<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGROUND AND AIM</title>
Dengue viral disease (DVD) is a tropical arboviral disease that is caused by dengue virus (DENV), which is transmitted mainly by the bite of female Aedes aegypti mosquitoes. No specific antiviral drug is approved yet to manage the patients with DENV infection, who are managed using symptomatic therapy and supportive care.
</sec>
<sec><title style='display:none'>AIM</title>
As a consequence, we intend to review the potential of Nilavembu kudineer in the management of DENV infection.
</sec>
<sec><title style='display:none'>MATERIALS AND METHODS</title>
To find articles pertinent to the clinical, <italic>in vitro</italic>, and <italic>in silico</italic> studies evaluating the effectiveness of <italic>Nilavembu Kudineer</italic> in the management of DENV infection, the literature was searched in databases such as Medline/PubMed Central/PubMed, Google Scholar, Science Direct, EBSCO, Scopus, Web of science, Embase, Directory of open access journals, and reference lists.
</sec>
<sec><title style='display:none'>RESULTS</title>
<italic>Nilavembu Kudineer</italic> may be able to alleviate signs and symptoms experienced by patients with DENV infection, according to few clinical, <italic>in vitro</italic>, and <italic>in silico</italic> studies.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
The effectiveness of <italic>Nilavembu Kudineer</italic> in patients with DENV infection would further be demonstrated by additional randomized controlled clinical trials.
</sec>
</abstract>

Efficacy of Nilavembu Kudineer for Dengue Fever Management – An Overview of Clinical and Preclinical Evidences

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGROUND</title>
Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints and varies in severity in patients. Inflammation in the joints causes high levels of systemic pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) which have an impact on permanent damage to the joints. Until now, the treatment of RA is only symptomatic, without being able to prevent the progression of damage to the joints, and this treatment also causes side effects such as gastrointestinal and cardiovascular toxicity. Therefore, many patients are looking for alternative medicine to complement their treatment.
</sec>
<sec><title style='display:none'>METHODS</title>
This research was a narrative review that was performed using PubMed, Science Direct, and Google Scholar using pre-clinical and clinical studies which aim to determine whether the therapeutic mechanism of gambier catechin (<italic>Uncaria gambir</italic> Roxb) on RA. A literature review is carried out to formulate a scientific basis for innovation.
</sec>
<sec><title style='display:none'>RESULTS</title>
The gambier plant is a typical plant of West Sumatra, which is rich in phytochemicals. The active compounds in gambier are catechins which are classified as flavanols/flavonoids. Catechins are compounds that are well-known as antioxidant, anti-inflammatory compounds, the highest found in gambier plants. Catechins affect the expression of inflammation-related genes and proteins such as TNF-α, IL-1, and show their anti-inflammatory roles. This research is a literature review using secondary data from original research based on <italic>in vitro</italic>, <italic>in vivo</italic>, and clinical trials. The results showed that catechins can inhibit the production of IL-1, TNF-α, prostaglandin and increase levels of cyclic adenosine monophosphate in rats. On histological findings, peri-synovial inflammation and cartilage damage decreased in the group given epigallocatechin-3-gallate which showed anti-rheumatic activity and increased CD4+ and CD25+ regulatory T cells, thereby inhibiting the B cell population effectively suppresses inflammation and arthritis pain and shows its therapeutic potential in the treatment of RA.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
It can be concluded that gambier catechins have the potential as a candidate for RA therapy. This, if developed, can certainly improve the health status of the community locally and globally.
</sec>
</abstract>

Anti-inflammatory Effect of Gambier Catechin (<italic>Uncaria gambir</italic> Roxb) on Rheumatoid Arthritis: A Review

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGROUND</title>
The preservation of post-extraction alveola, as part of guided bone regeneration, is recommended for the creation of a biological foundation for future implant-prosthetic or prosthetic production. Several graft materials are used, either independently or in a combination of each other. Advanced platelet-rich fibrin (A-PRF) as an autologous blood derivate in the recent years has been increasingly used because of its properties in angiogenesis, epithelialization, and hemostasis. Simple production, low cost, and non-use of anticoagulants are advantages for more mass use of it.
</sec>
<sec><title style='display:none'>CASE PRESENTATION</title>
Two clinical cases are described, one is using a combination of A-PRF with xenograft, and the second clinical case is using a solo A-PRF, for socket preservation.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
The properties of A-PRF for preserving both bone volume and quality have been confirmed, highlighting its potential as a valuable therapeutic tool. Furthermore, the post-operative period following A-PRF treatment has been found to be free of significant discomfort and morbidity for patients, suggesting that this approach may represent a safe and effective means of promoting optimal clinical outcomes.
</sec>
</abstract>

Advanced Platelet-rich Fibrin versus Sticky Bone in Socket Preservation - Clinical and X-ray Assessment: Case Report

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGOUND</title>
The prevalence of rheumatoid arthritis (RA) and its specific autoantibodies varies in different populations. This variability depends on the genetic polymorphism of the immune response genes among which the HLA system plays a major role.
</sec>
<sec><title style='display:none'>AIM</title>
We conducted a preliminary study of the distribution of HLA-DRB1 and HLA-DQB1 first field level alleles in a sample of 100 Albanian patients with RA.
</sec>
<sec><title style='display:none'>METHODS</title>
In this context, we studied the HLA-DRB1 and HLA-DQB1 first-level allele frequencies in 100 Albanian patients with RA and considering their rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPA) serologic subgroups. We compared them with the respective frequencies in a population of 191 Albanian individuals without known pathology.
</sec>
<sec><title style='display:none'>RESULTS</title>
No differences were found between the controls and the RA patient group, but three statistically significant differences were found: an increase in DRB1*04 among ACPA-positive, RF-positive and ACPA-positive/ RF-positive patients, a significant decrease in DRB1*11 among ACPA-positive/RF-positive, and also a decrease in DRB1*13 among RF-positive patient subgroups. The frequencies of DRB1 allotypes in ACPA+ and RF+ patients compared to their counterpart ACPA− and RF−patient subgroups showed the predisposing effect of HLA-DRB1*04 for ACPA and RF seropositivity (p, respectively, 0.0008 and 0.0017) and the protective role of HLA-DRB1*11 for ACPA and RF positivity (p, respectively, 0.007 and 0.02). The same protective role from the RF positivity is also found with the HLA-DRB1*13 alleles (p = 0.007). As far as the DQB1 locus is concerned, a protective association has been found between the HLA-DQB1*06 alleles with both RF+ and RF+ ACPA+ positivity (p, respectively, 0.05 and 0.04) when comparing the control group with the respective RA patient subgroups. In ACPA+ and RF+ patients compared to the ACPA− and RF− patient subgroups, the only detected difference was between RF (+) and RF (−) patients (p =0.04).
</sec>
<sec><title style='display:none'>CONCLUSION</title>
The relatively low frequencies of DRB1*04 and high (DRB1*11 and DRB1*13) in the Albanian population might explain the rather low positivity rate of ACPA and RF antibodies among the Albanian RA patients. Our study demonstrates that DRB1*11, DRB1*13 and DQB1*06 may be negatively associated with RA. Conversely, DRB1*04 may confer susceptibility to RA in Albanian population.
</sec>
</abstract>

The Protective Effect of HLA-DRB1 and HLA-DQB1 Alleles to ACPA-Positive and RF-Positive RA in Albanian Population

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGROUND</title>
Epidermolysis bullosa (EB) is a skin fragility disorder that results in the disruption of the dermoepidermal junction and painful blisters on the skin and mucous membranes. Currently, there is almost no definite treatment for EB patients.
</sec>
<sec><title style='display:none'>AIM</title>
This study aims to assess the effect of topical formulation based on <italic>Arnebia euchroma</italic> (AE) on lesions induced by EB.
</sec>
<sec><title style='display:none'>MATERIALS AND METHODS</title>
All patients with EB diseases treated with Hochobeh ointment (AE+Beewax+Olive oil) in 2022 at our dermatological clinic were included in the study. EB diseases were diagnosed based on the following criteria: (1) clinical features (2) histopathological findings (3) Linear depositions of IgG, IgA, IgM 4. salt-split skin (SSS) or other immune serological tests compatible with the diagnosis of EB disease. Hochobeh ointment and lotion treatment were initiated. Clinical evaluations were repeated 3 and 7 days after the treatment began, and photographs were taken to document the changes in clinical severity. EB Disease Activity and Scarring Index (EBDASI) and EB Quality of Life (EB-QoL) questionnaires were used to assess the severity of EB and the quality of life, respectively. All statistical analyses were performed using statistical package for the social sciences version 16.
</sec>
<sec><title style='display:none'>RESULTS</title>
Overall, fourteen patients were included. Improvement in clinical features, including reduction of infection and inflammation and improvement of wound healing, was observed. EBDASI and EB-QoL scores decreased significantly after treatment (91.5 ± 45.7 vs. 68.9 ± 43, p = 0.001; 24.6 ± 6.7 vs. 18 ± 5.2, p = 0.001, respectively).
</sec>
<sec><title style='display:none'>CONCLUSION</title>
Hochobeh ointment may be effective in treating EB skin and mucosal lesions.
</sec>
</abstract>

Topical Formulation Based on Arnebia euchroma as a Novel Possible Efficient Treatment on Epidermolysis Bullosa Lesions: A Case Series of Fourteen Patients

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGROUND</title>
Early onset of acute bronchiolitis is associated with early onset of childhood asthma. Unfortunately, childhood asthma tends to be frequently overlooked and not optimally managed. Family pediatricians, however, possess an exceptional opportunity to recognize the connection of these conditions and promptly identify, address, and oversee children with asthma. It is important to note that childhood asthma typically begins in the early years of life, often triggered by viral infections.
</sec>
<sec><title style='display:none'>AIM</title>
We aimed to analyze the early predictors linked to childhood asthma, such as previous episodes of acute bronchiolitis and the presence of atopy, to facilitate the early identification of children with childhood asthma within primary care settings.
</sec>
<sec><title style='display:none'>MATERIALS AND METHODS</title>
Retrospectively analyzed data from 1652 children from health records at the Primary Health Care Polyclinic - Pediatric Primary Health Care Practice -“Vitalino” in Veles, North Macedonia. Within this cohort, 108 children had experienced acute bronchiolitis in 2016, at an age range of 0–2 years. In 2020 and 2023, the data were analyzed to determine the existence of a connection between acute bronchiolitis and other predictors with the early onset of childhood asthma.
</sec>
<sec><title style='display:none'>RESULTS</title>
This retrospective research showed that from the total number of children, 108 children aged up to 2 years suffered from acute bronchiolitis, of which the analysis in 2020 showed that 50 children had atopy, 19 allergic rhinitis, 33 children had recurrent laryngitis, 24 children recurrent otitis, 68 children with recurrent bronchial obstructions (≤3), and 39 children developed early onset of bronchial asthma. The analysis in 2023 showed that 51 children have asthma. Based on the obtained results, the prevalence of acute bronchiolitis in the Republic of North Macedonia is 6.54%. If acute bronchiolitis is considered an early manifestation of childhood asthma, then the prevalence of childhood asthma in the Republic of North Macedonia is about 6.54%.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
Based on the obtained results, we can conclude that early onset of acute bronchiolitis is an early manifestation of childhood asthma. Additional predictors are early signs of atopy, frequent viral infections with broncho-obstruction, allergic rhinitis, and recurrent laryngitis.
</sec>
</abstract>

Acute Bronchiolitis and Other Predictors for Early Diagnosis of Childhood Asthma

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGROUND</title>
Dengue hemorrhagic fever is caused by the dengue virus which is transmitted through the bite of the Aedes aegypti mosquito which breeds in densely populated areas with humid and warm climates. The use of anti-mosquito drugs in the form of burns, sprays, lotions, or other forms has been widely used, but these drugs are not completely profitable. Anticipatory efforts need to be made by utilizing natural materials so that they can be used effectively and safely for both humans and the environment.
</sec>
<sec><title style='display:none'>AIM</title>
Our study tries to find the effectivity of the infusion from Jeruk Limau (Citrus amblycarpa) and Serai for botanical larvicide against Aedes aegypti larvae.
</sec>
<sec><title style='display:none'>METHODS</title>
This research is a pure experimental study with a Post-test Only Control Group Design by making larvicide products from lime and lemongrass waste infusions, the results of which are analyzed descriptively and analytically. The research used two factors, namely treatment (P) using infusion products whereas control (K) using distilled water.
</sec>
<sec><title style='display:none'>RESULTS</title>
From the results of effectiveness tests on larvae, it was found that there was a reduction in live larvae until all of them died. Lime and lemongrass waste contain flavonoid compounds which are respiratory toxins in larvae. The combination of saponin and tannin as a stomach poison has the power to kill mosquito larvae. The abundant availability of materials, enriching research treasures on local potential, as well as a good level of public acceptance are the advantages of the product.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
Apart from that, it is recommended to optimize the dosage and durability of the product so that it can be further patented as a concrete step in realizing the sustainable development agenda in the health sector.
</sec>
</abstract>

Botanical Larvicide from Jeruk Limau (<italic>Citrus amblycarpa</italic>) and Serai (<italic>Cymbopogon citratus</italic>) for Killing <italic>Aedes aegypti</italic> Larvae

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGROUND</title>
This study aimed to investigate ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia (EDTA-PTCP) a rare but significant phenomenon in clinical laboratories that cause diagnostic errors and unnecessary treatments.
</sec>
<sec><title style='display:none'>CASE PRESENTATION</title>
Here, we present an 83-year-old male patient with dyspnea and blood sputum and illustrate how EDTA, commonly used in complete blood count testing, causes falsely low platelet counts due to platelet aggregation and phagocytosis. Initially, the patient’s blood tested by the impedance method with a Sysmex XN-3000 analyzer demonstrated abnormally low platelet counts. However, further tests using different assays (fluorescent platelet count) and anticoagulants indicated the presence of EDTA-PTCP. Blood smear revealed platelet aggregation, satellitism, and phagocytosis that predominantly involve neutrophils. Remeasurements demonstrated significant improvement in platelet count and histogram waveform after incorporating K2-EDTA-added blood to K2-EDTA + kanamycin (KM)-containing vacutainer. These results indicate that remeasuring platelet counts after dissociation of platelet aggregation in EDTA-added blood with an additive such as KM is an effective method of handling EDTA- PTCP when platelet aggregation is observed. In addition, in vitro mixing studies were conducted with healthy control using platelet-poor plasma (PPP), prepared from EDTA and EDTA + KM blood collection tubes. It demonstrated that adding PPP from EDTA + KM tubes to whole blood did not decrease platelet count over time, unlike PPP from EDTA tubes. This revealed that KM, an aminoglycoside antibacterial agent, inhibited platelet aggregating factors in the patient’s plasma. The patient’s positive results for anti-ds-DNAIgG antibodies indicated active systemic lupus erythematosus, emphasizing a potential immunological mechanism of EDTA-PTCP in autoimmune diseases.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
The study reveals that EDTA causes platelet satellitism and phagocytosis by leukocytes, although the exact mechanism of EDTA-induced platelet phagocytosis remains unclear. In conclusion, this case demonstrates that using blood collection tubes other than those containing EDTA salt is a viable option in various laboratories, emphasizing the need for awareness and appropriate management of EDTA-PTCP in clinical practice.
</sec>
</abstract>

Ethylenediaminetetraacetic Acid-dependent Platelet Aggregation, Satellitism, and Phagocytosis in a Case in Which Aggregation was Resolved using Kanamycin Blood Collection Tubes

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGROUND</title>
Stevens–Johnson syndrome and toxic epidermal necrolysis (TEN) are severe mucocutaneous adverse drug reactions primarily caused by drugs. Characterized by fever, prodromal symptoms, and extensive epidermal sloughing with mucous membrane involvement (&gt;90%), they are collectively termed epidermal necrolysis and are considered a disease continuum.
</sec>
<sec><title style='display:none'>CASE PRESENTATION</title>
A 65-year-old man presented with widespread erythema and distinctive target-like lesions, accompanied by ruptured flaccid vesicles on the extremities. Following a 4-week carbamazepine treatment for a previous cerebrovascular insult, hematological analysis revealed abnormalities. A multidisciplinary team, including a neurologist, endocrinologist, and ophthalmologist, prescribed a 3-day course of intravenous immunoglobulin at 0.5 g/kg and an initial dose of 300 mg prednisolone for 3 days, supported by additional therapy. Discharged after 3 weeks, the rash completely resolved within 2 months.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
TEN, a severe mucocutaneous condition with a 30% mortality rate, often results from drug exposure. Swift identification of the causative drug is crucial for optimal outcomes. Treatment primarily includes discontinuing the offending drug and offering supportive care for mucocutaneous lesions. A multidisciplinary approach is vital based on organ system involvement. The effectiveness of pharmacological treatments, such as intravenous immunoglobulin and corticosteroids, is continually under evaluation.
</sec>
</abstract>

Toxic Epidermal Necrolysis: Case Report and Review

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>INTRODUCTION</title>
Childhood asthma frequently escapes timely diagnosis, a consequence of inadequate parental education, societal prejudices, and health-care professionals’ limited knowledge. Bringing attention to atopic dermatitis (AD) as an early indicator of childhood asthma can enhance awareness about the elevated risk of recurrent wheezing, bronchiolitis, and asthma in children, thereby advancing their care and treatment.
</sec>
<sec><title style='display:none'>AIM</title>
The objective of this study is to investigate the correlation between AD and the occurrence of recurrent wheezing, bronchiolitis, as well as asthma, in children aged 0–3 years. The findings of this research aim to contribute to early detection practices and guide the implementation of suitable treatment strategies for this vulnerable age group.
</sec>
<sec><title style='display:none'>MATERIALS AND METHODS</title>
In this study, retrospective data were gathered from health records at the Pediatric Primary Health Care Practice - “Vitalino” in Veles, North Macedonia. The analysis encompassed 414 children aged 0–3 years, spanning the years 2019–2022. The primary focus of the investigation was on children exhibiting early- onset AD and its association with recurrent wheezing, as well as bronchiolitis and the development of early childhood asthma.
</sec>
<sec><title style='display:none'>RESULTS</title>
The conducted statistical analyses, including measures such as prevalence, odds ratio, and multiple regression, revealed a significant association between AD and the early occurrence of recurrent wheezing. In addition, the analyses demonstrated a noteworthy association not only between AD and early recurrent wheezing but also between AD and childhood asthma. Moreover, a significant connection was identified between bronchiolitis and childhood asthma. These findings contribute to a more comprehensive understanding of the complex interrelationships among AD, bronchiolitis, and the early onset of childhood asthma.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
This study confirms that children under the age of 3 years who have early-onset AD are significantly more susceptible to recurrent wheezing and asthma. It is crucial to identify AD as a potential early indicator of childhood asthma. This knowledge can enhance awareness among health-care professionals and parents, leading to earlier detection of asthma symptoms in children. Ultimately, this can contribute to more effective management strategies for these young patients.
</sec>
</abstract>

Atopic Dermatitis as a Precursor to Early Onset of Recurrent Wheeze, Bronchiolitis, and Childhood Asthma

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGROUND</title>
Oral health is very important for general health and well-being. Oral diseases such as caries and periodontitis are common throughout the world. Periodontal is the main cause of tooth loss in adults. This disorder begins with gingivitis (swelling of the gums due to plaque), which, if left untreated, will result in periodontitis or infection that can destroy the teeth and surrounding tissue. The current management of this disease is to give analgesia and antibiotics, but early prevention and treatment are needed, one of them by using toothpaste.
</sec>
<sec><title style='display:none'>AIMS</title>
This study aims to assess the effectiveness of Gambier catechin as a preventive approach for streptococcal gingivitis.
</sec>
<sec><title style='display:none'>METHODS</title>
The research design used is a literature review study conducted from preclinical and clinical studies extracted from indexed international journals. Studies from 2012 to 2022 in English and related to the keywords are reviewed and synthesized.
</sec>
<sec><title style='display:none'>RESULTS</title>
The pathophysiology of the majority of gingivitis is related to inadequate cleaning of the oral cavity, which leads to the accumulation of plaque and bacteria. Catechins from Gambier also have a stronger capacity as antioxidants. Preclinical studies stated that Gambier has a strong potential for antioxidants. Catechins have stronger antioxidant capabilities than vitamins C and E. Catechins from Gambier also have a stronger capacity as antioxidants than vitamin E. Gambier catechin contains polyphenolic compounds that have antibacterial activity so that they can inhibit the formation of dental plaque. The catechin compound as an antibacterial has two properties, namely being able to inhibit (bacteriostatic) and kill (bacteria) the growth of bacteria.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
Gambier catechin has antioxidant and antibacterial effects and has potential for treating streptococcal gingivitis.
</sec>
</abstract>

The Antioxidant and Antibacterial Effects of Gambier Catechin (<italic>Uncaria gambir</italic> Roxb) in Streptococcal Gingivitis: A Review

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>BACKGROUND</title>Human immunodeficiency virus (HIV) is a type of virus that can weaken the immune system. People living with HIV (PLHIV) is vulnerable to a decrease in quality of life due to declining physical health and stigma from themselves and society. PLHIV is also found to have less intake, changes in the body’s metabolic rate, and changes in the digestive system, which results in malnutrition conditions.
</sec>
<sec><title style='display:none'>AIM</title>
The aim of the study is to analyze the effect of nutritional status on the quality of life of people with HIV/acquired immunodeficiency syndrome (AIDS) (ODHA) receiving antiretroviral therapy (ARV).
</sec>
<sec><title style='display:none'>METHODS</title>
This study was cross-sectional analytical study that examines nutritional status using body mass index with quality of life of PLHIV assessed by the World Health Organization Quality of life-HIV BREF questionnaire. Bivariate analysis was analyzed by Chi-square test and multivariate analysis by logistic regression test.
</sec>
<sec><title style='display:none'>RESULTS</title>
The results of the study found no relationship between nutritional status and quality of life. This study found a relationship between age, stigma, and depression with quality of life in PLHIV who received ARVs.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
The integration of psychologists in the treatment of HIV/AIDS is also recommended considering that depression plays a role in the quality of life of PLHIV. Counseling and health education to the community to reduce stigma should also be done.
</sec>
</abstract>

The Effect of Nutritional Status on the Quality of Life of People with HIV/AIDS (ODHA) Receiving Antiretroviral Therapy

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>AIM</title>
The link between the development of melanoma skin cancer and obesity is gaining recently an increased attention. A plethora of immune-related factors sustain a chronic inflammatory state modulated by the metabolic imbalance, the main examples being tumor necrosis factor alpha, interleukin 6, monocyte chemoattractant protein (MCP1), and several adipokines. Among the adipokines leptin (LEP) is steadily increasing interests as it involved in modulating different signaling pathways (e.g., JAK2/STAT3 and MAPK cascade/FOS) and immune cells fate by promoting the switch of memory cells to T helper-1 cell response, increases CD4+CD25- T-cell proliferation, and reduces autophagy during T-cell receptor stimulation. Our work investigates in a pilot study, using protein microarray technology, the LEP circulatory levels in melanoma patients in comparison to other cytokines and chemokines already reported as significantly involved in melanoma initiation and progression.
</sec>
<sec><title style='display:none'>METHODS</title>
Serum from melanoma cases and pool of serum from healthy volunteers were analyzed by an antibody array platform for a 42-cytokine profile.
</sec>
<sec><title style='display:none'>RESULTS</title>
The investigation of cytokines, chemokines, and growth factors has shown that all the proinflammatory circulating molecules are elevated in the melanoma patient’s serum. Inflammatory cytokines were found elevated and were correlated to the more advanced stage of the investigated patient (M2). The highest circulatory level was registered for LEP in both melanoma cases; moreover, in M1 patient, although the LEP level was completely comparable with the one found in M2, its IL-1 serum level was normal. In addition, there are ten analytes that show clear abnormal values and in patient M2 high LEP concentration is correlated with high IL-1, MCP-2, MCP-3, MCSF, and TARC serum concentrations.
</sec>
<sec><title style='display:none'>CONCLUSION</title>
Leptin is pleiotropic adipocytokine involved in various diseases, including skin cancer and melanoma. As it is involved in favoring inflammation and further tumorigenesis, the development of effective leptin-based therapeutic approaches opens new possibilities of adjuvant therapy in skin cancers.
</sec>
</abstract>

Systemic Circulating Leptin – Aiding New Dimension of Immune-Related Skin Carcinogenesis and Lipid Metabolism

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