Open Access Original Research Article

Knowledge, Attitude and Uptake of Hepatitis B Vaccine among Clinical Medical Students of a Tertiary Institution in Southeast Nigeria

N. C. Eze, E. C. Egba, J. E. Ogbanna, S. N. Nwamini, P. U. Nweke, J. S. Amasianya

Asian Journal of Immunology, Page 31-36

Background: Hepatitis B virus infection is a global public health problem especially in developing countries like Nigeria. Good knowledge of Hepatitis B virus, its infection and positive attitude by the public are key to the prevention of Hepatitis B infection The infection can be prevented with Hepatitis B virus vaccine. This study aimed at assessing the Knowledge, Attitude and Uptake of Hepatitis B virus vaccine among Clinical Medical Students of Ebonyi State University, Abakaliki.

Materials and Methods: The study is descriptive cross-sectional in design and comprised of 187 Clinical Medical Students selected by consecutive sampling technique. Data was collected using pretested, semi-structured, self-administered questionnaires and analysed using Statistical Package for Social Sciences (SPSS) for Microsoft window version 22.

Results: The mean age of the respondents was 25.6 ± 3.2 years. About 80.7% of the respondents (Clinical Medical Students of EBSU) had good knowledge of HBV infection. Also, all the respondents (100%) had good knowledge of HBV vaccine. Nearly, 74.3% of our respondents were concerned about being infected with HBV. However only 55.6% of them had tested for HBV surface antigen. Also 84.2% of the respondents said they would like to be vaccinated. Although the participants in this study had positive attitude towards HBV vaccination, only 29.4% of the respondents had received HBV vaccine. Most of those vaccinated received incomplete doses of the vaccine while only very few received complete doses of the vaccine.

Conclusions: There should be sustained health education to Clinical Medical Students on the need to be vaccinated against HBV and also HBV vaccine should be made free to the general public so as to remove the challenge created by cost.

Open Access Review Article

Molecular Pathogenesis, Clinical Efficacy and Safety of Therapeutics Used in the Treatment of Osteoarthritis

Shaayau Shehu, Abdulaziz Umar Kurya, Kamal Murtala Farouq, Abdulhakim Umar Toro

Asian Journal of Immunology, Page 1-10

Osteoarthritis (OA) also known as degenerative joint disease, is the most common form of arthritis which affects all the tissues of the joint, including the cartilage, bone, ligaments, and muscles. It can develop in any number of joints, but most commonly affects the knees, hands, and hips. OA is characterized by progressive cartilage deterioration, subchondral bone remodeling, loss of joint space, marginal osteophytosis, and loss of joint function. The prevalence rate is estimated to about 242 million people in the world. OA results from the disruption of the balance between synthesis and degradation of extracellular matrix components by the chondrocyte in combination with increased uncompensated chondrocyte apoptosis. It is increasingly understood that ageing contributes to the development of osteoarthritis by working in conjunction with a variety of other factors, both intrinsic and extrinsic to the joint. Several abnormalities in components of the healthy joints such as meniscus, articular cartilage, subchondral bone and synovial membrane results to manifestation the disease. In an attempt to discover new emerging therapeutic target, certain diagnostic strategies are applied such as X-ray, Ultrasonography, Anthroscopy and Magnetic resonance imaging to have a deep insight on its effect and monitor the progression of the disease. Interestingly, many clinical researches proved efficacy of Therapeutics such as Adamulimab which block TNF-α and plays significant role in the pathogenesis of the disease, Diacerein which inhibit interleukin- 1 β, natural anti-inflammatory compound such as curcumin, bisphosphonate drugs such as alendronate and risedronate and anti-osteoporotic drugs such as strontium ranelate, chondroitin sulfate, intraarticular hyaluronic acids and glucosamine sulfate are reported to be effective and safe in the management of the disease.

Open Access Review Article

Acute Immune Mediated Lung Injury in COVID 19: A Review

A. S. V. Prasad

Asian Journal of Immunology, Page 11-30

There are many gaps in our present understanding of the of the SARS CoV 2 related matters like its PAMPs,(pathogen associated molecular patterns),antigenic profile, immune evasive mechanisms and also other host related matters, like PRR s(pattern recognizing receptors) and the deranged host defense mechanisms, that cause self-damage. These constraints come in way of accurately delineating the pathogenesis of COVID19 lung disease. Hence is the speculative nature of any concept trying to explain the same. An integrated approach is embarked upon, taking into account the known clinical, radiological, laboratory, and autopsy findings, in search of clues that may suggest a possible mechanism, that explains the underlying lung damage in COVID 19. It is seen that no single mechanism or syndrome could explain fully the pathology and pathogenesis of lung damage in COVID19. Hence, multiple mechanisms consistent with each known facet of the pathology are explored. Thus the inflammatory damage of the alveolar tissue is sought to be explained by the3 complement activation pathways i.e. the alternative pathway, the MBL/Lectin pathway/ and Tissue factor/extrinsic pathway(of the classical complement activation), the contact cascade involving the kallikrein-kinin pathway, and the cytokine mediated pro and anti inflammatory mechanisms. The vascular pathology like hemorrhages and small blood vessel micro-thrombi as observed at autopsy , are viewed from the point of view of simple activation of the coagulation cascade to small vessel vasculitis (leucocytoclastic vasculitis) and coagulative micro angiopathy. Besides, the role of TM-PC-EPCR SYSTEM (Thrombomodulin-Protein C-EPCR System) is explored. The points in favour and against of each of the above are discussed.The central role played by the macrophage polymorphism is focused in the context of the simultaneous presence of active inflammation in the lung tissue and the interstetium and healing by interstitial fibrosis, seen in the lungs of COVID 19 patients. The role played by the other humoral and cellular elements of both innate and adaptive immunity is briefly reviewed. The uniqueness and diversified features of COVID 19 lung pathology, suggests two things - that the immune mediated damage seems more probable than could be explained by the viral infectivity and that the pathology seems to stem from a mixture of different underlying and overlapping syndromes. Hence, the author prefers to call all the COVID 19 related features of lung pathology as “Acute immune mediated Lung injury". (AILI) than trying to bunch them under a single syndrome.

Open Access Review Article

Role of Inflammatory Cytokines in the Pathogenesis of Rheumatoid Arthritis and Novel Therapeutic Targets

Shaayau Shehu, Abdulaziz Umar Kurya, Usama Aliyu, Dinesh C. Sharma

Asian Journal of Immunology, Page 37-46

Cytokines are low molecular weight secreted proteins that mediate and regulate immune responses, inflammation and hematopoiesis; they act by autocrine, paracrine, endocrine and antagonistic mode of actions. cytokines have strong correlation with autoimmune disease, the most prominent among others is rheumatoid arthritis (RA) which targets synovial joints, and often accompanied by an array of extra-articular manifestations which are ultimately major predictors of increased morbidity and mortality, RA affect about 1% of the world population and about 0.6% of the American population with annual incidence estimated to about 40 per 100,000 individuals and mostly women. Persistent inflammation endorsed by major pro-inflammatory cytokines such as Interleukins (IL-1, IL-6) and tumor necrosis factors (TNF-α) and imbalance between the pro-inflammatory and anti-inflammatory cytokines is the main pathogenesis of RA. Evidence suggests that interaction between antigen-presenting cells and CD4+ T helper cells is involved in the induction of inflammation in RA. Continuous recruitment and activation of macrophages and monocytes occur with the recruitment of pro-inflammatory cytokines, specifically TNF-α, IL-1 and IL-6 into the synovial cavity resulting to loss of cartilage and bone erosion. These activated immune cells stimulate angiogenesis, which explains increased vascularity found in the synovium of patients with RA. Novel therapeutic targets are developed to minimize the morbidity rate, the use of TNF-α blockade drugs such as Adalimumab, Etanercept and Infliximab is widely approved globally with more precise therapeutic effect on inflammation. As the IL-1 plays a critical role in joint damage by facilitating the degradation of cartilage which leads to RA, the use of interleukin-1 receptor antagonist drugs such as Anakinra suppresses RA by inhibiting the release of IL-1, likewise, the use of anti-IL-6 receptor agent such as tocilizumab has become a major resource for the treatment of RA.

Open Access Review Article

Role and Effects of Micronutrients Supplementation in Immune System and SARS-Cov-2(COVID-19)

Akibul Islam Chowdhury

Asian Journal of Immunology, Page 47-55

COVID-19 is a serious disease caused by the virus SARS-CoV-2 which is easily transmitted to humans. There are no vaccines or drugs discovered yet to control its transmission and prevent the disease. In that case, it is important to find the methods of preventing and controlling it. To fight against the virus a well-functioning immune system is necessary. The immune system is always active but if an individual becomes infected then the activity of immune system is enhanced to fight against the virus and recover the body from infection. Adequate intake of micronutrients through diet (vitamins A, B-complex, C, D and zinc, selenium, copper, iron) can help to boost up the immune system as each of the nutrients named above has roles in supporting antiviral and antibacterial defense. Although the supplementation of micronutrients can be given, it is necessary to provide the right amount of supplements after assessing the nutritional status of each individual as supplementation of micronutrient have some adverse effects. Therefore, it is recommended to follow a healthy diet to prevent COVID-19 and also assess the nutritional status of COVID-19 patients before prescribing treatments.