Possible inhibitory mechanism of FK506 (tacrolimus hydrate) ointment for atopic dermatitis based on animal models

Applications of topical immunomodulators enhance clinical signs of vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC): a meta-analysis

PURPOSE

This meta-analysis aimed to review the safety and efficacy of topical cyclosporine A (CsA) and topical tacrolimus in allergic eye disease.

METHODS

A systematic search identified thirteen studies and a total of 445 patients for inclusion, making this the largest meta-analysis published on the subject. The current review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

RESULTS

Thirteen randomized control trials were included in the meta-analysis. Eleven studies used CsA as the treatment, and two used Tacrolimus. In total, 445 participants were included, of whom 76.6% were male. The mean age of participants across the included studies was 14 years. All studies reported clinical signs as evaluated by an examining clinician. Signs were usually assessed by anatomical region, with the most common regions being the conjunctiva and the cornea, and the most common signs assessed were hyperemia and papillae. Three studies accounted for more than 50% of the meta-analysis's weight. Effect size (d) ranged from - 2.37 to - 0.03, negative values favoring immunomodulators. Fixed Effect Meta-Analysis returned an SMD of - 0.81 (95% CI [- 0.98, - 0.65]). However, there was significant heterogeneity (I2 = 61%, Qw = 30.76) in the outcome measure (P = 0.0021); therefore, a random-effect meta-analysis was also completed in which the pooled SMD was - 0.98 (95% CI [- 1.26, - 0.69], τ2 = 0.16).

CONCLUSIONS

This study affirms the current scientific community's stance that immunomodulators effectively treat clinical signs, including blepharitis, conjunctival hyperemia, edema, papillae, and corneal damage in severe ocular allergic disease.

An LC-MS/MS-based platform for the quantification of multiple amyloid beta peptides in surrogate cerebrospinal fluid

Introduction

The accurate quantification of amyloid beta (Aβ) peptides in cerebrospinal fluid (CSF) is crucial for Alzheimer's disease (AD) research, particularly in terms of preclinical and biomarker studies. Traditional methods, such as the enzyme-linked immunosorbent assay (ELISA), have limitations. These include high costs, labor intensity, lengthy processes, and the possibility of cross-reactivity.

Objectives

The primary objectives of this research were twofold: to comprehensively characterize Aβ peptides and to develop a reliable and accurate method for the simultaneous quantification of Aβ 1-40 and Aβ 1-42 peptides in surrogate CSF that is traceable to the International System of Units (SI).

Methods

We developed a novel method that combined solid phase extraction (SPE) with isotope dilution liquid chromatography/tandem mass spectrometry (ID-LC/MSMS). SPE was employed to efficiently eliminate matrix interferences, while [15N] Aβ1-40 and [15N] Aβ1-42 served as internal standards to improve accuracy. In addition, we introduced Peptide Impurity Corrected Amino Acid Analysis (PICAA) to ensure traceability to the SI and reliable quantification of Aβ peptides.

Results

The developed platform demonstrated a linear calibration range of 300-20000 pg/ml for both Aβ1-42 and Aβ1-40 peptides, accompanied by strong correlation coefficients greater than 0.995. Quality Control (QC) samples demonstrated an accuracy of at least 90.0 %.

Conclusion

The enhanced specificity and flexibility of the developed platform potentially have implications for Alzheimer's disease diagnosis and future investigations of novel Aβ peptide biomarkers.

Antioxidant, Antiglaucoma, Anticholinergic, and Antidiabetic Effects of Kiwifruit (Actinidia deliciosa) Oil: Metabolite Profile Analysis Using LC-HR/MS, GC/MS and GC-FID

Determining the antioxidant abilities and enzyme inhibition profiles of medicinally important plants and their oils is of great importance for a healthy life and the treatment of some common global diseases. Kiwifruit (Actinidia deliciosa) oil was examined and researched using several bioanalytical methods comprehensively for the first time in this research to determine its antioxidant, antiglaucoma, antidiabetic and anti-Alzheimer's capabilities. Additionally, the kiwifruit oil inhibitory effects on acetylcholinesterase (AChE), carbonic anhydrase II (CA II), and α-amylase, which are linked to a number of metabolic illnesses, were established. Furthermore, LC-HRMS analysis was used to assess the phenolic content of kiwifruit oil. It came to light that kiwifruit oil contained 26 different phenolic compounds. According to the LC-HRMS findings, kiwifruit oil is abundant in apigenin (74.24 mg/L oil), epigallocatechin (12.89 mg/L oil), caryophyllene oxide (12.89 mg/L oil), and luteolin (5.49 mg/L oil). In addition, GC-MS and GC-FID studies were used to ascertain the quantity and chemical composition of the essential oils contained in kiwifruit oil. Squalene (53.04%), linoleoyl chloride (20.28%), linoleic acid (2.67%), and palmitic acid (1.54%) were the most abundant compounds in kiwifruit oil. For radical scavenging activities of kiwifruit oil, 1,1-diphenyl-2-picryl-hydrazil (DPPH•) and 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS•+) radicals scavenging techniques were examined. These methods effectively demonstrated the potent radical scavenging properties of kiwifruit oil (IC50: 48.55 μg/mL for DPPH•, and IC50: 77.00 μg/mL for ABTS•+ scavenging). Also, for reducing capabilities, iron (Fe3+), copper (Cu2+), and Fe3+-2,4,6-tri(2-pyridyl)-S-triazine (TPTZ) reducing abilities were studied. Moreover, kiwifruit oil showed a considerable inhibition effect towards hCA II (IC50: 505.83 μg/mL), AChE (IC50: 12.80 μg/mL), and α-amylase (IC50: 421.02 μg/mL). The results revealed that the use of kiwifruit oil in a pharmaceutical procedure has very important effects due to its antioxidant, anti-Alzheimer, antidiabetic, and antiglaucoma effects.

Assessment of polybrominated diphenyl ether contamination and associated human exposure risk at municipal waste dumping sites

The reports concerning the occurrence and fate of polybrominated diphenyl ethers (PBDEs) at municipal solid waste (MSW) dumping sites are scarce, and considering the Indian context, no study has been conducted to assess PBDE contamination at MSW dumping sites and associated exposure and health risk. Therefore, in the present study, the concentration of PBDE congeners was investigated in soil samples amassed from MSW dumping sites of India and the factors affecting the dissemination of different PBDE congeners in soil were evaluated. Also, the human exposure and health risk through soil intake and dermal contact were also evaluated the first time in India. The total PBDE concentrations from tri- to deBDE congeners in soil ranged from 6.81 to 33.67 μg/g dw and showed a trend towards higher levels of PBDEs in the dumping sites of more populous cities. BDE 183 was found to be the main congener in the soil of the dumping sites. The congener profile in the soil exhibited the composition of the octa- and deBDE technical mixture and possibilities of biological and photodegradation of deBDE into lower brominated congeners. A significant correlation was observed between the measures of BDE 183 and BDE 209 congeners and carbon, nitrogen and hydrogen contents of the soil. The measured exposure doses of PBDEs through soil intake and dermal contact and the hazard index was estimated higher in children as compared to adults, which indicates the increased risk and susceptibility of infants and children to PBDE exposure. The results of the present study revealed that the MSW dumping sites in India are a sink of PBDEs and might have detrimental effects on human health.

Evaluation of ibuprofen and diclofenac in the main rivers of Colombia and striped catfish Pseudoplatystoma magdaleniatum

This is one of the first studies carried out over three climatic seasons on the determination of ibuprofen and diclofenac, in the main rivers of Colombia and striped catfish Pseudoplatystoma magdaleniatum. Determination of water concentrations was carried out using SPE extraction, while for the analysis of the muscular tissue, the extraction was carried out by QuEChERS. For both matrices, quantification was done by UHPLC-MS/MS. No levels of ibuprofen or diclofenac concentrations were found in the muscle tissue of Pseudoplatystoma magdaleniatum, in any season or sampling site, during the 2 years of sampling. In some sampling sites, concentrations of up to 75 µg/L of diclofenac were detected, corresponding to the sampling carried out in the dry season, being the highest reported so far in surface waters, possibly generated by large concentrations of population or agricultural activities. On the other hand, for ibuprofen, no concentrations above the limit of quantification (0.50 µg/L) were found in the waters of the Cauca and Magdalena rivers, for any season and sampling site.

Solid-state potentiometric sensor for the rapid assay of the biologically active biogenic amine (tyramine) as a marker of food spoilage

Tyramine (TYR) is a vasoactive biogenic amine found in food products due to improper storage and poor hygiene. High TYR intake results in a wide range of life-threatening physiological reactions. The work optimizes a solid-state potentiometric sensor in the absence of a reported potentiometric method for rapid and direct TYR assay. The optimization study included thirteen membrane cocktails of different compositions. The optimized sensor proved a near-Nernstian slope of 57.30 mV/decade, a quantification limit of 10.6 ppm, and a detection limit of 7.9 ppm. Validation results confirmed the sensor ability for the direct assay of TYR in blue cheese, aged cheese, Egyptian pickled cottage cheese, and pickled herring. A comparison with the reported chromatographic method expresses the merits and potentials of the developed sensor for the rapid testing of food edibility, quality, and safety based on its TYR content. Chemical compounds studied in this article: Tyramine (PubChem CID: 5610); Tyramine hydrochloride (PubChem CID: 66449); Poly(vinyl chloride) (PubChem SID: 24864273); Tricresyl phosphate (PubChem CID: 6529); sodium phosphotungstate tribasic hydrate (PubChem SID: 329753864).

Profiles of fungal metabolites including regulated mycotoxins in individual dried Turkish figs by LC-MS/MS

Fungal metabolites including regulated mycotoxins were identified by a validated LC-MS/MS method in 180 individual Turkish dried figs from 2017 and 2018 harvests. Hand-selected dried figs were subjectively classified based on the extent of fluorescence. Forty-three fungal metabolites including eight EU-regulated mycotoxins were identified and quantified. Figs classified as being uncontaminated mostly did not contain aflatoxins above 1 μg/kg. Despite being "uncontaminated" from an aflatoxin perspective, kojic acid was present in significant quantities with a maximum level of 3750 mg/kg (0.375% w/w) and tenuazonic acid was also found (2 μg/kg to 298 mg/kg) in some figs. Notable in the screening of figs has been the presence of significant amounts of aflatoxin M₁ (AFM1) in figs also containing significant levels of aflatoxin B₁ (AFB1), which is the first time that AFM1 has been reported as naturally occurring in dried figs.

Validation of an LC-MS/MS-based dilute-and-shoot approach for the quantification of > 500 mycotoxins and other secondary metabolites in food crops: challenges and solutions

This paper describes the validation of an LC-MS/MS-based method for the quantification of > 500 secondary microbial metabolites. Analytical performance parameters have been determined for seven food matrices using seven individual samples per matrix for spiking. Apparent recoveries ranged from 70 to 120% for 53-83% of all investigated analytes (depending on the matrix). This number increased to 84-94% if the recovery of extraction was considered. The comparison of the fraction of analytes for which the precision criterion of RSD ≤ 20% under repeatability conditions (for 7 replicates derived from different individual samples) and intermediate precision conditions (for 7 technical replicates from one sample), respectively, was met (85-97% vs. 93-94%) highlights the contribution of relative matrix effects to the method uncertainty. Statistical testing of apparent recoveries between pairs of matrices exhibited a significant difference for more than half of the analytes, while recoveries of the extraction showed a much better agreement. Apparent recoveries and matrix effects were found to be constant over 2-3 orders of magnitude of analyte concentrations in figs and maize, whereas the LOQs differed less than by a factor of 2 for 90% of the investigated compounds. Based on these findings, this paper discusses the applicability and practicability of current guidelines for multi-analyte method validation. Investigation of (apparent) recoveries near the LOQ seems to be insufficiently relevant to justify the enormous time-effort for manual inspection of the peaks of hundreds of analytes. Instead, more emphasis should be put on the investigation of relative matrix effects in the validation procedure. Graphical abstract.

Individual and cyclic estrogenic profile in women: Structure and variability of the data

The concentration of estrogens in the body fluids of women is highly variable, due to the menstrual cycle, circadian oscillations, and other physiological and pathological causes. To date, only the cyclic fluctuations of the principal estrogens (estradiol and estrone) have been studied, with limited outcome of general significance. Aim of the present study was to examine in detail the cyclic variability of a wide estrogens' panel and to interpret it by multivariate statistics. Four estrogens (17α-estradiol, 17β-estradiol, estrone, estriol) and eleven of their metabolites (4-methoxyestrone, 2-methoxyestrone, 16α-hydroxyestrone, 4-hydroxyestrone, 2-hydroxyestrone, 4-methoxyestradiol, 2-methoxyestradiol, 4-hydroxyestradiol, 2-hydroxyestradiol, estriol, 16-epiestriol, and 17-epiestriol) were determined in urine by a gas chromatography - mass spectrometry method, which was developed by design of experiments and fully validated according to ISO 17025 requirements. Then, urine samples collected every morning for a complete menstrual cycle from 9 female volunteers aged 24-35 years (1 parous) were analysed. The resulting three-dimensional data (subjects × days × estrogens) were interpreted using several statistical tools. Parallel Factor Analysis compared the estrogen profiles in order to explore the cyclic and inter-individual variability of each analyte. Principal Component Analysis (PCA) provided clear separation of the sampling days along the cycle, allowing discrimination among the luteal, ovulation, and follicular phases. The scores obtained from PCA were used to build a Linear Discriminant Analysis classification model which enhanced the recognition of the three cycle's phases, yielding an overall classification non-error rate equal to 90%. These statistical models may find prospective application in fertility studies and the investigation of endocrinology disorders and other hormone-dependent diseases.

Topical immunomodulators in the management of allergic eye diseases

PURPOSE OF REVIEW

Allergic eye diseases comprise a spectrum of diseases, with each condition being characterized by a complex immunopathology. The more severe and chronic conditions, such as vernal keratoconjunctivitis and atopic keratoconjunctivitis, involve predominantly mast cells and eosinophils, while also being associated with a preponderance of T cells. Treatment with topical antihistamines or mast cell stabilizers is often unsatisfactory, and therapy depends on topical corticosteroids. Corticosteroids have significant side-effects with long-term use; therefore, they appear to be more appropriate for short-term pulse therapy. Immunomodulatory agents can also be used to inhibit T-cell activation and show encouraging results among patients with severe allergic eye conditions. The present review is an attempt to present a coherent picture of the recent investigations of topical immunomodulatory agents' therapy in severe allergic eye diseases, especially cyclosporine A and tacrolimus, and their mechanisms of action.

RECENT FINDINGS

Immunomodulatory agents are commonly indicated for the treatment of severe and prolonged allergic conjunctivitis. This article reviews the recent studies of these drugs and the development of immunomodulatory treatments for severe allergic eye diseases.

SUMMARY

Cyclosporine A and tacrolimus are currently available for the treatment of severe allergic conjunctivitis. These agents have led to improved therapeutic results for patients with severe and chronic allergic eye diseases.

The effect of topical FK506 (tacrolimus) in a mouse model of allergic rhinitis

BACKGROUND

The management of allergic rhinitis (AR) encompasses education, pharmacotherapy, immunotherapy, and surgery. FK506 (tacrolimus) is an immunosuppressant that inhibits allergic reactions. The purpose of this study was to reveal whether FK506 treatment reduces allergic inflammation in an AR mouse model and to elucidate the mechanisms.

METHODS

Forty mice were divided into four groups: control, AR, FK (FK506), and dexamethasone (DEX). All mice except for the control group were sensitized by an i.p. injection of ovalbumin (OVA). After sensitization, the FK and DEX groups were treated with FK506 and DEX intranasally. All sensitized mice were challenged intranasally with OVA. Allergic symptoms and tissue eosinophil counts were recorded. Interleukin (IL)-5, interferon gamma, and IL-10 levels in nasal lavage fluid (NALF) and serum OVA-specific IgE levels were measured. T-bet, GATA-3, and Foxp3 mRNA expression in splenic mononuclear cells were determined by real-time polymerase chain reaction.

RESULTS

In the FK group and DEX group, allergic symptoms, serum OVA-specific IgE, tissue eosinophil counts, IL-5 in NALF, and GATA-3 mRNAs expression decreased (p < 0.05), and IL-10 in NALF and Foxp3 mRNAs expression increased compared with the AR group (p < 0.05). No significant difference was observed between the FK group and the DEX group.

CONCLUSION

These results suggest that topical FK506 may reduce allergic inflammation and have potency equal to DEX in the AR model. This mechanism may involve not only Th2 cells but also regulatory T cells. Additional studies are needed on FK506, but in the future, we can consider FK506 as an alternative to topical steroids in the treatment of AR.

Chronically relapsing pruritic dermatitis in the rats treated as neonate with capsaicin; a potential rat model of human atopic dermatitis

BACKGROUND

The pathophysiological mechanisms underlying chronic pruritic skin diseases, e.g. atopic dermatitis (AD), and effective therapies remain elusive due to the paucity of animal models. Recently, we rediscovered that injection of capsaicin into rat pups resulted in vigorous scratching behavior and chronically relapsing AD-like cutaneous lesions well into adulthood.

OBJECTIVES

To characterize the chronic pruritic dermatitis induced by neonatal capsaicin treatment.

METHODS

Capsaicin (50mg/kg) was given to rat pups subcutaneously within 48 h after birth, and then scratching behavior, dermatitis and pathophysiological changes of rat skin were investigated chronologically.

RESULTS

Neonatal capsaicin treatment led to not only severe scratching and cutaneous lesions but also a large number of pathophysiological changes in the skin, such as histopathological changes including the deficiency of epidermal filaggrin expression, increases in the number of mast cells, levels of tissue NGF and Th2 cytokine mRNA, impaired skin barrier function and colonization with S. aureus. In addition, we observed the hyperproduction of serum IgE, which is clinically similar to the pathophysiology seen in the patients with atopic dermatitis. During the follow-up observation, the rats showed the alternative periods of relapsing and remitting skin lesions.

CONCLUSION

Injection of capsaicin into rat pups results in chronically relapsing pruritic dermatitis, similar to human AD. Therefore, we think neonatal capsaicin treatment could be a useful model for studying human AD and for the development of novel therapeutic drugs.

Noninvasive delivery of siRNA into the epidermis by iontophoresis using an atopic dermatitis-like model rat

Topical application of siRNA to the skin should be an effective treatment for serious skin disorders, such as atopic dermatitis. However, it is difficult to introduce hydrophilic macromolecules, including siRNA, into the skin by conventional methods. For efficient delivery of siRNA, we examined an iontophoretic technique, since it is suitable for the delivery of charged molecules. Naked siRNA effectively accumulated in the epidermis (and not in the dermis) after iontophoretic delivery. In contrast, siRNA did not penetrate tape-stripped skin by passive diffusion. In a rat model of atopic dermatitis, skin was sensitized with ovalbumin to stimulate IL-10 mRNA expression as observed in skin lesions. Iontophoretic delivery of anti-IL-10 siRNA significantly reduced (73%) the level of IL-10 mRNA. In conclusion, we successfully delivered naked siRNA into the epidermis and concomitantly suppressed the expression of an endogenous immuno-regulatory cytokine.

Tacrolimus hydrate ointment inhibits skin plasma extravasation in rats induced by topical m-xylene but not capsaicin

Tacrolimus ointment is used to treat various chronic inflammatory skin diseases. However, the effect of this ointment on acute neurogenic inflammation in the skin remains to be fully elucidated. Topical capsaicin and m-xylene produce tachykinin release from sensory nerves in the skin, resulting in skin plasma leakage. We investigated the effect of tacrolimus ointment (0.1%) on skin microvascular leakage induced by topical capsaicin (10 mM) and m-xylene (neat), and intracutaneous compound 48/80 (c48/80) (10 microg/ml, 50 microl/site) in two groups of rats pretreated with excessive capsaicin or its vehicle. The amount of leaked Evans blue dye reflected skin plasma leakage. Capsaicin, m-xylene or c48/80 was applied to the shaved abdomens of rats 8 h after topical application of tacrolimus ointment or its base. Desensitization with capsaicin reduced the skin response to capsaicin and m-xylene by 100% and 65%, respectively, but not to c48/80. Tacrolimus ointment significantly inhibited the skin response induced by m-xylene and c48/80, regardless of pretreatment with capsaicin. However, topical tacrolimus did not influence the skin response induced by capsaicin. We also evaluated whether topical capsaicin and m-xylene, and intracutaneous c48/80 cause mast cell degranulation in skin treated with tacrolimus. Mast cell degranulation was microscopically assessed. Topical tacrolimus only significantly suppressed degranulation induced by m-xylene and c48/80. Our data shows that tacrolimus ointment partially inhibits plasma leakage and mast cell degranulation in rat skin induced by m-xylene and c48/80 but not capsaicin, suggesting that the inhibitory effect is not associated with a reduction in neurogenic-mediated mechanisms.

Tacrolimus ointment in the management of atopic dermatitis

Atopic dermatitis (AD) is a chronic, relapsing, highly pruritic inflammatory skin disease. AD long-term treatment is usually required to control and prevent flares, and patients need a treatment that is safe and efficacious when applied continuously or intermittently over a prolonged period of time. The treatment options should be chosen according to age, clinical features and severity of the disease in every single patient. For the treatment of a chronic disease like AD, sustained tolerability and efficacy of the applied medications are essential. A topical immunomodulator, tacrolimus ointment, provides an alternative to topical corticosteroids without the associated adverse events. Tacrolimus is a macrolide lactone with unique immunomodulatory properties and strong anti-inflammatory activities and can be used without increasing the risk of infection or other non-application site adverse events, and without loss of effectiveness, in patients with AD.

Dyshidrosis: Epidemiology, Clinical Characteristics, and Therapy

Dyshidrosis is a common chronic dermatitis of the hands and feet that may cause significant physical discomfort, psychological distress, and occupational impairment. Topics reviewed in this article include epidemiology, clinical findings, quality of life, and therapeutic considerations. Dyshidrosis is often difficult to manage; therefore, extra attention is given in this review article to current treatment options.

Effects of anti-nerve growth factor antibody on symptoms in the NC/Nga mouse, an atopic dermatitis model

Nerve growth factor (NGF) is an important substance in the skin, where it can modulate nerve maintenance and repair. However, the direct link between NGF and pruritic disease such as atopic dermatitis is not yet fully understood. To determine whether NGF plays a major role in atopic dermatitis and in the development or maintenance of skin lesions, we performed a study using NC/Nga mice and compared mice with and without skin lesions. Our examinations of the NC/Nga mice sought to detect nerve fibers in the epidermis, measured serum and skin NGF content, and observed skin NGF by immunohistochemistry staining. We also examined the effects of anti-NGF antibody on dermatitis symptoms in NC/Nga mice. In these mice, nerve fibers were significantly increased in the epidermis of lesioned skin, and the NGF content of the serum and skin was significantly elevated. Anti-NGF antibodies significantly inhibited the development and proliferation of skin lesions and epidermal innervation and significantly inhibited any growth in scratching but did not ameliorate scratching already developed. Our findings suggest that NGF plays important roles in the pathogenesis of atopic dermatitis-like skin lesions and that inhibiting the physiological effects of NGF or suppressing increased NGF production may prevent or even moderate the symptoms of atopic dermatitis.

Allergic contact dermatitis: pathophysiology applied to future therapy

Contact dermatitis is a common reason for patient visits to primary-care clinics and represents up to 7% of all dermatologic consultations in the US. Substantial progress has been made in elucidating the pathophysiology of contact dermatitis, particularly the allergic form. A better understanding of pathologic mechanisms has led to improved management of cases and will continue to advance treatment modalities. The present paper reviews the pathogenesis and current treatment of allergic contact dermatitis and speculates on the prospects for improved future therapy.

Investigation on the effects of topical therapy with 0.1% tacrolimus ointment (ProtopicR) on intradermal skin test reactivity in atopic dogs

Tacrolimus ointment (TAC) is an effective treatment for atopic dermatitis in humans and dogs. The purposes of the present study were to evaluate the effect of 4 weeks of TAC on intradermal skin testing (IST), and in case of suppression, to investigate if reactivity returned to baseline by 2 or 4 weeks post treatment. Intradermal skin test was performed using saline, histamine, lipopolysaccharide (LPS, 0.4 mg mL(-1)), house dust (25 PNU mL(-1)) and house dust mite (1 : 40 000 w/v) at weeks 0, 4, 6 and 8 on nine dogs enrolled in a blinded, crossover, clinical trial, using 0.1% TAC or placebo once daily for 4 weeks. Reactions were evaluated at 15 min, and at 4 and 6 h. Ointment was applied after the 15-min evaluation on weeks 0 and 4. Data were analysed using the statistical software SAS System for Windows. At week 4, TAC did not affect 15-min IST, but some reactions in the TAC group were suppressed at 6 h compared to baseline. In the TAC group, 4-h IST reactivity was reduced 2 weeks after discontinuation but returned to baseline by 4 weeks. In conclusion, TAC has no effect on immediate reactions but decreased some late-phase reactions. Therefore, no withdrawal is recommended to evaluate only immediate reactions, but a 4-week withdrawal may be necessary for evaluation of late-phase reactions.

Effect of FK506 eye drops on late and delayed-type responses in ocular allergy models

BACKGROUND

It is well-known that FK506 strongly inhibits cytokine production by T cells in vitro. However, less evidence is available from in vivo studies of ocular allergy.

OBJECTIVE

To study the anti-inflammatory effect of FK506 eye drops on late and delayed-type responses in several animal models of ocular allergy.

METHODS

Rats and guinea-pigs were sensitized with egg albumin (EA) in adjuvant and later challenged by topical EA application to their eyes to examine the late response. Biopsy specimens of conjunctiva were stained with haematoxylin-eosin or stained for T cells and eosinophils. In addition, rats, rabbits and guinea-pigs were sensitized with complete Freund's adjuvant and later challenged by injecting purified protein derivatives for the delayed-type response. Bulbar conjunctival oedema and hyperaemia were graded by score in rabbits, and Evans blue (EB) extravasation was measured in rats and guinea-pigs. FK506 (0.01-1%) and steroid (0.1%) eye drops were instilled in the eyes of animals several times, before and after challenge.

RESULTS

FK506 eye drops inhibited T cell and eosinophil infiltration in the late response and EB extravasation in the delayed-type response in rats. Also, they inhibited conjunctival oedema, hyperaemia and ocular mucus in the delayed-type response in rabbits. These effects were similar to those of steroid eye drops (betamethasone sodium phosphate, fluorometholone). FK506 eye drops also inhibited inflammatory cell infiltration, the loss of conjunctival epithelium and decrease of goblet cells in the late response as well as EB extravasation in the delayed-type response in guineapigs, a steroid-resistant species.

CONCLUSION

FK506 eye drops inhibit late and delayed-type responses in animal models of ocular allergy.

Protective and curative effects of topically applied CX-659S, a novel diaminouracil derivative, on chronic picryl chloride-induced contact hypersensitivity responses

BACKGROUND

CX-659S, a newly discovered anti-inflammatory compound, exerts inhibitory effects against acute contact hypersensitivity responses (CHRs) induced by picryl chloride (PC), oxazolone and dinitrochlorobenzene. The murine model of chronic CHR induced by repeated application of PC is known to mimic many, if not all, events occurring within the lesional skin of patients with atopic dermatitis (AD).

OBJECTIVES

To investigate the ability of CX-659S to inhibit PC-induced chronic CHR in mice.

METHODS

The protective and curative effects of CX-659S were tested on PC-treated ears of BALB/c mice, and were compared with those of prednisolone. Effects were quantified by measurements of ear thickness, serum IgE and cytokine mRNA expression.

RESULTS

Both protectively applied and curatively applied CX-659S significantly inhibited increases in ear thickness and total serum IgE. Inhibition was dose-dependent. Although protectively applied prednisolone showed similar activities to CX-659S against chronic CHR, curatively applied prednisolone did not affect the serum IgE level despite inhibiting increases in ear thickness and inflammatory cell infiltration. Consistent with these results, CX-659S reduced mRNA expression of interleukin (IL)-4 and IL-10 but not of interferon (IFN)-gamma, whereas prednisolone inhibited not only mRNA expression of IL-4 and IL-10 but also that of IFN-gamma in the ear lesion. In contrast to prednisolone, CX-659S did not show any side-effect such as atrophy, alopecia or telangiectasia.

CONCLUSIONS

CX-659S is the first promising compound having inhibitory activities against chronic CHR accompanied by a diminishing effect on elevated serum IgE, without any other side-effect. Therefore, CX-659S may be a promising candidate for management of patients with recurring AD who require long-term therapy.

Topical tacrolimus (FK506) and mometasone furoate in treatment of dyshidrotic palmar eczema: a randomized, observer-blinded trial

BACKGROUND

Dyshidrotic palmoplantar eczema is a frequent disease often running a chronic relapsing course. Topical glucocorticosteroids form the mainstay of therapy, and alternatives are urgently warranted.

OBJECTIVE

This study was performed to compare the efficacy of tacrolimus (FK506) 0.1% ointment and mometasone furoate 0.1% ointment in the treatment of dyshidrotic palmoplantar eczema.

METHODS

Sixteen patients were included in the study after a randomized, observer-blind, intrapersonal comparison protocol. After a 2-week washout period, the active treatment phase amounted to 4 weeks with twice-daily topical application of test substances and additional use of emollients at will. Thereafter, patients were monitored at weekly intervals up to 8 weeks.

RESULTS

The dyshidrotic area and severity index showed a more than 50% reduction of baseline values after 2 weeks of active treatment both for FK506 (P =.003) and mometasone furoate (P =.022) in palmar areas. After active treatment, a nonsignificant increase in the dyshidrotic area and severity index was seen with FK506 treated areas. Fourteen of 16 patients had recurring symptoms requiring further therapy within 3 weeks after the active treatment phase.

CONCLUSION

Treatment with FK506 offers the possibility for rotational therapy with mometasone furoate in long-standing cases of chronic dyshidrotic palmar eczema.

Tacrolimus suppressed the production of cytokines involved in atopic dermatitis by direct stimulation of human PBMC system. (Comparison with steroids)

Tacrolimus (FK506) ointment showed remarkable efficacy against atopic dermatitis in animal models and clinical trials. The suppressive effect of tacrolimus on the production of the cytokines involved in atopic dermatitis (IL-2, IL-3, IL-4, IL-5, IFN-gamma and GM-CSF) from human peripheral blood mononuclear cells (PBMC) was investigated. We constructed a new cytokine production system in which T cells are activated by direct stimulation in vitro with anti-CD3/CD2 or anti-CD3/CD28 antibody combination. Tacrolimus inhibited the production of these cytokines by both stimulations. In a comparative study with steroids (alclometasone dipropionate and betamethason valerate) in anti-CD3/CD2 system, tacrolimus and both steroids inhibited Th1 cytokines (IL-2, IFN-gamma), Th2 cytokines (IL-4, IL-5) and IL-3, GM-CSF (produced by both Th1 and Th2). The suppressive effect of tacrolimus on cytokine production was stronger than that of alclometasone dipropionate and equal to or stronger than that of betamethason valerate. The effective dose of tacrolimus (IC50, 0.02-0.11 ng/ml) is almost the same as for Th1 and Th2 cytokines, and 1 ng/ml of tacrolimus suppressed all cytokines completely. These results suggest that tacrolimus suppresses the allergic cytokines from T cells, and that tacrolimus ointment is effective against atopic dermatitis through the inhibition of cytokine production.

Mechanisms of food allergy

The prevalence of food allergy continues to rise, particularly in 'westernized' societies; it has been linked to the 'hygiene hypothesis' and the increased diversity of food consumption worldwide. The pathogenic mechanisms and Th1/Th2 paradigm are being closely examined with respect to the occurrence of inflammatory and injury/repair responses at different mucosal sites. Genetically modified plants as potential food sources and allergenicity are current topics of controversy.