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Finding a vaccine that can last a long time and effective against viruses with high mutation rates such as SARS-CoV-2 is still a challenge today. The various vaccines that have been available have decreased in effectiveness and require booster administration. As the professional antigen presenting cell, Dendritic Cells can also activate the immune system, especially T cells. This ability makes dendritic cells have been developed as vaccines for some types of diseases. In SARS-CoV-2 infection, T cells play a vital role in eliminating the virus, and their presence can be detected in the long term. Hence, this condition shows that the formation of T cell immunity is essential to prevent and control the course of the disease. The construction of vaccines oriented to induce strong T cells response can be formed by utilizing dendritic cells. In this article, we discuss and illustrate the role of dendritic cells and T cells in the pathogenesis of SARS-CoV-2 infection and summarizing the crucial role of dendritic cells in the formation of T cell immunity. We arrange the basis concept of developing dendritic cells for SARS-CoV-2 vaccines. A dendritic cell-based vaccine for SARS-CoV-2 has the potential to be an effective vaccine that solves existing problems.

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Background COPD is one of the comorbidities in heart failure patients with a prevalence of around 10-41%. The mortality and morbidity increase in patients with concomitant HF and COPD. Case Description A-54-year-old man, smoker, complained dyspnea that worsen for 48 hours, orthopnea, worsening productive cough with thick phlegm for 1 week, diaphoresis, and fatigue. History of untreated COPD since 2014, dyslipidemia, heart attack, and hypertension since 2018. Examination: Obesity, HR 54x/min, RR 30 x/min, BP 140/90 mmHg, SpO2 96% on O2 4 lpm. JVP was increased, gallops, bilateral crackles, wheezing, and pre-tibial edema. WBC count was 15.000, Inferior OMI and LVH on ECG. Signs of pulmonary congestion, cardiomegaly, and increased Broncho-vascular pattern on chest X-ray. Echocardiography and cardiac marker testing were unavailable. The patient was diagnosed with ADHF and AECOPD. The patient was initially given furosemide IV, ramipril, spironolactone but didn’t improve. SABA-anticholinergic nebulization was added then and improved the symptoms. These medications were continued and added corticosteroid IV, antibiotics, aspirin in inward room. After 5 days of treatment, the patient improved, considered as outpatient and advised to control after 3 days. Discussion In the limited setting, manages patients with heart disease is challenging. History of untreated COPD, heart attack, hypertension, and dyslipidemia led the patient to this condition. There was no consensus in managing HF in the COPD population. Clinical consideration based on the dominant patient condition was suggested by some studies. This patient had significant improvement after combining diuretic, nebulization, and corticosteroid.

Aging process is related with the increase of free radicals numbers that will lead to destruction of body structures including penis by the degradation of smooth muscle and the increasing of collagen numbers. Moderate physical activity is prospected to have an antioxidant effect that will maintain the penis structure. Aim: The aim of this study it to determine that the physical activity can increase the ratio of smooth muscle and collagen in penis of aged mice. Methods: This study was experimental posttest only control group design. Fourteen 18-month old mice were divided into two group, control and test group. Swimming 30 minutes/day for 8 weeks was conducted on the test group. After 8 weeks experiment, Corpus cavernosum were then collected from the mice and stained with Sirius red staining. The penis preparation were examined under the microscope and analyzed with photoshop cs 6 to get the pixel amounts of smooth muscle and collagen. Results: The result shows the mean of smooth muscle and collagen ratio for control group is 0.156 ± 0.021 and 0.312 ± 0.005 for the test group. This result shows that there is a difference between the smooth muscle and collagen ratio between the control and test group (p < 0.05). The smooth muscle and collagen ratio is higher in the test group than the control group. Conclusion: The physical activity increases the smooth muscle and collagen ratio in penis of aged mice (Rattus norvegicus).