ABSTRACT
The current work emphasizes the preparation of trimetallic core-shell Ag-TeO2@ZnO nanocomposites (NCs) by thermo-mechanical method for the efficient photocatalytic degradation of 2,4-Dichlorophenol and ß-naphthol pollutants. FE-SEM shows that Ag and TeO2nanoparticles are deposited on the surface of ZnO nanotubes. The band gap of pristine ZnO NPs and 5 wt% Ag-TeO2@ZnO nanocomposites are found to be 3.16 and 2.96 eV, respectively. The calculated specific surface area (SBET) of pristine ZnO NPs and 5 wt% Ag-TeO2@ZnO nanocomposites are 40.47 and 45.66 m2g-1respectively, confirming that Ag and TeO2nanoparticles contribute to increasing in surface area of pure ZnO. The synthesised nanocomposite showed excellent photocatalytic performance for the degradation of ß -naphthol (95.6%) in 40 min at the concentration of (0.6 mg ml-1) and 2,4-DCP (99.6%) in 180 min (0.4 mg ml-1) under natural sunlight. Cyclic Voltammetry and Electrochemical Impedance Spectroscopy were carried out to study the electrochemical properties. The determination of reactive oxygen species (ROS) confirmed that the degradation of the pollutants by 5 wt% Ag-TeO2@ZnO NCs was due to the formation of superoxide radicals. Electron paramagnetic resonance revealed the presence of sharp signals in pure ZnO nanoparticles at g â¼1.95 and oxygen vacancy peak at g â¼2.01 in 5 wt% Ag-TeO2@ZnO NCs. To study the mechanism behind the degradation of pollutants, Scavenger test using histidine and ascorbic acid (ROS scavengers) was performed. The synthesised nanocomposites are highly stable and showed enhanced efficiency up to three cycles, confirming their reusability as a photocatalyst.
ABSTRACT
Mitochondrial membrane potential (Ψm) is a critical parameter that can be used to determine cellular well-being. As it is a direct measure of the cell's ATP generating capability, in recent years, this key component in cell biology has been the subject of thousands of biochemical and biophysical investigations. Membrane-permeant fluorescent dyes, like tetramethylrhodamine ethyl ester (TMRE), have been predominantly employed to monitor ΔΨm in cells. These dyes are typically lipophilic cationic compounds that equilibrate across membranes in a Nernstian fashion, thus accumulating into the mitochondrial membrane matrix space in inverse proportion to Ψm. However, the bath loading method practiced for labelling tissue slices with these cationic dyes poses limitations in the form of non-specificity and low signal to noise ratio, which compromises the precision of the results. Therefore, we introduce an alternative way for TMRE loading to image the ΔΨm in tissue slices by utilizing a low resistance glass pipette attached to a pressure injector. This method shows highly precise fluorescent dye labelling of the mitochondria and offers maximum output intensity, in turn enhancing signal to noise ratio.
Subject(s)
Membrane Potential, Mitochondrial/physiology , Mitochondria/metabolism , Retina/metabolism , Animals , Fluorescent Dyes/metabolism , Male , Optical Imaging/methods , Organometallic Compounds/metabolism , Rats , Rats, Sprague-Dawley , Reactive Oxygen Species/metabolismABSTRACT
Severe allergic reactions (anaphylaxis) are unpredictable, and initial signs of what could be fatal anaphylaxis can be mild Adrenaline (epinephrine) remains the first-line drug of choice for the acute management of anaphylaxis and should be administered early There are no contraindications to intramuscular adrenaline in the treatment of anaphylaxis Correct positioning of the patient is vital as death can occur within minutes if a patient stands, walks or sits up suddenly. Position the patient correctly first and then promptly administer intramuscular adrenaline Updated guidelines by the Australasian Society of Clinical Immunology and Allergy now recommend that the 0.15 mg adrenaline injector device may be prescribed for infants and children weighing 7.5-10 kg. The recommendation to use the 0.3 mg adrenaline injector device for those over 20 kg remains unchanged The adrenaline doses in Australian Prescriber's anaphylaxis wallchart remain valid.
ABSTRACT
INTRODUCTION: The Australasian Society of Clinical Immunology and Allergy, the peak professional body for clinical immunology and allergy in Australia and New Zealand, develops and provides information on a wide range of immune-mediated disorders, including advice about infant feeding and allergy prevention for health professionals and families. Guidelines for infant feeding and early onset allergy prevention were published in 2016, with additional guidance published in 2017 and 2018, based on emerging evidence. MAIN RECOMMENDATIONS: When the infant is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods. (This is not a strict window of introduction but rather a recommendation not to delay the introduction of solid foods beyond 12 months.) Introduce peanut and egg in the first year of life in all infants, regardless of their allergy risk factors. Hydrolysed (partially and extensively) formula is no longer recommended for the prevention of allergic disease. CHANGES IN MANAGEMENT A RESULT OF THE GUIDELINES: The guidelines specifically recommend introducing solid foods at around 6 months of age and introducing peanut and egg in the first year of life in all infants to prevent allergy development. Hydrolysed formula is no longer recommended for prevention of allergic disease. A new document outlining the reasons for and the method of peanut introduction to high risk infants is available for health professionals.
Subject(s)
Food Hypersensitivity , Allergy and Immunology/organization & administration , Australasia , Child, Preschool , Diet , Female , Food Hypersensitivity/prevention & control , Food Hypersensitivity/therapy , Humans , Infant , Infant Food , Infant, Newborn , Practice Guidelines as Topic , PregnancyABSTRACT
Deleted in breast cancer 1 (DBC1) has emerged as an important regulator of multiple cellular processes, ranging from gene expression to cell cycle progression. DBC1 has been linked to tumorigenesis both as an inhibitor of histone deacetylases, HDAC3 and sirtuin 1, and as a transcriptional cofactor for nuclear hormone receptors. However, despite mounting interest in DBC1, relatively little is known about the range of its interacting partners and the scope of its functions. Here, we carried out a functional proteomics-based investigation of DBC1 interactions in two relevant cell types, T cells and kidney cells. Microscopy, molecular biology, biochemistry, and mass spectrometry studies allowed us to assess DBC1 mRNA and protein levels, localization, phosphorylation status, and protein interaction networks. The comparison of DBC1 interactions in these cell types revealed conserved regulatory roles for DBC1 in gene expression, chromatin organization and modification, and cell cycle progression. Interestingly, we observe previously unrecognized DBC1 interactions with proteins encoded by cancer-associated genes. Among these interactions are five components of the SWI/SNF complex, the most frequently mutated chromatin remodeling complex in human cancers. Additionally, we identified a DBC1 interaction with TBL1XR1, a component of the NCoR complex, which we validated by reciprocal isolation. Strikingly, we discovered that DBC1 associates with proteins that regulate the circadian cycle, including DDX5, DHX9, and SFPQ. We validated this interaction by colocalization and reciprocal isolation. Functional assessment of this association demonstrated that DBC1 protein levels are important for regulating CLOCK and BMAL1 protein oscillations in synchronized T cells. Our results suggest that DBC1 is integral to the maintenance of the circadian molecular clock. Furthermore, the identified interactions provide a valuable resource for the exploration of pathways involved in DBC1-associated tumorigenesis.
Subject(s)
Adaptor Proteins, Signal Transducing/metabolism , Gene Expression Regulation , Kidney/metabolism , Proteome/metabolism , T-Lymphocytes/metabolism , Cell Cycle , Cell Line , Chromatin Assembly and Disassembly , Circadian Clocks , HEK293 Cells , Humans , Kidney/cytology , Proteomics/methodsABSTRACT
Post mortem studies on familial and sporadic Parkinson's disease patient striatal tissue have shown that nearly 90% of α-synuclein deposited in Lewy-bodies is phosphorylated at serine-129 (pSyn-129) as opposed to only 4% in normal human brain. We aimed to find the influence of endogenous neurotoxin 6-hydroxydopamine (6-OHDA) on α-synuclein phosphorylation, resting vesicles, and vesicular dopamine release. The relative distribution of pSyn-129+ cells in apoptotic and non-apoptotic populations at different 6-OHDA concentrations was assessed along with changes in oxidant-antioxidant system, mitochondrial membrane-potential, and intracellular-Ca2+ . Exposing SH-SY5Y cells to different concentrations of 6-OHDA for 48 h showed cell-death and apoptosis. Immunocytochemical analysis indicated an increase in pSyn-129 with increasing 6-OHDA concentration, and ELISA-estimation showed a significant increase in the pSyn-129 to α-synuclein ratio. FACS analysis also showed a significant increase in pSyn-129; and at sub-lethal 6-OHDA concentrations, pSyn-129+ cells were primarily distributed in the non-apoptotic population, suggesting that phosphorylation of α-synuclein precedes apoptosis. At higher 6-OHDA concentrations, the pSyn-129+ cell count significantly increased in the apoptotic population and decreased in the non-apoptotic population. Cytosolic co-localization of α-synuclein and ubiquitin was noticed at higher doses of 6-OHDA. FACS analysis showed decrease in vesicular monoamine transporter-2 (VMAT2) expression in 6-OHDA-treated cells, confirmed by reduction in functional dopamine-release on KCl and ATP stimulation. Significant decrease in VMAT2 expression and vesicular dopamine-release were observed with the lower 6-OHDA concentration, together with mild occurrence of apoptosis and significant increase in phosphorylated α-synuclein. This suggests that at sub-lethal 6-OHDA concentrations, the decrease in resting vesicles (VMAT2) and vesicular dopamine release are not attributable to apoptotic cell death and occur concomitantly with the phosphorylation of α-synuclein. J. Cell. Biochem. 117: 2719-2736, 2016. © 2016 Wiley Periodicals, Inc.
Subject(s)
Dopamine/metabolism , Gene Expression Regulation, Neoplastic/drug effects , Neuroblastoma/metabolism , Oxidopamine/adverse effects , Synaptic Vesicles/metabolism , alpha-Synuclein/metabolism , Adrenergic Agents/adverse effects , Apoptosis/drug effects , Blotting, Western , Cell Proliferation , Humans , Membrane Potential, Mitochondrial/drug effects , Mutation/genetics , Neuroblastoma/drug therapy , Neuroblastoma/pathology , Oxidative Stress/drug effects , Phosphorylation/drug effects , Synaptic Vesicles/drug effects , Tumor Cells, Cultured , alpha-Synuclein/geneticsABSTRACT
Histone deacetylases (HDACs) are a diverse family of essential transcriptional regulatory enzymes, that function through the spatial and temporal recruitment of protein complexes. As the composition and regulation of HDAC complexes are only partially characterized, we built the first global protein interaction network for all 11 human HDACs in T cells. Integrating fluorescence microscopy, immunoaffinity purifications, quantitative mass spectrometry, and bioinformatics, we identified over 200 unreported interactions for both well-characterized and lesser-studied HDACs, a subset of which were validated by orthogonal approaches. We establish HDAC11 as a member of the survival of motor neuron complex and pinpoint a functional role in mRNA splicing. We designed a complementary label-free and metabolic-labeling mass spectrometry-based proteomics strategy for profiling interaction stability among different HDAC classes, revealing that HDAC1 interactions within chromatin-remodeling complexes are largely stable, while transcription factors preferentially exist in rapid equilibrium. Overall, this study represents a valuable resource for investigating HDAC functions in health and disease, encompassing emerging themes of HDAC regulation in cell cycle and RNA processing and a deeper functional understanding of HDAC complex stability.
Subject(s)
Histone Deacetylase 1/genetics , Histone Deacetylases/genetics , Protein Interaction Maps , SMN Complex Proteins/genetics , T-Lymphocytes/metabolism , Cell Cycle/genetics , Chromatin Assembly and Disassembly , Gene Expression Profiling , Gene Expression Regulation , Histone Deacetylase 1/metabolism , Histone Deacetylases/metabolism , Humans , Protein Folding , RNA Splicing , SMN Complex Proteins/metabolism , Signal Transduction , T-Lymphocytes/cytology , Transcription Factors/genetics , Transcription Factors/metabolismABSTRACT
BACKGROUND: Many children with IgE-mediated allergy to cow's milk (CM) can tolerate CM in baked foods. OBJECTIVE: To define the clinical characteristics and severity of reactions to baked CM in children with CM allergy (CMA) at an oral food challenge (OFC). METHODS: Children with CMA presenting to a tertiary clinic from 2010 through 2013 with complete dietary CM avoidance were offered a baked CM OFC. Challenges were performed with incremental dosages to a total of 1 baked muffin. RESULTS: Seventy children with CMA underwent a baked CM OFC. Fifty-one children (73%) passed the OFC and successfully incorporated baked CM into their diet. Nineteen children (27%) reacted to their challenge. Of reactors, 4 (21%) developed anaphylaxis and required intramuscular adrenalin. Predictors of clinical reactivity to baked CM were asthma, asthma requiring preventer therapy, IgE-mediated clinical reactions to more than 3 food groups, and those with a history of CM anaphylaxis. CONCLUSION: This study identified factors that were predictors of clinical reactivity to baked CM in this cohort of children with CMA. These risk factors do not represent contradictions to a baked CM challenge but may allow for risk stratification of challenges. Given the potential for anaphylaxis, an OFC to baked CM should be done under medical supervision in those children with CMA who have been strictly avoiding all CM.
Subject(s)
Anaphylaxis/immunology , Asthma/immunology , Hot Temperature , Milk Hypersensitivity/immunology , Milk/immunology , Anaphylaxis/drug therapy , Animals , Child , Child, Preschool , Female , Humans , Immunoglobulin E/immunology , Male , Skin TestsABSTRACT
Egg allergy is the commonest infant food allergy both in Australia and world-wide. The clinical presentation of egg allergy is varied - egg is involved in both IgE and non-IgE-mediated allergic reactions and has been implicated in conditions such as anaphylaxis, food protein-induced enterocolitis syndrome, atopic dermatitis and eosinophilic oesophagitis. The clinical presentation, pathophysiology and diagnosis as well as the natural history and management of egg allergy will be discussed. Current theories about primary prevention as well as potential future therapies are presented. Finally, practical information about egg allergy and immunisation is provided.
Subject(s)
Egg Hypersensitivity , Immunoglobulin E/immunology , Anaphylaxis/etiology , Child , Egg Hypersensitivity/diagnosis , Egg Hypersensitivity/immunology , Egg Hypersensitivity/therapy , HumansABSTRACT
BACKGROUND: Many children with IgE-mediated allergy to egg can tolerate egg in baked foods. However, the clinical characteristics and severity of reactions of egg-allergic children who react to baked egg at open food challenge (OFC) are not well defined. METHODS: Children presenting to our tertiary referral clinic with a diagnosis of egg allergy and following complete egg avoidance in their diet were offered OFC to baked egg. Challenges were performed with incremental dosages to a total of one baked muffin containing 1/6 egg (equivalent to 1 g egg protein) following a standardized protocol. Data were collected prospectively from 2009-2012. RESULTS: Open food challenge to baked egg were carried out on 236 egg-allergic children who had been strictly avoiding egg in their diet. A total of 150 children (64%) passed and successfully incorporated baked egg into their diet. Eighty-six children (36%) reacted to their challenge. Of these, 12 (14%) experienced anaphylaxis (according to WAO criteria), including four to <100 mg extensively heated egg protein. Intramuscular adrenaline was administered to 5 of the 12 children, one of whom required a second dose due to persistent hypotension. Skin prick testing, asthma, or prior egg anaphylaxis were not predictive of challenge outcome. CONCLUSION: The majority of children with IgE-mediated allergy to egg were able to tolerate 1 g of baked egg protein, but the outcome of OFC remained unpredictable, and 14% of children who failed OFC reacted with anaphylaxis. We recommend that OFC to baked egg should take place under medical supervision.
Subject(s)
Anaphylaxis/diagnosis , Egg Hypersensitivity/diagnosis , Egg Proteins , Administration, Oral , Anaphylaxis/etiology , Anaphylaxis/immunology , Child , Child, Preschool , Cohort Studies , Diet , Egg Hypersensitivity/complications , Egg Hypersensitivity/immunology , Egg Proteins/adverse effects , Egg Proteins/immunology , Eggs/adverse effects , Female , Hot Temperature , Humans , Immunoglobulin E/immunology , Immunoglobulin E/metabolism , Male , Prospective StudiesABSTRACT
A review of case notes from our Sydney-based paediatric allergy services, between 1 January 2003 and 31 December 2011, identified 74 children who had been prescribed diets that eliminated foods containing natural salicylates before attending our clinics. The most common indications for starting the diets were eczema (34/74) and behavioural disturbances (17/74) including attention deficit hyperactivity disorder (ADHD). We could find no peer-reviewed evidence to support the efficacy of salicylate elimination diets in managing these diseases. We do not prescribe these diets, and in a survey of European and North American food allergy experts, only 1/23 respondents used a similar diet for eczema, with none of the respondents using salicylate elimination to treat ADHD. A high proportion (31/66) of children suffered adverse outcomes, including nutritional deficiencies and food aversion, with four children developing eating disorders. We could find no published evidence to support the safety of these diets in children. While this uncontrolled study does not prove a causal relationship between salicylate elimination diets and harm, the frequency of adverse events appears high, and in the absence of evidence of safety or efficacy, we cannot recommend the use of these diets in children.
Subject(s)
Diet/methods , Salicylates/adverse effects , Attention Deficit Disorder with Hyperactivity/diet therapy , Child , Child Behavior Disorders/diet therapy , Diet/adverse effects , Eczema/diet therapy , Humans , Treatment OutcomeABSTRACT
The progressive nature of acquired epilepsy warrants a thorough examination of acute changes that occur immediately after an epileptogenic insult to better understand the cellular and molecular mechanisms that trigger epileptogenesis. Astrocytes are important regulators of neuronal functions and emerging evidence suggests an involvement of astrocytic purinergic signaling in the etiology of acquired epilepsy. However, how astrocytic purinergic signaling responds immediately after an acute seizure or an epileptogenic insult to impact epileptogenesis is not well studied. In the present study, we report area-specific rapid onset of astrocytic changes in morphology, as well as in expression and functional activity of the purinergic signaling in the hippocampus that occur immediately after pilocarpine-induced stage 5 seizure. After 3 hr of stage 5 acute seizure, hippocampal astrocytes show increased intrinsic calcium activity in stratum radiatum as well as reactive astrogliosis in the stratum lacunosum moleculare and hilus regions of the hippocampus. Hilar astrocytes also upregulated the expression of P2Y1 and P2Y2 metabotropic purinergic receptors. Subsequently, P2Y1 exhibited a functional upregulation by showing a significantly higher intracellular calcium rise in ex-vivo hippocampal slices on P2Y1 activation. Our results suggest that hippocampal astrocytes undergo rapid area-specific morphological and functional changes immediately after the commencement of the seizure activity and purinergic receptors upregulation is one of the earliest changes in response to seizure activity. These changes can be considered acute astrocytic responses to seizure activity which can potentially drive the epileptogenesis and can be explored further to identify astrocyte-specific targets for seizure therapy.
Subject(s)
Epilepsy , Pilocarpine , Rats , Animals , Calcium/metabolism , Gliosis/chemically induced , Gliosis/metabolism , Seizures/chemically induced , Seizures/metabolism , Hippocampus/metabolism , Epilepsy/chemically induced , Epilepsy/metabolism , Astrocytes/metabolismABSTRACT
Geographic atrophy (GA) is a progressive and irreversible retinal disease with no comprehensive recommendations for diagnosis or monitoring. We used a Delphi approach to determine consensus in key areas around diagnosis and management of GA. A steering committee of eight retina specialists developed two sequential online surveys administered to eye care professionals (ECPs). Consensus was defined as agreement by ≥ 75% of respondents. Up to 177 ECPs from eight countries completed one or both surveys. Consensus was achieved in several topics related to diagnostic imaging, including the use of optical coherence tomography, and the urgent need for treatments and beneficial interventions to reduce the associated burden. Currently, low-vision aids and smoking cessation are considered the most beneficial interventions. We demonstrate consensus for diagnosis and management of patients with GA including best practices in patient identification and monitoring, and unmet needs. [Ophthalmic Surg Lasers Imaging Retina 2023;54:589-598.].
Subject(s)
Geographic Atrophy , Macular Degeneration , Humans , Geographic Atrophy/diagnosis , Geographic Atrophy/etiology , Geographic Atrophy/therapy , Consensus , Delphi Technique , Fluorescein Angiography/methods , Macular Degeneration/complications , Macular Degeneration/diagnosis , Macular Degeneration/therapy , Tomography, Optical Coherence/methods , Atrophy/complicationsABSTRACT
Introduction: As the most common cancer in Australia, skin cancer generates a considerable health burden. This study outlines the establishment of a new model of integrated care for the diagnosis and management of skin cancer. Methods: A new model of integrated care was established to provide access to all aspects of skin cancer management. General practitioners (GPs) were upskilled through hands-on training and a 6-month skin cancer education program and partnered with specialist Dermatologists and Plastic Surgeons co-located in the same clinic. Data including median wait times between the initial consultation and treatment were prospectively collected and compared patients seen through the integrated pathway to patients referred from their primary GP to specialist Dermatologists and Plastic Surgeons directly (non-integrated pathway). The percentage of patients needing co-consultation with a specialist in the integrated pathway was also measured over time. Results: A total of 25341 patients were seen from the commencement of the clinic in August 2015 to June 2021. In 2017 and 2018 the median wait time to be treated was 7 days for the integrated model compared to 54 days (2017) and 46 days (2018) for non-integrated care (p < 0.0001). The percentage of GPs requesting specialist co-consultations for assessment of skin cancer fell from 98% in 2015, to 5.6% in 2021. Histopathology shows that 66% of lesions excised by GPs in this model were malignant or pre-malignant. Conclusions: This study firstly shows a significant reduction in time to treatment in an integrated skin cancer model over traditional models of health. Secondly it demonstrates GP upskilling over time in the integrated program. Integrating GP and specialist medical practitioners in the treatment of skin cancer offers potential for more efficient, accessible, and affordable care. This cooperative, co-located model may provide a template for the integrating the management of other conditions.
ABSTRACT
WHAT IS THIS SUMMARY ABOUT?: This is a summary of a publication about the FILLY study, which was published in Ophthalmology in 2020. The FILLY study looked at an investigational medicine called pegcetacoplan as a possible treatment for geographic atrophy. Geographic atrophy, also known as GA, is the late stage of an eye disease called dry age-related macular degeneration, also known as dry AMD. In people with GA, lesions form on a part of the back of the eye called the retina. GA lesions are patches of thin retina. Growth of GA lesions ultimately causes blindness, which cannot be reversed. There is currently no approved treatment for GA. Pegcetacoplan, also called APL-2, could be a possible treatment for GA. Pegcetacoplan is an investigational medicine, which means it has not yet been approved. It is currently being studied in clinical studies to see how well it works. WHAT HAPPENED IN THE FILLY STUDY?: The FILLY study included participants with GA and tested how well pegcetacoplan worked compared to a sham injection (an injection that looks like the study treatment but does not have any medicine in it). The study also looked at how safe it was in adults with GA. WHAT WERE THE RESULTS?: The main questions the researchers wanted to answer were: Did pegcetacoplan slow the growth of the study participants' GA lesions? âYes. Overall, the researchers found that pegcetacoplan did slow the growth of the study participants' GA lesions. Did pegcetacoplan change the participants' vision? âNo. Overall, the researchers found that pegcetacoplan did not change the participants' vision. What medical problems happened after the participants received pegcetacoplan? âThe researchers kept track of any serious medical problems that happened during the study, also called serious adverse events. They also kept track of other medical problems that happened, or got worse, only at some point after the participants received the study treatment. These are called treatment emergent adverse events, also known as TEAEs. The serious adverse events and TEAEs that the participants had are described later in this summary. WHAT DO THE RESULTS OF THE STUDY MEAN?: Overall, results from this study showed that participants who received pegcetacoplan had slower growth of GA lesions than participants who received the sham injection. After the participants had stopped receiving pegcetacaoplan, the effect of the treatment seemed to be reduced. Pegcetacoplan did not change how well the participants could see during their vision tests in this trial. ClinicalTrials.gov NCT number: NCT02503332.
Subject(s)
Geographic Atrophy , Macular Degeneration , Animals , Complement C3/therapeutic use , Complement Inactivating Agents/therapeutic use , Female , Geographic Atrophy/complications , Geographic Atrophy/drug therapy , Horses , Humans , Language , Macular Degeneration/complications , Macular Degeneration/drug therapy , Peptides, Cyclic , Visual AcuityABSTRACT
Background: Allergic diseases have become an increasing health issue worldwide, being one of the fastest growing chronic diseases in Australia and other westernized countries. In 2013, allergic diseases were reported to affect 20% of the Australian population. Despite the high prevalence there was no national strategy to address these complex health issues, to enable the health system to manage the increasing number of patients. This project aimed to develop and implement a national strategy to improve allergy management in Australia, with a view of improving the quality of life of people living with or caring for someone with allergic diseases. Methods: The need for a national strategy to improve allergy management was identified. The Australasian Society of Clinical Immunology and Allergy (ASCIA) and Allergy & Anaphylaxis Australia (A&AA) worked together as partners to progress a national strategy using a theoretical model to underpin its development. Unrestricted education grants were sought to fund engagement with stakeholder organizations for both development and implementation summits. Several stages of advocacy were undertaken. Results: The National Allergy Strategy was developed as a partnership between ASCIA and A&AA. The Kotter's Change Management Model provided the basis for the steps undertaken to develop and implement the National Allergy Strategy. Two Allergy Summits, one for development and the other for implementation, were held. Several events were held to advocate for federal government funding. Five individual funding grants were achieved to implement National Allergy Strategy projects addressing the most urgent issues. Conclusion: The development of the National Allergy Strategy, a partnership between ASCIA and A&AA, was important in enabling successful advocacy for funding and implementation of important Australia-wide projects. The partnership has also helped facilitate engagement with key stakeholders to help advocate for funding and provide guidance and expertise in project implementation and resource development. The National Allergy Strategy has been successful in attracting funding to implement projects and develop resources urgently needed. The National Allergy Strategy has also provided a framework and a collaborative approach, for advocacy for further funding and future work to be undertaken.
ABSTRACT
AIMS: The effect of Glucagon-like peptide 1 receptor agonists (GLP1 RA) on diabetic retinopathy (DR) remains controversial. Previous reviews combined data from randomized clinical trials (RCTs) with or without cardiovascular (CV) benefits and did not address confounders, therefore may have generated misleading results. The study aimed to examine the effect of GLP1RA on DR in type 2 diabetes (T2DM) in RCTs with or without CV benefits and distinguish the effect by major confounders. METHODS: We conducted electronic searches of multiple databases and a manual search using references lists. We included 13 RCTs examining the effect of GLP1 RA on health outcomes/adverse events including DR or DR complications in T2DM. We performed a random-effects model meta-analysis. RESULTS: GLP1RA was associated with an elevated risk of rapidly worsening DR in four major RCTs with CV benefits in T2DM (OR 1.23, 95 % CI 1.05-1.44). The association between GLP1 RA and DR was significant in subgroups of RCTs with length over 52 weeks (1.2, 1.00-1.43), using placebo as a comparator (1.22, 1.05-1.42). In subgroups with patients who had T2DM ≥10 years (1.19, 0.99-1.42) or with subjects enrolled from multiple countries (1.2, 0.99-1.46), the association appeared to be evident but did not reach statistical significance. CONCLUSIONS: GLP1 RA including liraglutide, semaglutide, and dulaglutide are associated with an increased risk of rapidly worsening DR in RCTs with CV benefits. Further data from clinical studies with longer follow-up purposefully designed for DR risk assessment, particularly including patients of established DR are warranted.
Subject(s)
Cardiovascular Diseases , Diabetes Mellitus, Type 2 , Diabetic Retinopathy , Cardiovascular Diseases/complications , Cardiovascular Diseases/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Diabetic Retinopathy/complications , Diabetic Retinopathy/epidemiology , Glucagon-Like Peptide-1 Receptor/agonists , Humans , Hypoglycemic Agents/adverse effects , Liraglutide/adverse effectsABSTRACT
OBJECTIVE: To identify a brand, key messages and resources to underpin a public health approach to food allergy prevention. METHODS: A focus group design was used to explore perceptions and opinions of potential brands, infant feeding messages and resources for providing standardised food allergy prevention information. Focus groups were conducted in February 2018 using interview guides and were transcribed verbatim. A content analysis of the transcripts was undertaken using thematic analysis software. The University of Western Australia provided ethics approval: RA/4/20/4280. RESULTS: Seven focus groups with 39 participants were conducted. Four slogans and styles of imagery were considered. 'Nip Allergies in the Bub' was the most favoured slogan and images of babies with food were most favoured. Participant feedback was sought regarding messages and supporting messages were considered important. Participants were consulted about useful resources and a website was identified. CONCLUSIONS: Conducting focus groups assisted the selection of a brand, messages and resources to underpin a public health approach to implementing allergy prevention guidelines. IMPLICATIONS FOR PUBLIC HEALTH: This is the first focus group research undertaken for food allergy prevention. Identification of a meaningful brand, key messages and resources will support a public health approach to implementing allergy prevention guidelines.
Subject(s)
Food Hypersensitivity , Public Health , Allergens , Focus Groups , Food Hypersensitivity/prevention & control , Humans , Infant , Qualitative ResearchABSTRACT
BACKGROUND AIMS: Mesenchymal stromal cells (MSC) derived from Wharton's jelly (WJ) of the umbilical cord are increasingly gaining prominence as substitutes for bone marrow (BM) MSC. While MSC isolated from different tissue sources may share common mesenchymal properties, the difference in their plasticity to individual lineages is ill-defined. Thus the focus of this study was to estimate the neuronal plasticity of WJ MSC to the dopaminergic (DA) cell type in comparison with BM MSC. METHODS: For neuronal differentiation, MSC were exposed to developmentally relevant cues for midbrain DA neurons: sonic hedgehog (SHH) and fibroblast growth factor 8 (FGF8), along with basic fibroblast growth factor (bFGF). RESULTS: Naive MSC from both sources constitutively expressed neuronal markers. Flow cytometry data revealed that the control WJ MSC shared a signature similar to BM MSC for early neuronal markers (nestin, musashi12 and A2B5) and DA-specific markers [tyrosine hydroxylase (TH) and Nuclear Receptor related protein 1 (Nurr1) but differed for mature neuronal proteins [ß-tubulin III and microtubule-associated protein 2 (Map2ab)]. Similar populations of cells in both sources of MSC were positive for the SHH receptors [patched (PTCH) and smoothened (SMO)]. In induced BM and WJ MSC, real-time reverse transcriptase (RT)-polymerase chain reaction (PCR) analysis showed similar levels of DA-related transcription factors Nurr1 and Engrailed (En) 1. Immunocytochemical and flow cytometry analysis showed an increase in mature neuronal marker Map2ab. Kv4.2, a K(+) channel marker, was observed only in the induced MSC. Induced MSC also expressed several DA-specific markers, TH, dopamine and cyclic AMP regulated phosphoprotein (DARPP) 32, paired-like homeodomain transcription factor (PitX) 3 and vesicular monoamine transporter (VMAT) 2, in comparable levels between the two sources. The efficiency (c. 65%) of transdifferentiation of WJ MSC to TH-positive cells was similar to that of induced BM MSC. Constitutive and inducible release of dopamine was found to be similar between induced BM and WJ MSC, as measured by dopamine enzyme-linked immunosorbent assay (ELISA). Interestingly, an adenosine triphosphate (ATP)-stimulated change in intracellular Ca(2+) was observed in both control and induced MSC, but only the induced MSC was capable of releasing dopamine. CONCLUSIONS: Our data demonstrate that MSC from the two different sources respond similarly to inductive cues to differentiate terminally to a DA cell type, and the neuronal plasticity of human WJ MSC is comparable with that of BM MSC.
Subject(s)
Dopaminergic Neurons/metabolism , Induced Pluripotent Stem Cells/metabolism , Mesenchymal Stem Cells/metabolism , Neuronal Plasticity , Stem Cell Niche , Biomarkers/metabolism , Bone Marrow Cells/cytology , Cell Differentiation , Cells, Cultured , Dopamine/metabolism , Dopaminergic Neurons/cytology , Fibroblast Growth Factor 2 , Fibroblast Growth Factor 8 , Hedgehog Proteins , Humans , Induced Pluripotent Stem Cells/cytology , Mesenchymal Stem Cells/cytology , Wharton Jelly/cytologyABSTRACT
Diabetic retinopathy, a leading cause of vision loss, was considered as a solely vascular disorder but some recent studies suggest that retinal neurons may be affected much before the appearance of vascular lesions. However, the cellular processes involved in diabetes-induced degeneration of retinal neurons are poorly understood. Calcium (Ca2+) signaling plays a key role in normal functioning of neurons, and its dysregulation may lead to degeneration of neurons. Mitochondria are crucial components involved in the regulation of intracellular Ca2+ signaling. In this study, we have investigated the effects of diabetes on Ca2+ signaling in retinal neurons. The study was performed in rat retinal neurons cultured in high glucose condition (HGC) for 7-14 days and in acutely prepared retinal slices isolated from diabetic rats. When Ca2+ influx was induced by depolarization of neurons with 60 mM KCl in HGC neurons, the Ca2+ rise was sustained for a much longer duration as compared to controls, suggesting perturbation of Ca2+ buffering. In addition, HGC neurons also showed notably enhanced Ca2+ load in the mitochondria, which was accompanied by depolarization of mitochondrial membrane and enhanced reactive oxygen species formation. Similar results were obtained in acutely prepared retinal slices from control and diabetic rats. The depolarization of mitochondrial membrane was more pronounced in the neurons of the inner nuclear layer of diabetic rats. The physiological changes in mitochondria were observed as early as 9 weeks post diabetes induction. Thus, we report here that the intracellular Ca2+ signaling and mitochondrial function in retinal neurons are altered at an early stage of diabetes.