دکتر محمد رضا خاکزاد

Considering the possible role of fungal sensitization in the treatment of resistant asthma, which may lead to the remodeling of bronchial structure, we theorized that itraconazole could result in better control of asthma. In this regard, this study aimed to compare the effects of itraconazole and prednisolone (routinely prescribed) on clinical, structural, and biomarker findings of the remodeling of asthma.

This double-blind controlled randomized clinical trial was performed on 70 adult patients suffering from severe persistent asthma. The intervention group received 200 mg of itraconazole per day, and the control group received 10 mg of prednisolone per day, for 32 weeks, in addition to the classic treatment of asthma. The subjects were randomly divided into two groups, and assigned by sealed envelope. Blinding was performed by repacking the drug in a similar container. Primary outcomes were asthma control test score, fibroblast growth factor 2, and wall area percentage on RB1 bronchus measured by computed tomography. The outcomes were compared in subjects classified as allergic, eosinophilic, T2 low asthma, and four types of inflammatory cell classification in sputum.

Seventy subjects finished the 32-week trial (35 subjects in each group). Baseline data did not show significant differences between groups. A comparison of asthma variants showed significantly more severe cough and dyspnea in the allergic variant and higher spirometry results in T2-low asthma. Sputum cytology revealed a mixed pattern as the most frequent type (47%). After the trial, two groups improved in many parameters; however, FGF-2 improved more significantly by itraconazole (4.66±16.92 decreased to 1.14±2.98), and FEV1/FVC was significantly higher in the itraconazole group,compared to the control group. These results did not change in terms of asthma variants and sputum classification.

Itraconazole was superior to prednisolone in the treatment of many clinical and spirometry aspects in severe persistent asthma.

Stomach cancer is the fifth most common cancer and the fourth leading cause of cancer deaths worldwide in 2020. Moderately increased risk of stomach cancer has been associated with tobacco smoking and Alcohol drinking. In this systematic review, we summarized the current knowledge on the relation between smoking and alcohol, both alone and in combination, to the risk of gastric cancer.

This study was conducted in 2023 with a structured overview in the Science Directe , PubMed, Web of Science (ISI) databases. We investigated the studies that were published between 2010 and 2023. In the first step, articles were extracted based on their titles and abstracts; the quality of 58 articles was evaluated using the STORBE tool. Inclusion criteria were English language (first step), year of the study and the study type (second step).

Of these 39 articles, 17 ones were case-control studies, 21 were cohort studies, one was a descriptive study. eleven articles were related to alcohol consumption and risk of gastric cancer, twenty-three articles were related to smoking and risk of gastric cancer, five articles were related smoking and alcohol consumption in combination and risk of gastric cancer. Many studies reported a significant association between alcohol and gastric cancer risk. Also, three studies showed that smoking acts as a risk factor for developing gastric cancer only in certain genotype and not in all people.

Based on the best our knowledge and present studies, consumption of alcohol and smoking are risk factors of gastric cancer. It is better to conduct more studies on this issue in different populations in the future. We also suggest that future studies focus more on the intracellular mechanisms of these associations than on epidemiological outcomes.

Transforming growth factor-beta (TGF-β), a group of multifunctional growth factors, plays an important role in the neuron survival and neurodevelopmental functions. Some studies have evaluated the correlation between TGF-β1 and TGF-β2 abnormalities and autism spectrum disorders. In this study, we compared the TGF-β1 andb TGF-β2 levels between autistic and intellectually normal individuals.

The study population consisted of 39 autistic and 30 age-matched intellectually normal individuals (control group). Blood samples were taken from all individuals, and all patients were divided into 2 groups (mild-to-moderate and severe) according to the childhood autism rating scale. The cytokines levels were measured by Enzyme Linked Immunosorbent Assay (ELISA).

The mean concentration of TGF-β1 was significantly lower (P < 0.0001) in children with autism compared to the control group (25.3 ± 6.5 versus 35.1 ± 9.4 ng/mL, respectively). Also, the mean concentration of TGF-β2 in children with autism (32.35± 7.75 ng/mL) was higher compared to those in the control group (30.47± 4.36 ng/mL); however, this difference did not reach statistical significance (P = 0.21). A positive correlation was observed between TGF-β1 concentration and autism severity (r = 0.41; P = 0.02), whereas a negative correlation was found between TGF-β2 concentration andautism severity (r = -0.41; P = 0.02).

The results of the present investigation suggest that there is a decrease in the levels of TGF-β1 in the serum of patients with autism and this cytokine may be effective in the treatment of the pathophysiological aspects of autism.