By using a reconstituted skin model, we aimed to evaluate the efficacy of a spray containing Rhealba oat extract on the rapidity of healing and the extension of the newly formed epithelium. A dermal equivalent was first made in a petri dish by combining skin fibroblasts with collagen type I. Then a punch biopsy as a source of epidermal cells was implanted on this dermal equivalent, where a multilayered epidermis developed. The spray containing Rhealba oat extract was added to the culture medium to evaluate epidermal growth by immunohistochemical analysis of mitotic activity (5-bromo-2'-deoxyuridine [BrDu] incorporation). The extension of the neoepithelium in comparison with untreated reconstituted skin over 22 days was evaluated histologically. On day 12, 16% of positive BrDu basal cells was detected after spray treatment in comparison with 4.2% positive cells in untreated reconstituted skin (p < 0.05). During epidermal differentiation between days 12 and 22, we observed a significant increase in the number of cellular epithelial layers after 16 and 18 days of spray treatment. Moreover the extension of re-epithelialization was also significantly increased after spray treatment on days 16 and 18. In conclusion, our results demonstrate a positive modulation of re-epithelialization on a newly formed epithelium by a spray containing Rhealba oat extract displaying a healing effect.
The aim of this study was to identify the distribution of aquaporin-9 by immunohistochemistry in rat tissues using specific antipeptide antiserum which we recently produced. Anti-aquaporin-9 antibody was raised in New Zealand white rabbits immunized with a conjugate of synthetic aquaporin-9 peptide with bovine serum albumin. Immunohistochemical analysis was performed by avidin-biotin complex method. Aquaporin-immunoreactivity was visualized in the anterior pituitary, central nervous system, retina, thyroid gland, gastrointestinal tract, liver, lung, pancreas and testis. When using antiserum preincubated with synthetic peptides or rat hypothalamus homogenate, which contains aquaporin-9 peptide, no significant stain of the hypothalamus was detected. These findings suggest that aquaporin-9 is widely distributed and that the method used is valuable in studying the distribution of aquaporin-9 in rats.
Hailey-Hailey disease, or familial benign chronic pemphigus, is a rare relapsing-remitting autosomal-dominant epidermal blistering disease. It preferentially affects females and is characterized by recurrent vesicles and erosions in the intertriginous areas. There are several topical corticosteroid therapeutic options, which are often limited in their use by their secondary effects and localization of the lesions. We report a case of a 60-year-old woman with Hailey-Hailey disease involving axillary, groin, cervical, antecubital, inframammary and abdominal folds. She was treated with 0.1% tacrolimus ointment, applied twice daily, with clinical improvement in 2 weeks and total remission in 4 weeks. She remains asymptomatic after a 10-month follow-up period.
Benign prostatic hyperplasia (BPH) is the nonmalignant, uncontrolled growth of prostate gland cells and stroma leading to difficulty in urinating. Lipid extracts from Saw palmetto (Arecaceae) fruits are used to treat BPH. The Cuban royal palm (Roystonea regia) is a member of this family and D-004, a lipid extract from its fruits, prevents prostate hyperplasia (PH) induced with testosterone, as opposed to dihydrotestosterone, in rodents. This study investigated whether D-004 could prevent the histological features of testosterone-induced PH in rats. Rats were distributed into six groups (10 rats per group): A negative control group receiving subcutaneous injections of soy oil and treated with vehicle, and five groups injected subcutaneously with testosterone and treated with the vehicle (positive control), D-004 (100, 200 and 400 mg/kg) or Saw palmetto (400 mg/kg). Treatments were given orally for 14 days. At sacrifice, prostates were removed and processed for light microscopy. The histopathological findings of PH were assessed according to a score-chart protocol. D-004 200 and 400 mg/kg, but not 100 mg/kg, significantly and moderately in a dose-dependent manner prevented prostate enlargement and the testosterone-induced histological changes. Compared with positive controls, D-004 200 and 400 mg/kg inhibited prostate size increases and the histological score up to 56.1% and 60.7%, respectively, while Saw palmetto 400 mg/kg reduced such variables by 45.8% and 49.0%, respectively. The effects of D-004 400 mg/kg on the histological changes, not on prostate size, were greater (p < 0.05) than those of Saw palmetto. D-004 and Saw palmetto did not affect body weight values. In conclusion, D-004 200 and 400 mg/kg administered orally for 14 days prevented the increase of prostate size and the testosterone-induced histological changes in rats, its effects being comparable or mildly better than those of Saw palmetto. These results extend previous data showing preventive effects of D-004 on testosterone-induced prostate enlargement with in rodents, and further studies are required to explore the mechanisms underlying such effects.
We report on successful induction of remission in a patient with necrotizing crescentic glomerulonephritis associated with myeloperoxidase-antineutrophil-cytoplasm antibodies by primary use of the anti-tumor necrosis factor (TNF)-alpha chimeric monoclonal antibody infliximab in combination with corticosteroids only. The standard treatment containing cyclophosphamide has reduced the former high mortality from systemic vasculitides. However, the toxicity of this alkylating agent limits its long-term use. As TNF-alpha has been shown to play a central pathogenic role in vasculitis as well as in crescentic glomerulonephritis, anti-TNF-alpha treatment in combination with cyclophosphamide has been found to be effective in therapy-resistant vasculitis. Previous reports on TNF-alpha-blocking therapies without additional cyclophosphamide did not include patients with active and severe crescentic glomerulonephritis. As our patient refused cyclophosphamide, he was given four infusions of infliximab (4 mg/kg on weeks 0, 2, 6 and 10) and methylprednisolone pulses (1 g on days 1-3), followed by daily oral prednisolone (starting with 2 mg/kg and tapering down to 5 mg daily within 3 months). After 12 weeks, control biopsy demonstrated lack of active glomerular inflammation while initially reduced renal function (creatinine 271 versus 172 mol/l, clearance 26 versus 62 ml/min) and proteinuria (2.4 versus 1.0 g/d) improved. Under remission maintenance therapy with azathioprine and prednisolone, the patient showed no relapses during a 1-year follow-up. Finally we demonstrate that there might be patients with crescentic glomerulonephritis who do not require therapy with alkylating substances and that less toxic agents such as the TNF-alpha-blocking monoclonal antibody infliximab could play a role in future primary treatment of crescentic glomerulonephritis.
The mevalonate pathway is crucial for osteoclast function. D-003 is a mixture of high molecular weight acids purified from sugarcane wax, which inhibits cholesterol biosynthesis through HMG-CoA reductase regulation. D-003 administered at 50 and 200 mg/kg for 12 weeks prevented bone loss in ovariectomized rats, increasing osteoclast apoptosis. The present study investigated whether the effects of D-003 on bone resorption and osteoclast apoptosis are dose-dependent. Rats were randomized into seven groups (10 rats/group): two control groups orally treated with the vehicle, one false-operated (sham) and another ovariectomized group (positive control), while another four groups received D-003 (5, 25, 50 and 200 mg/kg). The effects on bone resorption and formation were studied through histomorphometry and the effects on apoptosis through immunohistochemistry. D-003 (5-200 mg/kg) dose-dependently and significantly prevented (p < 0.001) changes in trabecular bone and increase in osteoclast surface and number versus ovariectomized controls, leaving osteoblast surfaces unchanged. Across the dose range, D-003 significantly increased (p < 0.05) osteoclast apoptosis in a dose-dependent manner and reduced (p < 0.05) osteoblast and osteocyte apoptosis versus ovariectomized controls, but these effects did not show dose dependence. In conclusion, D-003 (5-200 mg/kg) orally administered at for 12 weeks prevented bone loss and bone resorption and increased osteoclast apoptosis in ovariectomized rats in a dose-dependent manner. These results are consistent with previous data, showing that D-003 administered at relatively low doses prevents bone loss induced with ovariectomy, which could be useful to prevent or treat bone loss in postmenopausal women. Further experimental and clinical studies, however, are needed to confirm these findings.
Impaired endothelial cell growth and function have been suggested to be an initial event leading to the development of atherosclerosis. Nifedipine is one of the most widely used dihydropyridine-based calcium antagonists (DHPs) for the treatment of patients with angina and hypertension. Recently, nifedipine was shown to improve endothelial function in many cardiovascular diseases, thus slowing the development and progression of atherosclerosis. In this review, we discuss the molecular mechanisms for the atheroprotective effects of nifedipine, with special emphasis on its anti-oxidative properties.
The morphological relationship of chondroitin sulphates A, B, and C, collagen types I-IV and fibronectin in the wall of venous sinuses of the red pulp in human spleen has not been a focus of interest among morphologists. Regarding the hypothesis that the structure of the spleen lends it the function of a blood filter the substances described in our study might play a significant role in the functional morphology. Of 146 human spleen surgical specimens, groups of 12 specimens each were examined under a light microscope using the method of antibodies against fibronectin, against collagen types I-IV and against chondroitin sulphates A, B, and C. The sections of the red pulp of human spleen stained with hematoxylin and eosin provided limited information about the wall of the sinuses. Chondroitin sulphates A and B were observed on the surface of sinus-lining cells (SLC), and fibronectin was detected on the surface of the annular fibers. Collagen type 11 was observed almost in the same places as chondroitin sulphates A and B. Collagen type IV was present in annular fibers of the wall of the sinus and in the basement membrane, like fibronectin. Chondroitin sulphate was not present in the walls of sinuses. Binding of antibodies against chondroitin sulphate A and against chondroitin sulphate B indicates the presence of chondroitin sulfates on the surface of SLC, where they probably play a role in helping the human organism to recognize alien and self substances. The presence of chondroitin,sulphates A and B probably affects inhibition of binding of cells with collagen type I, but not with fibronectin.
Diabetes-induced erectile dysfunction is one of the most prevalent complications of diabetes in males. alpha-Lipoic acid (ALA) and its reduced form, dihydrolipoic acid, are powerful antioxidants. Data strongly suggest that, because of its antioxidant properties, ALA is particularly suited to the prevention and/or treatment of diabetic complications that arise from overproduction of reactive oxygen and nitrogen. The aim of this study was to investigate the localization of nitric oxide synthetase (NOS) in normal and diabetic rat cavernous smooth muscles and to examine the effects of ALA on them. Rats were divided into four groups: control, diabetic, diabetic plus ALA, and ALA only. Penile tissues were taken 15 days after drug application and examined histochemically and immunohistochemically. Comparison of the control and diabetic groups revealed that the axons of nerve cells were not identified with Masson trichrome in the diabetic group, whereas in the control group NOS localization and immunostaining (endothelial NOS [eNOS]) were normal. Diabetic rats administered ALA showed improvement in Masson trichrome, nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) and eNOS localization compared with untreated diabetic rats. Although there was no difference between the control group and the group administered ALA only, we observed an increase in NADPH-d and eNOS. In erection, eNOS and neuronal NOS (nNOS) may have a significant role. In pathologic conditions, erectile dysfunction may occur as a result of an increase in inducible macrophage-type NOS (iNOS). ALA plays an important role in treatment of erectile dysfunction by decreasing iNOS and increasing other isoforms of NOS.
We have previously shown that the peak latency of oscillatory potential (OP), the earliest electroretinographic manifestation of diabetic retina, was prolonged in Otsuka Long-Evans Tokushima Fatty (OLETF) rat, a model of non-insulin-dependent diabetes. These observations suggest that retinal neuronal dysfunction revealed by the OP abnormality in the electroretinogram takes place prior to the angiopathic diabetic changes in this animal model. However whether acellular capillaries and pericyte ghosts, one of the histopathological hallmarks of early diabetic retinopathy in humans, could occur in OLETF rat remains to be elucidated. In the present study, we first prepared the retinal trypsin digests of OLETF and control Long-Evans Tokushima Otsuka (LETO) rats at 45 weeks old and then compared the number of acellular capillaries and pericyte ghosts in the retinas of OLETF rats with that in LETO rats. Blood glucose levels were higher in the OLETF rats than those in LETO rats. Retinal capillaries of OLETF rats were found to remain morphologically normal and pericyte ghosts were barely detectable. There was no difference in the number of acellular capillaries in the retinas between OLETF and LETO rats. The present study indicates that acellular capillaries and pericyte ghosts, the characteristic morphological changes in early diabetic retinopathy, are not accelerated in OLETF rats. Our data suggest that OLETF rat is not a suitable animal model for the study of angiopathic diabetic retinopathy.
Cutaneous xerosis is a common clinical condition associated with an altered barrier function of the stratum corneum. Xerotic skin appears dry, rough and slightly scaling. Patients complain of pruritus and stinging. Our aim was to investigate the clinical effects of a cosmetic ointment (Scherilan) in patients with circumscribed senile xerosis (also called asteatotic eczema). Moreover, variations in expression of epidermal proteins such as keratin (K)-5 and involucrin, detected by immunohistochemistry, were also evaluated before and after topical treatment. We enrolled 30 patients (11 males, 19 females) with asteatotic eczema. We examined dryness, roughness and desquamation and symptoms such as itching and dryness. A score of 0 to 3 was assigned to each of these parameters. A biopsy was performed in seven patients before and after a 21-day topical treatment. All skin specimens were then immunostained with antibodies to K5 and involucrin. At day 7 or 21 of treatment all signs of xerosis and pruritus were significantly reduced; furthermore, the reduction increased with the duration of therapy. Before treatment K5 was strongly expressed in stratum basale (SB) and stratum spinosum (SS), while involucrin was strongly expressed in stratum granulosum (SG) and the upper portion of SS. In contrast, after treatment immunostaining for K5 was restricted to SB and the lower part of SS, while involucrin showed intense staining in SG. We highlight the importance of treating cutaneous xerosis with an ointment such as this one, which probably induces an increase of lipid content of the SC intercellular matrix.
The cause of psoriasis is still unknown. It occurs with equal frequency in both sexes. In many patients topical application alone will suffice to keep psoriasis under control. Vitamin D3 affects keratinocyte differentiation in psoiasis. Thirteen patients with mild to moderate psoriasis vulgaris were enrolled in this trial (eight men and five women), aged between 14 and 40 years. Each patient was instructed to apply calcipotriol cream once daily on the right side and twice daily on the left side for 6 weeks. The treatment assessment was based on psoriasis area severity index (PASI) at 0, 2, 4 and 6 weeks. Serum calcium was assessed prior to and at the end of treatment. Calcipotriol cream was clearly effective in psoriasis and in both sides an almost similar effect was seen. The reduction in PASI was remarkable in both sides and the change was from 7.9 (pretreatment) to 2.4 (once daily) and 2.1 (twice daily). Out of the treated patients, seven (53.8%) had complete to marked clearance of both sides. Two patients (once daily) versus three patients (twice) had moderate improvement. Mild improvement was observed in three with twice-daily and in two with once-daily application. Post-treatment serum calcium was normal in all cases. In conclusion, there was no significant difference between once- and twice-daily application of calcipotriol cream, and single night application of topical calcipotriol could be more practical and reliable, and less expensive.
Pigment epithelium-derived factor (PEDF) is a natural extracellular component of the retina with neuronal differentiating activity. Decreased levels of PEDF in the mammalian eye have been shown to participate in proliferative diabetic retinopathy. In addition, we have recently found in in vitro experiments that PEDF protected against pericyte apoptosis, the earliest histopathological hallmark of diabetic retinopathy. These observations suggest that the loss of PEDF in the mammalian eye plays an important role in the development and progression of diabetic retinopathy. However, the functional role of endothelial cell (EC)-derived PEDF in pericyte survival and the regulation of PEDF gene expression remain to be elucidated. In this study, we examined the effects of anti-PEDF antibody (Ab) on the viable cell number of cocultured pericytes with microvascular ECs. We further studied the effects of angiotensin II (Ang II) on PEDF gene expression in ECs. Anti-PEDF Ab significantly inhibited the growth-stimulating effects of cocultured ECs on pericytes. Furthermore, Ang II significantly decreased PEDF mRNA levels in ECs, which was completely reversed by an Ang II type 1 receptor blocker, telmisartan. Our present results suggest that PEDF is an EC-derived mitogen or survival factor for retinal pericytes. Suppression by Ang II of the EC-derived PEDF may be involved in exacerbation of diabetic retinopathy in patients with hypertension.
The aim of the present study was to detect entheseal abnormalities by means of ultrasonography (US) in patients with psoriasis. We evaluated 24 patients with psoriasis who underwent clinical and ultrasonographic examination of both lower limbs at the calcaneal insertions of the Achilles tendons and at the flexor and extensor tendons of all fingers of the hand. Fourteen patients with psoriatic arthritis were used as controls. US was performed using a real-time scanner (ATL SDI 3000) with a 5-12 MHz linear array transducer. Longitudinal and transverse scans of the talocrural joints, Achilles tendons and both the flexor and extensor tendons of the fingers of both hands were obtained at rest and during active and passive movements. On clinical examination no entheseal site was abnormal, but on US examination 33% of patients showed abnormalities. In particular, six psoriasis patients (25%) who were asymptomatic showed effusion around the extensor tendon of the first digit of the left hand and around the extensor tendon of the third and fourth digits of both hands; two patients (8.3%) showed a hypoechoic nodular formation of the flexor tendon sheath of the left hand. We conclude that entheseal abnormalities not detected at clinical examination were present in 33% of patients with psoriasis who underwent US examination. Therefore, we suggest the routine use of ultrasonography in the early diagnosis and in treatment and follow-up of patients with tendon enthesopathy, since these factors may have implications for therapy.
Advanced glycation end products (AGEs), the senescent macroprotein derivatives that form in increased amounts in diabetes, have been implicated in the pathogenesis of diabetic vascular complications. Indeed, AGEs elicit oxidative stress generation in vascular wall cells through an interaction with their receptor (RAGE), thus playing an important role in vascular inflammation and altered gene expression of growth factors and cytokines. We have previously shown that minodronate, a nitrogen-containing bisphosphonate, blocked the angiogenic signaling of vascular endothelial growth factor in ECs through its antioxidative properties. However, the effects of minodronate on AGE-exposed ECs remain to be elucidated. In this study, we investigated whether and how minodronate could inhibit AGE-induced reactive oxygen species (ROS) generation and subsequent vascular cell adhesion molecule-1 (VCAM-1) gene expression in human umbilical vein endothelial cells (HUVEC). Minodronate or an NADPH oxidase inhibitor, diphenylene iodonium, completely inhibited the AGE-induced ROS generation in HUVEC. Geranylgeranyl pyrophosphate reversed the antioxidative properties of minodronate in AGE-exposed ECs. Furthermore, minodronate was found to prevent AGE-induced nuclear factor--KB activation and subsequently suppress VCAM-1 gene expression in HUVEC. These results demonstrate that minodronate could inhibit VCAM- 1 expression in AGE-exposed ECs by suppressing NADPH oxidase-derived ROS generation, probably via inhibition of geranylgeranylation of Rac, a component of endothelial NADPH oxidase. Our present study suggests that minodronate may have a therapeutic potential in the treatment of patients with diabetic vascular complications.
Mycosis fungoides is the most common type of cutaneous T-cell lymphoma. The extent and type of skin involvement (T classification) and presence of lymph node or visceral involvement are important predictors in selecting the type of treatment. Skin directed treatment represents the most appropriate therapy for early stage disease. Current topical treatment including potent topical steroids and nitrogen mustard are associated with adverse effects such as cutaneous atrophy and contact dermatitis. In the present study, we tested the efficacy of imiquimod in mycosis fungoides plaques.
The increasing incidence of melanoma in the general population during the last few decades has provoked a great deal of research, aiming to identify the possible relationship between old and new etiological factors involved in the pathogenesis of this tumor. The aim of the study was to evaluate the incidence of melanoma in central Greece, especially in the prefecture of Larissa from January 1988 to December 1998. Data were collected from the General Hospital of Larissa. Seventy-one cases of melanoma were studied (41 females, 30 males). The incidence increased from 1.36/100,000 patients during the first year of the study (1988) to 5.2/100,000 patients in the last year of the study (1998). The patients'skin types were: type 12.8%, type II 52.1%, type III 45.1%. The median age of patients was 61.9 years, 61.4 years in female and 62.5 years in male patients. Concerning their occupation, farmers accounted for 56.3%. Melanomas were most frequently located on head and neck (36.6%), extremities (30.98%) and trunk (11.3%). Superficial spreading melanomas were observed in 44% of the patients and nodular melanomas in 20%. In conclusion. there was a rapid increase in the incidence of melanoma in our region especially during the last 3 years.
Psoriasis is characterized by three main pathogenic features: abnormal differentiation, keratinocyte hyperproliferation and inflammation. The lesions may disappear spontaneously or as a result of therapy, but recurrences are almost certain. Twenty-seven patients with scalp psoriasis were treated with calcipotriol solution 50 g/ml as twice-daily application for 8 weeks. The assessment was based on the mean sign scores (erythema, thickness and scaliness) at 0, 2, 4, 6 and 8 weeks. The results indicated that five patients were excluded from the study (four because of irregularity and one because of irritation), and 22 patients had completed the treatment course. There was a marked reduction in the total mean scores of erythema, thickness and scaling from 2.8, 2.7 and 2.7 to 0.3, 0.34 and 0.4, respectively. Fifteen patients (68.2%) showed complete clearance of their psoriasis, and most of the lesions cleared by week 6 of treatment. Two patients (9.1%) had marked improvement and four (18.2%) patients showed moderate improvement. No response to calcipotriol solution was seen in only one patient. No adverse effects occurred except severe irritation in one patient, who was excluded from this study. In conclusion, calcipotriol could be a valid choice for the treatment of scalp psoriasis.
Bone morphogenetic protein (BMP) is a unique cytokine that induces bony tissue in soft tissue. Tissue reactions at and around the implantation of recombinant human BMP-2 (rhBMP-2) into the soft tissue of rats and nonhuman primates were investigated. At the osteoinduced site of rats, massive trabeculae-lined osteoblasts and rich marrow were observed. At and around the nonosteoinduced sites of nonhuman primates, large clear nuclei were observed in reaction to rhBMP-2 implantation. The surrounding area was visually classified into zones 1, 2 and 3. Zone 3 was near the center of the implant. The area of nuclei, the major axis, the minor axis and the ratio of minor axis per major axis were image-analyzed in the histological views. In zones 1, 2 and 3, the nuclear areas were 18.0 (3.1) mean (SD); unit micron2, 33.4 (5.61) and 110.1 (23.7), respectively. The major axes of nuclear ellipses were 7.45 (0.22) (unit micron), 7.76 (0.26), and 13.9 (1.88), respectively. The minor axes were 3.07 (0.53), 5.59 (0.95) and 10.1 (1.35), respectively. The ratios of minor axis per major axis of nuclear ellipses were 0.4 (0.57), 0.72 (0.11) and 0.73 (0.11) in zones 1, 2 and 3, respectively. These results showed that in zones 2 and 3 cell and tissue reactions were marked against rhBMP-2 implantation.
Radiocontrast media can induce vascular endothelial cell apoptosis. Apoptotic damage to the vascular endothelium is an important mechanism in vascular disease. Several growth factors with anti-apoptotic effects may help protect the vascular endothelium from apoptosis. The present study evaluated whether the radiocontrast agent iopromide induces apoptosis in human umbilical vein endothelial cells and also whether angiopoietin-1 (Ang1) protects against iopromide-induced apoptosis through the p70 S6 kinase-dependent signaling pathway. Iopromide induced apoptosis in vascular endothelial cells in a dose-dependent manner. Ang1 reduced iopromide-induced apoptosis in a dose-dependent manner. Wortmannin and LY294002, phosphatidylinositol 3'-kinase inhibitors, decreased the Ang1-induced anti-apoptotic effect. Ang1 mediates the activation of mTOR/ribosomal protein p70 S6 kinase through phosphatidylinositol-3' kinase. Wortmannin and rapamycin, an inhibitor of mTOR, suppressed Ang1-induced p70 S6 kinase phosphorylation and partially inhibited the Ang1-induced anti-apoptotic effect. These results suggest that Ang1 may protect vascular endothelial cells from iopromide-induced apoptosis through phosphatidylinositol 3'-kinase and mTOR/S6 kinase. Pretreatment with Ang1 could help maintain normal vascular endothelial cell integrity before and during systemic radiocontrast administration.
