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Malešević A, Tucović D, Kulaš J, Mirkov I, Popović D, Čakić Milošević M, Popov Aleksandrov A. Impact of Skin Exposure to Benzo[a]pyrene in Rat Model: Insights into Epidermal Cell Function and Draining Lymph Node Cell Response. Int J Mol Sci 2024; 25:8631. [PMID: 39201318 PMCID: PMC11354278 DOI: 10.3390/ijms25168631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 07/29/2024] [Accepted: 08/02/2024] [Indexed: 09/02/2024] Open
Abstract
The skin is a direct target of the air pollutant benzo[a]pyrene (BaP). While its carcinogenic qualities are well-studied, the immunotoxicity of BaP after dermal exposure is less understood. This study examines the immunomodulatory effects of a 10-day epicutaneous BaP application, in environmentally/occupationally relevant doses, by analyzing ex vivo skin immune response (skin explant, epidermal cells and draining lymph node/DLN cell activity), alongside the skin's reaction to sensitization with experimental hapten dinitrochlorobenzene (DNCB). The results show that BaP application disrupts the structure of the epidermal layer and promotes immune cell infiltration in the dermis. BaP exposure led to oxidative stress in epidermal cells, characterized by decreased reduced glutathione and increased AHR and Cyp1A1 expression. Production and gene expression of proinflammatory cytokines (TNF, IL-1β) by epidermal cells decreased, while IL-10 response increased. Decreased spontaneous production of IFN-γ and IL-17, along with unchanged IL-10, was observed in DLC cells, whereas ConA-stimulated production of these cytokines was elevated. Local immunosuppression caused by BaP application seems to reduce the skin's response to an additional stimulus, evidenced by decreased effector activity of DLN cells three days after sensitization with DNCB. These findings provide new insight into the immunomodulatory effects and health risks associated with skin exposure to BaP.
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Affiliation(s)
- Anastasija Malešević
- Immunotoxicology Group, Department of Ecology, Institute for Biological Research “Siniša Stanković”, National Institute of Republic of Serbia, University of Belgrade, 142 Bulevar Despota Stefana, 11000 Belgrade, Serbia; (A.M.); (D.T.); (J.K.); (I.M.); (D.P.)
| | - Dina Tucović
- Immunotoxicology Group, Department of Ecology, Institute for Biological Research “Siniša Stanković”, National Institute of Republic of Serbia, University of Belgrade, 142 Bulevar Despota Stefana, 11000 Belgrade, Serbia; (A.M.); (D.T.); (J.K.); (I.M.); (D.P.)
| | - Jelena Kulaš
- Immunotoxicology Group, Department of Ecology, Institute for Biological Research “Siniša Stanković”, National Institute of Republic of Serbia, University of Belgrade, 142 Bulevar Despota Stefana, 11000 Belgrade, Serbia; (A.M.); (D.T.); (J.K.); (I.M.); (D.P.)
| | - Ivana Mirkov
- Immunotoxicology Group, Department of Ecology, Institute for Biological Research “Siniša Stanković”, National Institute of Republic of Serbia, University of Belgrade, 142 Bulevar Despota Stefana, 11000 Belgrade, Serbia; (A.M.); (D.T.); (J.K.); (I.M.); (D.P.)
| | - Dušanka Popović
- Immunotoxicology Group, Department of Ecology, Institute for Biological Research “Siniša Stanković”, National Institute of Republic of Serbia, University of Belgrade, 142 Bulevar Despota Stefana, 11000 Belgrade, Serbia; (A.M.); (D.T.); (J.K.); (I.M.); (D.P.)
| | - Maja Čakić Milošević
- Institute of Zoology, Faculty of Biology, University of Belgrade, 16 Studentski trg, 11000 Belgrade, Serbia;
| | - Aleksandra Popov Aleksandrov
- Immunotoxicology Group, Department of Ecology, Institute for Biological Research “Siniša Stanković”, National Institute of Republic of Serbia, University of Belgrade, 142 Bulevar Despota Stefana, 11000 Belgrade, Serbia; (A.M.); (D.T.); (J.K.); (I.M.); (D.P.)
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Palomar-Gallego MA, Ramiro-Bargueño J, Cuerda-Galindo E, Linares-García-Valdecasas R, Gómez-Sánchez SM, Delcan J, Díaz-Gil G. An Experimental Murine Model to Study Lipoatrophia Semicircularis. Curr Issues Mol Biol 2024; 46:7986-7996. [PMID: 39194689 DOI: 10.3390/cimb46080472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/19/2024] [Accepted: 07/24/2024] [Indexed: 08/29/2024] Open
Abstract
Lipoatrophia semicircularis is a benign pathology characterized by subcutaneous tissue atrophy that affects the skin and related structures. Its etiology remains unclear; however, in the recent few years, it has been proposed that electrostatic charges could be a potential factor. Based on this hypothesis, the aim of this work is to study the cause-effect relation between electrostatic energy and LS, providing insights into the molecular mechanisms. For this purpose, an experimental murine model was created using obese mice. One group served as a control and the other groups involved charging clothes with varying connections to the ground: through the skin, through the clothes or not connected to the ground). Skin biopsies showed that the most significant lesions, including lipophagic granulomas with inflammatory infiltrate, were found in the first group (connected to the ground through the skin). Lipophagic reactions without an inflammatory infiltrate were observed in the other groups subjected to electrical discharges. In the control mice, no histological changes were observed. Oxidative processes were also measured in lower limbs tissue. Malondialdehyde levels significantly increased in the lower limbs after electrostatic discharges. However, the presence of ground through a wire attached to highly conductive clothes around the thigh significantly reduced the effect of electrostatic charges on lipid peroxidation. To our knowledge, this is the first study in which an experimental model has been used to reproduce LS induced by electrostatic energy, suggesting a cause-effect relationship between electrostatic charge and discharge with fat tissue lesion.
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Affiliation(s)
- María Angustias Palomar-Gallego
- Department of Basic Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Grupo de Investigación Emergente de Bases Anatómicas, Moleculares y del Desarrollo Humano de la Universidad Rey Juan Carlos (GAMDES), 28922 Alcorcón, Spain
| | - Julio Ramiro-Bargueño
- Department of Signal Theory, Communications and Telematic Systems and Computing, Universidad Rey Juan Carlos, 28942 Fuenlabrada, Spain
| | - Esther Cuerda-Galindo
- Private Practice Consultation Ber-Matologie, Albrechtstraße 50, 12167 Berlin, Germany
| | | | - Stella M Gómez-Sánchez
- Department of Basic Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Grupo de Investigación Emergente de Bases Anatómicas, Moleculares y del Desarrollo Humano de la Universidad Rey Juan Carlos (GAMDES), 28922 Alcorcón, Spain
| | - José Delcan
- Department of Basic Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Grupo de Investigación Emergente de Bases Anatómicas, Moleculares y del Desarrollo Humano de la Universidad Rey Juan Carlos (GAMDES), 28922 Alcorcón, Spain
| | - Gema Díaz-Gil
- Department of Basic Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Grupo de Investigación Emergente de Bases Anatómicas, Moleculares y del Desarrollo Humano de la Universidad Rey Juan Carlos (GAMDES), 28922 Alcorcón, Spain
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Vo HVT, Nguyen YT, Kim N, Lee HJ. Vitamin A, D, E, and K as Matrix Metalloproteinase-2/9 Regulators That Affect Expression and Enzymatic Activity. Int J Mol Sci 2023; 24:17038. [PMID: 38069361 PMCID: PMC10707015 DOI: 10.3390/ijms242317038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/25/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Fat-soluble vitamins (vitamin A, D, E, and K) assume a pivotal role in maintaining human homeostasis by virtue of their enzymatic functions. The daily inclusion of these vitamins is imperative to the upkeep of various physiological processes including vision, bone health, immunity, and protection against oxidative stress. Current research highlights fat-soluble vitamins as potential therapeutics for human diseases, especially cancer. Fat-soluble vitamins exert their therapeutic effects through multiple pathways, including regulation of matrix metalloproteinases' (MMPs) expression and enzymatic activity. As MMPs have been reported to be involved in the pathology of various diseases, such as cancers, cardiovascular diseases, and neurological disorders, regulating the expression and/or activity of MMPs could be considered as a potent therapeutic strategy. Here, we summarize the properties of fat-soluble vitamins and their potential as promising candidates capable of effectively modulating MMPs through multiple pathways to treat human diseases.
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Affiliation(s)
- Ha Vy Thi Vo
- Department of Chemistry Education, Kongju National University, Gongju 32588, Republic of Korea;
| | - Yen Thi Nguyen
- Department of Chemistry, Kongju National University, Gongju 32588, Republic of Korea;
| | - Namdoo Kim
- Department of Chemistry, Kongju National University, Gongju 32588, Republic of Korea;
| | - Hyuck Jin Lee
- Department of Chemistry Education, Kongju National University, Gongju 32588, Republic of Korea;
- Kongju National University Institute of Science Education, Kongju National University, Gongju 32588, Republic of Korea
- Kongju National University’s Physical Fitness for Health Research Lab (KNUPFHR), Kongju National University, Gongju 32588, Republic of Korea
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Histological Skin Assessment of Patients Submitted to Bariatric Surgery: A Prospective Longitudinal Cohort Study. Obes Surg 2023; 33:836-845. [PMID: 36627534 DOI: 10.1007/s11695-023-06453-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023]
Abstract
BACKGROUND Obesity is a stigmatizing disease that can cause dermatological aberrations, such as sagging after rapid weight loss. OBJECTIVE This study is to evaluate the effects of obesity and massive weight loss following bariatric surgery on collagen and elastic fibers of the extracellular matrix of the skin. METHODS Thirty-three skin biopsies were collected from patients prior to bariatric surgery and one year after surgery. Histological analyses were performed using hematoxylin-eosin and Weigert's resorcin-fuchsin staining for collagen and elastic and elaunin fibers, respectively. Differences between means were submitted to the Student's t-test or Mann-Whitney U test, with p < 0.05 significant. RESULTS The study demonstrated an architectural alteration of the skin 1 year after bariatric surgery. In the histological analysis of the skin samples, a significant difference in the thickness of the epidermis was found 1 year after surgery in all age groups as well as in the 38-to-68-kg weight loss group (p < 0.0001). In addition to laxity, disorganization of collagen was found, with an apparent decrease in quantity and an increase in elastic fibers, although fragmented (p < 0.0001). CONCLUSION Obesity and massive weight loss following bariatric surgery cause the disorganization of collagen fibers and the fragmentation of elastic fibers of the extracellular matrix of the skin.
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Gao JF, Tang L, Luo F, Chen L, Zhang YY, Ding H. Myricetin treatment has ameliorative effects in DNFB-induced atopic dermatitis mice under high-fat conditions. Toxicol Sci 2023; 191:308-320. [PMID: 36575998 DOI: 10.1093/toxsci/kfac138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic, inflammatory cutaneous disorder. Obesity is associated with increased prevalence and severity of AD for reasons that remain poorly understood. Myricetin, a dietary flavonoid found in fruits and vegetables, is known to have anti-inflammatory effects, but its role in AD is unclear. Thus, we investigated the effects of obesity on exacerbation AD lesions and evaluated the effects of myricetin on obese AD. Mice were fed normal diet (ND) or high-fat diet, and then 2,4-dinitrofluorobenzene was used to induce AD-like lesions. We found that obesity exacerbated AD lesions, and myricetin topical administration ameliorated symptoms and skin lesions of obsess AD mice, such as dermatitis scores, scratching behavior, epidermal thickness, and mast cell infiltration. In addition, myricetin reduced the levels of immunoglobulin E and histamine, inhibited the infiltration of CD4+T cells, and modulated the expression of Th1, Th2, Th17, and Th22 cytokines and pro-inflammatory factors (CCL17, CCL22, IL-1β, and TGF-β). Moreover, myricetin restored impaired barrier function by reducing transepidermal water loss, increasing lamellar body secretion, as well as upregulating the mRNA and protein expression of filaggrin. Western blot results showed that significantly increased levels of phosphorylated IκB and NF-κB p65 was observed in the obese AD mice compared with the AD mice fed ND, whereas the myricetin could downregulated the phosphorylations of IκB and NF-κB, and inhibited mRNA expression of iNOS and COX2. Taken together, our results suggest that myricetin treatment exhibits potentially protective effects against the obeseassociated AD by inhibiting inflammatory response and restoring skin barrier function.
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Affiliation(s)
- Jie-Fang Gao
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China
| | - Liu Tang
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China.,Department of Pharmacy, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, PR China
| | - Fei Luo
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China
| | - Lu Chen
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China
| | - Yi-Yuan Zhang
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China
| | - Hong Ding
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, Hubei 430060, PR China
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Gohil K, Varma P, Byford G, Walsh K, Dutta P. Pretibial lacerations. Br J Hosp Med (Lond) 2022; 83:1-7. [PMID: 36594766 DOI: 10.12968/hmed.2022.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Patients with pretibial lacerations are commonly referred to plastic surgery services for operative intervention. However, the vast majority of cases can be managed conservatively. Through understanding the epidemiology and pathophysiology underlying these injuries to appropriately assessing and managing these patients, this review demonstrates how best to facilitate wound healing and undertake conservative management. A multidisciplinary approach to managing patients with pretibial lacerations is discussed so that clinicians can provide a better quality of life for patients through optimisation and preventing further decline.
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Affiliation(s)
- Kajal Gohil
- Burns and Plastic Surgery Department, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Parvathi Varma
- Burns and Plastic Surgery Department, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Geraldine Byford
- Burns and Plastic Surgery Department, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Karl Walsh
- Burns and Plastic Surgery Department, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Pratap Dutta
- Burns and Plastic Surgery Department, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
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M1 Polarized Macrophages Persist in Skin of Post-Bariatric Patients after 2 Years. Aesthetic Plast Surg 2022; 46:287-296. [PMID: 34750657 DOI: 10.1007/s00266-021-02649-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/23/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Obesity is considered a condition of systemic chronic inflammation. Under this condition, adipose tissue macrophages switch from an M2 (anti-inflammatory) activation pattern to an M1 (proinflammatory) activation pattern. OBJECTIVE The study aimed to verify the profile of skin macrophage activation after bariatric surgery as well as the role of MMP-1 in extracellular tissue remodeling. METHODS This is a prospective, controlled and comparative study with 20 individuals split into two groups according to their skin condition: post-bariatric and eutrophic patients. Histological and morphometric analyses based on hematoxylin-eosin, picrosirius red (collagen), orcein (elastic fiber systems), and alcian blue (mast cells)-stained sections and immunohistochemical analysis (CD68, iNOS, and mannose receptor) for macrophages and metalloproteinase-1 were performed. RESULTS Post-bariatric skin showed an increase in inflammation, angiogenesis, CD68, M1 macrophages (P< 0.001), and mast cells (P< 0.01); a decrease in M2 macrophages (P< 0.01); and a significant decrease in the collagen fiber network (P< 0.001). MMP-1 was increased in the papillary dermis of post-bariatric skin and decreased in the epidermis compared to eutrophic skin (P< 0.05). CONCLUSION This study shows that post-bariatric skin maintains inflammatory characteristics for two years. Mast cells and M1 macrophages maintain and enhance the remodeling of the dermal extracellular matrix initiated during obesity in part due to the presence of MMP-1 in the papillary dermis. EBM LEVEL IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Tetrahydrocurcumin Ameliorates Skin Inflammation by Modulating Autophagy in High-Fat Diet-Induced Obese Mice. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6621027. [PMID: 34222477 PMCID: PMC8219437 DOI: 10.1155/2021/6621027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 05/29/2021] [Indexed: 01/06/2023]
Abstract
Obesity can induce chronic low-grade inflammation via oxidative stress. Tetrahydrocurcumin (THC) is a major curcumin metabolite with anti-inflammatory and antioxidant effects, but little is known about its effects on the skin of obese individuals. Thus, the aim of this study was to investigate the effects of THC on inflammatory cytokine production, oxidative stress, and autophagy in the skin of mice with high-fat diet- (HFD-) induced obesity. Eight-week-old C57BL/6J mice were fed a regular diet, HFD (60% of total calories from fat), or HFD supplemented with THC (100 mg/kg/day orally) for 12 weeks. We measured their body weights during the experimental period. After 12-week treatments, we performed western blotting and real-time polymerase chain reaction analyses on skin samples to evaluate the expression of inflammatory cytokines, oxidative stress markers, and autophagy markers. We observed higher tumor necrosis factor-α (TNF-α), NADPH oxidase 2 (Nox2), Nox4, and phosphorylated p65 levels; lower nuclear factor erythroid 2-related factor 2 (Nrf2) expression; and higher light chain 3 (LC3), autophagy-related 5 (Atg5), and Beclin 1 expression in the skin of HFD mice compared to the corresponding levels in the skin of mice fed with regular diet. THC administration decreased TNF-α, Nox2, Nox4, and phosphorylated p65 levels and activated the Nrf2 pathway. Interestingly, THC administration suppressed the expression of the autophagy markers LC3, Atg5, and Beclin 1. Overall, HFD-fed mice exhibited an elevation in inflammation, oxidative stress, and autophagy in their skin. THC ameliorated obesity-related skin pathology, and therefore, it is a potential therapeutic agent for obesity-related inflammatory skin diseases.
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Baldini E, Testa E, Voellenkle C, De Domenico E, Cianfarani F, Martelli F, Ulisse S, Odorisio T. Dysregulation of microRNA expression in diabetic skin. J Dermatol Sci 2020; 98:186-194. [PMID: 32402513 DOI: 10.1016/j.jdermsci.2020.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Clinical skin manifestations are common in diabetes; however, molecular mechanisms underlying such defects are largely unknown. Several findings indicate a role for microRNAs (miRNAs) in skin homeostasis. OBJECTIVE To investigate whether miRNA expression is altered in diabetic skin. METHODS Type 1 and 2 mouse models of diabetes were used. MiRNA profiling was performed on RNA extracted from the skin of type 1 diabetic mice and non-diabetic controls. Expression levels of pri-miRNAs and of miRNA-biogenesis genes were also analyzed. Biogenesis gene expression analysis was performed in human dermal fibroblasts cultured in hyperglycemic, hypoxic or oxidative stress conditions. RESULTS Several miRNAs were differentially expressed in diabetic skin with a general down-modulation as compared to controls. Bioinformatics analysis of signature-miRNA target genes showed the enrichment in pathways involved in skin homeostasis, such as TGF-β and Wnt. MiRNA alteration in diabetic skin associated with reduced expression levels of DROSHA, DGCR8, XPO5, DICER1, AGO2, both as mRNA and protein. Reduced biogenesis gene expression did not correlate with accumulation of pri-miRNAs, which displayed differences in expression levels similar to those found for their mature miRNAs. Experiments with cultured fibroblasts showed that hypoxia and oxidative stress induced the down-regulation of miRNA-biogenesis genes in this skin cell type. CONCLUSION A general down-regulation of differentially expressed miRNAs was found in diabetic skin. This alteration is part of and is dependent from a wider transcriptional defect also affecting the expression of pri-miRNAs and of genes responsible for miRNA biogenesis. Such an alteration is likely contributing to diabetic skin manifestations.
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Affiliation(s)
- Enke Baldini
- Dept. Surgical Sciences, Sapienza University of Rome, Italy
| | - Erika Testa
- Lab. Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Via dei Monti di Creta, Rome, Italy
| | - Christine Voellenkle
- Lab. Molecular Cardiology, IRCCS-Policlinico San Donato, San Donato Milanese, Italy
| | - Emanuela De Domenico
- Lab. Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Via dei Monti di Creta, Rome, Italy
| | - Francesca Cianfarani
- Lab. Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Via dei Monti di Creta, Rome, Italy
| | - Fabio Martelli
- Lab. Molecular Cardiology, IRCCS-Policlinico San Donato, San Donato Milanese, Italy
| | | | - Teresa Odorisio
- Lab. Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Via dei Monti di Creta, Rome, Italy.
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Aoki M, Murase T. Obesity-associated insulin resistance adversely affects skin function. PLoS One 2019; 14:e0223528. [PMID: 31581253 PMCID: PMC6776356 DOI: 10.1371/journal.pone.0223528] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 09/23/2019] [Indexed: 01/12/2023] Open
Abstract
The aim of this study was to identify changes in skin function associated with obesity and the mechanisms underlying these changes. Functional changes and gene expression in skin were investigated in C57BL/6J mice fed either a control or high-fat diet (HFD). The insulin responsiveness of the skin and skeletal muscle was also evaluated. The effects of inhibiting insulin signaling and altered glucose concentration on skin function-associated molecules and barrier function were analyzed in keratinocytes. HFD-fed mice were not only severely obese, but also exhibited impaired skin barrier function and diminished levels of glycerol transporter aquaporin-3, keratins, and desmosomal proteins involved in maintaining skin structure. Moreover, the expression of cell cycle regulatory molecules was altered. Insulin signaling was attenuated in the skin and skeletal muscle of HFD-fed mice. In keratinocytes, inhibition of insulin signaling leads to decreased keratin expression and diminished barrier function, and higher glucose concentrations increased the expression of CDK inhibitor 1A and 1C, which are associated with cell-cycle arrest. Obesity-associated impairment of skin function can be attributed to structural fragility, abnormal glycerol transport, and dysregulated proliferation of epidermal cells. These alterations are at least partly due to cutaneous insulin resistance and hyperglycemia.
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Affiliation(s)
- Masafumi Aoki
- Biological Science Laboratories, Kao Corporation, Ichikai-machi, Haga-gun, Tochigi, Japan
| | - Takatoshi Murase
- Biological Science Laboratories, Kao Corporation, Ichikai-machi, Haga-gun, Tochigi, Japan
- * E-mail:
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Yang Y, Gu M. Association of body mass index and season with histamine skin reactivity in Chinese children with allergic rhinitis. Pediatr Neonatol 2019; 60:172-177. [PMID: 29983339 DOI: 10.1016/j.pedneo.2018.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/08/2018] [Accepted: 05/30/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To investigate the association between histamine skin reactivity and body mass index (BMI) and other clinical factors, 526 children (3-6 years old) who underwent a skin-prick test (SPT) to diagnose allergic rhinitis were enrolled. METHODS The SPT was carried out using 43 common allergens (commercial kit). The wheal size was analyzed. The associations between histamine reactivity and age, gender, BMI, atopy, parental smoking history, and testing season were examined. RESULTS Mean age was 4.6 ± 1.1 years. Among all 526 children, 202 (38.4%) had intermittent allergic rhinitis (IAR), 164 (32.1%) had IAR + persistent allergic rhinitis (PER), and 160 (30.4%) had PER. The size of the histamine skin wheal and maximum diameter for positive allergens showed significant seasonal differences (P = 0.001 and P = 0.02, respectively). Children with biparental allergy history had a higher BMI (P = 0.006). BMI (P < 0.001), summer testing (P = 0.001), and autumn testing (P < 0.001) were independently associated with the size of the histamine skin wheal. Only winter testing was independently associated with the maximal diameter for positive allergens (P = 0.002). CONCLUSIONS Higher histamine skin reactivity was associated with higher BMI and summer or autumn testing. Subject BMI and season should be considered for better interpretation of the SPT. The mechanisms underlying these associations require further study.
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Affiliation(s)
- You Yang
- Otorhinolaryngology Head and Neck Surgery of Beijing Edencare Hospital, Beijing, China.
| | - Manli Gu
- Otorhinolaryngology Head and Neck Surgery of Beijing Unicare ENT Hospital, Beijing, 100122, China
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Ibuki A, Minematsu T, Yoshida M, Iizaka S, Matsumoto M, Sugama J, Sanada H. Microsatellite polymorphism in the Heme oxygenase-1 gene promoter is associated with dermal collagen density in Japanese obese male subjects. PLoS One 2018; 13:e0199994. [PMID: 30024897 PMCID: PMC6053161 DOI: 10.1371/journal.pone.0199994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 06/18/2018] [Indexed: 11/19/2022] Open
Abstract
We previously reported elevated oxidative stress-related mechanical vulnerabilities of the skin as sparse distributions of hyperechoic areas. Although this helped establish a personalized skin care system to prevent skin disorders related to mechanical stress, obesity-related skin vulnerability involves individual differences. Here, we hypothesized that individual differences are caused by polymorphisms of GT repetitive sequences in the heme oxygenase1 (HMOX1) promoter region, which encodes an antioxidant enzyme. This cross-sectional study enrolled healthy male volunteers in a walking classroom aimed at weight control. Subjects with a body mass index <25 kg/m2 were classified as non-obese and those with body mass index ≥25 kg/m2 were classified as obese. Subject skin was categorized into sparse dermis or normal groups according to the distribution of hyperechoic areas by high-resolution skin ultrasonography (20 MHz). Genomic DNA and mRNA extracted from three body hairs with attached follicle cells were used to analyze GT repetitive sequences of the HMOX1 promoter, HMOX1 mRNA expression levels, and oxidative stress levels (8-hydroxy-2’-deoxyguanosine). Classifications of GT repetitive sequence of HMOX1 promoter were Short (<27 times) and Long (≥27 times). Higher numbers of subjects with sparse dermis were in the obese group compared with the non-obese group. In obese subjects, the number of subjects that had the Long allele of the HMOX1 promoter with sparse dermis was significantly higher compared with the normal group, whereas no association was observed between the polymorphism and ultrasonographic features in non-obese subjects. Thus, HMOX1 polymorphisms detected a risk of low collagen density in Japanese obese male subjects.
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Affiliation(s)
- Ai Ibuki
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Kanagawa, Japan
- Department of Gerontological Nursing/ Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeo Minematsu
- Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mikako Yoshida
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinji Iizaka
- School of Nutrition, College of Nursing and Nutrition, Shukutoku University, Chiba, Japan
| | - Masaru Matsumoto
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Sugama
- Advanced Health Care Science Research Unit Innovative Integrated Bio-Research Core Institute for Frontier Science Initiative, Kanazawa University, Ishikawa, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/ Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- * E-mail:
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13
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Nguyen-Tu MS, Nivoit P, Oréa V, Lemoine S, Acquaviva C, Pagnon-Minot A, Fromy B, Sethi JK, Sigaudo-Roussel D. Inflammation-linked adaptations in dermal microvascular reactivity accompany the development of obesity and type 2 diabetes. Int J Obes (Lond) 2018; 43:556-566. [PMID: 30006585 PMCID: PMC6223541 DOI: 10.1038/s41366-018-0148-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/26/2018] [Accepted: 06/08/2018] [Indexed: 01/04/2023]
Abstract
Background/Objectives The increased prevalence of obesity has prompted great strides in our understanding of specific adipose depots and their involvement in cardio-metabolic health. However, the impact of obesity on dermal white adipose tissue (dWAT) and dermal microvascular functionality remains unclear. This study aimed to investigate the temporal changes that occur in dWAT and dermal microvascular functionality during the development of diet-induced obesity and type 2 diabetes in mice. Methods Metabolic phenotyping of a murine model of hypercaloric diet (HCD)-induced obesity and type 2 diabetes was performed at three time points that reflected three distinct stages of disease development; 2 weeks of HCD-overweight-metabolically healthy, 4 weeks of HCD-obese-prediabetic and 12 weeks of HCD-obese-type 2 diabetic mice. Expansion of dWAT was characterized histologically, and changes in dermal microvascular reactivity were assessed in response to pressure and the vasodilators SNP and Ach. Results HCD resulted in a progressive expansion of dWAT and increased expression of pro-inflammatory markers (IL1β and COX-2). Impairments in pressure-induced (PIV) and Ach-induced (endothelium-dependent) vasodilation occurred early, in overweight-metabolically healthy mice. Residual vasodilatory responses were NOS-independent but sensitive to COX inhibition. These changes were associated with reductions in NO and adiponectin bioavailability, and rescued by exogenous adiponectin or hyperinsulinemia. Obese-prediabetic mice continued to exhibit impaired Ach-dependent vasodilation but PIV appeared normalized. This normalization coincided with elevated endogenous adiponectin and insulin levels, and was sensitive to NOS, COX and PI3K, inhibition. In obese-type 2 diabetic mice, both Ach-stimulated and pressure-induced vasodilatory responses were increased through enhanced COX-2-dependent prostaglandin response. Conclusions We demonstrate that the development of obesity, metabolic dysfunction and type 2 diabetes, in HCD-fed mice, is accompanied by increased dermal adiposity and associated metaflammation in dWAT. Importantly, these temporal changes are also linked to disease stage-specific dermal microvascular reactivity, which may reflect adaptive mechanisms driven by metaflammation.
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Affiliation(s)
- Marie-Sophie Nguyen-Tu
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France.,University of Lyon 1, 69367, Lyon Cedex 07, France
| | - Pierre Nivoit
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France.,University of Lyon 1, 69367, Lyon Cedex 07, France
| | - Valérie Oréa
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France.,University of Lyon 1, 69367, Lyon Cedex 07, France
| | | | - Cécile Acquaviva
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France.,Centre de Biologie et Pathologie Est, University Hospital, Hospices Civils de Lyon, 69677, Bron, France
| | | | - Bérengère Fromy
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France.,University of Lyon 1, 69367, Lyon Cedex 07, France
| | - Jaswinder K Sethi
- Faculty of Medicine, University of Southampton, Institute of Developmental Sciences Building, Southampton General Hospital, Southampton, SO16 6YD, UK. .,National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK. .,Institute for Life Sciences, Life Sciences Building 85, University of Southampton, Highfield, Southampton, SO17 1BJ, UK.
| | - Dominique Sigaudo-Roussel
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France. .,University of Lyon 1, 69367, Lyon Cedex 07, France.
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14
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Ibuki A, Kuriyama S, Toyosaki Y, Aiba M, Hidaka M, Horie Y, Fujimoto C, Isami F, Shibata E, Terauchi Y, Akase T. Aging-like physiological changes in the skin of Japanese obese diabetic patients. SAGE Open Med 2018; 6:2050312118756662. [PMID: 29449943 PMCID: PMC5808963 DOI: 10.1177/2050312118756662] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 01/09/2018] [Indexed: 12/28/2022] Open
Abstract
Objective: Obesity-associated diabetes causes aging-like changes to skin physiology in animal models, but there have been no clinical studies focusing on human obese diabetic patients. The purpose of this study was to examine the hypothesis that obesity-associated diabetes accelerates aging-like skin changes in Japanese people. Methods: This cross-sectional study enrolled obese-diabetes patients (body mass index ≥ 25 kg m−2) and healthy volunteers (body mass index < 25 kg m−2) as controls. Skin physiology parameters relating to aging (stratum corneum hydration, transepidermal water loss, skin pH, advanced glycation end-products, and dermal collagen density) were evaluated in the two groups. Results: About 37 subjects participated (16 in a control group and 21 in an obese-diabetes group). Age was not significantly different between the groups. The stratum corneum hydration level was significantly lower in the obese-diabetes group. Transepidermal water loss and levels of advanced glycation end-products were significantly higher in this group. Skin pH was not significantly different between groups. Dermal collagen density decreased in the obese-diabetes group. Conclusion: We showed that obese-diabetes patients have decreased stratum corneum hydration, increased transepidermal water loss, higher skin advanced glycation end-products and decreased dermal collagen fiber density compared with normal-weight subjects. These results indicate that the ordinary age-related physiological skin changes seen in the elderly can also occur in obese-diabetes patients aged in their 40s.
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Affiliation(s)
- Ai Ibuki
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Shoko Kuriyama
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yukiko Toyosaki
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Misaki Aiba
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Moeko Hidaka
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yoshiko Horie
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Chihiro Fujimoto
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | | | - Eriko Shibata
- Department of Endocrinology and Diabetes, Yokohama City University Hospital, Yokohama, Japan
| | - Yasuo Terauchi
- Department of Endocrinology and Diabetes, Yokohama City University Hospital, Yokohama, Japan
| | - Tomoko Akase
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
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15
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Matsumoto M, Ogai K, Aoki M, Urai T, Yokogawa M, Tawara M, Kobayashi M, Minematsu T, Sanada H, Sugama J. Changes in dermal structure and skin oxidative stress in overweight and obese Japanese males after weight loss: a longitudinal observation study. Skin Res Technol 2018; 24:407-416. [PMID: 29377346 DOI: 10.1111/srt.12443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND/PURPOSE Previous studies have reported decreased dermal echogenicity and increased skin oxidative stress in overweight males. However, it is unknown whether these skin parameters of overweight and obese people are similar to those of individuals exhibiting a normal body weight following weight loss. The purpose of this study was to (1) compare the changes in the dermal structure parameters and levels of skin oxidative stress before and after weight loss in overweight and obese people in Japan and (2) to clarify how these aspects changed when body weight would be reduced to normal body weight. METHODS Male volunteers with a body mass index of ≥25 kg/m2 were recruited. The dermal structure was visualized and dermal echogenicity and thickness were measured using ultrasound scanners. The mRNA expression level of heme oxygenase-1 in the hair follicles was quantitatively analyzed as a marker of skin oxidative stress. RESULTS When overweight individuals in their 20s to 30s reduced their weight to normal, decreased dermal thickness in the abdominal region was observed in 50% of the subjects; however, no increase in dermal echogenicity was observed. A decrease in dermal thickness and an increase in dermal echogenicity in the thighs was observed in 83.3% of the subjects. No decrease in the level of dermal oxidative stress was observed. CONCLUSION The dermal structure in the thighs of overweight young individuals can be improved to the level of the structure in those of normal body weight individuals following weight loss.
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Affiliation(s)
- M Matsumoto
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - K Ogai
- Wellness Promotion Science Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - M Aoki
- Wellness Promotion Science Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan.,Division of Health Science, Department of Clinical Nursing, Graduate School of Medicine, Kanazawa University, Ishikawa, Japan
| | - T Urai
- Institute for Frontier Science Initiative, Kanazawa University, Ishikawa, Japan
| | - M Yokogawa
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - M Tawara
- Department of Food and Nutrition, Hokuriku Gakuin University Junior College, Ishikawa, Japan
| | - M Kobayashi
- Wellness Promotion Science Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - T Minematsu
- Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - J Sugama
- Wellness Promotion Science Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan.,Institute for Frontier Science Initiative, Kanazawa University, Ishikawa, Japan
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16
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Sutton L, Edwards D, McColl M. Outpatient negative pressure dressing therapy for pretibial lacerations in a patient with high anaesthetic risk: a case study. J Wound Care 2017; 26:762-764. [PMID: 29244964 DOI: 10.12968/jowc.2017.26.12.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pretibial lacerations are a common cause of presentation to accident and emergency departments. The management of these wounds is contentious with a variation in practise between individual institutions. We present the case of a 49-year-old female with a background of pulmonary atresia and associated pulmonary hypertension, who underwent successful outpatient negative pressure wound therapy (NPWT) for three pretibial lacerations. We would propose that this therapy is an effective option for the management of these wounds in independently mobile patients who are at high-risk when under anaesthetic.
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Affiliation(s)
- L Sutton
- Otolarygology Specialist, Head and Neck Centre, University College London Hospitals NHS Trust, London, UK; UCL Cancer Institute, University College London, London, UK
| | - D Edwards
- Lead Nurse, Burns and Plastic Surgery, Plastic Surgery Department, The Royal London Hospital, Barts Health NHS Trust, London, UK
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17
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Singh P, Khatib M, Elfaki A, Hachach-Haram N, Singh E, Wallace D. The management of pretibial lacerations. Ann R Coll Surg Engl 2017; 99:637-640. [PMID: 29022785 PMCID: PMC5696929 DOI: 10.1308/rcsann.2017.0137] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2017] [Indexed: 11/22/2022] Open
Abstract
Introduction Pretibial lacerations are common injuries, often presenting in the elderly and infirm. Unclear management pathways often result in inappropriate care. We identify patient demographics, morbidity risk factors, injury severity and management options. Materials and methods This retrospective study involved analysing databases and hardcopy notes for patients admitted with pretibial lacerations to Addenbrooke's Hospital, January to December 2012. Microsoft Excel and Fishers exact test were used to analyse the data with a P-value of less than 0.05 representative of statistical significance. Information on patient demographics, site of lesion, preoperative symptoms, management, operative details and clinical outcomes were collected. Results A total of 36 patients were identified; the mean age was 79 years (± 16 years, 1 standard deviation) with a three to two female to male preponderance; 57% of injuries were caused by mechanical fall, 33% traumatic blunt impact and 7% road traffic accidents. American Society of Anesthesiologists physical status classification was 43% level III, 40% II, 9% I and 9% IV. Dunkin classification of severity was 33% grade III, 30% grade I, 24% grade IV and 12% grade II. Median inpatient duration was 11 days for surgically managed compared with 15 days for conservatively managed patients. Discussion Pretibial lacerations tend to affect the elderly. Management is compounded by polypharmacy and comorbidities. If inadequately managed, such injuries can adopt characteristics of chronic wounds, with lengthy inpatient stays. Surgical intervention may be appropriate where injuries are severe and the patient stable enough for theatre. Conclusions We believe that surgical management with autologous tissue repair, with minimal delay between presentation and theatre, is warranted for extensive injuries wherever possible, with conservative management used for predominantly less extensive pretibial lacerations.
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Affiliation(s)
- P Singh
- Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, University of Cambridge , Cambridge , UK
| | - M Khatib
- Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, University of Cambridge , Cambridge , UK
| | - A Elfaki
- Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, University of Cambridge , Cambridge , UK
| | - N Hachach-Haram
- Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, University of Cambridge , Cambridge , UK
| | - E Singh
- Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, University of Cambridge , Cambridge , UK
| | - D Wallace
- Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, University of Cambridge , Cambridge , UK
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18
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Powell RJ, Hayward CJ, Snelgrove CL, Polverino K, Park L, Chauhan R, Evans PH, Byford R, Charman C, Foy CJW, Pritchard C, Kingsley A. Pilot parallel randomised controlled trial of protective socks against usual care to reduce skin tears in high risk people: 'STOPCUTS'. Pilot Feasibility Stud 2017; 3:43. [PMID: 29075507 PMCID: PMC5644264 DOI: 10.1186/s40814-017-0182-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 09/05/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Skin tears are common in older adults and those taking steroids and warfarin. They are traumatic, often blunt injuries caused by oblique knocks to the extremities. The epidermis may separate from the dermis or both layers from underlying tissues leaving a skin flap or total loss of tissue, which is painful and prone to infection. 'Dermatuff™' knee-length socks containing Kevlar fibres (used in stab-proof vests and motorcyclists' clothing) aim to prevent skin tears. The acceptability of the socks and the feasibility of a randomised controlled trial (RCT) had not been explored. METHODS In this pilot parallel group RCT, 90 people at risk of skin-tear injury from Devon care homes and primary care were randomised to receive the socks or treatment as usual (TAU). The pilot aimed to estimate parameters to inform the design of a substantive trial and record professionals' views and participants' acceptability of the intervention and of study participation. RESULTS Participants were randomised from July 2013 and followed up until February 2015. Community participants were easier to recruit than care homes residents but were 10 years younger on average and more active. To recruit 90 participants, 395 had to be approached overall as 77% were excluded or declined. Seventy-nine participants (88%) completed the trial and 27/44 (61%) wore the socks for 16 weeks. There were 31 skin tear injuries affecting 18 (20%) of the 90 participants. The TAU group received more injuries, more repeated episodes, and larger tears with greater severity. Common daily diary reasons for not wearing the socks included perceived warmth in hot weather or not being available (holiday, in hospital, bed rest). Resource use data were obtainable and indicated that sock wearing gave a reduction in treatment costs whilst well-completed questionnaires showed improvements in secondary outcomes. CONCLUSIONS This pilot trial has successfully informed the design and conduct of a future definitive cost-effectiveness RCT. It would need to be conducted in primary care with 880 active at-risk, elderly patients (440 per arm). Skin tear incidence and quality of life (from EQ5D5L) over a 4-month period would be the primary and secondary outcomes respectively. TRIAL REGISTRATION ISRCTN, ISRCTN96565376.
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Affiliation(s)
- Roy J. Powell
- Research and Development Directorate, Noy Scott House, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW United Kingdom
| | - Christopher J. Hayward
- Peninsula Clinical Trials Unit (PenCTU), ITTC Building, Plymouth Science Park, Plymouth, PL6 8BX United Kingdom
- Exeter Clinical Trials Unit (ExeCTU), University of Exeter, RILD Level 3, Barrack Road, Exeter, Devon EX2 5DW United Kingdom
| | - Caroline L. Snelgrove
- Peninsula Clinical Trials Unit (PenCTU), ITTC Building, Plymouth Science Park, Plymouth, PL6 8BX United Kingdom
| | - Kathleen Polverino
- Research and Development Directorate, Noy Scott House, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW United Kingdom
| | - Linda Park
- Research and Development Directorate, Noy Scott House, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW United Kingdom
| | - Rohan Chauhan
- Research and Development Directorate, Noy Scott House, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW United Kingdom
| | - Philip H. Evans
- University of Exeter Medical School, St Luke’s Campus, Magdalen Road, Exeter, EX1 2LU United Kingdom
| | - Rachel Byford
- NIHR Clinical Research Network, South West Peninsula, Noy Scott House, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW United Kingdom
| | - Carolyn Charman
- Research and Development Directorate, Noy Scott House, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW United Kingdom
| | - Christopher J. W. Foy
- Research and Development Office, Leadom House, Gloucester Royal Hospital, Gloucester, GL1 3NN United Kingdom
| | - Colin Pritchard
- Royal Cornwall Hospital (Treliske), Treliske, Truro United Kingdom
| | - Andrew Kingsley
- Northern, Eastern and Western Devon Clinical Commissioning Group, County Hall, Topsham Road, Exeter, Devon EX2 4QD United Kingdom
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19
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Makihara H, Hidaka M, Sakai Y, Horie Y, Mitsui H, Ohashi K, Goshima Y, Akase T. Reduction and fragmentation of elastic fibers in the skin of obese mice is associated with altered mRNA expression levels of fibrillin-1 and neprilysin. Connect Tissue Res 2017; 58:479-486. [PMID: 27892729 DOI: 10.1080/03008207.2016.1255205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIM OF THE STUDY Our previous research suggested that obesity induces structural fragility in the skin. Elastic fibers impart strength and elasticity. In this study, we determined whether elastic fibers decrease in the skin of obese mice. MATERIALS AND METHODS To confirm alterations in elastic fiber content due to obesity, we used spontaneously obese model mice (TSOD) and control mice (TSNO). Furthermore, to evaluate the elastin structure and gene expression dependent on the severity of obesity, an obesity-enhanced mouse model was developed by feeding a high fat diet to TSOD (TSOD-HF). Back skin samples were stained with hematoxylin and eosin and Elastica van Gieson for microscopic examination, and the samples were stained for immunohistochemical analysis of neprilysin. Gene expression levels were determined using a real-time PCR system. RESULTS The abundance of elastic fibers beneath the epidermis was remarkably reduced and fragmented in TSOD as compared with TSNO. Fibrillin-1 mRNA levels in TSOD were significantly suppressed compared with those in TSNO, whereas neprilysin mRNA levels and immunohistochemical expression in TSOD were significantly increased, as compared with those in TSNO. The reduction of elastic fibers was enhanced and the expression levels of elastic fiber formed factors were significantly suppressed in TSOD-HF, as compared with those in the TSOD. CONCLUSIONS The abundance of elastic fibers was reduced and fragmented in obesity, suggesting that the reduction in elastic fibers is initially caused by increased neprilysin and decreased fibrillin-1 expression, which may inhibit formation and stabilization of elastic fibers, resulting in skin fragility in obesity.
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Affiliation(s)
- Hiroko Makihara
- a Department of Molecular Pharmacology and Neurobiology , Yokohama City University Graduate School of Medicine , Yokohama , Japan.,b Department of Biological Science and Nursing , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Moeko Hidaka
- b Department of Biological Science and Nursing , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Yui Sakai
- b Department of Biological Science and Nursing , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Yoshiko Horie
- b Department of Biological Science and Nursing , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Hideaki Mitsui
- c Department of Pathology , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Kenichi Ohashi
- c Department of Pathology , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Yoshio Goshima
- a Department of Molecular Pharmacology and Neurobiology , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Tomoko Akase
- b Department of Biological Science and Nursing , Yokohama City University Graduate School of Medicine , Yokohama , Japan
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20
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Dornuf F, Martín-Mateos P, Duarte B, Hils B, Bonilla-Manrique OE, Larcher F, Acedo P, Krozer V. Classification of skin phenotypes caused by diabetes mellitus using complex scattering parameters in the millimeter-wave frequency range. Sci Rep 2017; 7:5822. [PMID: 28724970 PMCID: PMC5517582 DOI: 10.1038/s41598-017-06034-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/06/2017] [Indexed: 11/30/2022] Open
Abstract
The pathological skin phenotype caused by hyperglycemia is an important indicator for the progress of diabetes mellitus. An early detection of diabetes assures an early intervention to regulate the carbohydrate metabolism. In this publication a non-invasive detection principle based on the measurement of complex scattering parameters in the millimeter-wave frequency range is presented. The measurement principle provides evidence of the applicability for the identification of different glycemic states in animal models. The method proposed here can be used to predict diabetes status in animal models and is interesting for application on humans in view of safeness of millimeter-wave radiation. Furthermore the complex scattering parameters give important information about the anatomic varieties between the analyzed skin samples of the different mice strains. In contrast to other methods, our approach is less sensitive to skin variations between animals.
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Affiliation(s)
- Fabian Dornuf
- Physics Institute, Goethe University Frankfurt am Main, 60438, Frankfurt am Main, Germany.
| | - Pedro Martín-Mateos
- Department of Electronics Technology, Universidad Carlos III de Madrid, Leganes, Madrid, 28911, Spain
| | - Blanca Duarte
- Epithelial Biomedicine Division, CIEMAT, Avenida Complutense 40, Madrid, 28040, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Bernhard Hils
- Physics Institute, Goethe University Frankfurt am Main, 60438, Frankfurt am Main, Germany
| | | | - Fernando Larcher
- Epithelial Biomedicine Division, CIEMAT, Avenida Complutense 40, Madrid, 28040, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain.,Department of Bioengineering, Universidad Carlos III de Madrid, Leganes, Madrid, 28911, Spain.,Instituto de Investigaciones sanitarias de la Fundación Jimenez Diaz (IIS-FJD), Madrid, Spain
| | - Pablo Acedo
- Department of Electronics Technology, Universidad Carlos III de Madrid, Leganes, Madrid, 28911, Spain
| | - Viktor Krozer
- Physics Institute, Goethe University Frankfurt am Main, 60438, Frankfurt am Main, Germany
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21
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Iizaka S, Nagata S, Sanada H. Nutritional Status and Habitual Dietary Intake Are Associated with Frail Skin Conditions in Community-Dwelling Older People. J Nutr Health Aging 2017; 21:137-146. [PMID: 28112767 DOI: 10.1007/s12603-016-0736-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Prevention of frail skin is important in older people because frail skin is associated with a risk of injury in this population. In this study, we investigated the association of nutritional status and habitual dietary intake with skin conditions in community-dwelling older people. DESIGN Cross-sectional study. SETTING Three community settings in Japan from autumn to winter. PARTICIPANTS Older people aged ≥65 years without care-need certification (n=118). MEASUREMENTS Malnutrition and obesity were evaluated to assess the nutritional status. Nutrient and food group intakes per 1000 kcal were evaluated using a brief self-administered diet history questionnaire. Dietary patterns based on food groups were evaluated by principal component analysis. Skin condition parameters, including stratum corneum hydration, appearance of xerosis (specific symptom sum score [SRRC score]), and dermal intensity by high-frequency ultrasonography, were measured on a lower leg. Multiple linear regression analysis was performed with adjustment for confounders. RESULTS The mean (standard deviation) age was 74.1 (4.8) years, and 83.1% of participants were female. A higher intake of plant fat (p=0.018) was associated with a lower SRRC score. Higher intakes of α-tocopherol (p=0.050) and vitamin C (p=0.017) were associated with increased dermal intensity. A body mass index ≥25 (p=0.016) was associated with decreased dermal intensity. A dietary pattern characterized by higher vegetable and fruit intake was associated with a better skin condition. CONCLUSION Plant fat, antioxidant vitamins, and a dietary pattern characterized by vegetables and fruits showed positive and obesity showed negative associations for frail skin in community-dwelling older people.
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Affiliation(s)
- S Iizaka
- Shinji Iizaka, RN, PhD, School of Nutrition, College of Nursing and Nutrition, Shukutoku University. 673 Nitonacho, Chuo-ku, Chiba-shi, Chiba, Japan Phone:81-43-305-1881 E-mail:
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22
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Park DY, Kim YS, Kim JH, Kang JW. Association of body mass index and other factors with histamine skin reactivity in adults with allergic nasal symptoms. Am J Rhinol Allergy 2016; 29:e160-3. [PMID: 26637562 DOI: 10.2500/ajra.2015.29.4233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The skin-prick test is the most commonly used method to diagnose allergy. In addition, histamine skin reactivity is used as a positive control for the skin-prick test. However, there is individual variation in histamine skin reactivity. The factors that influence individual variation in histamine skin reactivity remain unknown. OBJECTIVES We aimed to investigate the factors associated with histamine skin reaction. METHODS Ninety-seven subjects who underwent a skin-prick test to diagnose allergic rhinitis were enrolled in this study. The skin-prick test was performed with six common allergens. The wheal size of the histamine skin reaction was analyzed; other variables included age, sex, body mass index (BMI), atopy, smoking history, and the testing season. RESULTS The wheal size in the histamine skin test was significantly associated with age and BMI. The association between histamine skin reactivity and BMI was also present in multivariate analysis, adjusted for age, sex, atopy, smoking history, and season. CONCLUSION Histamine skin reactivity increased with BMI (degree of obesity). This association should be considered for better interpretation of the skin-prick test. Further studies regarding the mechanism for this association are needed.
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Affiliation(s)
- Do Yang Park
- Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea
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Hidaka M, Horikawa K, Akase T, Makihara H, Ogami T, Tomozawa H, Tsubata M, Ibuki A, Matsumoto Y. Efficacy of Kaempferia parviflora in a mouse model of obesity-induced dermatopathy. J Nat Med 2016; 71:59-67. [PMID: 27592007 DOI: 10.1007/s11418-016-1027-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/14/2016] [Indexed: 12/13/2022]
Abstract
Obesity results from excessive energy intake and physical inactivity, and predisposes one to various diseases. One of these reasons is that enlargement of adipocytes raises the lipid metabolic abnormalities that affect various organs. The skin is one such organ, and it has been reported that subcutaneous adipocyte cells secrete various factors and these factors are involved in reduction of dermal collagen fibers and fragility of the skin in obesity. The present study explored the efficacy of Kaempferia parviflora (KP) in preventing obesity-induced dermatopathy. We used Tsumura Suzuki obese diabetes (TSOD) mice as an obesity model. TSOD mice were fed a standard diet (MF) mixed with either an ethanol extract from KP (KPE), polymethoxyflavonoid-rich extract from KP (PMF), or polymethoxyflavonoid-poor extract from KP (X). We then evaluated the effect of these three KP fractions on aging-like skin damage induced by UVB irradiation. KPE and PMF caused a significant decrease of mouse body weight, and suppressed the increase in the thickness of the subcutaneous fat layer. In addition, KPE shifted the frequency of subcutaneous adipocyte sizes towards smaller cells possibly via its polypharmacological actions. Scanning electron microscopy revealed that the stereostructure of the collagenous fibers in the dermis was better retained in the KPE and PMF groups, in that order. These results offer the first evidence that KPE can attenuate obesity-induced dermatopathy more effectively than PMF, suggesting that KPE (or KP) might be a candidate supplement for preventing obesity-related skin disorders.
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Affiliation(s)
- Moeko Hidaka
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Kazumasa Horikawa
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Tomoko Akase
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Hiroko Makihara
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
- Department of Molecular Pharmacology and Neurobiology, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Takatoshi Ogami
- Research and Development Division, Toyo Shinyaku Co., Ltd.,, 7-28 Yayoigaoka, Tosu, Saga, 841-0005, Japan
| | - Hiroshi Tomozawa
- Research and Development Division, Toyo Shinyaku Co., Ltd.,, 7-28 Yayoigaoka, Tosu, Saga, 841-0005, Japan
| | - Masahito Tsubata
- Research and Development Division, Toyo Shinyaku Co., Ltd.,, 7-28 Yayoigaoka, Tosu, Saga, 841-0005, Japan
| | - Ai Ibuki
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Yutaka Matsumoto
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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Huang L, Minematsu T, Kitamura A, Quinetti PC, Nakagami G, Mugita Y, Oe M, Noguchi H, Mori T, Sanada H. Topical Administration of Acylated Homoserine Lactone Improves Epithelialization of Cutaneous Wounds in Hyperglycaemic Rats. PLoS One 2016; 11:e0158647. [PMID: 27404587 PMCID: PMC4942101 DOI: 10.1371/journal.pone.0158647] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/20/2016] [Indexed: 01/13/2023] Open
Abstract
Clinicians often experience delayed epithelialization in diabetic patients, for which a high glucose condition is one of the causes. However, the mechanisms underlying delayed wound closure have not been fully elucidated, and effective treatments to enhance epithelialization in patients with hyperglycaemia have not been established. Here we propose a new reagent, acylated homoserine lactone (AHL), to improve the delayed epithelialization due to the disordered formation of a basement membrane of epidermis in hyperglycaemic rats. Acute hyperglycaemia was induced by streptozotocin injection in this experiment. Full thickness wounds were created on the flanks of hyperglycaemic or control rats. Histochemical and immunohistochemical analyses were performed to identify hyperglycaemia-specific abnormalities in epidermal regeneration by comparison between groups. We then examined the effects of AHL on delayed epithelialization in hyperglycaemic rats. Histological analysis showed the significantly shorter epithelializing tissue (P < 0.05), abnormal structure of basement membrane (fragmentation and immaturity), and hypo- and hyperproliferation of basal keratinocytes in hyperglycaemic rats. Treating the wound with AHL resulted in the decreased abnormalities of basement membrane, normal distribution of proliferating epidermal keratinocytes, and significantly promoted epithelialization (P < 0.05) in hyperglycemic rats, suggesting the improving effects of AHL on abnormal epithelialization due to hyperglycemia.
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Affiliation(s)
- Lijuan Huang
- Departments of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
| | - Takeo Minematsu
- Departments of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
- * E-mail: (HS); (T. Minematsu)
| | - Aya Kitamura
- Departments of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
| | - Paes C. Quinetti
- Departments of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
| | - Gojiro Nakagami
- Departments of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
| | - Yuko Mugita
- Departments of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
| | - Makoto Oe
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
| | - Hiroshi Noguchi
- Department of Life Support Technology (Molten), Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
| | - Taketoshi Mori
- Department of Life Support Technology (Molten), Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
| | - Hiromi Sanada
- Departments of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Hongo, Tokyo, Japan
- * E-mail: (HS); (T. Minematsu)
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Ogai K, Matsumoto M, Aoki M, Minematsu T, Kitamura K, Kobayashi M, Sanada H, Sugama J. Increased level of tumour necrosis factor-alpha (TNF-α) on the skin of Japanese obese males: measured by quantitative skin blotting. Int J Cosmet Sci 2016; 38:462-9. [DOI: 10.1111/ics.12312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 02/07/2016] [Indexed: 12/11/2022]
Affiliation(s)
- K. Ogai
- Wellness Promotion Science Center; Institute of Medical; Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa 9200942 Japan
| | - M. Matsumoto
- Wellness Promotion Science Center; Institute of Medical; Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa 9200942 Japan
- Division of Health Science; Department of Clinical Nursing; Graduate School of Medicine; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa 9200942 Japan
| | - M. Aoki
- Division of Health Science; Department of Clinical Nursing; Graduate School of Medicine; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa 9200942 Japan
| | - T. Minematsu
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; 7-3-1 Hongo Bunkyo-ku Tokyo 1130033 Japan
| | - K. Kitamura
- Department of Clinical Laboratory Science; Graduate School of Medical Science; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa 9200942 Japan
| | - M. Kobayashi
- Wellness Promotion Science Center; Institute of Medical; Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa 9200942 Japan
| | - H. Sanada
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; 7-3-1 Hongo Bunkyo-ku Tokyo 1130033 Japan
| | - J. Sugama
- Wellness Promotion Science Center; Institute of Medical; Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa 9200942 Japan
- Division of Health Science; Department of Clinical Nursing; Graduate School of Medicine; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa 9200942 Japan
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Sasaki M, Shinozaki S, Shimokado K. Sulforaphane promotes murine hair growth by accelerating the degradation of dihydrotestosterone. Biochem Biophys Res Commun 2016; 472:250-4. [DOI: 10.1016/j.bbrc.2016.02.099] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 02/23/2016] [Indexed: 11/29/2022]
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Matsumoto M, Ogai K, Aoki M, Yokogawa M, Tawara M, Sugama J, Minematsu T, Nakagami G, Dai M, Sanada H. Relationship between Dermal Structural Changes on Ultrasonographic Images and Skin Viscoelasticity in Overweight and Obese Japanese Males. Health (London) 2016. [DOI: 10.4236/health.2016.811106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Alcalá M, Sánchez-Vera I, Sevillano J, Herrero L, Serra D, Ramos MP, Viana M. Vitamin E reduces adipose tissue fibrosis, inflammation, and oxidative stress and improves metabolic profile in obesity. Obesity (Silver Spring) 2015; 23:1598-606. [PMID: 26148343 DOI: 10.1002/oby.21135] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 03/27/2015] [Accepted: 04/07/2015] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To test whether enhancing the capability of adipose tissue to store lipids using antioxidant supplementation may prevent the lipotoxic effects and improve the metabolic profile of long-term obesity. METHODS C57BL/6J mice were randomized into three experimental groups for 28 weeks: control group (n = 10) fed chow diet (10% kcal from fat), obese group (O, n = 12) fed high-fat (HF) diet (45% kcal from fat), and obese group fed HF diet and supplemented twice a week with 150 mg of α-tocopherol (vitamin E) by oral gavage (OE, n = 12). RESULTS HF diet resulted in an obese phenotype with a marked insulin resistance, hypertriglyceridemia, and hepatic steatosis in O mice. Histological analysis of obese visceral adipose tissue (VAT) revealed smaller adipocytes surrounded by a fibrotic extracellular matrix and an increased macrophage infiltration, with the consequent release of proinflammatory cytokines. Vitamin E supplementation decreased oxidative stress and reduced collagen deposition in the VAT of OE mice, allowing a further expansion of the adipocytes and increasing the storage capability. As a result, circulating cytokines were reduced and hepatic steasosis, hypertriglyceridemia, and insulin sensitivity were improved. CONCLUSIONS Our results suggest that oxidative stress is implicated in extracellular matrix remodeling and may play an important role in metabolic regulation.
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Affiliation(s)
- Martín Alcalá
- Department of Chemistry and Biochemistry, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain
| | - Isabel Sánchez-Vera
- Department of Basic Sciences, Facultad de Medicina, Universidad CEU San Pablo, Madrid, Spain
| | - Julio Sevillano
- Department of Chemistry and Biochemistry, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain
| | - Laura Herrero
- Department of Biochemistry and Molecular Biology, Institut de Biomedicina de la Universitat De Barcelona (IBUB), Universitat de Barcelona, Barcelona, Spain
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Dolors Serra
- Department of Biochemistry and Molecular Biology, Institut de Biomedicina de la Universitat De Barcelona (IBUB), Universitat de Barcelona, Barcelona, Spain
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - M Pilar Ramos
- Department of Chemistry and Biochemistry, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain
| | - Marta Viana
- Department of Chemistry and Biochemistry, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain
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Ogai K, Matsumoto M, Minematsu T, Kitamura K, Kobayashi M, Sugama J, Sanada H. Development of an improved method for quantitative analysis of skin blotting: increasing reliability and applicability for skin assessment. Int J Cosmet Sci 2015; 37:425-32. [DOI: 10.1111/ics.12217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/07/2015] [Indexed: 01/08/2023]
Affiliation(s)
- K. Ogai
- Wellness Promotion Science Center; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Kanazawa Ishikawa Japan
| | - M. Matsumoto
- Division of Health Science; Department of Clinical Nursing; Graduate School of Medicine; Kanazawa University; Kanazawa Ishikawa Japan
| | - T. Minematsu
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Bunkyo-ku Tokyo Japan
| | - K. Kitamura
- Department of Clinical Laboratory Science; Graduate School of Medical Science; Kanazawa University; Kanazawa Ishikawa Japan
| | - M. Kobayashi
- Wellness Promotion Science Center; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Kanazawa Ishikawa Japan
| | - J. Sugama
- Wellness Promotion Science Center; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Kanazawa Ishikawa Japan
- Division of Health Science; Department of Clinical Nursing; Graduate School of Medicine; Kanazawa University; Kanazawa Ishikawa Japan
| | - H. Sanada
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Bunkyo-ku Tokyo Japan
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Histamine skin reactivity increases with body mass index in Korean children. Int J Pediatr Otorhinolaryngol 2015; 79:111-4. [PMID: 25497063 DOI: 10.1016/j.ijporl.2014.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 11/11/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Histamine skin prick testing is most commonly used to diagnose immunoglobulin E (IgE)-mediated allergic diseases, and histamine reactivity is used as a standardized positive control in the interpretation of a skin prick test. However, reactivity to histamine differs among individuals for reasons that are poorly understood. The present study aimed to evaluate the potential association between body mass index (BMI) and histamine skin reactivity in children. METHODS A total of 451 children (246 boys, 205 girls) aged 7-8 years were enrolled in this study. The skin prick test was performed with 26 aeroallergens commonly found in Korea. Other information was collected, including sex, age, BMI, parental allergy history, and parental smoking status. Multivariate analysis was used to confirm the association between histamine skin reactivity and BMI. RESULTS The histamine wheal size was revealed to be associated with BMI (Spearman's Rho 0.161, p<0.001). This association was confirmed by multivariate analysis, after adjusting for sex, age, parental allergy history, parental smoking status, and allergic sensitization (coefficient B 0.071, 95% confidence interval 0.030-0.112). CONCLUSIONS Skin responses to histamine were primarily correlated with increased BMI. Further studies are needed to understand the clinical implication of BMI when interpreting the results of skin prick test.
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Scioli MG, Cervelli V, Arcuri G, Gentile P, Doldo E, Bielli A, Bonanno E, Orlandi A. High Insulin-Induced Down-Regulation of Erk-1/IGF-1R/FGFR-1 Signaling Is Required for Oxidative Stress-Mediated Apoptosis of Adipose-Derived Stem Cells. J Cell Physiol 2014; 229:2077-87. [DOI: 10.1002/jcp.24667] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 04/18/2014] [Accepted: 05/09/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Maria Giovanna Scioli
- Anatomic Pathology; Department of Biomedicine and Prevention; Tor Vergata University; Rome Italy
| | - Valerio Cervelli
- Plastic Surgery; Department of Biomedicine and Prevention; Tor Vergata University; Rome Italy
| | - Gaetano Arcuri
- Experimental Medicine and Biochemical Sciences; Department of Biomedicine and Prevention; Tor Vergata University; Rome Italy
| | - Pietro Gentile
- Plastic Surgery; Department of Biomedicine and Prevention; Tor Vergata University; Rome Italy
| | - Elena Doldo
- Anatomic Pathology; Department of Biomedicine and Prevention; Tor Vergata University; Rome Italy
| | - Alessandra Bielli
- Anatomic Pathology; Department of Biomedicine and Prevention; Tor Vergata University; Rome Italy
| | - Elena Bonanno
- Anatomic Pathology; Department of Biomedicine and Prevention; Tor Vergata University; Rome Italy
| | - Augusto Orlandi
- Anatomic Pathology; Department of Biomedicine and Prevention; Tor Vergata University; Rome Italy
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Glass GE, Jain A. Pretibial lacerations: experience from a lower limb trauma centre and systematic review. J Plast Reconstr Aesthet Surg 2014; 67:1694-702. [PMID: 25175272 DOI: 10.1016/j.bjps.2014.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 06/11/2014] [Accepted: 08/05/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Pretibial lacerations are an important and neglected problem among the elderly. Poor management leads to prolonged hospitalisation and terminal decline. This study summarises our experience and evidence from the literature to ascertain an evidence-based rationale for referral and management. METHODS Our data were obtained from review of a prospectively gathered database. Additionally, Pubmed, Embase, Medline, and the Cochrane Database of Systematic Reviews were searched through July 2013, with eligible studies evaluated using standard methodology. RESULTS Seventy-three pretibial lacerations in 73 patients (63 females) were identified. Mean age was 78 ± 14, 1SD. Sixty patients were managed operatively with a mean length of stay of 11 ± 7 days, 1SD when uncomplicated by medical co-morbidity. Seven deaths occurred (4 in-hospital; 2 treated surgically and 2 treated conservatively) and 3 deaths occurred within 3 months of discharge; a death rate more than twice that of matched controls. Donor site "over-grafting" was performed in 19 cases and resulted in accelerated donor site healing (11 ± 9 days, 1SD vs. 29 ± 42 days, 1SD; P < 0.001). Negative pressure wound therapy delayed discharge (21 ± 23 days, 1SD vs. 15 ± 14 days, 1SD; P = 0.028). Microbiological sampling is unhelpful. Bed rest is unnecessary. "De-fatting" the flap is unproven. CONCLUSION Admissions expose the elderly to physical/functional decline and death. Our findings support a change of practice, minimising admissions for minor (Dunkin type I/II) injuries and rapid, protocol-driven surgical intervention and discharge for Dunkin type III/IV injuries with avoidance of negative pressure wound therapy in all but selected cases.
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Affiliation(s)
- G E Glass
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY, UK
| | - A Jain
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY, UK; Department of Plastic and Reconstructive Surgery, Imperial College NHS Foundation Trust, Charing Cross Hospital, Fulham Palace Road, Hammersmith, London, W6 8RF, UK.
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Matsumoto M, Ibuki A, Minematsu T, Sugama J, Horii M, Ogai K, Nishizawa T, Dai M, Sato A, Fujimoto Y, Okuwa M, Nakagami G, Nakatani T, Sanada H. Structural changes in dermal collagen and oxidative stress levels in the skin of Japanese overweight males. Int J Cosmet Sci 2014; 36:477-84. [PMID: 24893563 DOI: 10.1111/ics.12145] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 05/31/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE It has been reported that obese people have poorly organized dermal collagen structure because of the degradation of collagen fibers, which is caused by an increase in oxidative stress levels associated with the hypertrophy of subcutaneous adipose cells. However, it is unclear whether an increase in oxidative stress levels caused by the accumulation of subcutaneous adipose tissue and a change in the dermal structure also occur in overweight and obese Japanese people. The objectives of this study are to identify structural changes that occur in the dermis and to measure the levels of oxidative stress in Japanese overweight males. METHODS The overweight group included 43 Japanese male volunteers aged between 25 and 64 years and with a body mass index (BMI) of ≥25 and <30. The control group included 47 male volunteers aged between 22 and 64 years and with BMI of <25. The 20-MHz Dermascan C® ultrasound scanner with software for image analyses was used. Echogenicity of the upper and lower dermis was measured. The mRNA expression level of heme oxygenase-1 (HMOX1) in hair follicles was quantitatively analyzed by real-time reverse transcription polymerase chain reaction (RT-PCR) and was used as a marker of oxidative stress. Ultrasonographic imaging and collection of hair follicles were performed at the same site on the thigh, abdomen, and upper arm. RESULTS The HMOX1 mRNA expression level in the abdomen and thigh was significantly lower in the overweight group than in the control group. Moreover, the echogenicity of the upper dermis of the abdomen and the lower dermis of the abdomen and thigh was significantly lower in the overweight group than in the control group. CONCLUSION We detected an increase in oxidative stress levels and a decrease in the density of dermal collagen at the same site on the thigh, abdomen, and upper arm of Japanese overweight males. These findings suggest the fragility of the dermis of Japanese overweight males, which might have been caused by the accumulation of subcutaneous adipose tissue.
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Affiliation(s)
- M Matsumoto
- Department of Clinical Nursing, Division of Health Science, Graduate School of Medicine, Kanazawa University, Ishikawa, Japan
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Mori S, Kiuchi S, Ouchi A, Hase T, Murase T. Characteristic expression of extracellular matrix in subcutaneous adipose tissue development and adipogenesis; comparison with visceral adipose tissue. Int J Biol Sci 2014; 10:825-33. [PMID: 25076859 PMCID: PMC4115194 DOI: 10.7150/ijbs.8672] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 06/16/2014] [Indexed: 12/13/2022] Open
Abstract
Adipose tissue is a connective tissue specified for energy metabolism and endocrines, but functional differences between subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) have not been fully elucidated. To reveal the physiological role of SAT, we characterized in vivo tissue development and in vitro adipocyte differentiation. In a DNA microarray analysis of SAT and VAT in Wistar rats, functional annotation clusters of extracellular matrix (ECM)-related genes were found in SAT, and major ECM molecules expressed in adipose tissues were profiled. In a histological analysis and quantitative expression analysis, ECM expression patterns could be classified into two types: (i) a histogenesis-correlated type such as type IV and XV collagen, and laminin subunits, (ii) a high-SAT expression type such as type I, III, and V collagen and minor characteristic collagens. Type (i) was related to basal membrane and up-regulated in differentiated 3T3-L1 cells and in histogenesis at depot-specific timings. In contrast, type (ii) was related to fibrous forming and highly expressed in 3T3-L1 preadipocytes. Exceptionally, fibronectin was abundant in developed adipose tissue, although it was highly expressed in 3T3-L1 preadipocytes. The present study showed that adipose tissues site-specifically regulate molecular type and timing of ECM expression, and suggests that these characteristic ECM molecules provide a critical microenvironment, which may affect bioactivity of adipocyte itself and interacts with other tissues. It must be important to consider the depot-specific property for the treatment of obesity-related disorders, dermal dysfunction and for the tissue regeneration.
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Affiliation(s)
- Shinobu Mori
- Biological Science Laboratories, Kao Corporation, 2606 Akabane, Ichikai-Machi, Haga-gun, Tochigi, 321-3497, Japan
| | - Satomi Kiuchi
- Biological Science Laboratories, Kao Corporation, 2606 Akabane, Ichikai-Machi, Haga-gun, Tochigi, 321-3497, Japan
| | - Atsushi Ouchi
- Biological Science Laboratories, Kao Corporation, 2606 Akabane, Ichikai-Machi, Haga-gun, Tochigi, 321-3497, Japan
| | - Tadashi Hase
- Biological Science Laboratories, Kao Corporation, 2606 Akabane, Ichikai-Machi, Haga-gun, Tochigi, 321-3497, Japan
| | - Takatoshi Murase
- Biological Science Laboratories, Kao Corporation, 2606 Akabane, Ichikai-Machi, Haga-gun, Tochigi, 321-3497, Japan
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36
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Quondamatteo F. Skin and diabetes mellitus: what do we know? Cell Tissue Res 2013; 355:1-21. [PMID: 24318789 DOI: 10.1007/s00441-013-1751-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 10/29/2013] [Indexed: 12/20/2022]
Abstract
Diabetes mellitus (DM) is becoming increasingly prevalent worldwide. Although major complications of this condition involve kidney, retina and peripheral nerves, the skin of diabetic patients is also frequently injured. Hence, interest is mounting in the definition of the structural and molecular profile of non-complicated diabetic skin, i.e., before injuries occur. Most of the available knowledge in this area has been obtained relatively recently and, in part, derives from various diabetic animal models. These include both insulin-dependent and insulin-resistant models. Structural work in human diabetic skin has also been carried out by means of tissue samples or of non-invasive methods. Indications have indeed been found for molecular/structural changes in diabetic skin. However, the overall picture that emerges is heterogeneous, incomplete and often contradictory and many questions remain unanswered. This review aims to detail, as much as possible, the various pieces of current knowledge in a systematic and synoptic manner. This should aid the identification of areas in which key questions are still open and more research is needed. A comprehensive understanding of this field could help in determining molecular targets for the prevention and treatment of skin injuries in DM and markers for the monitoring of cutaneous and systemic aspects of the disease. Additionally, with the increasing development of non-invasive optics-based deep-tissue-imaging diagnostic technologies, precise knowledge of cutaneous texture and molecular structure becomes an important pre-requisite for the use of such methods in diabetic patients.
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Affiliation(s)
- Fabio Quondamatteo
- Skin and ECM Research Group-Anatomy, NUI Galway, Anatomy Building, University Road, Galway, Ireland,
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HSL Attenuates the Follicular Oxidative Stress and Enhances the Hair Growth in ob/ob Mice. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2013; 1:e60. [PMID: 25289255 PMCID: PMC4174062 DOI: 10.1097/gox.0000000000000000] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 08/30/2013] [Indexed: 12/04/2022]
Abstract
Summary: We demonstrated enhanced hair regeneration following topical administration of N-(3-oxododecanoyl)-l-homoserine lactone (HSL) in ob/ob mice. The ob/ob mice showed delayed hair regeneration (more than 6 wk) after depilation, which rapidly induced transition to anagen in the hair cycle in wild-type mice. Vehicle and HSL solutions were applied to the depilated dorsal skin of ob/ob mice. The depilated skin of the HSL-treated mice was fully covered with hair, whereas no macroscopic alteration was observed in vehicle-treated group by the fourth week after depilation. Oxidative stress was drastically decreased and the expression of the antioxidative enzymes PON1 and PON3 was increased in the HSL-treated skin with highly proliferative anagen follicles. These results suggest that HSL is a candidate therapeutic agent for alopecia in metabolic syndrome.
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Nguyen-Tu MS, Begey AL, Decorps J, Boizot J, Sommer P, Fromy B, Sigaudo-Roussel D. Skin microvascular response to pressure load in obese mice. Microvasc Res 2013; 90:138-43. [PMID: 24120748 DOI: 10.1016/j.mvr.2013.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 09/06/2013] [Accepted: 10/02/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The role of obesity in the appearance of skin pressure ulcers remains controversial. The aim of the present study was to evaluate blood perfusion and related lesions after skin compression in obese mice. METHODS Sixty C57BL6 male mice were randomly assigned to a control or hypercalorific diet (HCD) for 2, 4 and 12weeks. Skin compression was induced by a magnetic force of 11 kPa overlying a subcutaneous metal plate and applied for 4h. Skin perfusion was examined using laser Doppler imaging before skin compression, immediately after compression release and 24h later. 24h after magnet removal, skin injuries were determined by photography. RESULTS A heterogeneous distribution of blood perfusion was observed using the colour-coded map of the skin perfusion on the compressed area. At 24-h post-compression release, 60% to 75% of the compressed area was ischaemic in the 2-week HCD group and in all the control groups compared to 35% in the 4- and 15% in the 12-week HCD groups. The lowest occurrence of skin lesion seen as skin redness or pressure-sores was observed in the 12- week HCD group (4%) compared to about 12% in either the control or the 2- and 4-week HCD groups. CONCLUSIONS This study suggests that there was no clear relationship between the extent of ischaemia and skin lesion occurrence after skin compression in short-duration obese mice. In contrast, it appears that long-duration obesity could reduce both ischaemia and skin lesions in response to skin compression through changes in skin structure.
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Affiliation(s)
- Marie-Sophie Nguyen-Tu
- UMR 5305 CNRS, 69 367 Lyon cedex 07, France; University of Lyon 1, 69 367 Lyon cedex 07, France
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Stem cell therapy for lower extremity diabetic ulcers: where do we stand? BIOMED RESEARCH INTERNATIONAL 2013; 2013:462179. [PMID: 23586040 PMCID: PMC3613085 DOI: 10.1155/2013/462179] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 02/03/2013] [Accepted: 02/04/2013] [Indexed: 12/17/2022]
Abstract
The impairment of wound healing in diabetic patients is an important clinical problem affecting millions of patients worldwide. Various clinical and basic science studies show that stem cell therapy, as a regenerative medical therapy, can be a good solution. In this paper, we begin with an introduction of the cellular mechanism of the diabetic ulcer. We will then discuss the advantages and limitations of various stem cell therapies that have been under extensive recent study.
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