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BACKGROUND: Andrographis paniculata (A. paniculata), a medicinal plant, has shown anti-inflammatory, neuroprotective and antifibrotic effects in animal models as well as clinical efficacy in different studies, including an anti-fatigue effect in autoimmune diseases such as rheumatoid arthritis. In multiple sclerosis (MS), fatigue is rated as one of the most common and disabling symptoms. In the present trial, we investigated the effect of A. paniculata on relapse rate and fatigue in relapsing-remitting MS (RRMS) patients receiving interferon beta. METHODS: A randomised double-blind placebo-controlled trial assessed the effects of 170 mg of A. paniculata dried extract tablet b.i.d. p.o. on relapse rate and fatigue using the Fatigue Severity Scores (FSS) over 12 months in RRMS patients receiving interferon. The Expanded Disability Status Scale (EDSS) score, inflammatory parameters and radiological findings were also investigated. Twenty-five patients were enrolled, and twenty-two patients were ultimately analysed and randomised to the active or placebo group. RESULTS: Patients treated with A. paniculata showed a significant reduction in their FSS score as compared to the placebo, equivalent to a 44 % reduction at 12 months. No statistically significant differences were observed for relapse rate, EDSS or inflammatory parameters, with a trend in reducing new lesions among the A. paniculata group. One patient in the A. paniculata group presented with a mild and transient skin rash, which was alleviated with anti-histamine treatment for three weeks. CONCLUSION: A. paniculata was well tolerated in patients and no changes in clinical parameters were observed. A. paniculata significantly reduces fatigue in patients with RRMS receiving interferon beta in comparison to placebo and only interferon beta treatment. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02280876 ; Trial registration date: 20.10.2014.

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Andrographis paniculata (Burm. f.) Wall ex Nees (Acanthaceae) possesses anti-inflammatory effects, attributed to the main constituent andrographolide proposed as alternative in the treatment of autoimmune disease. A prospective, randomized, double blind, and placebo-controlled study in patients with rheumatoid arthritis (RA) was performed. Tablets (Paractin) made of an extract of A. paniculata (30% total andrographolides) were administered three times a day for 14 weeks, after a 2-week washout period to 60 patients with active RA. The primary outcomes were pain intensity measured using a horizontal visual analog pain scale (VAPS). In addition, ACR, EULAR, and SF36 clinical parameters were recorded. The intensity of joint pain decreased in the active vs placebo group at the end of treatment, although these differences were not statistically significant. A significant diminishing for week in tender joint -0.13 95% confidence interval (CI; -0.22 to 0.06; p = 0.001), number of swollen joints -0.15 95%CI (-0.29 to -0.02; p = 0.02), total grade of swollen joint -0.27 95%CI (-0.48 to -0.07; p = 0.010), number of tender joints -0.25 95%CI (-0.48 to -0.02; p = 0.033), total grade of swollen joints -0.27 95%CI (-0.48 to -0.07; p = 0.01), total grade of tender joints -0.47 95%CI (-0.77 to -0.17; p = 0.002) and HAQ -0.52 95%CI (-0.82 to -0.21; p < 0.001) and SF36 0.02 95%CI (0.01 to 0.02; p < 0.001) health questionnaires was observed within the group with the active drug. Moreover, it was associated to a reduction of rheumatoid factor, IgA, and C4. These findings suggest that A. paniculata could be a useful "natural complement" in the treatment of AR; however, a larger trial and a more extended period of treatment is necessary in order to corroborate these results.

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We determined the sensitivity of five strains of Campylobacter jejuni and C. coli isolated from children with diarrhea and from chicken feces to normal human blood serum (undiluted and at concentrations of 10, 30, 50 and 70%), a hypogammaglobulinemic serum and a complement-deficient serum. Both species were highly sensitive to the bactericidal activity of human serum, regardless of their source. The highest bactericidal activity was observed with pooled fresh normal serum, with bacterial survival rates inversely correlated to serum dilutions. Inactivated serum had the least bactericidal activity. When complement was partially restored to inactivated serum, lower survival rates were observed. The hypogammaglobulinemic-normal complement-containing serum had strong bactericidal activity whereas the normal immunoglobulin-containing but complement-deficient serum had little bactericidal activity. These results suggest that Campylobacter may be able to directly activate complement by the alternative pathway.

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We determined the sensitivity of five strains Compylobacter jejuni and C. coli isolated from children with diarrhea and from chicken feces to normal human blood serum (undiluted and at concentrationss of 10, 30, 50 and 70 per cent), hypogmmaglobulinemic serum and a complemented-deficient serum. Both species were highly sensitive to the bactecidal activity of human serum, regardless of their source. The highest bactericidal activity was observed with pooled fresh normal serum, with bacterial survival rates inversely correlated to serum dilutions. Inactivated serum had the least bactericidal activity. When complement was partially restored to inactivated serum, lower survival rates were observed. The hypogammaglobulinemic-normal complement-containing serum had strong bactericidal activity whereas the normal immunoglobulin-containing but complement-feficient serum had little bactericidal activity. These results suggest that Campylobacter may be able to directly activate complement by the alternative pathway

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Familial idiopathic membranous nephropathy, an immune-complex-associated glomerulopathy, has not been previously reported in father and son, despite its striking immunogenetic correlation, especially with HLA-DR3. As a dysfunction of the monocyte-phagocyte system (MPS), it has been observed linked to DR3 antigen, so we studied the MPS Fc receptor function in a father and his son with a histologically proven membranous nephropathy, associated with the haplotype A9-B35-DR3-DQw2. The Fc receptor function of the MPS was examined by measuring the clearance of IgG-sensitized, 51Cr-labeled erythrocytes and by measuring the ability of isolated monocytes to ingest autologous red blood cells coated with IgG anti-Rh (D) antibody. Immune clearance and in vitro phagocytosis was normal in both patients and not related to their levels of immune complexes (as measured by ELISA C1q and Conglutinin solid-phase binding assay). This report suggest that genetic factors may play an important role in the development of membranous nephropathy, and it seems not to be related to a dysfunction of MPS as measured by these tests.

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Since campylobacter infections in humans at early age have not been thoroughly documented yet, it seemed interesting to report the occurrence of two simultaneous cases of C. coli enteritis in one newborn monozygotic twin pair. Their clinical history, epidemiology and microbiological analysis, development of specific serum and mucosal immunity as well as total Ig synthesis are discussed on the basis of their close genetic and environmental relationships.

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