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  1. Fulltext Deciphering the Association of Cytokines, Chemokines, and Growth Factors in Chondrogenic Differentiation of Human Bone Marrow Mesenchymal Stem Cells Using an ex vivo Osteochondral Culture System
    Jafri MA, Kalamegam G, Abbas M, Al-Kaff M, Ahmed F, Bakhashab S, et al.
    Front Cell Dev Biol, 2019;7:380.
    PMID: 32010693 DOI: 10.3389/fcell.2019.00380
    Osteoarthritis (OA) is a chronic degenerative joint disorder associated with degradation and decreased production of the extracellular matrix, eventually leading to cartilage destruction. Limited chondrocyte turnover, structural damage, and prevailing inflammatory milieu prevent efficient cartilage repair and restoration of joint function. In the present study, we evaluated the role of secreted cytokines, chemokines, and growth factors present in the culture supernatant obtained from an ex vivo osteochondral model of cartilage differentiation using cartilage pellets (CP), bone marrow stem cells (BM-MSCs), and/or BM-MSCs + CP. Multiplex cytokine analysis showed differential secretion of growth factors (G-CSF, GM-CSF, HGF, EGF, VEGF); chemokines (MCP-1, MIP1α, MIP1β, RANTES, Eotaxin, IP-10), pro-inflammatory cytokines (IL-1β, IL-2, IL-5, IL-6, IL-8, TNFα, IL-12, IL-15, IL-17) and anti-inflammatory cytokines (IL-4, IL-10, and IL-13) in the experimental groups compared to the control. In silico analyses of the role of stem cells and CP in relation to the expression of various molecules, canonical pathways and hierarchical cluster patterns were deduced using the Ingenuity Pathway Analysis (IPA) software (Qiagen, United States). The interactions of the cytokines, chemokines, and growth factors that are involved in the cartilage differentiation showed that stem cells, when used together with CP, bring about a favorable cell signaling that supports cartilage differentiation and additionally helps to attenuate inflammatory cytokines and further downstream disease-associated pro-inflammatory pathways. Hence, the autologous or allogeneic stem cells and local cartilage tissues may be used for efficient cartilage differentiation and the management of OA.
  2. The efficacy of vagus nerve stimulation for epilepsy in Malaysia
    Fong SL, Lim KS, Raymond AA, Tan HJ, Khoo CS, Mohamed AR, et al.
    Med J Malaysia, 2024 Nov;79(6):729-734.
    PMID: 39614791
    INTRODUCTION: The first vagus nerve stimulation (VNS) implantation in Malaysia was back in 2000, and the implantation rate increased tremendously since 2019. VNS has been used in patients who had persistent seizures despite epilepsy surgeries or were not candidates for epilepsy surgeries. We aimed to study the efficacy of VNS in Malaysia.

    MATERIALS AND METHODS: We conducted a retrospective cross-sectional study on the VNS done in Malaysia. We included DRE patients from all age groups who underwent VNS from 1st January 2000 to 31st December 2022. We analysed the efficacy of VNS for patients with at least one year of implantation.

    RESULTS: A total of 62 implantations were performed from 2000 to 2022. Most patients (52.5%) had implantation at <18 years old, 54.0% had focal seizures, 34.4% had Lennox Gastaut Syndrome and 23.0% had developmental epileptic encephalopathy. A total of 22.6%, 42.8%, and 63.3% of patients achieve ≥ 50% seizure reduction at three months, six months, and one-year post-implantation, respectively. At their last follow-up, 73.5% of patients had ≥ 50% seizure reduction. The majority of responders were at a current intensity of ≥ 2mA (98.0%) and 81.6% were at a duty cycle of ≥35%. No significant difference was found between responders and non-responders by age at implantation, duration of epilepsy, and seizure type.

    CONCLUSION: VNS is effective for patients with refractory epilepsy in Malaysia with two-third achieving more than 50% seizure reduction at one year and the last follow-up.

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