Human leukocyte antigen (HLA) encoded by the HLA gene is an important modulator for immune responses and drug hypersensitivity reactions as well. Genetic polymorphisms of HLA vary widely at population level and are responsible for developing severe cutaneous adverse drug reactions (SCARs) such as Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), maculopapular exanthema (MPE). The associations of different HLA alleles with the risk of drug induced SJS/TEN, DRESS and MPE are strongly supportive for clinical considerations. Prescribing guidelines generated by different national and international working groups for translation of HLA pharmacogenetics into clinical practice are underway and functional in many countries, including Thailand. Cutting edge genomic technologies may accelerate wider adoption of HLA screening in routine clinical settings. There are great opportunities and several challenges as well for effective implementation of HLA genotyping globally in routine clinical practice for the prevention of drug induced SCARs substantially, enforcing precision medicine initiatives.

Background: There is still a lack of consensus on the efficacy of convalescent plasma (CP) treatment in COVID‐19 patients. We performed a systematic review and meta‐analysis to investigate the efficacy of CP vs standard treatment/non‐CP on clinical outcomes in COVID‐19 patients.Methods: Cochrane Library, PubMed, EMBASE and ClinicalTrials.gov were searched from December 2019 to 16 July 2021, for data from clinical trials and observational studies. The primary outcome was all‐cause mortality. Risk estimates were pooled using a random‐effect model. Risk of bias was assessed by Cochrane Risk of Bias tool for clinical trials and Newcastle‐Ottawa Scale for observational studies.Results: In total, 18 peer‐reviewed clinical trials, 3 preprints and 26 observational studies met the inclusion criteria. In the meta‐analysis of 18 peer‐reviewed trials, CP use had a 31% reduced risk of all‐cause mortality compared with standard treatment use (pooled risk ratio [RR] = 0.69, 95% confidence interval [CI]: 0.56‐0.86, P = .001, I² = 50.1%). Based on severity and region, CP treatment significantly reduced risk of all‐cause mortality in patients with severe and critical disease and studies conducted in Asia, pooled RR = 0.61, 95% CI: 0.47‐0.81, P = .001, I² = 0.0%; pooled RR = 0.67, 95% CI: 0.49‐0.92, P = .013, I² = 0.0%; and pooled RR = 0.62, 95% CI: 0.48‐0.80, P < .001, I² = 20.3%, respectively. The meta‐analysis of observational studies showed the similar results to the clinical trials.Conclusions: Convalescent plasma use was associated with reduced risk of all‐cause mortality in severe or critical COVID‐19 patients. However, the findings were limited with a moderate degree of heterogeneity. Further studies with well‐designed and larger sample size are needed.

Sepsis is a critical emergency condition characterized by life-threatening organ dysfunction due to a dysregulated response to infection. In the fast-paced

Hemoglobin-based oxygen carriers (HBOCs) represent a propitious type of blood substitute to transport oxygen throughout the body while acting as a carrier in biomedical applications. However, HBOCs in blood are recognized and rapidly scavenged by the body’s innate immune systems. To overcome this problem, HBOCs require a surface modification that provides protection against detection and elimination in order to prolong their circulation time after administration. In this study, we investigated different surface modifications of hemoglobin submicron particles (HbMPs) by double/triple precipitation, as well as by adsorption of human serum albumin (HSA), hyaluronic acid (HA), and pluronic (Plu) to discover how diverse surface modifications influence the oxygen binding capacity and the binding of anti-hemoglobin (Hb) antibodies, immunoglobulin G (IgG), and haptoglobin (HP) to HbMPs. The particle size and zeta potential of the six types of HbMP modifications were analyzed by zeta sizer, confocal laser scanning microscopy, and transmission electron microscopy (TEM), and were compared to the unmodified HbMPs. The results revealed that all surface-modified HbMPs had a submicron size with a negative charge. A slight decrease in the oxygen binding capacity was noticed. The specific binding of anti-Hb antibodies, IgG, and HP to all surface-modified HbMPs was reduced. This indicates a coating design able to protect the particles from detection and elimination processes by the immune system, and should lead to a delayed clearance and the required and essential increase in half-life in circulation of these particles in order to fulfill their purpose. Our surface modification method reflects a promising strategy for submicron particle design, and can lead the way toward novel biomedical applications.

Although riboflavin (RF) belongs to the water-soluble vitamins of group B, its solubility is low. Therefore, the application of micro-formulations may help to overcome this limiting factor for the delivery of RF. In this study we immobilized RF in newly developed albumin submicron particles prepared using the Co-precipitation Crosslinking Dissolution technique (CCD-technique) of manganese chloride and sodium carbonate in the presence of human serum albumin (HSA) and RF. The resulting RF containing HSA particles (RF-HSA-MPs) showed a narrow size distribution in the range of 0.9 to 1 μm, uniform peanut-like morphology, and a zeta-potential of −15 mV. In vitro release studies represented biphasic release profiles of RF in a phosphate buffered saline (PBS) pH 7.4 and a cell culture medium (RPMI) 1640 medium over a prolonged period. Hemolysis, platelet activation, and phagocytosis assays revealed a good hemocompatibility of RF-HSA-MPs.

Background: Long coronavirus disease (COVID) poses significant challenges for older adult patients, affecting their cardiopulmonary function and overall well-being. This study aimed to investigate the effects of slow deep breathing exercises on cardiopulmonary function, physical performance, biochemical markers, oxidative stress, and stress levels in older adult patients with long COVID. Methods: Sixty older adult patients with long COVID were randomly assigned to an exercise group of 30 patients and a control group of 30 patients. The exercise group engaged in slow deep breathing exercises for 30 minutes, five times a week over a period of 8 weeks, while the control group maintained their usual activities. Cardiovascular parameters, heart rate variability (HRV), respiratory muscle strength (RMS), pulmonary function tests (PFT), physical performance, biochemical and oxidative stress markers, and stress levels were assessed at baseline, 4 weeks, and 8 weeks. Data were analyzed using one-way repeated measures ANOVA. Results: The exercise group showed significant reductions in cardiovascular parameters (systolic and diastolic blood pressure, pulse pressure, mean arterial pressure, and heart rate). Additionally, RMS, PFT, and physical performance showed significant increases. Improvements were also observed in HRV, biochemical markers (fasting blood sugar and lipid profile), oxidative stress markers (catalase, superoxide dismutase, and malondialdehyde), and stress levels. In contrast, no significant changes were found in the control group. Conclusion: Slow deep breathing exercises, as a non-pharmacological intervention, significantly improve cardiopulmonary function, physical performance, and various health markers in older adult patients with long COVID. This approach provides a valuable and accessible therapeutic option for this population.