ABSTRACT
Background: The concept of the gut-retinal axis proposed by previous scholars primarily focused on the relationship between intestinal microbiota and retinal diseases, and few further expanded the relationship between intestinal diseases and retinal diseases. To further substantiate the concept of the gut-retinal axis, we analyzed inflammatory bowel disease (IBD) and diabetic retinopathy (DR) using Mendelian randomization (MR), and use mediation analysis to further explore the potential substances that influence this causal relationship. Methods: The genome-wide association study's (GWAS) summary statistics for genetic variations were utilized in a Mendelian randomization (MR) investigation. GWAS data on IBD (including ulcerative colitis (UC), Crohn's disease (CD), and IBD) for non-Finnish Europeans (NFE) were sourced from published articles. In contrast, data on DR (including DR and diabetic maculopathy (DMP)) were obtained from FinnGen R9. The causal relationship has been investigated using inverse variance weighted (IVW), MR-Egger, and weighted median and sensitivity analysis was applied to verify the stability of the results. In addition, we applied mediation analysis to investigate whether circulating inflammatory proteins and plasma lipids played a mediating role, and calculated its effect ratio. Results: The causal relationship between IBD and DR was discovered by employing the inverse variance weighted (IVW) method and weighted median method. In forward MR, UC was significantly associated with lower risk of DR (IVW: OR=0.874; 95%CI= 0.835-0.916; P value= 1.28E-08) (Weighted median: OR=0.893; 95%CI= 0.837-0.954; P value= 7.40E-04). In reverse MR, it was shown that DR (IVW: OR=0.870; 95%CI= 0.828-0.914; P value= 2.79E-08)(Weighted median: OR=0.857; 95%CI= 0.801-0.916; P value= 6.40E-06) and DMP (IVW: OR=0.900; 95%CI= 0.865-0.937; P value= 3.34E-07)(Weighted median: OR=0.882; 95%CI= 0.841-0.924; P value= 1.82E-07) could reduce the risk of CD. What's more, DR is associated with a lower risk of IBD according to genetic prediction (IVW: OR=0.922; 95%CI= 0.873-0.972; P value= 0.002) (Weighted median: OR=0.924; 95%CI= 0.861-0.992; P value= 0.029). Fibroblast growth factor 21 (FGF21), phosphatidylcholine (PC), and triacylglycerol (TG) serve as mediators in these relationships. Conclusions: Our research offers novel insights and sources for investigating the gut-retina axis in the genetic relationship between IBD and DR. We discover four mediators and more about the association between the intestine and retinal disorders and provide more evidence for the gut-retinal axis theory.
Subject(s)
Diabetic Retinopathy , Genome-Wide Association Study , Inflammatory Bowel Diseases , Mendelian Randomization Analysis , Humans , Diabetic Retinopathy/genetics , Diabetic Retinopathy/epidemiology , Inflammatory Bowel Diseases/genetics , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/complications , Mediation Analysis , Retina/metabolism , Retina/pathology , Polymorphism, Single Nucleotide , Gastrointestinal MicrobiomeABSTRACT
Peroxisomal acyl-CoA oxidase 1 (ACOX1), is a peroxisomal enzyme that catalyzes ß-oxidation of very-long-chain fatty acids (VLCFA). The gain-of-function variant p.Asn237Ser in ACOX1 has been shown to cause Mitchell syndrome (MITCH), a neurodegenerative disorder characterized by episodic demyelination, hearing loss, and polyneuropathy, through the overproduction of hydrogen peroxide. Only eight cases of MITCH have been reported. While all these patients experienced cutaneous abnormalities, detailed skin features and potential treatment have not been documented. Herein, we report two MITCH patients who harbored a de novo heterozygous variant p.Asn237Ser in ACOX1 and experienced progressive ichthyosiform erythroderma. Skin histopathology revealed hyperkeratosis and parakeratosis with focal hypogranulosis as well as dyskeratotic keratinocytes. Lipid accumulation in the epidermis was observed using Oil Red O staining. Both patients exhibited a remarkable response to treatment with the topical antioxidant N-acetylcysteine (NAC), with Patient 1 achieving complete recovery after 3 months of consistent treatment. This study provides the first comprehensive description of the clinicopathological characteristics and effective treatment of skin lesions in MITCH patients. The successful treatment with topical NAC suggests excessive reactive oxygen species might play a significant role in the pathogenesis of skin lesions in MITCH.
ABSTRACT
BACKGROUND: Treg plays a pivotal role in the suppression of Th2 cell and the maintenance of immune homeostasis. The precise molecular mechanism underlying the disruption of Treg suppression of Th2 cell and the promotion of Th2 type inflammation in allergic diseases remains elusive. OBJECTIVE: This study aims to investigate the molecular mechanism underlying quantitative and functional changes of Treg in AD. METHODS: The molecular mechanism was investigated using flow cytometry, mRNA sequencing, co-culture experiments, co-immunoprecipitation, chromatin immunoprecipitation, and bisulfite sequencing in vitro or in AD mice model and patients with AD. RESULTS: Increased proportion of Treg was detected in mild and moderate AD. Conversely, characteristic decrease in both the number and CTLA-4 expression of Treg was relevant to serum IL-4 level in severe AD patients, which was verified under a high concentration of IL-4 treatment in vitro. The underlying mechanism is that IL-4/pSTAT6 pathway recruits DNMT1 and HDAC2 to inhibit transcriptional regulation of Foxp3 and CTLA-4 loci. High level of IL-4 impaired the suppression of Treg against Th2 cell differentiation mediated by CTLA-4, and blockade of IL-4Rα signaling in Treg restored Treg number and suppression of Th2 cell in AD model mice and patients with AD. CONCLUSION: The number of Treg is relevant to stratification of severity and serum IL-4 level in patients with AD. Abnormal high level of IL-4 epigenetically triggers a decrease in both the number and CTLA-4 expression of Treg. The reduced expression of CTLA-4 on Treg induced by IL-4 impairs suppression of Th2 cell differentiation.
Subject(s)
CTLA-4 Antigen , Dermatitis, Atopic , Disease Models, Animal , Interleukin-4 , STAT6 Transcription Factor , T-Lymphocytes, Regulatory , Th2 Cells , Animals , CTLA-4 Antigen/metabolism , CTLA-4 Antigen/genetics , Dermatitis, Atopic/immunology , Dermatitis, Atopic/blood , T-Lymphocytes, Regulatory/immunology , T-Lymphocytes, Regulatory/metabolism , Interleukin-4/metabolism , Interleukin-4/blood , Th2 Cells/immunology , Humans , Mice , Female , Male , STAT6 Transcription Factor/metabolism , STAT6 Transcription Factor/genetics , Adult , Signal Transduction/immunology , Severity of Illness Index , Skin/immunology , Skin/pathology , Forkhead Transcription Factors/metabolism , Forkhead Transcription Factors/genetics , Mice, Inbred BALB C , Cell Differentiation/immunologyABSTRACT
Allergen-specific immunotherapy (AIT) has shown beneficial effects against atopic dermatitis (AD); however, the mechanisms and parameters underlying the efficacy of AIT remain unclear. Here, we report that the community structure and function of the oral and gut microbiota are changed in patients with AD undergoing AIT. Transplantation of fecal microbiota from patients who respond well to AIT improves AD-like dermatitis in mice. The abundance of Brevundimonas vesicularis in the gut of AD patients has been found to be positively correlated with disease severity and is decreased following AIT. Furthermore, we find that B. vesicularis from the oral cavity might ectopically colonize the gut of AD patients. In AD model mice, meanwhile, B. vesicularis promotes the skewing of the Treg/Th17 balance toward Th17 polarization and attenuates the efficacy of ovalbumin-specific immunotherapy. Our findings provide potential strategies for the optimization of AIT for AD via the modulation of the gut microbiota.
Subject(s)
Dermatitis, Atopic , Humans , Mice , Animals , Dermatitis, Atopic/therapy , Desensitization, Immunologic , Allergens , IntestinesABSTRACT
Chronic ocular graft-versus-host disease (oGVHD) is a common complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and can lead to vision loss if not diagnosed and treated promptly. Currently, no approved drugs exist for oGVHD treatment. However, umbilical cord-derived mesenchymal stem cells (UCMSCs) have known immunoregulatory properties and have been employed in clinical trials for immune-mediated diseases. To address oGVHD, the application of UCMSCs to the ocular surface is a logical approach. Intravenous administration of UCMSCs poses risks, necessitating topical and local delivery. Retaining UCMSCs on the ocular surface remains a challenge. To overcome this, we invented mesenchymal stem cell-coating high oxygen-permeable hydrogel lenses combining UCMSCs and machinery to enable the long-term retention of UCMSCs on the ocular surface. Animal model experiments demonstrated that these lenses effectively retained UCMSCs, providing therapeutic benefits by decreasing corneal inflammation and damage, and inhibiting immune rejection and response, all crucial aspects in oGVHD treatment.
Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Mesenchymal Stem Cells , Animals , Eye , Graft vs Host Disease/therapy , Graft vs Host Disease/drug therapy , Hematopoietic Stem Cell Transplantation/adverse effects , Models, AnimalABSTRACT
OBJECTIVE: Chemokine receptor 7 (CCR7) has been considered a critical biomarker in inflammation and the immune response; however, little is known about CCR7 in pterygia. This study aimed to investigate whether CCR7 participates in the pathogenesis of primary pterygia and how CCR7 affects the progression of pterygia. METHODS: This was an experimental study. Slip-lamp photographs of 85 pterygium patients were used to measure the width, extent, and area of pterygia with computer software. Pterygium blood vessels and general ocular redness were quantitatively analyzed with a specific algorithm. The expression of CCR7 and its ligands C-C motif ligand 19 (CCL19) and C-C motif ligand 21 (CCL21) in control conjunctivae and excised pterygia collected during surgery were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR) and immunofluorescence staining. The phenotype of CCR7-expressing cells was identified by costaining for major histocompatibility complex II (MHC II), CD11b or CD11c. RESULTS: The CCR7 level was significantly increased by 9.6-fold in pterygia compared with control conjunctivae (p = 0.008). The higher the expression of CCR7 was, the more blood vessels appeared in pterygia (r = 0.437, p = 0.002) and the more general ocular redness was (r = 0.51, p < 0.001) in pterygium patients. CCR7 was significantly associated with pterygium extent (r = 0.286, p = 0.048). In addition, we found that CCR7 colocalized with CD11b, CD11c or MHC II in dendritic cells, and immunofluorescence staining showed that CCR7-CCL21 is a potential chemokine axis in pterygium. CONCLUSIONS: This work verified that CCR7 impacts the extent of primary pterygia invading the cornea and inflammation at the ocular surface, which may provide a possibility for a further in-depth understanding of the immunological mechanism in pterygia.
Subject(s)
Pterygium , Humans , Pterygium/surgery , Pterygium/pathology , Receptors, CCR7/genetics , Ligands , Chemokine CCL21/genetics , InflammationABSTRACT
Transglutaminase 3 (TGM3) protects against skin inflammation in psoriasis, but the precise role and mechanism of action of TGM3 in the pathogenesis of psoriasis remain unclear. In this study, we show that TGM3 expression was increased in the skin lesions of patients with psoriasis and a mouse model of imiquimod-induced psoriatic dermatitis. TGM3 overexpression decreased the production of proinflammatory factors in cultured primary keratinocytes stimulated with psoriasis-related cytokines. TGM3 inhibited the phosphorylation of signal transducer and activator of transcription 3 and the recruitment of ten-eleven translocation 3 to the p65 gene promoter, resulting in decreased promoter demethylation and subsequent suppression of proinflammatory cytokine/chemokine production. TGM3-induced inhibition of phosphorylated p65 might also decrease ten-eleven translocation 3 expression. Moreover, topical application of Tgm3-specific small interfering RNA or the pan-transglutaminase inhibitor cysteamine exacerbated skin inflammation in mice with imiquimod-induced psoriatic dermatitis. Our study revealed an epigenetic pathway mediated by the interaction between TGM3 and ten-eleven translocation 3 in keratinocytes for regulation of skin inflammation in psoriasis, providing a potential target for psoriasis treatment.
Subject(s)
Dermatitis , Psoriasis , Transglutaminases , Animals , Mice , Cysteamine/adverse effects , Cytokines/metabolism , Dermatitis/pathology , Disease Models, Animal , Imiquimod , Inflammation/pathology , Keratinocytes/metabolism , Mice, Inbred BALB C , NF-kappa B/metabolism , Psoriasis/pathology , RNA, Small Interfering/metabolism , Skin/pathology , STAT3 Transcription Factor/metabolism , Transglutaminases/genetics , Transglutaminases/metabolismABSTRACT
Atopic dermatitis (AD) is a recurrent chronic inflammatory skin disease affecting up to 30% of the children population, and immuno-regulatory therapy that could modify the course of disease is urgently needed. Probiotics have demonstrated therapeutic effects on AD and could potentially regulate the disease process. However, the efficacy of probiotics for AD is inconsistent among different studies, which is mainly due to the elusive mechanism and different species and (or) strains used. In this study, we designed a mixture of five strains of probiotics (named IW5) and analyzed the effect and mechanism of IW5 on calcipotriol (MC903)-induced AD-like dermatitis. We found that IW5 significantly alleviated skin inflammation of the MC903-induced AD in mice. Administration with IW5 induced increased production of regulatory T cells and regulatory dendritic cells (DCregs) in the mesenteric lymph nodes. We also found that the diversity of the gut microbiota in the mice with MC903-induced dermatitis was increased after IW5 administration, and the level of butyrate in the gut was elevated. In cell culture, butyrate induced the production of DCregs. Our study revealed the therapeutic effects of a newly designed probiotics mixture and uncovered a possible mechanism, providing a foundation for future clinical studies.
Subject(s)
Calcitriol/analogs & derivatives , Dendritic Cells/immunology , Dermatitis, Atopic/etiology , Dermatitis, Atopic/therapy , Immunomodulation , Probiotics/administration & dosage , Animals , Biomarkers , Calcitriol/adverse effects , Cytokines/metabolism , Dendritic Cells/metabolism , Dermatitis, Atopic/diagnosis , Dermatologic Agents/adverse effects , Disease Management , Disease Models, Animal , Disease Susceptibility , Female , Immunohistochemistry , Inflammation Mediators/metabolism , MiceABSTRACT
Background: Immunologic graft rejection is the main complication of corneal transplants. This study aimed to investigate the effect of melatonin (MT) on the rejection of corneal transplantation. Methods: Corneal allografts were performed by grafting corneas from BALB/C mice to C57BL/6 hosts. MT (50 mg/kg) was intraperitoneally injected into the hosts every day from the day of transplantation. The survival of grafts was observed by slit lamp biomicroscopy, and inflammatory cell infiltration was detected by hematoxylin and eosin staining and immunohistochemistry. The balance of Teff and Treg immune cells in draining lymph nodes (DLNs) was detected by flow cytometry. The levels of cytokines related to the grafts and DLNs were detected using real-time fluorescence quantitative PCR. Additionally, we used the mouse macrophage line RAW264.7 to study the effect of MT on the activation of NLRP3 inflammatory body. Results: MT treatment improved the graft survival rate, reduced inflammatory cell infiltration in the graft, decreased the percentage of Th1/Th17 cells in the DLNs, and increased the percentage of Treg cells. Melatonin inhibited the activation of the NLRP3 inflammasome, thereby reducing the expression of IL-1ß and other related proinflammatory cytokines such as MCP-1, MIP-1, NLRP3, ASC, TNF-a and VEGF-A (all p < 0.05). Conclusion: Our study demonstrates that MT promotes the survival of mouse corneal grafts by inhibiting NLRP3-mediated immune regulation, reducing immune cell activation and cell migration, and inhibiting the production of inflammatory-related cytokines. Treatment with MT might provide a potential clinical therapeutic target for corneal transplantation.
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BACKGROUND: The efficacy of allergen-specific immunotherapy (AIT) is mainly depended on the tolerogenic immune responses elicited. Properly conjugated nano-vaccine has the advantages of both specific targeting and continuous and on-demand release of allergen. OBJECTIVES: The aim of this study is to investigate the effects of a dendritic cells (DCs)-targeting nano-vaccine for AIT. METHODS: The nano-vaccine was produced by coupling polylactic-co-glycolic acid (PLGA)-encapsulated ovalbumin (OVA) with mannan. Allergen capture, human monocytes-derived DCs (hMoDCs) activation, and T cells responses were assessed by flow cytometry, confocal microscopy, quantitative real-time PCR, ELISA, and Cytometric Bead Array. Balb/c mice were immunized with the nano-vaccines, and the immune responses were analyzed. RESULTS: OVA-PLGA nanoparticle (NP) displayed favorable safety profile. OVA-mannan-PLGA NP was captured more efficiently by hMoDCs than OVA-PLGA NP, which was mediated mainly through DC-specific intercellular adhesion molecule 3-grabbing nonintegrin. A tolerogenic phenotype of hMoDCs was induced by OVA-mannan-PLGA NP, but not OVA-PLGA NP, and increased number of regulatory T (Treg) cells was generated subsequently in in vitro coculture. Immunization of Balb/c mice with OVA-mannan-PLGA NP resulted in lower serum level of OVA-specific immunoglobulins and less production of pro-inflammatory cytokines in splenocytes culture than the mice immunized with OVA-PLAG NP, PLGA NP, or OVA, while the number of splenic Treg cells was higher in OVA-mannan-PLGA group than in other groups. Moreover, preimmunization with OVA-mannan-PLGA NP significantly inhibited the Th2 immune response induced by OVA sensitization. CONCLUSIONS: The biocompatible PLGA-encapsulated OVA coupling with mannan has augmented ability for tolerance induction and could be developed as a novel vaccine for AIT.
Subject(s)
Allergens/immunology , Dendritic Cells/immunology , Mannans/immunology , Nanoparticles , Polylactic Acid-Polyglycolic Acid Copolymer , T-Lymphocytes, Regulatory/immunology , Vaccines/immunology , Allergens/administration & dosage , Animals , Desensitization, Immunologic , Hypersensitivity/immunology , Hypersensitivity/therapy , Immune Tolerance , Immunization , Mice , T-Lymphocytes, Regulatory/metabolismABSTRACT
BACKGROUND: Localized scleroderma (LoS) is an autoimmune connective tissue disorder leading to serious long-term aesthetic impairment on patients. Objective evaluation methods are badly needed to facilitate the evaluation of the surgical treatment on individual patients and clinical studies. OBJECTIVE: To develop and assess the reliability and validity of Peking Union Medical College LoS facial aesthetic index (PUMC LoSFAI). METHODS: Twelve experts devoted their time and resources in the development and validation. LoS patients in the stable phase were recruited. Reliability and validity was then assessed. LoS patients were evaluated by two plastic surgeons using PUMC LoSFAI and LoS skin damage index (LoSDI). The PUMC LoSFAI comprises 4 domains for the local assessment (surface area of lesion, dyspigmentation, skin thickness and soft tissue atrophy) and 3 domains for the overall assessment (facial symmetry, proportion and profile) to describe LoS facial aesthetic impairment. Face-Q was completed by patients at each visit. RESULTS: Thirty-two LoS patients had 96 visits, during which 138 lesions were assessed. PUMC LoSFAI and 7 domains demonstrated substantial to excellent inter- and intra-rater reliability (ICC 0.995, κw 0.72-0.91, r 0.85-0.99, respectively). Seven domains considered to be important to extremely important variables (mean rank 3.2-3.8) had high I-CVI (> 0.78) and S-CVI (0.93). PUMC LoSFAI correlated excellently with LoSDI (r = 0.933, P < 0.001), and correlated fairly with Face-Q (r = - 0.399, P = 0.001). CONCLUSIONS: PUMC LoSFAI was developed and evaluated to play as a tool of aesthetic impairment assessment for LoS patients, which may facilitate the evaluation of the treatment on individual patients and clinical studies. PUMC LoSFAI demonstrated high reliability and validity, and further study in larger patient samples is needed to confirm these preliminary findings. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .
Subject(s)
Scleroderma, Localized , Esthetics , Face/surgery , Humans , Pilot Projects , Reproducibility of Results , Scleroderma, Localized/diagnosisABSTRACT
PURPOSE: To compare the quality of life of senior first-year students with normal vision and myopia, and to explore the risk factors related to quality of life in students with myopia. METHODS: In this study, 1103 senior first-year students were enrolled in ten high schools. These students were divided according to the diopter degree, with 916 myopia students and 187 normal vision students. Visual function indexes, such as naked eye vision, were measured and recorded, and social demographic indexes and the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) was used. The differences in quality of life between the two groups were compared. Multiple linear regression analysis was used to explore the possible risk factors for quality of life in myopia students. RESULTS: In the NEI VFQ-25, the total quality of life scores of myopia students (77.06 ± 15.66) were lower than those of normal vision students (85.49 ± 12.37). The difference was statistically significant (p = 0.007). In the correlation analysis, the total scores of quality of life in myopia students were positively correlated with wearing glasses (p = 0.049), and were negatively correlated with study time (p = 0.029). Multiple linear regression analysis showed that study time, wearing glasses and age were risk factors affecting quality of life in myopia students. CONCLUSION: Our results show that senior first-year myopia students have lower quality of life scores than students with normal vision. Study time, wearing glasses and age are risk factors for quality of life in senior first-year myopia students.
Subject(s)
Myopia , Quality of Life , China/epidemiology , Humans , Students , Surveys and Questionnaires , Visual AcuityABSTRACT
Purpose: To explore whether CCR7-CCL19 and CCR7-CCL21 affect the pathophysiology of the dry eye disease (DED) immuno-inflammatory response using a murine model.Methods: The mRNA expression levels of CCR7, CCL19, CCL21 and VEGF-C within corneas in DED mice were detected by real-time PCR. Immunofluorescence and flow cytometric analyses were performed to mark dendritic cells (DCs) and detect correlations among CCR7, CCL19, CCL21 and lymphatic vessels.Results: CCR7, CCL19 and CCL21 expression was dramatically increased during the development of DED. In addition, CCR7, which is expressed in DCs, was located inside and around lymphatic vessels and colocalized with CCL19 or CCL21. Positive correlations were observed between CCR7 and CCL19 (P < .01, r = 0.862), CCL21 (P < .01, r = 0.759), and VEGF-C (P < .05, r = 0.607).Conclusions: Our study revealed that both the CCR7-CCL19 and CCR7-CCL21 chemokine axis are important for DC migration to lymphatic vessels, but CCL19 may have a greater effect on DED than CCL21.
Subject(s)
Chemokine CCL19/genetics , Chemokine CCL21/genetics , Dry Eye Syndromes/genetics , Gene Expression Regulation , Immunity, Cellular , Inflammation/genetics , Receptors, CCR7/genetics , Animals , Cell Movement , Chemokine CCL19/biosynthesis , Chemokine CCL21/biosynthesis , Disease Models, Animal , Dry Eye Syndromes/immunology , Dry Eye Syndromes/metabolism , Female , Flow Cytometry , Inflammation/immunology , Inflammation/metabolism , Mice , Mice, Inbred C57BL , RNA/genetics , Receptors, CCR7/biosynthesis , Tears/metabolismABSTRACT
Cataracts have been identified as a main cause of global visual impairment and blindness; in addition, diabetic and aging cataracts are the most common types. The aim of this project was to develop a suitable animal model and investigate the key points of the mechanisms by which intraperitoneal (i.p.) injection of D-galactose forms cataracts. We optimized a method to investigate the safest and effective method and dosage; rats in Group H were treated with 50% D-galactose 15 g/kg i.p. twice daily based on the 11 different treatment methods. The simple oral group showed considerable differences in the same observed time, while the i.p. group showed relatively uniform cataracts due to intake of the same dose of D-galactose. The data suggest that i.p. injection of galactose is a relatively more successful and stable cataract-inducing method with a low mortality rate. Based on this model, we found that Na+/K+ ratios had important relevance for galactose cataract formation, and we used scanning electron microscopy (SEM), inductively coupled plasma mass spectrometry (ICP-MS), enzyme-linked immunosorbent assay (ELISA) and immunofluorescence examinations to test and verify this.
Subject(s)
Cataract , Lens, Crystalline , Animals , Cataract/chemically induced , Disease Models, Animal , Galactose , Rats , SodiumABSTRACT
BACKGROUND: Skin commensal bacteria play important roles in skin homeostasis. Langerhans cells (LCs) are epidermis-resident dendritic cells that sense environmental stimuli and are critical in the induction of immune tolerance to allergen and bacterial skin flora. However, response of LCs to the metabolites of the skin microbiota is not clear. OBJECTIVE: To explore the effects of the skin microbial metabolites on LCs activation. METHODS: LCs derived from CD34+ hematopoietic stem cells in the cord blood were treated with a microbial metabolite of tryptophan, indole-3-aldehyde (IAId). Activation aryl hydrocarbon receptor (AhR) signaling, production of IL-10, and expression of receptor activator of NF-κB (RANK) / receptor activator of NF-κB ligand (RANKL) in LCs or keratinocytes were analyzed using quantitative PCR, western blotting and flow cytometry. LCs maturation induced by IAId and CD4+ T cell response induced by IAId-conditioned LCs were also investigated. RESULTS: IAId induced the production of indoleamine 2,3-dioxygenase (IDO) and IL-10 in LCs through the activation of AhR. IAId promoted the expression of RANK and RANKL on LCs and keratinocytes in an AhR-dependent manner respectively, which might result in activation of NF-κB signaling and production of IL-10. Moreover, a mature phenotype of LCs was induced by IAId, and IAId-activated LCs inhibited CD4+ T cell proliferation and induced IL-10 secretion. CONCLUSIONS: Our study revealed a negatively regulatory function of a tryptophan metabolite on LCs through the activation of AhR, and the microbial metabolites could be utilized in future treatment for inflammatory skin diseases.
Subject(s)
Basic Helix-Loop-Helix Transcription Factors/metabolism , Dermatitis/immunology , Indoles/metabolism , Langerhans Cells/immunology , Microbiota/immunology , Receptors, Aryl Hydrocarbon/metabolism , Skin/immunology , Cells, Cultured , Dermatitis/microbiology , Dermatitis/pathology , Female , Fetal Blood/cytology , Healthy Volunteers , Hematopoietic Stem Cells , Humans , Indoleamine-Pyrrole 2,3,-Dioxygenase/metabolism , Interleukin-10/metabolism , Keratinocytes , Langerhans Cells/metabolism , Primary Cell Culture , Signal Transduction/immunology , Skin/microbiology , Skin/pathology , Tryptophan/metabolismABSTRACT
A challenge of chronic diseases that remains to be solved is how to liberate patients and medical resources from the burdens of long-term monitoring and periodic visits. Precise management based on artificial intelligence (AI) holds great promise; however, a clinical application that fully integrates prediction and telehealth computing has not been achieved, and further efforts are required to validate its real-world benefits. Taking congenital cataract as a representative, we used Bayesian and deep-learning algorithms to create CC-Guardian, an AI agent that incorporates individualized prediction and scheduling, and intelligent telehealth follow-up computing. Our agent exhibits high sensitivity and specificity in both internal and multi-resource validation. We integrate our agent with a web-based smartphone app and prototype a prediction-telehealth cloud platform to support our intelligent follow-up system. We then conduct a retrospective self-controlled test validating that our system not only accurately detects and addresses complications at earlier stages, but also reduces the socioeconomic burdens compared to conventional methods. This study represents a pioneering step in applying AI to achieve real medical benefits and demonstrates a novel strategy for the effective management of chronic diseases.
ABSTRACT
PURPOSE: The present study highlighted the value of anterior segment optical coherence tomography (AS-OCT) for different types of corneal foreign bodies in humans. METHODS: This study was a prospective observational study. The patients included were divided into two groups. If the patients were directly diagnosed based on eye injury history and slit-lamp examination, then they were assigned to Group A. Otherwise, the patients were assigned to Group B. We compared and described the characteristics of the corneal foreign body in both groups using AS-OCT. RESULTS: From October 2017 to January 2020, 36 eyes of 36 patients (9 females and 27 males) with a mean age of 37.8 ± 11.7 years were included in the study. Patients in Group A were the majority and accounted for 72.2% (26/36). High signals on AS-OCT images were the main constituent and accounted for 92.3% (24/26) in Group A and 70.0% (7/10) in Group B. Most of the patients in Group A, 96.2% (25/26), had clear boundaries. A blurred boundary was observed in 70.0% (7/10) of the patients in Group B. The foreign bodies on AS-OCT images had key characteristics of a high signal followed by a central zone shadowing effect and a low signal followed by a marginal zone shadowing effect. Further, all of the lesions could be directly located in Group B, and 92.3% (24/26) of the patients in Group A did not have directly located lesions. Six representative cases are described in detail. CONCLUSIONS: AS-OCT is a valuable tool in the diagnosis and management of corneal foreign bodies, especially for unusual corneal foreign body.
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BACKGROUND: Deep learning has had a large effect on medical fields, including ophthalmology. The goal of this study was to quantitatively analyze the functional filtering bleb size with Mask R-CNN. METHODS: This observational study employed eighty-three images of post-trabeculectomy functional filtering blebs. The images were divided into training and test groups and scored according to the Indiana Bleb Appearance Grading Scale (IBAGS) system. Then, 70 images from the training group were used to train an automatic detection system based on Mask R-CNN and perform a quantitative analysis of the function bleb size. Thirteen images from the test group were used to evaluate the model. During the training process, left and right image-flipping algorithms were used for data augmentation. Finally, the correlation between the functional filtering bleb area and the intraocular pressure (IOP) was analyzed. RESULTS: The 83 functional filtering blebs have similar morphological features. According to IBAGS, the functional filtering blebs have a high incidence of E1/E2, H1/H2, and V0/V1. Our Mask R-CNN-based model using the selected parameters achieves good results on the training group after a 200-epoch training process. All the Intersection over Union (IoU) scores exceeded 93% on the test group. The Spearman correlation coefficient between the area of functional filtering blebs and the IOP value was -0.757 (P<0.05). CONCLUSIONS: Deep learning is a powerful tool for quantitatively analyzing the functional filtering bleb size. This technique is suitable for use in monitoring post-trabeculectomy filtering blebs in the future.
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PURPOSE: The aim of this study was to investigate the differences in anxiety and depression between adolescents with myopia and those with normal vision and to examine the relationship between the level of anxiety and depression and the degree of myopia. METHODS: A total of 1,103 first-year high school students aged 14-17 years were included in the study. The study group comprised 916 persons with myopia, while the control group comprised 187 persons without refractive error. Volunteers underwent routine eye examinations and completed a set of questionnaires about anxiety and depression. Then, the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores were compared between groups, and the relationships between anxiety and the degree of myopia and between depression and the degree of myopia were analyzed. RESULTS: There was a significant difference in anxiety rate between the students with normal vision and those with myopia. The SAS scores among students with mild, moderate, and severe myopia were also significantly different. However, compared with the students with normal vision, the rate of depression was not significantly increased in the students with myopia, except in cases of severe myopia. Additionally, the SAS scores correlated closely with the diopters of the participants' glasses (r = 0.43, p = .045), while the relationship between SDS scores and the diopters of glasses was not significant (r = 0.19, p = .325). CONCLUSION: There was a correlation between myopia and mental health in adolescent students, especially in terms of anxiety.