of 3 mg/m L and 2.27 mg/mL accordingly. Both of the preparations were used as test antigens for the invitro use and for speific immune priming of rabbits. Cell free culture filtrate of test isolate was prepared and used as a skin sensitin in DTH test. Rabbits were were preconditioned with CFA adjuvant for two weeks then specific immune primed using multisite multi-injection protocols. Capsule immunogen induce leukocyte stimulatory factor cytokines. Four to six folds rise both titres and concentrations of anti capsular precipitins and anti OMP hemagglutinins were noted. Both C and AMP are proved to be lapin immunogens stimulate humoral immune responses at both systemic and mucosal immune compartments. These findings may forms the background information and be an integral part of preclinical and clinical development and production of local H. infleunzae b systemic and/or mucosal vaccines. Which could be valid on approval for local mass vaccination against childhood meningitis in this area.

Endotyping Cellular and Humoral Immunoreactivity against Pollen and Citrus Fruits in Patients with Non–IgE-mediated Rhinoconjunctivitis

Celso Eduardo Olivier — 2025-02-20

Background: Allergies to citrus fruits are often associated with pollinosis due to cross-reactivity among pollen and food allergens (fruit-pollen syndrome) displayed in patients with several conditions, such as allergic rhinoconjunctivitis.

Aim: To evaluate the potential of the Tube Titration of Precipitins (TTP) and the Leukocyte Adherence Inhibition Test (LAIT) to discriminate cellular and humoral immunoreactivity against two Citrus spices (orange and lemon) and a pollen extract in patients with non–IgE-mediated allergic rhinoconjunctivitis.

Study Design: We retrospectively examined the medical charts of two cohorts of patients clinically diagnosed with non–IgE-mediated rhinoconjunctivitis with clinical suspicion of hypersensitivity against Citrus spices and pollen, who were investigated with the help of TTP or LAIT, simultaneously tested against individual extracts of orange, lemon and pollen.

Methodology: The registered results of TTP and LAIT were distributed in ranges through a cascade distribution chart to outline the variability of the results. Dispersion graphs plotting the results of LAIT between the results of each pair of allergens were presented. The statistical significances were calculated.

Results: The TTP for the pollen, orange, and lemon extracts showed a distribution concentrated on the higher dilutions, precluding an adequate differentiation among patients’ immunoreactivities. On the contrary, the LAIT results showed a wide distribution of results, demonstrating a better potential to differentiate patients and predict hypersensitivity. While the TTP results showed a slight correlation between the paired tests (Pearson’s correlation coefficient between r = 0.007 to 0.11), the LAIT results demonstrated a significant moderate correlation between the paired assays, projecting a better potential to predict cross-reactivity among the allergens (Pearson’s correlation coefficient between r = 0.43 to 0.56).

Conclusion: Our preliminary results support that the TTP and LAIT performed with orange, lemon, and pollen extracts can potentially discriminate diverse degrees of humoral and cellular immunoreactivity in non–IgE-mediated allergic rhinoconjunctivitis patients.

Immunoreactivity to Cocoa and Nickel in Atopic and Allergic Contact Dermatitis

Celso Eduardo Olivier — 2025-04-05

Background: Cocoa is one of the foods more consistently associated with high nickel content, a metal that functions as a hapten responsible for various non–IgE-mediated symptomatic hypersensitivities.

Aim: The present study is a proof-of-concept that hypothesizes that LAIT and the TTP may differentiate diverse degrees of cellular and humoral immunoreactivity against cocoa extract and a nickel solution, as well to verify some sort of cross-reactivity between them in patients suffering from non–IgE-mediated Atopic and Allergic Contact Dermatitis.

Methodology: We examined the medical charts of two cohorts of patients clinically diagnosed with Intrinsic Atopic Dermatitis and Allergic Contact Dermatitis, who were simultaneously investigated with cocoa extract and nickel solution with the help of TTP or LAIT. The registered results of the semi-quantitative serum TTP against cocoa extract and nickel solution, as well as the registered results of the Leukocyte Adherence Inhibition (LAI) percentage promoted by the ex vivo challenges against a cocoa extract and a nickel solution, were distributed in ranges through a cascade distribution chart to outline the variability of the results inside the cohorts.

Results: The mean for the TTP for the cocoa extract was estimated at 1:385; the median at 1:512; and the SD at 1:180. The mean or the TTP for the nickel was estimated at 1:309; the median was 1:256; the SD was estimated at 1:199. The mean for for the Leukocyte Adherence Inhibition (LAI) the cocoa extract was 51.9%; the median was 56%; the SD was 26.3%. The mean for the LAI for nickel solution was 33%; the median was 33%; the SD was 26,6%. The Pearson correlation indicated that there is a significant medium positive relationship between TTP results between Cocoa (x-axis) and Nickel (y-axis), r(98) = .335; p < .001. The Pearson correlation indicated that there is a significant medium positive relationship between LAIT results between Cocoa (x-axis) and Nickel (y-axis), r(98) = .425; p < .001.

Conclusion: The results demonstrated a more significant immunoreactivity from the tests performed with cocoa extract than obtained with the nickel solution. These findings state that cocoa possesses other allergens responsible for cellular immunoreactivity besides nickel. This means that if a patient presents cellular immunoreactivity against cocoa, he/she will not necessarily present immunoreactivity against nickel; however, reciprocation is less probable.

Frequency and Patterns of Cardiac Involvement in Systemic Lupus Erythematosus

Esmat Esam Shaker — 2025-04-23

The aim of the study was to determine the prevalence of myocardial and circulatory complications among lupus patients, such as pericarditis, heart failure, endocarditis, ventricular dysfunction, and Myocarditis. It was also to assess the association of lupus with increased myocardial injury and to evaluate therapeutic (choriokinin, corticosteroids, and glucocorticoids) interventions to reduce the complication of cardiovascular disease.

This study focused on the immunological aspect of the effect of immunosuppressive therapy in systemic lupus erythematous (SLE), specifically choriokinin, corticosteroids, and glucocorticoids (GCs), on the exposure of cardiovascular disease. The study period extended from 2022 to early 2024 and relied on the results of screening of 88 SLE patients and a control group of 85 patients. The causes of heart damage in SLE patients were identified to assess the relationship with disease activity, duration, and rheumatic treatment. Previously, we first determined N_terminal prohormone of brain natriuretic peptide (NT_proBNP) levels in SLE patients not receiving specific rheumatic treatment and identified a relationship between biomarker and immunological marker concentrations of SLE activity (increased serum levels of anticardiolipin IgG, anti_dsDNA, antinuclear antibodies, and decreased complement C4) and markers reflecting impaired kidney function (Nasonov, 2010, Kim, et al., 2017). Corticosteroids are effective in preventing the progression of SLE and increasing patient survival, while reducing the exposure of atherosclerosis and thrombosis (Nasonov, 2010, Tan, et al., 1982, Hochberg, 1997) and hypercholesterolemia (Kim, et al., 2017, Petri, et al., 2012), ultimately reducing a exposure of cardiovascular disease at SLE patients, despite isolated reports of cardiac toxicity (Hochberg, 1997).

Noticed a statistical difference between the two groups in NT_proBNP, as it was shown that the second group had a lower NT_proBNP result 0.05 than the first group, and the same applies to Anti_JO1, which gives us evidence beyond doubt that immunosuppressive treatments work positively in treating heart muscle diseases resulting from lupus.

Endotyping Cellular and Humoral Immunoreactivity against Formaldehyde in Patients with Atopic and/or Contact Dermatitis

Celso Eduardo Olivier — 2025-04-25

Background: Several publications report that formaldehyde is responsible for hypersensitivity reactions in patients with contact dermatitis, as diagnosed by "in vivo" provocation tests. There is no standardized lab exam that can endotype the mechanisms responsible for these phenotypes,

Aim: To evaluate the potential of the Tube Titration of Precipitins (TTP) and the Leukocyte Adherence Inhibition Test (LAIT) to discriminate and endotype cellular and humoral immunoreactivity against formaldehyde in patients with contact dermatitis.

Methods: We retrospectively examined the medical charts of two cohorts (n = 100, each) of patients diagnosed with atopic dermatitis and/or contact dermatitis with clinical suspicion of formaldehyde hypersensitivity, who were investigated with the help of TTP or ex vivo challenge tests monitored by LAIT against formaldehyde. The registered results were distributed in ranges through cascade distribution charts. The statistical characteristics of these cohorts were calculated.

Results: TTP showed a distribution concentrated over the more diluted titrations with no negative result. The mean was estimated at 1:385; the median at 1:512; and the standard deviation at 1:166. The LAIT results demonstrated a wide range. The LAI ranged from 0% to 100%. The mean was 57.5%; the median was 65.5%; the standard deviation was 37.4%.

Conclusion: Our preliminary results support that the TTP and LAIT performed with formaldehyde solution may discriminate diverse degrees of humoral and cellular immunoreactivity in patients suffering from atopic and/or contact dermatitis. By evaluating the utility of TTP and LAIT as diagnostic tools, the study provides preliminary evidence for endotyping immunoreactivity, which could advance precision medicine in allergy management. The findings may guide clinicians in identifying hidden formaldehyde exposure in products and inform safer therapeutic strategies for sensitized patients. It is worthwhile conducting more in-depth studies to evaluate the usefulness of TTP and LAIT in endotyping non–IgE-mediated hypersensitivity to formaldehyde.

Clinical Profile and Analysis of Biological Markers (Fecal Calprotectin and CRP) during Relapse of Inflammatory Bowel Diseases in a Population of Adults

Asma Nassar — 2025-05-05

Inflammatory bowel diseases (IBD) are increasingly common pathologies, affecting both adults and children. This study investigates the clinical and epidemiological characteristics of IBD among patients at the gastroentero-hepatology department of Annaba University Hospital. Conducted from February 2023 to September 2024, the prospective descriptive analytical study included 77 patients diagnosed with IBD, focusing on the role of biological markers, specifically C-reactive protein (CRP) and fecal calprotectin (FC), in non-invasive disease assessment.

Inclusion criteria were based on clinical, endoscopic and histological assessments. Demographic data, clinical manifestations, CRP and FC levels were analyzed.

Among the 77 patients, 53 patients or 68.9% had Crohn's disease (CD), while 24 patients or 31.1% suffered from ulcerative colitis (UC). The most prevalent symptoms were abdominal pain and chronic diarrhea. Among CD patients, ileal involvement was common in 21 cases (39.62%) with 25 cases (32,47 %) experiencing complications

The study found that 34 or 46.57% of patients had elevated CRP levels, with a higher prevalence in those with CD compared to UC. A statistically significant association was observed between CRP levels and IBD type.

Additionally, the analysis revealed that among patients experiencing relapse, 20 cases or 52.63% had positive FC results, compared to 14 cases or 35.9% in remission, indicating a significant correlation between relapse status and FC levels (P=0.018). However, no significant association was found between relapse status and CRP levels, although a significant difference in mean CRP levels between active and remission states in UC was noted (P=0.03). A weak positive correlation (r =0.12) between CRP and FC during active phases was also identified.

The findings underscore the clinical and epidemiological profile of IBD in this population, highlighting the importance of FC as a valuable marker for monitoring disease activity and relapse status in IBD patients.

Serum Levels of TNF- α, IL-10 and Albumin in Female Patients with Post-Surgical Wound Infection in Asaba Delta State, Nigeria

Ehiaghe, F.A. — 2025-06-11

Post-operative wound infections (POWIs), sometimes referred to as post-surgical wound infections (PSWIs), are a common complication following surgery. Surgeries frequently elicit a variety of immunological responses subsequent to tissue damage and incision which may hinder wound healing and infection resolution leading to poor patient outcome. This cross-sectional study assessed the serum levels of TNF-α, IL-10 and albumin in female patients with post-surgical wound infection in Asaba Delta State, Nigeria. Twenty-five (25) patients with PSWIs and 25 apparently healthy individuals (control group) were recruited by random sampling method. Four millilitres (4 ml) of venous blood samples were collected for the determination of serum TNF-α, IL-10 and albumin levels. TNF-α and IL-10 levels were estimated with a sandwich enzyme-linked immunosorbent assay, whereas serum albumin was assessed with the Bromocresol green (BCG) method. The data obtained was analyzed using an independent t-test and Pearson correlation, with a p-value of <0.05 indicating statistical significance. The mean serum TNF-α (143.44 ±7.35 Vs 37.32 ±8.92; p = 0.001) and IL-10 (27.52 ±7.77 Vs 17.12 ±6.23; p = 0.001) levels were significantly higher while serum albumin level was significantly lower (34.14 ±5.43 Vs 40.19 ±3.38; p = 0.001) in the female patients with PSWIs than in the control group. However, no significant correlation was observed between the levels of TNF-α Vs albumin and IL-10 Vs albumin (p>0.05). The elevated levels of pro-inflammatory cytokine TNF-α may lead to adverse patient outcomes by hindering wound healing and slowing infection resolution.

Endotyping Cellular and Humoral Cross-reactivity among Canine, Feline, and Swine Allergens in Patients with Allergic Multimorbidity

Celso Eduardo Olivier — 2025-07-03

Background: The cat-pork syndrome and the cross-reactivity between cat dander and dog dander are particular situations associated with the allergic multimorbidity phenotypes. The perception of this cross-reactivity must benefit the allergist dealing with these conditions.

Aim: To evaluate the capacity of the Tube Titration of Precipitins (TTP) and the Leukocyte Adherence Inhibition Test (LAIT) to discriminate cellular and humoral immunoreactivity against cat fur and dog fur extracts as well as pork meat extract in patients with non–IgE-mediated multimorbidity phenotypes.

Study Design: We examined retrospectively the medical charts of two cohorts of patients clinically diagnosed with non–IgE-mediated multimorbidity allergic phenotypes related to inhalation or contact with cat fur, dog fur, and/or consumption of pork meat, who were investigated with the help of TTP or LAIT.

Methodology: The correlation between the paired assays was calculated using Pearson's methodology and demonstrated by dispersion graphs.

Results: Pearson's correlation indicated a significant positive relationship between the cat fur and dog fur extracts in LAIT results: r (98) = 0.395, p-value < 0.001. The paired-t test indicated a significant difference between the TTP results of cat fur and pork meat extracts (p-value = 0.009). Pearson correlation analysis indicated a non-significant, negative relationship between the TTP results of cat fur and pork meat (p-value = 0.644). The paired t-test indicated a significant difference between the TTP results of dog fur and pork meat extracts (p < 0.001).

Conclusion: The preliminary results suggest that the TTP and LAIT may discriminate between diverse humoral and cellular immunoreactivity levels in patients with various allergic phenotypes, as observed in cat and dog fur and pork meat extracts. A significant association was found between the immunoreactivity of cat fur and dog fur. There was no clear association between pork meat and fur immunoreactivity.

Endotyping Cellular and Humoral Cross-Reactivity between Blomia tropicalis and Farfantepenaeus brasiliensis in Patients with Allergic Multimorbidity

Celso Eduardo Olivier — 2025-07-03

Background: Panallergens, such as tropomyosin, produce cross-reactivity between indoor allergens and food allergens, including the house dust mite Blomia tropicalis and the Brazilian pink shrimp Farfantepenaeus brasiliensis, and are responsible for the clinical symptoms present in patients with allergic multimorbidity phenotypes.

Aim: To evaluate the potential of the Tube Titration of Precipitins (TTP) and the Leukocyte Adherence Inhibition Test (LAIT) to discriminate and correlate cellular and humoral immunoreactivity against protein extracts of B. tropicalis and F. brasiliensis in patients with non–IgE-mediated allergic multimorbidity phenotypes.

Study Design: We examined retrospectively the medical charts of two cohorts of patients clinically diagnosed with non–IgE-mediated allergic multimorbidity phenotypes related to inhalation or contact with house dust and/or consumption of shrimps, who were concomitantly investigated for these allergens with the help of TTP or LAIT.

Methodology: The registered results of the TTP and LAIT against protein extracts of B. tropicalis and F. brasiliensis were distributed in ranges through cascade distribution charts. The correlation between the paired assays was calculated using Pearson's methodology and demonstrated by dispersion graphs.

Results: The TTP for the B. tropicalis extract showed a distribution concentrated on the higher dilutions. The mean was 1:353; the median was 1:256; the standard deviation was 1:163; the mode was 1:512 (appeared 49 times). The TTP for the F. brasiliensis extract showed a distribution concentrated on the higher dilutions. The mean was 1:380; the median was 1:512; the standard deviation was 1:157; the mode was 1:512 (which appeared 57 times). The LAIT for the B. tropicalis extract showed a wide distribution range of results. The LAI ranged from 0% to 100%. The mean was 49.8%; the median was 51.5%; the standard deviation was 30.0%; the mode was 0% (appeared eleven times). The LAIT for the F. brasiliensis extract showed a wide distribution range of results. The LAI ranged from 0% to 100%. The mean was 55%; the median was 56%; the standard deviation was 28.8%; the mode was 0% (appeared five times). There was no significant correlation between B. tropicalis and F. brasiliensis when analyzed by TTP or LAIT results.

Conclusion: Our preliminary results suggest that the TTP and LAIT may reveal humoral and cellular immunoreactivity in patients with allergic multimorbidity phenotypes using protein extracts of B. tropicalis and F. brasiliensis.

Endotyping Cellular and Humoral Cross-Reactivity Against Chicken Meat and Egg Yolk in Non-IgE-Mediated Food Protein-Induced Gastrointestinal Allergies

Celso Eduardo Olivier — 2025-08-09

Background: Non-IgE-mediated food protein-induced gastrointestinal allergies (FPI-GIAs) are poorly understood, although IgE-mediated hypersensitivities have been extensively described. Patients with poultry meat allergy may present several phenotypes regarding clinical presentations and a wide range of symptom severity, suggesting the existence of several endotypes underlying their diseases.

Aim: To evaluate the potential of the Tube Titration of Precipitins (TTP) and the Leukocyte Adherence Inhibition Test (LAIT) to discriminate cellular and humoral immunoreactivity against chicken meat extract and chicken egg yolk extract in patients with non–IgE-mediated gastrointestinal food protein-induced allergic phenotypes.

Study Design: We examined retrospectively the medical charts of two cohorts of patients clinically diagnosed with non–IgE-mediated gastrointestinal food protein-induced allergic phenotypes related to consumption of chicken meat and/or chicken egg yolk, who were investigated with the help of TTP or LAIT.

Methodology: The TTP and LAIT's registered results against chicken meat and chicken egg yolk extracts were distributed in ranges through a cascade distribution chart to outline the variability of the results within the cohorts. The Pearson correlation test was used to evaluate the correlation between the results obtained simultaneously with both food allergens.

Results: The LAIT for the chicken meat extract and egg yolk extract showed a wide distribution range of results. The TTP for the chicken meat and egg yolk extracts showed a distribution concentrated on the higher dilutions. The Pearson correlation test showed a non-significant positive correlation between LAIT for egg yolk and LAIT for chicken meat extract; r(98) = 0.156, p = 0.121. The Pearson correlation test showed a non-significant positive correlation between TTP for the egg yolk extract and TTP for the chicken meat extract; r(98) = 0.181, p = 0.072.

Conclusion: Our preliminary results support that the TTP and LAIT performed with chicken meat and egg yolk extracts may discriminate diverse humoral and cellular immunoreactivity degrees in patients suffering from food protein-induced gastrointestinal allergies. Despite no statistically significant quantitative correlation between the results, these findings may improve dietary guidelines for impacted individuals and contribute to creating diagnostic biomarkers.

Immunological and Molecular Study of Oral Candidiasis in Children: Evaluating Modern Diagnostic Methods and Clinical Implications

Hayder Abdul Hussein Abass — 2025-10-04

Oral candidiasis, caused predominantly by Candida albicans, represents one of the most common opportunistic fungal infections in pediatric populations. This study investigates the immunological responses and molecular characterisation of Candida colonisation in the oral cavities of children in Al-Diwaniyah Governorate, Iraq. A cross-sectional study was conducted between January and June 2025 in Al-Diwaniyah Governorate, Iraq. A total of 180 children (aged 2–6 years) were enrolled. All data were analysed using SPSS v26. Chi-square (χ²) test was applied to determine the association between C. albicans colonisation, environmental zone, and ECC status. A p-value < 0.05 was considered statistically significant. Employing a cross-sectional design, 180 children aged 2–6 years were sampled across urban, rural, and agricultural zones. Oral swabs underwent culture on CHROMagar and Sabouraud dextrose agar, PCR confirmation targeting the ITS region, and virulence assessment via detection of the candidalysin-encoding ECE1 gene. Salivary cytokine levels (IL-36, IL-22) were quantified using ELISA. Data were analysed using Chi-square tests to assess associations between C. albicans prevalence, environmental zone, and early childhood caries (ECC) status. We found a significantly higher carriage rate in urban (36.7%) compared to rural (30.0%) and agricultural (18.3%) zones (χ² = 7.89, p = 0.019). ECC-positive children exhibited elevated IL-36 and IL-22 levels (p < 0.01) and a higher frequency of ECE1 detection. These findings underscore the interplay between environment, host immunity, and fungal virulence, offering insights for improved diagnostics and targeted interventions. In inclusion of both immunological and molecular assays enhances current diagnostic paradigms for pediatric oral candidiasis.

The Role of Trained Immunity in Protection against Infectious Diseases: Epigenetic Reprogramming and Long-term Immune Responses

Okolie Lucy Janefrancis — 2025-05-03

Trained immunity, a concept introduced more than a decade ago, defines the non-specific memory capacity of innate immunity by epigenetic and metabolic reprogramming. It involves features of epigenetic and metabolic reprogramming of innate immune cells that induce long-term functional changes in host defense. This review explores the mechanisms and duration of trained immunity, as well as the therapies related to its potential in infectious diseases. A systematic literature search was conducted across PubMed, Google Scholar, and Web of Science for studies published between 2019 and 2025. Experimental and clinical studies on innate immune memory, epigenetic modifications, and metabolic pathways associated with long-term immune responses were selected as study criteria. The synthesized data was narratively summarized to assess key themes, including molecular mechanisms, sustainability, and translational applications. A total of eight studies were included in this review. The findings revealed that trained immunity is mediated by histone modifications, metabolic changes, and long-term myelopoiesis. Studies also show that immune training has varying durations, with effects lasting from weeks to months. Emerging therapeutic strategies will focus on vaccine enhancement, cancer immunotherapy, and sepsis management. However, challenges remain, including a lack of clinical validation, incomplete mechanistic understanding, and ethical concerns. Trained immunity is a promising approach to immunomodulation between innate and adaptive immunity. Future research should aim to conduct clinical trials, assess safety, and develop precision medicine approaches to efficiently utilize this concept in therapeutic applications.

The Role of Monocytes and Macrophages in the Pathogenesis of Non-AIDS Defining Events: Mechanisms and Therapeutic Implications

Samuel Adinoyi Adavba — 2025-06-06

Monocytes and macrophages play a pivotal role in the pathogenesis of HIV infection, contributing not only to viral persistence but also to the development of non-AIDS-defining events (nADEs) in People Living with HIV (PLWH). These innate immune cells act as long-lived viral reservoirs, driving chronic inflammation through persistent immune activation, oxidative stress, and tissue-specific damage. HIV-infected monocytes infiltrate tissues, including the cardiovascular system, liver, kidneys, and central nervous system, where they differentiate into macrophages and release pro-inflammatory cytokines (e.g., TNF-α, IL-6), reactive oxygen species (ROS), and matrix metalloproteinases (MMPs). These mediators promote endothelial dysfunction, fibrosis, and organ damage, underpinning conditions such as atherosclerosis, neurocognitive disorders, and hepatorenal disorder. Emerging evidence highlights the role of macrophage polarization (M1/M2 imbalance) and epigenetic modifications in sustaining inflammation despite antiretroviral therapy (ART). Understanding these mechanisms provides critical insights for developing targeted therapies, including immunomodulators (e.g., IL-6 inhibitors), antioxidant agents, and reservoir-elimination strategies. This review synthesizes current knowledge on monocyte/macrophage-driven pathogenesis in HIV-associated nADEs. It explores plausible novel therapeutic approaches to mitigate chronic inflammation and improve clinical outcomes in PLWH.

T Cell Exhaustion and Immune Dysfunction in Spontaneous Abortion: A Targeted Review

Williams Walana — 2025-07-15

Background: Immune tolerance is established between the foetus and the mother in normal pregnancies. However, this tolerance may be breached, resulting in undesired pregnancy outcomes such as spontaneous abortion, foetal anomalies, and maternal complications. Reported studies suggest a potential link between immune response and unplanned pregnancy termination. A comprehensive understanding of immune responses in pregnancy loss harbours the potential to control the associated mechanisms.

Objective: This review synthesised existing studies on T cell exhaustion (TCE) in spontaneous abortion and pregnancy complications.

Methodology: A comprehensive database search from Scopus, Google Scholar, PubMed, and Web of Science identified 21 eligible studies that reported original data on spontaneous abortion and pregnancy complications and TCE.

Results: The review has shown that TCE is common in spontaneous abortion, characterised by the upregulation of inhibitory receptors and a suboptimal or lack of T-cells to perform their normal functions, such as proliferation, cytokine production, and cytotoxicity. Decreased expression of PD-1, LAG-3 and Tim-3 may contribute to an enhanced inflammatory response. Increased proportions of Th1 and Th17 cells are associated with pro-inflammatory responses and decreased immune regulatory function, resulting from altered PD-1/PD-L1 expression, which may contribute to pregnancy loss. Decreased anti-inflammatory cytokines (TGF-β1, IL-10, and IL-4) promote an imbalanced homeostasis, which can lead to pregnancy loss. These anomalies are partly anchored on chronic antigen exposure, oxidative stress, and hormonal changes, phenomena frequently associated with recurrent spontaneous abortion or poor pregnancy outcomes.

Conclusion: Optimal modulation of immune response to control TCE may prevent or minimise the occurrence of spontaneous abortion and promote successful pregnancies.

Metabolomics Role in Health and Disease: Current Status and Future Directions

Godiya Peter Mamman — 2025-07-29

The field of metabolomics involves the high-throughput identification and measurement of all endogenous and exogenous low-molecular-weight (<1kDa) small molecules or metabolites in a biological system by analyzing the metabolome in cells, biofluids, tissues, or organisms. Metabolome-wide association studies (MWAS), metabolic phenotyping, single-cell epidemiologic population studies, precision metabolomics, and in combination with other omics fields like integrative omics, biotechnology, and bioengineering are some of the applications of metabolomics in health and disease scenarios. Metabolomics and its potential to enhance human health, along with its developments and implications for pharmacometabolomics, lifespan, cancer, and the exposome, are the main focus of this review. Metabolomic profiles will facilitate the development and improvement of therapeutic strategies to treat human diseases. Future years will see a rise in the application of metabolomics to drug development, aging, and disease monitoring and diagnosis. Its potential extends to food science, and environmental research. Through clinical metabolomics studies, which may also uncover diagnostic biomarkers that predict disease risk, cardiometabolic disorders can be better understood. Metabolomics is already being applied in biomedical settings to develop drugs by using acylcarnitines, phospholipids, genomes, and branch-chain amino acids that are specific to monitoring the emergence of metabolic diseases such as obesity and diabetes. Indicators derived from metabolomics should be evaluated for therapeutic efficacy and adaptability, and their optimal application in large clinical settings should be the focus of future research.

Epigenetic Dysregulation and its Role in Immune-Mediated Diseases

Fagbemi Oluwaseyi Ajibola — 2025-09-27

Immune-mediated diseases, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), multiple sclerosis (MS) and Inflammatory Bowel Disease (IBD: Crohn's Disease & Ulcerative Colitis) represent a significant global health burden characterized by a loss of immune tolerance and chronic inflammation. While genetic predisposition plays a crucial role, it does not fully account for disease pathogenesis, onset, or flare-ups. The emerging field of epigenetics provides a critical mechanistic link between genetic susceptibility and environmental triggers. This review synthesizes current evidence on how dysregulation of key epigenetic mechanisms, DNA methylation, histone modifications, and non-coding RNA expression, contributes to the breakdown of immune homeostasis. We detail the aberrant epigenetic landscapes in specific immune cell subsets (e.g., T cells, B cells, macrophages) across major autoimmune disorders. Furthermore, we explore the potential of epigenetic modifications as novel biomarkers for diagnosis, prognosis, and disease activity monitoring. Finally, we discuss the promising therapeutic avenue of "epigenetic therapy," repurposing existing drugs and developing new compounds to reverse pathogenic epigenetic marks and restore immune tolerance.

Human Immunodeficiency Virus Epidemic among People Who Inject Drugs and Female Sex Workers in North Africa: A Systematic Review

Ahmed A. M. Khalaf — 2025-04-18

Background: Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) remain major health problems worldwide, with high mortality and morbidity rates, particularly in developing countries. The United Nations Programme on HIV/AIDS (UNAIDS) reported that there were 38.4 million individuals globally who had HIV. Around 1.5 million new HIV infections were recorded in 2021, while approximately 650,000 individuals worldwide lost their lives due to AIDS-related illnesses. The prevalence of HIV in people who inject drugs (PWID) and female sex workers (FSWs) has not been widely investigated. Information on the epidemiology of HIV infection among PWID and FSWs in North Africa is limited. The aim of the present study was to review the status of the HIV epidemic among PWID and FSWs in North African countries by explaining HIV prevalence.

Methods: A comprehensive literature search was performed on studies related to the prevalence of HIV infection in PWID and FSWs published between 1990 and 2024 using search engines such as PubMed, Science-Direct, Google scholar. Reports that are entirely on North Africa were considered, including studies reporting HIV infection in high-risk groups, particularly PWID and FSWs, with the data organized into a customized database.

Results: A total of 3605 records were retrieved in the initial search, 10 relevant records HIV among PWID and FSWs were recognized and included in the study. The overall prevalence of HIV in PWID ranged from 0.15% to 87.1% and 0% to 15.7% in FSWs. Injection drug abuse and women engaged in sex work were commonly associated with HIV infection.

Conclusion: The findings of this study showed that the prevalence of HIV among PWID and FSWs in North Africa is high. PWID and FSWs has been identified as the dominant method of transmission in various North African countries like Libya, Egypt, Morocco and Tunisia.

The execution of initiatives designed to improve sanitation infrastructure, elevate educational standards, and enhance socioeconomic situations is crucial for decreasing the prevalence of HIV infections among PWID and FSWs.