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      Immunomodulatory effect of a proprietary polyherbal formulation on healthy participants: A single- blind, randomized, placebo- controlled, exploratory clinical study

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          Abstract

          Context:

          Clinical study for immunity.

          Aims:

          The present study aimed to assess the effect of proprietary polyherbal formulation (PPHF), labelled as Kofol immunity tablets (KIT) on innate and adaptive immune responses in healthy individuals, on the backdrop of COVID-19 pandemic.

          Settings and Design:

          Single-blind, randomized, placebo-controlled, exploratory study in institutional setting.

          Materials and Methods:

          Post Ethics Committee permission, screened healthy individuals of either sex aged 18–35 years were randomized to PPHF/Placebo for 2 months. Major assessment variables included peak expiratory flow rate (PEFR), questionnaire-based immune status, perceived stress, and quality of life (QOL) with immune-specific cell counts (CD4+, CD8+), cytokines (interferon gamma [IFN-γ], tumor necrosis factor-alpha [TNF-α], interleukin 10 [IL-10]), and oxidative stress in red blood cells (RBCs) (malondialdehyde (MDA), glutathione peroxidase [GPx]), done at day 60.

          Statistical Analysis Used:

          Mean ± standard deviation and paired/unpaired t-test for parametric data analysis while median (range) and Wilcoxon Rank sum test/Mann–Whitney test for nonparametric data analysis, were done. Categorical data was analyzed using Chi-square test. GraphPad InStat software, version 9 was used with p < 0.05, as the level of statistical significance.

          Results:

          Of 52 recruited, 28 individuals completed the study. PPHF significantly increased PEFR, improved immune status along with QOL compared to baseline. It also decreased perceived stress from moderate and severe grade to mild. Serum IFN-γ levels remained almost constant post-PPHF treatment. PPHF significantly decreased MDA and increased GPx in RBCs. Significant decrease and increase in TNF-α and IL-10, respectively, were seen in PPHF group. The safety parameters post-PPHF treatment remained within normal reference ranges.

          Conclusions:

          PPHF is an efficacious and safe formulation with immunomodulatory potential.

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          Most cited references36

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          Impact of COVID-19 and Lockdown on Mental Health of Children and Adolescents: A Narrative Review with Recommendations.

          HIGHLIGHTS • We conducted a narrative review of articles on mental health aspects of children and adolescents during the COVID-19 pandemic and lockdown. • Most studies are cross-sectional in nature. Findings show that quality and magnitude of impact is determined by vulnerability factors like developmental age, educational status, pre-existing mental health condition, being economically underprivileged or being quarantined due to infection or fear of infection. • There is a crucial requirement for planning longitudinal and developmental studies, and evidence based elaborative strategies to cater to mental health needs of the vulnerable children and adolescents during and after the pandemic by mobilising direct and digital collaborative networks.
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            Macrophage Cytokines: Involvement in Immunity and Infectious Diseases

            The evolution of macrophages has made them primordial for both development and immunity. Their functions range from the shaping of body plans to the ingestion and elimination of apoptotic cells and pathogens. Cytokines are small soluble proteins that confer instructions and mediate communication among immune and non-immune cells. A portfolio of cytokines is central to the role of macrophages as sentries of the innate immune system that mediate the transition from innate to adaptive immunity. In concert with other mediators, cytokines bias the fate of macrophages into a spectrum of inflammation-promoting “classically activated,” to anti-inflammatory or “alternatively activated” macrophages. Deregulated cytokine secretion is implicated in several disease states ranging from chronic inflammation to allergy. Macrophages release cytokines via a series of beautifully orchestrated pathways that are spatiotemporally regulated. At the molecular level, these exocytic cytokine secretion pathways are coordinated by multi-protein complexes that guide cytokines from their point of synthesis to their ports of exit into the extracellular milieu. These trafficking proteins, many of which were discovered in yeast and commemorated in the 2013 Nobel Prize in Physiology or Medicine, coordinate the organelle fusion steps that are responsible for cytokine release. This review discusses the functions of cytokines secreted by macrophages, and summarizes what is known about their release mechanisms. This information will be used to delve into how selected pathogens subvert cytokine release for their own survival.
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              Effects of stress on immune function: the good, the bad, and the beautiful.

              Although the concept of stress has earned a bad reputation, it is important to recognize that the adaptive purpose of a physiological stress response is to promote survival during fight or flight. While long-term stress is generally harmful, short-term stress can be protective as it prepares the organism to deal with challenges. This review discusses the immune effects of biological stress responses that can be induced by psychological, physiological, or physical (including exercise) stressors. We have proposed that short-term stress is one of the nature's fundamental but under-appreciated survival mechanisms that could be clinically harnessed to enhance immunoprotection. Short-term (i.e., lasting for minutes to hours) stress experienced during immune activation enhances innate/primary and adaptive/secondary immune responses. Mechanisms of immuno-enhancement include changes in dendritic cell, neutrophil, macrophage, and lymphocyte trafficking, maturation, and function as well as local and systemic production of cytokines. In contrast, long-term stress suppresses or dysregulates innate and adaptive immune responses by altering the Type 1-Type 2 cytokine balance, inducing low-grade chronic inflammation, and suppressing numbers, trafficking, and function of immunoprotective cells. Chronic stress may also increase susceptibility to some types of cancer by suppressing Type 1 cytokines and protective T cells and increasing regulatory/suppressor T cell function. Here, we classify immune responses as being protective, pathological, or regulatory, and discuss "good" versus "bad" effects of stress on health. Thus, short-term stress can enhance the acquisition and/or expression of immunoprotective (wound healing, vaccination, anti-infectious agent, anti-tumor) or immuno-pathological (pro-inflammatory, autoimmune) responses. In contrast, chronic stress can suppress protective immune responses and/or exacerbate pathological immune responses. Studies such as the ones discussed here could provide mechanistic targets and conceptual frameworks for pharmacological and/or biobehavioral interventions designed to enhance the effects of "good" stress, minimize the effects of "bad" stress, and maximally promote health and healing.
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                Author and article information

                Journal
                Perspect Clin Res
                Perspect Clin Res
                PCR
                Perspect Clin Res
                Perspectives in Clinical Research
                Wolters Kluwer - Medknow (India )
                2229-3485
                2229-5488
                Jul-Sep 2023
                22 May 2023
                : 14
                : 3
                : 130-138
                Affiliations
                [1]Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be University), Pune, India
                [1 ]Department of Kayachikitsa, College of Ayurveda, Bharati Vidyapeeth (Deemed to be University), Pune, India
                [2 ]Charak Pharma Private Limited, Mumbai, Maharashtra, India
                Author notes
                Address for correspondence: Dr. Supriya Bhalerao, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be University), Pune Satara Road, Dhankawadi, Katraj, Pune - 411 043, Maharashtra India. E-mail: supriya.bhalerao@ 123456gmail.com
                Article
                PCR-14-130
                10.4103/picr.picr_100_22
                10405535
                bd91f49f-37d1-4649-a172-83e2e5acf9ba
                Copyright: © 2023 Perspectives in Clinical Research

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 30 April 2022
                : 25 August 2022
                : 05 September 2022
                Categories
                Original Article

                Medicine
                cd4-cd8 counts,covid,immunity,inflammation,oxidative stress,peak expiratory flow rate
                Medicine
                cd4-cd8 counts, covid, immunity, inflammation, oxidative stress, peak expiratory flow rate

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