Seeing the unseen: a trifoliate (MYB117) mutant allele fortifies folate and carotenoids in tomato fruits.

In tomato (Solanum lycopersicum), mutations in the gene encoding the R2R3-MYB117 transcription factor elicit trifoliate leaves and initiate the formation of axillary meristems; however, their effects on fruit ripening remain unexplored. The fruits of a new trifoliate (tf) mutant (tf-5) were firmer and had higher °Brix values and higher folate and carotenoid contents. The transcriptome, proteome, and metabolome profiling of tf-5 reflected a broad-spectrum change in cellular homeostasis. The tf-5 allele enhanced the fruit firmness by suppressing cell wall softening-related proteins. tf-5 fruit displayed a substantial increase in amino acids, particularly γ-aminobutyric acid, with a parallel reduction in aminoacyl-tRNA synthases. The increased lipoxygenase protein and transcript levels seemingly elevated jasmonic acid levels. In addition, increased abscisic acid hydrolase transcript levels coupled with reduced precursor supply lowered abscisic acid levels. The upregulation of carotenoids was mediated by modulation of methylerythreitol and plastoquinone pathways and increased the levels of carotenoid isomerization proteins. The upregulation of folate in tf-5 was connoted by the increase in the precursor p-aminobenzoic acid and transcript levels of several folate biosynthesis genes. The reduction in pterin-6-carboxylate levels and γ-glutamyl hydrolase activity indicated that reduced folate degradation in tf-5 increased folate levels. Our study delineates that in addition to leaf development, MYB117 also influences fruit metabolism. The tf-5 allele can be used to increase γ-aminobutyric acid, carotenoid, and folate levels in tomato.

Evaluation of Interleukin 6(Il-6), Tumor Necrosis Factor Alpha (Tnf-α) and Paraoxonase 1(Pon 1) in Obese and Non-Obese Metabolic Syndrome.

Metabolic syndrome is a multiplex of the risk factor for the development of type 2 diabetes and cardiovascular disease and it reflects the clustering of multiple risk factors resulting from obesity and insulin resistance. Despite its predominance in obese individuals, MS does occur in non-obese individuals. Many individuals characterized as normal weight as per their body mass index (BMI), have increased visceral adiposity thereby leading to an unfavorable inflammatory cytokine profile and altered PON levels. There are limited studies from India concerning inflammatory cytokines in obesity and MS in general and non-obese patients with MS in particular. MATERIAL: Study Design: An observational cross sectional comparative study was conducted which included 65 patients in each Obese and Non-obese Metabolic Syndrome group. The difference in biomarker profile between the two groups was studied. MATERIAL AND METHODS: Patients were subjected to detailed history, physical and anthropometric examination. NCEP-ATP III criteria were used for the diagnosis of Metabolic Syndrome. Patients were considered obese if BMI ≥ 25kg/m2. Normal weight individuals with MS were further subdivided into two groups based on the presence of abdominal obesity (WC cut off 90 cm for men and 80 cm for women). Blood samples were collected for analysis for FBS, Lipid Profile, and HbA1c. Blood samples for biomarker analysis were collected in clotted sample tubes followed by deep freezing and analyzed using ELISA kits. The results were interpreted according to manufacturer guidelines. OBSERVATION: There were no significant differences in IL-6, TNF-α, and PON 1 profiles among Obese and Non-obese Metabolic Syndrome. Moreover significant (p < 0.05) positive correlation was seen in TNF-α levels among patients with abdominal obesity than without abdominal obesity among the Non-obese group. CONCLUSION: TNF-α levels were significantly higher among patients with abdominal obesity than without abdominal obesity among the Non-obese group. There was no significant difference in IL-6, TNF-alpha, and PON 1 among Obese and Non-obese MS. This finding indicates that apart from adipose tissue, other factors are also responsible for the development of MS and its associated proinflammatory profile. There could be a significant contribution of genetic and epigenetic factors which need to be further explored.

A randomized open label parallel group pilot study to evaluate efficacy of Ayurveda interventions in the management of asymptomatic and mild COVID-19 patients-experiences of a Lucknow based level 2 hospital of Uttar Pradesh, India.

BACKGROUND: SARS--CoV-2 has emerged as a global threat since its onset in December 2019. India has also been severely affected by the dreadful Corona Virus and is currently battling one of the worst pandemics of history. WHO and the world medical fraternity are putting their efforts to materialize a treatment or vaccine for this novel virus. A randomized open label parallel group study was designed in a Lucknow based level 2 COVID hospital to evaluate the efficacy of Ayurvedic interventions in the management of asymptomatic and mild COVID 19 patients. OBJECTIVE: To evaluate the efficacy of Ayurveda in the management of mildly affected COVID-19 patients. MATERIALS AND METHODS: The current trial was an open label randomized 10-day study. Total 120 asymptomatic and/or mild COVID-19 positive patients fulfilling inclusion criteria were randomly grouped into three. RT-PCR of all the patients were done on 5th, 7th and on 10th day respectively. The observations were noted and results were analyzed statistically. Kruskal-Wallis test and Wilcoxon Sign rank test were used for data analysis where applicable. RESULTS: Improvement in symptoms, enhancement in Agni and recovery from COVID infection was observed. The results obtained were encouraging and showed better viral clearance and control of symptom progression in the patients placed on Ayurvedic medications. CONCLUSION: The promising results in the study showed that an approach involving Ayurveda can be helpful for the management of the mild COVID-19 patients. Ayurveda can be used to limit community spread and check disease progression to a more appalling state. TRIAL REGISTRATION: Trial was registered with Clinical Trials Registry- India (CTRI registration number: CTRI/2020/06/025800.

Pre-bypass levosimendan in ventricular dysfunction-effect on right ventricle.

BACKGROUND: Levosimendan is an effective calcium sensitizer with complementary mechanisms of action: calcium sensitization and opening of adenosine triphosphate-dependent potassium channels, both on the sarcolemma of the smooth muscle cells in the vasculature and on the mitochondria of cardiomyocytes. Levosimendan has a long-acting metabolite with a half-life of approximately 80 h. There have been a few small studies on this drug regarding right ventricular function. In view of this, we investigated the effect of levosimendan on right ventricular function in patients with coronary artery disease. METHODS: This was a prospective, randomized, double-blind study on 50 patients with coronary artery disease and severe left ventricular dysfunction (left ventricular ejection fraction ≤35%) undergoing elective off-pump coronary artery bypass. RESULTS: Levosimendan had an inotropic effect on right ventricular myocardium and a vasodilatory effect on blood vessels. It caused a decline in pulmonary vascular resistance (p < 0.018), right ventricular systolic pressure (p < 0.001), and pulmonary artery systolic pressure (p < 0.001), and improved right ventricular diastolic function as shown by the decrease in right ventricular Tei index (p < 0.001), right ventricular end-diastolic pressure, and the ratio of early diastolic tricuspid inflow to tricuspid lateral annular velocity (p < 0.006). However, we found no beneficial effects on intensive care unit or hospital stay (p = 0.164, p = 0.349, respectively) nor a mortality benefit. CONCLUSIONS: Levosimendan has salutary effects on right ventricular function in patients with severe left ventricular dysfunction undergoing coronary artery bypass, in terms of improved hemodynamic parameters.

Topical vs Peribulbar Anesthesia: Comparison of Anterior Chamber Depth and the Resultant Visual Outcome After Phacoemulsification.

PURPOSE: To compare anterior chamber depth and postoperative visual outcome in patients undergoing phacoemulsification under topical vs peribulbar anesthesia. MATERIALS AND METHODS: Prospective, randomized, comparative observational study.Sample size: 110 eyes with 55 eyes each. Group I: Patients undergoing phacoemulsification under topical anesthesia.Group II: Patients undergoing phacoemulsification under peribulbar anesthesia.Once patients were selected, baseline a standard ophthalmic examination was done including best-corrected visual acuity (BCVA), refraction, IOP by NCT, anterior segment evaluation with slit lamp biomicroscopy, keratometry, axial length, and ACD measurement by IOL master. Post-operatively, the patients were reviewed at day 1, week 1, week 6 for the same parameters.Statistics:Quantitative variables: Paired and unpaired t-test.Qualitative variables: Chi square test.A P-value of <0.05 was considered statistically significant. RESULTS: Inter-group comparisons of post-operative change in ACD at 1-week post-op (P-value<0.001) and 6-week post-op (P-value<0.001) were statistically significant when compared to the pre-op values. The mean spherical equivalent in group I was 0.27±0.26 d and that in group II was 1±0.32 d at 1-week post-op. The mean spherical equivalent in group I was 0.23±0.20 d, while that in group II was 0.85±0.64 d at 6-week post-op. This difference was statistically significant both at 1-week post-op (P-value=0.002) and 6-week post-op (P-value<0.001). CONCLUSION: Post-phacoemulsification, the ACD is more after peribulbar anesthesia as compared to topical anesthesia. Post-op refractive outcome is better with the use of topical anesthesia.

Evaluation of serum Glutathione-S Transferase-Alpha as a Biomarker of Intrahepatic Cholestasis of Pregnancy.

OBJECTIVE: To evaluate if serum Glutathione-S Transferase-Alpha (GSTA) can be used as a biomarker of intrahepatic cholestasis of pregnancy (IHCP). METHODS: 45 pregnant women with IHCP and 45 age and weight matched pregnant women as controls were enrolled and liver function tests including serum GSTA were measured. All cases and controls were followed for their maternal and foetal outcomes till delivery. Statistical analysis included unpaired t test, Mann-Whitney test and chi square test. RESULTS: IHCP group showed higher mean serum GSTA concentrations compared to controls (85.6 ± 42.7 mcg/l vs. 40.6 ± 6.8 mcg/l; p < 0.001, CI 95%). A positive correlation was observed between serum GSTA and other markers of IHCP like serum bilirubin (r=0.346; p< 0.001), AST (r=0.708; p< 0.001), ALT (r=0.656; p< 0.001) and bile acids (r= 0.491; p< 0.001).Cut off value for GSTA of 47 mcg/l demonstrated good sensitivity (97.8%),specificity (88.9%), positive predictive value (89.8%) and accuracy (93.3%) to diagnose IHCP. CONCLUSION: Serum GSTA may be a new promising, diagnostic tool with good accuracy compared to the routine markers for diagnosing IHCP.

Contribution of point sources and non-point sources to nutrient and carbon loads and their influence on the trophic status of the Ganga River at Varanasi, India.

To determine the possible contributions of point and non-point sources to carbon and nutrient loading in the Ganga River, we analyzed N, P, and organic carbon (OC) in the atmospheric deposits, surface runoff, and in the river along a 37-km stretch from 2013 to 2015. We also assessed the trophic status of the river as influenced by such sources of nutrient input. Although the river N, P, and productivity showed a declining trend with increasing discharge, runoff DOC and dissolved reactive phosphorus (DRP) increased by 88.05 and 122.7% between the Adpr and Rjht sites, indicating contributions from atmospheric deposition (AD) coupled with land use where agriculture appeared to be the major contributor. Point source input led to increased river concentrations of NO3-, NH4+, DRP, and DOC by 10.5, 115.9, 115.2, and 67.3%, respectively. Increases in N, P, and productivity along the gradient were significantly negatively correlated with river discharge (p < 0.001), while river DOC and dissolved silica showed positive relationships. The results revealed large differences in point and non-point sources of carbon and nutrient input into the Ganga River, although these variations were strongly influenced by the seasonality in surface runoff and river discharge. Despite these variations, N and P concentrations were sufficient to enhance phytoplankton growth along the study stretch. Allochthonous input together with enhanced autotrophy would accelerate heterotrophic growth, degrading the river more rapidly in the near future. This study suggests the need for large-scale inter-regional time series data on the point and non-point source partitioning and associated food web dynamics of this major river system.

Antiplasmodial potential and quantification of aloin and aloe-emodin in Aloe vera collected from different climatic regions of India.

BACKGROUND: In this study, Aloe vera samples were collected from different climatic regions of India. Quantitative HPTLC (high performance thin layer chromatography) analysis of important anthraquinones aloin and aloe-emodin and antiplasmodial activity of crude aqueous extracts was done to estimate the effects of these constituents on antiplasmodial potential of the plant. METHODS: HPTLC system equipped with a sample applicator Linomat V with CAMAG sample syringe, twin rough plate development chamber (20 x 10 cm), TLC Scanner 3 and integration software WINCATS 1.4.8 was used for analysis of aloin and aloe-emodin amount. The antiplasmodial activity of plant extracts was assessed against a chloroquine (CQ) sensitive strain of P. falciparum (MRC-2). Minimum Inhibitory Concentration (MIC) of aqueous extracts of selected samples was determined according to the World Health Organization (WHO) recommended method that was based on assessing the inhibition of schizont maturation in a 96-well microtitre plate. EC (effective concentration) values of different samples were observed to predict antiplasmodial potential of the plant in terms of their climatic zones. RESULTS: A maximum quantity of aloin and aloe-emodin i.e. 0.45 and 0.27 mg/g respectively was observed from the 12 samples of Aloe vera. The inhibited parasite growth with EC50 values ranging from 0.289 to 1056 µg/ml. The antiplasmodial EC50 value of positive control Chloroquine was observed 0.034 µg/ml and EC50 values showed by aloin and aloe-emodin was 67 µg/ml and 22 µg/ml respectively. A positive correlation was reported between aloin and aloe-emodin. Antiplasmodial activity was increased with increase in the concentration of aloin and aloe-emodin. The quantity of aloin and aloe-emodin was decreased with rise in temperature hence it was negatively correlated with temperature. CONCLUSIONS: The extracts of Aloe vera collected from colder climatic regions showed good antiplasmodial activity and also showed the presence of higher amount of aloin and aloe-emodin in comparison to collected from warmer climatic sites. Study showed significant correlation between quantities of both the anthraquinones used as marker compounds and EC50 values of the different Aloe vera extracts. Although, both the anthraquinones showed less antiplasmodial potential in comparison to crude extracts of different Aloe vera samples. Diverse climatic factors affect the quantity of tested compounds and antiplasmodial potential of the plant in different Aloe vera samples.

Water Quality Interaction with Alkaline Phosphatase in the Ganga River: Implications for River Health.

Carbon, nitrogen and phosphorus inputs through atmospheric deposition, surface runoff and point sources were measured in the Ganga River along a gradient of increasing human pressure. Productivity variables (chlorophyll a, gross primary productivity, biogenic silica and autotrophic index) and heterotrophy (respiration, substrate induced respiration, biological oxygen demand and fluorescein diacetate hydrolysis) showed positive relationships with these inputs. Alkaline phosphatase (AP), however, showed an opposite trend. Because AP is negatively influenced by available P, and eutrophy generates a feedback on P fertilization, the study implies that the alkaline phosphatase can be used as a high quality criterion for assessing river health.

Effect of climate change on phytochemical diversity, total phenolic content and in vitro antioxidant activity of Aloe vera (L.) Burm.f.

BACKGROUND: The aim of the present study was to analyse the effect of climate change on phytochemicals, total phenolic content (TPC) and antioxidant potential of methanolic extracts of Aloe vera collected from different climatic zones of the India. METHODS: Crude methanolic extracts of A. vera from the different states of India were screened for presence of various phytochemicals, total phenolic content and in vitro antioxidant activity. Total phenolic content was tested by Folin-Ciocalteau reagent based assay whilst DPPH free radical scavenging assay, metal chelating assay, hydrogen peroxide scavenging assay, reducing power assay and ß carotene-linoleic assay were used to assess the antioxidant potential of A. vera methanolic leaf extracts. RESULTS: Alkaloids, phenols, flavonoids, saponins, and terpenes were the main phytochemicals presents in all accessions. A significant positive correlation was found between TPC and antioxidant activity of different accessions. Extracts of highland and semi-arid zones possessed maximum antioxidant potential. Accessions from tropical zones showed the least antioxidant activity in all assays. CONCLUSIONS: It could be concluded that different agro-climatic conditions have effects on the phytochemicals, total phenolic content (TPC) and antioxidant potential of the A. vera plant. The results reveal that A. vera can be a potential source of novel natural antioxidant compounds.

Spatial and seasonal influences on culturable endophytic mycobiota associated with different tissues of Eugenia jambolana Lam. and their antibacterial activity against MDR strains.

BACKGROUND: Present study focuses on diversity and distribution analysis of endophytic fungi associated with different tissues of Eugenia jambolana. The influence of season and geographical location on diversity and distribution of endophytic fungi has been analyzed. Antibacterial activity of isolated fungal species has also been investigated against MDR bacterial strains. RESULT: A total of 1896 endophytic fungal isolates were obtained from healthy, surface sterilized tissues of leaf, stem and petiole tissues during summer, monsoon and winter season. Out of 24 fungal species isolated, 20 species belong to class Ascomycetes, 2 to Basidiomycetes and 2 to Zygomycetes. Maximum species diversity was in rainy season whereas colonization frequency was in winter. All the diversity indices showed maximum species diversity at site 5 (Yamunanager), rainy among the seasons and leaf among the tissues studied. Aspergillus genus was most frequently isolated. Aspergillus niger and Alternaria alternata were most dominant species. Three way ANOVA results showed that effect of season was highly significant on species diversity in relation to sites and tissues. 60% endophytic fungal extracts showed significant antibacterial activity against one or more than one MDR bacterial strain. CONCLUSION: Different fungal species were recovered from different sites but the inter-site comparisons were not significant according to Jaccard similarity coefficient. Diversity of such fungal endophytes indicates that Eugenia jambolana plant acts as an ecosystem facilitating survival of many microbes with impressive antibacterial potential.

Dehydration-responsive miRNAs in foxtail millet: genome-wide identification, characterization and expression profiling.

MAIN CONCLUSION: A set of novel and known dehydration-responsive miRNAs have been identified in foxtail millet. These findings provide new insights into understanding the functional role of miRNAs and their respective targets in regulating plant response to dehydration stress. MicroRNAs perform significant regulatory roles in growth, development and stress response of plants. Though the miRNA-mediated gene regulatory networks under dehydration stress remain largely unexplored in plant including foxtail millet (Setaria italica), which is a natural abiotic stress tolerant crop. To find out the dehydration-responsive miRNAs at the global level, four small RNA libraries were constructed from control and dehydration stress treated seedlings of two foxtail millet cultivars showing contrasting tolerance behavior towards dehydration stress. Using Illumina sequencing technology, 55 known and 136 novel miRNAs were identified, representing 22 and 48 miRNA families, respectively. Eighteen known and 33 novel miRNAs were differentially expressed during dehydration stress. After the stress treatment, 32 dehydration-responsive miRNAs were up-regulated in tolerant cultivar and 22 miRNAs were down-regulated in sensitive cultivar, suggesting that miRNA-mediated molecular regulation might play important roles in providing contrasting characteristics to these cultivars. Predicted targets of identified miRNAs were found to encode various transcription factors and functional enzymes, indicating their involvement in broad spectrum regulatory functions and biological processes. Further, differential expression patterns of seven known miRNAs were validated by northern blot and expression of ten novel dehydration-responsive miRNAs were confirmed by SL-qRT PCR. Differential expression behavior of five miRNA-target genes was verified under dehydration stress treatment and two of them also validated by RLM RACE. Overall, the present study highlights the importance of dehydration stress-associated post-transcriptional regulation governed by miRNAs and their targets in a naturally stress-tolerant model crop.

In vitro antioxidant activity and total phenolic content of endophytic fungi isolated from Eugenia jambolana Lam.

OBJECTIVE: To elucidate the antioxidant activity and total phenolic content (TPC) of ethyl acetate extracts of endophytic fungi isolated from Eugenia jambolana by three different antioxidant assays. METHODS: Twenty one different endophytic fungal extracts were screened for presence of various phytochemicals, TPC and in vitro antioxidant activity. TPC was tested by Folin-Ciocalteau reagent based assay. DPPH free radical scavenging, hydrogen peroxide scavenging and reducing power assays were used to evaluate the antioxidant activity. RESULTS: Alkaloids, phenols, flavonoids, saponins, and terpenes were the main phytochemicals presents in all 21 endophytes. A significant positive correlation was found between antioxidant activity and TPC in fungal extracts. There is 36% endophytic extracts having high phenolic content exhibited potent antioxidant activity. Chaetomium sp., Aspergillus sp., Aspergillus peyronelii and Aspergillus niger strain showed the highest antioxidant activity ranging from 50% to 80% having 58 mg/g to 60 mg/g GAE total phenolics. Ascorbic acid used as a standard showed 90% reducing potential. CONCLUSIONS: The results reveal that metabolites produced by endophytic fungi isolated from Eugenia jambolana can be a potential source of novel natural antioxidant compounds.

Dedifferentiated chondrosarcoma of the rib masquerading as a giant chest wall tumor in a teenage girl: an unusual presentation.

Chondrosarcoma of the chest wall is a rare primary neoplasm found to occur in elderly men. Patients present with an enlarging, painful, anterior chest wall mass arising from either the vicinity of the costochondral junction or the sternum. Treatment includes wide resection with appropriate chest wall reconstruction. We report an unusual presentation of this uncommon tumor occurring as a huge chest wall mass in a young teenage girl.

High uptake of HIV testing in a cohort of male injection drug users in Delhi, India: prevalence and correlates of HIV infection.

We report baseline findings from a longitudinal cohort study to examine HIV incidence, high-risk injection and sexual behaviors of 3,792 male injection drug users (IDUs) in Delhi. The majority (95.4 %) accepted HIV testing; HIV prevalence was 21.9 %. In multivariate analysis, belonging to states adjacent to Delhi (AOR: 1.23; 95 % CI: 1.07-1.52), earning INR 500-1,500 (AOR: 2.38; 95 % CI: 1.43-3.96); duration of drug use 2-5 years (AOR: 2.02; 95 % CI: 1.09-3.73), 6-10 years (AOR: 2.81; 95 % CI: 1.55-5.11), ≥11 years (AOR: 3.35; 95 % CI: 1.84-6.11); prior HIV testing (AOR: 1.60; 95 % CI: 1.35-1.91), self-reported risky-injection behavior (AOR: 1.60; 95 % CI: 1.33-1.92), and utilization of harm-reduction services (AOR: 1.32; 95 % CI: 1.11-1.58) were positively associated with HIV infection. Alcohol use ≤2 times/week (AOR: 0.67; 95 % CI: 0.55-0.82) or ≥3 times/week (AOR: 0.74; 95 % CI: 0.54-1.01), unit increase in age (AOR: 0.99; 95 % CI: 0.98-1.00), ≥7 years of schooling (AOR: 0.82; 95 % CI: 0.66-1.02) and unsafe sex with any female partner (AOR: 0.69; 95 % CI: 0.55-0.86) were negatively associated with HIV infection. HIV prevalence remains high among male IDUs in Delhi. HIV prevention programs should include comprehensive package of services for IDUs.

Role of leptin and adiponectin in insulin resistance.

Adipose tissue is a major source of energy for the human body. It is also a source of major adipocytokines adiponectin and leptin. Insulin resistance is a condition in which insulin action is impaired in adipose tissue and is more strongly linked to intra-abdominal fat than to fat in other depots. The expression of adiponectin decreases with increase in the adiposity. Adiponectin mediates insulin-sensitizing effect through binding to its receptors AdipoR1 and AdipoR2, leading to activation of adenosine monophosphate dependent kinase (AMPK), PPAR-α, and presumably other yet-unknown signalling pathways. Weight loss significantly elevates plasma adiponectin levels. Reduction of adiponectin has been associated with insulin resistance, dyslipidemia, and atherosclerosis in humans. The other major adipokine is leptin. Leptin levels increase in obesity and subcutaneous fat has been a major determinant of circulating leptin levels. The leptin signal is transmitted by the Janus kinase, signal transducer and activator of transcription ((JAK-STAT) pathway. The net action of leptin is to inhibit appetite, stimulate thermogenesis, enhance fatty acid oxidation, decrease glucose, and reduce body weight and fat.

Correlation of creatinine with TSH levels in overt hypothyroidism - a requirement for monitoring of renal function in hypothyroid patients?

OBJECTIVE: Renal function is influenced by thyroid status. Therefore, this study was done to determine the relationship between renal function and different degrees of thyroid dysfunction. DESIGN AND METHODS: Thyroid and kidney function tests were analyzed in 47 patients with overt (TSH ≥ 10.0 µIU/L) and 77 patients with subclinical hypothyroidism (TSH 6.0-9.9 µIU/L) in a cross-sectional study. These were compared with 120 age- and sex-matched euthyroid controls. RESULTS: Overt hypothyroid subjects showed significantly raised serum urea, creatinine and uric acid levels as compared to controls whereas subclinical hypothyroid patients showed significant increased levels of serum urea and creatinine levels. TSH showed significant positive correlation with creatinine and uric acid values and, fT4 had a negative correlation with uric acid in overt hypothyroidism. CONCLUSION: Hypothyroid state is associated with significant derangement in biochemical parameters of renal function. Hence the renal function should be regularly monitored in hypothyroid patients.

Role of hormones in acne vulgaris.

OBJECTIVE: To elucidate the role of endogenous hormones like testosterone, progesterone, estrogen, insulin-like growth factor, insulin and glucocorticoids in a common skin condition acne vulgaris. DESIGN AND METHODS: We conducted a systematic review of the literature and abstracted the data for every published cut point. RESULTS: We screened more than 1000 studies and found that serum testosterone, progesterone, glucocorticoids, insulin and insulin-like growth factors are increased in patients with acne vulgaris and serum estrogen levels are low in patients. CONCLUSIONS: Various endogenous hormones play important role in the pathogenesis of acne vulgaris. Thus, in the clinical practice it is important to evaluate serum levels of these hormones and patients must be treated accordingly to avoid serious endocrine disorders at an early age.

Cytokines in recurrent pregnancy loss.

BACKGROUND: Recurrent pregnancy loss (RPL) is defined as the occurrence of three or more consecutive miscarriages prior to 20 weeks gestation. Exaggerated maternal immune response to fetal antigens has been proposed to be one of the mechanisms underlying recurrent pregnancy loss. METHOD: A comprehensive literature search was conducted from the websites of the National Library of Medicine (http://www.ncbl.nlm.nih.gov) and Pubmed Central, the US National Library of Medicine's digital archive of life sciences literature (http://www.pubmedcentral.nih.gov/). The data was assessed from books and journals that published relevant articles in this field. RESULT: In normal pregnancy, tolerance of the genetically incompatible fetus by the maternal immune system depends on the interactions of an array of cytokines secreted by maternal and fetal cells at the site of implantation. Earlier research indicated that altered immunity in RPL is dominated by the Th1/Th2 hypothesis, which proposed that the fetus escapes maternal-derived T-cell responses through skewing the Th0 differentiation toward Th2 pathway which dampens pro-inflammatory Th1-type immunity. Recent studies indicate the role of proinflammatory Th17 cells and immunoregulatory Treg cells in RPL in addition to Th1/Th2 interactions. CONCLUSION: Cytokines form a complex regulatory network which maintains homeostasis between the fetal unit and the maternal immune system. If this delicate balance is adversely affected, immunoregulatory mechanisms may be insufficient to restore homeostasis and this may lead to pregnancy failure.