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Medical Patients with Epilepsy
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Aluminum hydroxide, magnesium hydroxide, and calcium carbonate preparations are in wide use for the treatment of peptic ulcer disease and sundry ill-defined stomach ailments. Some of these preparations can decrease the absorption of PHT horn the GI tract, but this effect appears to be quite variable (18). A single report also suggests that the absorption of some VPA preparations can be increased by some but not other antacid formulations (20,21). When feasible, given the uncertainties of changes in VPA or PHT bioavailability during concomitant antacid therapy, these AEDs should be administered either 1 to 2 hours before or 2 hours after taking the antacid. AED plasma levels should be followed during concurrent therapy to screen for significant interactions.
Clinical Considerations in Radiotracer Biodistribution Studies
Published in Lelio G. Colombetti, Biological Transport of Radiotracers, 2020
Liver uptake of 99mTc-Sn-EHDP has been demonstrated in the presence of AΓ3 ions possibly leached from the technetium generator. This was believed to be due to the formation of a colloidal complex, although no particles were visible under light microscopy.47 Plasma aluminum levels have been reported to rise markedly during ingestion of aluminum hydroxide, carbonate, and aminoacetate.48
Manufacturing and standardizing allergen extracts in Europe
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2020
Jørgen Nedergaard Larsen, Christian Gauguin Houghton, Manuel Lombardero Vega, Hendrik Nolte, Henning Løwenstein
Physical modification of allergens involves adsorption of the allergen extract with insoluble complexes of inorganic salts, such as aluminum hydroxide or calcium phosphate. Aluminum hydroxide, Al(OH)3, is especially useful for vaccination purposes and is used in both human and veterinary medicine [22]. Its advantages are based on two characteristics of the complexes, the depot effect and the adjuvant effect. The allergens bind firmly to the inorganic complexes, giving rise to slow release of the proteins, thereby lowering the concentration of allergen in the tissue and reducing the risk of systemic side effects. Furthermore, the depot effect reduces the number of injections needed in the course of specific allergy vaccination. Although the significance of the adjuvant effect is unclear, higher levels of IgG antibodies are observed when alum-adsorbed vaccines are used in specific allergy vaccination, as compared to aqueous vaccine [23]. Compared to aqueous vaccines, patients receiving depot preparations seem to experience fewer systemic side effects [24], particularly severe early reactions. The frequency of late reactions, which seem to be milder and can be managed by the patient at home, are reduced to a lesser extent, especially in asthmatic patients [25].
Nanotechnology-based photo-immunotherapy: a new hope for inhibition of melanoma growth and metastasis
Published in Journal of Drug Targeting, 2023
Ji-Yuan Zhang, Wei-Dong Gao, Jia-Yi Lin, Shan Xu, Li-Jun Zhang, Xin-Chen Lu, Xin Luan, Jian-Qing Peng, Yi Chen
The inorganic adjuvants applied in combination with nanotechnology-based phototherapy for melanoma are usually metal compounds, such as aluminium hydroxide, aluminium oxide, alum, zinc oxide (ZnO), etc. [84]. Aluminium hydroxide has been used as an immunoadjuvant for human vaccines for more than 80 years. It is reported that aluminium hydroxide combined with nanotechnology-based phototherapy in melanoma treatment can induce a strong anti-tumour immune response. The interaction of antigens and aluminium hydroxide promotes the recruitment and maturation of DCs and induces strong cellular immunity. For example, Zhu et al. [85] prepared bovine serum albumin NPs (Al-BSA-Ce6 NPs) loaded with aluminium hydroxide and chlorin e6 (Ce6) by albumin-based biomineralization. Al-BSA-Ce6 NPs can not only effectively and severely damage tumour tissue, but also prevent tumour recurrence and metastasis by inducing a strong anti-tumour immune response. In the meanwhile, it was reported that ZnO is a potential immunoadjuvant that can effectively enhance the immune response. Zhang et al. [86] designed an immunoadjuvant-covered multifunctional nanocomposite AuNP@mSiO2 loaded with doxorubicin and ZnO, which have significantly triggered the ICD of melanoma cells via PTT. Meanwhile, ZnO exhibited preferential selectivity for melanoma cells. However, the complex mechanism of the auxiliary behaviour and cooperative strategy shown by ZnO NPs in cancer treatment needs to be further investigated.
Preclinical developments in the delivery of protein antigens for vaccination
Published in Expert Opinion on Drug Delivery, 2023
Dylan A. Hendy, Alex Haven, Eric M. Bachelder, Kristy M. Ainslie
Aluminum hydroxide (alum) is one adjuvant that is widely used with subunit vaccines. One example of a current clinical subunit vaccine that includes alum is the anthrax vaccine adsorbed (AVA) which is produced under the name BioThrax® (Emergent BioDefense Corporation) and first licensed for human use in 1970 [25]. AVA contains the anthrax protective antigen (PA) protein and is adjuvanted with alum. Alum containing adjuvants were first found to be immunostimulatory in 1926 and since then they have been used in various vaccines such as diphtheria, pertussis, and tetanus [26]. Broadly, alum covers multiple similar adjuvants and can include aluminum salts such as aluminum hydroxide, aluminum phosphate, and aluminum potassium sulfate. Although the exact mechanism of alum is still in contention, it is thought that these adjuvants promote immunogenicity by adsorbing antigens as well as causing local inflammation at the site of injection resulting in activation of the NLR family pyrin domain containing 3 (NLR3) inflammasome [27,28]. This in turn promotes a strong Th2 response with high levels of neutralizing antibodies; however, alum only very weakly activates a Th1 response. Furthermore, while AVA is effective in producing neutralizing antibodies against PA the protection is extremely inefficient requiring 5 doses followed by boosters every 12–18 months [29].
Is SARS-CoV-2 vaccination safe and effective for elderly individuals with neurodegenerative diseases?
Published in Expert Review of Vaccines, 2021
Yan Shi, Minna Guo, Wenjing Yang, Shijiang Liu, Bin Zhu, Ling Yang, Chun Yang, Cunming Liu
Vaccination is the most promising measure to reduce infection rates and mortality in patients with neurodegenerative diseases. After completing SARS-CoV-2 sequencing, several SARS-CoV-2 vaccine candidates began research and development. After SARS-CoV-2 vaccination, the body can produce an immune response against the vaccine antigen, including cellular and/or humoral immunity, and generate memory immune cells, thereby gaining antiviral ability. As patients with neurodegenerative diseases often have complex conditions such as advanced age and poor immune function, we must consider the safety and effectiveness of vaccines in these patients. Unfortunately, most SARS-CoV-2 vaccine candidates exclude elderly patients in clinical trials, and we are unable to obtain relevant clinical data. Based on previous vaccination data, we speculate that most inactivated vaccines are relatively safe for patients with neurodegenerative diseases. There is not sufficient data to prove the safety of live attenuated vaccines, viral vector vaccines, and nucleic acid vaccines. Because neurodegenerative diseases are often associated with immunosuppression, live attenuated vaccines should be avoided. Furthermore, vaccines containing aluminum hydroxide as an adjuvant should be used with caution in these patients.