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The present study aimed to investigate the effects of propolis and melatonin supplementation on inflammation, clinical outcomes, and oxidative stress markers in patients with primary pneumosepsis.This pilot randomized controlled trial was conducted on 55 patients with primary pneumosepsis who were randomly assigned to the intervention and control groups. In the three intervention groups, the patients received propolis alone (1,000 mg/day), propolis (1,000 mg/day) plus melatonin (20 mg/day), and melatonin alone (20 mg/day). The control group received placebo. The inflammatory and oxidative stress markers as well as clinical outcomes were evaluated before and after the intervention, and the 28-day survival rate was also recorded.After the intervention, the combination of propolis and melatonin significantly reduced interleukin-6 (-55.282 pg/mL) and C-reactive protein (-21.656 mg/L) levels, while increasing gavage intake (326.680 mL/day) and improving some clinical outcomes (APACHE II, SOFA, and NUTRIC scores) compared to the control group. However, no significant difference was observed between the groups in terms of oxidative stress and hematological indices. In addition, there was no significant difference in the 28-day survival rate between the groups (p = 0.07).Supplementation with propolis and melatonin may improve clinical outcomes by reducing inflammation. Further investigations are required to confirm these findings.Hintergrund und Zielsetzung: Mit der vorliegenden Studie sollten die Auswirkungen einer Supplementierung mit Propolis und Melatonin auf das Entzündungsgeschehen, die klinischen Ergebnisse und die Marker für oxidativen Stress bei Patienten mit primärer Pneumosepsis untersucht werden. Material und Methoden: An dieser randomisierten kontrollierten Pilotstudie nahmen 55 Patienten mit primärer Pneumosepsis teil, die randomi­siert den Interventionsgruppen bzw. der Kontrollgruppe zugewiesen wurden. In den drei Interventionsgruppen erhielten die Patienten Propolis als Monotherapie (1’000 mg/Tag), Propolis (1’000 mg/Tag) plus Melatonin (20 mg/Tag) und Melatonin als Monotherapie (20 mg/Tag). Die Kontrollgruppe erhielt ein Placebo. Vor und nach der Intervention wurden die Entzündungsmarker sowie die Marker für oxidativen Stress und die klinischen Ergebnisse beurteilt, und es erfolgte eine Erfassung der 28-Tage-Überlebensrate. Ergebnisse: Nach der Intervention war unter der Kombination von Propolis und Melatonin ein signifikanter Rückgang der Konzentration von Interleukin-6 (–55,282 pg/mL) und C-reaktivem Protein (–21,656 mg/L) gegenüber der Kontrollgruppe zu beobachten, wohingegen die Aufnahme von Sondennahrung (326,680 mL/Tag) zunahm und einige klinische Ergebnisse (APACHE-II-, SOFA- und NUTRIC-Scores) eine Verbesse­rung zeigten. In Hinblick auf den oxidativen Stress und die hämatologischen Indizes bestand jedoch kein signifikan­ter Unterschied zwischen den Gruppen, und auch bei der 28-Tage-Überlebensrate fand sich kein signifikanter Unterschied zwischen den Gruppen (p = 0,07). Schlussfolgerung: Eine Supplementierung mit Propolis und Melatonin kann die klinischen Ergebnisse durch eine Verringe­rung des Entzündungsgeschehens verbessern. Zur Bestätigung dieser Ergebnisse sind weitere Untersuchungen erforderlich.

Inflammation plays an important role in the pathophysiology of traumatic brain injury (TBI). Based on the anti-inflammatory properties of French maritime pine bark extract and the neuroprotective effects, we aimed to evaluate the effects of its supplementation on TBI. Sixty-seven TBI patients admitted to the intensive care units (ICUs) were enrolled. After stabilizing the hemodynamic status, the intervention group received 150 mg of French maritime pine bark extract supplementation (Oligopin) with enteral nutrition for 10 days. The control group received a placebo. Inflammatory status and oxidative stress markers were measured three times. Also, clinical and nutritional statuses were assessed. Supplementation, significantly decreased IL-6 (β = -53.43 pg/ml, 95% confidence interval [CI] = -91.74, -15.13, p = .006), IL-1β (β = -111.66 pg/ml, 95% CI = -183.79, -39.5402, p = .002) and C-reactive protein (β = -19.99 mg/L, 95% CI = -27.23, -12.76, p ˃ .001) in the intervention group compared to control group after 10 days. Clinical scores including acute physiology and chronic health evaluation II and sequential organ failure assessment were reduced (β = -3.72, 95% CI = -5.96, -1.49, p = .001and β = -2.07, 95% CI = -3.23, -0.90, p < .001, respectively), and Nutric score was reduced compared to control group (β = -.60, 95% CI = -1.08, -0.12, p = .01). The survival rate was higher by 15% in the intervention group compared to control group. Oligopin supplementation in TBI patients in ICU reduced inflammation and improved the clinical status and malnutrition score and thereby reducing the mortality rate.

The aim of this study was to perform a systematic review and meta-analysis on randomized controlled trials investigating the effects of carotenoids on selected inflammatory parameters. PubMed, SCOPUS, and Web of science were searched from inception until April 2021. The random-effect model was used to analyze data and the overall effect size was computed as weighted mean difference (WMD) and corresponding 95% of confidence interval (CI). A total of 26 trials with 35 effect sizes were included in this meta-analysis. The results indicated significant effects of carotenoids on C-reactive protein (CRP) (WMD: ‒0.54 mg/L, 95% CI: ‒0.71, ‒0.37, P < 0.001), and interleukin-6 (IL-6) (WMD: ‒0.54 pg/mL, 95% CI: ‒1.01, ‒0.06, P = 0.025), however the effect on tumor necrosis factor-alpha (TNF-α) was not significant (WMD: ‒0.97 pg/ml, 95% CI: ‒1.98, 0.03, P = 0.0.059). For the individual carotenoids, astaxanthin, (WMD: ‒0.30 mg/L, 95% CI: ‒0.51, ‒0.09, P = 0.005), lutein/zeaxanthin (WMD: ‒0.30 mg/L, 95% CI: ‒0.45, ‒0.15, P < 0.001), and β-cryptoxanthin (WMD: ‒0.35 mg/L, 95% CI: ‒0.54, ‒0.15, P < 0.001) significantly decreased CRP level. Also, only lycopene (WMD: ‒1.08 pg/ml, 95%CI: ‒2.03, ‒0.12, P = 0.027) led to a significant decrease in IL-6. The overall results supported possible protective effects of carotenoids on inflammatory biomarkers.

A crucial component of the immune system are chemokiness. Chemokine's dysregulation has been linked to a number of pathological diseases. Recently, CXCL17, a chemokine belonging to the CXC subfamily, was identified. With regard to a number of physiological conditions and disorders, CXCL17 either has homeostatic or pathogenic effects. Some research suggests that CXCL17 is an orphan ligand, despite the fact that G protein-coupled receptor (GPR) 35 has been suggested as a possible receptor for CXCL17. Since CXCL17 is primarily secreted by mucosal epithelia, such as those in the digestive and respiratory tracts, under physiological circumstances, this chemokine is referred to as a mucosal chemokine. Macrophages and monocytes are the cells that express GPR35 and hence react to CXCL17. In homeostatic conditions, this chemokine has anti-inflammatory, antibacterial, and chemotactic properties. CXCL17 promotes angiogenesis, metastasis, and cell proliferation in pathologic circumstances like malignancies. However, other studies suggest that CXCL17 may have anti-tumor properties. Additionally, studies have shown that CXCL17 may have a role in conditions such as idiopathic pulmonary fibrosis, multiple sclerosis, asthma, and systemic sclerosis. Additionally, deregulation of CXCL17 in some diseases may serve as a biomarker for diagnosis and prognosis. Clarifying the underlying mechanism of CXCL17's activity in homeostatic and pathological situations may thus increase our understanding of its role and hold promise for the development of novel treatment strategies.

Propolis is a sticky, resinous material gather from plants and is blended with wax and other constituents. It is reported to have anti-inflammatory, anti-oxidative and blood glucose-lowering properties. This review aims to summarise evidences for the cellular and molecular mechanism of Propolis in inflammation, oxidative stress, and glycemic control. Propolis stimulate the production and secretion of anti-inflammatory cytokines and to inhibit the production of inflammatory cytokines and due to its various antioxidant and poly-phenolic compounds may has a role in control and treating some of the chronic diseases. Most studies have shown that Propolis may affect metabolic factors including plasma insulin levels, and it has proposed that it could be used in the prevention and treatment of T2D Mellitus. In general, to demonstrate the definite effects of Propolis on chronic diseases, more studies are required using larger sample sizes and various doses of Propolis, using better characterized and standardized agents.

Cytokines are considered vital mediators of the immune system. Down- or upregulation of these mediators is linked to several inflammatory and pathologic situations. IL-26 is referred to as an identified member of the IL-10 family and IL-20 subfamily. Due to having a unique cationic structure, IL-26 exerts diverse functions in several diseases. Since IL-26 is mainly secreted from Th17, it is primarily considered a pro-inflammatory cytokine. Upon binding to its receptor complex (IL-10R1/IL-20R2), IL-26 activates multiple signaling mediators, especially STAT1/STAT3. In cancer, IL-26 induces IL-22-producing cells, which consequently decreases cytotoxic T cell functions and promotes tumor growth through activating anti-apoptotic proteins. In hypersensitivity conditions such as rheumatoid arthritis, multiple sclerosis, psoriasis, and allergic disease, this cytokine functions primarily as the disease-promoting mediator and might be considered a biomarker for disease prognosis. Although IL-26 exerts anti-microbial function in infections such as hepatitis, tuberculosis, and leprosy, it has also been shown that IL-26 might be involved in the pathogenesis and exacerbation of sepsis. Besides, the involvement of IL-26 has been confirmed in other conditions, including graft versus host disease and chronic obstructive pulmonary disease. Therefore, due to the multifarious function of this cytokine, it is proposed that the underlying mechanism regarding IL-26 function should be elucidated. Collectively, it is hoped that the examination of IL-26 in several contexts might be promising in predicting disease prognosis and might introduce novel approaches in the treatment of various diseases.

Background: Systemic Inflammatory Response Syndrome (SIRS) that occurs under stressful conditions affecting all organs of the body. Previous studies have shown that propolis and melatonin have the potential to improve inflammation and oxidative stress, so the aim of this study was to investigate the effects of these supplements on SIRS treatment.Method: This was a randomized, controlled clinical trial in SIRS patients comprising 55 subjects that were randomly assigned to 3 intervention or control groups. In the 3 intervention groups, patients were treated with propolis alone (at dose of 1000 mg/day), propolis (1000 mg/day) plus melatonin (20 mg/day), and melatonin alone (20 mg/day) respectively, while there was no intervention in the control group. The inflammatory and oxidative stress markers and clinical outcomes were measured before and after of the intervention, also 28-day survival rate was assessed. Results: Propolis plus melatonin reduced serum interleukin 6 (p = 0.001) and CRP levels (p 0.001). The average survival after 28 days of follow-up in the propolis, propolis+melatonin, melatonin and control groups were 24.08, 25.69, 22.05 and 19.42 days respectively, although this was not statistically significant (p=0.07).Conclusion and relevance: Supplementation with propolis+melatonin may help to improve clinical outcomes by reducing inflammation and was probably associated with an increase in the calorie intake, leading to an increase in the survival rate in SIRS patients, although more studies are necessary to prove these effects. Trial registration: IRCT20181025041460N1.

Background Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patients. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective The objective of this work is to survey the effect of pycnogenol on the clinical, nutritional, and inflammatory status of TBI patients. Methods This is a double-blind, randomized controlled trial. Block randomization will be used. An intervention group will receive pycnogenol supplementation of 150 mg for 10 days and a control group will receive a placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (malondialdehyde, total antioxidant capacity), at the baseline, at the 5th day, and at the end of the study (10th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. The Sequential Organ Failure Assessment (SOFA) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index, and body composition will be measured. All analyses will be conducted by an initially assigned study arm in an intention-to-treat analysis. Discussion We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients. Trial registration This trial is registered at clinicaltrials.gov (ref: NCT03777683) at 12/13/2018.

Critically ill patients are diagnosed with signs such as oxidative stress, mitochondrial function impairment, dysfunction of the immune system, and acute inflammation. Inflammation and oxidative stress play a major role in the pathogenicity of most diseases in patients, especially those in intensive care units. Because of the side effects of chemical anti-inflammatory drugs, which include large intestinal ulcers, bleeding, and perforation, it seems that the use of natural anti-inflammatory compounds like melatonin could be very helpful. Melatonin productively interacts with different receptive nitrogen and oxygen species (receptor autonomous activities), up-regulates antioxidant chemicals, and down-regulates pro-oxidant chemicals (receptor-dependent activities). Melatonin attenuates molecular and cellular damage resulting from inflammation and oxidative stress. Previous studies have shown that melatonin reduces inflammation and oxidative stress levels. Thus, the use of safe doses of melatonin can reduce inflammation and oxidative stress. However, further studies are needed to verify these results.

Oxidative stress is an important factor in the etiology of several chronic diseases that include cardiovascular disease (CVD), Type 2 diabetes (T2D), and rheumatoid arthritis (RA). Oxidative stress can lead to inflammation, and this can contribute to these chronic diseases. Reducing inflammation and oxidative stress may, therefore, be useful in the prevention and treatment of these conditions. One of the treatment options for chronic diseases is the use of traditional medicine and herbs, such as Nigella sativa. This is one of the herbs that have recently been assessed for its ability to reduce inflammation and oxidative stress. We have reviewed the reported effects of N. sativa on risk factors of chronic diseases (CVD, DM, and RA) with emphasis on molecular and cellular mechanisms in controlling inflammation and oxidative stress. Various mechanisms have been proposed to contribute to the beneficial properties of N. sativa, including a reduction of lipid peroxidation via its antioxidant properties; agonist of peroxisome proliferator-activated receptor gamma in adipose tissue; activation of AMP-activated protein kinase, increased antioxidants, inhibition of nuclear factor-kappa B pathway; increased in interleukin-10 expression, CD4+ T-cell percentage, T regulatory cell percentage (CD4+ CD25+ T-cell) in peripheral blood, and CD4+/CD8+ ratio, but to prove this claim, it is necessary to conduct experimental and well-designed clinical trial studies with a larger sample size on the effects of N. sativa on these chronic diseases.