AUCTORES
Globalize your Research
Review Article | DOI: https://doi.org/10.31579/2690-8808/237
1Medical microbiology department /College of Health Sciences/ Hawler Medical University, Erbil/Iraq
2Microbiology, Education College, Salahaddin University, Erbil, Kurdistan, Iraq.
*Corresponding Author: Fattma A. Ali. College of Health Sciences/ Hawler Medical University, Erbil/Iraq.
Citation: Fattma A. Ali, Ahmed Akil Al-Daoody, Cheman H. Hamid, Sawsan M. Sorche, (2024), The Role of Virulence Factors of Haemophilus Influenza, J, Clinical Case Reports and Studies, 6(1); DOI:10.31579/2690-8808/237
Copyright: ©, 2024, Fattma A. Ali. 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: 11 December 2024 | Accepted: 30 December 2024 | Published: 03 January 2025
Keywords: haemophilus influenza; virulence factors; pathogenesis; unencapsulated; encapsulated
Background: Haemophilus influenzae is a pathogenic bacterium that frequently leads to serious infections, especially in newborns. Haemophilus influenzae is a Gram-ve coccobacillus belonging to the Pasteurellaceae family. It is microscopic in size, ranging from 0.3 to 1 micrometers. Its facultative anaerobic can survive with or without oxygen and has the ability to change its shape. It grows in an environment with increased levels of carbon dioxide. The development of this organism on chocolate agar is facilitated by a medium that contains two erythrocyte factors: factor X (hematin) and factor V (phosphopyridine nucleotide).
Objectives: Our study aimed to carry out the role of the virulence factors of haemophilus influenza that facilitate the pathogenesis of infections caused by this bacteria.
Main body: The pathogenicity determinants of H..influenzae contribute to its capacity to colonies and induce illness in the host. The following are important virulence.factors of H.. influenzae: Capsule used for inhibition of phagocytosis to avoid detection by the host's immune system. Pili: are adhesion molecules that enable the binding of cells or microorganisms to surfaces. IgA Protease: H..influenzae secretes IgA1 protease, an enzyme that specifically splits human IgA1 antibodies. Endotoxin (Lipopolysaccharide - LPS) This endotoxin has the ability to initiate an inflammatory reaction in the host. Beta- lactamase: Beta-lactamase is a bacterial enzyme that provides resistance to beta-lactam antibiotics.
Conclusion: H. influenzae can be categorised into six separate categories, known as serotypes a, b, c, d, e, and f, based on the presence of a polysaccharide capsule. Types A, E, and F are also isolated, although less frequently than type B. C and D are hardly identified. All serotypes, especially type b, are frequently responsible for lower respiratory tract infections, such as pneumonia. In addition, they have the potential to induce various additional severe illnesses including meninigitis , epiglottitis, cellulitis , septic arthritis and bacteremia.
Haemophilus influenzae is a pathogenic bacterium that frequently leads to seriousinfections, especially in newborns. Richard. Pfeiffer originally documented it in 1892. Throughout an influenza outbreak, he discovered the presence of H. influenzae in the sputum of patientsand put up a hypothesis suggesting a direct link between this bacteria and the clinical illness often referred to asinfluenza. The organismwas given the name Haemophilus by Charles-Edward Winslow, et al. in 1920. The discovery that influenza is caused by a virus and that H. influenzae can induce secondary infection was made in 1933 [1]. Haemophilusinfluenzae is a Gram-ve coccobacillus belonging to the Pasteurellaceae family. It is microscopic in size, ranging from 0.3 to 1 micrometers. Its facultative anaerobic can survive with or without oxygen and has the ability to change its shape. It grows in an environment with increased levels of carbon dioxide. The development of this organismon chocolate agar is facilitated by a medium that containstwo erythrocyte factors:factor X(hematin) and factor V (phosphopyridine nucleotide). These factors are released when red blood cells are lysed [2] . H.influenzae canbe categorised into six separate categories, known as serotypes a, b, c, d, e, and f, based on the presenceof a polysaccharide capsule. These serotypes are identified by their particular reactivity to serum agglutination. H..influenzae typeb is notable due to its polyribosyl. ribitol phosphate capsule, which is responsible for 95% of invasive diseasein children and over 50% of invasivedisease in adults .Less frequentpathogens, the other capsular kinds, are responsible for a smallerproportion of infections. The majority of isolates are non-typeable , indicating the absence of a polysaccharide. capsule and the resultinglack of agglutination with antiserum[3] .The most commonly encountered and prevailing variantis H.. influenzae type b which primarilyaffects youngsters and individuals with weakened immunesystems. Types A, E, and F are also isolated, although less frequently than type B. C and D are hardly identified. All serotypes, especially type b, are frequently responsible for lower respiratory tract infections, such as pneumonia. In addition, they have the potential to induce variousadditional severe illnesses, including meningitis, epiglottitis, cellulitis, septic.arthritis, as well as empyema and bacteremia as diagram (1) [4] . Diagnostic cultures of blood, cerebrospinal fluid (CSF), and other typicallysterile fluids are obligatory under the suitableconditions. Whenever possible,it is advisable to gram-stain specimens obtained for culture. The presence of capsular antigen in blood, CSF, or concentrated urine can be detected using immunoelectrophoresis, latex agglutination, or enzyme-linked immunosorbent assay. This diagnostic method can identifythe antigen in up to 90 percent of cases of meningitis that have been confirmed through culture.Untreated Haemophilus influenzae infection can lead to immediatefatality, especially throughmeningitis and epiglottitis. Currently, there is a tendency to utilize certain injectable third generation cephalosporins as the first treatmentoption for potentially life-threatening Haemophilus influenzae infections in children older than the newborn stage. The typically used drugs for this purpose are cefotaxime or ceftriaxone. Supportive care is crucial in managing Haemophilus influenzaeinfection in children,in addition to antibiotic therapy [5].
Diagram (1) [6]
This diagram shows the how the types of the bacteria can cause infections, in which bacteriadivided to encapsulated and encapsulated. 1- Unencapsulated bacteria are part of normal flora of upper respiratory tract may cause mild infection inchildlike otitis media, conjunctivitis and bronchitis. 2- Encapsulated bacteria mainly type b is the most virulent strain that invades mucosa by IgA protease in the bloodstream that cause systemicdiseases may complicated to bacteremia or encapsulated bacteriaproduce endotoxin that induce inflammation lead to appearance of symptoms of bacterial infection.
The pathogenicity determinants of H. influenzae contribute to its capacity to colonies and induce illness in the host. The following are important virulencefactors of H. influenzae:
1.1 Capsule
The polysaccharide capsuleof H.influenzae is a significant determinant of its abilityto cause disease.The bacterium uses inhibition of phagocytosis to avoid detectionby the host's immune system [7]. H.influenzae serotypes are categorized accordingto their capsularantigens, with the type b (Hib) capsulebeing specifically linked to invasiveillnesses .The capsuleof Haemophilus influenzae is a significant virulence factor due to its antiphagocytic properties, which provide protection against phagocytosis by macrophages or neutrophils. H.influenzae is able to evade destruction and adhere to epithelial cells in the airways[8]. The nativetype B capsule consists of linear teichoicacid, which containsribose, ribitol,and phosphate, and is referredto as such. Polyribosyl-ribitol-phosphate is a compound.The process of capsule synthesis is determined by the capB genes, which exist in two identical copies (17-18 kb) within the chromosome and are connected by a small area (1-1.3kb). The genetic sequencein this area includes a gene known as bexA, which is responsible for producing a protein necessary for transporting the capsular material to the surface of the cell .The remaining 5 serotypes possess the cap gene alone in a single copy. Approximately 2% of H.influenzae type b individualspossess a single copy of the gene. The absence of the other copy results in the inability to produce capsules,and these strainsare referred to as capsule-deficient mutants [9]. Contraryto encapsulated type b bacteria, which are linked to decreased ability to stick to and invade host cells, mutant strainshave a significantly. Enhanced capacityto adhere and infiltrate the macro organism,occurring at a frequency of 50 times [10].
1.2 Pili
Pili are adhesion molecules that enable the binding of cells or microorganisms to surfaces. Pili and non- pilus adhesions aid in the adherence of H.influenzae tohost cells, facilitating colonization and the initiation of infection [11] . The pili are an additionalelement that contributes to the pathogenicity of H.influenzae. They are present in the encapsulated strains of serotype b and in over 50% of the cases. Encapsulated strains.The composition of these structures includes a single substantial protein(HifA) together with two minor proteins (HifD and HifE).Pili facilitate the adherence of the bacterial cell to the eukaryotic cell by attachingto glycoproteins and glycolipids on the eukaryotic cell's surface. H.influenzae possesses a single copyof each gene that encodes fimbria proteins, namely hifA, hifD and hifE. Within this gene cluster, there are two additional genes (hifV and hifS) that encode proteins responsible for synthesizing and protectingfimbria proteins during their export from the cell. Non typable H.influenzae possesses an additional fimbriaprotein known as P5-fibrin, which bears resemblance to one of the outer membrane proteins (P5) [12]. Exterior membrane The number of H.influenzae proteins ranges from six to eight. Some of these antigens, such as P2 and P6, are currentlyundergoing intensive research.May be used into vaccineformulations targeting none capsulated pathogens. Antibodies targeting P2 have bactericidal properties and provide protection. P2 proteins are the predominant outer membrane proteins. These are porins characterized by a very changeable outer portion that exhibits differences among different strains. Their intracellular region,situated within the outer membrane, possesses a conserved amino acid sequence. The extrinsic region of these proteins may undergo temporalvariations due to individual modifications in the structural genes associated with P2. This results in a persistent manifestation of certainH.influenzae infections.P6 is a proteinlocated on the outer membrane that is produced on the surface of both encapsulated and non typablestrains. The gene responsible for encoding it exhibits a significant level of conservation, resulting in a notable similarity in terms of its nucleotide sequence across various strains [13].
1.3 IgA Protease
H.influenzae secretes IgA1 protease, an enzyme that specifically splits human IgA1 antibodies. This enzyme facilitates the evasion of the host's mucosal immune responsesby the bacteria [14]. The IgA1 proteaseis a crucial element in determining the pathogenicity of H.influenzae. It works by deactivating human immunoglobulin A1 and aiding in the colonization of mucosae. Approximately 95%of strains that cannot be typed possess the gene responsible for encoding this enzyme is known asn iga. The protease activity is maintained to a higher degree in invasive isolates blood and cerebrospinal fluid and isolates obtainedfrom sputum. This particular virulence factor is more commonly seen in strainsoriginating from the upper respiratory tract, particularly in non typable strains. A second IgA protease has been identified, which is more prevalent in isolates from individuals with COPD [15].
1.4 Endotoxin (Lipopolysaccharide - LPS):
H.influenzae, similarto other Gram-vebacteria, contains endotoxinon its outer membrane. This endotoxin has the ability to initiate an inflammatoryreaction in the host [16]. H. influenzae, like other Gram-ve microbes, possesses a lipopolysaccharide. However, its lipopolysaccharide has a shorterpolysaccharide chain and is referredto as lipooligosaccharide. Aside from having the distinct lipooligosaccharide, which is a characteristic feature of Gram-vebacteria's endotoxins, aids in evading the process of opsonization and phagocytosis by mimicking molecular structures found in the host organism. This is becausethe lipooligosaccharide has ends that are sialated, meaning they have sialic acid attached to them. These sialated ends have a comparable structureand antigenic properties to the sialatedoligosaccharides found in the sphingolipids of the human body [17].
1.5 Beta- lactamase
Beta-lactamase is a bacterial enzyme that provides resistance to beta-lactam antibiotics, such as penicillins and cephalosporins. H.influenzae has the ability to generate beta-lactamase, which is a method it employs to counteract the impact of beta-lactam antibiotics. The enzyme hydrolyzes the beta-lactam ring compound found in these antibiotics, causingthem to lose their efficacyagainst the bacterium [18] . The phenomenon of ampicillin resistance in H.influenzae was first documented in the early 1970s [19]. β-Lactams have historically been employed for the treatment of H.influenzae infections, but, resistance has arisen and spread. Ampicillin resistance in bacteriaH.influenzae has become prevalent worldwide, with varied incidencerates ranging from 8 to 30% in diverse European countries and North America, to over 50% in certainEastern Asian countries[20]. There have been two described mechanisms of β- lactam resistance. One method involvesthe breakdown of β-lactam by enzymes called (?TEM-1 or ROB-1 β-lactamases. Bacteriawith these enzymesare referred to be β-lactamase-positive ampicillin-resistant. The other involves decreased β-lactam affinityfor penicillin bindingprotein 3 owing to changein the ftsI gene [21].
The classification of H.influenzae that is resistant to antimicrobial agents is intricate. The term often used, β-lactamase-negative ampicillin-resistant is applied to isolates that exhibit resistance to ampicillin, but do not show any indication of β- lactamase [22] . The isolates exhibited resistance to Ampicillin as a result ofsignificant changes in theftsI gene, which encodes the penicillin-binding protein3. These mutationscaused a decreasein the affinity for β-lactam [22]. Nevertheless, certain isolates exhibited such changes, yet were not the strain has demonstrated resistance to ampicillin asdetermined by phenotypic testing. Isolates that have criticalmutations in penicillin-binding protein 3 , regardless of their resistance profile, are classified as genomic BLNAR [23] . The term often used is "β-lactamase positive" in reference to amoxicillin. The term "clavulanic acid-resistant" (BLPACR) refers to isolates that have resistance to amoxicillin/clavulanic acid and show indications of β-lactamase synthesis . The identified isolates were found to have both the β-lactamase gene and significant mutations in the ftsI gene [1]. Certain isolates had this profile, however,they did not demonstrate resistance to amoxicillin clavulanic acid based on phenotypic testing. The genomic BLPACR isolatesare denoted as genomic BLNAR[22]. Resistance caused by modifiedpenicillin- binding proteinshas become a significant mechanismof β-lactam resistance in various bacterialpathogens, including non typeable H.influenzae . In recent years, numerousnations have shown a significant rise in the occurrence of BLNAR non typeable H.influenzae isolates, especially among respiratory tract isolates [23] . Geno typically characterized BLNAR isolates make up 15-30% of all non typeableH.influenzae isolates in Australia the USA and Europe, and a concerning 50% in Japan[24].
1.6 Pathogenesis
The exact mechanismby which H.influenzae infections develop is not fully comprehended, however, the presence of the type b polysaccharide capsulesignificantly contributes to its abilityto cause disease.Enclosed microorganisms have the ability to enter the epithelium of the nasopharynx and directly infiltrate blood vessels. Non typable strainshave reduced invasiveness, although they, alongwith typable strains,elicit an inflammatory response that leads to disease; the significance of exotoxingeneration in pathogenicity is not considered significant. The nasopharynx of the majority of healthy personsis colonized by non- typeableH.influenzae strains, while type b H.influenzae strains are presentin just a small percentage (1 to 2 percent) of normal youngsters. Occurrences of type b infection are prevalent, particularly in nurseries and child care centers. In such cases, the preventive use of antibiotics may be employed. Immunization with type b polysaccharide has shown efficacy in avoiding infection, and vaccines are currently accessible for regular [25].
Figure (1) [26] .
This figure shows some of important virulencefactors that are required for the pathogenesis of H.infleunzae including 1- Polysaccharide capsule which is important for inhibition of phagocytosis to avoid detection by the host's immune system. 2- Are adhesion molecules that enable the binding of cells or microorganisms to surfaces. Pili adhesions aid in the adherence of H.influenzae to host cells, facilitating colonization and the initiation of infection .
Haemophilus influenzae is a pathogenic bacteriumthat frequently leads to seriousinfections, especially in newborns. Haemophilus influenzae is a Gram-vecoccobacillus belonging to the Pasteurellaceae family. It is microscopic in size, ranging from 0.3 to 1 micrometers. Its facultative anaerobic can survive with or without oxygen and has the ability to change its shape. It grows in an environment with increased levels of carbon dioxide. The development of this organismon chocolate agar is facilitated by a medium that contains two erythrocyte factors: factor X (hematin) and factor V (phosphopyridine nucleotide). These factors are released when red blood cells are lysed. H.influenzae can be categorised into six separatecategories, known as serotypes a, b, c, d, e, and f, based on the presence of a polysaccharide capsule. Types A, E, and F are also isolated, although less frequently than type B. C and D are hardly identified. All serotypes, especially type b, are frequently responsible for lower respiratory tract infections, such as pneumonia.In addition, they have the potential to induce variousadditional severe illnesses, including meningitis, epiglottitis, cellulitis, septic.arthritis, as well as empyema and bacteremia. The pathogenicity determinants of H.influenzae contribute to its capacity to colonies and induce illness in the host. The followingare important virulence factors of H.influenzae Capsule The polysaccharide capsuleof H.influenzae is a significant determinant of its abilityto cause disease.The bacterium uses inhibition of phagocytosis to avoid detectionby the host's immune system. Pili : are adhesion molecules that enable the bindingof cells or microorganisms to surfaces. Pili and non-pilusadhesions aid in the adherence of H.influenzae to host cells, facilitating colonization and the initiation of infection. IgA Protease H.influenzae secretes IgA1 protease, an enzymethat specifically splits human IgA1 antibodies. Endotoxin(Lipopolysaccharide - LPS) H.influenzae similar to other Gram- ve bacteria, containsendotoxin on its outer membrane.This endotoxin has the ability to initiate an inflammatory reaction in the host. Beta- lactamaseBeta- lactamase is a bacterialenzyme that providesresistance to beta-lactam antibiotics, such as penicillins and cephalosporins. H.influenzae has the ability to generate beta-lactamase, which is a method it employs to counteract the impact of beta-lactam antibiotics. The enzyme hydrolyzes the beta-lactam ring compound found in these antibiotics, causingthem to lose their efficacyagainst the bacterium.
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.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
