Inflammasomes, a group of multiprotein complexes, are essential in regulating inflammation and immune responses. Several inflammasomes, including nucleotide-binding domain leucine-rich repeat-containing protein 1 (NLRP1), NLRP3, NLRP6, NLRP7, NLRP12, interferon-inducible protein 16 (IFI16), NOD-like receptor family CARD domain-containing protein 4 (NLRC4), absent in melanoma 2 (AIM2), and pyrin, have been studied in various inflammatory diseases. Activating inflammasomes leads to the processing and production of proinflammatory cytokines, such as interleukin (IL)-1β and IL-18. The NLRP3 inflammasome is the most extensively studied and well characterized. Consequently, targeting inflammasomes (particularly NLRP3) with several compounds, including small molecule inhibitors and natural compounds, has been studied as a potential therapeutic strategy. This review provides a comprehensive overview of different inflammasomes and their roles in six inflammatory diseases, including multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, atherosclerosis, type 2 diabetes, and obesity. We also discussed different strategies that target inflammasomes to develop effective therapeutics.
17 November 2023 in British Journal of Anaesthesia
Two thirds of Americans infected with chronic hepatitis B are unaware of their infection. In March 2023, the Centers for Disease Control and Prevention recommended moving from risk-based to universal adult chronic hepatitis B screening. In April 2022, Stanford implemented chronic hepatitis B universal screening discussion alerts for primary care providers. After 6 months, the authors surveyed 143 primary care providers at 13 Stanford primary care clinics about universal chronic hepatitis B screening acceptability and implementation feasibility. They conducted semistructured interviews with 15 primary care providers and 5 medical assistants around alerts and chronic hepatitis B universal versus risk-based screening. Forty-five percent of surveyed primary care providers responded. A total of 63% reported that universal screening would identify more patients with chronic hepatitis B. Before implementation, 77% ordered 0–5 chronic hepatitis B screenings per month. After implementation, 71% ordered >6 screenings per month. A total of 66% shared that universal screening removed the stigma around discussing high-risk behaviors. Interview themes included (1) low clinical burden, (2) current underscreening of at-risk groups, (3) providers preferring universal screening, (4) patients accepting universal screening, and (5) ease of chronic hepatitis B alert implementation. Consistent with Centers for Disease Control and Prevention guidelines, implementing universal chronic hepatitis B screening in primary care clinics in Northern California was feasible, was acceptable to providers and patients, eased health maintenance burdens, and improved clinic workflows.