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Fulltext “CanDiTM”: a Malaysian-tailored dietary smartphone app for cancer patients and survivors

Noor Salihah, Pei LL, Aryati Ahmad, Mohd. Razif Shahril

Malaysian Journal of Public Health Medicine, 2017;17 Special(2):32-40.

Despite being effective in promoting healthy dietary behaviour, smartphone apps are scarcely available for our local communities and the majority of nutritional-related information is based on western food selections. Our new innovation aims to provide specific educational advice about recommended food intake, types, nutritional qualities and weight issues for cancer patients and survivors who suffer appetite problems and nutritional deficits. The Cancer Dietary (CanDiTM) app was developed as a convenient, flexible and attractively engaging smartphone app containing healthy tips which are uniquely tailored to the local food choices, preferences and ingredients. This helps customise users’ dietary needs besides permitting constant information up-dating. Features are broadly categorised into Healthy Eating Guide (advice from healthy eating to eating problems, weight loss prevention and increasing proteins and calories intake) and Malaysian Recipes For Cancer Patients (focusing on common Malaysian dishes, ingredients, treatment-based recipes and special diets). An additional Symptom Diary allows user’s personal profile to be recorded and stored virtually online. Its feasibility and acceptability were further tested among 30 cancer patients, family caregivers and dieticians recruited from a public hospital in Terengganu, Malaysia. Very good feasibility (> 80%) and excellent acceptability (> 90%) were reported regarding its ease of operation, suitability of language used, attractiveness, knowledge enhancement and perceived usefulness. With this scientific yet creative innovation, routine dietary habits related to cancer conditions could be easily facilitated for both patients/survivors as well as family caregivers for their independent and healthy living.
Fulltext Vitrification of Blastocyst Murine embryos affects PI3K pathway by modulating the expression of XIAP and S6K1 proteins

Mohd Fazirul, M., Sharaniza, A.R., Norhazlin, J.M.Y., Wan Hafizah, W.J., Razif, D., Froemming, G.R.A., et al.

Pertanika Journal of Science & Technology, 2017;25(108):187-198.
MyJurnal

Cryopreservation by vitrification has been widely used in Assisted Reproductive Technology (ART) to preserve embryos for an extended period of time. However, the effect of vitrification on development of the embryos is lacking. Therefore, understanding on vitrification effects on embryonic proteins, especially those involved in preimplantation development is crucial to provide high quality embryos for further usage. In this study, XIAP and S6K1 protein expressions following vitrification was investigated, since they have been implicated in diverse cellular processes including cell growth, migration, proliferation, differentiation, survival and development of preimplantation embryos via the PI3K pathway. Embryos were obtained from superovulated female ICR mice which were mated with fertile males. The embryos were harvested at the 2-cell stage and cultured until blastocyst stage. Blastocysts were then vitrified in ESF40 cryoprotectant. Western blot was carried out to determine the expression of XIAP and S6K1 proteins. The results showed the expression of XIAP and S6K1 significantly decreased in vitrified blastocyst compared to the control. This indicates that blastocyst vitrification may impact developmental competence through the activation of apoptotic pathways.
Fulltext Vitamin A, C, E and risk of breast cancer according to menopausal status in Malaysia

Mohd Razif Shahril, Suhaina Sulaiman, Sharifah Wajihah Wafa, Sharifah Noor Akmal

Malaysian Journal of Public Health Medicine, 2016;16(2):72-79.
MyJurnal

Vitamin A, C and E intake has been shown to play a role in the etiology of breast cancer, but the findings have been
inconsistent and limited to developed countries with higher cancer incidence. Therefore, the aim of this study is to
examine the association of premenopausal and postmenopausal breast cancer risk with vitamin A, C and E intake from
dietary sources. This is a population based case-control study conducted in Malaysian population among 382 breast cancer
patients and 382 control group. Dietary intake was assessed via an interviewer-administered food frequency
questionnaire. Logistic regression was used to compute odds ratios (OR) with 95% confidence intervals (CI) and a broad
range of potential confounders were included in analysis. The results of this study shows a significant decreased risk of
breast cancer among premenopausal (ORQ4 to Q1=0.38, 95% CI, 0.12 – 0.55, p-trend=0.001) and postmenopausal (ORQ4 to
Q1=0.26, 95% CI, 0.03 – 0.75, p-trend=0.017) women was observed in the highest quartile of beta-carotene intake.
Meanwhile, a higher intake of vitamin C showed significantly lowered risk only for premenopausal women (ORQ4 to
Q1=0.13, 95% CI, 0.03 – 0.32, p-trend=0.001). As a conclusion, beta-carotene intake was independently related to pre- and
postmenopausal breast cancer risk, while vitamin C intake was associated with decreased risk among premenopausal
women only. However, no association was observed for vitamin A especially retinol and vitamin E intake from dietary
sources.
Fulltext Visible and angular interrogation of Kretschmann-based SPR using hybrid Au-ZnO optical sensor for hyperuricemia detection

Mustaffa SN, Md Yatim N, Abdul Rashid AR, Md Yatim N, Pithaih V, Sha'ari NS, et al.

Heliyon, 2023 Dec;9(12):e22926.
PMID: 38125452 DOI: 10.1016/j.heliyon.2023.e22926

Uric acid is a waste product of the human body where high levels of it or hyperuricemia can lead to gout, kidney disease and other health issues. In this paper, Finite Difference Time Doman (FDTD) simulation method was used to develop a plasmonic optical sensor to detect uric acid with molarity ranging from 0 to 3.0 mM. A hybrid layer of gold-zinc oxide (Au-ZnO) was used in this Kretschmann-based Surface Plasmon Resonance (K-SPR) technique with angular interrogation at 670 nm and 785 nm visible optical wavelengths. The purpose of this study is to observe the ability of the hybrid material as a sensing performance enhancer for differentiating between healthy and unhealthy uric acid levels based on the refractive index values from previous study. Upon exposure to 670 nm wavelength, the average sensitivity of this sensor was found to be 0.028°/mM with a linearity of 98.67 % and Q-factor value of 0.0053 mM-1. While at 785 nm, the average sensitivity is equal to 0.0193°/mM with slightly lower linearity at 94.46 % and Q-factor value of 0.0076 mM-1. The results have proven the ability of hybrid material Au-ZnO as a sensing performance enhancer for detecting uric acid when compared with bare Au and can be further explored in experimental work.
Fulltext Vancomycin-loaded bone cement bullet for treatment of chronic septic arthritis post ACL reconstruction surgery

Soon Teck Seo, Seow Hui Teo, Mohamed Zubair Mohamed Al-Fayyadh, Mohamed Razif Mohamed Ali, Wuey Min Ng

Malaysian Journal of Medicine and Health Sciences, 2019;15(3):158-160.
MyJurnal

The consequence of post-operative infection can be devastating despite its rare incidence. Common organisms caus- ing post-operative infection are normal flora of the skin: Staphylococcus aureus and Staphylococcus epidermidis. Early diagnosis followed by arthroscopic debridement and antibiotic therapy with graft retention remains the main aim of treatment. However, there are certain cases where the infection persists despite early intervention. Vancomy- cin-loaded bone cement bullet inserted into bone tunnel can provide a high local concentration of vancomycin with bactericidal effect and low systemic complications to treat deep-seated infection.
Fulltext Validation of the Malay Version of the Shame and Stigma Scale among Cancer Patients in Malaysia

Zhang Z, Azman N, Eyu HT, Nik Jaafar NR, Mohd Salleh Sahimi H, Mohamad Yunus MR, et al.

Int J Environ Res Public Health, 2022 Nov 01;19(21).
PMID: 36361144 DOI: 10.3390/ijerph192114266

The assessment of stigma among cancer patients is of the utmost importance as stigma may lead to various psychological sequelae and a lower quality of life. This study aimed to translate the English version of the Shame and Stigma Scale (SSS) into Malay and validate the Malay version of the SSS (SSS-M) to assess the degree of stigma among cancer patients in Malaysia. Initially, the concurrent translation and back translation of the SSS-M were performed, and the face and content validity were assessed. Subsequently, the SSS-M was administered to a total of 234 patients with mixed types of cancer to assess its reliability (internal consistency and test-retest reliability), construct validity (convergent and discriminant validity), and conduct an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). The SSS-M total score registered a good internal consistency (a Cronbach's α of 0.881) and test-retest reliability (an intraclass correlation coefficient of 0.876, p < 0.001). The EFA and CFA confirmed that the SSS-M consisted of 16 items in 3 domains. Its convergent and discriminant validity were achieved. Hence, the SSS-M demonstrated good psychometric properties and is available for use to assess stigma among cancer patients in Malaysia.
Usefulness of the Widal test in diagnosing childhood typhoid fever in endemic areas

Choo KE, Razif AR, Oppenheimer SJ, Ariffin WA, Lau J, Abraham T

J Paediatr Child Health, 1993 Feb;29(1):36-9.
PMID: 8461177

Data are presented for 2382 children investigated for fever in a Malaysian hospital between 1984 and 1987 when Widal tests and blood cultures were a routine part of every fever screen. There were 145 children who were culture positive (TYP-CP) for Salmonella typhi, while 166 were culture negative but were diagnosed as having typhoid (TYP-CN). Analyses of the sensitivity and specificity of combinations of initial Widal titres in predicting a positive S. typhi culture in a febrile child (culture positive vs the rest) showed the best model to be an O- and/or H-titre of > or = 1 in 40 (sensitivity 89%; specificity 89%). While the negative predictive value of the model was high (99.2%) the positive predictive value remained below 50% even for very high titres of O and H (> 1 in 640), at which point the specificity was 98.5%, supporting the clinical view that a high proportion of the TYP-CN patients really were typhoid but were missed by culture. The TYP-CN patients showed a very similar clinical and age profile to TYP-CP patients. The length of history of fever did not affect the initial Widal titre in culture positive cases. The Widal test in children remains a sensitive and specific 'fever screen' for typhoid although it will not identify all cases. In children, lower cut-off points for O- and H-titres should be used than are generally recommended.
Typhoid fever in hospitalized children in Kelantan, Malaysia

Choo KE, Razif A, Ariffin WA, Sepiah M, Gururaj A

Ann Trop Paediatr, 1988 Dec;8(4):207-12.
PMID: 2467604

A retrospective study of 137 patients with blood culture-positive typhoid fever admitted to the paediatric unit of the Hospital Universiti Sains Malaysia was carried out to study epidemiological, clinical, laboratory and treatment aspects of typhoid fever in Kelantanese children in hospital. The male:female ratio was 1:1.1. School-children were the most affected. Cases were seen throughout the year. The five most frequently presenting features were fever, hepatomegaly, diarrhoea, vomiting and cough. Rose spots were seen in only two patients. Complications included gastritis, bronchitis, ileus, psychosis, encephalopathy, gastro-intestinal bleeding and myocarditis. Relative bradycardia was not seen. Blood and stool cultures were positive in the 1st, 2nd and 3rd weeks of illness. There was no significant difference between percentages of elevated O and H titres, whether done during or after the 1st week of illness. A four-fold rise in (O) titres occurred in 50% of cases tested. We would miss 50% of typhoid fever cases if a titre (O) equal to more than 1/160 were relied upon for diagnosis. Altogether, 46% of patients had leucopenia. Chloramphenicol was the most commonly used antibiotic. There were two deaths.
Tuberculous cervical lymphadenitis in a patient with suspected neck recurrence

Yong DJ, Iskandar H, Razif MY

Chin Med J (Engl), 2012 May;125(9):1667-8.
PMID: 22800842

The significance of metastastic disease in the cervical lymph nodes has long been appreciated. The rich lymphatics of the upper aerodigestive tract explained the high incidence of cervical metastasis, occasional bilaterally spread. Even with appropriate treatment, cervical recurrences do occur. Nonetheless, with the resurgence of tuberculosis, the differential of tuberculous cervical lymphadenitis should be excluded. Appropriate modalities should be employed in making the appropriate diagnosis possible.
Tracheostomy during the COVID-19 pandemic in Malaysia; a revised guideline

Rohaizam J, Tham YS, Zakinah Y, Mohd Razif MY, Marina MB

Med J Malaysia, 2021 08;76(Suppl 4):23-26.
PMID: 34558553

Performing tracheostomy on COVID-19 patients poses a significant risk to the procedural team. Such procedures should be evaluated individually via close communication between the otorhinolaryngology-head and neck surgeon and the intensivist. Comprehensive examination and preparation should be well-planned before tracheostomy, optimal technique during tracheostomy and special care following the surgery. We would like to highlight our revised guidelines at Hospital Kuala Lumpur, Malaysia on the timing of tracheostomy, management of anticoagulant and the surgical planning in COVID-19 patients during these challenging times.
Total nucleated cell count and cd34+ cell is reduced in preeclampsia and gestational diabetes mellitus pregnancies: viable affix criteria for cord blood banking

Mohd Razif Mohd Idris, Fazlina Nordin, Fadilah Abd Wahid S, Zaleha Abdullah Mahdy

Sains Malaysiana, 2018;47:2491-2499.

The aim of this study to determine the numbers of CD34+ cells and total nucleated cell (TNC) in umbilical cord blood (UCB)
collected from pregnant mothers with gestational diabetes mellitus (GDM) and preeclampsia (PE), following statistical
analysis of both maternal and perinatal factors which affect UCB parameters. Most of studies explored the influence of
obstetric factors on the number of UCB cell collection and only a few looked at the effects on UCB haematopoietic stem
cell (UCB-HSC) of common disorders complicating pregnancy. A total of 112 UCB samples (32 PE, 42 GDM and 38 nondiseased) were collected. CD34+ cell and NC count were enumerated using FACS Calibur. The TNC and CD34+ cells were
significantly reduced in both PE and GDM groups as compared to the control group. The PE group shows significantly
lower birth weight and higher BP which led to a lower UCB volume and CD34+ count. Gestational age shows significant
correlation with nucleated cell count (NCC) and TNC. GDM group shows significantly lower systolic BP, NCC and TNC count,
including low placental weight and birth weight. Conclusively, some obstetrics factors have significant influences to the
numbers and quality of UCB-HSC in both PE and GDM groups, which could guide in the selection criteria for CB banking.
Timing of The First Zygotic Cleavage Affects Post-Vitrification Viability of Murine Embryos Produced In Vivo

Jusof WH, Khan NA, Rajikin MH, Satar NA, Mustafa MF, Jusoh N, et al.

Int J Fertil Steril, 2015 07 27;9(2):221-9.
PMID: 26246881

BACKGROUND: Timing of the first zygotic cleavage is an accurate predictor of embryo quality. Embryos that cleaved early (EC) have been shown to exhibit higher develop- mental viability compared to those that cleaved at a later period (LC). However, the vi- ability of EC embryos in comparison to LC embryos after vitrification is unknown. The present study aims to investigate the post-vitrification developmental viability of murine EC versus LC embryos.
MATERIALS AND METHODS: In this experimental study, female ICR mice (6-8 weeks old) were superovulated and cohabited with fertile males for 24 hours. Afterwards, their ovi- ducts were excised and embryos harvested. Embryos at the 2-cell stage were catego- rized as EC embryos, while zygotes with two pronuclei were categorized as LC embryos. Embryos were cultured in M16 medium supplemented with 3% bovine serum albumin (BSA) in a humidified 5% CO2atmosphere. Control embryos were cultured until the blastocyst stage without vitrification. Experimental embryos at the 2-cell stage were vitri- fied for one hour using 40% v/v ethylene glycol, 18% w/v Ficoll-70 and 0.5 M sucrose as the cryoprotectant. We recorded the numbers of surviving embryos from the control and experimental groups and their development until the blastocyst stage. Results were analyzed using the chi-square test.
RESULTS: A significantly higher proportion of EC embryos (96.7%) from the control group developed to the blastocyst stage compared with LC embryos (57.5%, P<0.0001). Similarly, in the experimental group, a significantly higher percentage of vitrified EC embryos (69.4%) reached the blastocyst stage compared to vitrified LC embryos (27.1%, P<0.0001).
CONCLUSION: Vitrified EC embryos are more vitrification tolerant than LC embryos. Prese- lection of EC embryos may be used as a tool for selection of embryos that exhibit higher developmental competence after vitrification.
Fulltext Three squamous cell carcinomas of different sites in three years: A mere coincidence?

Azman M, Mohd Yunus MR

Indian J Cancer, 2015 Apr-Jun;52(2):201-2.
PMID: 26853404 DOI: 10.4103/0019-509X.175817
Fulltext The use of complementary and alternative medicine among Malay breast cancer survivors

Shaharudin SH, Sulaiman S, Emran NA, Shahril MR, Hussain SN

Altern Ther Health Med, 2011 Jan-Feb;17(1):50-6.
PMID: 21614944

BACKGROUND: A cross-sectional study was carried out to determine the prevalence of complementary and alternative medicine (CAM) use by breast cancer survivors.
METHODS: A descriptive survey design was developed. Information on socio-demographic characteristics, cancer clinical treatment history, and use of CAM were obtained through a modified self-administered questionnaire from 116 Malay breast cancer survivors aged 21 to 67 years who were 2 years postdiagnosis and currently undergoing follow-up treatment at breast cancer clinics at Hospital Kuala Lumpur and Universiti Kebangsaan Malaysia Medical Centre.
RESULTS: Data suggest that 64% of the participants were identified as CAM users; dietary supplements were the most common form used, followed by prayer and Malay traditional medicine. Within the wide range of dietary supplements, multivitamins were most often taken followed by spirulina, vitamin C, evening primrose oil, and herbal products. Contrary to other findings, the CAM users were found to be older, had secondary education levels, and were from middle-income households. However, there was no significant difference between CAM users and nonusers in this study. Family members played an important role as the main source of information along with doctors/health care providers, friends, and printed materials/mass media. The reasons participants gave for using CAM were mainly to assist in healing the body's inner strength, to cure cancer, and to reduce stress. Only half of the participants consulted with their physicians regarding the safety of CAM use. The participants began to use CAM while undergoing clinical treatments. Most of the participants used CAM for more than a year. About RM100 to RM149 (31.88 USD to 47.50 USD at press time) were spent monthly on CAM by 32% of the participants. The CAM use was found to be effective and beneficial for patients' disease states, and they were contented with the usage of the CAM therapies. Multivariate analysis revealed that thedecision to use or not to use CAM was not dependent on sociodemographic background or cancer clinical treatment history.
CONCLUSIONS: CAM was commonly used by breast cancer survivors as a coping mechanism to battle the disease.
Study site: Breast cancer clinics, Hospital Kuala Lumpur and Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
The sequelae of barium aspiration

Gendeh HS, Hashim ND, Mohammad Yunus MR, Gendeh BS, Kosai NR

ANZ J Surg, 2018 09;88(9):937-938.
PMID: 27122196 DOI: 10.1111/ans.13624
The potentials of boron-doped (nitrogen deficient) and nitrogen-doped (boron deficient) BNNT photocatalysts for decontamination of pollutants from water bodies

Itas YS, Isah KA, Nuhu AH, Razali R, Tata S, K A N, et al.

RSC Adv, 2023 Aug 04;13(34):23659-23668.
PMID: 37564254 DOI: 10.1039/d3ra03838f

This work investigates the structural, elastic, electronic, and photoabsorption properties of boron- (N-deficient) and nitrogen- (B-deficient) doped single-walled boron nitride nanotube (SWBNNT) for photocatalytic applications for the first time. All calculations of the optimized systems were performed with DFT quantum simulation codes. The results of the structural analysis showed that SWBNNT is stable to both B and N dopants. It was also observed that the photodecomposition activity of the B-doped nanotube improved significantly under the condition of slight compressive stress, while it decreased for the N-doped nanotube. Therefore, N-doped SWBNNT showed poor performance under external pressure. Both B and N-doped systems could narrow the wide band gap of SWBNNT to the photocatalytic region below 3 eV, therefore this material can be used as photocatalysts in water splitting for hydrogen evolution, dye degradation, wastewater treatment, etc. Analysis of the optical properties revealed that B-doped SWBNNT absorbs more photons in the visible range than the N-doped SWBNNT and can therefore be considered as a more efficient photocatalyst. In addition, it was found that all doped nanotubes are anisotropic since the absorption in one direction of nanotube axes is worse than the other.
Fulltext The contribution of reproductive factors and family history towards premenopausal breast cancer risk in Kuala Lumpur, Malaysia

Razif SM, Sulaiman S, Hanie SS, Aina EN, Rohaizak M, Fuad I, et al.

Med J Malaysia, 2011 Aug;66(3):220-6.
PMID: 22111444 MyJurnal

Breast cancer is the most common cancer among Malaysian women. This study aimed to determine the reproductive for premenopausal breast cancer risk in Kuala Lumpur, Malaysia. A case-control study was conducted in 216 histopathologically confirmed cases of premenopausal breast cancer and 216 community-based controls that were matched by age within a 5-year period and ethnicity. The results of this study showed that premenopausal breast cancer risks were strongly related to parity, number of live births and family history of breast cancer. Premenopausal women with these known reproductive and family history risk factors should take extra measures to undergo appropriate screening method for early detection of breast cancer.
The Prevalence of Hearing Loss Among Babies in the Neonatal Intensive Care Unit in a Tertiary Hospital in Malaysia

Abdullah A, Dahari KASA, Tamil AM, Rohana J, Razif MYM, Shareena I

Medeni Med J, 2020;35(2):116-120.
PMID: 32733760 DOI: 10.5222/MMJ.2020.68466

Objective: To study the prevalence of hearing loss (HL) and to identify the possible risk factors causing HL.
Methods: This retrospective study was conducted from January 2014-December 2016 at a tertiary hospital in Malaysia. All neonates admitted to the neonatal intensive care unit (NICU), Universiti Kebangsaan Malaysia Medical Centre (UKMMC) were screened with a two-step protocol using an automated auditory brain response (AABR) and/or Otoacoustic Emission and auditory brain response (ABR). Descriptive analysis was used for the prevalence of HL, degree of HL and number of risk factors per infant.
Results: A total of 2713 babies underwent hearing screening in NICU was enrolled in this study. Two thousand six hundred eight (96%) babies passed the screening test and 214 (4%) babies required further diagnostic test. Only 105 (49%) babies completed diagnostic tests. Out of 105 babies, 40 (38.1%) babies had HL. Mild HL was the commonest HL with 22 (55%), moderate HL was in seven babies (17.5%), severe HL in two babies (5%), and profound HL in nine babies (22.5%). The presence of craniofacial anomalies was the only significant independent risk factor for HL with p<0.05 with an odds ratio of 0.105 CI 95% [0.028-0.389]. Of Babies with the presence of three or more risk factors, 100% of them had HL.There was an increased risk of hearing loss in those with craniofacial anomalies up to 11 times higher compared to those without such anomalies.
Conclusion: The prevalence of HL among the NICU babies was 1.5% and mild HL was the commonest degree of HL (55%).
The Importance of Some Plant Extracts as Skin Anti-aging Resources: A Review

Yasin ZAM, Ibrahim F, Rashid NN, Razif MFM, Yusof R

Curr Pharm Biotechnol, 2017;18(11):864-876.
PMID: 29256348 DOI: 10.2174/1389201019666171219105920

BACKGROUND: Skin is the largest and most visible organ of the body. Many of its functions include temperature regulation, immunity from microorganisms, maintaining electrolyte balance, and protection from physical injuries, chemical agents and ultraviolet (UV) radiation. Aging occurs in every layer of the skin, primarily due to the degradation of its components. Induction of degradative enzymes and the abundant production of reactive oxygen species lead to skin aging. Understanding the complexity of skin structure and factors contributing to the skin aging will help us impede the aging process. Applications of anti-aging products are a common method to prevent or repair damages that lead to aging.
CONCLUSION: This review will provide information on the causes and indicators of skin aging as well as examine studies that have used plants to produce anti-aging products.
The Immunomodulating Properties of Tiger Milk Medicinal Mushroom, Lignosus rhinocerus TM02® Cultivar (Agaricomycetes) and Its Associated Carbohydrate Composition

Sum AYC, Li X, Yeng YYH, Razif MFM, Jamil AHA, Ting NS, et al.

Int J Med Mushrooms, 2020;22(8):803-814.
PMID: 33389874 DOI: 10.1615/IntJMedMushrooms.2020035658

Natural compounds found in Lignosus rhinocerus like polysaccharides and polysaccharide-protein complexes have the capabilities to modulate the immune system. It possesses antitumor and anti-inflammatory properties and is commonly used in Southeast Asia and Southern China to alleviate illness. To investigate its immunomodulating properties, composition of polysaccharides and the expression of cytokines/chemokines from L. rhinocerus (TM02®) cultivar treated RAW 264.7 were explored. It was revealed, CWE contains linear polysaccharides with 1,4-linkages and rhinoprolycan fraction (HMW & MMW) possesses 1,4-Glcp and 1,6-Glcp backbone and branched chain (1,3,6-Glcp, 1,4,6-Glcp, 1,3,6-Glcp, 1,2,4,6-Glcp). Cytokines profile showed upregulation from CWE (IL-5: 12.078 ± 1.225), HMW (IL-6: 7.297 ± 0.338; TIMP-1: 3.358 ± 0.200), MMW (IL-5: 15.412 ± 5.823; TIMP-1: 1.747 ± 0.053), and LMW (MIP-2: 3.495 ± 0.416; TIMP-1: 7.573 ± 0.088) and possible involvement of NF-κB and MAPK signaling pathway. Further in vivo studies are needed to fully understand the immunomodulatory effects of TM02®.

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