Basal cell carcinoma risk and solar UV exposure in occupationally relevant anatomic sites: do histological subtype, tumor localization and Fitzpatrick phototype play a role? A population-based case-control study.

BACKGROUND: A two-fold risk increase to develop basal cell carcinoma was seen in outdoor workers exposed to high solar UV radiation compared to controls. However, there is an ongoing discussion whether histopathological subtype, tumor localization and Fitzpatrick phototype may influence the risk estimates. OBJECTIVES: To evaluate the influence of histological subtype, tumor localization and Fitzpatrick phototype on the risk to develop basal cell carcinoma in highly UV-exposed cases and controls compared to those with moderate or low solar UV exposure. METHODS: Six hundred forty-three participants suffering from incident basal cell carcinoma in commonly sun-exposed anatomic sites (capillitium, face, lip, neck, dorsum of the hands, forearms outside, décolleté) of a population-based, case-control, multicenter study performed from 2013 to 2015 in Germany were matched to controls without skin cancer. Multivariate logistic regression analysis was conducted stratified for histological subtype, phototype 1/2 and 3/4. Dose-response curves adjusted for age, age2, sex, phototype and non-occupational UV exposure were calculated. RESULTS: Participants with high versus no (OR 2.08; 95% CI 1.24-3.50; p = 0.006) or versus moderate (OR 2.05; 95% CI 1.15-3.65; p = 0.015) occupational UV exposure showed a more than two-fold significantly increased risk to develop BCC in commonly UV-exposed body sites. Multivariate regression analysis did not show an influence of phototype or histological subtype on risk estimates. The restriction of the analysis to BCC cases in commonly sun-exposed body sites did not influence the risk estimates. The occupational UV dosage leading to a 2-fold increased basal cell carcinoma risk was 6126 standard erythema doses. CONCLUSION: The risk to develop basal cell carcinoma in highly occupationally UV-exposed skin was doubled consistently, independent of histological subtype, tumor localization and Fitzpatrick phototype.

[Occupational aspects of palmoplantar pustulosis : Discussion based on the evaluation of retrospective data]. / Berufsdermatologische Aspekte der Pustulosis palmoplantaris : Diskussionsbeitrag anhand einer retrospektiven Datenauswertung.

BACKGROUND: Palmoplantar pustulosis (PPP) is a chronic inflammatory skin disease. Its classification as a variant of psoriasis is controversial. Exogenous factors may affect PPP. OBJECTIVES: Occupational aspects of PPP based on a retrospective evaluation of patient data are discussed. METHODS: Data from 1518 patients who took part in a tertiary prevention program (TIP) for occupational skin diseases in our department between January 2015 and June 2019 were evaluated. RESULTS: PPP was diagnosed in 30 patients (1.98%). The hands were affected in all of them, while concomitant feet involvement was found in 83.3%. The majority was female (70.0%) and reported tobacco smoking (83.3%). Systemic treatment was continued or initiated in one third of patients. In only 8 patients (26.7%) was PPP considered to be work-related. CONCLUSIONS: PPP is an endogenous disease which is influenced by nonoccupational factors (e.g., tobacco smoking). Therefore, a thorough investigation is mandatory when assessing whether occupational factors are legally essential and exceed aggravation by everyday life. For this purpose, a well-documented course of the disease and a critical appraisal of occupational and nonoccupational factors are crucial. Only if occupational causality is probable can preventive measures be provided by the statutory accident insurance and PPP can be legally recognized as an occupational disease.

Protocol for the development of a core domain set for hand eczema trials.

BACKGROUND: Clinical hand eczema trials measure a variety of outcome domains to determine the success of interventions. This considerably limits the comparability and overall confidence in the study results, and thereby the strength of recommendations for clinical practice. OBJECTIVES: The Hand Eczema Core Outcome Set (HECOS) initiative aims to develop a core outcome set (COS) for the standardized evaluation of interventions in future hand eczema trials and reviews. This COS will define the minimum that should be measured and reported in controlled and randomized-controlled trials of therapeutic hand eczema interventions. The objective of this protocol is to specify the methods to develop a core domain set. METHODS: In Phase 1, a list of candidate domains will be derived from a systematic literature review concerning previously measured outcomes in hand eczema trials, from qualitative patient interviews and from expert interviews. In Phase 2, a consensus study about core domains will be conducted by an online 3-round Delphi survey and a face-to-face meeting, applying predefined consensus criteria. HECOS involves hand eczema and methods experts as well as patients and further stakeholders with an interest in the initiative. OUTLOOK: When a set of core domains has been defined, HECOS is going to identify appropriate outcome measurement instruments in a development process that will be detailed in another protocol. The COS will considerably enhance the methodological quality, comparability and usefulness of hand eczema trials for clinical decision-making and the development of new therapeutic options for hand eczema, and also reduce the effort of planning, conducting, and reporting individual hand eczema studies, reviews and meta-analyses.

[How common is fragrance allergy really?] / Wie häufig ist die Duftstoffallergie wirklich?

BACKGROUND: Fragrances are regarded as the most common contact allergens after nickel. In this context, the frequency of positive patch test reactions to fragrance mix is often presented as proof. According to EU regulation No. 1223/2009, 26 fragrances that are regarded as significant allergens have to be declared on cosmetic products. OBJECTIVES: The frequency of patch test reactions to fragrances and differentiation between frequently and rarely sensitizing fragrances were evaluated. MATERIALS AND METHODS: Data from the Information Network of Departments of Dermatology (IVDK), mostly of the years 2016-2018, were retrospectively analyzed. RESULTS: Frequency of positive reactions to fragrance mix I in the departments of dermatology joining the IVDK reached a historical low of 5.4% in 2018. Since 2013, positive reactions to fragrance mix II have been declining, yielding 3.2% in 2018. Of fragrance mix I, the allergen with the most positive test reactions is no longer oakmoss absolute, but isoeugenol. In fragrance mix II, hydroxyisohexyl 3­cyclohexene carboxaldehyde (HICC) is still leading. Only 11 of the 26 fragrances subject to mandatory declaration elicited allergic test reactions in more than 1% of the patients tested. DISCUSSION: The decline of positive test reactions to the fragrance mixes is mainly due to the reduced use of oakmoss containing atranol and chloroatranol, and HICC. Use of these substances in cosmetic products was prohibited within the EU starting in August 2019. Therefore, a further decline of the sensitization frequencies can be expected. A differentiated consideration of the individual fragrances under allergological aspects is urgently required.

The epidemic of methylisothiazolinone contact allergy in Europe: follow-up on changing exposures.

BACKGROUND: Methylisothiazolinone (MI) has caused an unprecedented epidemic of contact allergy in Europe and elsewhere. Subsequently, regulatory action has been taken, at least in Europe, aiming at reducing risk of MI sensitization. OBJECTIVE: To follow-up on the prevalence of contact allergy to MI in consecutively patch tested patients and assess the spectrum of products containing MI or methylchloroisothiazolinone (MCI)/MI in patients positive to MI which elicited current allergic contact dermatitis. METHODS: A cross-sectional survey was performed in 2016 and 2017, including all adult patients patch tested with the baseline series (including MI 0.2% aq.) between 1 May and 31 October at 14 centres in 11 European countries. Patients with positive reactions (+ to +++) to MI were further examined regarding history, clinical characteristics and eliciting products, which were categorized into 34 types and 4 classes (leave-on, rinse-off, household, occupational). The results were compared with the reference year 2015. RESULTS: A total of 317 patients, n = 202 of 4278 tested in 2016 (4.72%) and n = 115 of 3879 tested in 2017 (2.96%), had positive reactions to MI; the previous result from 2015 was 5.97% (P < 0.0001). The share of currently relevant contact allergy among all positive reactions declined significantly as well (P = 0.0032). Concerning product classes, a relative decline of leave-on and a relative increase of rinse-off and household products was noted. CONCLUSION: The prevalence of MI contact allergy decreased by 50% from 2015 to 2017. As a consequence of regulation, the share of cosmetics products (leave-on in particular) eliciting allergic contact dermatitis is decreasing. The chosen method of analysing causative products in sensitized patients has proven useful to monitor effects of intervention.

Assessment of occupational exposure and spectrum of contact sensitization in metalworkers with occupational dermatitis: results of a cohort study within the OCCUDERM project.

BACKGROUND: Metalworkers occupationally exposed to metals, tools, metalworking fluids (MWFs), technical oils, gloves, skin care products etc. frequently suffer from occupational dermatitis (OD). OBJECTIVES: To investigate occupational exposure and to identify relevant occupational sensitizers in metalworkers with OD, and to evaluate suitability of current German patch test recommendations for this occupational group. PATIENTS AND METHODS: As part of the OCCUDERM project, occupational exposure of 230 metalworkers with suspected OD patch tested in the departments of dermatology in Göttingen and Osnabrück (both Lower Saxony, Germany) in 2012-2017 was recorded by questionnaire. These data, as well as results, of patch testing with standardized allergens and with workplace material were analysed. RESULTS: Metalworking fluids and skin care products were the most important exposures. Among MWF allergens, most frequently sensitizations to formaldehyde and formaldehyde releasers, colophony/abietic acid and monoethanolamine were observed. Sensitization to methylisothiazolinone (MI) was frequent, probably as part of the general European epidemic of contact allergy to MI in leave-on cosmetics. Sensitization to glove ingredients only played a minor role. CONCLUSIONS: The known occupational allergen spectrum could largely be confirmed. In order not to miss relevant sensitizations, patch testing with material from the patients' workplaces in parallel to baseline and MWF series is recommended. Sensitizations diagnosed could not always be linked to particular occupational exposures.

[Prevention of hand eczema]. / Prävention des Handekzems.

Apart from endogenous factors, hand eczema is often caused by irritant or allergic contact dermatitis related to occupational or non-occupational exposure to skin hazards. This enables several complementary approaches on the level of primary, secondary and tertiary prevention. A high priority is set on identification and subsequent reduction or elimination of causative exposures. Important preventive approaches include legal regulations, technical and organizational measures as well as correct use of adequate personal protective equipment (e.g. protective gloves). Interventions based on health education are conducted to improve individual protective behaviour. Even though evidence-based proof of effectiveness is limited, preventive measures are considered of particular importance for avoidance of occupational hand eczema and its adverse sequelae. Therefore, a complex, step-wise approach to occupational skin diseases has been established in Germany. In recent years, the positive impact of secondary and tertiary preventive measures of this approach has been demonstrated.

[Alpha-Gal-associated delayed red meat anaphylaxis as an occupational disease]. / Alpha-Gal-assoziierte verzögerte Anaphylaxie gegen rotes Fleisch als Berufskrankheit.

In a 30-year-old chef with recurrent delayed angioedema history as well as the experimental detection of IgE antibodies against galactose-alpha-(1,3)-galactose (alpha-Gal) pointed to alpha-Gal as the causative agent. The diagnosis, therefore, was delayed anaphylaxis due to alpha-Gal. Because of the potential relationship to his profession, we submitted a dermatologist's report BK 5101 to the liability and insurance association, whereupon his contract of employment was terminated without notice. As a consequence, we reported an occupational disease. This case demonstrates an underdiagnosed, potentially life-threatening allergy to the disaccharide alpha-Gal in red meat as an occupational disease.

Stratum corneum profiles of inflammatory mediators in patch test reactions to common contact allergens and sodium lauryl sulfate.

BACKGROUND: Recent studies have demonstrated allergen-specific differences in the gene expression of inflammatory mediators in patch tested skin. OBJECTIVES: To determine levels of various inflammatory mediators in the stratum corneum (SC) after patch testing with common contact allergens and the skin irritant sodium lauryl sulfate (SLS). METHODS: In total, 27 individuals who had previously patch tested positive to nickel, chromium, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) or para-phenylenediamine were retested and then patch tested with SLS and petrolatum, with petrolatum serving as the patch test control. At 72 h, the test sites were clinically graded and the SC samples collected on adhesive tape. RESULTS: The levels of 18 of the 32 quantified mediators differed significantly from that of the control patches for at least one of the tested substances. SLS and MCI/MI induced the largest number of immunomediators. Interleukin (IL)-16 levels were significantly higher in patch test reactions in all allergens than they were in the controls, while no significant difference was detected for SLS. Furthermore, a strong negative correlation was found between strength of patch test reaction and IL-1α levels. CONCLUSIONS: Cytokine profiles in the SC of patch tested skin did not show a distinct allergen-specific pattern. However, MCI/MI induced a larger and wider immune response than the other allergens, perhaps due to its potency as an irritant. The levels of IL-16 were significantly increased in patch test reactions to allergens but not to SLS; thus, they may help clinicians to differentiate between allergic contact dermatitis and irritant contact dermatitis.

The European Status Quo in legal recognition and patient-care services of occupational skin cancer.

BACKGROUND: Skin cancer is the most common malignancy in Caucasian populations worldwide and ultraviolet radiation (UVR) is known for being the number one carcinogen. As, especially in outdoor workers, UVR is an inevitable carcinogen, the prevention and management of UVR-related skin cancers in these at-risk populations represent a collective challenge for dermatologists and healthcare policymakers likewise. OBJECTIVE: To provide an overview on the current regulations on the acknowledgement and management of work-related skin cancer in 11 European countries. METHODS: Dermatologists from 11 countries networking within the EU Horizon 2020 COST Action TD1206 'StanDerm' contributed to a standardized survey regarding current national regulations, implemented for the recognition, prevention and management as well as possible compensation regulations in their individual country of residence. RESULTS: Ten of 11 participating countries in this survey reported the existence of an established programme available on certain occupational diseases; work-related skin diseases were only specifically recognized in eight countries. Seven of 11 countries recognize cutaneous squamous cell carcinoma in outdoor workers as 'occupational skin cancer'. Basal cell carcinoma (6 of 11), actinic keratosis (5 of 11), Bowen's disease (5 of 11) and malignant melanoma (5 of 11) are not as regularly approved as potentially 'work-induced'. Only a few of the countries included into this survey established a general documentation system (national registry) on occupational skin diseases. So far, representatives of only three countries of this survey referred to a specific established national programme for the prevention, management or compensation of occupational skin cancers acquired during work-related UVR exposure. CONCLUSION: This survey highlights the need for mandatory regulations on the prevention, management and potential compensation of work-related UV-induced skin cancer across Europe. Against the background of a joint European domestic market, equal standards of occupational safety across Europe should include binding regulations for the protection and management of work-related skin cancer. The design of a common regulation to meet the increasing incidence of skin cancers in outdoor workers should become part of the European agenda, ensuring equal working and living conditions in the member states.

Clinical patterns and associated factors in patients with hand eczema of primarily occupational origin.

BACKGROUND: Hand eczema (HE) is the most common skin disease acquired at work. It presents in different clinical patterns. OBJECTIVE: To classify different types of HE according to their clinical pattern and associated factors in patients taking part in a tertiary individual prevention programme (TIP) for occupational skin diseases. METHODS: In a retrospective cohort study, the medical records of 843 patients taking part in the TIP were evaluated. HE was classified into three clinical subtypes: vesicular HE, hyperkeratotic HE and HE with erythema and desquamation. RESULTS: About 723 patients (85.8%) suffered from HE. Female TIP patients with HE were significantly younger (OR 0.97, 95% CI 0.96-0.99) and had a higher prevalence of flexural eczema (OR 1.60, 95% CI 1.15-2.23) and an atopic HE component (OR 1.84, 95% CI 1.36-2.48) than men. Vesicular HE was more common in women (OR 1.44, 95% CI 1.07-1.94) and significantly associated with hyperhidrosis (OR 1.69, 95% CI 1.23-2.33), flexural eczema (OR 1.37, 95% CI 0.99-1.89) and an atopic HE component (OR 1.93, 95% CI 1.44-2.61). Hyperkeratotic HE was more frequent in men (OR 3.70, 95% CI 2.27-6.25) and associated with older age (OR 1.04, 95% CI 1.02-1.06). The cohort of patients with HE characterized by erythema and desquamation was very heterogeneous. Vesicular HE was significantly associated with tobacco smoking (OR 1.94, 95% CI 1.40-2.68), while hyperkeratotic HE was significantly less common in smokers (OR 0.38, 95% CI 0.22-0.65). CONCLUSION: Environmental and individual factors are associated with different clinical patterns of HE in patients taking part in the TIP. They may influence the prognosis and should be considered in the individual management of disease. Tobacco smoking may be in particular a risk factor for vesicular HE.

[Quality management in occupational dermatology]. / Qualitätssicherung im Hautarztverfahren.

BACKGROUND: Health care of patients with occupational dermatitis (OD) in the sense of suspected "BK 5101" is carried out in Germany within the optimized dermatologist's procedure and the "dermal intervention" (formerly: hierarchical multistep intervention approach) of the statutory accident insurance (UVT), respectively. OBJECTIVES AND METHODS: Dermatologists and UVT administrators are obliged to improve OD patient care by continuous quality management measures. Essential quality management elements include the research projects EVA_Haut and VVH, the clearing procedure of the Task Force on Occupational and Environmental Dermatology (ABD), training of dermatologists to receive the CME certificate "Occupational Dermatology (ABD)", the establishment of processing standards for administrators and optimized dermatologist's report forms (based on the results of all the above steps taken). RESULTS: It was shown that the optimized dermatologist's procedure and "dermal intervention" are established in Germany. Also, the available preventive and therapeutic measures for OD patients are effective. Despite the increase of cases with suspected OD, the number of cases in which a career change was required is almost constant (3 %); at the same time the percentage of notified cases which, as a result, are covered within the dermatologist's procedure by the UVT is rising (86 %). The measures recently taken have continuously increased quality of health care in occupational dermatology.

Association between tobacco smoking and prognosis of occupational hand eczema: a prospective cohort study.

BACKGROUND: Hand eczema (HE) is a common occupational skin disease. Tobacco smoking is known to be associated with adverse cutaneous effects. However, its influence on the prognosis of occupational HE has not yet been studied. OBJECTIVES: To evaluate relations between smoking status, severity and prognosis of occupational HE in patients taking part in an interdisciplinary tertiary individual prevention programme (TIP). METHODS: In a prospective, multicentre, cohort study 1608 patients with occupational HE taking part in a TIP were recruited and followed up for 3 years. The clinical and self-reported outcome data of smokers and nonsmokers were compared. RESULTS: Nonsmokers and smokers were equally distributed. During the TIP, the average self-reported daily cigarette consumption and the severity of HE decreased significantly (P < 0·01). However, at all time points HE was significantly more severe in smokers than in nonsmokers. This association was not dependent on the self-reported number of cigarettes smoked daily. Smokers had significantly more days of absence from work due to occupational HE than nonsmokers in the year before the TIP (P < 0·01) and in the following year (P = 0·02). After the TIP, smokers reported significantly more often that they had to give up their occupation (P = 0·02) than nonsmokers. CONCLUSIONS: The severity of occupational HE is increased in smokers. Tobacco smoking is associated with a higher number of days of absence from work and with not staying in the workforce owing to occupational HE. Thus, smoking confers a worse prognosis and interferes with the outcome of prevention programmes.

[Embrace, a model for integrated elderly care]. / SamenOud, een model voor geïntegreerde ouderenzorg: studieprotocol van een gerandomiseerde studie naar de effectiviteit betreffende patiëntuitkomsten, kwaliteit van zorg, zorggebruik en kosten.

UNLABELLED: Ongoing growth in health care expenditures and changing patterns in the demand for health care challenge societies worldwide. The Chronic Care Model (CCM), combined with classification for care needs based on Kaiser Permanente (KP) Triangle, may offer a suitable framework for change. The aim of the present study is to investigate the effectiveness of Embrace, a population-based model for integrated elderly care, regarding patient outcomes, service use, costs, and quality of care. METHODS: The CCM and the KP Triangle were translated to the Dutch setting and adapted to the full elderly population living in the community. A randomized controlled trial with balanced allocation was designed to test the effectiveness of Embrace. Eligible elderly persons are 75 years and older and enrolled with one of the participating general practitioner practices. Based on scores on the INTERMED-Elderly Self-Assessment and Groningen Frailty Indicator, participants will be stratified into one of three strata: (A) robust; (B) frail; and (C) complex care needs. Next, participants will be randomized per stratum to Embrace or care as usual. Embrace encompasses an Elderly Care Team per general practitioner practice, an Electronic Elderly Record System, decision support instruments, and a self-management support and prevention program - combined with care and support intensity levels increasing from stratum A to stratum C. Primary outcome variables are patient outcomes, service use, costs, and quality of care. Data will be collected at baseline, twelve months after starting date, and during the intervention period. DISCUSSION: This study could provide evidence for the effectiveness of Embrace.

Clinical course of occupational irritant contact dermatitis of the hands in relation to filaggrin genotype status and atopy.

BACKGROUND: Filaggrin loss-of-function mutations and atopy may alter the clinical course of irritant contact dermatitis (ICD). OBJECTIVE: To investigate the clinical course of patients with occupational ICD according to loss-of-function mutations in the filaggrin gene (FLG) and atopy. METHODS: In a prospective cohort study, the clinical course, use of topical corticosteroids, sick leave, recovery rate and job continuation were investigated in 459 inpatients treated for occupational ICD of the hands. Patients were genotyped for four FLG mutations, examined for atopy and followed for up to 3 years after discharge. RESULTS: Our study included 327 (71·2%) atopic individuals and 132 nonatopic individuals. Overall, 68 patients showed a mutation in the FLG alleles R501X, R2447X, S3247X and 2282del4 (60 atopic and eight nonatopic). Nonatopic patients with ICD responded well to therapeutic approaches, while atopy status made subjects more resistant to therapy, resulting in lower rates of recovery and job continuation and higher use of topical corticosteroids. Carriage of FLG loss-of-function mutations in combination with atopy worsened the course. The risk of abandoning one's profession in this group was significantly increased when compared with 'pure' ICD (odds ratio 3·1) after 3 years. CONCLUSIONS: Patients with atopy are a special risk population for ICD. In the presence of atopy, FLG mutations seem to be a modifier of the severity of the clinical course in ICD. Early-stage identification of this subgroup may result in additional emphasis to these patients regarding the importance of adherence to specific therapeutic interventions.

Is there change in intelligence quotient in chronically ill schizophrenia patients? A longitudinal study in twins discordant for schizophrenia.

BACKGROUND: Intellectual deficits are commonly found in schizophrenia patients. These intellectual deficits have been found to be heritable. However, whether the intellectual deficits change over time and, if so, whether the change is related with an increased genetic risk for the disease are not known. METHOD: We investigated change of intelligence quotient (IQ) in a twin sample of chronically ill schizophrenia patients, the discordant co-twins and healthy controls during a follow-up period of 5 years. A total of 52 twins completed two IQ assessments: nine patients [three monozygotic (MZ) and six dizygotic (DZ)], 10 unaffected co-twins (three MZ and seven DZ) and 33 healthy control twins (21 MZ and 12 DZ). RESULTS: A significant interaction effect over time was found between IQ measurement and illness (F=4.22, df=1, p<0.05), indicating that change in IQ over time is significantly different between the groups. A stable course in IQ over time was found in the patients with schizophrenia (mean IQ from 109.78 at baseline to 108.44 at follow-up) relative to both the healthy control twins who showed a small increase (from 114.61 at baseline to 119.18 at follow-up) (t=2.06, p<0.05) and the unaffected co-twins (from 111.60 to 117.60, t=-2.32, p<0.05). IQ change in the unaffected co-twins of schizophrenia patients was comparable with that in healthy control twins (t=-0.49, p=0.63). CONCLUSIONS: Patients with schizophrenia in the chronic phase of the disease, but not the discordant co-twins, show a lack of increase in IQ, which is probably due to environmental (non-genetic) factors related to the disease.

Ultraviolet B radiation and reactive oxygen species modulate interleukin-31 expression in T lymphocytes, monocytes and dendritic cells.

BACKGROUND: Interleukin (IL)-31 is a novel Th2 T-cell cytokine that induces pruritus and dermatitis in transgenic mice. While enhanced mRNA expression of this cytokine is detected in skin samples of inflammatory skin diseases, the regulation of IL-31 expression is poorly understood. OBJECTIVES: To assess the effects of ultraviolet (UV) B radiation and H2O2 on IL-31 mRNA and protein expression in skin and different peripheral blood mononuclear cells (PBMCs). METHODS: The effects of UVB radiation and H2O2, as a prototypic reactive oxygen species, on IL-31 mRNA and protein expression were analysed in various inflammation-related cells and murine skin tissue. RESULTSTreatment of cells with UVB radiation and H2 O2 strongly induced IL-31 mRNA and protein expression in human PBMCs and in the skin of SKH-1 mice. Following exposure to UVB or H2O2, we observed increased expression of IL-31 mRNA in T cells, monocytes, macrophages, and immature and especially mature dendritic cells. H2O2 treatment but not UVB radiation led to a moderate upregulation of IL-31 mRNA expression in epidermal keratinocytes and dermal fibroblasts. Pretreatment of T lymphocytes with the MAPK p38 inhibitor SB203580 or the MEK1 inhibitor U0126 reduced the stimulatory effect of H2O2. These experiments suggest that p38 is involved in the regulation of IL-31 expression in human skin. CONCLUSIONS: Our studies reveal that UVB and reactive oxygen species stimulate the expression of IL-31 in PBMCs and skin, especially in T cells, monocytes and monocyte-derived dendritic cells.

[Evaluation of a dominant-negative recombinant herpes simplex virus (HSV) type 1 as a vaccine against genital herpes in mice und guinea pigs]. / Evaluation eines dominant-negativen rekombinanten Herpes-simplex-Virus (HSV) Typ 1 als Impfstoff gegen Herpes genitalis bei Mäusen und Meerschweinchen.

Genital herpes caused by herpes simplex virus (HSV) is one of the most common sexually transmitted diseases worldwide. Currently, no safe and effective vaccine against HSV is available. CJ9-gD is a completely replication-defective HSV-1 recombinant which inhibits replication of wild-type HSV-1/-2 in co-infected cells (dominant-negative effect). Moreover, it expresses high levels of HSV-1 major antigen glycoprotein D (gD). Immunization with CJ9-gD induces strong and long-lasting humoral and Th1-like cellular immune responses against both HSV-1 and HSV-2 in mice protecting immunized animals significantly against genital challenge with HSV-1 or HSV-2. Guinea pigs immunized with CJ9-gD were significantly protected against primary and recurrent HSV-2 genital disease and latent infection.