The rate of allergy is increasing particularly among infants due to several factors reaching up to 30%. Several materials components have been implicated in the development and excessive activation of the immune system, acting as irritants and allergic agents. In several studies, in Mediterranean inhabitants with a specific diet, the prevalence of allergies in children was low, whereas dietary supplements in the Western and Mediterranean countries had a different role in the regulation of immune responses and in the reduction of allergic reactions. Probiotics have been associated with reduction of allergic reactions mostly by positive effect on T helper cells, regulatory T cells (Tregs), B cells and dendritic cells. Furthermore, probiotics existing in the human intestine can modulate the immune response and allergic reactions through downregulation of Th2-related responses (IgE, IL-4 and IL-5). They mostly exert anti-inflammatory and immunomodulatory properties by modulation of immune system components via hindering of various signaling pathways such as the NF-κB pathway, probably associated with changes in mitogen-activated protein kinases and pattern recognition receptors pathways. These microorganisms have also potential to inhibit the bacterial lipopolysaccharide attachment to the CD14 receptor, hence reducing the overall activation of NF-κB and proinflammatory cytokines production. Bifidobacterium and Lactobacillus species act through increase in proinflammatory (Th1) cytokines (INF-γ, IL-12, IL-13, TNF-α and also IL-4 and IL-10), dendritic cells, CD4+FoxP3+ T cells, GATA-3 and intestinal barrier maturation, whereas decrease the Th2-mediated cytokines, IgA, IgE, IgG1, IL-4, IL-5 and IL-6, IL-13, airway reactivity, pulmonary eosinophilia. Furthermore, Clostridium butyricum could act by improvement of anaphylaxis symptoms and increase of sIgA and CD4+ CD25+FoxP3Treg cells. In this review, we assessed the recent evidence that confirms the role of probiotics compounds as an important factor in the safety of homeostasis and the development of allergic reactions through a complex set of metabolites and the immune cells. The employment and application of probiotics combined with immunotherapy approaches can be possibly effective in reducing allergic reactions and related therapeutic costs.
The role of efflux pumps in antibiotic resistance development among Escherichia coli may have been underappreciated. The objective of this study was assessment the association of AcrAB-TolC efflux pumps and qepA genes with resistance to common antibiotics among E. coli isolates. A total of 200 E. coli isolates were obtained from diverse samples of inpatients. Minimum inhibitory concentrations and Kirby–Bauer disk diffusion tests were determined for ceftazidime, cefotaxime, imipenem, gentamicin, and tetracycline. The Acr-AB-TolC and qepA genes were amplified using PCR technique and their association with antibiotics was also evaluated using Chi-square test. A majority of isolates (64%) were retrieved from gastrointestinal samples, followed by urinary tract infections (33%), and bloodstream (3%). All the isolates were resistant to ampicillin (100%), followed by cefazolin (59%), and cefoxitin (58%). However, 100% of the isolates showed susceptibility to fosfomycin. The prevalence of acrA, acrB, and qepA genes was 94% (n = 188), 86% (n = 172), and 8% (n = 16), respectively. The acrA and acrB were significantly associated with resistance to cefoxitin and cefazolin (P < 0.01), ceftazidime (P < 0.01), carbapenems (P = 0.022), and tetracycline (P = 0.0112). In addition, qepA gene was significantly associated with tetracycline resistance (P = 0.032). None of the patients had death outcome. A majority of E. coli isolates harbored the AcrAB genes, but qepA was observed among lower number of the isolates. It is notable that three strains lacked the extended spectrum beta-lactamase and carbapenemases and none of multidrug resistant strains carried tet and aminoglycoside modifying enzymes genes. Over-expression of efflux pumps has been increasingly is associated with clinically relevant antibiotic resistance. For this reason, the expression and functionality of efflux pumps should be more investigated profoundly and be compared between drug-resistant and drug-susceptible isolates.
On account of the continuing increase in antimicrobial resistance among infectious agents which are mostly life-threatening, seeking novel and alternative therapeutic approaches seems essential. Eucalyptus camaldulensis, generally known as eucalyptus, contains various healing traits such as antimicrobial characteristics. These herbs generally grow alongside the rivers with both continuous and seasonal water. The antimicrobial applications of this herb, particularly against pandrug and multidrug resistant microorganisms mostly attributed to phenolic, polar terpene compounds and spathulenol. Major bioactive antimicrobial fractions include flavonoids, alkaloids, pigments, terpenes, phenolics, starches, steroids and essential oils. E. camaldulensis has antimicrobial features against various bacterial (both Gram-positive and Gram-negative species), fungal, parasitic and viral infections. Regarding molecular mechanisms, the discharge of Gram-negative outer membrane lipopolysaccharide and increase the permeability of the cytoplasmic membrane have been proposed. Leaf extracts might be a good source of antibacterial and antifungal materials that might be useful in pharmaceutical industry. Interactions with various conventional antimicrobial agents providing synergistic effects suppose a variety of antimicrobial mechanisms by fractions remaining to be entirely elucidated.
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