Sequential administration of paricalcitol followed by IL-17 blockade for progressive refractory IgA nephropathy patients.

There is no established treatment for progressive IgA nephropathy refractory to steroids and immunosuppressant drugs (r-IgAN). Interleukin 17 (IL-17) blockade has garnered interest in immune-mediated diseases involving the gut-kidney axis. However, single IL-17A inhibition induced paradoxical effects in patients with Crohn's disease and some cases of de novo glomerulonephritis, possibly due to the complete Th1 cell response, along with the concomitant downregulation of regulatory T cells (Tregs). Seven r-IgAN patients were treated with at least six months of oral paricalcitol, followed by the addition of subcutaneous anti-IL-17A (secukinumab). After a mean follow-up of 28 months, proteinuria decreased by 71% (95% CI: 56-87), P < 0.001. One patient started dialysis, while the annual eGFR decline in the remaining patients [mean (95% CI)] was reduced by 4.9 mL/min/1.73 m2 (95% CI: 0.1-9.7), P = 0.046. Circulating Th1, Th17, and Treg cells remained stable, but Th2 cells decreased, modifying the Th1/Th2 ratio. Intriguingly, accumulation of circulating Th17.1 cells was observed. This novel sequential therapy appears to optimize renal advantages in patients with r-IgAN and elicit alterations in potentially pathogenic T helper cells.

Epidemiological study of granulomatous prostatitis in a tertiary hospital: Associated risk factors and relationship with prostate cancer.

OBJECTIVE: The primary objective was to estimate the incidence of granulomatous prostatitis (GP) in Son Espases University Hospital, a tertiary care hospital, in Palma de Mallorca (Spain). As secondary objectives, presence of concomitant PCa in the biopsy was analyzed, as well as the history of previous BCG instillations, biopsy origin, urinary symptoms, and cardiovascular risk (CV) factors. METHODS: A descriptive retrospective study of GP and the aforedescribed variables were carried out from 2010 to 2017. RESULTS: A total of 3651 histopathological prostate specimens were analyzed, 39 of which were diagnosed with GP (incidence of 1.06%). Lower urinary tract symptoms (LUTS) were present in a 48.7% and previous history of bladder tumor resection (TURBT) was present in 35.9% of the cases. Also, urinary tract infections were equally present. All cases with prior TURBT had intravesical instillations with BCG, although 5 (12.8%) and 4 (10.3%) cases had abnormal rectal examination and elevated PSA levels after instillations, respectively. Finally, in 14 cases (35.9%) there was also a diagnosis of concomitant PCa. The most common CV risk factor in these patients was smoking (79.5%) followed by hypertension (64.8%). CONCLUSIONS: The estimated incidence of GP in our center (1.06%)g is close to that described by other authors. About 14 cases were diagnosed with PCa (35.9%), a higher value than previously described in the literature, and most of these were found incidentally, especially in cystoprostatectomies. This high percentage of concomitant GP and PCa could be due to a rise in Transrectal Prostate biopsies (TRPB), as in recent years there has been a tendency to increase the use of PSA in routine clinical practice.

Is There an Association between ß-Carotene and Breast Cancer? A Systematic Review on Breast Cancer Risk.

It is suspected that diet influences the risk of developing breast cancer. Several ß-carotenoids have been inversely associated with breast cancer risk, but association by type of tumor and participant characteristics remain nuclear. The objective of this review of epidemiological studies is to investigate the relationship between ß-carotenoids and breast cancer. This review covers the 2014-2020 period and was carried out using the PubMed and EMBASE databases. Only epidemiological studies carried out on ß-carotenoids and breast cancer were included. The initial keyword search yielded 1559 results and finally a total of 28 studies were included. The quality of the articles and the risk of bias for each included article were assessed. The selected articles were subsequently classified according to their quality. The evidence from the included studies confirms that there is an association between ß-carotenoids and breast cancer risk; the dietary intake of ß-carotenoids may be beneficial in reducing the risk of developing breast cancer.