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IJCRR - 13(21), November, 2021

Pages: 07-13

Date of Publication: 09-Nov-2021


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Immuno-Metabolic Aspects of Pathological Processes

Author: Zemskov Vladimir M, Zemskov Andrey M, Pronko Konstantin N, Neymann Victoria, Demidova Valentina S, Zemskova Veronika A, Barsukov Alexander A, Kozlova Maria N, Shishkina Nadezhda S, Revishvili Amira

Category: Healthcare

Abstract:On an extensive panel of purulent-inflammatory, bronchopulmonary, and various other human diseases, the organismic and immuno-metabolic role of low-molecular-weight RNA, the state of oxidation of lipids, proteins, factors of the antioxidant system, and metabolic syndrome were studied. The relationship between clinical and laboratory parameters (haematological, biochemical, neurological, endocrine, and immune) has been analyzed. The effectiveness of modulators and antioxidants is discussed, and the pronounced laboratory-clinical activity of the drug combination is shown.

Keywords: Metabolic syndrome, Modulators, Antioxidants, Laboratory markers, Immuno-metabolic disorders, Targeted correction

Full Text:

INTRODUCTION

Immuno-metabolic disorders are a probable universal element of the pathogenesis of a wide range of diseases. It seems relevant to study these mechanisms and the possibilities of their targeted correction.1

FUNCTIONAL RELATIONSHIP OF IMMUNO-METABOLIC MECHANISMS

Nucleic acid exchange

Its state is a marker of the severity of pathological processes and regulation of immune reactivity.2 So, in the acute period of nonspecific bronchopulmonary diseases in patients, accumulation occurs in the blood, and in lymphocytes, the synthesis of nucleic acids (NA) is stimulated with a decrease in parameter values ??in the stage of remission and after effective therapy. An indirect confirmation of the stated pattern is the fact of an increase in urinary excretion of the components of NA guanine, uracil, cytidine, and thymine in children during the period of asthma attacks in the relatively calm period of bronchial asthma. In patients with the absence of normalization of nucleic acid metabolism, there was no clear recovery, and chronicity of the pathology was noted. A significant inverse correlation was found between the content of plasma RNA and "zero" lymphocytes with bronchial asthma, chronic pneumonia, and a direct correlation with mature T and B cells.3Perhaps RNA is one of the factors limiting the maturation of lymphocytes. A possible secondary messenger between NA and immune reactivity is the cyclic nucleotide system cAMP/cGMP.4

In patients with peptic ulcer disease and nonspecific inflammatory lung diseases, a direct correlation was established between the content of serum RNA with the level of T-cells and an inverse relationship with immature “zero” lymphocytes. Violation of RNA metabolism was closely related to the content of cAMP in the mucosa. In the case of gastric ulcer and to a lesser extent in the case of duodenal ulcer, the amount of cAMP in the mucosal area remote from the defect was overstated, and in the case of peptic ulcer of the anastomosis, it was reduced. In the area of ??direct injury, the amount of cAMP in the tissue was reduced.3,5 A direct correlation was established.6,7 between the content of the total pool of nucleic acids (DNA+RNA) in the blood serum in acute dysentery in proportion to its severity.

The role of low molecular weight ribonucleotides

In infection and immunity

The accumulation of RNA in the body in the initial period of the development of the infectious process stimulates the reproduction of microorganisms of various taxonomic groups, the selection of virulent clones, the production of exotoxins, which causes the potentiation of the infection.2,3,8 Later, the same factor causes an increase in antigenicity, immunogenicity, antibiotic sensitivity bacteria. To this should be added the activation of the mobility, absorption, and metabolic capacity of macrophages, the production of humoral defence factors, quantitative and functional characteristics of populations of lymphocytes, differentiation, cooperation of T- and B-lymphocytes, which provides an increase in the body's resistance.

Nucleic acids and, above all, RNA, replenish the fund of substances necessary for the normal functioning of the body. ATP is a source of energy, cytosine nucleotides are involved in the synthesis of lipids, uridine, and guanine nucleotides in the exchange of polysaccharides, and the latter is also involved in the synthesis of proteins. There is an indirect, mediated pathway of RNA action on cells through the system of cyclic nucleotides.

Metabolic immunomodulation

Antioxidant protection

It is carried out by a system of high-molecular enzymes (superoxide dismutase (SOD), catalase, glutathione peroxidase, glutathione reductase), and low-molecular bio-antioxidants proteins containing metals with variable valence (transferrin, ferritin, ceruloplasmin-CP). The second non-enzymatic group of AOD is made up of carotenoids (β-carotene, retinol), α-tocopherols, polyunsaturated phospholipids, ascorbic acid, glutathione, some amino acids, urea, uric acid, and selenium compounds. High-molecular antioxidants are associated with various cellular structures, while low-molecular antioxidants are relatively freely distributed between cells, intercellular fluids, and blood. A decrease in the antioxidant potential is accompanied by the need to replenish the pool of low molecular weight metabolites by their exogenous introduction into the body.9

Free radical oxidation processes lipids and proteins

They are central to cell metabolism. The products of this process are a source of energy, plastic material for the creation and renewal of cellular structures, are directly involved in the metabolism of carbohydrates, lipids, proteins, nucleic acids, the biosynthesis of prostaglandins, and catecholamines, and regulate the permeability of biological membranes.10FRO reactions are an indicator of resistance stationary mode of biochemical transformations in the body, regulating its adaptive capabilities. The main laboratory parameters of FRO are malondialdehyde (MDA), diene conjugates (DC), ketodienes (KD), bityrosine cross-links (BC), Schiff bases (SB).

Therapeutic metabolic modulation

Immunodeficiency states are realized through targeted stimulation of the AOS (antioxidant system). The most widely used antioxidant drugs are energizers riboflavin and nicotinamide, free fatty acids, pantothenate and carnitine, glycolysis activators thiamine, riboxin, beta-oxidation stimulants biotin, thiamine, lipoate, antioxidants β-carotene, retinol, α-tocopherol, ascorbic acid, ubiquinone, polyunsaturated phospholipids, hepato-protectors essential, carsil, lipostabil, phosphoglyph, medicinal enzymes trypsin and other proteolytic drugs.9

Immuno-metabolic associations

The correlation dependence of metabolic parameters on the indices of the T-link of immunity was revealed, and positive correlations undoubtedly prevailed over negative ones. The level of total T-lymphocytes had a positive relationship with thymol "test", blood amylase, cholesterol, prothrombin, the antioxidant activity of blood plasma (AOA), the activity of superoxide dismutase, and negative with ALAT (alanine- aminotransferase). All three types of regulatory cells had a negative significant association with ALAT. The absorption capacity of leukocytes, assessed by the phagocytic index (PI) and phagocytic number (PN), was under the "negative control" of prothrombin, ALAT, thymol "test", free and bound bilirubin, and under the "positive control" of cholesterol. Prothrombin was negatively associated with the metabolic activity of neutrophils, and total bilirubin, ASAT (aspartate aminotransferase), and total protein were positively "dependent" on them .11

The coordinated dynamics of key tests of the formula of immune system disorders with metabolic parameters in patients with proinflammatory diseases is of theoretical importance.12In pyoderma, the formula CIC3+NKc3+IL63+ (deciphering the designations of the formulas in the text and the table) with the total antioxidant blood activity (AOA), total thiols, SB, CP, with pyelonephritis of the formula B3+MVM3+NBTsp2- with vitamin E (VE), SOD, respectively, with chronic adnexitis T3+IgM3+IL63+ with SB, CP, KD, and in chronic cystitis of the formula Tc3+IgA2-IL63+ with DC, BE, BC. These regularities changed after the correction.

Pathogenesis of metabolic syndrome (MS)

The pathogenesis of MS is based on insulin resistance, which entails hyperinsulinism. There is evidence that it is visceral obesity, an increase in the activity of many counterinsular hormones (insulin antagonists) that provoke and maintain insulin resistance. As indicated by Talantov et al. and Shevchuk (cited from 13), patients with MS have decreased levels of TSH (thyroid-stimulating hormone), thyroid hormones T3 and T4, STH (somatotropic hormone) with a simultaneous increase in ACTH (adrenocorticotropic hormone) levels, cortisol, aldosterone. Analysis of the state of the immune system in patients MS without concomitant chronic infections and thyroid pathology disorders of the immune system were revealed in a decrease in the number of T-lymphocytes and dysimmuno-globulinemia, with this pathology there is an inversion of the immune status with a deficiency of T-suppressors, T-helpers, NK-cells. Autoimmune thyroiditis was detected in 54%, chronic infectious diseases in 58.3%, their combination in 29.2%.13

There is a frequent combination of diabetes mellitus with thyroid pathology, which may also indicate the interest of the immune system in the latter. 14

Ischemic and hemorrhagic strokes, burdened

With metabolic syndrome

The layering of this pathology on various diseases causes a probable, but insufficiently studied, change in the homeostasis of the body. It was found that patients with similar processes develop a qualitatively similar, quantitatively more pronounced reaction in hemorrhagic stroke in the form of an imbalance of the primary and secondary products of free radical oxidation of lipids and proteins, preferential activation of enzymatic and non-enzymatic mechanisms of the antioxidant system against the background of accumulation of pro-inflammatory cytokines.15

Ischemic heart disease, aggravated

Metabolic syndrome

This complication causes pathological stimulation of carbohydrate and lipid components of the antioxidant system, cytokine, endocrine, and other indicators - glucose, insulin, glycosylated haemoglobin, HOMA-IR, IL-1β, IL8, thyroglobulin, γ-interferon (γ-IFN).11

The functional unity of the central nervous system,

Endocrine and immune regulatory systems

The ability of various parts of the brain to regulate the severity of immune reactions, innervation of the central and peripheral organs of the immune system, and conditioned reflex and intellectual modification of its functions was established. As well as the production of various regulatory peptide hormones by the organs of the immunocompetent sphere, and the CNS of mediators of the immune system, the “endocrine-like” effect of cytokines with the reproduction of endocrine function and the presence of common receptors in nerve and immunocompetent cells, stimulating and suppressive immunotropic potencies of hormones. It is essential that the restoration of disorders of one system - the immune, is accompanied by changes at the level of the organism, causing modifications in the endocrine status, metabolic parameters, the nervous system. 16, 17, 18, 19

RELATIONSHIP OF IMMUNO-METABOLIC DISORDERS

WITH CLINICAL COURSE OF DISEASES

Severe asphyxia in newborns

In these sick children, a significant negative relationship was found between the levels of CD3, CD4, CD8, CD95 lymphocytes and the degree of anti-infectious resistance. At the same time, the concentration of IgA in the umbilical cord blood correlated with the formation of atopic dermatitis (AD) in the child, anaemias, CD56 lymphocytes with intestinal dysbiosis, urinary tract infection, vulvovaginitis.20The correlation analysis revealed a negative dependence of the NBTac of neutrophils in the umbilical cord blood and oligohydramnios, CD4 levels on days 4-5, and polyhydramnios, vaginal candidiasis in the mother during pregnancy, endometritis, and the content of CD95 lymphocytes and gestosis. A positive relationship was found in the value of PN with a long anhydrous gap in the mother and the number of CD56 lymphocytes on days 4-5 with perinatal damage to the central nervous system of the child.

The role of metabolic processes in the

Genesis of diseases

Evidence of their participation in pathology is the accumulation of low molecular weight nucleic acids in thyrotoxicosis, primary rheumatic heart disease, infiltrative tuberculosis, dysentery, poisoning, radiation damage, and a decrease in rheumatoid arthritis, obstructive jaundice, infectious hepatitis, diabetes mellitus, peptic ulcer of the gastrointestinal tract and alcohol intoxication.21 At the same time, clinical models of eight variants of cerebrovascular diseases have shown the involvement of lipid peroxidation and antioxidant system factors in key immune mechanisms of metabolic reactions as the severity of the pathological process increases.5, 12

CORRECTION OF IMMUNO-METABOLIC DISORDERS

Metabolic effects of immuno-modulators

Poly- and lipopolysaccharides

Thus, the metabolic action of this group of drugs is expressed in the intensification of protein synthesis, activation of the "adenylate cyclase - cAMP" system, various enzyme systems, and the inclusion of 3H-thymidine into the spleen cells.22

Prodigiosan

Under its influence, 23 the activity of glycolytic dehydrogenases was significantly stimulated (cytoplasmic α-GPDG [α-glycerophosphate dehydrogenase] and LDG [lactate dehydrogenase]), the activity of the key enzyme hexose monophosphate shunt (G-6-PDG). The general effect of prodigiosin on the body was expressed in the mobilization of the hormonal system "pituitary-adrenal cortex", activation of lymphoid cells, macrophages, plasmocytes, synthesizing immunoglobulins.

Synthetic modulators

Synthetic double-stranded RNA poly I: C,

poly-A: U, poly G: C

They increased the incorporation of 3H-thymidine into lymphoid and other cells, stimulated the formation of adenylate cyclase, cAMP, and had colossal immunomodulatory activity.24

Thymusderivatives, myelo peptides

Potentiated the synthesis of protein and nucleic acids in various cells.25, 26 The former proved to be additionally powerful regulators of lipid metabolism, reduced blood glucose levels, and normalized liver function indices. In patients with superficial vasculitis, thymomimetics determined from the level of traditional treatment the normalization of tryptophan in the blood, and in the urine of cystic acid, taurine, glutamic acid, proline, glycine, alanine, a-aminobutyric acid, cystine, lysine, 1-methylhistidine, arginine, 2- methylhistidine, the number of amino acids. Among other changes in the biochemical parameters of blood, taktivin caused a decrease to the norm of the initially increased level of glucose, alkaline phosphatase, ASAT, ALAT, cholesterol, triglycerides, LDG, calcium, and an increase to the norm of creatinine, total bilirubin, albumin, iron, creatinine phosphokinase, a total of 13 parameters. In the urine, there was an increase in the reduced content of creatinine and a decrease in sodium.

Sodiumnucleinate

Its effect on cell metabolism turned out to be very broad.2 In the spleen lymphocytes, the synthesis of RNA, DNA, the protein was stimulated, ATP and ADP accumulated, monoamine oxidase, α-GPDG were activated, the biosynthesis of mitochondrial, nuclear, cytoplasmic RNA increased in the liver, the activity of tryptophanpyrrolase increased. In the granulocytes of healthy individuals, oxygen consumption increased, and the rate of glycolysis decreased.

The differentiated effect of monoribo-nucleotides on lymphocyte receptors has been established. AMP had the highest activity, minimal GMP, the combination of complementary GMP+CMP was also highly active, with minimal changes on T-helper and T-suppressor. 27

In patients with acute dysentery CMP and UMP stimulate the formation of antibody-forming cells by 9-19 times, and AMP decreases them by 10 times. AMP inhibited antigen-specific responses and increased delayed-type hypersensitivity.27

Immuno modulatory effects of metabolic

A wide panel of combined studies was performed on various clinical models of proinflammatory diseases (PID). They consisted of exacerbation of deep pyoderma (EDP) and chronic pyelonephritis (ECPN), ECPN + urolithiasis disease (ULD), purulent soft tissue infection (PSTI)+AD, +true eczema (TE), acute salping-oophoritis (ASO), and exacerbation of chronic salping-oophoritis (ECSO), ECSO+bacterial vaginosis (BV), urogenital chlamydia, nonspecific inflammatory diseases of the lungs, which included mixed, exogenous and endogenous bronchial asthma (mBA, exBA, enBA), chronic obstructive lung disease (COLD), mBA+COLD, mBA+AD. The effect of the "traditional" treatment of diseases and its combination with the antioxidant hypoxene, immunotropic drugs with antihypoxic, antitoxic, metabolic, haemo-stimulating, immunological properties, cygapan metabolic (food supplement containing 63 micro-and macroelements, amino acids, vitamins) was studied, tycveolum (realizing hepatoprotective, regenerative, immunostimulating, anti-inflammatory effects), limontar (a preparation of citric and succinic acids, which are stimulators of nucleic acid metabolism and redox processes) and metabolites of nucleic acid origin with sodium nucleinate, derinate (officinal drug, high molecular weight DNA), isoprenaline on immune, haematological, biochemical, bacteriological and clinical parameters. 28,29,30

In patients by the rank method (used to compare the effectiveness of immuno corrections, when immune markers in patients receiving drugs, the greatest changes are measured by rank 1, then by rank 2, etc., and the minimum sum of ranks reflects the maximum effect of the action), the normalizing the effect of antioxidants and metabolites on grouped (divided into groups) laboratory parameters, built the final rating algorithm of complex treatment (determined by the degree of immune disorders of the indicators, which are arranged in the order of decreasing significant deficiency from the specified values), identified the key targets of the drug action on the immune system (see the table for the ITF decoding) with an indication of the order of the parameters in the formulas, vectors and the degree of their dynamics from the initial level.30

Hypoxene (Hp)

Patients Hp causes an ambiguous positive effect on the studied parameters of patients suffering from various PID. Thus, the predominant normalization of immune parameters was achieved in patients with ACPN, PIST+TE, haematological parameters with?DP, ECPN, ECPN+ULD, PIST+AD, bacteriological parameters with PIST+AD, clinical patients with ECPN, PIST+AD. In total, an increase in the final effectiveness of complex treatment due to hypoxene was shown in five cases out of seven (EDP, ECPN, ECPN+ ULD, PIST+AD, PIST+TE). With mBA, the antioxidant increased the final efficacy of the complex treatment.

When determining the spectrum of targets of hypoxene in the immune system in patients with six types of bronchopulmonary diseases, leukocytes, lymphocytes, Th, NK, Ig of three classes, PI, IL4 concentration with a stimulating vector turned out to be key.

In patients with nonspecific inflammatory lung diseases, a high immuno-clinical effect of sodium nucleinate has been shown.3 The maximum normalizing effect of the modulator in patients with mBA, ecBA, mBA+AD, enBA, COLD, mBA+ COLD was found in biochemical, immune and clinical action, which included markers of T cells, their regulatory subpopulations, B-lymphocytes, IgA and M, CEC, absorption and metabolic activity of neutrophils, cytokines. In principle, positive clinical and laboratory results were obtained in patients with ECPN, PIST, and DP using the nucleic acid modulators ridostin, derinat, and isoquinoline.

Thus, various metabolites and antioxidants against the background of traditional treatment of proinflammatory and nonspecific bronchopulmonary diseases in most cases significantly increase the final clinical and laboratory effectiveness of complex effects on patients and fundamentally change the sets of signal markers in the formulas of targets for immunoprotection of drugs.

Comparative effectiveness of immunomodulatory and immuno-metabolic therapy of diseases

On clinical models of PID (pyoderma, pyelonephritis, adnexitis), we studied the effect of the Gl modulator and its combination with the antioxidant hypoxemia (Gl + Hp) on the grouped clinical, laboratory, and signalling immuno-metabolic parameters.31 The data obtained are summarized in Table.1.

Legend: G, I, M, C, B – haematological, immune, metabolic, clinical, bacteriological indicators, * reliability of differences, withP< 0.05, ITFown, MTFown  - immunoprotection and metabolic target formulas regarding basic treatment; own - own effect of some modulators, Ma - CD95+ lymphocytes, Ct - common thiols, the rest see the text.

The data in the table indicate that in patients with deep pyoderma, immunotherapy with Galavit relative to traditional treatment led to the normalization of three groups of markers - haematological, metabolic, and clinical, with four CPNs - G, I, M, C, with CA of one haematological one. The combination of Gl with Hp led to a modification and an increase in the clinical and laboratory effect.

Specifically, in DP, galavit provided a decrease in the level of pro-inflammatory TNF, total lymphocytes and lymphocytes with apoptosis receptor expression, hyperimmunoglobulinemia M, in CPN - IL4, phagocytic index, and T-regulators turned out to be signalling targets, and in CA, thymus-dependent NK, CIC, IgM turned out to be supporting markers. When using a combination of Gl+Hp in patients with DP, CPN, CA, typical ITFown were accordingly modified (NKc3+PI2+IL83+, which affected cytotoxic natural killers, phagocytic index and interleukin-8), in CPN, respectively, Th3+IL83+B3+ that affected T-helpers, IL8 and B-lymphocytes, with CA, respectively, IgM2+Tc3+NKc3+, which affected immune globulins M, T-cytotoxic lymphocytes and cytotoxic NK cells).32Thus, in patients with DP, the composition of ITFown during galavit was expressed in AOA2+MDA1+Ct1- and, in the case of a combination of Gl+Hp, in turn, MDA2-SOD2+VE1+.

Discussion: The article describes the problem of immuno-metabolic aspects of pathological processes, which is practically new for clinical immunology, and its formulation and consideration mainly belongs to the authors of this article. In fact, for the first time, the relationship between immune-metabolic mechanisms in the implementation of immune responses is discussed. The greatest importance is attached to the state of nucleic acid metabolism as a marker of the severity of immunopathology and a regulator of immune reactivity. His condition turned out to be key in the development of immuno-associated diseases, infectious pathology and substantiated new approaches for nucleic acid replacement immunotherapy. The most important role of the antioxidant defence system, free-radical oxidation of lipids and proteins was shown, which made it possible for the first time to propose therapeutic metabolic modulation. New information is presented on the currently intensively studied metabolic syndrome, its effect on patient homeostasis. A large body of information with the discussion of new aspects covers various pathologies, including diabetes, cardiovascular diseases, psoriasis, the relationship of immuno-metabolic disorders with the clinical course of various infectious and non-infectious diseases, correction of developing disorders by various immunotropics  and, which is especially important, novelty drugs is postulated low molecular weight RNA. In this area, serious research has been done and excellent clinical results have been obtained. As a result, the discussion of new aspects of immuno-metabolic associations led to the creation of a new direction in clinical immunology - immunomodulatory metabolism therapy and new approaches to correcting immune and metabolic disorders in the body with a wide range of pathology.

CONCLUSION

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A Study by Prabhu A et al. entitled "Awareness of Common Eye Conditions among the ASHA (Accredited Social Health Activist) Workers in the Rural Communities of Udupi District- A Pilot Study" is awarded Best Article for Vol 14 issue 07
A Study by Divya MP et al. entitled "Non-Echoplanar Diffusion-Weighted Imaging and 3D Fiesta Magnetic Resonance Imaging Sequences with High Resolution Computed Tomography Temporal Bone in Assessment and Predicting the Outcome of Chronic Suppurative Otitis Media with Cholesteatoma" is awarded Best Article for Vol 14 issue 06
A Study by Zahoor Illahi Soomro et al. entitled "Functional Outcomes of Fracture Distal Radius after Fixation with Two Different Plates: A Retrospective Comparative Study" is awarded Best Article for Vol 14 issue 05
A Study by Ajai KG & Athira KN entitled "Patients’ Gratification Towards Service Delivery Among Government Hospitals with Particular Orientation Towards Primary Health Centres" is awarded Best Article for Vol 14 issue 04
A Study by Mbungu Mulaila AP et al. entitled "Ovarian Pregnancy in Kindu City, D.R. Congo - A Case Report" is awarded Best Article for Vol 14 issue 03
A Study by Maryam MJ et al. entitled "Evaluation Serum Chemerin and Visfatin Levels with Rheumatoid Arthritis: Possible Diagnostic Biomarkers" is awarded Best Article for Vol 14 issue 02
A Study by Shanthan KR et al. entitled "Comparison of Ultrasound Guided Versus Nerve Stimulator Guided Technique of Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries" is awarded Best Article for Vol 14 issue 01
A Study by Amol Sanap et al. entitled "The Outcome of Coxofemoral Bypass Using Cemented Bipolar Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fracture of Femur in a Rural Setup" is awarded Best Article Award of Vol 13 issue 24
A Study by Manoj KP et al. entitled "A Randomized Comparative Clinical Trial to Know the Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block Against Multimodal Analgesia for Postoperative Analgesia Following Caesarean Section" is awarded Best Article Award of Vol 13 issue 23
A Study by Karimova II et al. entitled "Changes in the Activity of Intestinal Carbohydrases in Alloxan-Induced Diabetic Rats and Their Correction with Prenalon" is awarded Best Article of Vol 13 issue 22
A Study by Ashish B Roge et al. entitled "Development, Validation of RP-HPLC Method and GC MS Analysis of Desloratadine HCL and It’s Degradation Products" is awarded Best Article of Vol 13 issue 21
A Study by Isha Gaurav et al. entitled "Association of ABO Blood Group with Oral Cancer and Precancer – A Case-control Study" is awarded Best Article for Vol 13 issue 20
A Study by Amr Y. Zakaria et al. entitled "Single Nucleotide Polymorphisms of ATP-Binding Cassette Gene(ABCC3 rs4793665) affect High Dose Methotrexate-Induced Nephrotoxicity in Children with Osteosarcoma" is awarded Best Article for Vol 13 issue 19
A Study by Kholis Ernawati et al. entitled "The Utilization of Mobile-Based Information Technology in the Management of Dengue Fever in the Community Year 2019-2020: Systematic Review" is awarded Best Article for Vol 13 issue 18
A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
A Study by Chandran Anand et al. entitled "A Prospective Study on Assessment of Quality of Life of Patients Receiving Sorafenib for Hepatocellular Carcinoma" is awarded Best article for Vol 13 issue 15
A Study by Rosa PS et al. entitled "Emotional State Due to the Covid – 19 Pandemic in People Residing in a Vulnerable Area in North Lima" is awarded Best Article for Vol 13 issue 14
A Study by Suvarna Sunder J et al. entitled "Endodontic Revascularization of Necrotic Permanent Anterior Tooth with Platelet Rich Fibrin, Platelet Rich Plasma, and Blood Clot - A Comparative Study" is awarded Best Article for Vol 13 issue 13
A Study by Mona Isam Eldin Osman et al. entitled "Psychological Impact and Risk Factors of Sexual Abuse on Sudanese Children in Khartoum State" is awarded Best Article for Vol 13 issue 12
A Study by Khaw Ming Sheng & Sathiapriya Ramiah entitled "Web Based Suicide Prevention Application for Patients Suffering from Depression" is awarded Best Article for Vol 13 issue 11
A Study by Purushottam S. G. et al. entitled "Development of Fenofibrate Solid Dispersions for the Plausible Aqueous Solubility Augmentation of this BCS Class-II Drug" is awarded Best article for Vol 13 issue 10
A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08
A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

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