: In December 2019 in Wuhan, China, the Severe Acute Respiratory Syndrome - Corona Virus - 2 (SARS-CoV-2) (also 2019 nCoV) was first discovered. Later WHO declared that SARS-CoV-2 was responsible for Coronavirus Disease 2019 (COVID-19). The round, elliptical or pleomorphic shape of the 2019-nCoV is 60–140 nm in diameter. It comprises a single stranded genome of RNA that comprises 29891 nucleotides, a lipid shell and spike protein, envelops membrane, and hemagglutinin-esterase (HE) proteins. Several therapeutic approaches have been proposed to combat with this disease as this disease became global pandemic. Bacillus Calmette–Guérin (BCG) vaccine could be another approach and at present it is the only TB prevention vaccine approved. Both TB and COVID-19 causes severe pneumonia. In this review, we have tried to correlate the pathophysiology of both these disease condition. . In this review, we also have shown the history and current BCG practice throughout the world and it is hypothesized that the countries which strictly maintained and made mandatory call to recommend BCG vaccination are relatively less affected by COVID-19 pandemic. When BCG is exposed to a subsequent viral infection, it is allowed to lead to cross-reactive T cell responses which result in increased activity of Cluster of differentiation (CD) 4 + and Cluster of differentiation (CD) 8 + T cells and this may be a ray of hope in treating the SARS infection.
Background: Ranitidine (RAN) is one of the common drugs associated with idiosyncratic adverse drug reactions (IADRs) in humans. It was found to be associated with severe adverse drug reactions due to the presence of contaminants such as N-Nitrosodimethylamine (NDMA) which is claimed to be carcinogenic. As a consequence, on April 1, 2020, United States Food and Drug Administration (USFDA) had decided to call off all the RAN products from the market. The exact cause of RAN associated idiosyncratic hepatotoxicity is not clear yet. Purpose: To summarize and analyze the reason behind the withdrawal of RAN products from the market and whether ranitidine will be available again in future or will FDA withdraw approvals of ranitidine National Drug Authority (NDA) and an abbreviated new drug application (ANDA)? Methods: We performed a systematic PubMed/MEDLINE search of studies investigating the reason behind the withdrawal of RAN products and explored the possible mechanism associated with RAN induced hepatotoxicity.Conclusion: RAN induced liver injury is difficult to diagnose and study because of its relative rarity and unpredictive occurrence. Recent studies suggest that most of the RAN associated idiosyncratic reactions may lead to hepatocyte damage, followed by a series of events, such as activation of specific T- and B-cells, release of proinflammatory mediators like TNFα, interleukins, various cytokines and chemokines. The exact cause of RAN associated idiosyncratic hepatotoxicity is not clear yet. More studies must be carried out on this to know about the exact reason behind RAN associated hepatotoxicity.
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