Estimation of the tissue and serum levels of IL-35 in Mycosis fungoides: a case-control study.

Mycosis fungoides (MF) is the most common primary cutaneous T-cell lymphoma (CTCL) with its etiology not yet fully understood. Interleukin (IL)-35 is an inhibitory cytokine that belongs to the IL-12 family. Elevated IL-35 in the plasma and the tumor microenvironment increases tumorigenesis and indicates poor prognosis in different types of malignancies. The objective of this study is to estimate the expression levels of IL-35 in tissue and serum of MF patients versus healthy controls. This case-control study included 35 patients with patch, plaque, and tumor MF as well as 30 healthy controls. Patients were fully assessed, and serum samples and lesional skin biopsies were taken prior to starting treatment. The IL-35 levels were measured in both serum and tissue biopsies by ELISA technique. Both tissue and serum IL-35 levels were significantly higher in MF patients than in controls (P < 0.001) and tissue IL-35 was significantly higher than serum IL-35 in MF patients (P < 0.001). Tissue IL-35 was significantly higher in female patients and patients with recurrent MF compared to male patients and those without recurrent disease (P < 0.001). Since both tissue and serum IL-35 levels are increased in MF, IL-35 is suggested to have a possible role in MF pathogenesis. IL-35 can be a useful diagnostic marker for MF. Tissue IL-35 can also be an indicator of disease recurrence.

Topical sodium valproate-loaded nanospanlastics versus conventional topical steroid therapy in alopecia areata: a randomized controlled study.

BACKGROUND: A myriad of therapeutic modalities for alopecia areata are available; however, none is of high level of evidence, creating an immense need for the evaluation of other treatment modalities, of which topical sodium valproate is of potential role via proposed decrease in beta-catenin breakdown, despite its well-known side effect of hair fall as an oral therapy. OBJECTIVE: Evaluating the efficacy and the safety of sodium valproate (SV)-loaded nanospanlastics, in comparison to topical corticosteroids, this is the currently available gold standard topical treatment for patchy AA. METHODOLOGY: A total of 66 patients with patchy AA were randomly assigned to receive either topical mometasone furoate lotion or topical SV applied twice daily to all patches except a control patch, which was left untreated. Clinical, trichoscopic and biochemical assessments of beta-catenin tissue levels and Axin-2 gene expression were carried out at baseline and after 3 months. RESULTS: Both therapeutic modalities were comparable. Potential efficacy was highlighted by significant improvement in the representative patch, the largest treated patch, to the control patch, the smallest untreated patch in both steroid and valproate groups (p = 0.027, 0.003 respectively). Both beta-catenin levels and Axin-2 gene expression were reduced after treatment, pointing to the inhibitory effect of dominating uncontrolled inflammatory milieu. Baseline beta-catenin was found to significantly negatively correlate with improvement in the representative patch in patients with baseline level above 0.42 ng/ml (p = - 0.042). CONCLUSION: Both topical SV and steroids are of comparable modest efficacy. Thus, further evaluation of SV is due in combination with intralesional steroids and other anti-inflammatory treatment modalities, together with developing individualized approaches based on baseline beta-catenin level. GOV IDENTIFIER: NCT05017454, https://clinicaltrials.gov/ct2/show/NCT05017454 .

Serotonin variations and sleep disorders among shift workers. A cross-sectional study.

Sleep disorders are prevalent occupational health problems among shift workers, especially healthcare workers with long shifts. Serotonin is a neurotransmitter related to circadian variations accompanied by shift work. A cross-sectional study was performed on 73 nurses at a tertiary hospital in Cairo, Egypt, to assess sleep quality among shift work nurses (SWNs), to determine blood serotonin level, and its relation to shift work and sleep quality. A demographic and occupational history questionnaire, Pittsburgh Sleep Quality Index (PSQI) questionnaire, and measurement of blood serotonin were carried out to the studied group. The data were analyzed using SPSS 25, and descriptive statistics, unpaired t-test, ANOVA, Kruskal-Wallis Test, Chi-square, Spearman correlation, and multivariate regression analysis were utilized. The results showed that the mean PSQI global score was significantly higher among SWNs than non-shift work nurses (NSWNs) and was the highest (10.32 ± 3.56 and 10.22 ± 2.4, respectively) among rotatory and fixed night shift nurses. Blood serotonin showed highly significant differences between SWNs over NSWNs (p = 0.001), and mostly reduced among rotatory and fixed night shift nurses (66.7% and 65%, respectively). Moreover, there were highly significant differences in serotonin levels between poor and good sleep quality nurses (p < 0.001), and most of the poor sleep quality nurses (62.7%) had low serotonin levels. Abnormal serotonin level (odds = 246.5) and working years (odds = 1.2) were statistically significant predictors of poor sleep quality. In conclusion, SWNs, especially rotating and night shift nurses, suffer from poor sleep quality associated with abnormal levels of blood serotonin.