Functional textiles for atopic dermatitis: a systematic review and meta-analysis

Atopic dermatitis (AD) is a relapsing inflammatory skin disease with a considerable social and economic burden. Functional textiles may have antimicrobial and antipruritic properties and have been used as complementary treatment in AD. We aimed to assess their effectiveness and safety in this setting. We carried out a systematic review of three large biomedical databases. GRADE approach was used to rate the levels of evidence and grade of recommendation. Meta-analyses of comparable studies were carried out. Thirteen studies (eight randomized controlled trials and five observational studies) met the eligibility criteria. Interventions were limited to silk (six studies), silver-coated cotton (five studies), borage oil, and ethylene vinyl alcohol (EVOH) fiber (one study each). Silver textiles were associated with improvement in SCORAD (2 of 4), fewer symptoms, a lower need for rescue medication (1 of 2), no difference in quality of life, decreased Staphyloccosus aureus colonization (2 of 3), and improvement of trans-epidermal water loss (1 of 2), with no safety concerns. Silk textile use was associated with improvement in SCORAD and symptoms (2 of 4), with no differences in quality of life or need for rescue medication. With borage oil use only skin erythema showed improvement, and with EVOH fiber, an improvement in eczema severity was reported. Recommendation for the use of functional textiles in AD treatment is weak, supported by low quality of evidence regarding effectiveness in AD symptoms and severity, with no evidence of hazardous consequences with their use. More studies with better methodology and longer follow-up are needed.

Determinants of inadequate fruit and vegetable consumption amongst Portuguese adults

BACKGROUND

A low consumption of fruit and vegetables (F&V) represents a high burden on health. The present study evaluates sociodemographic, lifestyle and anthropometric determinants of an inadequate consumption of F&V (<5 servings per day).

METHODS

Participants were randomly selected within the adult Porto population (n = 2485). Those with normal cognitive function and information on key variables were analysed (n = 2362). Diet was assessed by a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by logistic regression, after sex stratification and controlling for age, education, marital status, smoking, regular physical exercise and total energy intake.

RESULTS

Older women and men had 37% and 67%, respectively, lower odds of inadequate F&V consumption (≥65 versus <40 years: OR = 0.63, 95% CI = 0.42-0.94; OR = 0.33, 95% CI = 0.20-0.56). More educated subjects (>12 versus <5 years) and those engaged in regular physical exercise had approximately 50% lower probability of F&V inadequacy compared to nonpractitioners, and this was similar in both sexes. On the other hand, female and male current smokers had 1.86- and 2.05-fold higher probabilities of having inadequate F&V consumption. Individuals consuming excessive alcohol (women: ≥15 g day(-1) ; men: ≥30 g day(-1) ) presented a two- and four-fold higher probability of having inadequate F&V consumption compared to nondrinkers (OR = 1.95, 95% CI = 1.38-2.77 in women; OR = 4.40, 95% CI = 2.70-7.18 in men).

CONCLUSIONS

In both sexes, an inadequate consumption of F&V was more frequently found in younger, less educated and less physically active subjects with smoking and drinking habits. Strategies aiming to increase F&V consumption should consider these target groups that present a clustering of unhealthy lifestyles.

A cross sectional assessment of allergic rhinitis and asthma control at an immunoallergology outpatient hospital setting using CARAT10 questionnaire

INTRODUCTION

The most recent guidelines on asthma and rhinitis management recommend the optimal control of both diseases as the primary goal of treatment. CARAT10 is a recently developed and validated Portuguese questionnaire, which permits the simultaneous assessment of allergic rhinitis and asthma (ARA) control. There is no published data about the use of this tool.

AIMS

To assess ARA control using CARAT10 in an Immunoallergology hospital setting;

METHODS

Patients with diagnosis of allergic rhinitis with or without asthma (positive aeroallergens prick-tests and/or positive specific IgE) were sequentially enrolled and asked to fill in CARAT10 questionnaire at their first appointment.

RESULTS

Two hundred patients were included, mostly female (n=142) with an average age of 33.6±12.3 years. ARA was present in 86 patients while 114 had isolated allergic rhinitis. In ARA group, 86% scored CARATtotal ≤ 24, meaning poor control. Subscores revealed that 83% had poorly controlled rhinitis (CARATr ≤ 8) and 74% had poorly controlled asthma (CARATa < 16). There were no age or gender related differences in ARA control. In allergic rhinitis group (n=114), 89% were poorly controlled.

CONCLUSIONS

Only 14% of patients presenting rhinitis and asthma had both diseases controlled.

Characterization of heavy-metal contamination in surface sediments of the Minho river estuary by way of factor analysis

Surface sediments were collected in August 2009 from 49 sites along the Minho estuary (between Tui and Caminha) and analyzed for grain size, organic carbon (Corg) and total nitrogen (Ntot) contents, and major (silicon [Si], aluminum [Al], iron [Fe], calcium [Ca], magnesium [Mg], sodium [Na], potassium [K], titanium [Ti], and mangesese [Mn]) and trace element (arsenic [As], chromium [Cr], copper [Cu], mercury [Hg], lithium [Li], lead [Pb], rubidium [Rb], tin [Sn], and zinc [Zn]) concentrations. Factor analysis was used to decrease 22 selected variables into 4 factors accounting for 85.9 % of the total variance explained, suggesting distinct elemental sources or sediment components affecting their spatial distributions. Although factors 1 (detrital component; elements strongly associated with fine- [Na, Mg, Ti, Li, Cr, Cu, Fe, Al, Zn, Ca, and As] and coarse-grained sediments [Si, K, Rb; mean grain-size [MGS]) and 3 (Fe-Mn oxyhydroxide sediment component; Fe, Mn, As, fine fraction) are interpreted as reflecting predominance of natural contributions, factors 2 (urban and industrial contamination: sediment components [Pb, Hg, organic carbon [Corg], total nitrogen [Ntot] and 4 (components associated with contamination by nautical activities; the association of tin [Sn] and calcium [Ca]) seem to indicate anthropogenic contributions). Nevertheless, the influence of elemental contributions derived from tungsten (W)-Sn mineralizations and those resulting from mining activities can also contribute to the obtained geochemical associations and should be considered. Spatial distribution of dominant factor scores shows the dominance of factors 2 and 4 between Tui and Vila Nova de Cerveira, whereas samples dominated by factors 3 and 1 are found between Ilha da Boega and Seixas and in the Caminha areas, respectively. Despite the dominance of factor score 1 in the Caminha area, the distribution pattern of dominant factor scores shows samples dominated by other factor scores that can be explained by dredging activities in this river sector that restore ancient sedimentary characteristics or expose contaminated sediments. Through the identification of sample locations dominated by factors associated with contamination, it will be possible to select them as priority areas where new environmental (e.g., toxicity tests, organic Sn compounds, tracers of sewage contamination) studies should be implemented in the future.

E-cadherin and β-catenin expression during urothelial carcinogenesis induced by N-butyl-N-(4-hydroxybutyl) nitrosamine in mice

BACKGROUND

E-cadherin and β-catenin are adhesion molecules that promote integrity and stability of the urothelium. A decrease in their expression is associated with more aggressive tumour phenotypes with the ability to invade and metastasize.

MATERIAL AND METHODS

45 ICR male mice were used, of which 25 received N-butyl-N-(4-hydroxybutyl)nitrosamine (0.05%) in drinking water for a period of 12 weeks. Immunohistochemical expression was evaluated in all urinary bladder preparations for E-cadherin and for β-catenin.

RESULTS

Preneoplastic lesions showed staining patterns similar to normal urothelium. In simple and nodular hyperplasia, membrane staining was dominant (66.7-78.6 and 50-100%, respectively). In dysplasia a cytoplasmic pattern was prevalent (86.7-100%). Neoplastic lesions exhibit an abnormal staining pattern (100%) with heterogeneous staining (cytoplasmic, nuclear and membrane staining). A strong correlation was observed between both adhesion molecule staining patterns (r = 0.83; p = 0.039).

CONCLUSIONS

In mice, as in humans, E-cadherin and β-catenin are valuable tools to investigate cellular adhesion status of urothelium and can be considered as indicators of tumour aggressiveness and evolution.

Phosphorylated EGFR at tyrosine 1173 correlates with poor prognosis in oral squamous cell carcinomas

OBJECTIVES

To evaluate the expression of epidermal growth factor receptor (EGFR) and phosphorylated EGFR (pEGFR), in oral squamous cell carcinomas (OSCC). We examined their utility as prognostic markers by relating to clinicopathological characteristics and the clinical outcome.

MATERIALS AND METHODS

We analysed 74 primary OSCC and examined immunohistochemical expression of EGFR and pEGFR (phosphorylated at tyrosine 1173) using tissue microarray technology. Their role in survival was assessed by Kaplan-Meier method and Cox regression models.

RESULTS

Epidermal growth factor receptor expression was observed in all cases, and pEGFR expression was observed in 41.1% of the cases. We found a significant correlation between EGFR and pEGFR expression (P = 0.003). In the multivariable analysis for cause-specific survival, we found an independent prognostic value for pEGFR expression (HR 7.94, 95% CI 2.03-31.06, P = 0.003) and for clinical stage (HR 2.88, 95% CI 1.10-7.53, P = 0.031). For recurrence-free survival, clinical stage (HR 6.59, 95% CI 1.36-31.90, P = 0.019) and tumour grade (HR 3.35, 95% CI 1.07-10.44, P = 0.037) presented independent prognostic value.

CONCLUSION

Epidermal growth factor receptor is highly expressed in OSCC and is phosphorylated in more than one-third of the cases. The independent value of pEGFR expression in cause-specific survival of OSCC suggests that this marker may serve as reliable biological marker to identify high-risk subgroups and to guide therapy.

Use of poly(DL-lactide-ε-caprolactone) membranes and mesenchymal stem cells from the Wharton's jelly of the umbilical cord for promoting nerve regeneration in axonotmesis: in vitro and in vivo analysis

Cellular systems implanted into an injured nerve may produce growth factors or extracellular matrix molecules, modulate the inflammatory process and eventually improve nerve regeneration. In the present study, we evaluated the therapeutic value of human umbilical cord matrix MSCs (HMSCs) on rat sciatic nerve after axonotmesis injury associated to Vivosorb® membrane. During HMSCs expansion and differentiation in neuroglial-like cells, the culture medium was collected at 48, 72 and 96 h for nuclear magnetic resonance (NMR) analysis in order to evaluate the metabolic profile. To correlate the HMSCs ability to differentiate and survival capacity in the presence of the Vivosorb® membrane, the [Ca(2+)]i of undifferentiated HMSCs or neuroglial-differentiated HMSCs was determined by the epifluorescence technique using the Fura-2AM probe. The Vivosorb® membrane proved to be adequate and used as scaffold associated with undifferentiated HMSCs or neuroglial-differentiated HMSCs. In vivo testing was carried out in adult rats where a sciatic nerve axonotmesis injury was treated with undifferentiated HMSCs or neuroglial differentiated HMSCs with or without the Vivosorb® membrane. Motor and sensory functional recovery was evaluated throughout a healing period of 12 weeks using sciatic functional index (SFI), extensor postural thrust (EPT), and withdrawal reflex latency (WRL). Stereological analysis was carried out on regenerated nerve fibers. In vitro investigation showed the formation of typical neuroglial cells after differentiation, which were positively stained for the typical specific neuroglial markers such as the GFAP, the GAP-43 and NeuN. NMR showed clear evidence that HMSCs expansion is glycolysis-dependent but their differentiation requires the switch of the metabolic profile to oxidative metabolism. In vivo studies showed enhanced recovery of motor and sensory function in animals treated with transplanted undifferentiated and differentiated HMSCs that was accompanied by an increase in myelin sheath. Taken together, HMSC from the umbilical cord Wharton jelly might be useful for improving the clinical outcome after peripheral nerve lesion.

Review: BBN as an urothelial carcinogen

Experimental urinary bladder tumours have been proposed as a useful model for the study of urinary bladder carcinogenesis, as well as for evaluating new therapeutic strategies. Consequently, the administration of chemical carcinogens is one of the most commonly used methods for inducing urinary bladder tumours. N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) is, undoubtedly, the most-used urothelial chemical carcinogen. BBN belongs to the nitrosamine family, a wide group of alkylating agents that are able to induce bladder tumours in laboratory animals. Depending on the animal species, the spectrum of urothelial lesions induced by BBN varies, but is similar to those observed in humans. BBN has a high propensity to induce mutations affecting the expression of genes such as p53, RAS and H19 among others. The aim of this study was to review BBN as a urothelial tumour inducer, taking into consideration its chemical characteristics, properties and spectrum of lesions induced, as well as its possible applications.

Transfer of PCBs from bottom sediment to freshwater river fish: a food-web modelling approach in the Rhône River (France) in support of sediment management

Since 2005, restrictions have been because of fish consumption along the Rhone River because of high polychlorobiphenyl (PCB) concentrations, which have resulted inadverse economic consequences for professional fisheries in affected areas. French environmental authorities have expended considerable efforts to research sediment remediation strategies and development of sediment quality guidelines designed to protect the health of humans consuming Rhône River fish. Here we: (1) develop a bioaccumulation food-web model that describes PCB concentrations in three common freshwater fish species of the Rhône River, using Bayesian inference to estimate the input parameters; (2) test the predictive power of the model in terms of risk assessment for fish consumption; and (3) discuss the use of this approach to develop sediment quality guidelines that protect the health of humans consuming Rhône River fish. The bioaccumulation model predictions are protective for human consumer of fish and are efficient for use in risk assessment. For example, 85% of the predicted values were within a factor of 5 of measured CB153 concentrations in fish. Using sensitivity analyses, the major role played by sediment and diet behaviors on bioaccumulation process is illustrated: the parameters involved in the respiratory process (contamination from water) have little impact on model outputs, whereas the parameters related to diet and digestion processes are the most sensitive. The bioaccumulation model was applied to derive sediment concentrations compatible with safe fish consumption. The resulting PCB sediment thresholds (expressed as the sum of seven PCB indicator congeners) that are protective for the consumption of the fish species ranged from 0.7 to 3 ng/g (dw).

Cross-sectional and longitudinal associations between serum uric acid and metabolic syndrome

Research on the importance of serum uric acid (SUA) as a contributing metabolic factor to cardiovascular diseases has conducted to conflicting results, with most studies assuming a cross-sectional design. The aim of this study was to evaluate the association of SUA and metabolic syndrome (MetS) and its features. A representative sample of 2,485 individuals aged ≥18 years was randomly selected from the non-institutionalized resident population of Porto, Portugal. A total of 1,054 eligible subjects were included for the longitudinal analyses. Hyperuricemia was defined as SUA ≥70 mg/L in men and ≥60 mg/L in women. MetS was defined according the Joint Interim (2009) criteria. Associations were estimated using Poison regression and binomial models. In the cross-sectional analysis, subjects with hyperuricemia had a 2.10-fold increased risk of MetS as compared with normouricemic subjects (PR = 2.10, 95% CI: 1.68-2.63). Among MetS features, high triglycerides presented the strongest association with hyperuricemia (PR = 2.32, 95% CI: 1.84-2.91). The MetS crude incidence rate was 4.5/100 person-year (95% CI: 3.9-5.2) in normal uricemic and 13.0/100 person-year (95% CI: 8.5-20.0) in hyperuricemic participants. Using a multivariate longitudinal approach, hyperuricemia was positively associated with MetS incidence rate ratios (IRR = 1.73, 95% CI: 1.08-2.76). One standard deviation increase of SUA concentration was associated with a 1.22-fold increase in MetS risk (IRR = 1.22, 95% CI: 1.05-1.42). Elevated SUA presented the strongest association with high-triglycerides concentration (IRR = 1.44, 95%: 1.22-1.71) and waist circumference (IRR = 1.25, 95%: 1.05-1.49). The independent positive association between SUA and MetS suggested by this longitudinal study supports that SUA might be a risk factor for MetS.

First-degree relatives of patients with early-onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA/OLGIM stages and dysplasia

BACKGROUND

First-degree relatives (FDRs) of early-onset gastric carcinoma (EOGC) patients are at increased risk of cancer development. OLGA/OLGIM (Operative Link on Gastritis/Intestinal Metaplasia Assessment) classifications have been proposed for the identification of individuals at high risk of gastric cancer development.

AIM

To estimate the prevalence and severity of premalignant conditions and lesions in FDRs of EOGC patients.

METHODS

A case-control study was conducted encompassing 103 FDRs of EOGC patients (cases) and 101 age- and gender-matched controls, all submitted to upper GI endoscopy and OLGA and OLGIM used for staging as well as modified versions with exclusion of the biopsies from incisura angularis in the analysis.

RESULTS

Helicobacter pylori infection was present in 82% of cases (P = 0.001). Atrophy was present in 70% of cases (OLGA stages I-IV). High-risk stages (III-IV) were identified only in cases (19%) (P < 0.001). Dysplasia was diagnosed only in cases (n = 7, P = 0.007). The application of OLGIM, modified OLGA and modified OLGIM classifications led to downgrade of stages in comparison with the original OLGA classification (27%, 15% and 30% respectively). In all classification systems, dysplastic lesions clustered (86%) in high-risk stages.

CONCLUSIONS

FDRs of EOGC patients have, even at young ages, a high prevalence of H. pylori infection, high-risk OLGA and OLGIM stages and dysplasia. These patients should undergo accurate endoscopic observation with at least four biopsies in antrum and corpus to allow adequate staging and follow-up of premalignant conditions and lesions scored in high-risk stages, in accordance with international guidelines recently proposed.

Microarray based IgE detection in poly-sensitized allergic patients with suspected food allergy - an approach in four clinical cases

BACKGROUND

Component-resolved diagnosis and microarray technology have been recently introduced into clinical allergy practice, and may be particularly useful in poly-sensitized allergic patients.

METHODS

We compare the clinical usefulness of a microarray-based IgE detection assay (ISAC(®)) with skin tests and specific IgE with standard allergens (sIgE) or their monocomponents in four case reports of patients poly-sensitized to aeroallergens and food.

RESULTS

Case 1: a woman with rhinitis, oral allergy syndrome to several fruits and anaphylaxis to cherry. Diagnostic tests supported non-specific lipid transfer proteins (nsLTPs) primary sensitization. Case 2: a woman with exercise-induced asthma, rhino-conjunctivitis and oral allergy syndrome to fresh fruits of different families. A diagnosis of primary grass and weed pollen allergy with profilin and pathogenesis-related protein family 10 (PR-10) cross-reactive food allergy was proposed. Case 3: a man with atopic eczema, asthma, rhinitis, and multiple anaphylactic episodes with cashew nuts and oral allergy syndrome to fruits. The diagnostic workup supported a primary birch pollen allergy with PR-10 and nsLTPs cross-reactive food allergy. Case 4: a woman with rhino-conjunctivitis, per-operative anaphylaxis due to latex and recent pharyngeal angio-oedema episodes. The diagnosis was a primary grass and weed pollen allergy with equivocal profilin sensitization and no obvious cross-reactivity mediated by nsLTPs sensitization.

CONCLUSIONS

The possibility to carry out multiple sIgE measurements with single protein allergens, in particular with the microarray technique, is a useful, simple and non-invasive diagnostic tool in complex poly-sensitized allergic patients.

Bracken-associated human and animal health hazards: chemical, biological and pathological evidence

Bracken (Pteridium aquilinum) is a widely distributed carcinogenic fern, to whose toxins human populations are exposed through multiple routes. Animals are also affected by bracken toxins, leading to serious production losses yearly. Accordingly, several governmental reports regarding the safeguard of public health against bracken carcinogens have been recently issued. This review describes the main bioactive compounds identified in bracken and their biological effects at the molecular, cellular, pathological and populational levels, with particular emphasis on ptaquiloside, the main bracken carcinogen. Recent biopathological studies shedding further light on the genotoxicity immunotoxicity and carcinogenicity of ptaquiloside are discussed. Key steps on the long effort to understand bracken toxicology are also reviewed, along with the latest findings on new bracken toxins and human exposures routes. The presence of ptaquiloside and related terpene glycosides in milk, meat and water are of particular concern from the viewpoints of both human and animal health.

Is PCBs concentration variability between and within freshwater fish species explained by their contamination pathways?

Many chemical, physiological, and trophic factors are known to affect bioaccumulation of polychlorinated biphenyls (PCBs) in biota. Understanding the primary factors affecting fish contamination is critical for predicting and assessing risks to upper-trophic level consumers, including humans. Here we identify PCB contamination pathways that could explain within- and between-species variability in fish concentration levels. Three freshwater river fish species (barbel, chub and bream) were sampled at three sites along the Rhone River (France) where fish consumption is partially prohibited because of PCB levels exceeding the European health-based benchmark. The trophic position was assessed using an innovative approach based on stable isotope analyses and Bayesian inference, which takes into account both isotope data variability and parameter uncertainty. The effect of foraging habitat on fish contamination was addressed using stable isotope mixing models. The fish trophic position and PCB concentrations were found to be unrelated while the exploitation of sediment detrital carbon as a food source appeared to be a critical factor affecting fish contamination. Fish length, PCB concentration of the sediment, and individual fish foraging habitat (exploitation of detrital versus planktonic carbon sources) explained 80% of within- and between-species variability observed in PCB concentrations. These results, obtained for species that have overlapping TPs and exploit different carbon sources, reveal that the important factor in fish PCB contamination is not only what fish consume, but also and essentially the feeding location.