Opportunistic etiological agents causing lung infections: emerging need to transform lung-targeted delivery

Debnath, Sujit Kumar; Debnath, Mousumi; Srivastava, Rohit

doi:10.1016/j.heliyon.2022.e12620

Cited by 15 publications

(5 citation statements)

References 207 publications

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“…The number of patients in the CD4 < 350 cells/µL group of our study increases to 9 (out of 50 cases). These adjusted results sustain and confirm the idea of immunologic impairment of CMV infection in PLWH obtained in previous studies [23][24][25][26].…”

Section: Discussionsupporting

confidence: 90%

CMV and HIV Coinfection in Women from a Region in Eastern Europe

Halichidis,

Aschie,

Cozaru

et al. 2023

JPM

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(1) Background: Human cytomegalovirus (CMV) infection is one of the most frequent opportunistic infections in immunosuppressed patients. Romania has one of the highest incidences of patients living with human immunodeficiency virus (HIV) which determines an immunosuppressive state. The aim of this study was to establish the prevalence of CMV infection among women living with HIV in Southeastern Romania and also to evaluate and correlate antiretroviral therapy (ART) with CD4 level and CMV disease evolution. (2) Methods: Seventy women living with HIV from Southeastern Romania were screened for CMV infection using antigen quantification. Of these, 50 were included in the study. First, the patients filled out a questionnaire regarding social conditions and other associated diseases. Then, we explored the statistical correlations between the data and HIV status, CD4+ cell counts, viral load, and antiretroviral therapy (ART). (3) Results: Median age of the patients was 33 years. Twenty-nine cases were diagnosed with HIV after sexual life beginning and 21 before. Most of the patients had a CD4 level over 200 cells/µL. ART duration in the CD4 under 200 cells/µL group was a bit longer than that in the CD4 over 200 cells/µL group. Forty-one patients had undetectable viremia. CD4 average value in the lot of patients with undetectable viremia was 704.71 cells/µL and in the lot with detectable viremia was 452.44 cells/µL. Viremia values correlated negatively with CD4 level. A positive correlation between IgG CMV values and ART therapy length was identified. A negative significant correlation between values of IgG CMV and values of CD4 was identified. CD4 value correlated negatively with IgG CMV values and with CMV avidity. (4) Conclusions: IgG CMV values had a weak positive correlation with ART therapy length, and a negative statistically significant correlation with values of CD4. CMV avidity has a negative correlation with CD4 value.

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Section: Discussionsupporting

confidence: 90%

CMV and HIV Coinfection in Women from a Region in Eastern Europe

Halichidis,

Aschie,

Cozaru

et al. 2023

JPM

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“…There have been several advancements in pMDI technology, of which the replacement of chlorofluorocarbons (CFC) propellants with hydrofluoroalkane (HFA) propellants. This transition was quite essential as CFC propellants possessed "cold Freon" effect and relatively high throat deposition, causing cough and paradoxical bronchospasm in patients, thus leading to patient incompliance [40,41]. To control drug deposition, which frequently occurs with the formulation of ethanol-free HFA suspension, as well as to reduce drug and canister deterioration, pMDI canisters have been redeveloped.…”

Section: Pmdimentioning

confidence: 99%

“…There is a lesser possibility of oropharyngeal deposition since the soft mist leaves the nozzle at a speed that is approximately one-tenth that of an aerosol cloud released from a pMDI. To accomplish drug deposition, significant inspiratory flows are not necessary [41,58]. A good example is the Respimat Soft Inhaler, where more than 60% of the drug dose is contained in a fine-particle dose of 5.0 micromete, allowing a better inhalational drug delivery to the patient and a reduction in the nominal drug dose without any appreciable loss of pharmacodynamic effect or clinical efficacy [57,59,60].…”

Section: Soft Mist Nebulizersmentioning

confidence: 99%

Amelioration in Approaches for Enhanced Pulmonary Drug Delivery

CHOUDHARY,

PATIL

2023

Asian J Pharm Clin Res

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Pulmonary disorders including asthma, chronic obstructive pulmonary disorder (COPD), cystic fibrosis, and other severe conditions like cancer have indeed made pulmonary drug delivery systems, both, an area of interest as well as concern. The mortality rate, around 8%, has enabled researchers to develop novel technologies for efficient drug delivery and reduced side effects. As the drug delivery through inhalation involves two major influencing factors, that is, formulation type and the device used for inhalation, various strategies have been designed with an intent to upgrade the existing drug formulations and devices used. Apart from this, various targeting strategies including gene therapy and magnetic targeting so as to improve the target specificity of the administered drug in the regions of the pulmonary system have been developed. In spite of these advancements, pulmonary drug delivery appears to be challenging in terms of formulation design and animal model design as well as lack of availability of FDA-approved excipients for inhalation. Persistent efforts have been made by the researchers in combining various strategies to negate the drawbacks/limitations of pulmonary drug delivery so as to develop a drug delivery system with improved efficacy and negligible adverse effects.

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“…The solidification and discharge of fluid in the lung tissue characterizes pneumonia, a serious respiratory illness also known as a lower respiratory tract infection. Epidemiological studies have shown that, beyond bacterial and viral agents, various factors contribute to the incidence and severity of pneumonia, with environmental determinants playing a pivotal role [1,2]. These environmental factors include air pollution, exposure to tobacco smoke, and living conditions that predispose individuals to respiratory infections [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Childhood Pneumonia in Low- and Middle-Income Countries: A Systematic Review of Prevalence, Risk Factors, and Healthcare-Seeking Behaviors

Vaithilingan

2024

Cureus

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Childhood pneumonia is a major contributor to illness and death in children under the age of five globally. Despite advancements in medical science, the burden of pediatric community-acquired pneumonia (CAP) remains high, particularly in low-and middle-income countries. This systematic review aims to synthesize existing literature on the prevalence, risk factors, and healthcare-seeking behaviors associated with pediatric CAP to inform the development of targeted community-based interventions.An extensive search of various databases such as Medline, EMBASE, Web of Science, Cochrane, PubMed, PubMed Central, Helinet, SpringerLink, Google Scholar, and Biomed Central was performed, resulting in 65 potentially relevant studies. After a thorough evaluation process, 25 studies were selected for the final analysis. These selected studies offered valuable information on the epidemiology, risk factors, and healthcare-seeking behaviors associated with childhood pneumonia.The review revealed that environmental factors such as indoor air pollution, overcrowding, and exposure to tobacco smoke are significant risk factors for pediatric pneumonia. Additionally, socioeconomic factors, including poverty and a lack of access to clean water and sanitation, contribute to the vulnerability of children to this disease. Poor healthcare-seeking behaviors, driven by limited knowledge and awareness of pneumonia symptoms and treatment, further exacerbate the situation.The review also highlighted the critical role of vaccination, particularly against Haemophilus influenzae type b (Hib) and pneumococcus, in preventing pneumonia. However, gaps in vaccination coverage and challenges in accessing healthcare services remain barriers to effective pneumonia control.In light of these findings, the review recommends the implementation of community-based interventions that address the multifaceted determinants of pediatric pneumonia. These interventions should focus on improving environmental conditions, enhancing access to preventive measures such as vaccination, and promoting better healthcare-seeking behaviors through education and awareness campaigns. It is essential for healthcare providers, policymakers, and community members to collaborate in developing and implementing culturally appropriate and sustainable interventions. This cooperation aims to lessen the impact of pneumonia on children and their families.

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Opportunistic etiological agents causing lung infections: emerging need to transform lung-targeted delivery

Cited by 15 publications

References 207 publications

CMV and HIV Coinfection in Women from a Region in Eastern Europe

CMV and HIV Coinfection in Women from a Region in Eastern Europe

Amelioration in Approaches for Enhanced Pulmonary Drug Delivery

Childhood Pneumonia in Low- and Middle-Income Countries: A Systematic Review of Prevalence, Risk Factors, and Healthcare-Seeking Behaviors

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