Atopic eczema: burden of disease and individual suffering - results from a large EU study in adults.

BACKGROUND: Atopic eczema (AE, atopic dermatitis) is one of the most common non-communicable inflammatory skin diseases affecting 1-5% of the adult population in Europe with marked impairment in quality of life. In spite of great progress in understanding the pathophysiology of disturbed skin barrier and immune deviation, AE still represents a problem in daily clinical practice. Furthermore, the true impact of AE on individual suffering is often not recognized. OBJECTIVES: With a large European study, we wanted to provide insights into the actual suffering and individual burden of disease in adult patients with AE. METHODS: A total of 1189 adult patients (18-87 years, 56% female) with moderate to severe AE were recruited in nine European countries by dermatologists or allergists together with the help of patient organizations. A computer-assisted telephone interview was performed by experienced interviewers between October 2017 and March 2018. The following instruments were used to assess severity or measure quality of life: Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS-D) and a newly developed Atopic Eczema Score of Emotional Consequences (AESEC). Patients were also asked to self-assess the severity of their disease. RESULTS: Despite current treatment, 45% of participants still had actual moderate to very severe AE in POEM. Due to their skin disease, 57% missed at least 1 day of work in the preceding year. DLQI showed moderate to extremely large impairment in 55%. According to HADS-D, 10% scored on or above the threshold of eight points with signs of depressive symptoms. Assessed with AESEC, 57% were emotionally burdened with feelings such as 'trying to hide the eczema', 'feeling guilty about eczema', having 'problems with intimacy' and more. Of persons actually suffering from severe AE, 88% stated that their AE at least partly compromised their ability to face life. CONCLUSIONS: This real-life study shows that adults with a moderate to severe form of AE are suffering more than what would be deemed acceptable. There is a need for increased awareness of this problem among healthcare professionals, policymakers and the general public to support research in the development of new and more effective treatments and provide access to better and affordable health care for affected patients.

[Stem Cells for Retina Replacement]. / Künstliche Netzhaut aus Stammzellen.

In ophthalmology, regenerative medicine is rapidly becoming a reality. Cell based treatment strategies in end stage retinal degeneration may be of therapeutic value, whatever the mechanism of disease mechanism. However, while corneal transplantation is commonly performed with excellent results, many obstacles must be overcome before retinal transplants can become clinically useful. The major problems are the production of appropriate transplants and functional integration in situ. New technologies allow the production of autologous transplants by inducing pluripotency in adult somatic cells. Driven by this development, exciting new research has been conducted on the development of artificial retinal tissue for basic research and transplantation. This article reviews this progress and discusses its clinical utility.

Structural organization and expression of human MTUS1, a candidate 8p22 tumor suppressor gene encoding a family of angiotensin II AT2 receptor-interacting proteins, ATIP.

The Mitochondrial Tumor suppressor 1 (MTUS1) gene is a newly identified candidate tumor suppressor gene at chromosomal position 8p22. We report here that MTUS1 encodes a family of proteins whose leader member (ATIP1) was previously isolated in our laboratory as a novel interacting partner of the angiotensin II AT2 receptor involved in growth inhibition (Nouet, JBC 279: 28989-97, 2004). The MTUS1 gene contains 17 coding exons distributed over 112 kb of genomic DNA. Alternative exon usage generates three major transcripts (ATIP1, ATIP3 and ATIP4), each showing different tissue distribution. ATIP polypeptides are identical in their carboxy-terminal region carrying four coiled-coil domains. In their amino-terminal portion, ATIP polypeptides exhibit distinct motifs for localisation in the cytosol, nucleus or cell membrane, suggesting that MTUS1 gene products may be involved in a variety of intracellular functions in an AT2-dependent and independent manner. ATIP1 is ubiquitous and highly expressed in the brain. ATIP3 is the major transcript in tissues (prostate, bladder, breast, ovary, colon) corresponding to cancer types with frequent loss of heterozygosity at 8p22. Interestingly, ATIP4 is a brain-specific transcript highly abundant in the cerebellum and fetal brain. High evolutionary conservation of ATIP amino-acid sequences suggests important biological roles for this new family of proteins in tumor suppression and/or brain function.

Mutation analysis of the 8p22 candidate tumor suppressor gene ATIP/MTUS1 in hepatocellular carcinoma.

A high frequency of allelic loss affecting chromosome 8p and a minimal region of deletion at p21-22 have been previously reported in hepatocellular carcinoma (HCC), suggesting that at least one tumor suppressor gene is present in this region. In this study, we assessed whether the angiotensin II AT2 receptor interacting protein (ATIP)/mitochondrial tumor suppressor gene (MTUS1), a gene newly identified at position 8p22, may be a candidate tumor suppressor gene mutated in HCC. We searched for alterations in the 17 coding exons of ATIP/MTUS1 by means of denaturating high-performance liquid chromatography and sequencing, in 51 HCC tumors and 58 cell lines for which loss of heterozygosity status was known. Five major nucleotide substitutions were identified, all located in exons used by the ATIP3 transcript which is the only ATIP transcript variant expressed in liver. These nucleotide variations result in amino-acid substitution or deletion of conserved structural motifs (nuclear localisation signal, polyproline motif, leucine zipper) and also affect exonic splicing enhancer motifs and physiological splice sites, suggesting potential deleterious effects on ATIP3 function and/or expression.

Culture of human cells obtained with DNA from chick Rous sarcoma.

An infectious process was reproduced in the culture of chick embryo cells by means of DNA isolated from Rous chick sarcoma tissue (Carr-Zilber strain). This DNA preparation displays biological activity also in the culture of human embryo diploid cells (HEDC) which is manifested in: 1. discontinuous synthesis of avian oncovirus group-specific antigen; 2. enhancement of proliferative activity and morphological transformation of human cells; 3. continuous presence of virus-specific sequences as revealed by DNA/RNA hybridization. Producing complete oncornavirus by means of DNA isolated from Rous chick sarcoma in HEDC was unsuccessful. DNA preparation from gs negative chick embryo cells shows no infectious activity in HEDC culture.

[Biochemical and molecular biology characteristics of gastric carcinogenesis in humans and animals]. / Nekotorye biokhimicheskie i molekuliarno-biologicheskie osobennosti gastrokantserogeneza u cheloveka i zhivotnykh.

The data on the changes in the isoenzyme spectrum of pepsinogen-pepsin inversely correlating with the development and retaining of the malignant condition of gastric mucosa in human and animals are reviewed. The results of the molecular-genetic studies of gastric carcinogenesis, in particular the role of protooncogenes--oncogenes in this process are presented.

[Biochemical changes in the glandular part of the rat stomach as affected by N-methyl-N'-nitro-N-nitrosoguanidine]. / Biokhimicheskie izmeneniia zhelezistoi chasti zheludka krys pri deistvii N-metil-N'-nitro-N-nitrozoguanidina.

Biochemical changes in the stomach mucous membrane of rats treated with N-methyl-N-nitro-N-nitrosoguanidine (MNNG) were studied. Carcinogenesis was shown to involve considerable changes in gastric mucous membrane, e. g. disorders in biosynthesis of isoforms of pepsinogen-pepsin. Their level and proteolytic activity are gradually declined. This effect can be reversed at an early stage of treatment and is persistent in advanced tumors of glandular part of rat stomach.

Tissue Factor-Factor VIIa complex induces cytokine expression in coronary artery smooth muscle cells.

OBJECTIVE: Within atherosclerotic lesions Tissue Factor (TF)-Factor VIIa (FVIIa) not only contributes to thrombotic events but also alters vascular remodeling through enhancement of migration. Moreover, the TF-FVIIa-FXa complex activates protease-activated receptors (PAR). TF/FVIIa/PAR-2 signaling has also been shown to promote proliferation and metastasis of tumor cells. Since coagulation factors promote inflammation which plays a major role during atherosclerosis as well as tumor metastasis this study sought to investigate the effects of FVIIa on the inflammatory response in vascular cells. METHODS/RESULTS: FVIIa induces interleukin-8 (IL-8) and IL-6 in primary smooth muscle cells (SMC), which was correlated to the expression of TF and PAR-2 as shown by immunoassay and qRT-PCR. The effect was dose-dependent and required TF, the proteolytic activity of FVIIa and PAR-2. Secondary effects of downstream coagulation factors were excluded. No proinflammatory FVIIa effect was observed in endothelial cells (EC) and mononuclear cells (MNC), expressing either TF or PAR-2. In atherosclerotic lesions mRNA expression of PAR-1, PAR-2 and IL-8 was elevated compared to healthy vessels indicating a role for PAR-1 and PAR-2 signaling in atherosclerosis. CONCLUSION: In addition to the procoagulant and promigratory role of the TF-FVIIa complex we identify a proinflammatory role of FVIIa in human SMC dependent on expression of TF and PAR-2 that provides yet another link between coagulation and inflammation.

[Comparative bioavailability of eicosapentaenoic acid and docasahexaenoic acid from triglycerides, free fatty acids and ethyl esters in volunteers]. / Vergleich der Bioverfügbarkeit von Eicosapentaensäure und Docosahexaensäure aus Triglyceriden, freien Fettsäuren und Ethylestern bei Probanden.

Comparative Bioavailability of Eicosapentaenoic Acid and Docosahexaenoic Acid from Triglycerides, Free Fatty Acids and Ethyl Esters in Volunteers. The bioavailability of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) from triglycerides, free fatty acids and ethyl esters was investigated in 8 female volunteers in a randomized triple cross-over trial with baseline control. EPA/DHA was administered in capsules in form of triglycerides (1.68/0.72 g), free fatty acids (1.35/1.065 g) and ethyl esters (1.86/1.27 g). The resulting EPA/DHA plasma levels were determined and evaluated. The mean relative bioavailability of EPA/DHA compared to triglycerides was 186/136% from free fatty acids and 40/48% from ethyl esters. Maximal plasma levels were about 50% higher with free fatty acids and about 50% lower with ethyl esters as compared to triglycerides. The tolerability of the free fatty acids was much worse than that of triglycerides and ethyl esters. The main side effect was eructation.

[Effect of body posture and venous congestion on blood fat picture]. / Einfluss der Körperlage und der venösen Stauung auf die Blutfettspiegel.

The effects on the concentrations of total cholesterol, high-density lipids (HDL), triglycerides and glycerol of temporary venous occlusion during blood sampling and changing body posture (lying and standing) were measured on 20 healthy male volunteers (mean age 25 [21-27] years) with normal blood-lipid levels. Venous occlusion in the upper arm increased the concentration of lipids in the antecubital vein, by 8% after five min and 37% after 15 min. Initial levels were restored 10 and 15 min after the occlusion. Blood-lipid levels were similarly raised on standing up again. After 5 min they had risen by about 9%, after 15 min by 16%. After renewed recumbency the levels were up from the initial values by 5% after 10 min and by 3% after 15 min (P less than 0.01). The concentration of free glycerol on the whole varied randomly, but there was a statistically significant rise after 10 and 15 min standing. These results indicate that different techniques of blood sampling can influence the lipid concentrations in venous blood.

Molecular, biochemical and morphological aspects of the dynamics of rat stomach mucous membrane changes in experimental carcinogenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG).

The dependence of gastrocarcinogenesis on biochemical and morphological disorders of the stomach mucous membrane, i.e. epimolecular alteration of chromatin structure, inhibition of pepsinogen synthesis, alteration of ontogenetic heritage of glandular epithelium was studied in 450 random-bred white rats with the aid of a model of gastrocarcinogenesis induced with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). This agent weakened the DNA-protein linkage in the chromatin. The irreversibility of this phenomenon coincided with the crucial point of the MNNG gastrocarcinogenesis (precancer sign appearance). The consequences of MNNG-induced specific alteration of epithelial stem cells became inherited (stomach adenocarcinoma development). In parallel with gastrocarcinogenesis, concomitant deficiency of pepsinogen-pepsin in the mucous membrane also developed. The data suggest that deficiency of the enzyme was in some degree obliged to alteration of pepsinogen mRNA synthesis.