Antithymocyte immunoglobulin (equine) 100mg/5ml solution for infusion vials

BackgroundVascularized composite allotransplantation (VCA) joins skin, muscle, bone, nerve, and vessels into a single graft that is both highly immunogenic and mechanically complex. Biopolymers, natural or synthetic, can provide structural scaffolding, localized drug release, and immune modulation. Although widely explored in solid-organ transplantation, their utility in VCA is poorly defined. We therefore conducted a systematic review to consolidate current evidence and map translational priorities.MethodsAdhering to PRISMA 2020 and registered in PROSPERO (CRD420251039845), we searched PubMed, Web of Science, EMBASE, Cochrane Library, and Google Scholar through April 2025. Original studies evaluating biopolymers in any VCA-relevant setting (in vitro, animal, or clinical) were eligible. Clinical quality was judged with the Newcastle-Ottawa Scale and pre-clinical studies with the SYRCLE tool. Given methodological heterogeneity, findings were narratively synthesized.ResultsEleven studies published between 2014 and 2024 fulfilled inclusion criteria. Collectively, they demonstrate that biopolymers, ranging from decellularized limb and auricular scaffolds to collagen-hydroxyapatite or polycaprolactone bone substitutes, hyaluronic-acid-functionalized vascular grafts, chitosan- or alginate-based drug-eluting coatings, and extracellular-matrix (ECM) sheets delivering cytotoxic T-lymphocyte-associated protein 4-immunoglobulin (CTLA4-Ig) with or without rapamycin, consistently enhance vascularization, support multi-tissue regeneration, and preserve mechanical integrity across diverse VCA models. Immunologically, polymer platforms bias host responses toward tolerance: in a murine hind-limb model, ECM combined with CTLA4-Ig and rapamycin extended graft survival to 72 days while promoting pro-regenerative macrophage polarization. Drug-delivery applications also proved effective; calcium-alginate coatings prolonged vancomycin release for up to 50 days in vitro, highlighting the potential for infection control during graft integration. Notwithstanding these benefits, chitosan scaffolds displayed inadequate load-bearing capacity, and heterogeneity in species, graft types, follow-up intervals, and outcome metrics limited direct comparison and impeded meta-analysis.ConclusionBiopolymers emerge as potential adaptable platforms that merge mechanical support with finely tuned immune regulation in VCA. Successful translation will depend on tissue-specific material optimization, standardized immunological endpoints, and multicenter studies that replicate clinical complexity. Drawing on lessons from solid-organ transplantation and fostering collaboration among immunologists, biomaterial scientists, and surgeons will be pivotal to moving these technologies from bench to bedside in VCA.

Abstract licence: CC BY

Asthma is a serious global health issue that affects millions of people worldwide. It is a heterogeneous disease characterized by inflammation, bronchial hyperresponsiveness and airway remodelling. Compounds from the coumarin class have been extensively documented in the literature as promising agents for asthma treatment. This review highlights the potential of coumarins and their effects in animal models of asthma. Articles from the past 10 years (2014-2024) were selected according to the guidelines of the PRISMA from the PubMed, Virtual Health Library (BVS) and ScienceDirect databases. The search strategy utilized descriptors from the Medical Subject Headings (MeSH) and Descriptors in Health Sciences (DeCS) databases. Were selected 18 articles after applying the inclusion criteria: full-text articles published in English and Portuguese, freely accessible and investigating coumarins and their derivatives with antiasthmatic activity. The coumarins most explored by the authors were imperatorin and osthole, and the results showed that these coumarins relax airway smooth muscle, reduce inflammation and the release of Th2 cytokines IL-4, IL-5 and IL-13 and increase protection against inflammation through pro-inflammatory cells, Th1, macrophages and dendritic cells. Thus, it is concluded that coumarins and their effects, particularly imperatorin and osthole, present a promising potential in asthma management and could serve as important molecular scaffolds for future investigations.

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Abstract ATOS is a prospective observational study evaluating the outcome of patients receiving anti-human T-lymphocyte immunoglobulin (ATLG) in unrelated donor transplantation. Primary endpoint was severe GvHD and relapse-free survival (SGRFS). GvHD prophylaxis consisted of ATLG and CSA/ MTX or MMF. Outcome was compared to the ATLG arm of our prospective randomized phase III multicenter trial trial (RCT).1, 2 165 patients with haematological malignancies were included. ATLG dose differed between centers (median total ATLG dose of 46 (IQR 32–60, range 15–91) mg/kg). Median follow-up was 70 months. As compared to the ATLG arm of our RCT, patients in ATOS were older, had a more advanced disease status, reduced intensity conditioning, HLA 10/10 match and PBSC transplantation were more frequent, given median ATLG dose was lower, and incidences of acute GvHD °III-IV (0.13), relapse (0.34), non-relapse mortality (0.23), and overall survival rates (0.52) were similar after 5 years. After adjusting for baseline differences, the largest difference in outcome was seen with respect to severe chronic GvHD (ATOS vs ATLG arm RCT: hazard ratio 2.79 [1.20, 6.51], p = 0.017). This long-term, multicenter, experience in routine clinical practice confirms the GvHD-protective effect of ATLG without compromising relapse and non-relapse mortality rates. Clinical Trial Registry: German clinical trials register DRKS00004581

Abstract licence: CC BY 4.0