Microemulsions Improve Topical Protoporphyrin IX (PpIX) Delivery for Photodynamic Therapy of Skin Cancer

Abstract We report here microemulsions (MEs) for topical delivery of protoporphyrin IX (PpIX) for Photodynamic Therapy (PDT) of skin cancers. Selected MEs consisting of Oil/Water (O/W) bicontinuous (BC) and Water/Oil (W/O) preparations were characterized as to pH, nanometric size, zeta potential, drug content, and viscosity. Sustained in vitro PpIX release was achieved from MEs 2A (O/W), 10B (BC) and 16B (W/O) through an artificial membrane for up to 24 h, characterizing MEs as drug delivery systems. None of these MEs showed permeation through the skin, demonstrating the required topical effect. After 4 h, in vitro retention of PpIX in the stratum corneum (SC) was higher from both ME 10B and control (PpIX at 60 µg/mL in PEG 300). However, in the Epidermis + Dermis ([Ep + D]), retention from ME 10B and ME 16B was ~40 times higher compared to control. Confocal Laser Scanning Microscopy (CLSM) showed higher fluorescence intensity in the SC for both control and ME 10B, whereas ME 10B fluorescence was higher in [Ep+D]. The results indicate that ME 10B is suitable for PpIX encapsulation, showing good characteristics and a localized effect for a potential delivery system for PDT-associated treatments of skin cancers.

Ultrasonographical examination of bovine claws through the sole horn on weight-bearing claws.

Claw horn disruptions in the bovine claw are believed to be a consequence of pressure on the sole corium from the third phalanx, which may be caused by a weakening of the suspensory apparatus in the claw. We aimed to develop an ultrasonographic method that would make it possible to measure the thickness of the soft tissue between the third phalanx and the sole horn on a weight-bearing claw. A device was developed to record the sole horn and soft tissue thickness indirectly through a polyethylene plate, and 52 feet from slaughtered cows were examined using ultrasonography, both directly and indirectly. Soft tissue and sole horn thickness measurements in the apex and the plantar part of the sole were compared with anatomical measurements of transected claws. To assess the method on weight-bearing versus non-weight-bearing claws, we examined the hind claws of 10 live cattle without transection. We found a weak correlation between the soft tissue thickness measured by ultrasound and anatomical measurements. A strong correlation was observed between the direct ultrasound approach and the developed indirect method. There was a considerable difference between weight-bearing and non-weight-bearing claws, signifying a weak or nonexistent correlation. However, this part of the study was only done on 10 live cows and the results should be interpreted with caution. We concluded that it would be possible to measure the soft tissue using an indirect ultrasound approach on a weight-bearing-claw standing on a polyethylene plate. The major difference between the results of weight-bearing versus non-weight-bearing claws suggests that future studies of the suspensory apparatus could focus on weight-bearing claws.

Utilidad de la ecografía de alta frecuencia en el diagnóstico de las pápulas piezogénicas / Usefulness of High-Frequency Ultrasound in the Diagnosis of Piezogenic Pedal Papules

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Infrastructure of the telocytes from tumor stroma in the skin basal and squamous cell carcinomas.

In this paper, we focus our interest on the ultrastructure of telocytes (TCs) present inside of tumor-stroma in basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Tumor-stroma cooperation is necessary for tumor growth, invasive behavior and ectopic development of microtumors. There is a plethora of reports about the role of different stromal cell types in tumor evolution in the human body. In this line, almost nothing is known about the recently identified interstitial cell type called telocyte (TC). To our best knowledge, this is the first study to publish TCs in malignant tumors, namely BCC and SCC. Here, we described the infrastructural aspects of TCs as well as their relationships with other tumor stroma components. TC from the tumor stroma has cell body where the nucleus is located and exhibits two (rarely more) very long cell extensions of tens (over 60-100 µm) termed telopodes. A telopode appears as an alternation of very thin segments called podomers and dilated segments called podomes, which accommodate mitochondria, rough endoplasmic reticulum, cytoskeleton, caveolae, as well as coated vesicles. TCs establish homocellular junctions leading to a 3-D network inside of peritumoral stroma. TCs may play an important role in intercellular signaling via stromal synapses and shed microvesicle transfer. Comparative evaluation with normal dermal skin showed that telocytes from tumor stroma have a very restraint number of heterocellular junctions. The limitation of TCs heterocellular junctions suggests a possible involvement in induction of cell-cell communication alterations into the peritumoral stroma and, consequently, into the whole tumor mass.

Expression in SPARC-null mice of collagen type I lacking the globular domain of the α1(I) N-propeptide results in abdominal hernias and loss of dermal collagen.

The sequence encoding the N-propeptide of collagen I is characterized by significant conservation of amino acids across species; however, the function of the N-propeptide remains poorly defined. Studies in vitro have suggested that one activity of this propeptide might be to act as a feedback inhibitor of collagen I synthesis. To determine whether the N-propeptide contributed to decreased collagen content in SPARC-null mice, mice carrying a deletion of exon 2, which encodes the globular domain of the N-propeptide of collagen I, were crossed to SPARC-null animals. Mice lacking SPARC and expressing collagen I without the globular domain of the N-propeptide were viable and fertile. However, a significant number of animals developed abdominal hernias within the first 2 months of life with an approximate 20% penetrance (~35% of males). The dermis of SPARC-null/exon 2-deleted mice was thinner and contained fewer large collagen fibers in comparison with wild-type or in either single transgenic animal. The average collagen fibril diameter of exon 2-deleted mice did not significantly differ from wild-type mice (WT: 87.9 nm versus exon 2-deleted: 88.2 nm), whereas SPARC-null/exon 2-deleted fibrils were smaller than that of SPARC-null dermis (SPARC-null: 60.2 nm, SPARC-null/exon 2-deleted: 40.8 nm). As measured by hydroxyproline analysis, double transgenic skin biopsies contained significantly less collagen than those of wild-type, those of exon 2-deleted, and those of SPARC-null biopsies. Acetic acid extraction of collagen from skin biopsies revealed an increase in the proportion of soluble collagen in the SPARC-null/exon 2-deleted mice. These results support a function of the N-propeptide of collagen I in facilitating incorporation and stabilization of collagen I into the insoluble ECM and argue against a primary function of the N-propeptide as a negative regulator of collagen synthesis.

C. elegans sym-1 is a downstream target of the hunchback-like-1 developmental timing transcription factor.

In the nematode Caenorhabditis elegans, the let-7 microRNA (miRNA) and its family members control the timing of key developmental events in part by directly regulating expression of hunchback-like-1 (hbl-1). C. elegans hbl-1 mutants display multiple developmental timing deficiencies, including cell cycle defects during larval development. While hbl-1 is predicted to encode a transcriptional regulator, downstream targets of HBL-1 have not been fully elucidated. Here we report using microarray analysis to uncover genes downstream of HBL-1. We established a transgenic strain that overexpresses hbl-1 under the control of a heat shock promoter. Heat shock-induced hbl-1 overexpression led to retarded hypodermal structures at the adult stage, opposite to the effect seen in loss of function (lf) hbl-1 mutants. The microarray screen identified numerous potential genes that are upregulated or downregulated by HBL-1, including sym-1, which encodes a leucine-rich repeat protein with a signal sequence. We found an increase in sym-1 transcription in the heat shock-induced hbl-1 overexpression strain, while loss of hbl-1 function caused a decrease in sym-1 expression levels. Furthermore, we found that sym-1(lf) modified the hypodermal abnormalities in hbl-1 mutants. Given that SYM-1 is a protein secreted from hypodermal cells to the surrounding cuticle, we propose that the adult-specific cuticular structures may be under the temporal control of HBL-1 through regulation of sym-1 transcription.

Mutations in LTBP4 cause a syndrome of impaired pulmonary, gastrointestinal, genitourinary, musculoskeletal, and dermal development.

We report recessive mutations in the gene for the latent transforming growth factor-beta binding protein 4 (LTBP4) in four unrelated patients with a human syndrome disrupting pulmonary, gastrointestinal, urinary, musculoskeletal, craniofacial, and dermal development. All patients had severe respiratory distress, with cystic and atelectatic changes in the lungs complicated by tracheomalacia and diaphragmatic hernia. Three of the four patients died of respiratory failure. Cardiovascular lesions were mild, limited to pulmonary artery stenosis and patent foramen ovale. Gastrointestinal malformations included diverticulosis, enlargement, tortuosity, and stenosis at various levels of the intestinal tract. The urinary tract was affected by diverticulosis and hydronephrosis. Joint laxity and low muscle tone contributed to musculoskeletal problems compounded by postnatal growth delay. Craniofacial features included microretrognathia, flat midface, receding forehead, and wide fontanelles. All patients had cutis laxa. Four of the five identified LTBP4 mutations led to premature termination of translation and destabilization of the LTBP4 mRNA. Impaired synthesis and lack of deposition of LTBP4 into the extracellular matrix (ECM) caused increased transforming growth factor-beta (TGF-beta) activity in cultured fibroblasts and defective elastic fiber assembly in all tissues affected by the disease. These molecular defects were associated with blocked alveolarization and airway collapse in the lung. Our results show that coupling of TGF-beta signaling and ECM assembly is essential for proper development and is achieved in multiple human organ systems by multifunctional proteins such as LTBP4.

Elastolisis de la dermis media: a propósito de una caso / Elastolisis half of the dermis: about one case

Describimos al cuadro clínico de una paciente que presenta lesiones circunscriptas con aspecto de piel envejecida, localizadas en tronco. El estudio histopatológico muestra ausencia de fibras elásticas en una banda que compromete la dermis reticular alta. El término elastolisis se utiliza para definir la disminución o ausencia de las fibras elásticas. Las enfermedades elastolíticas pueden ser localizadas o generalizadas, congénitas o adquiridas, con o sin manifestaciones sistémicas. La elastolisis de la dermis media es una afección rara, adquirida, idiopática y sin compromiso extracutáneo. Los hallazgos histológicos son patognomónicos, observándose ausencia de tejido elástico en una banda que compromete la porción media de la dermis.

Aplasia cutis. Diagnóstico en el posparto inmediato / Aplasia cutis: diagnosis in the immediate postpartum period

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The natural history, including orofacial features of three patients with Ehlers-Danlos syndrome, dermatosparaxis type (EDS type VIIC).

Ehlers-Danlos syndrome (EDS) dermatosparaxis type (type VIIC) and the related disease of cattle dermatosparaxis, are recessively inherited connective tissue disorders, caused by a deficient activity of procollagen I N-proteinase, the enzyme that excises the N-terminal propeptide in procollagen type I, type II, and type III. Although well documented in cattle, to date only seven human cases have been recorded, most of them aged under 2 years. We document the natural history of three patients with EDS dermatosparaxis type, two of whom have been reported before the age of 2 years, and one new patient. The phenotype of the patients, and especially the facial resemblance, is striking, making this a clinically recognizable condition. The most consistent anomalies during the first years of life are premature rupture of the membranes, extreme skin fragility and easy bruising, large fontanels, blue sclerae, puffy eyelids, micrognathia, umbilical hernia, and short fingers. Joint hypermobility becomes more important with age. The children are at risk for rupture of internal organs due to soft tissue fragility, as is illustrated by different internal events in two of the three patients described here. Orofacial features include micrognathia, a frontal open bite, and gingival hyperplasia with varying degrees of hyperkeratosis. The deciduous dentition shows abnormal morphology of the molars, obliteration of the tooth pulp, and severe enamel attrition. The permanent dentition shows agenesis and microdontia of several teeth. Tooth discoloration, dysplastic roots, and tooth pulp obliteration are present in a restricted number of permanent teeth.

SPARC-null mice display abnormalities in the dermis characterized by decreased collagen fibril diameter and reduced tensile strength.

Although collagen and elastic fibers are among the major structural constituents responsible for the mechanical properties of skin, proteins that associate with these components are also important for directing formation and maintaining the stability of these fibers. We present evidence that SPARC (secreted protein acidic and rich in cysteine) contributes to collagen fibril formation in the dermis. The skin of SPARC-null adult mice had approximately half the tensile strength as that of wild-type skin. Moreover, the collagen content of SPARC-null skin, as measured by hydroxyproline analysis, was substantially reduced in adult mice. At 2 weeks of age, no differences in collagen content were observed; within 2 months, however, the dermis of SPARC-null mice displayed a reduced collagen content that persisted through adulthood until approximately 20 months, when collagen levels of SPARC-null skin approximated those of wild-type controls. The collagen fibrils present in SPARC-null skin were smaller and more uniform in diameter, in comparison with those of wild-type skin. At 5 months of age, the average fibril diameter in SPARC-null versus wild-type skin was 60.2 nm versus 87.9 nm, respectively. Extraction of soluble dermal collagen revealed a relative increase in collagen VI, accompanied by a decrease in collagen I, in SPARC-null mice. A reduction in the relative amounts of higher-molecular weight collagen complexes was also observed in extracts of dermis from SPARC-null animals. Thus the absence of SPARC compromises the mechanical properties of the dermis, an effect that we attribute, at least in part, to the changes in the structure and composition of its collagenous extracellular matrix.

Sporadic aplasia cutis congenita.

Aplasia cutis congenita (ACC) is a rare group of disorders characterized by the focal absence of skin at birth. The majority of cases affect the scalp, but involvement of the trunk and extremities has been described. Proposed etiologies for ACC include infection, vascular malformations, amniogenesis, and teratogens, but no unifying theory has been identified. We present the case of a 1-day-old female with large, bilateral posterolateral trunk skin defects noted at birth. The prenatal history was significant for maternal diabetes, fetal papyraceus at 12 weeks' gestation, and a family history of limb defects. The infant was treated non-surgically with local wound care and antibiotics, as well as frequent dressing changes. The areas of absent skin developed a granulation-tissue layer followed by re-epithelialization and mild wound contracture. With early identification of the etiology of the lesions and appropriate investigation and treatment, including conservative wound management, aplastic lesions can heal successfully without affecting growth, but may require cosmetic repair at a later stage.

Genetic ablation of the CDP/Cux protein C terminus results in hair cycle defects and reduced male fertility.

Murine CDP/Cux, a homologue of the Drosophila Cut homeoprotein, modulates the promoter activity of cell cycle-related and cell-type-specific genes. CDP/Cux interacts with histone gene promoters as the DNA binding subunit of a large nuclear complex (HiNF-D). CDP/Cux is a ubiquitous protein containing four conserved DNA binding domains: three Cut repeats and a homeodomain. In this study, we analyzed genetically targeted mice (Cutl1(tm2Ejn), referred to as Delta C) that express a mutant CDP/Cux protein with a deletion of the C terminus, including the homeodomain. In comparison to the wild-type protein, indirect immunofluorescence showed that the mutant protein exhibited significantly reduced nuclear localization. Consistent with these data, DNA binding activity of HiNF-D was lost in nuclear extracts derived from mouse embryonic fibroblasts (MEFs) or adult tissues of homozygous mutant (Delta C(-/-)) mice, indicating the functional loss of CDP/Cux protein in the nucleus. No significant difference in growth characteristics or total histone H4 mRNA levels was observed between wild-type and Delta C(-/-) MEFs in culture. However, specific histone genes (H4.1 and H1) containing CDP/Cux binding sites have reduced expression levels in homozygous mutant MEFs. Stringent control of growth and differentiation appears to be compromised in vivo. Homozygous mutant mice have stunted growth (20 to 50% weight reduction), a high postnatal death rate of 60 to 70%, sparse abnormal coat hair, and severely reduced fertility. The deregulated hair cycle and severely diminished fertility in Cutl1(tm2Ejn/tm2Ejn) mice suggest that CDP/Cux is required for the developmental control of dermal and reproductive functions.

The Caenorhabditis elegans distal-less ortholog ceh-43 is required for development of the anterior hypodermis.

Homeobox genes of the Distal-less (Dll) class are expressed in developing appendages as well as in the central nervous system in invertebrates and vertebrates. Mutant analyses in mice and Drosophila have implicated these genes in outgrowth of structures, cell adhesion, cell migration, and cell fate decisions. We have investigated the expression and function of ceh-43, the Dll ortholog from the nematode Caenorhabditis elegans, by using gfp reporter constructs and double-stranded RNA-mediated interference (RNAi). Our results show that, as in the fly, the C. elegans Dll ortholog seems to play a role in cell adhesion. An antibody against the butterfly Distal-less homeodomain stains the nervous system of C. elegans embryos (Panganiban et al. [1997] Proc Natl Acad Sci USA. 94:5162-5166). GFP expression under the control of the ceh-43 promoter looks similar, although strong expression is primarily confined to the head hypodermis and to neuronal support cells. ceh-43(RNAi) results in 100% lethality at embryonic or early larval stages. At the beginning of morphogenesis, ceh-43(RNAi) embryos start to lose cells through a hole in the head hypodermis. They either rupture anteriorly as elongation proceeds, or they elongate normally to threefold egg length with the pharynx not connected to the mouth. Elongated ceh-43(RNAi) animals die before or soon after hatching with a fluid-filled pseudocoel and large vacuoles. These phenotypes suggest a role for ceh-43 in development of adhesive properties in the head hypodermis that connects the epithelia of the skin and the digestive tract. Furthermore, possible defects in the excretory system may result at least in part from a requirement for ceh-43 in the CAN neurons where ceh-43:gfp is also expressed.

Cultivo de queratinocitos humanos in vitro / In vitro human keratinocytes cultured

La técnica de cultivo de queratinocitos puede considerarse como un arma irreemplazable y una alternativa confiable para ser aplicada a pacientes con daño parcial o externo de su piel que ameriten sus propias células especializadas para su recuperación. El objetivo de este estudio fue desarrollar una metodología propia para obtener monocapas de epidermis, para lo cual se obtuvieron muestras de piel procedentes de 7 pacientes sometidos a diferentes procedimientos de cirugía estética. Mediante la dispasa tipo II (2,4 unid/ml) se logró una excelente separación de la epidermis de la dermis al obtener una lámina de epidermis libre de fibroblastos, evidenciado además en los cultivos primarios de las células epidermales, donde se observó el crecimiento celular de los queratinocitos libres de células dérmicas, cuando se cultivaron en el substrato de colágeno tipo I obtenido partir de cola de la rata. En los subcultivos se hizo una comparación de diferentes subtratos-plásticos, fibroblastos inhibidos con mitomicina C (4 Mg/ml), substratos de colágeno y se observó un comportamiento similar de agregación y formación de monocapas entre 8-14 días de cultivo, a excepción de los queratinocitos subcultivos sobre plástico donde las células degeneraron en un tiempo corto. También se analizaron subcultivos en presencia de geles de colágeno tipo I con medios condicionados y se apreció una mayor velocidad de crecimiento en los queratinocitos al igual que cuando se utilizaron fibroblastos inactivados. La obtención de monocapas de células epidermicas se logró entre los 27 y 35 dias después de haberse iniciado el cultivo, mediante hormona de crecimiento a una concentración de 2 Mg/ml; se demostró diferenciación y estratificación de las monocapas de queratinocitos obtenidas in vitro