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Mushrooms have been valued as food and health supplements by humans for centuries. They are rich in dietary fiber, essential amino acids, minerals, and many bioactive compounds, especially those related to human immune system functions. Mushrooms contain diverse immunoregulatory compounds such as terpenes and terpenoids, lectins, fungal immunomodulatory proteins (FIPs) and polysaccharides. The distributions of these compounds differ among mushroom species and their potent immune modulation activities vary depending on their core structures and fraction composition chemical modifications. Here we review the current status of clinical studies on immunomodulatory activities of mushrooms and mushroom products. The potential mechanisms for their activities both in vitro and in vivo were summarized. We describe the approaches that have been used in the development and application of bioactive compounds extracted from mushrooms. These developments have led to the commercialization of a large number of mushroom products. Finally, we discuss the problems in pharmacological applications of mushrooms and mushroom products and highlight a few areas that should be improved before immunomodulatory compounds from mushrooms can be widely used as therapeutic agents.

Feline infectious peritonitis (FIP) is a fatal disease that poses several challenges for veterinarians: clinical signs and laboratory changes are non-specific, and there are two pathotypes of the etiologic agent feline coronavirus (FCoV), sometimes referred to as feline enteric coronavirus (FECV) and feline infectious peritonitis virus (FIPV) that vary fundamentally in their virulence, but are indistinguishable by a number of diagnostic methods. This review focuses on all important steps every veterinary practitioner has to deal with and new diagnostic tests that can be considered when encountering a cat with suspected FIP with the aim to establish a definitive diagnosis. It gives an overview on all available direct and indirect diagnostic tests and their sensitivity and specificity reported in the literature in different sample material. By providing summarized data for sensitivity and specificity of each diagnostic test and each sample material, which can easily be accessed in tables, this review can help to facilitate the interpretation of different diagnostic tests and raise awareness of their advantages and limitations. Additionally, diagnostic trees depict recommended diagnostic steps that should be performed in cats suspected of having FIP based on their clinical signs or clinicopathologic abnormalities. These steps can easily be followed in clinical practice.

Feline infectious peritonitis (FIP) is a systemic, potentially fatal viral disease of domestic and wild felids. This study demonstrates the pleural and abdominal manifestation of the effusive form of FIP from the clinical and pathological points of view. Two approximately one-year-old cats (male and female) are presented. A set of clinical (haematology, biochemistry), morphological (cytology, necropsy histopathology and immunohistochemistry) and other diagnostic assays (PCR, FIP antibodies detection, protein electrophoresis) were carried out. The results, like lymphopenia, lower A/G ratio, and hyperbilirubinemia are among the most characteristic signs for FIP. The morphology revealed the occurrence of effusions, severe diffuse adhesive pleuritis, icterus, vasculitis/perivasculitis, severe liver and lungs alteration and granulomatous-like reactions with the presence of giant cell type macrophages in the lungs. At the end of this work a list of tests required for FIP diagnosis is mentioned.

Background GS‐441524 has been successfully used to treat feline infectious peritonitis (FIP) in cats. However, the use of its prodrug, remdesivir, in combination with a PO GS‐441524 containing product for the treatment of FIP has not yet been described. Objectives Describe treatment protocols, response to treatment and outcomes in cats with FIP treated with a combination of PO GS‐441524 and injectable remdesivir. Animals Thirty‐two client‐owned cats diagnosed with effusive or non‐effusive FIP including those with ocular and neurological involvement. Methods Cats diagnosed with FIP at a single university hospital between August 2021 and July 2022 were included. Variables were recorded from time of diagnosis, and subsequent follow‐up information was obtained from the records of referring veterinarians. All surviving cats were observed for the entire 12‐week treatment period. Results Cats received treatment with different combinations of IV remdesivir, SC remdesivir, and PO GS‐441524 at a median (range) dosage of 15 (10‐20) mg/kg. Clinical response to treatment was observed in 28 of 32 cats (87.5%) in a median (range) of 2 (1‐5) days. Twenty‐six of 32 cats (81.3%) were alive and in clinical and biochemical remission at the end of the 12‐week treatment period. Six of 32 cats (18.8%) died or were euthanized during treatment with 4 of the 6 cats (66%) dying within 3 days of starting treatment. Conclusions We describe the effective use of injectable remdesivir and PO GS‐441524 for the treatment of FIP in cats. Success occurred using different treatment protocols and with different presentations of FIP including cats with ocular and neurological involvement.

Feline coronavirus (FCoV) is a ubiquitous RNA virus of cats, which is transmitted faeco-orally. In these guidelines, the European Advisory Board on Cat Diseases (ABCD) presents a comprehensive review of feline infectious peritonitis (FIP). FCoV is primarily an enteric virus and most infections do not cause clinical signs, or result in only enteritis, but a small proportion of FCoV-infected cats develop FIP. The pathology in FIP comprises a perivascular phlebitis that can affect any organ. Cats under two years old are most frequently affected by FIP. Most cats present with fever, anorexia, and weight loss; many have effusions, and some have ocular and/or neurological signs. Making a diagnosis is complex and ABCD FIP Diagnostic Approach Tools are available to aid veterinarians. Sampling an effusion, when present, for cytology, biochemistry, and FCoV RNA or FCoV antigen detection is very useful diagnostically. In the absence of an effusion, fine-needle aspirates from affected organs for cytology and FCoV RNA or FCoV antigen detection are helpful. Definitive diagnosis usually requires histopathology with FCoV antigen detection. Antiviral treatments now enable recovery in many cases from this previously fatal disease; nucleoside analogues (e.g., oral GS-441524) are very effective, although they are not available in all countries.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led the medical and scientific community to explore the pathogenesis and clinical manifestations of coronaviruses. In felines, a widespread coronavirus known as feline coronavirus (FCoV) can lead to feline infectious peritonitis (FIP), a highly fatal disease characterised by severe systemic inflammation. Diagnosing FCoV remains challenging due to the limited accuracy of the available methods. The present study introduces the FIP Effusion Index, a novel diagnostic method that combines the albumin-to-globulin (ALB/GLOB) ratio with the delta total nucleated cell (∆TNC) count obtained via flow cytometry using the Sysmex XN-1000V® analyser in effusions. Samples from cats (n = 50) with suspected FIP were analysed for ∆TNC, with findings showing that a ∆TNC ≥ 2.1 is highly indicative of FIP and a ∆TNC ≥ 4.9 can be considered diagnostic. The FIP Effusion Index enhanced diagnostic precision in our group of samples, achieving 96.3% sensitivity and 95.7% specificity for values ≥ 5.06, and reaching perfect specificity (100%) with 96.3% sensitivity for values ≥ 7.54. This combined approach surpasses the accuracy of individual parameters, establishing the FIP Effusion Index as a superior diagnostic tool for FIP, with potential applications in both veterinary and human medicine for related coronavirus diseases.

The abundances of low first ionization potential (FIP) elements are three to four times higher in the closed loop active corona than in the photosphere, known as the FIP effect. Observations suggest that the abundances vary in different coronal structures. Here, we use the soft X-ray spectroscopic measurements from the Solar X-ray Monitor (XSM) onboard the Chandrayaan-2 orbiter to study the FIP effect in multiple A-class flares observed during the minimum of Solar Cycle 24. Using time-integrated spectral analysis, we derive the average temperature, emission measure, and the abundances of four elements – Mg, Al, Si, and S. We find that the temperature and emission measure scales with the sub-class of flares while the measured abundances show an intermediate FIP bias for the lower A-flares (e.g. A1), while for the higher A-flares, the FIP bias is near unity. To investigate it further, we perform a time-resolved spectral analysis for a sample of the A-class flares and examine the evolution of temperature, emission measure, and abundances. We find that the abundances drop from the coronal values towards their photospheric values in the impulsive phase of the flares and, after the impulsive phase, they quickly return to the usual coronal values. The transition of the abundances from the coronal to photospheric values in the impulsive phase of the flares indicates the injection of fresh unfractionated material from the lower solar atmosphere to the corona due to chromospheric evaporation. However, explaining the quick recovery of the abundances from the photospheric to coronal values in the decay phase of the flare is challenging.

Feline infectious peritonitis (FIP) caused by feline coronavirus (FCoV) is a common dis-ease in cats, fatal if untreated, and no effective treatment is currently legally available. The aim of this study was to evaluate efficacy and toxicity of the multi-component drug Xraphconn® in vitro and as oral treatment in cats with spontaneous FIP by examining survival rate, development of clinical and laboratory parameters, viral loads, anti-FCoV antibodies, and adverse effects. Mass spectrometry and nuclear magnetic resonance identified GS-441524 as an active component of Xraphconn®. Eighteen cats with FIP were prospectively followed up while being treated orally for 84 days. Values of key parameters on each examination day were compared to values before treatment initiation using linear mixed-effect models. Xraphconn® displayed high virucidal activity in cell culture. All cats recovered with dramatic improvement of clinical and laboratory parameters and massive reduction in viral loads within the first few days of treatment without serious adverse effects. Oral treatment with Xraphconn® containing GS-441524 was highly effective for FIP without causing serious adverse effects. This drug is an excellent option for the oral treatment of FIP and should be trialed as potential effective treatment option for other severe coronavirus-associated diseases across species.

Background Feline infectious peritonitis (FIP) is a viral disease in cats, caused by certain strains of coronavirus and has a high case fatality rate. Objective This case series reports the outcomes of treatment of cats with FIP using molnupiravir. Animals Eighteen cats diagnosed with FIP at the You‐Me Animal Clinic, Sakura‐shi, Japan between January and August 2022, and whose owners gave informed consent to this experimental treatment. Methods For this prospective observational study, molnupiravir tablets were compounded in‐house at the You‐Me Animal Clinic. Owners administered 10‐20 mg/kg PO twice daily. Standard treatment duration was 84 days. Results Among 18 cats, 13 cats had effusive FIP and 5 had noneffusive FIP. Three cats had neurological or ocular signs of FIP before treatment. Four cats, all with effusive FIP, died or were euthanized within 7 days of starting treatment. The remaining 14 cats completed treatment and remained in remission at the time of writing (139‐206 days after starting treatment). Elevated serum alanine transaminase (ALT) activity was found in 3 cats, all at Days 7‐9, and all recovered without management. Two cats with jaundice were hospitalized, 1 during treatment (Day 37) and 1 with severe anemia at the start of treatment. Conclusions and Clinical Importance This case series suggests that molnupiravir might be an effective and safe treatment for domestic cats with FIP at a dose of 10‐20 mg/kg twice daily.

Case series summary This case series describes three shelter-housed cats concurrently diagnosed with feline infectious peritonitis (FIP). The cats were from a cohort of seven surrendered from the site of a house fire. The three cats presented with mild upper respiratory signs. Within 10 days they clinically declined: progressive signs included pyrexia, icterus, lethargy, anorexia and cavitary effusions. Necropsy followed by histopathology and immunohistochemistry confirmed a diagnosis of FIP in all three. Molecular analysis of the causative feline coronavirus (FCoV) revealed varied amino acid alterations in the spike gene both between cats and between sample types in individual cats. A fourth cat from the cohort remained healthy in the shelter but succumbed to FIP 6 weeks post-adoption. Relevance and novel information This case series places FCoV genetic sequences in the context of clinical signs in a small shelter outbreak. Each of the three cats concurrently developed a slightly different clinical presentation. PCR amplification and genetic sequencing revealed that two cats shared an S1/S2 cleavage site mutation (R790S) previously described to be associated with the development of FIP; one of the cats had an additional S1/S2 cleavage site mutation (R793S). The third cat had a single, identical S1/S2 point mutation (R790G) unique from the other two cats; the R790G mutation has not been previously reported. This case series provides interesting data on point mutations associated with the development of FIP and provides support for a ‘circulating virulent–avirulent theory’ of FIP pathogenesis in a small shelter outbreak.