RESUMO
The primary function of the skin is to form a mechanical, permeability, antimicrobial, and ultraviolet radiation barrier, which is essential for maintaining physiological homeostasis. Our previous studies demonstrated that cutaneous pigmentation could promote skin barrier function in addition to providing anti-ultraviolet irradiation defense. The present study aimed to develop a new regimen that enhances skin barrier function by regulating skin pigmentation using low-concentration imiquimod. Results showed that topical application of low-concentration imiquimod effectively induced skin hyperpigmentation in the dorsal skin and external ear of mice without inducing inflammatory cell infiltration. An in vitro study also revealed that low-concentration imiquimod did not induce any cytotoxic effects on melanoma cells but triggered excessive melanin synthesis. In coculture systems, low-concentration imiquimod was noted to increase tyrosinase activity in a broader cellular context, revealing the potential role of neighboring cells in melanin production. The next-generation sequencing result indicated that PKCη and Dnm3 might regulate melanin synthesis and release during imiquimod treatment. Overall, our study presents new insights into the regulation of melanin production by low-concentration imiquimod, both in a mice model and cultured cells. Furthermore, our study highlights the potential benefits of imiquimod in promoting melanin synthesis without causing skin disruptions or inducing inflammation, validating its potential to serve as a method for enhancing skin barrier functions by regulating the epidermal melanization reaction.
Assuntos
Imiquimode , Melaninas , Animais , Humanos , Camundongos , Epiderme/efeitos dos fármacos , Epiderme/metabolismo , Hiperpigmentação/tratamento farmacológico , Melaninas/metabolismo , Camundongos Endogâmicos C57BL , Monofenol Mono-Oxigenase/metabolismo , Pele/efeitos dos fármacos , Pele/metabolismo , Pigmentação da Pele/efeitos dos fármacos , Linhagem Celular , FemininoRESUMO
BACKGROUND: Though vitiligo is a common depigmentary disorder, it still represents a substantial therapeutic challenge. Therapeutic options are limited in part due to its uncertain etiology. OBJECTIVE: Because recent studies suggest that histamine stimulates melanogenesis in vitro, we determined here whether topical histamine stimulates repigmentation in patients with stable, nonsegmental vitiligo. METHODS: A total of 23 otherwise normal volunteers with vitiligo, including 14 males and 9 females aged 6-59 years (mean age 29.2 ± 2.8), were enrolled in this study. 1% histamine in distilled water was applied to the lesions twice daily for 5 weeks, while comparable lesions, treated with distilled water alone, served as the controls. The melanin index was measured on the uninvolved and lesional skin sites before and after 5 weeks of treatments using the melanin/erythema probe connected to a Courage-Khazaka MPA5 (Cologne, Germany). Changes in epidermal permeability barrier were also assessed at the same time point. To determine whether histamine-induced repigmentation is receptor-dependent, both ears of C57BL/6J mice were treated topically with 5% cimetidine, a histamine type 2 receptor (H2r) antagonist, twice daily for 10 days. One hour after each cimetidine application, the right ear was treated topically with 10% histamine, while vehicle alone was applied to the left ear. Changes in melanin index were measured 24 h after the last application of histamine and vehicle as described in the human study. RESULTS: In patients with vitiligo treated with vehicle alone for 5 weeks, the melanin index remained unchanged, while topical histamine treatment increased the melanin index by 38% (p < 0.001 vs. both vehicle and pretreatment), which was paralleled by a >60% reduction in lesion surface area. Moreover, topical histamine accelerated permeability barrier recovery. No adverse events were observed following histamine applications. In mice, topical histamine significantly increased the melanin index, while topical co-applications of the H2r antagonist (cimetidine) prevented the expected histamine-induced increase in melanin index. CONCLUSIONS: These studies indicate that topical histamine or an H2r agonist could be useful for treating nonsegmental vitiligo, but further clinical studies in large populations will be required to validate the efficacy and safety of this approach.
Assuntos
Histamina/farmacologia , Histamina/uso terapêutico , Receptores Histamínicos H2/metabolismo , Vitiligo/tratamento farmacológico , Administração Tópica , Adolescente , Adulto , Animais , Criança , Cimetidina/farmacologia , Feminino , Antagonistas dos Receptores H2 da Histamina/farmacologia , Humanos , Masculino , Melaninas/metabolismo , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Pigmentação/efeitos dos fármacos , Resultado do Tratamento , Vitiligo/metabolismo , Adulto JovemRESUMO
The hypothalamic-pituitary-adrenal (HPA) axis is one of the body's neuroendocrine networks that responds to psychological stress (PS). In the skin, there exists a peripheral HPA axis similar to the central axis. Glucocorticoids (GCs) are key effector molecules of the HPA axis and are essential for cutaneous homeostasis. Atopic dermatitis (AD) is a condition typically characterized by a chronic relapsing course that often results in PS. HPA dysfunction is present in AD patients by the decreased response of GCs elevation to stress as compared to those unaffected by AD. Nevertheless, in skin, acute PS activates several metabolic responses that are of immediate benefit to the host. During the acute phase of PS, increased endogenous GCs have been shown to provide benefit rather than by aggravating cutaneous inflammatory dermatoses. However, a chronic T helper cell type 2 (Th2) predominant cytokine profile acts as a negative feedback loop to blunt the HPA axis response in AD. In this article, we reviewed the role of CRF, pro-opiomelanocortin (POMC)-derived peptides, GCs of the HPA, and 11ß-hydroxysteroid dehydrogenase 1 (11ß-HSD1) in AD, with a discussion of the pathogenetic mechanisms of inflammation and skin barrier functions, including antimicrobial defense, and their association with PS.
Assuntos
Dermatite Atópica/etiologia , Dermatite Atópica/metabolismo , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipófise-Suprarrenal/metabolismo , Estresse Fisiológico , Estresse Psicológico , Animais , Biomarcadores , Dermatite Atópica/patologia , Regulação da Expressão Gênica , Glucocorticoides/metabolismo , Humanos , Transdução de SinaisRESUMO
Plant oils have been utilized for a variety of purposes throughout history, with their integration into foods, cosmetics, and pharmaceutical products. They are now being increasingly recognized for their effects on both skin diseases and the restoration of cutaneous homeostasis. This article briefly reviews the available data on biological influences of topical skin applications of some plant oils (olive oil, olive pomace oil, sunflower seed oil, coconut oil, safflower seed oil, argan oil, soybean oil, peanut oil, sesame oil, avocado oil, borage oil, jojoba oil, oat oil, pomegranate seed oil, almond oil, bitter apricot oil, rose hip oil, German chamomile oil, and shea butter). Thus, it focuses on the therapeutic benefits of these plant oils according to their anti-inflammatory and antioxidant effects on the skin, promotion of wound healing and repair of skin barrier.
Assuntos
Anti-Inflamatórios/farmacologia , Antioxidantes/farmacologia , Óleos de Plantas/farmacologia , Envelhecimento da Pele/efeitos dos fármacos , Pele/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Administração Tópica , Animais , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/química , Antioxidantes/administração & dosagem , Antioxidantes/química , Humanos , Óleos de Plantas/administração & dosagem , Óleos de Plantas/química , Plantas/químicaRESUMO
BACKGROUND: Diabetic patients are at an increased risk of developing Klebsiella pneumoniae pyogenic liver abscess (KLA) and its extrahepatic complications. This is the first case report depicting the concurrence of pyogenic liver abscess, emphysematous pyelonephritis, and necrotizing fasciitis in 1 patient. CASE REPORT: A 29-year-old male with a history of poorly controlled diabetes presented to the emergency department with lower back pain and right lower leg pain for 1 week. Abdominal ultrasound and computed tomography revealed pyogenic liver abscess, bilateral emphysematous pyelonephritis, and right lower-extremity necrotizing fasciitis. The patient then received emergent fasciectomy and bilateral percutaneous nephrostomy. K. pneumoniae was isolated from the blood culture, right nephrostomy tube, and right lower-extremity wound, indicating that it was the cause of these infections. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: In diabetic patients diagnosed with KLA, an emergency physician must perform thorough examinations to exclude potential systemic extrahepatic infections. KLA seeding infections are usually hematogenous in origin, as bacteremia is significantly more common in KLA than other pyogenic liver abscess. Documented sites of KLA seeding include eyes, lungs, kidneys, brain, meninges, soft tissues, and bone.
Assuntos
Bacteriemia/complicações , Diabetes Mellitus Tipo 2/complicações , Enfisema/microbiologia , Fasciite Necrosante/microbiologia , Infecções por Klebsiella/complicações , Klebsiella pneumoniae , Abscesso Hepático Piogênico/microbiologia , Pielonefrite/microbiologia , Adulto , Bacteriemia/microbiologia , Enfisema/diagnóstico , Fasciite Necrosante/diagnóstico , Humanos , Abscesso Hepático Piogênico/diagnóstico , Masculino , Pielonefrite/diagnósticoRESUMO
Noninvasive lung drug delivery is critical for treating respiratory diseases. Pluronic-based copolymers have been used as multifunctional materials for medical and biological applications. However, the Pluronic F127-based hydrogel is rapidly degraded, adversely affecting the mechanical stability for prolonged drug release. Therefore, this study designed two thermosensitive copolymers by modifying the Pluronic F127 terminal groups with carboxyl (ADF127) or amine groups (EDF127) to improve the viscosity and storage modulus of drug formulations. ß-alanine and ethylenediamine were conjugated at the terminal of Pluronic F127 using a two-step acetylation process, and the final copolymers were characterized using 1H nuclear magnetic resonance (1H NMR) and Fourier-transform infrared spectra. According to the 1H NMR spectra, Pluronic F127 was functionalized to form ADF127 and EDF127 with 85 % and 71 % functionalization degrees, respectively. Rheological studies revealed that the ADF127 (15 wt%) and EDF127 (15 wt%) viscosities increased from 1480 Pa.s (Pluronic F127) to 1700 Pa.s and 1800 Pa.s, respectively. Furthermore, the elastic modulus of ADF127 and EDF127 increased, compared with that of native Pluronic F127 with the addition of 5 % mucin, particularly for ADF127, thereby signifying the stronger adhesive nature of ADF127 and EDF127 with mucin. Additionally, ADF127 and EDF127 exhibited a decreased gelation temperature, decreasing from 33 °C (Pluronic F127 at 15 wt%) to 24 °C. Notably, the in vitro ADF127 and EDF127 drug release was prolonged (95 %; 48 h) by the hydrogel encapsulation of the liposome-Bdph combined with mucin, and the intermolecular hydrogen bonding between the mucin and the hydrogel increased the retention time and stiffness of the hydrogels. Furthermore, ADF127 and EDF127 incubated with NIH-3T3 cells exhibited biocompatibility within 2 mg/mL, compared with Pluronic F127. The nasal administration method was used to examine the biodistribution of the modified hydrogel carrying liposomes or exosomes with fluorescence using the IVIS system. Drug accumulation in the lungs decreased in the following order: ADF127 > EDF127 > liposomes or exosomes alone. These results indicated that the carboxyl group-modified Pluronic F127 enabled well-distributed drug accumulation in the lungs, which is beneficial for intranasal administration routes in treating diseases such as lung fibrosis.
Assuntos
Lipossomos , Poloxâmero , Camundongos , Animais , Poloxâmero/química , Hidrogéis , Mucinas , Distribuição Tecidual , Polímeros , PulmãoRESUMO
The beneficial effects of certain herbal medicines on cutaneous function have been appreciated for centuries. Among these agents, chrysanthemum extract, apigenin, has been used for skin care, particularly in China, for millennia. However, the underlying mechanisms by which apigenin benefits the skin are not known. In this study, we first determined whether topical apigenin positively influences permeability barrier homoeostasis, and then the basis thereof. Hairless mice were treated topically with either 0.1% apigenin or vehicle alone twice daily for 9 days. At the end of the treatments, permeability barrier function was assessed with either an electrolytic water analyzer or a Tewameter. Our results show that topical apigenin significantly enhanced permeability barrier homoeostasis after tape stripping, although basal permeability barrier function remained unchanged. Improved barrier function correlated with enhanced filaggrin expression and lamellar body production, which was paralleled by elevated mRNA levels for the epidermal ABCA12. The mRNA levels for key lipid synthetic enzymes also were upregulated by apigenin. Finally, both cathelicidin-related peptide and mouse beta-defensin 3 immunostaining were increased by apigenin. We conclude that topical apigenin improves epidermal permeability barrier function by stimulating epidermal differentiation, lipid synthesis and secretion, as well as cutaneous antimicrobial peptide production. Apigenin could be useful for the prevention and treatment of skin disorders characterized by permeability barrier dysfunction, associated with reduced filaggrin levels and impaired antimicrobial defenses, such as atopic dermatitis.
Assuntos
Apigenina/administração & dosagem , Apigenina/farmacologia , Permeabilidade da Membrana Celular/efeitos dos fármacos , Epiderme/fisiologia , Homeostase/efeitos dos fármacos , Extratos Vegetais/administração & dosagem , Extratos Vegetais/farmacologia , Transportadores de Cassetes de Ligação de ATP/metabolismo , Administração Tópica , Animais , Peptídeos Catiônicos Antimicrobianos/metabolismo , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/fisiologia , Permeabilidade da Membrana Celular/fisiologia , Células Cultivadas , Chrysanthemum , Relação Dose-Resposta a Droga , Células Epidérmicas , Epiderme/efeitos dos fármacos , Feminino , Proteínas Filagrinas , Homeostase/fisiologia , Proteínas de Filamentos Intermediários/metabolismo , Queratinócitos/citologia , Queratinócitos/efeitos dos fármacos , Queratinócitos/metabolismo , Camundongos , Camundongos Pelados , Modelos Animais , Pele/citologia , Pele/efeitos dos fármacos , Pele/metabolismo , beta-Defensinas/metabolismo , CatelicidinasRESUMO
Although it is widely accepted that filaggrin (FLG) deficiency contributes to an abnormal barrier function in ichthyosis vulgaris and atopic dermatitis, the pathomechanism of how FLG deficiency provokes a barrier abnormality in humans is unknown. We report here that the presence of FLG mutations in Caucasians predicts dose-dependent alterations in epidermal permeability barrier function. Although FLG is an intracellular protein, the barrier abnormality occurred solely via a paracellular route in affected stratum corneum. Abnormal barrier function correlated with alterations in keratin filament organization (perinuclear retraction), impaired loading of lamellar body contents, followed by nonuniform extracellular distribution of secreted organelle contents, and abnormalities in lamellar bilayer architecture. In addition, we observed reductions in corneodesmosome density and tight junction protein expression. Thus, FLG deficiency provokes alterations in keratinocyte architecture that influence epidermal functions localizing to the extracellular matrix. These results clarify how FLG mutations impair epidermal permeability barrier function.
Assuntos
Ictiose Vulgar/genética , Ictiose Vulgar/fisiopatologia , Proteínas de Filamentos Intermediários/genética , Queratinócitos/patologia , Pele/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Permeabilidade da Membrana Celular/genética , Matriz Extracelular/patologia , Feminino , Proteínas Filagrinas , Genótipo , Humanos , Ictiose Vulgar/patologia , Masculino , Microscopia Eletrônica de Transmissão , Pessoa de Meia-Idade , Mutação , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adulto JovemRESUMO
SR-T100 gel, containing solamargine extracted from Solanum undatum (synonym: Solanum incanum), had good therapeutic effects on actinic keratosis (AK) in human and ultraviolet B-induced papilloma in mice. This study aimed to investigate the immunohistochemical changes in the human skin after SR-T100 treatment. An immunohistochemical study was performed and the changes in photocarcinogenesis and photoaging markers after 16-week SR-T100 gel treatment were documented. SR-T100 gel treatment for 16 weeks resulted in complete remission in nine AK lesions and partial remission in four AK lesions. SR-T100 gel abolished the expression of mutant p53 and SOX2 and restored the expression of NOTCH1. Additionally, SR-T100 gel improved wrinkling in human skin, while restoring the expression of lamin B1 and increasing synthesis of new elastic fibers. SR-T100 gel had therapeutic effects on photocarcinogenesis and photoaging of photodamaged skin with AK.
Assuntos
Ceratose Actínica , Envelhecimento da Pele , Solanum , Animais , Ceratose Actínica/tratamento farmacológico , Camundongos , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêuticoRESUMO
Male sterility has been widely used in hybrid seed production in Brassica, but not in B. rapa ssp. chinensis, and genetic models of male sterility for this subspecies are unclear. We discovered a spontaneous mutant in B. rapa ssp. chinensis A series of progeny tests indicated that male sterility in B. rapa ssp. chinensis follows a three-allele model with BrMsa , BrMsb , and BrMsc The male sterility locus has been mapped to chromosome A07 in BC1 and F2 populations through genotyping by sequencing. Fine mapping in a total of 1,590 F2 plants narrowed the male sterility gene BrMs to a 400 kb region, with two SNP markers only 0.3 cM from the gene. Comparative gene mapping shows that the Ms gene in B. rapa ssp. pekinensis is different from the BrMs gene of B. rapa ssp. chinensis, despite that both genes are located on chromosome A07. Interestingly, the DNA sequence orthologous to a male sterile gene in Brassica napus, BnRf, is within 400 kb of the BrMs locus. The BnRf orthologs of B. rapa ssp. chinensis were sequenced, and one KASP marker (BrMs_indel) was developed for genotyping based on a 14 bp indel at intron 4. Cosegregation of male sterility and BrMs_indel genotypes in the F2 population indicated that BnRf from B. napus and BrMs from B. rapa are likely to be orthologs. The BrMs_indel marker developed in this study will be useful in marker-assisted selection for the male sterility trait.
Assuntos
Brassica rapa , Genes de Plantas , Infertilidade das Plantas/genética , Alelos , Brassica rapa/genética , Mapeamento CromossômicoRESUMO
BACKGROUND: The cropping area of genetically modified (GM) crops has constantly increased since 1996. However, currently, cultivating GM crops is associated with many concerns. Transgenes are transferred to non-GM crops through pollen-mediated gene flow, which causes environmental problems such as superweeds and introgressive hybridization. Rapeseed (Brassica napus L.), which has many GM varieties, is one of the most crucial oil crops in the world. Hybridization between Brassica species occurs spontaneously. B. rapa grows in fields as a weed and is cultivated as a crop for various purposes. Both B. rapa weeds and crops participate in gene flow among rapeseed. Therefore, gene flow risk and the coexistence of these two species should be studied. RESULTS: In this study, field experiments were conducted at two sites for 4 years to evaluate gene flow risk. In addition, zero-inflated models were used to address the problem of excess zero values and data overdispersion. The difference in the number of cross-pollination (CP) events was nonsignificant between upwind and downwind plots. The CP rate decreased as the distance increased. The average CP rates at distances of 0.35 and 12.95 m were 2.78% and 0.028%, respectively. In our results, zero-inflated negative binomial models were comprehensively superior to zero-inflated Poisson models. The models predicted isolation distances of approximately 1.36 and 0.43 m for the 0.9% and 3% threshold labeling levels, respectively. CONCLUSIONS: Cultivating GM crops is prohibited in Taiwan; however, the study results can provide a reference for the assessment of gene flow risk and the coexistence of these two species in Asian countries establishing policies for GM crops.
RESUMO
A 46-year-old nonsmoking female was diagnosed with pulmonary lymphoepithelioma-like carcinoma (LELC). She simultaneously had a rare skin manifestation, erythema elevatum diutinum (EED), which did not respond to topical treatment. The patient underwent platinum-based chemotherapy and thoracic radiotherapy and had shown complete remission in both LELC and EED. EED is therefore considered as a paraneoplastic syndrome of pulmonary LELC in this case. Literature on LELC and EED were also reviewed.
Assuntos
Carcinoma/diagnóstico , Eritema/diagnóstico , Neoplasias Pulmonares/diagnóstico , Síndromes Paraneoplásicas/diagnóstico , Antineoplásicos/farmacologia , Biópsia , Carcinoma/complicações , Eritema/complicações , Feminino , Humanos , Pulmão/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/patologia , Pessoa de Meia-Idade , Platina/farmacologia , Indução de Remissão , Pele/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
Pigmentation evolved in ancestral humans to protect against toxic, ultraviolet B irradiation, but the question remains: "what is being protected?" Because humans with dark pigmentation display a suite of superior epidermal functions in comparison with their more lightly pigmented counterparts, we hypothesized and provided evidence that dark pigmentation evolved in Africa to support cutaneous function. Because our prior clinical studies also showed that a restoration of a competent barrier dampens cutaneous inflammation, we hypothesized that resistance to inflammation could have provided pigmented hominins with yet another, important evolutionary benefit. We addressed this issue here in two closely related strains of hairless mice, endowed with either moderate (Skh2/J) or absent (Skh1) pigmentation. In these models, we showed that (a) pigmented mice display a markedly reduced propensity to develop inflammation after challenges with either a topical irritant or allergen in comparison with their nonpigmented counterparts; (b) visible and histologic evidence of inflammation was paralleled by reduced levels of pro-inflammatory cytokines (i.e., IL-1α and INFα); (c) because depigmentation of Skh2/J mouse skin enhanced both visible inflammation and pro-inflammatory cytokine levels after comparable pro-inflammatory challenges, the reduced propensity to develop inflammation was directly linked to the presence of pigmentation; and (d) furthermore, in accordance with our prior work showing that pigment production endows benefits by reducing the surface pH of skin, acidification of albino (Skh1) mouse skin also protected against inflammation, and equalized cytokine levels to those found in pigmented skin. In summary, pigmentation yields a reduced propensity to develop inflammation, consistent with our hypothesis that dark pigmentation evolved in ancestral humans to provide a suite of barrier-linked benefits that now include resistance to inflammation.
RESUMO
BACKGROUND: Currently available topical treatments for actinic keratosis (AK) are associated with substantial side-effects. OBJECTIVES: To evaluate the efficacy and safety of topical SR-T100 gel in treating AK. METHODS: A multicenter, randomized, double-blinded phase III trial was conducted. Patients with at least two clinically visible AK were enrolled and a punch biopsy was performed on one of the AK to confirm the diagnosis. This study consisted of up to 16-week treatment and 8-week post-treatment periods. Medication was applied daily with occlusive dressing. RESULTS: 123 subjects were recruited and 113 were randomized. 76 subjects were in the SR-T100 and 37 in the vehicle arms. In SR-T100 and vehicle groups, 32.39% and 17.14% of subjects achieved complete clearance, respectively. For 75% partial clearance of lesions, 71.83% and 37.1% of subjects achieved this goal in SR-T100 and vehicle group, respectively. When comparing SR-T100 to vehicle, the odds ratio of complete clearance was 2.14 (pâ¯=â¯0.111), and odds ratio of partial clearance was 4.36 (pâ¯<â¯0.001). Severe local reactions were reported by only one subject using SR-T100. CONCLUSION: The imitation of the study was that not all the treated AK lesions were confirmed by histopathology. The diagnostic uncertainty may contribute to the high partial clearance rate in the vehicle group since the clinical-diagnosed AK showed higher clearance rate compared to histopathology-confirmed AK. The use of occlusive dressing was another possible explanation for high placebo effects. The results suggested that topical SR-T100 gel may be an effective and safe treatment for field therapy of AK.
Assuntos
Fármacos Dermatológicos/uso terapêutico , Ceratose Actínica/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Alcaloides de Solanáceas/uso terapêutico , Administração Cutânea , Idoso , Idoso de 80 Anos ou mais , Biópsia , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Géis , Humanos , Ceratose Actínica/patologia , Masculino , Pessoa de Meia-Idade , Placebos , Pele/patologia , Taiwan , Resultado do TratamentoRESUMO
BACKGROUND: Previous studies have shown that human sebum may play a role in barrier function but with much debate. OBJECTIVE: To elucidate the effects of human sebum on skin barrier function. METHODS: We used hairless mouse skin to study the functional and morphological alternation of epidermis after the application of human sebum. RESULTS: The results showed a significant increase in transepidermal water loss and erythema value, and a decrease in skin hydration, accompanied by epidermal hyperplasia with parakeratosis following sebum application. Nile red staining together with electron microscopic examination confirmed the underlying mechanisms for sebum-induced barrier disruption are related directly to the interaction of sebum with the intracellular lipid lamellae of the SC, thereby leading to the increase in the fluidity of SC intracellular lipids as demonstrated by ATR-FTIR measurement. An inflammatory reaction characterized by an enhanced cytokine cascade, including up-regulation of TNF-α, IL-1α and IL-6, was also observed. On the other hand, there were insignificant expression of thymic stromal lymphopoietin and unchanged serum levels of IgE, suggesting non-immunogenic stimulation by sebum treatment. CONCLUSION: It may be concluded that inflammation induced by excess amount of sebum is more likely an irritant contact dermatitis rather than an allergic one. Moreover, these findings implicated possible relationships between sebum, irritant contact dermatitis, and seborrheic dermatitis.
Assuntos
Citocinas/metabolismo , Dermatite Irritante/metabolismo , Epiderme/metabolismo , Mediadores da Inflamação/metabolismo , Sebo/metabolismo , Adulto , Animais , Citocinas/imunologia , Dermatite Irritante/imunologia , Dermatite Irritante/patologia , Epiderme/imunologia , Epiderme/patologia , Eritema/imunologia , Eritema/metabolismo , Eritema/patologia , Humanos , Hiperplasia , Mediadores da Inflamação/imunologia , Masculino , Fluidez de Membrana , Lipídeos de Membrana/metabolismo , Camundongos Pelados , Paraceratose/imunologia , Paraceratose/metabolismo , Paraceratose/patologia , Permeabilidade , Sebo/imunologia , Fatores de Tempo , Perda Insensível de ÁguaRESUMO
Growing evidence shows alopecia areata (AA) to be a T cell-mediated organ-specific autoimmune disease. This study aimed to evaluate the efficacy of high-dose steroid pulse therapy in Taiwanese patients with severe widespread AA exceeding 40% of the scalp. A total of 17 Taiwanese patients with severe AA lasting less than 2 years were treated once monthly at the outpatient clinic for six sessions. Children younger than 12 years of age received oral prednisolone (5 mg/kg) in three divided doses, while for adults, 500 mg methylprednisolone was infused intravenously over 2 hours. Patients with multifocal AA exhibited the most favorable response, with more than 75% hair regrowth (9/11). Relapse occurred in two patients at 4 and 8 months after the last treatment, respectively. One patient with ophiatic AA showed a transient response, but subsequently lost hair even upon continuation of therapy. Two patients of four with alopecia totalis had full hair regrowth but one lost hair again 6 months later. In the only patient with alopecia universalis, less than 10% hair regrowth occurred. No major side effects were observed. In summary, 11 of 17 patients (64.7%) had more than 75% hair regrowth after steroid pulse therapy. Our results indicated that steroid pulse therapy, given at 5-10 mg/kg once monthly for an average of 6 months, is effective and well tolerated in Taiwanese patients with severe multifocal AA lasting less than 2 years.
Assuntos
Corticosteroides/administração & dosagem , Alopecia em Áreas/tratamento farmacológico , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Widespread bullous fixed drug eruption (FDE) is the most severe form of FDE and may be mistaken clinically for Stevens-Johnson syndrome or toxic epidermal necrolysis (SJS/TEN). We report two cases of generalized bullous drug eruption with extensive epidermal necrosis and detachment mimicking SJS/TEN overlap and TEN, respectively. The first patient, a 78-year-old man, developed SJS/TEN-like eruption with widespread dusky red patches and denuded areas shortly after taking multiple nonsteroidal antiinflammatory drugs (NSAIDs). Histopathology showed vacuolar interface dermatitis with numerous necrotic keratinocytes and a superficial and deep perivascular infiltrate containing lymphocytes, eosinophils, neutrophils and melanophages. These findings are consistent with FDE. The second patient, a 61-year-old woman, had three episodes of near-total body epidermal detachment shortly after taking NSAIDs. TEN was diagnosed clinically in all three episodes without pathologic confirmation. FDE was suspected due to lack of involvement of two mucosal sites and uneventful recovery. These cases highlight the importance of considering severe bullous FDE in the differential diagnosis of SJS and TEN, and the necessity of skin biopsy in such cases.
Assuntos
Toxidermias/diagnóstico , Dermatopatias Vesiculobolhosas/diagnóstico , Síndrome de Stevens-Johnson/diagnóstico , Idoso , Diagnóstico Diferencial , Toxidermias/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dermatopatias Vesiculobolhosas/patologia , Síndrome de Stevens-Johnson/patologiaRESUMO
The neutral lipids existing in the intercellular spaces of the stratum corneum (SC) provide a permeability barrier to prevent water loss. Nile red is the most sensitive lipid stain for tissue sections. However, due to the extremely flattened morphology of corneocytes and the resolution limits of the light microscope, Nile red staining is seldom used as a fluorescent probe for the lipid-rich SC. In this study, we modified the traditional method for visualization of intracellular lipid by adding 4% potassium hydroxide after Nile red staining. This modified method not only allowed visualization of lipids existing in the intercellular membrane regions and the lateral junctions of the adjoining corneocytes, but also clearly demonstrated small lipid droplets within pathological corneocytes. These features were not observed with the traditional staining method. Thus, this modified Nile red staining method greatly improved the resolution of the SC lipids under light microscopy and should be useful for studying lipid depositions in both normal and pathological SC.
Assuntos
Células Epidérmicas , Corantes Fluorescentes , Lipídeos/análise , Oxazinas , Coloração e Rotulagem/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Epiderme/química , Feminino , Humanos , Hidróxidos , Masculino , Pessoa de Meia-Idade , Compostos de PotássioRESUMO
Acute psychological stress (PS) mobilizes metabolic responses that are of immediate benefit to the host, but the current medical paradigm holds that PS exacerbates systemic and cutaneous inflammatory disorders. Although the adverse consequences of PS are usually attributed to neuroimmune mechanisms, PS also stimulates an increase in endogenous glucocorticoids (GCs) that compromises permeability barrier homeostasis, stratum corneum cohesion, wound healing, and epidermal innate immunity in normal skin. Yet, if such PS-induced increases in GC were uniformly harmful, natural selection should have eliminated this component of the stress response. Hence, we hypothesized here instead that stress-induced elevations in endogenous GC could benefit, rather than aggravate, cutaneous function and reduce inflammation in three immunologically diverse mouse models of inflammatory diseases. Indeed, superimposed exogenous (motion-restricted) stress reduced, rather than aggravated inflammation and improved epidermal function in all three models, even normalizing serum IgE levels in the atopic dermatitis model. Elevations in endogenous GC accounted for these apparent benefits, because coadministration of mifepristone prevented stress-induced disease amelioration. Thus, exogenous stress can benefit rather than aggravate cutaneous inflammatory dermatoses through the anti-inflammatory activity of increased endogenous GC.