AUCTORES
Globalize your Research
Review Article
*Corresponding Author: Emerson Barbosa da Silva, Biomedicine Course, Centro Universitário Italo Brasileiro, São Paulo,SãoPaulo,Brazil
Citation: Carolina S Matheus, Camila dos Santos Chagas, Daniela Rodrigues Pereira, Anita de Carvalho Garcias, Patrick Gabriel dos Santos Pessini, Emerson Barbosa da Silva (2022) Use of Dolutegravir in Hiv Treatment. J. Pharmaceutics and Pharmacology Research 5(6); DOI: 10.31579/2693-7247/077
Copyright: © 2022 Emerson Barbosa da Silva, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 09 March 2022 | Accepted: 18 March 2022 | Published: 26 April 2022
Keywords: dolutegravir; coping with HIV/AIDS; antiretroviral drugs.
The present work deals with the theme of the use of the retroviral Dolutegravir in the fight against the HIV virus, aiming to present the pharmacological aspects of the drug. The thematic focus was guided by two major interconnected questions: a) how has the evolution of the disease occurred in Brazil and which policies have been adopted in the fight against HIV/AIDS; b) how is Dolutegravir being used to face this epidemic? The methodological procedures adopted were the research of some normative documents and materials considered of reference in the area. As a result, it was evidenced that because it is a drug that had its use approved in August/2013 by the FDA in the USA and by the European Commission in January/2014, Dolutegravir presents itself as a new efficient pharmacological option for the treatment/coping of HIV/AIDS in the country, incorporated in 2017 to the ministry of health to minimize infection in patients with cross-resistance to other drugs used.
Infection with the HIV virus began to be observed in the mid-20th century. Initial reports say that the disease emerged in central Africa found in the immune system of chimpanzees and the African green monkey, undergoing a mutation. Some experiments prove that the missing link in the passage from the first primates to man seems to be related to the issue of handling the meat of infected chimpanzees in Africa. The disease, then taken to small communities in the central region, spread around the world with globalization. (Pinto; Pinheiro; Vieira, et al., 2007).
Human immunodeficiency syndrome (AIDS) is a pandemic disease whose etiological agent is the HIV virus and a retrovirus (virus that contains the enzyme reverse transcriptase) that belongs to the lentivirinae family. (Antunes, 2012)
The main target of the HIV virus during infection is TCD4 and TCD8 lymphocytes, for this reason, the clinical picture of the disease is characterized as a function of the blood count of lymphocytes and viral load in the infected individual and the clinical conditions of the patient. (Rodrigues; Minari; Almeida; Jorge; Machado; Junior; Furine et al., 2014).
AIDS (acquired immunodeficiency syndrome), in Portuguese Acquired Immunodeficiency Syndrome (AIDS) is an infectious disease that attacks the immune system, causing its deficiency and allowing some opportunistic infections to settle in the patient's body such as: tuberculosis, intestinal diseases, pneumonia, thrush, herpes simplex, tumors such as Kaposi's sarcoma, by which the weakened organism allows the development of opportunistic diseases. (Souza and Almeida, 2003)
Drugs have been developed over the years, since the discovery of AIDS in the 1980s. These are: Reverse Transcriptase Nucleoside inhibitors, Abacavir, Didanosine , Lamivudine, Zidovudine and Tenofovir; Non-Nucleoside Reverse Transcriptase Inhibitors, Efavirenz, Nevirapine, Etravirine; fusion inhibitor, Efurvitide ; entry inhibitor, Maraviroc; protease inhibitors (enzyme that matures viral proteins), Fosamprenavir, Atazanavir, Darunavir, Lopinavir, Nelfinavir, Ritonavir, Saquinavir, Tipranavir; and inhibitors of Enzyme Integrase (enzyme that integrates viral DNA into the genetic material of the host cell) Raltegravir and Dolutegravir. (Brito, 2011).
Dolutegravir was a drug developed by the company GSK (GlaxoSmithKline), it is a potent inhibitor of the integrase enzyme, responsible for the insertion of viral DNA into Human DNA (the cell's genetic code). Thus, it inhibits the replication of the virus and its ability to infect new cells. (Min S., Sloan L., Dejesus E., et al., 2011)
In Brazil, the drug was incorporated into the Ministry of Health in 2017 in the STD/AIDS program by the Unified Health System (SUS) (RENAME, 2017), used in combination with other antiretroviral drugs, is a drug of first choice in the treatment of the epidemic. . (Castellino S, Moss L., Wagner D, et al., 2013).
Brazil is one of the pioneer countries in the control of the disease and 80% of the population has an undetectable viral load, the medication is distributed free of charge to the Brazilian population that needs treatment. Today, the carrier lives well with HIV due to the commitment of the Ministry of Health in caring for HIV-positive patients, through the free distribution of antiretrovirals. However, due to lack of education of the young population, new cases among this group have been growing. (Freitas O., Pereira L., 2008).
In the midst of this awareness policies are being carried out in schools, with the aim of instructing and informing young people about the virus, highlighting the importance of preventing the disease. (www.aids.gov.br).
The present work aims to present the pharmacological aspects of the drug Dolutegravir, as well as its effectiveness in the fight/treatment of Aids/HIV.
To carry out the work, a literature review was carried out, through the Virtual Health Library (BVS), SciELO (www.scielo.org) and LILACS (http://lilacs.bvsalud.org/) databases, in articles published in English, Portuguese and Spanish. To carry out the research, the described ones used were: Dolutegravir, Antiretroviral Drugs, Integrase Inhibitors and HIV/Aids. In addition to some normative documents and reference materials in the area (books and websites).
Source: NIH’s Office of AIDS Research
The GP120 and PG41 portion are responsible for the recognition of CCR5 and CXCR4 receptors present in the lymphocytes target cells of the virus. Integrase: Integrates viral DNA into human DNA, protease breaks long proteins into smaller proteins for the formation of a new virus and reverse transcriptase transforms viral RNA into Viral DNA. RNA is the Genetic Material of HIV. (Rodrigues; Minari; Almeida; Braz; Machado; Junior; Furine et al., 2014).
Source: Trends in Basic and Therapeutic Options in HIV Infection
Patients become infected with HIV through contact with blood, sharing syringes, blood transfusions and sexual contact without using a condom. The virus falls into the bloodstream and the virus particles reach their target cell through specific receptors present on the membrane. The receptors used by the virus are CCR5 or CXCR4 (HIV2). The protein responsible for the recognition of HIV is the GP120 portion, this portion binds to specific receptors on the cell membrane, allowing the fusion of the virus into the cytoplasm. Inside the cytoplasm, 3 enzymes responsible for its replication are released, namely: reverse transcriptase, protease and entregrase. (Lima; Cunha et al., 2008).
Reverse transcriptase is responsible for reverse transcription (conversion of RNA into viral DNA), when transcription occurs, the enzyme entegrase (enzyme responsible for integrating the viral genetic material into human DNA) comes into action, the protease is responsible for the maturation of the capsule virus to form a new virus that is released by budding and can infect another cell. (Brito; 2011).
The Human Immunodeficiency Virus (HIV) initiates the process through an interaction of the glycoprotein (GP120) with the cell's CD4 receptor and consequently induces the V3 loop of GP120 to bind to the CCR5 or CXCR4 receptor. By activating the GP41 glycoprotein and allowing the viral capsule to attach to the target cell, then depositing the capsid in the cell's cytoplasm, then the capsid breaks down releasing RNA, this viral genetic material undergoes the action of the reverse transcriptase enzyme that synthesizes the viral DNA from this RNA, with the viral DNA synthesized, the integrase enzyme binds this DNA to the DNA of the host cell, then the cell activates the gene transcription process, the viral DNA will also be transcribed and new viral particles will appear. The protease enzyme synthesizes the proteins necessary for the development of the viral particle. (Paker; Junior, et al., 2000).
Antiretroviral drugs act by interrupting or hindering the viral cycle, preventing the action of the integrase enzyme from binding the viral DNA to the cell's DNA; or inhibiting the function of the protease enzyme to synthesize the important proteins for the development of the viral particle and the antiretroviral fusion inhibitors have the function of acting on the transmembrane glycoproteins of the virus, not allowing or hindering the connection with the cellular receptors, preventing the infection from occurring. (Pinto; Pinheiro; Viera et al., 2007).
Integrase inhibitors (INI) are the newest class of antiretrovirals proven by the Food Drug Administration (FDA) for the treatment/combat of HIV, based on their efficacy and safety profiles (WALMSLEY et al., 2013).
INI act on the HIV integrase enzyme – one of the three essential enzymes for the replication of the virus, preventing the process of integrating the viral DNA into the host cell genome (HAZUDA et al., 2009). More specifically, the INI's are responsible for blocking the transfer process of the viral DNA strand, whose 3' hydroxyl groups formed by the pre-integration complex should be covalently linked to the 5' phosphate groups of the host cell's DNA exposed by the action of the host cell itself. viral enzyme in question (GANDHI; GANDHI, 2014).
The interruption of the binding of the viral DNA to the host DNA is made possible by the chelation of the two divalent metal cations present in the active site of the integrase (HAZuDA et al., 2009; MIN et al., 2010). Thus, the active site is occupied and the enzyme disconnects from the 3' ends of viral DNA, paralyzing the integration process (KATLAMA; MURPHY, 2012; SHAH et al., 2014). Furthermore, integrase inhibitors are effective against cases of resistance to other drugs such as: reverse transcriptase inhibitors; non-nucleoside reverse transcriptase; of protease and fusion (KATLAMA; MURPHY, 2012; SHAH et al., 2014).
Raltegravir and elvitegravir were the first drugs used in the treatment of HIV patients, more recently Dolutegravir (DTG) (KANDEL; WALMSLEY, 2015; CID-SILVA et al., 2017). DTG is an evolution of integrase inhibitors, due to its superiority over previous generations in terms of antiretroviral potency; dosage, side effects and genetic barrier to resistance (KATLAMA; MURPHY, 2012).
Dolutegravir, approved by the FDA on August 13, 2013, is a second-generation integrase enzyme inhibitor with an antiviral potency and tolerability similar to first-generation integrase inhibitors (Raltegravir and Elvitegravir). Administration of dolutegravir is indicated for the treatment of HIV-infected adults and children over 12 years of age in combination with other drugs. Dolutegravir, whose structure is shown in Figure 3, binds to the active site of the integrase enzyme, blocking the integration of viral DNA. This being an essential step in the replication cycle, HIV stops producing new viral particles.
Source: Der Pharma Chemica
Dolutegravir is designed to have: 1) high antiretroviral potency; 2) low dose of ligament; 3) given once daily without drug booster; 4) improved resistance profile with greater genetic barrier to resistance (KATLAMA; MURPHY, 2012). Regarding the effectiveness of DTG, it is possible to mention its high antiviral potency for wild-type and antiretroviral-resistant viruses, which is important due to the increasing tendency of resistance to treatments. Initiation of antiretroviral therapy with a DTG-containing regimen is recommended for initial preferential treatment and therapeutic rescue in cases of ARV therapy failure, as well as post-exposure therapy. This drug has very rapid inhibition of viral replication as well as a superior genetic barrier to other regimens containing first-generation integrase inhibitors (KATLAMA; MURPHY, 2012; KANDEL; WALMSLEY, 2015).
In 2017, dolutegravir became part of the National List of Essential Medicines (Rename) of the Unified Health System (SUS). Currently, in Brazil, 76,713 people use DTG as a first line and another 45,645 have switched to DTG. Altogether, there are more than 122,000 Brazilians living with HIV using dolutegravir in their antiretroviral treatment regimens, a number that represents 19% of the total of 572,000 Brazilians receiving antiretroviral treatment free of charge through the SUS. It is also noteworthy that 87% of people who started treatment in 2018 started with DTG. (aids.gov.br).
Dolutegravir inhibits HIV integrase by binding to the integrase active site and blocking the retroviral deoxyribonucleic acid (DNA) integration strand transfer step, a step essential to the HIV replication cycle.
The pharmacokinetics of dolutegravir are similar in healthy subjects and those living with HIV. The pharmacokinetic variability of dolutegravir is low to moderate.
Tmax two to three hours after administration in tablet form. The linearity of dolutegravir pharmacokinetics is dose and formulation dependent. In general, following oral administration of tablet formulations, dolutegravir sodium exhibited non-linear pharmacokinetics with less than dose-proportional increases in plasma exposure between 2 and 100 mg; however, the increase in dolutegravir exposure appears dose-proportional in the range of 25 to 50 mg. Dolutegravir sodium can be administered with or without food. Food increased the extent and reduced the rate of absorption of dolutegravir. The bioavailability of dolutegravir depends on the content of the meal: low, moderate and high fat meals increase absorption. The absolute bioavailability of dolutegravir has not been determined.
According to in vitro data, dolutegravir is highly bound (approximately 99.3%) to human plasma proteins. The apparent volume of distribution (following oral administration of the suspension formulation, Vd/F) is estimated to be 12.5 L. Plasma protein binding of dolutegravir was concentration independent. The concentration ratios of drug-related radioactivity in whole blood and plasma ranged, on average, between 0.441 and 0.535, indicating minimal association of radioactivity with cellular components of blood. The free fraction of DTG in plasma is estimated to be about 0.2% to 1.1% in healthy subjects, about 0.4% to 0.5% in subjects with moderate hepatic dysfunction, 0.8% to 1.0% in individuals with severe renal dysfunction and 0.5% in patients living with HIV-1. Dolutegravir is found in cerebrospinal fluid (CSF). In 12 dolutegravir plus abacavir/lamivudine (3TC) naive subjects for 16 weeks, the mean CSF concentration of dolutegravir was 15.4 ng/mL at week 2 and 12.6 ng/mL at week 16, ranging from 3.7 to 23.2 ng/mL (comparable to plasma concentration of unbound drug). The CSF dolutegravir concentration ratio: plasma ranged from 0.11% to 2.04%. CSF concentrations of dolutegravir exceeded the IC50, which confirms the median CSF HIV-1 RNA reduction of 2.2 log from baseline after 2 weeks and 3.4 log after 16 weeks of treatment (see Pharmacodynamics, in Pharmacological Characteristics). Dolutegravir is present in both female and male genitalia. The AUC in cervicovaginal fluid, cervical tissue and vaginal tissue ranged from 6% to 10% of the corresponding plasma AUC at steady state. In semen the AUC was 7% and in rectal tissue it was 17% of the corresponding plasma AUC at steady state.
component (9.7% of the total dose administered in a human mass balance study). Dolutegravir is the predominant circulating substance in plasma; renal elimination of unchanged drug is low (< 1>
Dolutegravir has a terminal half-life of approximately 14 hours and an apparent clearance (CL/F) of 0.56 L/h.
Since its emergence in the early 1980s, the HIV/AIDS epidemic has redesigned its profile of infected people over the years.
As a result, there was a rapid spread of AIDS cases in Brazil. To contain the advances, the country started to develop health actions that could respond to the demands placed in daily life. The consolidation of the SUS and the creation of the National STD/AIDS Policy represented great advances in the development of prevention programs and policies, and treatments available for free and universal access, with the State being the main responsible for ensuring health for all People. Living with HIV/AIDS (PLWHA).
According to the HIV Clinical Monitoring Report, the increase in diagnosis among people living with HIV and the increase in the number of people undergoing treatment are highlights in Brazil. The country has been advancing more and more in access to antiretroviral drugs, optimizing and reducing the number of pills for patients undergoing treatment, thus ensuring free access to all.
Dolutegravir, one of the most modern antiretrovirals in the world, is shown to be quite efficient in the treatment/combating AIDS/HIV, the introduction of Dolutegravir in the SUS only contributed more to achieving the established goals.
In the midst of this scenario, pharmaceutical care becomes important, as it promotes the rational use of the drug, maintaining the effectiveness and safety of treatment for PLWHA.
Therefore, Dolutegravir is a very promising drug, where, if used with the prescription/indication and the proper monitoring of a specialized doctor, it becomes a great alternative for the improvement in the clinical picture of HIV carriers, in addition to guaranteeing a longer and healthier life for carriers.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
