Comparative in vitro and in silico evaluation of the toxic effects of metformin and/or ascorbic acid, new treatment options in the treatment of Melasma

Melasma is a chronic condition that leads to the buildup of melanin pigment in the epidermis and dermis due to active melanocytes. Even though it is considered a non-life-threatening condition, pigment disorders have a negative impact on quality of life. Since melasma treatment is not sufficient and complicated, new treatment options are sought. Research on metformin and ascorbic acid suggested that they might be used against melasma in the scope of "drug repositioning."The MNT-1 human melanoma cell line was used to assess the effects of metformin, ascorbic acid, and metformin+ascorbic acid combination on cytotoxicity and oxidative stress. Melanin, cAMP, L-3,4-dihydroxyphenylalanine (L-DOPA) and tyrosinase levels were determined by commercial ELISA kits and tyrosinase gene expression was analyzed with RT-qPCR. Cytopathological evaluations were performed by phase contrast microscopy. Tyrosinase expression was determined by immunofluorescence (IF) staining of MNT-1 cells. The online service TargetNet was used for biological target screening. The parameters were not significantly altered by ascorbic acid applied at non-cytotoxic concentrations. On the contrary, metformin dramatically raised tyrosinase and intracellular ROS levels. Moreover, intracellular ROS levels and tyrosinase levels were found to be considerably elevated with the combined treatment. Also, potential metformin and ascorbic acid interactions were determined. According to the results, it can be said that these parameters were not significantly altered by ascorbic acid. On the contrary, metformin dramatically raised tyrosinase and intracellular oxidative stress levels. Moreover, intracellular oxidative stress and tyrosinase levels were elevated with the combined treatment. In conclusion, individual treatments of ascorbic acid or metformin may only provide a limited effect when treating melasma and extensive in vitro and in vivo research are required.

Melasma and Its Effect on Quality of Life: A Cross-Sectional Perspective

INTRODUCTION

Melasma is a skin disorder that causes brown spots on the face, especially in females and people with dark skin. This situation can have a significant impact on the patient's quality of life, including issues with self-confidence, mental strain, and difficulty in social and familial relationships.

OBJECTIVES

This study aimed to evaluate the quality of life of patients with melasma.

METHODS

We conducted a study analyzing the relationship between the severity of melasma and quality of life using the Dermatology Life Quality Index (DLQI) questionnaire.

RESULTS

The study found that severity of melasma, which was measured by the Melasma Area and Severity Index (MASI), was closely related to the degree of maximum darkness in the affected area. The researchers also found a modest impact on quality of life related to the condition, with DLQI scores averaging 6.16, and a strong correlation between MASI scores and quality of life.

CONCLUSIONS

Healthcare professionals should also consider the emotional and societal consequences of skin pigmentation conditions in addition to providing medical and therapeutic interventions. Further research is needed to better understand the complex relationships between different factors and their impact on skin health.

Biomimetic polydopamine loaded with janus kinase inhibitor for synergistic vitiligo therapy via hydrogel microneedles

BACKGROUND

Both oxidative stress and autoimmune responses play crucial roles in the development of vitiligo. Under oxidative stress, the apoptotic melanocytes expose self-antigens and release high mobility group box 1 (HMGB1), triggering autoimmune activation and recruiting CD8+ T cells. This process further leads to the destruction of melanocytes, resulting in the lack of melanin granules. Additionally, the accumulated CD8+ T cells release interferon-γ (IFN-γ) to activate janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway in keratinocytes. Both oxidative stress and IFN-γ-JAK-STAT activation induce keratinocytes to express and release T cell chemotactic factors, exacerbating the process of vitiligo. Reducing the accumulation of CD8+ T cells by safeguarding melanocytes and keratinocytes from oxidative stress may be contemplated as a promising approach for vitiligo therapy.

RESULTS

In this study, we introduce a novel therapeutic agent called PDA-JAKi, which is capable of both eliminating oxidative stress and inhibiting T cell activation. Specifically, we have incorporated the janus kinase inhibitor (JAKi) tofacitinib into antioxidant polydopamine (PDA) nanoparticles, resulting in the formation of uniform PDA-JAKi nanodrug. PDA-JAKi effectively mitigates oxidative stress-induced apoptosis in melanocytes, reducing the antigen presentation and release of HMGB1. In addition, PDA-JAKi simultaneously attenuates oxidative stress and blocks the IFN-γ-JAK-STAT pathway to reduce the expression of C-X-C motif chemokine ligand 9/10/16 (CXCL9/10/16) in keratinocytes. We precisely deliver this therapeutic agent to the dermis using microneedle (MN) patches, aiming to enhance therapeutic efficacy compared to traditional drug administration methods. After PDA-JAKi MN treatment, the symptoms of vitiligo in mice are alleviated, and the affected areas regain pigmentation. Enhancements have been observed in the dermal thickness, the numbers of melanocytes and the content of melanin within the treated skin area. Moreover, there is a notable reduction in reactive oxygen species (ROS) level. Concurrently, substantial decreases were noted in CD8+ T cell infiltration, as well as the levels of IFN-γ and chemotactic factors CXCL9/10/16.

CONCLUSIONS

In summary, PDA-JAKi MN patches emerge as a promising therapeutic agent for vitiligo treatment.

The Impact of Hangeshashinto on Symptoms and Gut Microbiota in Diarrhea-type Irritable Bowel Syndrome: A Retrospective Analysis

Objectives

Effective treatments for diarrhea-type irritable bowel syndrome (IBS-D) are limited. Hangeshashinto (HST), an anti-inflammatory Kampo medicine, may offer benefits but its efficacy for IBS-D requires further investigation. This study evaluated IBS-D symptom improvement and gut microbiota changes following HST administration.

Methods

This was a multicenter retrospective study with a prospective analysis of microbiota conducted at five affiliated institutions. Patients diagnosed with IBS-D based on the ROME IV criteria between April 2019 and December 2023, who received HST 7.5 g/day for 2-3 weeks were included. The outcome measures were improvement rates in overall symptoms, stool frequency, stool consistency, and abdominal pain. Intestinal microbiota was analyzed using 16S rRNA gene sequencing from fecal samples of 20 patients before and after HST treatment.

Results

One hundred patients (42 males/58 females, mean age: 69.5±11.8 years) were analyzed. The overall improvement rate of HST was 82.0%. Those of males and females were 81.0% and 82.8% (p=0.816). By age, those of patients aged ≥75 and aged <75 years were 82.9% and 81.5% (p=0.869). The improvement rates of stool frequency, stool consistency, and abdominal pain were 59.0%, 51.0%, and 62.0%, respectively. The stool frequency per week before and after HST was 21.7±18.2 vs. 14.0±12.6 (p<0.001). Significant differences in gut microbiota β diversity were observed, although α diversity was not significantly changed. Bacteroides (p=0.003) and Ruminococcus (p=0.010) decreased significantly, while Megasphaera (p=0.030) and Subdoligranulum (p=0.002) increased.

Conclusions

HST may improve IBS-D symptoms by altering microbiota composition.

The oxygen level in air directs airway epithelial cell differentiation by controlling mitochondrial citrate export

Oxygen controls most metazoan metabolism, yet in mammals, tissue O2 levels vary widely. While extensive research has explored cellular responses to hypoxia, understanding how cells respond to physiologically high O2 levels remains uncertain. To address this problem, we investigated respiratory epithelia as their contact with air exposes them to some of the highest O2 levels in the body. We asked how the O2 level in air controls differentiation of airway basal stem cells into the ciliated epithelial cells essential for clearing airborne pathogens from the lung. Through a metabolomics screen and 13C tracing on primary cultures of human airway basal cells, we found that the O2 level in air directs ciliated cell differentiation by increasing mitochondrial citrate export. Unexpectedly, disrupting mitochondrial citrate export elicited hypoxia transcriptional responses independently of HIF1α stabilization and at O2 levels that would be hyperoxic for most tissues. These findings identify mitochondrial citrate export as a cellular mechanism for responding to physiologically high O2 levels.

Chitooligosaccharides suppress airway inflammation, fibrosis, and mucus hypersecretion in a house dust mite-induced allergy model

Background

Respiratory allergy is a serious respiratory disorder characterized by inflammation, mucus hypersecretion, and airway tissue sclerosis. Disruption of the T helper 1 (Th1) and T helper 2 (Th2) immune systems by stimuli induced by house dust mites (HDM) and fine particulate matter leads to the secretion of various inflammatory cytokines, resulting in immune respiratory diseases characterized by airway inflammation. Chitooligosaccharides (COS) are known for their antioxidant and anti-inflammatory properties.

Methods

Human airway epithelial cells (BEAS-2B) were cultured in DMEM/F12 medium containing COS at concentrations of 25-100 µg/ml for 24 h. No intracellular toxicity was observed up to 1,000 µg/ml. Cell experiments were conducted at COS concentrations below 100 µg/ml, while animal experiments were performed at concentrations below 100 mg/kg body weight for 4 weeks. Samples of right lung tissue obtained from the experimental animals were used for gene and protein expression analysis, whereas samples of contralateral lung tissue were used for immunohistochemical analysis.

Results

COS regulated Th1 immunity by inhibiting major cytokines, including inflammatory tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6), in BEAS-2B cells. In the HDM-induced allergic respiratory model, COS suppressed the infiltration of inflammatory cells around the airways and inhibited the mRNA expression of Th1 immune cytokines in lung tissues, while also reducing the expression of nuclear factor kappa B (NF-κB)-related proteins. Furthermore, the results confirmed the suppression of the levels of immunoglobulin E (IgE) in the blood secreted by mast cells activated by HDM, which led to a reduction in allergic mucus hypersecretion and airway sclerosis.

Conclusion

In summary, COS are thought to improve airway resistance by alleviating inflammatory allergic respiratory diseases caused by HDM and are regarded as substances that regulate the balance of the Th1 and Th2 immune systems in epithelial cells affected by mucus hypersecretion.

Dosimetry Assessment of Potential Hazard from Visible Light, Especially Blue Light, Emitted by Screen of Devices in Daily Use

Visible light has been considered to have minimal impact on the skin. However, the increasing use of electronic devices has led to a significant increase in exposure to visible light, especially blue light. We measured the irradiance (mW/cm2) and estimated dose (J/cm2) of visible light and blue light emitted from various electronic devices including smartphones, tablets and computers. The measurement was done in normal screen mode and night shift mode at different brightness levels and distances across six screens. The irradiance and dose of visible light and blue light corresponded to the brightness, distance, and screen size of the devices. This study has shown that the irradiance and dose of visible light and blue light emitted from electronic devices in daily use are small and unlikely to be harmful to human skin.

Dietary Interventions, Supplements, and Plant-Derived Compounds for Adjunct Vitiligo Management: A Review of the Literature

Vitiligo is a chronic autoimmune pigmentation disorder shaped by a complex interplay of genetic predispositions and environmental triggers. While conventional therapies-phototherapy, corticosteroids, and immunosuppressants-can be effective, their benefits are often partial and temporary, with recurrence common once treatment stops. As such, there is increasing interest in exploring complementary approaches that may offer a more sustainable impact. Emerging evidence suggests that macronutrient and micronutrient-level changes could be beneficial for managing progression and, in some cases, facilitating repigmentation. Antioxidant-rich foods, such as apples, green tea, Indian gooseberry, onions, and peppers, may help mitigate oxidative stress, while inflammatory foods, such as gluten and high-phenol nuts and berries, may exacerbate the condition. Certain supplements, including high-dose vitamin D, vitamin C, vitamin E, and selenium, may enhance phototherapy outcomes. Omega-3 and other unsaturated fatty acids, in addition to prebiotics and probiotics, are under active investigation for their roles in gut health and immune regulation. Notably, plant-derived compounds, i.e., Ginkgo biloba, have demonstrated promise in promoting repigmentation and managing disease progression. However, it must be emphasized that these nutritional interventions remain exploratory, and more research is needed to establish their efficacy, safety, and optimal usage before they can be recommended as part of a standard treatment regimen.

Ingested house dust mite favors sensitization to egg white in mice independently of its proteinase activity

Background

It is well-documented that house dust mite (HDM) exposure can cause tissue damage and activate innate immune responses. However, its role in promoting gastrointestinal sensitization and allergenicity to food proteins has been relatively unexplored.

Methods

This study investigates the immunostimulatory effects of HDM in a murine model of oral sensitization to egg white (EW) in the absence of exogenous adjuvants. Additionally, we examined a proteolytically inactivated form of HDM (iHDM) to assess the contribution of HDM protease activity to its adjuvant potential.

Results

Both HDM and iHDM enhanced allergic responses to EW proteins via the oral route, evidenced by mast cell degranulation in the intestinal tract upon EW challenge. Notably, only iHDM induced detectable concentrations of serum EW-specific IgE and IgG1 antibodies. Whereas HDM increased intestinal expression of genes encoding tight junction proteins and Th2-inducing alarmins to a greater extent than iHDM, active proteinases were not required for its adjuvant activity, as iHDM preferentially promoted Th2 responses in intestinal lymphoid tissues.

Conclusions

These findings suggest that ingestion of environmental dust may contribute to food allergy development and highlight the complex and context-dependent nature of the adjuvant activity of HDM.

Recent advances in clinical practice: mastering the challenge-managing IBS symptoms in IBD

Many patients with IBD report persisting symptoms, despite resolution of the inflammatory process. Although by definition, a diagnosis of IBS cannot be made, the prevalence of 'IBS in IBD' surpasses the rate of IBS in the global population by fivefold. Because IBS-like symptoms are associated with a decreased quality of life and increased healthcare utilisation in IBD, diagnosis and treatment are necessary. In this review, we summarise the current knowledge on IBS-like symptoms in IBD. A pathophysiological common ground is present, which includes genetic susceptibility, environmental triggers, gut microbial dysbiosis, increased intestinal permeability, visceral hypersensitivity and involvement of brain-gut interaction. When symptoms persist after resolution of inflammation, other GI diseases should be excluded based on the chief complaint, considering any possible psychological co-morbidity early in the diagnostic work-up. Subsequent treatment should be initiated that is evidence-based and often multimodal, including classical and non-classical pharmacological agents as well as lifestyle and microbiota-based approaches, spanning the breadth of the gut, brain and its interaction. Treatment goals in this substantial part of the IBD population should be adapted to not only focus on treating the inflammation but taking care of the patient.

Correlation Between the Koebner Phenomenon and Clinical Features in Vitiligo

Purpose

To investigate the correlation between the presence of the Koebner phenomenon (KP) and clinical features of patients with vitiligo.

Patients and Methods

The clinical characteristic data, including age, age of onset, disease duration, gender, clinical stage, clinical type, family history, and comorbid immune-related diseases, of 1472 patients with/without KP were analyzed with SPSS 17.0 software.

Results

Of the 1472 patients, 290 (19.70%) were positive for KP. The clinical course (6.95 vs 5.62, P = 0.015), percentage of patients with progressive stage (78.97% vs 70.05%, P = 0.002), the acrofacial type (4.49% vs 1.69%, P = 0.004), comorbid immune-related diseases (28.29% vs 19.04%, P = 0.001) and lesion area ≥2% (47.24% vs 38.24%, P = 0.005) in KP-positive group were significantly greater than those in KP-negative group. Binary logistic regression analysis found that progressive stage (P = 0.003, OR = 1.60, 95% confidence interval (CI): 1.17-2.18), area of skin lesion ≥2% (P = 0.008, OR = 1.44, 95% CI: 1.10-1.88) and comorbid immune-related diseases (P = 0.001, OR = 1.63, 95% CI: 1.21-2.20) were significantly associated with KP.

Conclusion

The presence of KP in patients with vitiligo is associated with clinical progression, the acrofacial type, comorbid immune-related disease and a larger lesion area. This study suggested the presence of KP may be an indicator of disease activity and aggression, and underlay its importance in the management of disease.

Balancing act: optimizing blue light for melanogenesis while minimizing cellular damage in primary human skin cells

Introduction

Recent findings show that visible light, particularly blue light, stimulates melanogenesis in human skin, though the underlying mechanisms remain debated. This study aimed to determine the cell damage threshold of non-ionizing blue light on keratinocytes while preserving their ability to stimulate melanogenesis.

Methods

Human keratinocytes (N = 3) and melanocytes (N = 3) were isolated from skin samples of varying Fitzpatrick skin phototypes and irradiated with blue light (λpeak = 457 nm) and UVA light (λpeak = 385 nm). Cellular metabolic activity was assessed using the AlamarBlue HS assay, α-Melanocyte-Stimulating Hormone (α-MSH) production by keratinocytes was quantified using ELISA, and Western blotting was used to assess pro-melanogenic factor expression in melanocytes.

Results

High blue light intensity (50 mW/cm2, 50 J/cm2) and UVA light (15 mW/cm2, 20 J/cm2) significantly reduced cellular metabolic activity, with a 0.86 ± 0.055 and 0.60 ± 0.031 (mean ± SD) fold decrease compared to their respective sham by day 7. In contrast, moderate blue light intensities (5-15 mW/cm2, 10-20 J/cm2) preserved cellular metabolic activity while stimulating α-MSH production, with an optimal balance achieved at 10 mW/cm2, 15 J/cm2 (1.14 ± 0.046 fold increase relative to sham on day 7). Co-culture experiments confirmed that irradiated keratinocytes enhanced melanogenesis in melanocytes via paracrine signaling, increasing the expression of Tyrosinase and Dopachrome Tautomerase (DCT). Direct blue light irradiation on melanocytes also increased pigmentation without significant cellular damage.

Discussion

Moderate-intensity blue light at 10 mW/cm2, 15 J/cm2 effectively stimulates melanogenesis while maintaining cellular metabolic activity in both keratinocytes and melanocytes, offering a promising, safe approach for blue light therapies targeting pigmentation disorders.

Vitiligo and the microbiome of the gut and skin: a systematic review

Vitiligo is a chronic autoimmune skin condition characterized by depigmentation due to the destruction of melanocytes. Recent research has identified potential links between vitiligo and alterations in both the gut and skin microbiomes. This systematic review aims to explore these microbiome changes and their potential role in the onset and progression of vitiligo. A comprehensive search of the PubMed, Medline (OVID), and Web of Science databases was conducted to identify studies examining the gut and/or skin microbiota in vitiligo patients. A total of six studies were included in the qualitative analysis. Data extracted included study type, patient demographics, microbiome sampling methods, bacterial diversity, and bacterial ratios. The studies were assessed using the Methodological Index for Non-Randomized Studies (MINORS) scale. The results revealed inconsistent findings regarding microbial diversity in vitiligo patients. Some studies observed decreased α-diversity in the gut microbiome, while others found an increase, particularly in patients with longer disease duration. An increased Firmicutes-to-Bacteroidetes ratio (higher levels of Firmicutes bacteria compared to Bacteroidetes) was noted in several studies, suggesting a dysbiotic gut microbiome. In the skin microbiome, similar trends of dysbiosis were observed, with alterations in bacterial diversity between lesional and non-lesional skin. The findings indicate that gut and skin microbiome changes may play a role in the pathogenesis of vitiligo. However, the data remain inconclusive due to variability in methodologies and sample sizes. Further research is needed to elucidate the clinical relevance of microbiome alterations in vitiligo, with a focus on controlling external factors such as diet and lifestyle.

Oral Lipids/Fatty Acids Supplements and Eczema: What Is Known?

The pathogenesis of atopic dermatitis (AD) points to skin barrier dysfunction as a critical piece of the puzzle. Deficiencies in fatty acids and ceramides-key elements of the skin barrier-have been linked to AD. Fatty acids can be separated into omega-3 and omega-6, which can be found in a variety of foods such as fish, nuts, seeds, and even plants. In dogs, supplementation with oral fatty acids has shown promising benefits. This review aims to explore whether humans can similarly benefit from these supplements based on current literature. The results of our search varied by compound type. For borage oil and evening primrose oil, evidence of their effectiveness is mixed, though they may offer some preventative benefits. Fish oil supplements appear to be effective in treating AD, as they reduce clinical scores and symptom severity. Oral ceramides, blackcurrant seed oil, and hempseed oil have yet to be thoroughly studied, but preliminary results are promising. Among the studies, the supplementation doses and duration of treatment varied extensively. The literature did not provide comparative analysis between the supplements, and data on the overall safety and tolerability of these supplements are limited. While some evidence is promising, the reliability of these products, as well as their optimal dosage and frequency, remains uncertain.

UVA Irradiation Promotes Melanoma Cell Proliferation Mediated by OPN3 Independently of ROS Production

UVA radiation, a primary risk factor in melanoma progression, partly acts through the mediation of reactive oxygen species (ROS). The role of ROS in driving cutaneous melanoma toward an invasive phenotype and whether it occurs through opsins (OPNs), which are photosensitive G protein-coupled receptors, is not fully understood. This study focuses on the impact of UVA radiation on melanoma cell proliferation, with a special emphasis on OPN3. Investigating the biphasic response to various UVA doses (0.75-9 J/cm2) in A375 and MV3 cell lines, and using EdU and CCK-8 assays, we observed dose-dependent changes in cell proliferation. Interestingly, UVA irradiation at these doses of 0.75, 1.5 and 3 J/cm2 did not significantly induce ROS production. Our study further delves into the role of OPN3, a photosensitive receptor, in melanoma progression. Following UVA exposure, an increase in OPN3 expression was observed in melanoma cells lines A375 and MV3, indicating its role as a UVA-sensitive sensor and its influence on cell proliferation. Additionally, UVA-induced calcium flux in two melanoma cells lines pointed to a calcium-dependent G protein-coupled pathway in melanoma proliferation, mediated by OPN3 and not reliant on ROS. This research sheds light on the mechanism of UVA-induced melanoma progression, underscoring OPN3 as a pivotal regulator and advancing our understanding of UVA's interaction with opsins in melanoma progression.

Interplay of Light, Melatonin, and Circadian Genes in Skin Pigmentation Regulation

Circadian regulation of skin pigmentation is essential for thermoregulation, ultraviolet (UV) protection, and synchronization of skin cell renewal. This regulation involves both cell-autonomous photic responses and non-cell-autonomous hormonal control, particularly through melatonin produced in a light-sensitive manner. Photosensitive opsins, cryptochromes, and melatonin regulate circadian rhythms in skin pigment cells. We studied light/dark cycles and melatonin coordination in melanin synthesis and cell proliferation of Xenopus laevis melanophores. In vivo, tadpole pigmentation shows robust circadian regulation mainly hormone-driven, in that isolated melanophores respond strongly to melatonin but only slightly to light. Melanophore proliferation is faster in the dark and slower with melatonin as compared to a 12/12 light/dark cycle. Expression of circadian core genes (clock, bmal1, per1, per2, per3, cry1, cry2, and cry4) in melatonin-treated cells during the light phase mimics dark phase expression. Overexpression of individual Crys did not affect melanization or cell proliferation, likely due to their cooperative actions. Melanin synthesis was inhibited by circadian cycle deregulation through (a) pharmacological inhibition of Cry1 and Cry2 degradation with KL001, (b) continuous light or dark conditions, and (c) melatonin treatment. Our findings suggest that circadian cycle regulation, rather than proliferative capacity, alters melanization of melanophores.

Association of Vitamin D Level in Hyperreactive Airway Diseases: A Case-Control Study

BACKGROUND

Low vitamin D levels have been associated with hyperreactive airway diseases (HRADs) such as wheeze-associated lower respiratory tract infections, asthma, and allergic rhinitis in children. Vitamin D insufficiency is a modifiable risk factor for managing recurrent respiratory tract infections. This study aimed to estimate vitamin D levels in HRAD patients and assess their association with HRAD by comparing them to healthy children.

METHODS

This case-control study was conducted over 18 months in the Department of Paediatrics, Guru Gobindsingh Government Hospital, Jamnagar. A total of 200 children (100 cases with HRADs and 100 healthy controls) aged six months to 12 years were enrolled using simple random sampling. Cases included children with ≥2 episodes of wheeze-associated lower respiratory tract infections or asthma. Controls were healthy children who were not taking vitamin D3 supplements attending the immunization clinic. Vitamin D levels were measured using electrochemiluminescence immunoassay (ECLIA). Data on dietary habits, sun exposure, and nutritional status were collected. Chest and wrist X-rays were evaluated.

RESULTS

The mean vitamin D level in cases (30.2 ± 17.8 ng/mL) was lower than that of controls (33.6 ± 14.5 ng/mL), with significantly higher odds of deficiency in cases (OR 3.31, p = 0.001). Vitamin D deficiency was associated with younger age, poor nutritional status, limited sun exposure, and low dietary intake of vitamin D-rich foods. Chest X-ray hyperinflation and wrist X-ray findings were significantly linked to vitamin D deficiency.

CONCLUSIONS

Vitamin D deficiency is significantly associated with HRADs in children. Screening and prophylaxis for vitamin D deficiency, particularly in at-risk groups, may help manage HRADs effectively.

Airway Remodeling in Asthma: Mechanisms, Diagnosis, Treatment, and Future Directions

Airway remodeling (AR) with chronic inflammation, are key features in asthma pathogenesis. AR characterized by structural changes in the bronchial wall is associated with a specific asthma phenotype with poor clinical outcomes, impaired lung function and reduced treatment response. Most studies focus on the role of inflammation, while understanding the mechanisms driving AR is crucial for developing disease-modifying therapeutic strategies. This review paper summarizes current knowledge on the mechanisms underlying AR, diagnostic tools, and therapeutic approaches. Mechanisms explored include the role of the resident cells and the inflammatory cascade in AR. Diagnostic methods such as bronchial biopsy, lung function testing, imaging, and possible biomarkers are described. The effectiveness on AR of different treatments of asthma including corticosteroids, leukotriene modifiers, bronchodilators, macrolides, biologics, and bronchial thermoplasty is discussed, as well as other possible therapeutic options. AR poses a significant challenge in asthma management, contributing to disease severity and treatment resistance. Current therapeutic approaches target mostly airway inflammation rather than smooth muscle cell dysfunction and showed limited benefits on AR. Future research should focus more on investigating the mechanisms involved in AR to identify novel therapeutic targets and to develop new effective treatments able to prevent irreversible structural changes and improve long-term asthma outcomes.

How maternal factors shape the immune system of breastfed infants to alleviate food allergy: A systematic and updated review

What infants eat early in life may shape the immune system and have long-standing consequences on the health of the host during later life. In the early months post-birth, breast milk serves as the exclusive and optimal nourishment for infants, facilitating crucial molecular exchanges between mother and infant. Recent advances have uncovered that some maternal factors influence breastfed infant outcomes, including the risk of food allergy (FA). To date, accumulated data show that breastfed infants have a lower risk of FA. However, the issue remains disputed, some reported preventive allergy effects, while others did not confirm such effects, or if identified, protective effects were limited to early childhood. The disputed outcomes may be attributed to the maternal status, as it determines the compounds of the breast milk that breastfed infants are exposed to. In this review, we first detail the compounds in breast milk and their roles in infant FA. Then, we present maternal factors resulting in alterations in breast milk compounds, such as maternal health status, maternal diet intake, and maternal food allergen intake, which subsequently impact FA in breastfed infants. Finally, we analyze how these compounds in breast milk alleviated the infant FA by mother-to-infant transmission. Altogether, the mechanisms are primarily linked to the synergetic and direct effects of compounds in breast milk, via promoting the colonization of gut microbiota and the development of the immune system in infants.

Angiogenesis Factors as Emerging Circulating Biomarkers in Asthma

Angiogenesis is an important event in the development of allergic inflammation as well as in the pathophysiology of tissue remodeling in asthma. Increased angiogenesis is a well-documented feature of airway remodeling in asthma. Angiogenesis refers to the formation of new blood vessels from pre-existing endothelium. Angiogenesis can be initiated by endogenous angiogenic factors released from mesenchymal cells or inflammatory cells. Under physiological conditions, angiogenesis is controlled by an equilibrium between pro-endogenous and anti-endogenous angiogenic factors released from the extracellular matrix to become bioavailable. The presence of increased size and number of bronchial blood vessels indicates that angiogenesis plays a crucial role in tissue growth and remodeling in asthma. However, the diagnostic significance of circulating angiogenic factors in asthma remains unclear. This review summarizes the role of angiogenesis in airway remodeling in asthma, and the potential diagnostic implications of circulating angiogenetic factors.

Relationship between maternal egg consumption during lactation and the risk of developing egg allergies in 12-month-old infants: A multicenter cohort study

AIM

To determine the effect of maternal egg consumption during lactation on the development of egg allergies in 12-month-old infants. We hypothesized that infants whose mothers consume larger amounts of eggs during the early lactation period acquire oral immune tolerance and are less likely to develop egg allergies at 12 months.

METHODS

This study was a part of the Japan Pregnancy Eating and Activity Cohort Study. Mothers answered questionnaires on egg consumption, breastfeeding rates at 1 month, infants' eczema at 6 months, and the development of egg allergies among infants at 12 months. In order to assess the actual impact of maternal egg consumption on infants' egg allergy development, breastfeeding-dependent egg consumption was calculated at 1 month by multiplying maternal egg consumption at 1 month with the breastfeeding rates at the same time. Logistic regression analysis was performed to examine the potential risk and protective factors.

RESULTS

Data from 420 infants were analyzed, of whom 27 had egg allergies at 12 months. No significant impact of breastfeeding-dependent egg consumption was observed on infants' egg allergy development at 12 months. However, infants with eczema at 6 months showed a greater risk of developing an egg allergy at 12 months (adjusted odds ratio, 3.59; 95% confidence interval, 1.59-8.13).

CONCLUSION

The results suggest that breastfeeding-dependent egg consumption at 1 month did not contribute to sufficient oral immune tolerance in 12-month-old infants. Eczema at 6 months significantly impacted the development of an egg allergy, emphasizing the importance of preventing cutaneous exposure to egg allergens.

Interactions between epithelial mesenchymal plasticity, barrier dysfunction and innate immune pathways shape the genesis of allergic airway disease

INTRODUCTION

In genetically predisposed individuals, exposure to aeroallergens and infections from RNA viruses shape epithelial barrier function, leading to Allergic Asthma (AA). Here, activated pattern recognition receptors (PRRs) in lower airway sentinel cells signal epithelial injury-repair pathways leading to cell-state changes [epithelial mesenchymal plasticity (EMP)], barrier disruption and sensitization.

AREAS COVERED

1. Characteristics of sentinel epithelial cells of the bronchoalveolar junction, 2. The effect of aeroallergens on epithelial PRRs, 3. Role of tight junctions (TJs) in barrier function and how aeroallergens disrupt their function, 4. Induction of mucosal TGF autocrine loops activating type-2 innate lymphoid cells (ICL2s) leading to Th2 polarization, 5. How respiratory syncytial virus (RSV) directs goblet cell hyperplasia, and 6. Coupling of endoplasmic reticulum (ER) stress to metabolic adaptations and effects on basal lamina remodeling.

EXPERT OPINION

When aeroallergens or viral infections activate innate immunity in sentinel cells of the bronchoalveolar junction, normal barrier function is disrupted, promoting chronic inflammation and Th2 responses. An improved mechanistic understanding of how activated PRRs induce EMP couples with TJ disruption, metabolic reprogramming and ECM deposition provides new biologically validated targets to restore barrier function, reduce sensitization, and remodeling in AA.

Effects of pregnancy and lactation prebiotics supplementation on infant allergic disease: A randomized controlled trial

BACKGROUND

Ingestion of prebiotics during pregnancy and lactation may have immunomodulatory benefits for the developing fetal and infant immune system and provide a potential dietary strategy to reduce the risk of allergic diseases.

OBJECTIVE

We sought to determine whether maternal supplementation with dietary prebiotics reduces the risk of allergic outcomes in infants with hereditary risk.

METHODS

We undertook a double-blind randomized controlled trial in which pregnant women were allocated to consume prebiotics (14.2 g daily of galacto-oligosaccharides and fructo-oligosaccharides in the ratio 9:1) or placebo (8.7 g daily of maltodextrin) powder from less than 21 weeks' gestation until 6 months postnatal during lactation. Eligible women had infants with a first-degree relative with a history of medically diagnosed allergic disease. The primary outcome was medically diagnosed infant eczema by age 1 year, and secondary outcomes included allergen sensitization, food allergy, and recurrent wheeze by age 1 year.

RESULTS

A total of 652 women were randomized between June 2016 and November 2021 (329 in the prebiotics group and 323 in the placebo group). There was no significant difference between groups in the percentage of infants with medically diagnosed eczema by age 1 year (prebiotics 31.5% [103 of 327 infants] vs placebo 32.6% [105 of 322 infants]; adjusted relative risk, 0.98; 95% CI, 0.77-1.23; P = .84). Secondary outcomes and safety measures also did not significantly differ between groups.

CONCLUSIONS

We found little evidence that maternal prebiotics supplementation during pregnancy and lactation reduces the risk of medically diagnosed infant eczema by age 1 year in infants who are at hereditary risk of allergic disease.

Effect of the arabinogalactan from Ixeris chinensis (Thunb.) Nakai. attenuates DSS-induced colitis and accompanying depression-like behavior

An arabinogalactan (ICPA) was extracted from the medicinal and edible plant Ixeris chinensis (Thunb.) Nakai., and ICPA exhibited excellent immunomodulatory activity. In this research, the impact of ICPA on DSS-induced ulcerative colitis was investigated. The results indicated that ICPA ameliorated the symptoms of colitis mice including loss of body weight, decrease of disease activity index, shortness of colon length and reduction of spleen index that caused by DSS. After treatment with ICPA, inflammatory cell infiltration and crypt loss were alleviated, and the number of goblet epithelial cells was enriched. ICPA inhibited the overproduction of TNF-α, IL-1β, and NLRP3, and promoted the secretion of IL-10 in colon tissues. Meanwhile, the intestinal barrier integrity was restored through increasing the expression of ZO-1 and occludin. ICPA could also regulate the structure of gut microbiota through elevating the abundance of Turicibacter and Bifidobacterium, and decreasing the ratio of Bacteroidetes/Firmicutes. In addition, ICPA improved the depression-like behavior of UC mice, and reduced the expression of proteins NLRP3, GFAP, and Iba-1 in brain tissues. These results suggested ICPA had an alleviative effect on UC and accompanied depression-like behavior, and could be developed as a dietary supplement for the prevention and treatment of UC.

Enhanced Light Response Performance of Ceria-Based Composites with Rich Oxygen Vacancy

Increasing the concentration of oxygen vacancies in ceria-based materials to solve the bottleneck of their applications in various fields has always been a research hotspot. In this paper, ceria-based cerium-oxygen-sulfur (Ce-O-S) composites that were composed of CeO2, Ce4O4S3, and Ce2(SO4)3 were synthesized by a precipitation method. The compositional, structural, morphological, and light response characteristics of prepared Ce-O-S composites were investigated by various characterization techniques. The molar ratio of oxygen vacancies to lattice oxygen can reach a maximum of 1.83 with Ce-O-S composites. The band gap values of the Ce-O-S composites were less than 3.00 eV, and the minimum value was 2.89 eV (at pH 12), which successfully extended the light response range from the ultraviolet light region to the short-wave blue light region. The remarkable light response performance of Ce-O-S composites can be mainly attributed to the high proportion of oxygen vacancy. Moreover, the higher proportion of oxygen vacancies can be attributed to the doping of Ce (+3) and S (-2) in the lattice of CeO2, and the synergistic effect of CeO2, Ce4O4S3, and Ce2(SO4)3. Moreover, the ceria-based Ce-O-S composites with rich oxygen vacancy in this research can be applied in light blocking, photocatalysis, and other related fields.

Bacillus Subtilis-Derived Exopolysaccharide Halts Depigmentation and Autoimmunity in Vitiligo

Vitiligo has a complex multifactorial etiology involving a T-cell-mediated autoimmune response to cutaneous melanocytes. Microbial dysbiosis has been assigned a contributing role in vitiligo etiology. Treating vitiligo can be a challenging task, and finding novel treatment approaches is crucial. In this study, we tested exopolysaccharides (EPSs) isolated from Bacillus subtilis as a microbiome-based therapy. Vitiligo-prone h3TA2 mice were treated by weekly intraperitoneal EPS injection for 18 weeks. Depigmentation was evaluated over time, measuring immune responses at end point. EPS treatment significantly limited the rate of depigmentation. The abundance of cutaneous T cells, specifically CD8+ cytotoxic T cells, was reduced, whereas regulatory T cells were more abundant in the skin of treated mice than in untreated mice. Moreover, EPS treatment was associated with increased numbers of splenic M2 macrophages, elevated splenic indoleamine 2,3-dioxygenase expression, and a systemic cytokine shift toward a type 2 pattern of cytokines. Importantly, splenocytes retrieved from EPS-treated mice were less responsive to cognate tyrosinase peptide, as demonstrated by limited release of IFN-γ and other inflammatory cytokines. In summary, EPS isolated from Bsubtilis interfered with T-cell-mediated depigmentation in the h3TA2 mouse model of vitiligo, suggesting that Bsubtilis EPS could serve as a novel treatment entity for vitiligo.

Effects of Repeated Cisplatin and Monosodium Glutamate on Visceral Sensitivity in Rats

Cisplatin, a chemotherapeutic drug, is known for causing gastrointestinal disorders and neuropathic pain, but its impact on visceral sensitivity is unclear. Monosodium glutamate (MSG) has been shown to improve gastrointestinal dysmotility and neuropathic pain induced by cisplatin in rats. This study aimed to determine if repeated cisplatin treatment alters visceral sensitivity and whether dietary MSG can prevent these changes. Male Wistar HAN rats were treated with saline or cisplatin (2 mg/kg/week, ip) for 5 weeks, and visceral sensitivity to intracolonic mechanical stimulation was recorded after the final cisplatin administration (week 5) and one-week post-treatment (week 6). In a second cohort, rats treated with cisplatin or saline also received MSG (4 g/L) in their drinking water, and visceral sensitivity was evaluated on week 6. Finally, the untouched distal colon was obtained from a third cohort of animals one week after treatment to assess immunocyte infiltration. Cisplatin significantly increased colonic mechanical sensitivity on week 6 but not on week 5. MSG did not prevent cisplatin-induced visceral hypersensitivity on week 6 and even exacerbated it. On week 6, compared with the control, cisplatin (with or without MSG) did not modify the colonic infiltration of eosinophils, macrophages, neutrophils, or mast cells. Although MSG seems to be useful in ameliorating some of the adverse effects of cisplatin, such as gastrointestinal motility disturbances or neuropathic pain, it does not alleviate visceral pain.

CLEC12B Regulates Melanocyte Immunity and Homeostasis in the Skin through the Signal Transducer and Activator of Transcription 1/IRF1 Axis

CLEC12B is a C-type lectin receptor involved in the inhibition of NKs-mediated cytotoxicity. We have previously shown that CLEC12B is predominantly expressed on melanocytes and inhibits melanin production and pigmentation as well as proliferation of melanoma. To date, the role of CLEC12B in skin immunity is unknown. Upon phosphorylation of its immunoreceptor tyrosine-based inhibitory motif, we demonstrate that CLEC12B increases the production of innate chemokines from human melanocytes through the activation of the signal transducer and activator of transcription 1/IFN regulatory factor 1-mediated IFNγ pathway, resulting in chemoattraction of immune cells. We have demonstrated CLEC12B to potentiate the effect of IFNγ in primed melanocytes. Furthermore, CLEC12B recognizes cutaneous (Staphylococcus aureus and E coli) but not gut (Listeria monocytogenes) bacteria and is capable of modulating their chemokine responses. Finally, we have shown that CLEC12B senses motifs present on human melanocytes and fibroblasts but not keratinocytes. Together, these results demonstrate that CLEC12B plays an important function in the human skin, bridging innate and adaptative immunity. This mechanism is of great interest because IFNγ and cellular recruitment are key initial steps involved in inflammation of many skin pathologies, making this receptor an interesting therapeutic target.

Exploring the causal relationship between gut microbiota and atopic dermatitis: A Mendelian randomization study

Accumulating evidence indicates a correlation between gut microbiota (GM) and atopic dermatitis (AD). Nevertheless, the causal relationship between specific pathogenic bacterial taxa and AD remains uncertain. This investigation utilized a two-sample Mendelian randomization (MR) analysis to assess the causal association between GM and AD, identifying the most influential GM taxa. An MR study was conducted utilizing summary statistics derived from genome-wide association studies encompassing 207 GM taxa and their association with AD risk. The genome-wide association studies summary statistics for 207 GM taxa (from phylum to species level) were generated by the Dutch Microbiome Project. The genetic variants (P < 1 × 10-5) correlated with GM (n = 7738) were identified from this investigation. Additionally, 4 supplementary MR approaches, simple mode, MR-Egger, weighted mode, and weighted median, supported the inverse-variance weighted approach. Furthermore, sensitivity analyses were executed using leave-one-out analysis, Cochran Q test, MR-Egger intercept test, MR pleiotropy residual sum and outlier global test, and MR Steiger test. The MR analysis identified 17 distinct bacterial taxa involving 2 orders, 4 families, 5 genera, and 6 species. The inverse-variance weighted method demonstrated that 6 bacterial taxa were positively associated with AD. These taxa included the order Pasteurellales, family Burkholderiales noname, family Pasteurellaceae, genus Burkholderiales noname, species Burkholderiales bacterium_1_1_47, and species Desulfovibrio piger. Eleven bacterial taxa were negatively associated with AD, comprising the order Actinomycetales, family Micrococcaceae, family Oscillospiraceae, genus Rothia, genus Collinsella, genus Oscillibacter, genus Pseudoflavonifractor, species Oscillibacter_unclassified, species Roseburia hominis, species R mucilaginosa, and species Parabacteroides merdae. Moreover, the MR-Egger intercept test and MR pleiotropy residual sum and outlier global test validated that the MR analysis remained unaffected by horizontal pleiotropy (P > .05). Furthermore, the leave-one-out analysis contributed to validating the robustness of the outcomes. Finally, an MR Steiger directionality test confirmed the assessment of potential causal direction (P < .001). This investigation identified specific intestinal flora causally associated with AD risk, offering novel insights for future investigations and innovative avenues for AD diagnosis, therapeutic intervention, and prognostic assessment.

Focusing on the Dark Side of the Moon: Involvement of the Nonlesional Skin in Vitiligo

Research over the last decade has revealed that the normally pigmented skin of patients with vitiligo is not normal at all, as evidenced by alterations in cutaneous morphology and modifications in cellular and metabolic functions that ultimately drive immune activation against melanocytes. Furthermore, nonlesional skin is in a state of subclinical inflammation until triggered by internal and/or external exposomal events. Therefore, targeting early processes that drive immune dysregulation in normally pigmented skin may avoid or reduce melanocyte loss. Thus, shifting the focus to nonlesional skin may prevent the appearance of clinical manifestations of the disease rather than treating the lesions.

An Overview of the Biological Complexity of Vitiligo

Vitiligo is a skin disease that affects all ethnicities and genders and is characterized by the loss of pigment essentially due to the selective loss of melanocytes. Although it is generally considered a systemic disease associated with polymorphisms in genes involved in the immune response, vitiligo is also considered an oxidative imbalance-associated disease. It represents a multifactorial pathology in which some genetic predisposition and epigenetic factors coupled with some critical biochemical and molecular pathways could play a pivotal role. The aim of this work was thus to review some of the fine cellular mechanisms involved in the etiopathogenesis of vitiligo, mainly focusing on the nonimmunological ones, extensively highlighted elsewhere. We took into consideration, in addition to oxidative stress, both the cause and the hallmark of the pathology, some less investigated aspects such as the role of epigenetic factors, e.g., microRNAs, of receptors of catecholamines, and the more recently recognized role of the mitochondria. Sex differences associated with vitiligo have also been investigated starting from sex hormones and the receptors through which they exert their influence. From literature analysis, a picture seems to emerge in which vitiligo can be considered not just a melanocyte-affecting disease but a systemic pathology that compromises the homeostasis of a complex tissue such as the skin, in which different cell types reside playing multifaceted physiological roles for the entire organism. The exact sequence of cellular and subcellular events associated with vitiligo is still a matter of debate. However, the knowledge of the individual biological factors implicated in vitiligo could help physicians to highlight useful innovative markers of progression and provide, in the long run, new targets for more tailored treatments based on individual manifestations of the disease.

Serum Vitamin D Profiles of Children with Asthma in Southwest Saudi: A Comparative Cross-Sectional Study

Background

Evidence suggests a strong association between vitamin D status and asthma, with individuals exhibiting vitamin D deficiency demonstrating increased prevalence and severity of asthma symptoms. This study aimed to determine the prevalence of vitamin D deficiency among asthmatic children, assess the association between vitamin D status and asthma severity/control, and identify potential predictors of vitamin D deficiency in this population.

Patients and Methods

This comparative cross-sectional, hospital-based study was conducted at Abha Maternity and Children's Hospital, a tertiary care and teaching institution in southwestern Saudi Arabia, between January 2023 and May 2024.

Results

A total of 331 asthmatic children and 101 non-asthmatic children were analyzed. Children with asthma had significantly lower serum vitamin D levels than those without asthma (21.5 ± 8.8 ng/mL vs 33.3 ± 13.2 ng/mL, p < 0.001). Significantly higher proportions of asthmatic children exhibited vitamin D deficiency (51.1%) and insufficiency (34.7%) compared to non-asthmatic children (19.8% and 29.7%, respectively). Serum vitamin D levels among asthmatic children showed significant negative correlations with age (r = -0.332, p < 0.001), weight (r = -0.292, p < 0.001), height (r = -0.298, p < 0.001), and BMI (r = -0.274, p < 0.001). These findings were further supported by univariate linear regression analysis. Multivariable analysis additionally confirmed age (β = -0.66, p < 0.001) and BMI (β = -0.25, p = 0.05) as independent predictors of vitamin D status, with older age and higher BMI associated with lower vitamin D levels. For each additional year of age, serum vitamin D decreased by an average of 0.66 ng/mL (p < 0.001) and a one-unit increase in BMI was associated with a decrease of 0.25 ng/mL in serum vitamin D (p = 0.05).

Conclusion

This study found a strikingly high prevalence of vitamin D deficiency among asthmatic children in southwestern Saudi Arabia, significantly exceeding rates in controls. These findings underscore the need for widespread vitamin D screening and supplementation in this population, particularly among older, overweight asthmatic children.

Inhalation exposure to chemicals, microbiota dysbiosis and adverse effects on humans

As revealed by culture-independent methodologies, disruption of the normal lung microbiota (LM) configuration (LM dysbiosis) is a potential mediator of adverse effects from inhaled chemicals. LM, which consists of microbiota in the upper and lower respiratory tract, is influenced by various factors, including inter alia environmental exposures. LM dysbiosis has been associated with multiple respiratory pathologies such as asthma, lung cancer, idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). Chemically-induced LM dysbiosis appears to play significant roles in human respiratory diseases, as has been shown for some air pollutants, cigarette smoke and some inhalable chemical antibiotics. Lung microbiota are also linked with the central nervous system (CNS) in the so-called lung-brain axis. Inhaled chemicals that undergo mucociliary clearance may be linked to respiratory conditions through gut microbiota (GM) dysbiosis in the so-called Gut-Lung axis. However, current linkages of various disease states to LM appears to be associative, with causal linkages requiring further studies using more robust approaches, methods and techniques that are different from those applied in studies involving (GM). Most importantly, the sampling techniques determine the level of risk of cross contamination. Furthermore, the development of continuous or semi-continuous systems designed to replicate the lung microbiome will go a long way to further LM dysbiosis studies. These challenges notwithstanding, the preponderance of evidence points to the significant role of LM-mediated chemical toxicity in human disease and conditions.

Alpha-synuclein knockout impairs melanoma development and alters DNA damage repair in the TG3 mouse model in a sex-dependent manner

Strong evidence suggests links between Parkinson's Disease (PD) and melanoma, as studies have found that people with PD are at an increased risk of developing melanoma and those with melanoma are at increased risk of developing PD. Although these clinical associations are well-established, the cellular and molecular pathways linking these diseases are poorly understood. Recent studies have found a previously unrecognized role for the neurodegeneration-associated protein alpha-synuclein (αSyn) in melanoma; the overexpression of αSyn promotes melanoma cell proliferation and metastasis. However, to our knowledge, no studies have investigated the role of αSyn in in vivo melanoma models outside of a xenograft paradigm. Our study created and characterized Snca knockout in the spontaneously developing melanoma TG3 mouse line, TG3+/+Snca-/-. We show that αSyn loss-of-function significantly delays melanoma onset and slows tumor growth in vivo. Furthermore, decreased tumor volume is correlated with a decreased DNA damage signature and increased apoptotic markers, indicating a role for αSyn in modulating the DNA damage response (DDR) pathway. Overall, our study provides evidence that targeting αSyn and its role in modulating the DDR and melanomagenesis could serve as a promising new therapeutic target.

Anti-CdtB and anti-vinculin antibodies to diagnose irritable bowel syndrome in inflammatory bowel disease patients

BACKGROUND

Despite adequate treatment, a subgroup of patients with inflammatory bowel disease (IBD), including Crohn`s disease and ulcerative colitis, have persistent gastrointestinal symptoms that are not always related to mucosal damage. Recently, two autoantibodies, anti-CdtB and anti-vinculin, were validated as post-infectious IBS (PI-IBS) markers, however there is limited evidence of its diagnostic role in IBD population.

METHODS

Patients with more than 3 bowel movements/day and indication of colonoscopy were enrolled. Samples were collected at the time of colonoscopy for assessment of serum levels of anti-CdtB and anti-vinculin antibodies.

RESULTS

A total of 160 subjects were included in 4 groups: active IBD (n = 44); quiescent IBD and chronic diarrhea IBD-IBS (n = 25); predominant-diarrhea IBS (n = 45) and controls (n = 46). The mean value of the optical density for anti-CdtB was 1.2 ± 0.65 in group 1, 1.27 ± 0.64 in group 2, 1.49 ± 0.47 in the group 3 and 1.6 ± 0.68 in group 4, p = 0.012. For anti-vinculin, optical densities were: 1.34 ± 0.78 in group 1, 1.46 ± 0.92 in group 2, 1.31 ± 0.79 in group 3 and 1.41 ± 0.86 for controls (p = 0.875). Using a cut-off of 1.56 for anti-CdtB, the positivity between groups was n = 10 (22.7%) in group 1, n = 9 (34.6%) in group 2, 19 (43.2%) in group 3, 21 (45.7%) in group 4 (p = 0.106). The positivity of anti-vinculin using a cut-off of 1.6 was n = 18 (40.9%) in group 1, n = 11 (42.3%), n = 15 (34.1%), n = 22 (47.8%) (p = 0.622).

CONCLUSIONS

Our findings show that anti-CdtB and anti-vinculin could not identify IBD-IBS patients or discriminate IBS-D from healthy controls.

Targeted nuclear degranulation of neutrophils promotes the progression of pneumonia in ulcerative colitis

Background

Both intestinal and pulmonary systems are parts of the mucosal immune system, comprising ∼80% of all immune cells. These immune cells migrate or are transported between various mucosal tissues to maintain tissue homeostasis.

Methods

In this study, we isolated neutrophils from the peripheral blood of patients and utilized immunofluorescence, flow cytometry, and Western blotting to confirm the incidence of "nucleus-directed degranulation" in vitro. Subsequently, we conducted a precise analysis using arivis software. Furthermore, using the DSS mouse model of colitis and tissue clearing technologies, we validated the "targeted nuclear degranulation" of neutrophils and their migration to the lungs in an inflammatory intestinal environment.

Result

In this study, we found that among patients with ulcerative colitis, the migration of neutrophils with "targeted nuclear degranulation" from the intestinal mucosa to the lungs significantly exacerbates lung inflammation during pulmonary infections. Notably, patients with ulcerative colitis exhibited a higher abundance of neutrophils with targeted nuclear degranulation. Using DSS mice, we observed that neutrophils with targeted nuclear degranulation from the intestinal mucosa migrated to the lung and underwent activation during pulmonary infections. These neutrophils rapidly released a high amount of neutrophil extracellular traps to mediate the progression of lung inflammation. Alterations in the neutrophil cytoskeleton and its interaction with the nuclear membrane represent the primary mechanisms underlying targeted nuclear degranulation.

Conclusion

This study revealed that neutrophils accelerate lung inflammation progression in colitis, offering new insights and potential treatment targets for lung infections for patients with colitis.

Evidence for a sex-dependent effect modification in the association between IFN-λ DNA polymorphisms and expression of IFN-λ and interferon-stimulated genes in human PBMCs

Human interferon (IFN) lambda (IFNL, IFN-L or IFN-λ) locus has several functional genetic variants but their role in regulating in vivo gene expression, and whether they associate with antiviral states in healthy individuals, is not clear. In this study, we recruited ∼550 healthy individuals belonging to both sexes, genotyped them for several IFNL genetic variants and measured, by qPCR, the expression of IFNL2/3, IFNL4 and four IFN-stimulated genes (ISGs) (MX1, OAS1, ISG15 and RSAD2) from their peripheral blood mononuclear cells (PBMC) both before and after stimulation with a viral mimic, poly I: C. We also measured secreted levels of several cytokines including IFN-λ1 and IFN-λ3 in poly I:C stimulated PBMCs. We found that males secrete higher levels of IFN-λs than females. The IFNL3/4 genetic variants significantly associated with secreted levels of both IFN-λ1 and IFN-λ3 in opposite directions, only in males. While the IFNL3/4 variants significantly associated with ISG expression either in basal or poly I:C induced or in both states, the direction of effect was opposite for the two sexes, suggesting that sex was a strong effect modifier. We did not see this trend in the association of ISG expression with the IFNL1 polymorphism, rs7247086, whose association with ISG expression and secreted IFN-λ3 levels was seen in females but not in males. Further, expression of several genes was associated with the IFN-λ4 activity-modifying variant rs117648444. However, we neither saw any strong correlation between levels of IFN-λ1/3 and ISG expression, nor did we see any strong evidence of IFNL4 expression that could be responsible for the association between ISG expression and IFNL genetic variants. These results suggest that there are complex interactions involving gender, IFN-λs, IFN-λ genetic variants and antiviral states in humans.

Advances in Understanding Drug Resistance Mechanisms and Innovative Clinical Treatments for Melanoma

OPINION STATEMENT

Melanoma, a highly invasive skin cancer resulting from melanocyte malignant transformation, is the third most common skin malignancy. Despite accounting for only 4% to 5% of all skin malignancies, it is responsible for 80% of skin cancer-related deaths. Targeted therapies and immune checkpoint inhibitors have improved survival rates, yet drug resistance remains a major challenge. In this review, I explore the latest research progress on melanoma drug resistance mechanisms and clinical treatment methods. This aims to provide insights for more effective treatment strategies and improve patient prognosis and quality of life. I also discuss potential strategies to overcome drug resistance based on the latest scientific findings, with a particular focus on the complex and multi-factorial drug resistance mechanisms of melanomas, including genetic mutations, epigenetic changes, and tumor microenvironment factors. Understanding these mechanisms is crucial for developing new drugs and combination therapies targeting drug-resistant tumors. Analyzing complex drug resistance pathways paves the way for personalized medical approaches, which is expected to provide enlightenment on breaking through drug resistance barriers and enhancing the effectiveness of melanoma treatment.

Systematic review on antipruritic therapies for patients with Epidermolysis bullosa

INTRODUCTION

Itch is one of the most burdensome symptoms in epidermolysis bullosa (EB), indicating a hitherto unmet therapeutic need. This review leverages existing data on efficacy of itch treatment in EB to support sound decision making.

METHODS

A systematic literature search was performed on 29 March 2022. Studies written later than 1991 and reporting outcomes in patients with EB treated for itch were considered.

RESULTS

Of the 3,099 articles screened, 21 studies met eligibility criteria, comprising 353 patients (65.9%) diagnosed for recessive dystrophic EB. Only two studies (9.5%) evaluated itch as primary endpoint, of which solely one revealed a significant relief of self-reported itch upon topical skin care. In those studies assessing itch as secondary endpoint (19/21, 90.5%), only 36.8% studies (n = 7/19) revealed a statistically significant itch reduction of up to 42%. Methodological limitations (heterogeneity of outcomes, inconsistent data assessment) in addition to limited superiority over control were implicated to account for low treatment efficacy observed in most studies.

CONCLUSION

Current data quality impairs comparative efficacy analyses of itch treatments in EB. Large scale randomized clinical trials and more personalized approaches applying validated measurement instruments for core outcomes are needed to substantiate evidence-based treatment approaches for EB-associated itch.

Chemical Profile and Promising Applications of Cucurbita pepo L. Flowers

Although edible flowers have been historically principally used due to their visual appeal and smell, the world is discovering their value as innovative and natural sources of bioactive compounds. Cucurbita pepo L. (CpL), a plant from the Cucurbitaceae family, is widely cultivated for its edible fruits and flowers, which are rich in polyphenols and carotenoids-compounds known for their potent antioxidant and anti-inflammatory properties. Despite their potential, the use of CpL flowers for skin-related applications remains underexplored. This study aimed to comprehensively analyze CpL flower extract (CpLfe), focusing on its polyphenolic and carotenoid content using, for the first time, advanced UHPLC-Q-Orbitrap HRMS and HPLC-DAD analysis. CpLfe highlighted remarkable antioxidant activity according to the DPPH, ABTS, and FRAP tests. CpLfe showed significantly reduced intracellular ROS in HaCaT (23%, p < 0.05) and protected against UVB-induced damage by lowering MMP-1 expression. CpLfe also upregulated genes crucial for skin hydration (AQP3) and barrier function (CerS2, CerS4, and CerS6). A placebo-controlled, randomized clinical trial further validated CpLfe efficacy, demonstrating marked improvements in moisture retention, wrinkle reduction, and collagen production in women aged 35-55. These findings suggested that CpL flowers could be a source of bioactive compounds recovered from edible flowers able to improve the major skin aging and photoaging features.

Unique genital microbiota in male lichen sclerosus urethral stricture associated with urine exposure

BACKGROUND

Lichen sclerosus (LS) is a chronic inflammatory cicatricial skin disease that can lead to urethral stricture or even malignant transformation and the etiology is still unknown. This study comparatively analyzed the balanopreputial swab and urine microbiota simultaneously between male patients with LS urethral stricture (LSUS) and non-LS urethral stricture (non-LSUS).

METHODS

We prospectively included 31 male patients with LSUS and 30 with non-LSUS in this case-control study. Midstream urine samples and balanopreputial swabs were collected from each patient for the 16S V3-V4 hypervariable region sequencing. Operational taxonomic units were defined using a > 97% sequence similarity threshold. We compared the differences in alpha diversity, beta diversity, and microbial structure between the two groups.

RESULTS

Whether in swab or urine samples, there was no significant difference in alpha diversity between the two groups. Swab samples showed a significant difference in beta diversity (p = 0.001). For all individuals, composition analyses showed that the most abundant phyla were Actinobacteria, Firmicutes, Proteobacteria, and Bacteroidetes in both samples. Additionally, the microbial communities of swab samples were significantly more similar to the communities of urine samples in the LSUS group (p = 0.047).

CONCLUSIONS

Microbiota showed significant variation between LSUS and non-LSUS groups, suggesting that microecological imbalance may be closely related to the occurrence of LS. Urinary irritation may be related to the unique microbiota on the genital skin of patients with LSUS.

Increased splicing of CXCR3 isoform B (CXCR3B) by impaired NRF2 signaling leads to melanocyte apoptosis in active vitiligo

Apoptotic melanocytes (MCs) may release neoantigenic epitopes preceding epidermal infiltration by autoreactive CD8+ T cells in early vitiligo. However, the mechanism by which vitiligo MCs are prone to apoptosis under oxidative stress remains elusive. Pro-apoptotic receptor C-X-C motif chemokine receptor 3 isoform B (CXCR3B) is critical for inducing MC apoptosis in the inflammatory microenvironment of lesional vitiligo skin. Here, we show that C-X-C motif chemokine ligand 10 (CXCL10), a functional ligand for CXCR3B, is upregulated in primary dermal fibroblasts and in CD90+ reticular fibroblasts of vitiligo skin. The number of CXCR3B+ MCs was increased in active vitiligo skin compared with healthy skin and stable vitiligo skin. Mechanistically, impaired nuclear factor erythroid 2-related factor 2 (NRF2) signaling in oxidatively stressed MCs leads to the elevated expression of CXCR3B and increased apoptosis. The overexpression of NRF2 prevents MCs from CXCL10-induced apoptosis through upregulation of pro-survival receptor CXCR3 isoform A (CXCR3A). Overall, MCs expressing CXCR3B are more susceptible to apoptosis. Suppressing CXCR3B could be a promising therapeutic approach to extinguish inflammation in vitiligo skin.

Impact of blue light on cutaneous barrier structures and properties: NPLC/HR-MSn and Raman analyses

Skin health relies heavily on a well-maintained cutaneous barrier. While the detrimental effects of UV radiation on the epidermis are established, the impact of blue light, a significant component of sunlight and artificial sources, is less clear. This study aims to explore blue light's influence on the reconstructed human epidermis (RHE) using two complementary analytical approaches: Raman microspectroscopy and normal phase liquid chromatography coupled with high-resolution mass spectrometry (NPLC/HR-MSn). RHE samples were exposed to blue light (415 nm and 455 nm) during different stages of their maturation. Raman spectra were acquired for both irradiated and non-irradiated (control) samples. Raman descriptors were analyzed to assess potential alterations in the structural organization of proteins and lipids' conformational changes. Additionally, lipids from RHE samples were extracted and analyzed using NPLC/HR-MSn. Blue light exposure led to changes in the structural organization of RHE lipids and proteins, as well as changes in the lipid composition. These changes varied depending on the wavelength and exposure dose. Exposure to blue light could disrupt the integrity of the skin's protective barrier, leading to increased sensitivity to environmental stressors and potential skin damage.

Dual Inhibition of SYK and EGFR Overcomes Chemoresistance by Inhibiting CDC6 and Blocking DNA Replication

Targeting multiple signaling pathways has been proposed as a strategy to overcome resistance to single-pathway inhibition in cancer therapy. A previous study in epithelial ovarian cancers identified hyperactivity of spleen tyrosine kinase (SYK) and EGFR, which mutually phosphorylate and activate each other. Given the potential for pharmacologic inhibition of both kinases with clinically available agents, this study aimed to assess the antitumor efficacy of both pharmacologic and genetic SYK and EGFR coinhibition using a multifaceted approach. We assessed the coinactivation effects in chemoresistant ovarian cancer cell lines, patient-derived organoids, and xenograft models. Dual inhibition of SYK and EGFR in chemoresistant ovarian cancer cells elicited a synergistic antitumor effect. Notably, the combined inhibition activated the DNA damage response, induced G1 cell-cycle arrest, and promoted apoptosis. The phosphoproteomic analysis revealed that perturbation of SYK and EGFR signaling induced a significant reduction in both phosphorylated and total protein levels of cell division cycle 6, a crucial initiator of DNA replication. Together, this study provides preclinical evidence supporting dual inhibition of SYK and EGFR as a promising treatment for chemoresistant ovarian cancer by disrupting DNA synthesis and impairing formation of the prereplication complex. These findings warrant further clinical investigation to explore the potential of this combination therapy in overcoming drug resistance and improving patient outcomes. Significance: SYK and EGFR coinhibition exerts synergistic anticancer effects in chemoresistant ovarian cancer, providing a strategy to treat chemotherapy-resistant ovarian cancers using clinically available agents by targeting critical signaling pathways involved in DNA replication.

The roles of cancer stem cells and therapeutic implications in melanoma

Melanoma is a highly malignant skin tumor characterized by high metastasis and poor prognosis. Recent studies have highlighted the pivotal role of melanoma stem cells (MSCs)-a subpopulation of cancer stem cells (CSCs)-in driving tumor growth, metastasis, therapeutic resistance, and recurrence. Similar to CSCs in other cancers, MSCs possess unique characteristics, including specific surface markers, dysregulated signaling pathways, and the ability to thrive within complex tumor microenvironment (TME). This review explored the current landscape of MSC research, discussing the identification of MSC-specific surface markers, the role of key signaling pathways such as Wnt/β-catenin, Notch, and Hedgehog (Hh), and how interactions within the TME, including hypoxia and immune cells, contribute to MSC-mediated drug resistance and metastatic behavior. Furthermore, we also investigated the latest therapeutic strategies targeting MSCs, such as small-molecule inhibitors, immune-based approaches, and novel vaccine developments, with an emphasis on their potential to overcome melanoma progression and improve clinical outcomes. This review aims to provide valuable insights into the complex roles of MSCs in melanoma biology and offers perspectives for future research and therapeutic advances against this challenging disease.

Synchronized development of thymic eosinophils and thymocytes

The thymus is an organ required for T cell development and is also an eosinophil-rich organ; however, the nature and function of thymic eosinophils remain unclear. Here, we characterized the gene expression and differentiation mechanism of thymic eosinophils in mice. Thymic eosinophils showed a distinct gene expression profile compared with other organ-resident eosinophils. The number of thymic eosinophils was controlled by medullary thymic epithelial cells (mTECs). In Rag-deficient mice, the unique gene expression signature of thymic eosinophils was lost but restored by pre-T cell receptor signalling, which induces CD4+ CD8+ thymocyte differentiation, indicating that T cell differentiation beyond the CD4- CD8- stage is necessary and sufficient for the induction of thymic eosinophils. These results demonstrate that thymic eosinophils are quantitatively and qualitatively regulated by mTECs and developing thymocytes, respectively, suggesting that thymic eosinophils are a distinct, thymus-specific cell subset, induced by interactions with thymic cells.

Integrative Gut Microbiota and Metabolomic Analyses Reveal the PANoptosis- and Ferroptosis-Related Mechanisms of Chrysoeriol in Inhibiting Melanoma

Chrysoeriol, a natural flavonoid, has shown potential in inhibiting melanoma. However, the detailed molecular mechanisms of its action still need to be clarified. In this study, chrysoeriol showed significant suppressive effects on melanoma progression in a mouse model. The integrative gut microbiota and metabolomic analyses revealed that chrysoeriol modulates multiple pathways associated with apoptosis, necroptosis, pyroptosis, and ferroptosis. Morphological changes in chrysoeriol-treated melanoma cells showed PANoptosis- and ferroptosis-related characteristics. Additionally, chrysoeriol induced apoptosis, altered mitochondrial membrane potential, increased ROS production, promoted necroptosis, and also upregulated molecules linked to pyroptosis and ferroptosis. Molecular-level experiments confirmed that chrysoeriol promoted the upregulation of crucial proteins associated with the PANoptosis and ferroptosis pathways. Inhibition of PANoptosis and ferroptosis pathways by inhibitors or gene knockdown significantly attenuated the inhibitory effects of chrysoeriol on melanoma cell viability. This study provides robust evidence that chrysoeriol triggers both PANoptosis and ferroptosis in melanoma cells, underscoring its promise as a treatment option for melanoma.

Light-sensitive Ca2+ signaling in the mammalian choroid

The choroid is the thin, vasculature-filled layer of the eye situated between the sclera and the retina, where it serves the metabolic needs of the light-sensing photoreceptors in the retina. Illumination of the interior surface of the back of the eye (fundus) is a critical regulator of subretinal fluid homeostasis, which determines the overall shape of the eye, but it is also important for choroidal perfusion. Noted for having some of the highest blood flow rates in the body, the choroidal vasculature has been reported to lack intrinsic, intravascular pressure-induced (myogenic) autoregulatory mechanisms. Here, we ask how light directly regulates choroid perfusion and ocular fluid homeostasis, testing the hypothesis that light facilitates ocular fluid absorption by directly increasing choroid endothelial permeability and decreasing choroid perfusion. Utilizing ex vivo pressurized whole-choroid and whole-eye preparations from mice expressing cell-specific Ca2+ indicators, we found that the choroidal vasculature has two intrinsically light-sensitive Ca2+-signaling mechanisms: One increases Ca2+-dependent production of nitric oxide in choroidal endothelial cells; the other promotes vasoconstriction through Ca2+ elevation in vascular smooth muscle cells. In addition, we found that choroidal flow, or pressure, modulates endothelial and smooth muscle photosensitivity and trans-retinal absorption of fluid into the choroid. These results collectively suggest that the choroid vasculature exhibits an inverted form of autoregulatory control, where pressure- and light-induced mechanisms work in opposition to regulate blood flow and maintain fluid balance in response to changes in light and dark, aligning with the metabolic needs of photoreceptors.

From Phenotype to Molecules: Unveiling the Genetic and Immunological Bridges Between Autoimmune Diseases and Vitiligo

Introduction

Vitiligo is an autoimmune disease characterized by the loss of skin pigmentation. This study aims to explore genetic associations between vitiligo and 21 autoimmune diseases using Mendelian randomization (MR) analysis, with a focus on identifying potential risk and protective factors.

Methods

We performed univariable and multivariable Mendelian randomization analyses to assess the causal associations between 21 autoimmune diseases and vitiligo. Confounding factors, including smoking, alcohol consumption, and Body Mass Index (BMI), were integrated into the multivariable analysis. Strongly associated single nucleotide polymorphisms (SNPs) were mapped to genes, followed by Summary-data-based Mendelian Randomization (SMR) analysis with expression Quantitative Trait Loci (eQTL) and methylation Quantitative Trait Loci (mQTL) data. Risk and protective factors were further identified by evaluating inflammatory mediators and immune cell phenotypes.

Results

The MR analysis identified seven autoimmune diseases with potential causal associations with vitiligo. However, after accounting for confounding factors, only Hashimoto's thyroiditis and type 1 diabetes maintained genetic associations with vitiligo. Gene mapping revealed 25 intersecting genes between these two diseases and vitiligo. SMR analysis confirmed Sulfite Oxidase (SUOX) as a protective gene across multiple tissues. Furthermore, several inflammatory factors were identified as risk factors, including C-X-C motif chemokine ligand 9 (CXCL9), C-X-C motif chemokine ligand 10 (CXCL10), Tumor Necrosis Factor (TNF), and Signaling Lymphocytic Activation Molecule (SLAM). In contrast, Osteoprotegerin (OPG) was identified as a protective factor.

Discussion

This study provides novel insights into the shared molecular mechanisms linking vitiligo with other autoimmune diseases. The identification of SUOX as a common protective gene and the discovery of specific inflammatory and immune-related factors may facilitate future therapeutic strategies.