\r\n\tThere will be a chapter on secondary causes of sexual dysfunction disorders related to diabetes, cardiovascular disease, and obesity. A chapter on remedial measures to enhance sexual activity and maintain human relationships will be discussed. As there is a growing number of cancer survivors a chapter on cancer-related sexual dysfunction will be welcomed for including it.
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1. Introduction
\n
Pregnancy is one of the most “special periods” for a woman. Changes in the endocrine and immune systems and in the metabolism will result in an overall change in body, including skin. Although some of these changes may be physiologic, pregnant women are more careful, meticulous and concerned about their body. As the skin changes can easily be observed by naked eye, this additional problem helps to increase anxiety and lower their self-esteem. During pregnancy, acne can have psychological effects. Even very small changes draw attention and raise questions related to the medical concerns for the baby. Moreover, pregnant women can be anxious and depressed because of their health, self-image, cosmetic problems and limitations on treatments.
\n
Some of the metabolic changes may also trigger sebaceous and eccrine glands to produce acneiform eruptions. Acneiform eruptions are follicular eruptions characterized by papules and pustules resembling acne. Diagnosis of acne is usually done clinically. However, differential diagnosis of acneiform eruptions during pregnancy should be done carefully and mostly depends on exclusion. Typically acne has predilection sites such as face, neck, chest, and back [1]. Papular and pustular lesions appearing on this sites are generally considered as “acne” which can be a misdiagnose. Moreover, during pregnancy acne rosacea, perioral dermatitis, hidradenitis suppurativa, Fox-Fordyce disease, pruritic folliculitis of pregnancy may be seen in different clinical presentations. So, differential diagnosis of acneiform eruptions should not be underestimated. Gynecologists and family physicians also should be aware of “acne-like” eruptions and consult a dermatologist [2].
\n
Acne and acneiform eruptions during pregnancy also need treatments to prevent worsening, secondary infections, scarring, and lowering self esteem of the mother. However, the treatment of acne and acneiform eruptions are not easy to treat in this life period. First, as many cosmetics and procedures are not tested on pregnant patients and impossible to predict the possible consequences of the procedures on fetus, many women quit cosmetic procedures during that period [3]. Second, the underlying conditions such as hormonal influx and immunosuppression continue. Third, the medications for acne have limitations due to the lack of evidence of safety during pregnancy.
\n
Here in this chapter we will make a close look to acneiform eruptions during pregnancy period including acne vulgaris, acne rosacea, perioral dermatitis, and hidradenitis suppurativa. Each of these diseases will be evaluated by clinical presentation, differential diagnosis and treatment options focusing on maternal and fetal safety.
\n
2. Hormonal changes during pregnancy
\n
In the pregnant women subsequent hormonal changes which are unique for that period appear. The placenta is a fantastic hormone factory that produces large amounts of hCG, relaxin, oestradiol, progesterone and human chorionic somato mammatrophin (hCS or human placental lactogen, hPL). Estrogen production from the placenta as well as the ovary increases gradually from the second month of pregnancy until term. Also, placental progesterone rises to a peak during the fifth month of pregnancy. Moreover, the placenta is a source of human chorionic gonadotropin, which increases during the first trimester and decreases dramatically with the elevation of estrogen and progesterone. The hPL is synthesised from the 4 week of gestation. The hPL stimulates maternal lipolysis and inhibits insulin effects, causing hyperglycaemia [2].
\n
During pregnancy some other hormonal changes occur as well. The anterior pituitary gland increases in weight by more than two-fold during pregnancy with a concomitant increase in gonadotropin hormone secretion. The production and secretion of adrenal cortex hormones are increased in addition to the adrenal hypertrophy. The typical hormonal changes and immunity in pregnancy cause a shift in maternal immune function from cell mediated (helper T 1 [TH1] cytokine production) to humoral (helper T 2 [TH2] cytokine production). Moreover, the activity of sebaceous and eccrine glands is increased and apocrine gland activity is decreased. So, all these physiologic changes may influence the course of inflammatory and glandular skin disease during gestation [4].
\n
3. Acne in pregnancy
\n
Acne vulgaris is a chronic inflammatory disorder clinically presenting with comedones, papules, pustules and cysts. The course of acne in pregnancy is unpredictable and severity shows variations [4, 5]. In the majority, pregnancy has a beneficial effect on the activity of acne, and often improves in the first trimester. This is suggested to be related with the sebosuppressive effect of estrogens [5]. In a small number of cases, there is a flare-up of acne requiring active intervention, especially if scarring is a threat. Ratzer reported 58% improvement and 29% reporting worsening of acne during pregnancy [6]. In another study, improvement of acne by 41% in pregnant women was reported [7].
\n
The increase in sebaceous gland activity, especially during the third trimester, results in an aggrevation of acne which is most upsetting at this time. Other clinical findings are post inflammatory pigment alterations and flare of truncal acne [2]. Some women experience new-onset acne, such as acne conglobata, in the postpartum period (“postgestational acne”) [4, 8].
\n
Hyperandrogenism in pregnancy is rare and can develop in any trimester. The signs and symptoms are similar as the non pregnant women and may present as acne and hirsutism. The most common ovarian pathologies that present during pregnancy and which lead to hyperandrogenic states are hyperreactio luteinalis (HL) and pregnancy luteoma (PL) whereas ovarian tumors and adrenal pathologies are very rare. Although spontaneous regression occurs in the post-partum period in the vast majority of cases, such cases with a clue of androgen excess should be re-evaluated by means of underlying pathologies and fetal virilisation [9].
\n
Acne cosmetica and pregnancy: sunscreens are commonly used in pregnancy to treat or prevent melasma. Pregnant women are adviced and prefer to use inorganic sun blockers such as zinc oxide, titanium dioxide, iron oxide, talc, and calamine which are generally safer than their organic counterparts due to their nontoxic, stable properties and absence of systemic absorption. But these formulations are thick pastes that promote comedogenesis [10, 11]. So, pregnant women may experience extensive acne problem while trying to prevent melasma.
\n
Treatment of acne in pregnancy is challenging as most drugs are contraindicated or considered unsafe [12]. The Food and Drug Administration (FDA) has five established categories to indicate potential teratogenicity of a medication when used by patients during pregnancy. FDA categories are shown as Table 1.
Category
A
Well-controlled studies in humans show no risk to the fetus
B
No well controlled studies have been conducted in humans, animal studies show no risk to the fetus
C
No well controlled studies have been conducted in humans; animal studies have demonstrated an adverse effect on the fetus
D
Evidence of human risk to the fetus exists; however benefits may outweigh risks in certain situations
X
Controlled studies in animals or humans demonstrate fetal abnormalities; the risk in pregnant women clearly outweighs any possible benefit
Table 1.
FDA categories for drug use during pregnancy.
\n
The treatment of acne during pregnancy depends on its type and severity. Unfortunately, there are no “evidence” level studies to support the clinical efficacy of any acne treatment during pregnancy or lactation [13]. The available reports are mainly observational studies and often with small samples sizes. There are pregnancy-exposure registries that collect data on the use of certain medications in pregnancy. However, there are no relevant registries for “acne” treatments [14]. Although there is no evidence-based recommendations about acne treatment during pregnancy, it should depend on acne type, severity and in its impact on quality of life. The goal of treatment and expectations of patient should be determined based on risk/benefit ratio and should rely on relief of symptoms rather than total clearance.
\n
There are many oral and topical medications for the treatment of acne. Some of the patients might be using one or more of these treatments before conception. It is not always very easy while deciding to stop or not therapy because the evidence to guide this clinical question is not relevant. The half-life of medications and FDA categories may be a key to answer these questions.
\n
3.1. Systemic treatments
\n
For severe acne, systemic treatments may be needed to avoid scarring. There are only few options available for the safe management of acne in pregnancy. Isotretinoin, which is the mainstay of treatment for severe and nodulocystic acne, is contraindicated in pregnancy. Hormonal treatments (anti-androgens, spironalacton) also should be avoided for its effects on fetus. Some of the oral antibiotics are safe during pregnancy and can be used.
\n
3.1.1. Isotretinoin
\n
Systemic retinoids are important treatments in women with moderate to severe acne, but must be avoided during pregnancy due to teratogenicity. Isotretinoin, is FDA pregnancy category X. Its association with increased risk of spontaneous abortion, retinoid embryopathy which is specific with facial and palatal defects, micrognathia, cardiovascular defects, and developmental problems of the central nervous system and thymus have been reported [15, 16]. Both isotretinoin and its metabolite are thought to be teratogenic. The half-life of isotretinoin is 10–20 h and its metabolite (4-oxo-isotretinoin) between 17 and 50 h. General recommendation is five times this half-life would be enough to allow levels of the drug to return to negligible levels. So, a washout period (one month between completely discontinuing isotretinoin – beginning attempts to conceive a pregnancy) will be needed [13]. Similarly, conception one menstrual cycle after completely stopping isotretinoin is advised in a published guideline [17]. But on the contrary, many cases of unwanted pregnancies and relevant abortuses have been reported all over the world [18]. This indicates that there is still insufficient control of isotretinoin associated with pregnancy. So pregnant women with acne should be questioned in detail about the total dosing, the time of last dose of isotretinoin and in case of a suspicion, prenatal diagnostic research should be provided.
\n
3.1.2. Antibiotics
\n
In non-pregnant patients oral antibiotics are commonly prescribed as a second-line therapy for acne and the most commonly used are tetracyclines: doxycycline, oxytetracycline, lymecycline, minocycline, and tetracycline [19]. Penicillins, macrolides, and cephalosporins are thought to have the best safety profile in pregnancy with erythromycin the oral antibiotic most commonly used for acne in pregnancy [18]. But tetracyclines should not be used during pregnancy, as use in the second and third trimester can cause discoloration of teeth and bones [20].
\n
During pregnancy, erythromycin should be the first choice in case of a necessity [21]. As it is used in pregnancy to treat other infections, there is quite satisfactory data coming from these retrospective studies of pregnancy outcomes. Its usage in combination with a topical preparation is recommended to avoid bacterial resistance [14, 22]. Only, erythromycin estolate is not recommended in pregnancy because of potential risk of reversible hepatotoxicity which is rarely reported with other ester forms. The common side effect of erythromycin is gastrointestinal dyspepsy and rarely increasing serum levels of medications metabolized by cytochrome p450 enzymes [20].
\n
Another macrolide antibiotic that can be used for treatment of acne in pregnancy is oral azithromycin. It has efficacy against Propionibacterium acnes and anti-inflammatory actions and in a study comparing the efficacy of azithromycin with doxycycline, azithromycin was found to be as effective as doxycycline. The longer half-life of 68 h also can be advantage as a single daily dose [23]. Also a new macrolide antibiotic, roxithromycin is shown to be effective on acne lesions with similar safety with erythromycin, has a better side effect profile and less frequently associated with bacterial resistance. The only disadvantage is being expensive [24].
\n
Oral clindamycin is also considered to be effective and safe for use in pregnancy but due to one serious potential side effect it is rarely used. Disturbance of gastrointestinal flora by this agent can cause pseudo-membranous colitis. Diarrhea is also a common side effect [25].
\n
3.1.3. Hormonal treatment
\n
Hormonal therapy includes oral contraceptive pills (OCP) and androgen receptor blockers such as cyproterone acetate and spironolactone which are particularly useful in the treatment of acne linked to hyperandrogenism. However, these anti androgenic treatments are not suggested to be used during pregnancy because of the risk of hypospadias and feminization of a male fetus [26]. Also, higher incidence of Down syndrome has been reported with use of OCPs in early pregnancy [27].
\n
3.1.4. Zinc
\n
Oral zinc salt preparations have historically been shown to be effective in reducing the severity of mild and moderate inflammatory acne vulgaris when either used alone or in combination with another acne treatment [28]. Zinc sulfate (N) and zinc gluconate (N) have been shown to be effective in the treatment of acne vulgaris at elemental doses of 30–150 mg daily [29]. It is shown that elemental zinc has no harm at doses below 75 mg/day to the growing fetus [30]. There is huge literature data on the use of zinc salts in lactation, but no adverse effects have been reported thus far.
\n
3.2. Topical treatments
\n
Topical medications are first line therapies for acne [31]. Most of the pregnant women prefer staying on the safe zone rather than aesthetic targets. Also, both patients and physicians prefer topical treatments only to avoid possible side effects especially on fetus [32].
\n
Proper cleansing is an important step in acne treatment, also in pregnancy. Twice daily washing with a gentle cleanser followed by a topical preparation should be the first step. Mechanical comedo removal can be performed with a comedone extractor in comedonal forms.
\n
3.2.1. Azelaic acid
\n
It is a dicarboxylic acid with antimicrobial, anti-inflammatory and comedolitic properties. Also, being a competitive inhibitor of thyrosinase it decreases pigmentation. This effect on pigmentation could be used as an advantage when tendency to pigmentation is increased in pregnancy. It is generally well tolerated with a transient burning sensation but has no phototoxic or photoallergic potential. Azelaic acid is pregnancy category B, with no known fetal effects. Studies indicate that using high oral doses in animals do not cause teratogenic effects in the offspring, but there are no controlled studies in humans. It is also present in milk, rye, barley, and wheat. So azelaic acid can be a good choice for topical acne treatment in pregnancy [31].
\n
3.2.2. Benzoyl peroxide
\n
Benzoyl peroxide (BP) is one of the most common topical preparations with varying concentrations of 2.5–10%. There are many forms of BP such as cream, lotion, gel, wash, and pledgets. BP is a powerful antimicrobial agent. By decreasing the hydrolysis of triglycerides and generation of reactive oxygen species within the follicle, it has bactericidal effect. Moreover, bacterial resistance does not develop against that antimicrobial agent. That makes it an ideal combination for topical or systemic antibiotic therapy. But it is in FDA category C should be used during pregnancy on a limited area and only if needed [32].
\n
3.2.3. Salicylic acid
\n
Salicyclic acid is a comedolytic and anti inflammatory agent which is commonly found in many over the counter and prescription acne preparations. It is FDA pregnancy category C. Although there are no human studies on topical salicylic acid usage during pregnancy, there is no report of teratogenicity as well. It is usage may be limited with facial washes or cleansers to avoid long exposure and systemic absorption during pregnancy [31].
\n
3.2.4. Glycolic acid
\n
Glycolic acid is an alpha-hydroxy acid with keratolytic effect and used in the treatment of mild, comedogenic, and noninflammatory acne by its comedolytic effect. It also reduces sebum production [33]. There is no FDA pregnancy category assigned for glycolic acid but glycolic acid peels have been used extensively, and apparently safely in pregnancy [31].
\n
3.2.5. Sulfacetamide with sulfur compounds
\n
Sulfacetamide is a bacteriostatic agent that inhibits bacterial growth via inhibition of dihydropteroate synthetase with additional anti-inflammatory action from additional sulfur compounds [34]. Sulfur has been used for many years for treating pregnant women suffering from scabies with sulfur-containing ointments on a whole body surface with no adverse results. Although elemental sulfur, typically compounded in cream or ointment form, is considered safe in pregnancy; there are minimal data about safety of sulfacetamide during pregnancy.
\n
3.2.6. Topical antibiotics
\n
Many topical antibiotics can be used in the treatment of acne for their effect on P. acnes. In general, if a systemic antibiotic is considered safe in pregnancy, its topical formulation is also deemed safe. Topical agents are often added to oral antibiotics because of synergistic effects [13]. Erythromycin and clindamycin are the most commonly used topical antibiotics for acne. Both erythromycin and clindamycin are category B. They have bactericidal effect on P. acnes, reduce pro-inflammatory free fatty acids and have anti-inflammatory effect. However, antibiotic resistance to P. acnes is a very frequent problem. Results of many studies denote combination of these antibiotics with different concentrations of BP are suggested to overcome this problem [31].
\n
Metronidazole is also an antiinflammatory, immunosuppressive, and antimicrobial properties. In a study, 2% metronidazole gel was shown to be effective for moderate acne vulgaris [35]. It is in FDA pregnancy categorize B. Also, an investigation of metronidazole usage during pregnancy revealed no association with preterm birth, low birth weight, or congenital anomalies [36].
\n
Tetracyclines are also commonly used topical acne preparations in non-pregnant patients. Even though they have a broad-spectrum bacteriostatic activity, their use in pregnancy is not suggested as they cross the placenta and bind strongly to calcium ions. After the 16th week of pregnancy, these can result in deciduous teeth discoloration and bone growth inhibition [20].
\n
3.2.7. Topical retinoids
\n
Topical retinoids are commonly used in acne treatment especially in comedogenic and inflammatory forms as they have anti-comedonegic, anti-inflammatory effects and normalize desquamation of the follicular epithelium. Three topical retinoids are currently available: adapalene, tretinoin, and tazarotene. Adapalene and tretinoin are pregnancy category C while tazarotene is category X. Tazoretene cannot be used in pregnancy. However, the data about the systemic absorption and teratogenity of adapalene and tretinoin are limited. There are case reports describing retinoid embryopathy, specifically ear, cerebral, and cardiac malformations in infants who were exposed to retinoids in utero, due to maternal topical tretinoin usage [37–41]. But some other studies did not reveal a significantly increased risk associated with topical tretinoin [42–44]. In one retrospective case control study of 235 pregnant women exposed to topical retinoids in the first trimester (including adapalene, tretinoin, tazarotene, and retinol) were evaluated for fetal embryopathy and were compared with 444 controls. No significant difference was reported between the groups regarding the rate of spontaneous abortion, minor or major birth defects; including retinoid teratogenity [45]. However, study authors concluded that topical retinoids could not be safely recommended for use during pregnancy because of the inferred risk based on safety data associated with systemic retinoid medications. Still, topical retinoids cannot be advised for use during pregnancy [32].
\n
3.3. Phototherapy and lasers
\n
Various forms of phototherapy and lasers are under investigation for their use in treating acne vulgaris and some of them have already been FDA approved for the treatment of some forms of acne. As ultraviolet light has been reported to be beneficial by most of the patients, studies focused on mechanisms and using light as a treatment option [31]. Both visible and laser light are effective treatments for acne. Visible light and many lasers target porphyrins endogenously produced by P. acnes. Laser and light therapies have few if any side effects and appear to be safe during pregnancy. Ultimately, combining laser and light with topical therapy may well become the mainstay of acne treatment [46].
\n
The main devices used for acne treatments are lasers (pulse dye lasers (PDL), potassium titanyl phosphate lasers (KTP), infrared diode lasers) and intense pulsed light systems (IPL), broad-spectrum of visible light sources (blue light, blue-red light), and photodynamic therapy (PDT). The supposed mechanisms of action for optical treatments are photothermal heating of sebaceous glands and photochemical inactivation of P. acnes, which produces coproporphyrins and protoporphyrins. Moreover, photoimmunological reactions may possibly contribute to improve acne [47].
\n
Narrowband-ultraviolet B phototherapy (NB-UVB) has been reported as a treatment for acne in pregnancy with its local immunosuppressive effects on skin. In one case report, a successful treatment with NBUVB treatment of acne vulgaris in a woman who was 5 months pregnant was reported [48]. The data regarding the safety of NBUVB treatment in pregnant women comes from its use in pregnant psoriasis patients. But recently it has been shown that patients with high cumulative NBUVB doses have a decrease in serum folic acid levels [49]. This finding is especially important for the pregnant women as they usually need folic acid supplementation to prevent neural tube defects. During treatment period dermatologists should be aware of the folic acid levels, check regularly and cooperate with the obstetrician of the patient.
\n
4. Rosacea in pregnancy
\n
Acne Rosacea is a chronic inflammatory condition of the facial skin affecting the blood vessels and pilosebaceous units. Patients usually present with red papules pustules on the face in addition to complaints of flushing, blushing, and sensitivity of skin [50]. It may manifest as papules and pustules as well as other forms such as centrofacial distribution of blushing and telangiectasia (erythematotelangiectatic rosacea), phymatous changes, or ocular rosacea [4].
\n
Similar to acne, the course of rosacea in pregnancy is unpredictable. There are a limited number of case studies related with the course of rosacea during pregnancy. But, as there are reports about rosacea fulminans in pregnancy, it should be taken into consideration by means of prognosis. Rosacea fulminans is a rare and severe subtype of rosacea that is characterized by the sudden onset of severe facial inflammation consisting of numerous pustules, cystic swellings and coalescing sinuses. Three cases of RF in pregnancy were reported with differing obstetric outcomes: an intrauterine death, a termination of pregnancy, and a normal vaginal delivery [51]. Rosacea fulminans is the only indication for topical or systemic corticosteroids in the treatment of rosacea [52]. One case of RF in pregnancy successfully treatment with systemic azithromycin and topical metronidazole [53]. Another patient with RF in pregnancy presented with severe ocular disease culminating in ocular perforation [54]. A case of pregnant woman who had rosacea fulminans during the first trimester presented and treated with conventional therapeutic approaches with systemic corticosteroids were associated with clear improvement within 2 months, and subsequently only 0.75% metronidazole topical cream was used during the second trimester [55]. One patient with rosacea fulminans in pregnancy was complicated by stillbirth [56].
\n
Generally the treatment of rosacea during pregnancy relies the avoiding triggering factors such as sun exposure, wind, physical irritation, anxiety and spicy food, as so as in the non pregnants. In pregnancy, general safety precautions are the same with acne medications. Azelaic acid and topical antibiotics, including metronidazole, clindamycin, and erythromycin, may be used for treating papulopustular rosacea. In the erythematotelangiectatic form light based therapies such as lasers can be used [57]. But a delay in their use is suggested as the condition may improve spontaneously after delivery [4].
\n
5. Perioral dermatitis in pregnancy
\n
Perioral dermatitis is also should be differentiated from acne vulgaris. It is an acneiform eruption of unknown etiology. Fluorinated topical corticosteroids, contact dermatitis, and over moisturization of skin were implicated in the etiology. Clinical appearance is papulopustular lesions as clusters localizing periorally (on the chin or nasolabial folds, but not on the vermilion border of the lips) with an erythematous base [58]. There are few data about the perioral dermatitis in pregnancy. Yang et al. emphasizes flares to have been noted, but not as a regular finding [4]. Treatment with topical and oral agents is the same as that of acne vulgaris or rosacea.
\n
6. Hidradenitis suppurativa in pregnancy
\n
Hidradenitis suppurativa/acne inversa (HS) is a chronic, inflammatory, recurrent and debilitating skin disease of the terminal follicular epithelium caused by occlusion and rupture of follicular units with subsequent inflammation of the apocrine glands [4]. It is destructive in nature and manifests as painful inflammatory nodules and sterile abscesses located in hair and apocrine gland-bearing skin creases in the axilla; groin or perineum, buttocks, and/or breast [59]. The disease often progresses with the formation of draining sinus tracts and due to subcutaneous extension with induration, destruction of skin appendages, and subsequent scarring [2, 60]. The etiology of the disease seems to be multifactorial and is only fragmentarily understood. The role of hormones in HS remains unclear, but the female predominance, typical onset of the disease after puberty, observation of premenstrual flares, and improvement during pregnancy and the traditionally described resolution after menopause suggest a hormonal/metabolic background [61, 62]. However, as some patients experience improvement and some other worsening in pregnancy. A typical relationship between HS and pregnancy has not been confirmed. A literature review presents two cases of women who had improvement or remission of their disease during pregnancy with some rebound symptoms postpartum supporting this hormonal effect [63]. The condition is associated with hyperandrogenism and often is accompanied by acne, hirsutism, and irregular menses. The reported positive effects of antiandrogen therapy supports a possible role of androgens [64]. Another study showed no evidence of biochemical hyperandrogenism in HS, noting both persistence and primary development of the disease in the postmenopausal state [65]. Findings, therefore, remain inconsistent. Obesity contributes significantly to HS pathogenesis; diabetes, dyslipidemia, the metabolic syndrome, and polycystic ovarian syndrome are among the commonest comorbidities. More studies are required to clarify a potential hormonal dysregulation in HS [61].
\n
One of the first staging systems for HS was proposed by Hurley (Table 2). Hurley separated patients into three groups based largely on the presence and extent of cicatrization and sinuses [66].
Hurley stage
Extent of disease in tissue
I
Abscess formation (single or multiple) without sinus tracts and cicatrization
II
One or more widely separated recurrent abscesses with tract formation and scars
III
Multiple interconnected tracts and abscesses throughout an entire area
Table 2.
Hurley staging system for hidradenitis suppurativa.
\n
Management of HS includes emotional support, given the debilitating nature of the disease; counseling to wear loose fitting clothing to avoid aggravating the areas. For patients with Hurley stage I, antibiotics are a good first-line therapy. The same oral antibiotics mentioned for acne as well as oral clindamycin can help during pregnancy and provide antiinflammatory effects. Limited lesions can be injected with corticosteroids, and flares can be addressed with short courses of oral or intramuscular corticosteroids. Patients with Hurley stage II, long-term immunosuppressive therapy or surgical therapies, such as limited excisions or the laying open of sinus tracts, may be helpful. Patients with Hurley stage III may have such debilitating disease that only surgery can adequately address their symptoms. Wide excision of all the patients\' affected tissue and the underlying sinus tracts is the most effective treatment for these patients [67]. The use of TNF-α inhibitors in pregnancy remains controversial, and biologic medications should be used only if benefit greatly outweighs the risks and all other treatment options have been exhausted [68].
\n',keywords:"acne, acneiform eruptions, sebaceous gland, pregnancy, treatment",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/53667.pdf",chapterXML:"https://mts.intechopen.com/source/xml/53667.xml",downloadPdfUrl:"/chapter/pdf-download/53667",previewPdfUrl:"/chapter/pdf-preview/53667",totalDownloads:1644,totalViews:387,totalCrossrefCites:1,totalDimensionsCites:1,totalAltmetricsMentions:0,introChapter:null,impactScore:1,impactScorePercentile:65,impactScoreQuartile:3,hasAltmetrics:0,dateSubmitted:"April 14th 2016",dateReviewed:"November 22nd 2016",datePrePublished:null,datePublished:"March 15th 2017",dateFinished:"December 28th 2016",readingETA:"0",abstract:"Acne and acneiform eruptions during pregnancy need special attention. The physician should be aware of the special condition of a pregnant patient. Acne treatments may aim to prevent worsening, secondary infections, scarring and lowering self-esteem of the mother. However, the treatment of acne and acneiform eruptions are not easy to treat during pregnancy. First, because many cosmetics and procedures are not tested on pregnant patients and it is impossible to predict the possible consequences of the procedures on fetus, many women quit cosmetic procedures during pregnancy. Second, the underlying conditions such as hormonal influx and immunosuppression continue. Third, the medications for acne have limitations due to the lack of evidence of safety during pregnancy. Here, a acneiform eruptions during pregnancy, including acne vulgaris, acne rosacea, perioral dermatitis, and hidradenitis suppurativa, are reviewed focusing on these points and each of them is evaluated by clinical presentation, differential diagnosis and treatment options focusing on maternal and fetal safety.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/53667",risUrl:"/chapter/ris/53667",book:{id:"5433",slug:"acne-and-acneiform-eruptions"},signatures:"Aslı Feride Kaptanoglu and Didem Mullaaziz",authors:[{id:"189031",title:"Dr.",name:"Asli Feride",middleName:null,surname:"Kaptanoglu",fullName:"Asli Feride Kaptanoglu",slug:"asli-feride-kaptanoglu",email:"dr.aslikaptanoglu@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Marmara University",institutionURL:null,country:{name:"Turkey"}}},{id:"189355",title:"Dr.",name:"Didem",middleName:null,surname:"Mullaaziz",fullName:"Didem Mullaaziz",slug:"didem-mullaaziz",email:"didem_mullaaziz@yahoo.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Near East University",institutionURL:null,country:{name:"Cyprus"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Hormonal changes during pregnancy",level:"1"},{id:"sec_3",title:"3. Acne in pregnancy",level:"1"},{id:"sec_3_2",title:"3.1. Systemic treatments",level:"2"},{id:"sec_3_3",title:"3.1.1. Isotretinoin",level:"3"},{id:"sec_4_3",title:"3.1.2. Antibiotics",level:"3"},{id:"sec_5_3",title:"3.1.3. Hormonal treatment",level:"3"},{id:"sec_6_3",title:"3.1.4. Zinc",level:"3"},{id:"sec_8_2",title:"3.2. Topical treatments",level:"2"},{id:"sec_8_3",title:"3.2.1. Azelaic acid",level:"3"},{id:"sec_9_3",title:"3.2.2. Benzoyl peroxide",level:"3"},{id:"sec_10_3",title:"3.2.3. Salicylic acid",level:"3"},{id:"sec_11_3",title:"3.2.4. Glycolic acid",level:"3"},{id:"sec_12_3",title:"3.2.5. Sulfacetamide with sulfur compounds",level:"3"},{id:"sec_13_3",title:"3.2.6. Topical antibiotics",level:"3"},{id:"sec_14_3",title:"3.2.7. Topical retinoids",level:"3"},{id:"sec_16_2",title:"3.3. Phototherapy and lasers",level:"2"},{id:"sec_18",title:"4. Rosacea in pregnancy",level:"1"},{id:"sec_19",title:"5. Perioral dermatitis in pregnancy",level:"1"},{id:"sec_20",title:"6. Hidradenitis suppurativa in pregnancy",level:"1"}],chapterReferences:[{id:"B1",body:'Schaller M, Plewig G. Structure and function of eccrine, apocrine, apoeccrine and sebaceous glands. In: Dermatology. Bolognia JL, Jorizzo JL, Rapini RP (eds). Edinburgh: Mosby; 2003. pp. 525–86.'},{id:"B2",body:'Lowenstein EB, Lowenstein EJ. Glandular changes. In: Text Atlas of Obstetric Dermatology. Kroumpouzos G (ed). Philadelphia, PA: Lippincott Williams & Wilkins; 2013. pp. 47–56.'},{id:"B3",body:'Durmazlar SPK, Eskioğlu F. Cosmetic procedures in pregnancy: review. Turkiye Klinikleri J Med Sci. 2008;28(6):942–6'},{id:"B4",body:'Yang CS, Teeple M, Muglia J, Robinson-Bostom L. Inflammatory and glandular skin disease in pregnancy. Clin Dermatol. 2016;34(3):335–43.'},{id:"B5",body:'Chien AL, Qi J, Rainer B, Sachs DL, Helfrich YR. Treatment of acne in pregnancy. 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Dermatology. 1994;188:251–4.'},{id:"B53",body:'Fuentelsaz V, Ara M, Corredera C, Lezcano V, Juberias P, Carapeto FJ. Rosacea fulminans in pregnancy: successful treatment with azithromycin. Clin Exp Dermatol. 2011;36(6):674–6.'},{id:"B54",body:'de Morais e Silva FA, Bonassi M, Steiner D, da Cunha TV. Rosacea fulminans in pregnancy with ocular perforation. J Dtsch Dermatol Ges. 2011;9(7):542–3.'},{id:"B55",body:'Ferahbas A, Utas S, Mistik S, Uksal U, Peker D. Rosacea fulminans in pregnancy: case report and review of the literature. Am J Clin Dermatol. 2006;7(2):141–4.'},{id:"B56",body:'Lewis VJ, Holme SA, Wright A, Anstey AV. Rosacea fulminans in pregnancy. Br J Dermatol. 2004;151(4):917–9.'},{id:"B57",body:'Van Zuuren EJ, Fedorowicz Z, Carter B, van der Linden MMD, Charland L. Interventions for rosacea. Cochrane Database Syst Rev. 2015;4:CD003262.'},{id:"B58",body:'Malik R, Quirk CJ. Topical applications and perioral dermatitis. Australas J Dermatol. 2000;41:34–8.'},{id:"B59",body:'Smith HS, Chao JD, Teitelbaum J. Painful hidradenitis suppurativa. Clin J Pain. 2010;26(5):435–44.'},{id:"B60",body:'Oumeish OY, Al-Fouzan AW. Miscellaneous diseases affected by pregnancy. Clin Dermatol. 2006;24(2):113–7.'},{id:"B61",body:'Karagiannidis I, Nikolakis G, Zouboulis CC. Endocrinologic aspects of hidradenitis suppurativa. Dermatol Clin. 2016;34(1):45–9.'},{id:"B62",body:'Yu CC, Cook MG. Hidradenitis suppurativa: a disease of follicular epithelium, rather than apocrine glands. Br J Dermatol. 1990;122:763–9.'},{id:"B63",body:'Cornbleet T. Pregnancy and apocrine diseases: hidradenitis, Fox-Fordyce disease. Arch Dermatol Syph. 1952;65:12–9.'},{id:"B64",body:'Mortimer PS, Dawber RP, Gales MA, et al. Mediation of hidradenitis suppurativa by androgens. Br Med J (Clind Res Ed). 1986;292:245–8.'},{id:"B65",body:'Barth JH, Layton AM, Cunliffe WJ. Endocrine factors in pre- and postmenopausal women with hidradenitis suppurativa. Br J Dermatol. 1996;134:1057–9.'},{id:"B66",body:'Hurley H. Dermatologic surgery, principles and practice. New York: Marcel Dekker; 1989.'},{id:"B67",body:'Alikhan A, Lynch PJ, Eisen DB. Hidradenitis suppurativa: a comprehensive review. J Am Acad Dermatol. 2009;60(4):539–61.'},{id:"B68",body:'Gupta AK, Studholme C. Adalimumab (Humira) for the treatment of hidradenitis suppurativa. Skin Therapy Lett. 2016;21(4):1–4.'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Aslı Feride Kaptanoglu",address:"dr.aslikaptanoglu@gmail.com",affiliation:'
Marmara University Medical Faculty, Department of Dermatology and Venereology, İstanbul, Turkey
Department of Dermatology and Venereology, Near East University, Lefkoşe, North Cyprus
'}],corrections:null},book:{id:"5433",type:"book",title:"Acne and Acneiform Eruptions",subtitle:null,fullTitle:"Acne and Acneiform Eruptions",slug:"acne-and-acneiform-eruptions",publishedDate:"March 15th 2017",bookSignature:"Selda Pelin Kartal and Muzeyyen Gonul",coverURL:"https://cdn.intechopen.com/books/images_new/5433.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-953-51-2990-5",printIsbn:"978-953-51-2989-9",pdfIsbn:"978-953-51-7350-2",reviewType:"peer-reviewed",numberOfWosCitations:4,isAvailableForWebshopOrdering:!0,editors:[{id:"72686",title:"Prof.",name:"Selda Pelin",middleName:null,surname:"Kartal",slug:"selda-pelin-kartal",fullName:"Selda Pelin Kartal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"187044",title:"Dr.",name:"Müzeyyen",middleName:null,surname:"Gönül",slug:"muzeyyen-gonul",fullName:"Müzeyyen 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1. Introduction
Chemical control remains the most important and widely used strategy against noxious insect pests around the world. It is used to kill, harm, repel, or mitigate one or more species of an insect by disrupting the nervous system and damaging their exoskeletons. Insecticides have not only controlled insects, but it also used to control diseases carrier agents and helps in the economy and social benefits through better health and increase food production [1, 2]. After the introduction of neonicotinoids in the 1990s, most widely used against the sap-feeding insect. Among these imidacloprid is the most widely used insecticide in the world. Neonicotinoids currently account for approximately 25% of the total insecticide market and are increasing in use as they replace the organophosphate (OP) and carbamate insecticides, causing less toxicity in birds and mammals than insects. Overwhelming evidence has risen over the past decade regarding potentially harmful risks to humans, nontarget insects, aquatic invertebrates, and side effects on the natural environment following usage of specific classes of insecticides [3, 4].
There is various kind of factors that helps the occurrence and initial successful establishment of neonicotinoids to control, mitigate the especially soft body insect pests. At that time there was no known pesticide resistance in target pests, mainly because of recently synthesized nicotine contain plants, their physicochemical properties included many advantages such as selectivity, target-specific, less residual effect on soil, and metabolism rate fast over previous generations of insecticides (i.e., organophosphates, carbamates, pyrethroids, etc.) they shared an assumed reduced operator and consumer risk [5, 6]. But after some time, due to large and indiscriminate use of the same mode of action insecticides have been responsible for developed resurgence and insecticide tolerance ability increased. The first report of neonicotinoid resistance was published in 1996, describing the low efficacy of imidacloprid against Spanish greenhouse populations of cotton whitefly. There are three major detoxification enzymes involved in the development of resistance against insecticides viz., cytochrome P450 monooxygenases, carboxylesterases, and glutathione S-transferases [1, 7].
Several field problems such as poor selection of chemicals and substandard application practices exacerbated the control failures of insecticides against Bemisia tabaci in India. The repeated use of compounds of the same active ingredients and application of excessive organophosphates, carbamate, pyrethroids, and neonicotinoids against insect pests cause the development of resistance. Resistance to insecticides resulting in loss of efficacy of many older insecticides has placed excessive pressure on novel products. One of the major limitations to resistance management is the occurrence of cross-resistance [8].
2. Landmark to development of neonicotinoids and their mode of action
In 1970, first-time nithiazine was precursor by Henry Feuer, a reputed chemist at Purdue University [4, 9].
Shell (oil refinery company) researchers found in screening that this precursor showed insecticide activity on insect pest management and refined it to develop nithiazine.
In 1984, the mode of action of nithiazine was found to be as a postsynaptic acetylcholine receptor same as nicotine.
In 1985, Bayer patented imidacloprid as the first commercial neonicotinoid, and till 1990 used at large scale.
The early 2000s, two other neonicotinoids, clothianidin, and thiamethoxam, entered the market, which is drastically changing the thinking of people.
During 2013, virtually all corn planted in the United States was treated with one of these two insecticides. Thiamethoxam among the neonicotinoids has less residual effect and persistence in nature.
Beginning of 2014, about a third of US soybean acreage was planted with neonicotinoid-treated seeds, usually imidacloprid or thiamethoxam [3].
Electrophysiological studies on identified cockroach neurons, and the binding to cockroach nervous system membrane.
2.1 Neonicotinoid groups Vs Older groups
Neonicotinoids have been the most commonly used insecticides since the early 1990s as an alternative to older organophosphate and carbamate insecticides. Neonicotinoids are insecticides that exhibit physicochemical properties, rendering them more useful over other classes of insecticides [10]. Over the last few years, neonicotinoids have been combined with pyrethroids in formulated products, and with diatomaceous earth (e.g., Alpine dust insecticide, with dinotefuran) for the control of insect pests. Moderate to high levels of tolerance/resistance to various neonicotinoids showed by insect pests. Romero and Anderson reported that resistance to neonicotinoids may likely be conferred by the increased enzymatic activities found in these populations. Those findings showed that tolerance or even resistance to neonicotinoids is now present in field and storage pest populations [1, 11].
Neonicotinoids show high acute toxicity to honeybees. The neonicotinoid family includes imidacloprid, clothianidin, and thiamethoxam (the latter is metabolized to clothianidin in the plant and the insect). Recently, imidacloprid has been replaced by thiamethoxam and clothianidin in some parts of the world. To date, neonicotinoids have proved the development of resistance, such as Myzus persicae and Phorodon humuli. The effects of imidacloprid on Nilaparvata lugens, tebufenozide on Plutella xylostella and Spodoptera exigua, thiamethoxam on Bemisia tabaci, trichlorphon on Bactrocera dorsalis, imidacloprid on Spodoptera litura, and emamectin benzoate on Chrysoperla carnea have been reported [12].
The first report of neonicotinoid resistance was published in 1996, describing the low efficacy of imidacloprid against Spanish greenhouse populations of cotton whitefly. Later-generation, show stronger resistance (up to 17-fold in the first 15 generations, but >80-fold resistance after 24 generations, which has been confirmed in some populations of the whitefly (Bemisia tabaci) and the Colorado potato beetle (Leptinotarsa decemlineata) [13]. Although neonicotinoids are applied as foliar insecticides with possible direct exposure risks to honeybees, a large part of neonicotinoid use consists of seed coating or root drench application [14, 15].
2.2 Mode of action of neonicotinoid
All neonicotinoids act on the insect central nervous system as agonists of the postsynaptic nicotinic acetylcholine receptors (nAChRs). Neonicotinoids act as agonists on the postsynaptic insect nicotinic acetylcholine receptors (nAChRs), biodegradable substituents which have a much higher affinity on insects than mammals [16, 17]. Neonicotinoid insecticides are highly toxic to many invertebrates, including honey bees, bumblebees, and solitary bees. The neonicotinoids (including imidacloprid, dinotefuran, clothianidin, and thiamethoxam) are nitro functional group (▬NO2) instead of a cyano functional group (▬C〓N) in their molecular structure. This slight difference in their molecular structure affects the toxicity level of neonicotinoids, which bind to an insect receptor site. The nitro-group neonicotinoids are much more toxic to bees than the cyano-group neonics, which include acetamiprid and thiacloprid [11, 13, 18].
3. Global growth, status, and uses of neonicotinoid insecticide
During 1990, the global insecticide market was dominated by carbamates, organophosphates, and pyrethroids. In 2008, one-quarter of the insecticide market was neonicotinoid to 27% in 2010 and nearly 30% in 2012. The Overuse of chemical products in different spheres of life not only brings benefits for humanity but also presents a large number of threats against the environment and in consequence to human health. The present graph indicates the maximum use of neonicotinoids insecticide and its application in different countries. Here, thiamethoxam shares maximum contribution in the market (37.6) followed by imidacloprid (33.5), clothianidin (14.7), acetamiprid (7.2), thiacloprid (3.8), dinotefuran (2.9), nitenpyram (0.3), and the area uses maximum in agriculture production in Latin America (29.4), Asia (23.1), and North America (22.1) followed by others unallocated areas (Figure 1).
Figure 1.
Agricultural use by region and market share of individual neonicotinoids in percent. Abbreviations: TMX (thiamethoxam), IMD (imidacloprid), CLT (clothianidin), ACT (acetamiprid), TCP (thiacloprid), DNF (dinotefuran), NIT (nitenpyram).
3.1 The use of neonicotinoids covers four major domains
The uses of neonicotinoid are to protect crops and ornamentals against polyphagous insects and mites, urban pest control to target harmful organisms such as cockroaches, ants, termites, wasps, flies, etc., apart from the agricultural uses, it is also applicable in veterinary sciences to reduce the chances of occurrence (fleas, ticks on pet animals) and fish farming infestations. In agriculture as well as horticulture crop, neonicotinoid can be functional in many different ways such as foliar spraying, seed dressing, soil drenching, furrow application, trunk injections in trees, mixing with irrigation water, drenching of flower, soil treatment, granular application, dipping of seedlings, bulbs and application with a brush on the stems of fruit trees. Seed and soil applications denote approximately 60% of their uses globally [16, 19]. The usage of neonicotinoid insecticides has grown considerably since the forerunner of this group, it is first introduced among neonicotinoids in the year 1991 followed by acetamiprid and thiamethoxam. Till now, seven insecticides be in the right place to this chemical class are available to farmers all over the world and classified as Group A within the Insecticide Resistance Action Committee (IRAC) and Mode of Action Classification Scheme. All neonicotinoids are agonists of insect nicotinic acetylcholine receptors [18]. In 1941, the first case documented by insects demonstrated resistance to an inorganic resistance; 1987—first reported in First reported on tobacco in vaeck, and later on tomato in Bischoff district. Insect resistance genetically modified crops (primarily cotton and maize), are toxic to certain insects. They are often called Bt crops because the introduction genes were originally identified in a bacterial species called Bacillus thuringiensis(Figure 2).
Figure 2.
Several reported cases of neonicotinoid resistance up to 2014. Only those pests with >10 (fold) reported cases are shown.
3.2 Insecticide resistance to neonicotinoid
Resistance is quickly developed due to the selection of highly effective compounds with kill or mitigate to insect, long residual effect, and is regular use of single biochemical target site. The toxicant is converted into a nontoxicant form in the body of an insect by various enzymes. All these enzymatic changes are carried forward and transmitted through genes. Resistance in B- and Q-type has been noticed in Bemisia tabaci to enhanced oxidative detoxification of neonicotinoids due to overexpression of monooxygenases. No evidence for target-site resistance has been found in whiteflies [18, 19]. Biotic and abiotic degradation processes contribute to the environmental persistence of neonicotinoids. The half-life of neonicotinoids varies depending on physiochemical conditions (i.e., organic matter content, soil texture, residence time) before undergoing complete degradation. The development of resistance is a complex and dynamic process and depends upon many factors. As per the IRAC, resistance is well-defined as a heritable change in the sensitivity of a pest population, that is reflected in the constant failure of a product to attain the expected level of control when used according to the label endorsement for that pest species [20]. The environmental protection agency (EPA) is divided into two classes of toxicity agents i.e., II and III. Accumulation (increase the level of pesticides) of those pesticides into the soil affects the pollen quality of sprayed plants, especially due to their toxic effects, against pollinators the consequences of the occurrence of these insecticides have been discussed [10, 21]. It is determined that the transfer of vertical gene (a particular gene) from the microorganism, higher plants, animals into a host plant for crop improvement and researches are called transgenic plant or insects, virus, fungus resistance plant. It gives us facts for future research. Mutation (can build up in the pest population when a change in the genetic characteristic of the pest population is inherited from one generation to the next) in nAChR subunits and in most cases, metabolism is also responsible for the development of resistance (Figure 3). The brown planthopper, Nilaparvata lugens, was selected with imidacloprid treatment at a sublethal dose to obtain resistant mutation. Both Bemisia tabaci (sweet potato whitefly) and Trialeurodes vaporariorum (greenhouse whitefly) have been shown to have a high possibility for resistance development and characterize some of the main targets for which IRAC specific strategies have been developed [8, 22]. Global resistance management guiding principles were designed by the Neonicotinoid Working Group of the Insecticide Resistance Action Committee and are based on guidelines published and updated earlier [9].
Figure 3.
Pesticide resistance can build up in the pest population when a change in the genetic characteristic of the pest population is inherited from one generation to the next.
4. Mechanism of resistance and factors that influence resistance development
4.1 Resistance mechanisms
The various mechanisms that enable insects to resist the action of insecticides can be grouped into several categories:
4.1.1 Single resistance
Resistance to Dichloro diphenyl trichloroethane (DDT) amounts to resistance to several DDT analogs such as methoxychlor, but not to hexa chloro cyclohexane (HCH). Due to excessive and continuous use of the insecticides.
4.1.2 Cross-resistance
It occurs when resistance to one insecticide or within a group. Eg: organophosphate insecticides, fungicides etc.
4.1.3 Multiple resistance
It involves multiple, independent resistance mechanisms, which often lead to resistance to chemicals from different families (i.e., organophosphate and carbamate insecticides) [23].
4.1.4 Metabolic resistance
It plays one of the significant roles, in the development of resistance which helps to change the activity of enzyme systems that all insects possess to help them detoxify naturally occurring foreign materials. Enzymes are classified viz., esterases, monooxygenases, and glutathione S-transferases typically fulfill this function. These enzyme systems are often enhanced in resistant insect strains enabling them to metabolize or degrade insecticides before they can exert a toxic effect. Metabolic resistance appliances have been noticed in whitefly, aphid, and Colorado potato beetle populations for all major classes of insecticides, currently also used for soft body insect control including neonicotinoids insecticide [24].
4.1.5 Target site resistance
Insecticides generally perform on a specific site within the insect, especially within the nervous system (e.g., OP, carbamate, and pyrethroid insecticides). The site of action can be reformed in resistant strains of insects such that the insecticide no longer binds effectively. This results in the insects being unaffected, or less affected, by the action of insecticide than susceptible insects.
4.1.6 Reduced penetration
Changes in the insect cuticle or digestive tract linings that avoid or slow the absorption or diffusion of insecticides can be found in some strains of resistant insects. This resistance mechanism can affect a broad range of insecticides. Examples of reduced penetration mechanisms are limited and are often considered a contributing factor to reduced susceptibility.
4.1.7 Behavioral resistance
This resistance illustrates any adjustment in insect behavior that helps to avoid the lethal effects of insecticides [22]. Insecticide resistance in mosquitoes is not always based on biochemical mechanisms such as metabolic detoxification or target site mutations, but may also be conferred by behavioral changes in response to prolonged exposure to an insecticide.
4.1.8 Genetic basis of resistance
It occurs naturally, genetic mutations allow a small proportion of the population to resist and endure the effects of the insecticide. This occurs due to continually using the same insecticide and horizontal genes. Resistance insects will reproduce and the genetic changes that confer resistance are transferred from parents to offspring so that eventually they become numerous within the population (Table 1).
Mechanism
Species
Resistance to neonicotinoids
Enhanced expression of CYP6G1
Drosophila melanogaster
Enhanced expression of CYP6AY1, CYP6ER1, CYP4CE1, and CYP6CW1
Nilaparvata lugens
Enhanced expression of glutathione S-transferase (MdGST) and galactosyltransferase (MdGT1)
Musca domestica
Mutation of Dα1/Dβ2 subunits
Drosophila melanogaster
Deletion of Dα1 subunit
Y151 mutation in Nlα1/Nlα3 subunits
Nilaparvata lugens
Reduced expression of Nlα8 nicotinic acetylcholine receptor (nAChR) subunit
R81T mutation in Mpβ1 subunit
Myzus persicae
Aphis gossypii
Tolerance to neonicotinoids
Reduced sensitivity to thiacloprid and acetamiprid due to metabolism by CYP9Q3
Apis mellifera
Reduced sensitivity to thiacloprid and acetamiprid due to metabolism by CYP9Q4 and CYP9Q6
Bombus terrestris
Reduced sensitivity to thiacloprid due to metabolism by CYP9BU1 and CYP9BU2
Osmia bicornis
Table 1.
Mechanisms of neonicotinoid resistance and tolerance in insects.
5. Factors influence in the development of resistance
5.1 Frequency of application
However, usually pesticide or management measures are used, one of the important factors that influence resistance development. With every use, an advantage is given to the resistance insects inside a population. The speed of increase of resistance in any population can usually be faster within the presence of a lower applicable value.
5.2 Dosage and persistence of effect
The period of pesticide persistence remains effective, additionally referred to as its persistence, relies upon the chemical science of the pesticide, the short of formulation, and also the application rate. The product that gives a persistent impact equally gives continuous selection pressure to multiple species. As an example, an area spray can persist for short time and can choose solely against one generation of mosquitoes [22]. In addition, a residual wall application or a bed net treatment can persist for months or years providing choice pressure against several generations of an equivalent insect. It is so vital to frequently follow manufacturer and United Nations agency recommendations once victimization such pesticides.
5.3 Rate of reproduction
As we have got identified that usually, insects that have a short life cycle, and high reproductive rate are possible to develop resistance earlier than species that have a lower reproductive rate, as any resistance generation will quickly unfold throughout the population. The homopterans insect has an associate in nursing account for pesticide resistance and is considered by a comparatively short life cycle and high fecundity, with female laying a huge number of eggs throughout their reproductive life. However, the tse-tse fly have shorter life cycle and fecundity comparatively less than hemipterans and comparatively low rate of reproduction, females produce in total fewer approximately 10 offspring.
5.4 Population isolation
With vectors of sickness, the goal is common to get rid of all or the bulk of the population, but the larger the choice pressure that is placed on a population, the quicker status could also be lost. Immigration of people possessing susceptible genes from untreated areas can beneficially dilute and contend with the resistance genes within the overall population. Associate in nursing early step during a vector management program should therefore to be to estimate the importance of immigration of untreated insects. As an example, associate in nursing island wherever the whole space was treated would have the next risk of developing resistance as few untreated mosquitoes would be part of the treated population. The hazard of pesticide resistance rising out to be measured once designing resistance management ways [25, 26]. Awareness of and coordination with neighboring vector management programs and agricultural activities should be excited, so the regional impact on the target population is deliberated.
Prolonged exposure to a single insecticide
High selection pressure
Large coverage area
Insects multiplying by asexual means
The selection at every stage of the insect life cycle
6. Neonicotinoid resistance management
Always use products at the recommended label rates and spray intervals with the appropriate application equipment.
Rotation of insecticide group against the rapid selection of resistant population.
Use suitable integrated pest management (IPM) approaches.
Neonicotinoids are used against different pests in the same cultivars.
Repeatable uses of different chemistry of neonicotinoids against more than one pest species in the same crop are less susceptible but need at the local level, to take into account the pest populations dynamics, overlapping of the various species, their relative importance, and each species’ potential risk for developing resistance [2].
Do not control a multigeneration pest exclusively with neonicotinoids.
The use of nonspecific products helps to prevent the development of resistance.
Plan to use neonicotinoid insecticides in such a way that they do not affect the beneficial organisms.
Good agricultural practices should be applied alongside physical and biological pest control methods.
Judicious use of insecticides (need-based and recommended dose).
The use of insecticide synergists.
Window system of pesticide application.
Area-wide management.
Crop pest host management.
Monitor problematic pest populations to detect first shifts insensitivity.
6.1 Alternative prospects
Use other synthetic or naturally occurring chemical insecticides
Biological control with microorganisms
Biological control through farming practices
Use of semiochemicals for mass trapping, mating disruption, repulsion, antifeeding effects, push-and-pull or attract-and-kill techniques
Use other techniques like physical and mechanical methods to minimize insecticidal loads
Genetically improved plant varieties
We used four criteria to rank the alternatives to neonicotinoids—efficacy (E), applicability (A), durability (D), and practicability (P)
7. Summary
The widespread use of synthetic insecticides has given rise to the serious problem of insecticide resistance all over the world. The problem of insecticide resistance is growing in magnitude is no doubt steadily diminishing the choice of effective insecticides for vector control. The frequent change in insecticides involves a substantial increase in cost. The practice with neonicotinoid develops harmful possible impacts on nontarget species and the environment worldwide. This review provides a beneficial means for categorizing regions that may need improved development of best management practices (BMPs) to mitigate the adverse consequences associated with extensive use of insecticides in surface and groundwater. Pesticides must be used judiciously in an IPM program to preserve cost-effective pesticides and maintain susceptible individuals in a pest population. The recent finding that nAChR subunit composition can be switched in insects exposed to sublethal concentrations of neonicotinoids is of considerable interest. To manage pest species effectively while minimizing conditions that lead to the onset of resistance, we need to know how messenger ribonucleic acids (mRNAs) encoding, nAChR subunits, and their associated proteins, as well as enzymes involved in metabolism, are dynamically modified. The challenge of optimizing and implementing such tactics for specific pests depends on a suite of ecological, genetic, operational, and socioeconomic.
\n',keywords:"insect resistance, neonicotinoids, overuse, nicotinic acetylcholine receptors, management strategies",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/79339.pdf",chapterXML:"https://mts.intechopen.com/source/xml/79339.xml",downloadPdfUrl:"/chapter/pdf-download/79339",previewPdfUrl:"/chapter/pdf-preview/79339",totalDownloads:102,totalViews:0,totalCrossrefCites:0,dateSubmitted:"June 9th 2021",dateReviewed:"October 8th 2021",datePrePublished:"November 16th 2021",datePublished:null,dateFinished:"November 15th 2021",readingETA:"0",abstract:"Pesticides are any substance used for controlling, preventing, destroying, repelling, or mitigating of pests. Neonicotinoids have been the most commonly used insecticide since the early 1990s, current market share of more than 25% of total global insecticide sales. Neonicotinoid insecticides are highly selective agonists of insect nicotinic acetylcholine receptors (nAChRs) that exhibit physicochemical properties, rendering them more useful over other classes of insecticides. This includes having a wide range of application techniques and efficacy in controlling sucking and biting insects. Although neonicotinoids are applied as foliar insecticides with possible direct exposure risks to honeybees, a large part of neonicotinoid use consists of seed coating or root drench application. There are three major detoxification enzymes involved in the development of resistance against insecticides viz., cytochrome P450 monooxygenases, carboxylesterases, and glutathione S-transferases. The repeatedly used use of compounds of the same active ingredients and application of excessive organophosphates (OPs) and pyrethroids in Bemisia tabaci. Resistance to insecticides resulting in loss of efficacy of many older insecticides has placed excessive pressure on novel products. One of the major limitations to resistance management is the occurrence of cross-resistance. This review briefly summarizes the current status of neonicotinoid resistance, the biochemical and mechanisms involved, and the implications for resistance management.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/79339",risUrl:"/chapter/ris/79339",signatures:"Shrawan Kumar Sahani, Vikas Kumar and Subhajit Pal",book:{id:"11015",type:"book",title:"Insecticides",subtitle:null,fullTitle:"Insecticides",slug:null,publishedDate:null,bookSignature:"Dr. Ramón Eduardo Rebolledo Ranz",coverURL:"https://cdn.intechopen.com/books/images_new/11015.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-83969-027-3",printIsbn:"978-1-83969-026-6",pdfIsbn:"978-1-83969-028-0",isAvailableForWebshopOrdering:!0,editors:[{id:"193813",title:"Dr.",name:"Ramón Eduardo",middleName:null,surname:"Rebolledo Ranz",slug:"ramon-eduardo-rebolledo-ranz",fullName:"Ramón Eduardo Rebolledo Ranz"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Landmark to development of neonicotinoids and their mode of action",level:"1"},{id:"sec_2_2",title:"2.1 Neonicotinoid groups Vs Older groups",level:"2"},{id:"sec_3_2",title:"2.2 Mode of action of neonicotinoid",level:"2"},{id:"sec_5",title:"3. Global growth, status, and uses of neonicotinoid insecticide",level:"1"},{id:"sec_5_2",title:"3.1 The use of neonicotinoids covers four major domains",level:"2"},{id:"sec_6_2",title:"3.2 Insecticide resistance to neonicotinoid",level:"2"},{id:"sec_8",title:"4. Mechanism of resistance and factors that influence resistance development",level:"1"},{id:"sec_8_2",title:"4.1 Resistance mechanisms",level:"2"},{id:"sec_8_3",title:"4.1.1 Single resistance",level:"3"},{id:"sec_9_3",title:"4.1.2 Cross-resistance",level:"3"},{id:"sec_10_3",title:"4.1.3 Multiple resistance",level:"3"},{id:"sec_11_3",title:"4.1.4 Metabolic resistance",level:"3"},{id:"sec_12_3",title:"4.1.5 Target site resistance",level:"3"},{id:"sec_13_3",title:"4.1.6 Reduced penetration",level:"3"},{id:"sec_14_3",title:"4.1.7 Behavioral resistance",level:"3"},{id:"sec_15_3",title:"Table 1.",level:"3"},{id:"sec_18",title:"5. Factors influence in the development of resistance",level:"1"},{id:"sec_18_2",title:"5.1 Frequency of application",level:"2"},{id:"sec_19_2",title:"5.2 Dosage and persistence of effect",level:"2"},{id:"sec_20_2",title:"5.3 Rate of reproduction",level:"2"},{id:"sec_21_2",title:"5.4 Population isolation",level:"2"},{id:"sec_23",title:"6. Neonicotinoid resistance management",level:"1"},{id:"sec_23_2",title:"6.1 Alternative prospects",level:"2"},{id:"sec_25",title:"7. Summary",level:"1"}],chapterReferences:[{id:"B1",body:'Buszewski B, Bukowska M, Ligor M, Staneczko-Baranowska I. A holistic study of neonicotinoids neuroactive insecticides—Properties, applications, occurrence, and analysis. Environmental Science and Pollution Research. 2019;26:34723-34740'},{id:"B2",body:'Gorman K. Report of resistance to the neonictonoid insecticide imidacloprid in Trialeurodes vaporariorum. Pest Management Science. 2007;63:555'},{id:"B3",body:'Insecticide Resistance Action Committee (IRAC). Prevention and Management of Insecticide Resistance in Vectors of Public Health Importance. 2nd ed; 2011'},{id:"B4",body:'Pisa LW, Amaral-Rogers V, Belzunces LP, Bonmatin JM, Downs CA, Goulson D, et al. Effects of neonicotinoids and fipronil on non-target invertebrates. Environmental Science and Pollution Research. 2015;22:68-102'},{id:"B5",body:'Korrat RAA, Ahmed SA, Badr NF. The potential side effects of certain insecticide formulations on the green lacewing, Chrysoperla carnea (Stephens). Journal of Plant Protection and Pathology. 2019;10:605-612'},{id:"B6",body:'Tomizawa M, Casida JE. Neonicotinoid insecticide toxicology: Mechanisms of selective action. Annual Review of Pharmacology and Toxicology. 2005;45:247-268'},{id:"B7",body:'Dang K, Doggett SL, Singham GV, Lee CY. Insecticide resistance and resistance mechanisms in bed bugs, Cimex spp. (Hemiptera: Cimicidae). Parasites & Vectors. 2017;10:1-31'},{id:"B8",body:'Horowitz AR, Kontsedalov S, Denholm I, Ishaaya I. Dynamics of insecticide resistance in Bemisia tabaci: A case study with the insect growth regulator pyriproxyfen. Pest Management Science. 2002;58:1096-1100'},{id:"B9",body:'Nauen R, Denholm I. Resistance of insect pests to neonicotinoid insecticides: Current status and future prospects. Archives of Insect Biochemistry and Physiology. 2005;58:200-215'},{id:"B10",body:'Bose A, Murugan M, Shanthi M, Ramalingam J, Mini ML. Prevalence of neonicotinoid resistance in cotton aphid Aphis gossypii. Indian Journal of Entomology. 2020;82:110-114'},{id:"B11",body:'Bonmatin JM, Giorio C, Girolami V, Goulson D, Kreutzweiser DP, Krupke C, et al. Literature review: Global neonicotinoid insecticide occurrence in aquatic environments. Water. 2020;12:33-88'},{id:"B12",body:'IRAC. Mode of Action Classification Scheme. Version 9.4. Issued: March 2020'},{id:"B13",body:'Bass C, Denholm I, Williamson MS, Nauen R. The global status of insect resistance to neonicotinoid insecticides. Pesticide Biochemistry and Physiology. 2015;121:78-87'},{id:"B14",body:'Jeschke P, Nauen R. Chapter 3: Neonicotinoid insecticides. In: Gilbert LI, Gill S, editors. Insect Control: Biological and Synthetic Agents. Vol. 62. London, England: Academic Press; 2010. ISBN 9780123814500'},{id:"B15",body:'Matsuda K, Ihara, Sattelle DB. Neonicotinoid insecticides: Molecular targets, resistance, and toxicity. Annual Review of Pharmacology and Toxicology. 2020;60:241-255'},{id:"B16",body:'Marzaro M, Mitchell EAD. Environmental fate and exposure; neonicotinoids and fipronil. Environmental Science and Pollution Research. 2015;22:35-67'},{id:"B17",body:'Satar G, Ulusoy MR, Nauen R, Dong K. Neonicotinoid insecticide resistance among populations of Bemisia tabaci in the Mediterranean region of Turkey. Bulletin of Insectology. 2018;71:171-177'},{id:"B18",body:'Jeschke P, Nauen R. Neonicotinoids from zero to hero in insecticide chemistry. Pest Management Science. 2008;64:1084-1098'},{id:"B19",body:'Rauch N, Nauen R. Biochemical markers linked to neonicotinoid cross-resistance in Bemisia tabaci. Archives of Insect Biochemistry and Physiology. 2003;54:165'},{id:"B20",body:'Elbert A, Bailo-Schleiermacher I, Bruggen KU, Nauen R, Rogers D, Steffens R, et al. Bayer crop science guidelines on resistance management for neonicotinoids. Pflanzenschutz-Nachrichten Bayer. 2005;58:4-32'},{id:"B21",body:'Zhang C, Tian D, Yi X, Zhang T, Ruan J, Wu R, et al. Occurrence, distribution and seasonal variation of five neonicotinoid insecticides in surface water and sediment of the Pearl Rivers, South China. Chemosphere. 2019:437-446'},{id:"B22",body:'Simon-Delso N, Amaral-Rogers V, Belzunces LP, Bonmatin JM, Chagnon M, Downs C, et al. Systemic insecticides (neonicotinoids and fipronil): Trends, uses, mode of action and metabolites. Environmental Science and Pollution Research. 2015;22:5-34'},{id:"B23",body:'Radolinski J, Wu J, Xia K, Hession WC, Stewart RD. Plants mediate precipitation-driven transport of a neonicotinoid pesticide. Chemosphere. 2019;222:445-452'},{id:"B24",body:'Zota AR, Calafat AM, Woodruff TJ. Temporal trends in phthalate exposures: Findings from the National Health and Nutrition Examination Survey,2001-2010. Environmental Health Perspectives. 2014;122:235-241'},{id:"B25",body:'Zeng T, Arnold WA. Pesticide photolysis in prairie potholes: Probing photosensitized processes. Environmental Science & Technology. 2013;47:6735-6745'},{id:"B26",body:'Zhu F, Lavine L, O’Neal S, Lavine M, Foss C, Walsh D. Insecticide resistance and management strategies in urban ecosystems. Insects. 2016;7:2'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Shrawan Kumar Sahani",address:"sahanishrawan@gmail.com",affiliation:'
Department of Entomology, Bihar Agricultural University, India
Department of Agricultural Entomology, Visva-Bharati University, India
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Unfortunately, no therapeutic agent has been developed from targeting these receptors. Accumulating evidence has suggested that GlyRs are one primary target for exogenous and endogenous cannabinoids in the central nervous system. Cannabinoids enhance the function of GlyRs in various neurons in the brain. However, this line of research has been largely ignored since little is known about the molecular mechanism and behavioral implication of cannabinoid modulation of GlyRs. Recent studies using various experimental approaches have explored molecular insights into cannabinoid-GlyR interaction and shed light on the molecular basis of nonpsychoactive cannabinoid modulation of GlyRs. Emerging evidence has suggested that cannabinoid modulation of GlyRs can contribute to some of the cannabis-induced therapeutic effects. In this chapter, I discuss recent development in studies of mechanism and therapeutic potential of cannabinoid modulation of GlyR subunits. 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She is the acting\nhead of the NutriNeuro Institute (UMR1286 INRA/University\nof Bordeaux) and co-acting head of the International Associated\nLaboratory OptiNutriBrain. She is a renowned scientist in the\nfield of psychoneuroimmunology. She was the first to demonstrate that dietary omega-3 impacts on the endocannabinoid\nsystem to modulate emotional behaviors. She has authored more than 105 original\nscientific articles and 14 book chapters. She is reviewer for more than 15 international scientific journals. She has organized more than 30 international congresses\nand conferences, given more than 110 conferences, and participated in more than\n80 press releases in the media. 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The company was founded in Vienna in 2004 by Alex Lazinica and Vedran Kordic, two PhD students researching robotics. While completing our PhDs, we found it difficult to access the research we needed. So, we decided to create a new Open Access publisher. A better one, where researchers like us could find the information they needed easily. The result is IntechOpen, an Open Access publisher that puts the academic needs of the researchers before the business interests of publishers.
",metaTitle:"Our story",metaDescription:"The company was founded in Vienna in 2004 by Alex Lazinica and Vedran Kordic, two PhD students researching robotics. While completing our PhDs, we found it difficult to access the research we needed. So, we decided to create a new Open Access publisher. A better one, where researchers like us could find the information they needed easily. The result is IntechOpen, an Open Access publisher that puts the academic needs of the researchers before the business interests of publishers.",metaKeywords:null,canonicalURL:"/page/our-story",contentRaw:'[{"type":"htmlEditorComponent","content":"
We started by publishing journals and books from the fields of science we were most familiar with - AI, robotics, manufacturing and operations research. Through our growing network of institutions and authors, we soon expanded into related fields like environmental engineering, nanotechnology, computer science, renewable energy and electrical engineering, Today, we are the world’s largest Open Access publisher of scientific research, with over 4,200 books and 54,000 scientific works including peer-reviewed content from more than 116,000 scientists spanning 161 countries. Our authors range from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery.
\\n\\n
In the same year that IntechOpen was founded, we launched what was at the time the first ever Open Access, peer-reviewed journal in its field: the International Journal of Advanced Robotic Systems (IJARS).
\\n\\n
The IntechOpen timeline
\\n\\n
2004
\\n\\n
\\n\\t
Intech Open is founded in Vienna, Austria, by Alex Lazinica and Vedran Kordic, two PhD students, and their first Open Access journals and books are published.
\\n\\t
Alex and Vedran launch the first Open Access, peer-reviewed robotics journal and IntechOpen’s flagship publication, the International Journal of Advanced Robotic Systems (IJARS).
\\n
\\n\\n
2005
\\n\\n
\\n\\t
IntechOpen publishes its first Open Access book: Cutting Edge Robotics.
\\n
\\n\\n
2006
\\n\\n
\\n\\t
IntechOpen publishes a special issue of IJARS, featuring contributions from NASA scientists regarding the Mars Exploration Rover missions.
\\n
\\n\\n
2008
\\n\\n
\\n\\t
Downloads milestone: 200,000 downloads reached
\\n
\\n\\n
2009
\\n\\n
\\n\\t
Publishing milestone: the first 100 Open Access STM books are published
\\n
\\n\\n
2010
\\n\\n
\\n\\t
Downloads milestone: one million downloads reached
\\n\\t
IntechOpen expands its book publishing into a new field: medicine.
\\n
\\n\\n
2011
\\n\\n
\\n\\t
Publishing milestone: More than five million downloads reached
\\n\\t
IntechOpen publishes 1996 Nobel Prize in Chemistry winner Harold W. Kroto’s “Strategies to Successfully Cross-Link Carbon Nanotubes”. Find it here.
\\n\\t
IntechOpen and TBI collaborate on a project to explore the changing needs of researchers and the evolving ways that they discover, publish and exchange information. The result is the survey “Author Attitudes Towards Open Access Publishing: A Market Research Program”.
\\n\\t
IntechOpen hosts SHOW - Share Open Access Worldwide; a series of lectures, debates, round-tables and events to bring people together in discussion of open source principles, intellectual property, content licensing innovations, remixed and shared culture and free knowledge.
\\n
\\n\\n
2012
\\n\\n
\\n\\t
Publishing milestone: 10 million downloads reached
\\n\\t
IntechOpen holds Interact2012, a free series of workshops held by figureheads of the scientific community including Professor Hiroshi Ishiguro, director of the Intelligent Robotics Laboratory, who took the audience through some of the most impressive human-robot interactions observed in his lab.
\\n
\\n\\n
2013
\\n\\n
\\n\\t
IntechOpen joins the Committee on Publication Ethics (COPE) as part of a commitment to guaranteeing the highest standards of publishing.
\\n
\\n\\n
2014
\\n\\n
\\n\\t
IntechOpen turns 10, with more than 30 million downloads to date.
\\n\\t
IntechOpen appoints its first Regional Representatives - members of the team situated around the world dedicated to increasing the visibility of our authors’ published work within their local scientific communities.
\\n
\\n\\n
2015
\\n\\n
\\n\\t
Downloads milestone: More than 70 million downloads reached, more than doubling since the previous year.
\\n\\t
Publishing milestone: IntechOpen publishes its 2,500th book and 40,000th Open Access chapter, reaching 20,000 citations in Thomson Reuters ISI Web of Science.
\\n\\t
40 IntechOpen authors are included in the top one per cent of the world’s most-cited researchers.
\\n\\t
Thomson Reuters’ ISI Web of Science Book Citation Index begins indexing IntechOpen’s books in its database.
\\n
\\n\\n
2016
\\n\\n
\\n\\t
IntechOpen is identified as a world leader in Simba Information’s Open Access Book Publishing 2016-2020 report and forecast. IntechOpen came in as the world’s largest Open Access book publisher by title count.
\\n
\\n\\n
2017
\\n\\n
\\n\\t
Downloads milestone: IntechOpen reaches more than 100 million downloads
\\n\\t
Publishing milestone: IntechOpen publishes its 3,000th Open Access book, making it the largest Open Access book collection in the world
We started by publishing journals and books from the fields of science we were most familiar with - AI, robotics, manufacturing and operations research. Through our growing network of institutions and authors, we soon expanded into related fields like environmental engineering, nanotechnology, computer science, renewable energy and electrical engineering, Today, we are the world’s largest Open Access publisher of scientific research, with over 4,200 books and 54,000 scientific works including peer-reviewed content from more than 116,000 scientists spanning 161 countries. Our authors range from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery.
\n\n
In the same year that IntechOpen was founded, we launched what was at the time the first ever Open Access, peer-reviewed journal in its field: the International Journal of Advanced Robotic Systems (IJARS).
\n\n
The IntechOpen timeline
\n\n
2004
\n\n
\n\t
Intech Open is founded in Vienna, Austria, by Alex Lazinica and Vedran Kordic, two PhD students, and their first Open Access journals and books are published.
\n\t
Alex and Vedran launch the first Open Access, peer-reviewed robotics journal and IntechOpen’s flagship publication, the International Journal of Advanced Robotic Systems (IJARS).
\n
\n\n
2005
\n\n
\n\t
IntechOpen publishes its first Open Access book: Cutting Edge Robotics.
\n
\n\n
2006
\n\n
\n\t
IntechOpen publishes a special issue of IJARS, featuring contributions from NASA scientists regarding the Mars Exploration Rover missions.
\n
\n\n
2008
\n\n
\n\t
Downloads milestone: 200,000 downloads reached
\n
\n\n
2009
\n\n
\n\t
Publishing milestone: the first 100 Open Access STM books are published
\n
\n\n
2010
\n\n
\n\t
Downloads milestone: one million downloads reached
\n\t
IntechOpen expands its book publishing into a new field: medicine.
\n
\n\n
2011
\n\n
\n\t
Publishing milestone: More than five million downloads reached
\n\t
IntechOpen publishes 1996 Nobel Prize in Chemistry winner Harold W. Kroto’s “Strategies to Successfully Cross-Link Carbon Nanotubes”. Find it here.
\n\t
IntechOpen and TBI collaborate on a project to explore the changing needs of researchers and the evolving ways that they discover, publish and exchange information. The result is the survey “Author Attitudes Towards Open Access Publishing: A Market Research Program”.
\n\t
IntechOpen hosts SHOW - Share Open Access Worldwide; a series of lectures, debates, round-tables and events to bring people together in discussion of open source principles, intellectual property, content licensing innovations, remixed and shared culture and free knowledge.
\n
\n\n
2012
\n\n
\n\t
Publishing milestone: 10 million downloads reached
\n\t
IntechOpen holds Interact2012, a free series of workshops held by figureheads of the scientific community including Professor Hiroshi Ishiguro, director of the Intelligent Robotics Laboratory, who took the audience through some of the most impressive human-robot interactions observed in his lab.
\n
\n\n
2013
\n\n
\n\t
IntechOpen joins the Committee on Publication Ethics (COPE) as part of a commitment to guaranteeing the highest standards of publishing.
\n
\n\n
2014
\n\n
\n\t
IntechOpen turns 10, with more than 30 million downloads to date.
\n\t
IntechOpen appoints its first Regional Representatives - members of the team situated around the world dedicated to increasing the visibility of our authors’ published work within their local scientific communities.
\n
\n\n
2015
\n\n
\n\t
Downloads milestone: More than 70 million downloads reached, more than doubling since the previous year.
\n\t
Publishing milestone: IntechOpen publishes its 2,500th book and 40,000th Open Access chapter, reaching 20,000 citations in Thomson Reuters ISI Web of Science.
\n\t
40 IntechOpen authors are included in the top one per cent of the world’s most-cited researchers.
\n\t
Thomson Reuters’ ISI Web of Science Book Citation Index begins indexing IntechOpen’s books in its database.
\n
\n\n
2016
\n\n
\n\t
IntechOpen is identified as a world leader in Simba Information’s Open Access Book Publishing 2016-2020 report and forecast. IntechOpen came in as the world’s largest Open Access book publisher by title count.
\n
\n\n
2017
\n\n
\n\t
Downloads milestone: IntechOpen reaches more than 100 million downloads
\n\t
Publishing milestone: IntechOpen publishes its 3,000th Open Access book, making it the largest Open Access book collection in the world
\n
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His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. 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After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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Currently, he is a professor of Orthodontics. He holds a Certificate of Advanced Study type A in Technology of Biomaterials used in Dentistry (1995); Certificate of Advanced Study type B in Dento-Facial Orthopaedics (1997) from the Faculty of Dental Surgery, University Denis Diderot-Paris VII, France; Diploma of Advanced Study (DESA) in Biocompatibility of Biomaterials from the Faculty of Medicine and Pharmacy of Casablanca (2002); Certificate of Clinical Occlusodontics from the Faculty of Dentistry of Casablanca (2004); University Diploma of Biostatistics and Perceptual Health Measurement from the Faculty of Medicine and Pharmacy of Casablanca (2011); and a University Diploma of Pedagogy of Odontological Sciences from the Faculty of Dentistry of Casablanca (2013). 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He also obtained an MSc in Molecular and Genetic Medicine, and a Ph.D. in Clinical Immunology and Human Genetics from the University of Sheffield, UK. He also completed a short-term fellowship in Pediatric Clinical Immunology and Bone Marrow Transplantation at Newcastle General Hospital, England. Dr. Rezaei is a Full Professor of Immunology and Vice Dean of International Affairs and Research, at the School of Medicine, Tehran University of Medical Sciences, and the co-founder and head of the Research Center for Immunodeficiencies. He is also the founding president of the Universal Scientific Education and Research Network (USERN). Dr. Rezaei has directed more than 100 research projects and has designed and participated in several international collaborative projects. He is an editor, editorial assistant, or editorial board member of more than forty international journals. He has edited more than 50 international books, presented more than 500 lectures/posters in congresses/meetings, and published more than 1,100 scientific papers in international journals.",institutionString:"Tehran University of Medical Sciences",institution:{name:"Tehran University of Medical Sciences",country:{name:"Iran"}}},{id:"180733",title:"Dr.",name:"Jean",middleName:null,surname:"Engohang-Ndong",slug:"jean-engohang-ndong",fullName:"Jean Engohang-Ndong",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180733/images/system/180733.png",biography:"Dr. Jean Engohang-Ndong was born and raised in Gabon. After obtaining his Associate Degree of Science at the University of Science and Technology of Masuku, Gabon, he continued his education in France where he obtained his BS, MS, and Ph.D. in Medical Microbiology. He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. 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She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. 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\r\n\tIn general, the harsher the environmental conditions in an ecosystem, the lower the biodiversity. Changes in the environment caused by human activity accelerate the impoverishment of biodiversity.
\r\n
\r\n\tBiodiversity refers to “the variability of living organisms from any source, including terrestrial, marine and other aquatic ecosystems and the ecological complexes of which they are part; it includes diversity within each species, between species, and that of ecosystems”.
\r\n
\r\n\tBiodiversity provides food security and constitutes a gene pool for biotechnology, especially in the field of agriculture and medicine, and promotes the development of ecotourism.
\r\n
\r\n\tCurrently, biologists admit that we are witnessing the first phases of the seventh mass extinction caused by human intervention. It is estimated that the current rate of extinction is between a hundred and a thousand times faster than it was when man first appeared. The disappearance of species is caused not only by an accelerated rate of extinction, but also by a decrease in the rate of emergence of new species as human activities degrade the natural environment. The conservation of biological diversity is "a common concern of humanity" and an integral part of the development process. Its objectives are “the conservation of biological diversity, the sustainable use of its components, and the fair and equitable sharing of the benefits resulting from the use of genetic resources”.
\r\n
\r\n\tThe following are the main causes of biodiversity loss:
\r\n
\r\n\t• The destruction of natural habitats to expand urban and agricultural areas and to obtain timber, minerals and other natural resources.
\r\n
\r\n\t• The introduction of alien species into a habitat, whether intentionally or unintentionally which has an impact on the fauna and flora of the area, and as a result, they are reduced or become extinct.
\r\n
\r\n\t• Pollution from industrial and agricultural products, which devastate the fauna and flora, especially those in fresh water.
\r\n
\r\n\t• Global warming, which is seen as a threat to biological diversity, and will become increasingly important in the future.
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\r\n\tThe environment is subject to severe anthropic effects. Among them are those associated with pollution, resource extraction and overexploitation, loss of biodiversity, soil degradation, disorderly land occupation and planning, and many others. These anthropic effects could potentially be caused by any inadequate management of the environment. However, ecosystems have a resilience that makes them react to disturbances which mitigate the negative effects. It is critical to understand how ecosystems, natural and anthropized, including urban environments, respond to actions that have a negative influence and how they are managed. It is also important to establish when the limits marked by the resilience and the breaking point are achieved and when no return is possible. The main focus for the chapters is to cover the subjects such as understanding how the environment resilience works, the mechanisms involved, and how to manage them in order to improve our interactions with the environment and promote the use of adequate management practices such as those outlined in the United Nations’ Sustainable Development Goals.
\r\n\tPollution is caused by a wide variety of human activities and occurs in diverse forms, for example biological, chemical, et cetera. In recent years, significant efforts have been made to ensure that the environment is clean, that rigorous rules are implemented, and old laws are updated to reduce the risks towards humans and ecosystems. However, rapid industrialization and the need for more cultivable sources or habitable lands, for an increasing population, as well as fewer alternatives for waste disposal, make the pollution control tasks more challenging. Therefore, this topic will focus on assessing and managing environmental pollution. It will cover various subjects, including risk assessment due to the pollution of ecosystems, transport and fate of pollutants, restoration or remediation of polluted matrices, and efforts towards sustainable solutions to minimize environmental pollution.
\r\n\tWater is not only a crucial substance needed for biological life on Earth, but it is also a basic requirement for the existence and development of the human society. Owing to the importance of water to life on Earth, early researchers conducted numerous studies and analyses on the liquid form of water from the perspectives of chemistry, physics, earth science, and biology, and concluded that Earth is a "water polo". Water covers approximately 71% of Earth's surface. However, 97.2% of this water is seawater, 21.5% is icebergs and glaciers, and only 0.65% is freshwater that can be used directly by humans. As a result, the amount of water reserves available for human consumption is limited. The development, utilization, and protection of freshwater resources has become the focus of water science research for the continued improvement of human livelihoods and society.
\r\n
\r\n\tWater exists as solid, liquid, and gas within Earth’s atmosphere, lithosphere, and biosphere. Liquid water is used for a variety of purposes besides drinking, including power generation, ecology, landscaping, and shipping. Because water is involved in various environmental hydrological processes as well as numerous aspects of the economy and human society, the study of various phenomena in the hydrosphere, the laws governing their occurrence and development, the relationship between the hydrosphere and other spheres of Earth, and the relationship between water and social development, are all part of water science. Knowledge systems for water science are improving continuously. Water science has become a specialized field concerned with the identification of its physical, chemical, and biological properties. In addition, it reveals the laws of water distribution, movement, and circulation, and proposes methods and tools for water development, utilization, planning, management, and protection. Currently, the field of water science covers research related to topics such as hydrology, water resources and water environment. It also includes research on water related issues such as safety, engineering, economy, law, culture, information, and education.
",coverUrl:"https://cdn.intechopen.com/series_topics/covers/41.jpg",keywords:"Water, Water Resources, Freshwater, Hydrological Processes, Utilization, Protection"}],annualVolumeBook:{},thematicCollection:[],selectedSeries:null,selectedSubseries:null},seriesLanding:{item:{id:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343",scope:"Biomedical Engineering is one of the fastest-growing interdisciplinary branches of science and industry. The combination of electronics and computer science with biology and medicine has improved patient diagnosis, reduced rehabilitation time, and helped to facilitate a better quality of life. Nowadays, all medical imaging devices, medical instruments, or new laboratory techniques result from the cooperation of specialists in various fields. The series of Biomedical Engineering books covers such areas of knowledge as chemistry, physics, electronics, medicine, and biology. 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The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. 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We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. 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