Soybean isoflavones regulate dendritic cell function and suppress allergic sensitization to peanut.

BACKGROUND: Although peanut and soybean proteins share extensive amino acid sequence homology, the incidence and severity of allergic reactions to soy are much less than those to peanut. Soybeans are rich in anti-inflammatory isoflavones and are the most common source of isoflavones in the human food supply. OBJECTIVE: We hypothesized that the active isoflavones in the gut milieu are capable of modulating immune responses to dietary antigens by regulating dendritic cell (DC) function. METHODS: We tested this hypothesis in a murine model of peanut allergy and in human monocyte-derived dendritic cells (MDDCs). C3H/HeJ mice were fed a diet containing genistein and daidzein. The mice were sensitized and challenged with peanut, and the anaphylactic symptoms were compared with those of mice fed a soy-free diet. Human MDDCs were activated with cholera toxin in the presence of isoflavones. The surface expression of DC activation markers and DC-mediated effector functions were analyzed by means of flow cytometry. RESULTS: Dietary isoflavones significantly reduced the anaphylactic symptoms and mast cell degranulation in vivo after peanut challenge. Serum peanut-specific antibodies were markedly reduced in mice fed the isoflavone diet. Isoflavones inhibited cholera toxin-induced DC maturation in the mesenteric lymph nodes and human MDDCs and subsequent DC-mediated CD4(+) T-cell function in vitro. CONCLUSIONS: These data suggest that dietary isoflavones suppress allergic sensitization and protect against peanut allergy in vivo. Dietary supplementation of soybean isoflavones could be a novel strategy to prevent the development of allergic reactions to food.

The Role of the Microbiome in Food Allergy: A Review.

Food allergies are common and estimated to affect 8% of children and 11% of adults in the United States. They pose a significant burden-physical, economic and social-to those affected. There is currently no available cure for food allergies. Emerging evidence suggests that the microbiome contributes to the development and manifestations of atopic disease. According to the hygiene hypothesis, children growing up with older siblings have a lower incidence of allergic disease compared with children from smaller families, due to their early exposure to microbes in the home. Research has also demonstrated that certain environmental exposures, such as a farming environment, during early life are associated with a diverse bacterial experience and reduced risk of allergic sensitization. Dysregulation in the homeostatic interaction between the host and the microbiome or gut dysbiosis appears to precede the development of food allergy, and the timing of such dysbiosis is critical. The microbiome affects food tolerance via the secretion of microbial metabolites (e.g., short chain fatty acids) and the expression of microbial cellular components. Understanding the biology of the microbiome and how it interacts with the host to maintain gut homeostasis is helpful in developing smarter therapeutic approaches. There are ongoing trials evaluating the benefits of probiotics and prebiotics, for the prevention and treatment of atopic diseases to correct the dysbiosis. However, the routine use of probiotics as an intervention for preventing allergic disease is not currently recommended. A new approach in microbial intervention is to attempt a more general modification of the gut microbiome, such as with fecal microbiota transplantation. Developing targeted bacterial therapies for food allergy may be promising for both the treatment and prevention of food allergy. Similarly, fecal microbiota transplantation is being explored as a potentially beneficial interventional approach. Overall, targeted bacterial therapies for food allergy may be promising for both the treatment and prevention of food allergy.

Patient and disease related factors associated with lost-to follow-up/drop-outs of cervical cancer patients: a study at a Major Cancer Hospital in South India.

OBJECTIVE: Cervical cancer is the one of most common cancer in India, and a significant proportion of patients do not complete the prescribed courses of treatment and post therapy surveillance, due to deficiencies in treatment availability, accessibility, affordability and other socio-demographic factors. MATERIALS AND METHODS: Cervical cancer patient data for the year 2006-2007 were collected during June-August, 2008 from the Regional Cancer Centre (RCC), Thiruvananthapuram, Kerala, India and investigated for socio-economic, demographic and disease (SEDD) related factors impacting patients to drop-out during treatment and patients to loss to follow-up (LFU) post therapy. Odds ratio (OR) for drop-out and LFU and their 95% confidence intervals (CIs) according to SEDD factors were estimated through logistic regression model. RESULTS: Among a total of 784 patients, 94 (12%) did not complete the initially planned treatment and among 690 cases who had completed the initially planned treatment, 34% were lost to follow up (LFU). In the multivariate analysis, higher chances of LFU for older patients (OR=1.8; 95% CI: 1.1-3.1), widowed/divorced/separated/unmarried (OR=1.5; 95%CI: 1.0-2.1), middle school education (OR=1.8; 95% CI: 1.0-3.1), poorer performance status (OR=2.4; 95% CI: 1.2-5.0) and in higher stages (OR= 4.6; 95% CI: 2.1- 10.3). Higher chances of drop-outs were noted for patients with medium income (OR=2.0; 95% CI: 1.0-4.1), higher stages (OR=4.8; 95% CI: 1.9-12.2) and ischemic heart disease (OR=3.4; 95% CI: 1.1-10.9). CONCLUSION: Drop-out rates are associated with disease related factors and patients in the LFU group were affected mainly by SEDD factors. Physicians should be aware of patients' different needs in these two different phases, thus improving the retention rate in the near future of cancer treatment.

NIR laser tissue welding of in vitro porcine cornea and sclera tissue.

BACKGROUND AND OBJECTIVE: The objective of this study was to test the hypothesis that an near infrared (NIR) laser system (1,455 nm) in combination with a motorized translational stage to control the position and speed of the laser beam and a shutter to control the laser exposure to the tissue being welded could be used to successfully weld ocular tissues. STUDY DESIGN/MATERIALS AND METHODS: Seventy-five porcine corneas and 23 porcine scleral tissues were welded in vitro in this study. The welded tissues were examined using histopathology and tensile strength analysis. Eight different welding conditions were analyzed for porcine cornea and one for sclera tissues. The tensile strength of the welded groups was compared to a sutured cornea control group. RESULTS: The NIR laser welding system provides strong, full thickness welds and does not require the use of extrinsic dyes, chromophores, or solders. Mean weld strengths of 0.15-0.45 kg/cm(2) were obtained for the cornea and 1.01 kg/cm(2) for sclera welds. The native H(2)O in the ocular tissue serves as an absorber of the 1,455 nm radiation and helps to induce the welds. CONCLUSIONS: We conclude that an NIR laser system using an optimal laser radiation wavelength of 1,455 nm can effectively weld cornea and sclera tissue and that this laser tissue welding (LTW) methodology typically causes minimal disruption of tissue, and thus, avoids opacities and irregularities in the tissue which may result in decreased visual acuity. The optimization of a laser welding system that leads to a strong full thickness tissue bond without tissue destruction, an instant seal that promotes wound healing, and the absence of a continued presence of a foreign substance like a suture, is of considerable importance to the ophthalmology medical community. This need is especially apparent with respect to corneal transplantation and fixing the position of corneal flaps in Laser-Assisted In Situ Keratomileusis (LASIK), a laser procedure used to permanently change the shape of the cornea.