Effects of "second-hand" smoke on structure and function of fibroblasts, cells that are critical for tissue repair and remodeling

Mechanistic study of C5F10O-induced lung toxicity in rats: An eco-friendly insulating gas alternative to SF6

The global warming and other environmental problems caused by SF6 emissions can be reduced due to the widespread use of eco-friendly insulating gas, perfluoropentanone (C5F10O). However, there is an exposure risk to populations in areas near C5F10O equipment, so it is important to clarify its biosafety and pathogenesis before large-scale application. In this paper, histopathology, transcriptomics, 4D-DIA proteomics, and LC-MS metabolomics of rats exposed to 2000 ppm and 6000 ppm C5F10O are analyzed to reveal the mechanisms of toxicity and health risks. Histopathological shows that inflammatory cell infiltration, epithelial cell hyperplasia, and alveolar atrophy accompanied by alveolar wall thickening are present in both low-dose and high-dose groups. Analysis of transcriptomic and 4D-DIA proteomic show that Cell cycle and DNA replication can be activated by both 2000 ppm and 6000 ppm C5F10O to induce cell proliferation. In addition, it also leads to the activation of pathways such as Antigen processing and presentation, Cell adhesion molecules and Complement and coagulation cascades, T cell receptor signal path, Th1 and T cell receptor signal path, Th1 and Th2 cell differentiation, complement and coagulation cascades. Finally, LC-MS metabolomics analysis confirms that the metabolic pathways associated with glycerophospholipids, arachidonic acid, and linoleic acid are disrupted and become more severe with increasing doses. The mechanism of lung toxicity caused by C5F10O is systematically expounded based on the multi-omics analysis and provided biosafety references for further promotion and application of C5F10O.

Impact of Smoking on the Healing of Apical Periodontitis after Nonsurgical Endodontic Treatment

OBJECTIVES

 The aim of this prospective study was to compare the healing of periapical bone between smokers and nonsmokers after root canal therapy. The effects of duration and intensity of smoking on the healing rate of apical periodontitis were analyzed.

MATERIALS AND METHODS

 Fifty-five smokers were included in this study. The control group consisted of healthy nonsmokers who matched the smoker group in age and sex. Only teeth with a favorable periodontal prognosis and adequate coronal restoration were included in the study. The periapical status of treated teeth was assessed using the periapical index system at follow-ups after 6 and 12 months.

STATISTICAL ANALYSIS

 The chi-squared test and Mann-Whitney U test were used to assess the changes in periapical index score at baseline and in subsequent time intervals between the two groups examining dichotomized and ordinal data, respectively. Multivariate logistic regression analysis was used to test the association of independent variables age, gender, tooth type, arch type, and smoking index with the outcome variable. The outcome variable was set as the presence versus absence of apical periodontitis.

RESULTS

 The analysis at 12-month follow-up revealed a significantly higher healing rate in control group than in smokers (90.9 vs. 58.2; χ2 = 13.846; p < 0.001). Smokers had significantly higher periapical index scores than the control group (p = 0.024). The multivariate logistic regression analysis demonstrated that an increase in the value of the smoking index significantly increases the risk of apical periodontitis persistence (odds ratio [OR] =7.66; 95% confidence interval [CI]: 2.51-23.28; p < 0.001) for smoking index < 400 and (OR = 9.65; 95% CI: 1.45-64.14; p = 0.019) for smoking index 400 to 799.

CONCLUSION

 The results from this study show a lower rate of apical periodontitis healing in a group of smokers at 1-year follow-up. Delayed periapical healing seems to be associated with the cigarette smoking exposure.

Multivitamin consumption and childhood asthma: a cross-sectional study of the NHANES database

BACKGROUND

Dietary intakes of vitamins are associated with asthma. However, previous studies mainly explored the association between a single vitamin intake and asthma, which did not take the multivitamins into consideration. Herein, this study aims to explore the overall effect of dietary multivitamins consumption on childhood asthma.

METHODS

Data of children and adolescents (aged 2-17 years old) were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2015-2018 in this cross-sectional study. Weighted univariate logistic regression analysis was used to screen covariates. The association between multivitamins (including vitamin A, C, D, E, B1, B2, B6, B12, K, niacin, folic acid, and choline) and childhood asthma was explored using univariate and multivariate logistic regression analyses. The evaluation indexes were odds ratio (OR) and 95% confidence interval (CI). We further introduced the Bayesian kernel machine regression (BKMR) to assess the joint effect of the twelve vitamins on childhood asthma, the impact of an individual vitamin as part of a vitamin mixture, and the potential interactions among different vitamins.

RESULTS

Among 4,715 eligible children and adolescents, 487 (10.3%) had asthma. After adjusting for covariates including race, family history of asthma, pregnant smoking, BMI Z-score, energy intake, breast feeding, and low birth weight, we found that for each 1-unit increase in vitamin K consumption, the odds of childhood asthma decreased 0.99 (P=0.028). The overall effect analysis reported a trend of negative relationship between the multivitamins and childhood asthma, especially at the 75th percentile and over. According to the BKMR models, when other vitamins are fixed at the median level, the odds of childhood asthma increased along with the elevated vitamin D (VD) and vitamin B2 (VB2), whereas along with the depressed vitamin C (VC). In addition, no potential interaction has been found between every two vitamins of multivitamins on childhood asthma.

CONCLUSION

Among children and adolescents who have high-risk of asthma, it may be beneficial to increase dietary consumption of multivitamins. Our findings recommended that children and adolescents should increase the intake of VC-rich foods, whereas control the dietary consumption of VD and VB2 in daily life.

Exposure to Secondhand Smoke Extract Increases Cisplatin Resistance in Head and Neck Cancer Cells

Chemotherapy and radiotherapy resistance are major obstacles in the long-term efficacy of head and neck squamous cell carcinoma (HNSCC) treatment. Secondhand smoke (SHS) exposure is common and has been proposed as an independent predictor of HNSCC recurrence and disease-free survival. However, the underlying mechanisms responsible for these negative patient outcomes are unknown. To assess the effects of SHS exposure on cisplatin efficacy in cancer cells, three distinct HNSCC cell lines were exposed to sidestream (SS) smoke, the main component of SHS, at concentrations mimicking the nicotine level seen in passive smokers' saliva and treated with cisplatin (0.01-100 µM) for 48 h. Compared to cisplatin treatment alone, cancer cells exposed to both cisplatin and SS smoke extract showed significantly lower cisplatin-induced cell death and higher cell viability, IC50, and indefinite survival capacity. However, SS smoke extract exposure alone did not change cancer cell viability, cell death, or cell proliferation compared to unexposed control cancer cells. Mechanistically, exposure to SS smoke extract significantly reduced the expression of cisplatin influx transporter CTR1, and increased the expression of multidrug-resistant proteins ABCG2 and ATP7A. Our study is the first to document that exposure to SHS can increase cisplatin resistance by altering the expression of several proteins involved in multidrug resistance, thus increasing the cells' capability to evade cisplatin-induced cell death. These findings emphasize the urgent need for clinicians to consider the potential role of SHS on treatment outcomes and to advise cancer patients and caregivers on the potential benefits of avoiding SHS exposure.

Osseointegration of implants with superhydrophilic surfaces in rats with high serum levels of nicotine

This study aimed to evaluate the effect of nicotine administration on the osseointegration of a superhydrophilic implants surface on rat tibiae. Thirty-two rats were used and divided into 2 groups according to the administration or not of nicotine: HH - Installation of implants with superhydrophilic surfaces in healthy animals; and HN - Installation of implants with superhydrophilic surfaces in animals subjected to nicotine administration. The animals were euthanized 15 and 45 days after implant placement (n = 8). Osseointegration was assessed by means of biomechanical analyses (removal torque), microcomputed tomography (volume of bone around the implants- %BV/TV), and histomorphometry (bone-implant contact -%BIC and the bone area between implant threads -%BBT). The animals subject to the nicotine administration presented lower removal torque than the control animals at the 45-day period (21.88 ± 2.80 Ncm vs. 17.88 ± 2.10 Ncm). The implants placed in the control rats presented higher %BIC (54.26 ± 6.59% vs. 39.25 ± 4.46%) and %BBT (50.57 ± 5.28% vs. 32.25 ± 5.24%) than the implants placed in nicotine animals at 15-day period. The nicotine administration reduces the osseointegration at 15 days, however, the superhydrophilic surface equalized the osseointegration in nicotine-exposed animals compared with healthy animals after 45 days of implant placement.

The Effect of Smoking on the Outcome of Matrix-Based Autologous Chondrocyte Implantation: Data from the German Cartilage Registry

Smoking is known to have various deleterious effects on health. However, it is not clear whether smoking negatively affects the postoperative outcome following matrix-based autologous cartilage implantation (MACI) in the knee. The purpose of this study was to evaluate the effect of smoking on the outcome of MACI in the knee. A total of 281 patients receiving MACI in the knee between 2015 and 2018 were registered in the German Cartilage Database. The cohort was divided into ex-smokers, smokers, and nonsmokers. Data regarding the Knee Injury and Osteoarthritis Outcome Score (KOOS), the numeric rating scale (NRS) for pain, and satisfaction with the outcome were analyzed and compared. Follow-ups were performed at 6, 12, and 24 months after surgery. Of the 281 patients, 225 (80.1%) were nonsmokers, 43 (15.3%) were smokers, and 13 (4.6%) were ex-smokers. The three groups were comparable with respect to age, sex, body mass index (BMI), height, defect size, the need for additional reconstruction of the subchondral bone defect, number of previous knee surgeries, and defect location. However, nonsmokers had a significantly lower weight as compared with smokers. Besides a significantly lower preoperative NRS of nonsmokers as compared with smokers, there were no significant differences between the three groups with respect to KOOS, NRS, and satisfaction at 6, 12, and 24 months of follow-ups. The present study of data retrieved from the German Cartilage Registry suggests that the smoking status does not influence the outcome of MACI in the knee.

Apelin-Induced Relaxation of Coronary Arteries Is Impaired in a Model of Second-Hand Cigarette Smoke Exposure

ABSTRACT

Apelin, an endogenous ligand for APJ receptors, causes nitric oxide (NO)-dependent relaxation of coronary arteries. Little is known about the effects of apelin/APJ receptor signaling in the coronary circulation under pathological conditions. Here, we tested the hypothesis that the vasorelaxing effect of apelin is impaired by cigarette smoke extract (CSE), an established model for second-hand smoke exposure. Isolated rat coronary arteries were treated with 2% CSE for 4 hours. Apelin-induced relaxation of coronary arteries was abolished by CSE exposure, while relaxations to acetylcholine (ACh) (endothelium-dependent relaxation) and to diethyl amine NONOate (NO donor) were similar in control and CSE-treated arteries. Immunoblot analysis demonstrated that apelin increased eNOS ser1177 phosphorylation under control conditions but had no effect after exposure to CSE. Moreover, GRK2 expression was increased in CSE-exposed coronary endothelial cells. Pretreatment with CMPD101, a GRK2 inhibitor, improved the relaxation response to apelin in CSE-exposed coronary arteries. CSE treatment failed to inhibit relaxations evoked by CMF-019, an APJ receptor biased agonist that has little effect on GRK2. In arteries exposed to CSE, apelin impaired the response to ACh but not to diethyl amine NONOate. ACh-induced relaxation was unaffected by CMF-019 in either control or CSE-treated coronary arteries. The results suggest that APJ receptor signaling using the GRK2 pathway contributes to both loss of relaxation to apelin itself and the ability of apelin to inhibit endothelium-dependent relaxation to ACh in CSE-exposed coronary arteries, likely because of impaired production of NO from endothelial cells. These changes in apelin/APJ receptor signaling under pathological conditions (eg, exposure to second-hand smoke) could create an environment that favors increased vasomotor tone in coronary arteries.

Effects of tobacco and vaping on the skin

Cigarette and electronic cigarette use are significant public health concerns across the United States. Tobacco use remains the single most preventable cause of morbidity and mortality in the world. Electronic cigarettes initially emerged as a better alternative to conventional cigarettes and for promoting smoking cessation; however, current evidence reveals similar deleterious health implications caused by both products on almost all organ systems, including the skin. Recognition of the cutaneous manifestations associated with cigarette and electronic cigarette use is essential for dermatologists in current clinical practice. Dermatologists play a vital role in educating and counseling patients on smoking cessation. We specifically highlight the cutaneous consequences of conventional cigarette smoking and electronic cigarettes on dermatologic disease.

Does smoking affect your skin?

Smoking has a negative influence on human beings. Carcinogens detected in smoke can increase the risk of developing chronic disorders, cancer and premature death. Nicotine can also affect dermatological diseases such as psoriasis, hidradenitis suppurativa, chronic dermatoses, alopecia, lupus erythematosus, polymorphous light eruption, skin cancer and tobacco-associated oral lesions. Advanced education at a doctor's surgery in various medical occupations can change the bad habits and protect people from the consequences.

E-cig vapor condensate alters proteome and lipid profiles of membrane rafts: impact on inflammatory responses in A549 cells

Electronic cigarettes (e-cigs) are battery-operated heating devices that aerosolize e-liquid, typically containing nicotine and several other chemicals, which is then inhaled by a user. Over the past decade, e-cigs have gained immense popularity among both smokers and non-smokers. One reason for this is that they are advertised as a safe alternative to conventional cigarettes. However, the recent reports of e-cig use associated lung injury have ignited a considerable debate about the relative harm and benefits of e-cigs. The number of reports about e-cig-induced inflammation and pulmonary health is increasing as researchers seek to better understand the effects of vaping on human health. In line with this, we investigated the molecular events responsible for the e-cig vapor condensate (ECVC)-mediated inflammation in human lung adenocarcinoma type II epithelial cells (A549). In an attempt to limit the variables caused by longer ingredient lists of flavored e-cigs, tobacco-flavored ECVC (TF-ECVC±nicotine) was employed for this study. Interestingly, we observed significant upregulation of cytokines and chemokines (IL-6, IL-8, and MCP-1) in A549 cells following a 48 h TF-ECVC challenge. Furthermore, there was a significant increase in the expression of pattern recognition receptors TLR-4 and NOD-1, lipid raft-associated protein caveolin-1, and transcription factor NF-кB in TF-ECVC with and/or without nicotine-challenged lung epithelial cells. Our results further demonstrate the harboring of TLR-4 and NOD-1 in the caveolae of TF-ECVC-challenged A549 cells. Proteomic and lipidomic analyses of lipid raft fractions from control and challenged cells revealed a distinct protein and lipid profile in TF-ECVC (w/wo nicotine)-exposed A549 cells. Interestingly, the inflammatory effects of TF-ECVC (w/wo nicotine) were inhibited following the caveolin-1 knockdown, thus demonstrating a critical role of caveolae raft-mediated signaling in eliciting inflammatory responses upon TF-ECVC challenge. Graphical Abstract Graphical Abstract.

Smoking and Radiolucent Periapical Lesions in Root Filled Teeth: Systematic Review and Meta-Analysis

Aim: This systematic review and meta-analysis aimed to investigate the association between smoking habits and the prevalence of radiolucent periapical lesions (RPLs) in root-filled teeth (RFT). Methods: The Population, Intervention, Comparison, and Outcome (PICO) question was: in adult patients who have RFT, does the absence or presence of a smoking habit affect the prevalence of RPLs associated with RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, Scopus, and PRISMA protocol were used to evaluate and present the results. Studies comparing smokers with control non-smoker subjects, including RFT, and providing data on the prevalence of RFT with RPLs, were included. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. Results: Four studies reported data on inclusion criteria, representing data from 9257 root-filled teeth—4465 from non-smokers and 4792 from smoker patients. The meta-analysis provided an odds ratio indicating a significant association between smoking and higher prevalence of root filled teeth with radiolucent periapical lesions (OR = 1.16; 95% CI = 1.07–1.26; p = 0.0004). The certainty of the literature assessment was moderate per GRADE. The ROBINS-I tool classified three studies as low risk of bias, and the fourth as moderate risk of bias. Conclusions: Moderate, quality scientific evidence indicates a weak but significant relationship between smoking and the prevalence of RPLs in RFT. Smoking can be considered a negative prognostic factor for the outcome of root canal treatment. Endodontic providers should be aware of the relationship between smoking and persistent apical periodontitis, assessed as RPLs, in RFT.

Cigarette Smoking and Root Filled Teeth Extraction: Systematic Review and Meta-Analysis

Aim: The aim of this systematic review and meta-analysis was to investigate the possible association between smoking habits and the occurrence of root-filled teeth (RFT) extraction. Material and Methods: The Population, Intervention, Comparison, and Outcome (PICO) question was in adult patients who had RFT, does the absence or presence of smoking habits affect the prevalence of extracted RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, and PRISMA protocol was used to evaluate and present the results. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. Results: After search strategy, 571 articles were recovered, seven were selected for full-text analysis, and two reported data on inclusion criteria, including 516 RFT, 351 in non-smokers, and 165 in smoker subjects. The meta-analysis provided an odds ratio indicating significant association between smoking and the prevalence of extracted RFT (OR = 3.43, 95% CI = 1.17–10.05, p = 0.02, I² = 64%). The certainty of the literature assessment was low per GRADE. Both studies were considered as moderate risk of bias. Conclusions: Tobacco smoking should be considered a negative prognostic factor for the outcome of root canal treatment, although the quality of the evidence is low. RFT of smoking patients are three times more likely to be extracted. Continuing to smoke after endodontic treatment may increase the risk of treatment failure. However, the overall strength of evidence is low. This must be considered a limitation of the present study and the conclusion should be valued with caution.

Impact of cigarette smoke on physical-chemical and molecular proprieties of human skin in an ex vivo model

BACKGROUND

This is a study about the skin ageing exposome, focusing on the effect of cigarette smoke. Human living skin explants (HSE) were exposed to cigarette smoke (CS) of two cigarettes for 2 hours using a custom-made exposure chamber, the Pollubox^® . Effects on the surface physico-chemistry and molecular properties of the skin were analyzed and reported for the first time.

BASIC PROCEDURES

To this end, transcriptomic study followed by immunohistochemistry, MDA (Malondialdehyde Dosage), and surface physio-chemistry data: surface free energy determination, TEWL (Trans Epidermal Water Loss), skin pH and FT-IR (Fourier Transform-Infrared) spectroscopy of the explant were collected from untreated and treated HSE.

MAIN FINDINGS

Results showed a decrease of the total surface free energy of the treated HSE. This decrease reflected higher interactions with polar compounds from the environment and consequently a decrease of the surface hydrophobicity. Additionally, an increase of TEWL and skin pH was observed after treatment. The transcriptomic analysis showed downregulation of mitochondrial genes (PON2-NDUFA4L2-ATP1A1-ALDH2-PRODH) combined with an increase of MDA in CS-treated HSE.

CONCLUSIONS

CS-induced oxidation of lipids at HSE surface alters the skin barrier: interactions with polar products are enhanced and the lipid chain packing at the surface is modified. Consequently, skin permeability could increase which correlated with repression of CA9 and AQP1 genes. Beside activation of AHR-NRF2 pathway in CS-exposed HSE, our results suggested that mitochondrial functions were strongly impacted and oxidized lipids failed to be eliminated promoting skin barrier alteration. A mitophagy activity was suggested through the confirmation of PINK1 accumulation in the epidermis by immunostaining.

Selected conditions associated with an increased incidence of incisional hernia: A review of molecular biology

BACKGROUND

Incisional hernias (IH) following a laparotomy, on average, occur in 10-20% of patients, however, little is known about its molecular basis. Thus, a better understanding of the molecular mechanisms could lead to the identification of key target(s) to intervene pre-and post-operatively.

METHODS

We examined the current literature describing the molecular mechanisms of IH and overlap these factors with smoking, abdominal aortic aneurysm, obesity, diabetes mellitus, and diverticulitis.

RESULTS

The expression levels of collagen I and III, matrix metalloproteinases, and tissue inhibitors of metalloproteases are abnormal in the extracellular matrix (ECM) of IH patients and ECM disorganization has an overlap with these comorbid conditions.

CONCLUSION

Understanding the pathophysiology of IH development and associated risk factors will allow physicians to identify patients that may be at increased risk for IH and to possibly act preemptively to decrease the incidence of IH.

Validated 60-Second General Foot Screen: A Pilot Trial and Guide to Diagnoses and Treatment

GENERAL PURPOSE

To provide information on a 60-second General Foot Screen to assist in the prevention and/or identification and management of common foot problems.

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant should be better able to:1. Use the 60-second General Foot Screen to assist healthcare professionals in the recognition of common foot problems.2. Identify risk factors, causes, and treatment of selected foot problems.

ABSTRACT

Foot health is important to overall patient health. Early diagnosis and treatment of diabetes, neuropathy, fungal foot infections, foot deformity, and vascular disease/lower leg edema can improve patient quality of life. One way to achieve this is effective screening. To this end, researchers piloted a validated 10-item screening tool to assess foot health on 120 patients; 74.17% had at least one positive abnormality, demonstrating the critical importance of these early findings. Only 25.83% of individuals had completely low-risk feet. This easy-to-use tool can assist healthcare professionals in the recognition and treatment of common foot problems. The article also outlines the early signs of disease by screening item and provides a guide to treatment to enable effective prevention and quality care.

Cutaneous Effects of Smoking

Background:

Cigarette smoking is the single biggest preventable cause of death and disability in developed countries and is a significant public health concern. While known to be strongly associated with a number of cardiovascular and pulmonary diseases and cancers, smoking also leads to a variety of cutaneous manifestations.

Objective:

This article reviews the effects of cigarette smoking on the skin and its appendages.

Methods:

A literature review was based on a MEDLINE search (1966–2004) for English-language articles using the MeSH terms cutaneous, dermatology, tobacco, skin, and smoking. An additional search was subsequently undertaken for articles related to smoking and associated mucocutanous diseases, with the focus on pathogenesis and epidemiologic data. Articles presenting the highest level of evidence and latest reports were preferentially selected.

Results:

Smoking is strongly associated with numerous dermatologic conditions including poor wound healing, wrinkling and premature skin aging, squamous cell carcinoma, psoriasis, hidradenitis suppurativa, hair loss, oral cancers, and other oral conditions. In addition, it has an impact on the skin lesions observed in diabetes, lupus, and AIDS. The evidence linking smoking and melanoma, eczema, and acne is inconclusive. Anecdotal data exist on the possible protective effects of smoking in oral/genital aphthosis of Behçet's disease, herpes labialis, pyoderma gangrenosum, acral melanoma, and Kaposi's sarcoma in AIDS patients.

Conclusions:

An appreciation of the adverse cutaneous consequences of smoking is important. Dermatologists can play an integral role in promoting smoking cessation by providing expert opinion and educating the public on the deleterious effects of smoking on the skin.

Comparative assessment of HIF-1α and Akt responses in human lung and skin cells exposed to benzo[α]pyrene: Effect of conditioned medium from pre-exposed primary fibroblasts

Exposure to atmospheric pollutants has been accused for many adverse health effects. Benzo[α]pyrene (Β[α]Ρ) in particular, the most extensively studied member of pollutants, is implicated in both cancer initiation and promotion. In the present study, we compared the effects of noncytotoxic doses of Β[α]Ρ, between human skin and lung epithelial cells A431 and A549, respectively, focusing on Akt kinase and HIF-1α, as it is well known that these proteins are upregulated in various human cancers promoting survival, angiogenesis and metastasis of tumor cells. Also, taking into consideration that fibroblasts are involved in cancer progression, we tested the possible modulation of epithelial cell response by paracrine factors secreted by Β[α]Ρ-treated fibroblasts. Low doses of Β[α]Ρ were found to enhance epithelial cell proliferation and upregulate both Akt kinase and HIF-1α, with A549 cells exhibiting a more sustained profile of upregulation. It is to notice that, the response of HIF-1α was remarkably early, acting as a sensitive marker in response to airborne pollutants. Also, HIF-1α was induced by Β[α]Ρ in both lung and skin fibroblasts indicating that this effect may be conserved throughout different cell types and tissues. Interestingly however, the response of both proteins was differentially modified upon treatment with conditioned medium from Β[α]Ρ-exposed fibroblasts. This is particularly evident in A459 cells and confirms the critical role of intercellular and paracrine factors in the modulation of the final response to an extracellular signal. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 1103-1112, 2016.

Smoking, chronic wound healing, and implications for evidence-based practice

Chronic wounds are rising in prevalence and creating significant socioeconomic burdens for patients and healthcare systems worldwide. Therefore, it is now more important than ever that clinicians follow evidence-based guidelines for wound care when developing personalized treatment plans for their patients with chronic wounds. Evidence-based guidelines for treating venous leg ulcers, diabetic foot ulcers, and pressure ulcers, the 3 main categories of chronic wounds, focus primarily on biologic therapies. However, there are also evidence-based guidelines for treating behavioral risks to poor healing, such as smoking, which should be incorporated into treatment plans when appropriate. The purpose of this article was to review the mechanisms through which smoking adversely impacts the wound healing process, and propose strategies for incorporating evidence-based guidelines for treating tobacco dependence into treatment plans for patients with chronic wounds who smoke.

Randomized Controlled Trial Evaluating Dialkylcarbamoyl Chloride Impregnated Dressings for the Prevention of Surgical Site Infections in Adult Women Undergoing Cesarean Section

Background: Surgical site infections (SSI) occur in 1.8%–9.2% of women undergoing cesarean section (CS) and lead to greater morbidity rates and increased treatment costs. The aim of the study was to evaluate the efficacy and cost-effectiveness of dialkylcarbamoyl chloride (DACC) impregnated dressings to prevent SSI in women subject to CS.

Methods: Randomized, controlled trial was conducted at the Mazovian Bródno Hospital, a tertiary care center performing approximately 1300 deliveries per year, between June 2014 and April 2015. Patients were randomly allocated to receive either DACC impregnated dressing or standard surgical dressing (SSD) following skin closure. In order to analyze cost-effectiveness of the selected dressings in the group of patients who developed SSI, the costs of ambulatory visits, additional hospitalization, nursing care, and systemic antibiotic therapy were assessed. Independent risk factors for SSI were determined by multivariable logistic regression.

Results: Five hundred and forty-three women undergoing elective or emergency CS were enrolled. The SSI rates in the DACC and SSD groups were 1.8% and 5.2%, respectively (p = 0.04). The total cost of SSI prophylaxis and treatment was greater in the control group as compared with the study group (5775 EUR vs. 1065 EUR, respectively). Independent risk factors for SSI included higher pre-pregnancy body mass index (adjusted odds ratio [aOR] = 1.08; [95% confidence interval [CI]: 1.0–1.2]; p < 0.05), smoking in pregnancy (aOR = 5.34; [95% CI: 1.6–15.4]; p < 0.01), and SSD application (aOR = 2.94; [95% CI: 1.1–9.3]; p < 0.05).

Conclusion: The study confirmed the efficacy and cost-effectiveness of DACC impregnated dressings in SSI prevention among women undergoing CS.

Exploration of the wound healing effect of topical administration of nicotine in combination with collagen scaffold in a rabbit model

Nicotine has been reported to prolong the wound healing; however, we showed that the topical application of 10(-4) M nicotine promoted murine wound healing. The objective of this study was to explore the wound healing effects of nicotine in combination with collagen scaffold using skin defects in rabbit. Three full-thickness skin defects 8 mm in diameter were made on the rabbit auricle. Artificial dermis was applied to the defects, and 10 μl of nicotine solution (10(-5), 10(-4), and10(-3) M), bFGF solution (0.5 μg/10 μl), and both bFGF and 10(-4) M nicotine solutions were injected into the artificial dermis once daily for 7 days. Rabbits were sacrificed on day 10, 15, or 20, and the wound healing process was evaluated. bFGF was superior in the formation of the dermis-like tissue and capillaries. In nicotine groups, the epithelial length and the dermis-like tissue formations in the 10(-4) M group were superior, in contrast, those were inhibited in the 10(-3) M group. The synergistic effect of bFGF and 10(-4) M nicotine was not confirmed. This study suggests that the topical application of 10(-4) M nicotine promoted wound healing in rabbit, but the effect was not apparent compared with murine models.

The effect of rat bone marrow derived mesenchymal stem cells transplantation for restoration of olfactory disorder

The purpose of the study was to investigate the effect of bone marrow-derived mesenchymal stem cells (BMSCs) transplantation on olfactory epithelium (OE) of morphologic and functional restoration following neural Sensorineural Disorder in rats. Except the Normal group, twenty-one rats underwent Triton X-100 (TX-100) irrigation to induce degeneration of OE, and then BMSCs and PBS were treated from the both medial canthus to the rear part of the both nasal cavity into the experimental group and then were observed for restoration according to time point. At two and four weeks after transplantation with BMSCs, restoration of OE was observed with olfactory marker protein (OMP) and behavioral test. And we observed the expression of OMP, nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF). After TX-100 irrigation, the OE almost disappeared in 3 days. At four weeks after transplantation with BMSCs, the thickness and cellular composition of OE was considerably restored to normal group and expression of OMP was markedly increased when compared with PBS group and reduced the searching time in the behavioral test. Furthermore at two weeks after treatment with BMSCs, expression of NGF and BDNF was greatly increased when compared with PBS group. However at four weeks after treatment with BMSCs, expression of NGF and BDNF was slightly decreased. Our results suggest the BMSCs transplantation affect restoration of OE and olfaction, most likely via regulation of the neurotrophic factor expression, especially the expression of NGF and BDNF and has a possibility of a new therapeutic strategy for the treatment of olfactory disorder caused by the degeneration of OE.

Children, sealants, and guardians who smoke: Trends in NHANES 2001-2002 to 2010-2012

OBJECTIVE

There are many factors influencing dental behavior. The relationship of smokers who smoked inside the home toward preventive care (measured as dental sealant placement) of the children living in their homes is examined in this study.

METHODS

Data from the National Health and Nutrition Examination Surveys in 2001-2002 and in 2011-2012 were analyzed. Data included variables to someone smoking inside the home, dental sealant placement in children ages 6-less than 20 years, and sociodemographics which were obtained from a dental examination and a home interview.

RESULTS

There were 3,352 eligible participants in 2001-2002 and 2,374 in 2011-2012. The unadjusted odds ratio for not having dental sealants when there was someone who smoked inside the home as compared with not having dental sealants when there was no one who smoked inside the home was 1.57 (95%CI: 1.17, 2.10) in 2001-2002. The unadjusted odds ratio was 1.56 (95% CI: 1.20, 2.03) in 2011-2012. When the data were adjusted for age, sex, race/ethnicity, insurance, and income to poverty ratio, the 2001-2002 adjusted odds ratio was 1.31 (95%CI: 0.97, 1.78). The adjusted odds ratio in 2011-2012 was 1.41 (95% CI:1.01, 1.95).

CONCLUSIONS

Children who lived in homes in which someone smoked inside the home were more likely to not have dental sealants compared with children who lived in homes in which no one smoked inside the home. These results are important for understanding the factors related to access to dental care issues for children.

Serum Cotinine and Chronic Pain: NHANES 2003-2004

PURPOSE

Tobacco smoke exposure continues to be the leading preventable risk factor for many diseases and has the potential to be a risk factor for chronic pain. The purpose of this study is to determine the relationship of chronic pain with smoking, secondhand smoke exposure and non-smoking using serum cotinine (and self-report of living with someone who smokes in the home) to identify the tobacco exposure groups.

METHODS

The National Health and Nutrition Examination Survey (NHANES) 2003-2004 was used for this study. Participants were queried about pain duration and had serum cotinine levels determined during the course of the NHANES examination/survey. Participants, ages 20 years and above, with complete data on chronic pain, cotinine level, sex, race/ethnicity, and responses concerning living with someone who smoked in the home were included in the study (n=4429).

RESULTS

The adjusted odds ratio of tobacco smoke exposure on chronic pain was 1.67 (95% CI: 1.08, 2.59; p=0.0220) for participants with a serum cotinine level >10 ng/mg (smokers) as compared with individuals who had a non-detectable serum cotinine level. For individuals with a serum cotinine level >0.011 ng/mg to 10 ng/mg who identified as living with someone who smoked in the home, the adjusted odds ratio was 0.88 (95% CI: 0.47, 1.65; p=0.6785) as compared with individuals who had a non-detectable serum cotinine level.

CONCLUSION

Chronic pain is a complex situation with many factors affecting it. Similarly, smoking is a complex addiction. The interplay of chronic pain and cotinine levels in this study were significant.

Smoking and its effects on the healing process of chronic wounds

Smoking has a negative impact on skin health. Numerous studies have effectively linked smoking with delayed wound healing and healing complications. Research has identified cigarette smoking affects wound healing at a cellular level. Reducing fibroblast activity and keratinocyte migration. Such is the concern around the affects that smoking has on wound healing that some question whether smoking abstinence should be a pre requisite before some surgical procedures. This article will discuss current research and clinical studies that have investigated impaired wound healing as a result of cigarette smoking.

Quantitative proteomic analysis revealed N'-nitrosonornicotine-induced down-regulation of nonmuscle myosin II and reduced cell migration in cultured human skin fibroblast cells

The association of tobacco smoke with decreased cell motility and wound healing is well documented; however, the cellular mechanisms and specific toxic tobacco constituents responsible for this effect are not well understood. Tobacco-specific N-nitrosamines (TSNAs) are among the most important classes of carcinogens found in tobacco products. The TSNA N'-nitrosonornicotine (NNN) is present at relatively high levels in tobacco and its smoke, as well as second- and third-hand smoke. To investigate the cellular pathways that are perturbed upon NNN exposure, we employed a quantitative proteomic approach, utilizing stable isotope labeling by amino acids in cell culture and mass spectrometry, to assess the NNN-induced alteration of protein expression in GM00637 human skin fibroblast cells. With this approach, we were able to quantify 2599 proteins, 191 of which displayed significantly changed expression following NNN exposure. One of the main findings from our proteomic analysis was the down-regulation of six different subunits of myosin, particularly nonmuscle myosin II heavy chain, isoforms A, B, and C. In addition, we found the altered expression of several extracellular matrix proteins and proteins involved in cellular adhesion. Together, our quantitative proteomic results suggested that NNN exposure may interfere with fibroblast motility. An in vitro scratch wound assay result supported that NNN exposure reduced the ability of dermal fibroblast to migrate into the scratched area. The results from the present study offer novel insights into the cellular mechanisms of NNN toxicity and identify NNN as a specific tobacco constituent that contributes to decreased fibroblast migration.

A prospective investigation of injury incidence and injury risk factors among Army recruits in military police training

BACKGROUND

United States Army military police (MP) training is a 19-week course designed to introduce new recruits to basic soldiering skills, Army values and lifestyle, and law enforcement skills and knowledge. The present investigation examined injury rates and injury risk factors in MP training.

METHODS

At the start of training, 1,838 male and 553 female MP recruits were administered a questionnaire containing items on date of birth, height, weight, tobacco use, prior physical activity, injury history, and menstrual history. Injuries during training were obtained from electronic medical records and the training units provided data on student graduation and attrition.

RESULTS

Successfully graduating from the course were 94.3% of the men and 83.7% of the women. Experiencing at least one injury during training were 34.2% of the men and 66.7% of the women (risk ratio (women/men) = 1.95, 95% confidence interval = 1.79-2.13). Recruits were at higher injury risk if they reported that they were older, had smoked in the past, or had performed less frequent exercise or sports prior to MP training. Men were at higher injury risk if they reported a prior injury and women were at higher risk if they reported missing at least six menstrual cycles in the last year or had previously been pregnant.

CONCLUSION

The present investigation was the first to identify injury rates and identify specific factors increasing injury risk during MP training.

Chronic nicotine exposure augments renal oxidative stress and injury through transcriptional activation of p66shc

BACKGROUND

Chronic nicotine (Ch-NIC) exposure exacerbates ischemia/reperfusion (I/R)-induced oxidative stress and acute kidney injury (AKI), and mitochondrial production of reactive oxygen species (ROS) in cultured renal proximal tubule cells (RPTCs). Because Ser36-phosphorylated p66shc modulates mitochondrial ROS production and injury of RPTCs, we hypothesized that Ch-NIC exacerbates AKI by increasing stress-induced phosphorylation of p66shc.

METHODS

We first tested whether Ch-NIC augments I/R-AKI-induced expression and phosphorylation of p66shc in vivo. We then examined whether knocking down p66shc, or impairing its Ser36 phosphorylation or binding to cytochrome c, alters the effects of Ch-NIC on oxidative stress (H₂O₂)-induced production of ROS, mitochondrial depolarization and injury in RPTCs in vitro.

RESULTS

We found that Ch-NIC increased the expression of p66shc in the control and ischemic kidneys, but only increased its Ser36 phosphorylation after renal I/R. Knocking down p66shc or impairing phosphorylation of its Ser36 residue, via the S36A mutation (but not the phosphomimetic S36D mutation), blunted Ch-NIC + H2O2-dependent ROS production, mitochondrial depolarization and injury in RPTCs. Additionally, Ch-NIC + H2O2-dependent binding of p66shc to mitochondrial cytochrome c was attenuated by S36A mutation of p66shc, and impairing cytochrome c binding (via W134F mutation) abolished ROS production, mitochondrial depolarization and injury, while ectopic overexpression of p66shc (which mimics Ch-NIC treatment) augmented oxidant injury. We determined that Ch-NIC stimulates the p66shc promoter through p53- and epigenetic modification (promoter hypomethylation).

CONCLUSIONS

Ch-NIC worsens oxidative stress-dependent acute renal injury by increasing expression and consequent oxidative stress-dependent Ser36 phosphorylation of p66shc. Thus, targeting this pathway may have therapeutic relevance in preventing/ameliorating tobacco-related kidney injury.

Leucine-rich repeat kinase 2 functionally interacts with microtubules and kinase-dependently modulates cell migration

Recent studies indicate that the Parkinson's disease-linked leucine-rich repeat kinase 2 (LRRK2) modulates cytoskeletal functions by regulating actin and tubulin dynamics, thereby affecting neurite outgrowth. By interactome analysis we demonstrate that the binding of LRRK2 to tubulins is significantly enhanced by pharmacological LRRK2 inhibition in cells. Co-incubation of LRRK2 with microtubules increased the LRRK2 GTPase activity in a cell-free assay. Destabilization of microtubules causes a rapid decrease in cellular LRRK2(S935) phosphorylation indicating a decreased LRRK2 kinase activity. Moreover, both human LRRK2(G2019S) fibroblasts and mouse LRRK2(R1441G) fibroblasts exhibit alterations in cell migration in culture. Treatment of mouse fibroblasts with the selective LRRK2 inhibitor LRRK2-IN1 reduces cell motility. These findings suggest that LRRK2 and microtubules mutually interact both in non-neuronal cells and in neurons, which might contribute to our understanding of its pathogenic effects in Parkinson's disease.

Treating a collagen scaffold with a low concentration of nicotine promoted angiogenesis and wound healing

BACKGROUND

Nicotine, one of the major pharmacologically active agents of cigarette smoke, has various effects on cell proliferation, and it has recently been reported to have angiogenic effects. In our previous study, we showed that the topical administration of nicotine at a low concentration accelerated wound healing. This study aimed to evaluate the efficacy of nicotine and synergistic effects of combination treatment with nicotine and basic fibroblast growth factor (bFGF) in a murine excisional wound model treated with artificial dermis.

METHODS

Full-thickness defects (8 mm in diameter) were created on the backs of mice, and artificial dermis was sutured to the defects. Phosphate-buffered saline (10 μL), nicotine (10(-3), 10(-4), or 10(-5) M), bFGF (0.5 μg), and both bFGF and 10(-4) M nicotine were topically administered to the artificial dermal tissue for 7 d. The mice were killed on day 14, and the wound area, neoepithelium length, and area of newly formed capillaries in the artificial dermis were evaluated.

RESULTS

The wound areas treated with 10(-4) M nicotine, bFGF, or bFGF plus 10(-4) M nicotine were significantly smaller than those in the control group. In these three groups, the neoepithelium in the bFGF plus 10(-4) M nicotine group was significantly longer than that in the other groups. There was no significant difference between the neoepithelium lengths of the control and 10(-5) M nicotine groups. The 10(-3) M nicotine group displayed the least re-epithelization among the groups.

CONCLUSIONS

In this study, 10(-4) M nicotine induced angiogenesis in, and accelerated the healing of, wounds treated with artificial dermis. bFGF and nicotine had synergistic effects, and the combined use of nicotine and bFGF is an effective wound healing method.

Smoking and the skin

Cigarette smoking has been associated with significant morbidity affecting all systems of the body, including the integumentary system. We review the many dermatologic hazards of tobacco use. It is important to distinguish between the effects of tobacco smoke from effects of pure nicotine on the skin. All skin cells express several subtypes of the nicotinic class of acetylcholine receptors, including the α7 receptor. Many chronic dermatoses are affected by smoking either negatively or positively. Elucidation of positive associations with a particular disease can lead to improvement from smoking cessation, whereas inverse correlation may lead to development of a disease-specific treatment with nicotinergic agonists.

Special considerations in wound bed preparation 2011: an update©

This article builds and expands upon the concept of wound bed preparation introduced by Sibbald et al in 2000 as a holistic approach to wound diagnosis and treatment of the cause and patient-centered concerns such as pain management, optimizing the components of local wound care: Debridement, Infection and persistent Inflammation, along with Moisture balance before Edge effect for healable but stalled chronic wounds.

Proteomic analyses of lung lysates from short-term exposure of Fischer 344 rats to cigarette smoke

A short-term 5 day mainstream cigarette smoke exposure study was conducted in Fischer 344 rats to identify changes in lung proteins. Groups of 10 male and female rats at 5 weeks of age were assigned to one of four exposure groups. Animals received either nose-only filtered air (Air Control) or 75, 200, or 400 mg total particulate matter (TPM)/m(3) of diluted cigarette smoke. Exposures were conducted for 3 h per day, for 5 consecutive days. One lung per animal was frozen in liquid nitrogen and processed for proteomic analyses. Lung lysates from control verses treated animals were screened with 650 antibodies for changes in signaling protein levels and phosphorylation using antibody microarray technology, and then over 100 of the top protein hits were assessed by immunoblotting. The top smoke-altered proteins were further evaluated using reverse lysate microarrays. Major protein changes showed medium to strong bands on Western blots, depended on dose and gender, and included protein-serine kinases (Cot/Tpl2, ERK1/2, GSK3α/β, MEK6, PKCα/γ, RSK1), protein phosphatases (PP4/A'2, PP1Cβ), and other proteins (caspase 5, CRMP2, Hsc70, Hsp60, Rac1 and STAT2). The most pronounced changes occurred with 75 mg TPM/m(3) exposed females and 200 mg TPM/m(3) exposed males. Smoke-altered proteins regulate apoptosis, stress response, cell structure, and inflammation. Changes in identified proteins may serve as early indicators of lung damage.

Comparison of the toxicity of smoke from conventional and harm reduction cigarettes using human embryonic stem cells

This study evaluated the hypothesis that smoke from harm reduction cigarettes impedes attachment and proliferation of H9 human embryonic stem cells (hESCs). Smoke from three harm reduction brands was compared with smoke from a conventional brand. Doses of smoke were measured in puff equivalents (PE) (1 PE = the amount of smoke in one puff that dissolves in 1 ml of medium). Cytotoxic doses were determined using morphological criteria and trypan blue staining, and apoptosis was confirmed using Magic Red staining. Attachment and proliferation of hESC were followed at a noncytotoxic dose in time-lapse videos collected using BioStation technology. Data were mined from videos either manually or using video bioinformatics subroutines developed with CL-Quant software. Mainstream (MS) and sidestream (SS) smoke from conventional and harm reduction cigarettes induced apoptosis in hESC colonies at 1 PE. At 0.1 PE (noncytotoxic), SS smoke from all brands inhibited attachment of hESC colonies to Matrigel with the strongest inhibition occurring in harm reduction brands. At 0.1 PE, SS smoke, but not MS smoke, from all brands inhibited hESC growth, and two harm reduction brands were more potent than the conventional brand. In general, hESC appeared more sensitive to smoke than their mouse ESC counterparts. Although harm reduction cigarettes are often marketed as safer than conventional brands, our assays show that SS smoke from harm reduction cigarettes was at least as potent or in some cases more potent than smoke from a conventional brand and that SS smoke was more inhibitory than MS smoke in all assays.

Tobacco and the skin

Smoking negatively impacts the health of the skin as it does every organ system. This contribution reviews the effect of cigarette smoking on wound healing, wrinkling, and aging of the skin, skin cancer, psoriasis, and other inflammatory skin diseases, hidradenitis suppurativa, acne, alopecia, lupus erythematosus, polymorphous light eruption, and tobacco-associated oral lesions. Dermatologists need to encourage their patients to discontinue this deleterious habit.

Cellular transformation by cigarette smoke extract involves alteration of glycolysis and mitochondrial function in esophageal epithelial cells

Cigarette-smoking increases the risk of developing various types of human cancers including esophageal cancers. To test the effects of chronic cigarette smoke exposure directly on esophageal epithelium, cellular resistance to mainstream extract (MSE), or sidestream smoke extract (SSE) was developed in chronically exposed nonmalignant Het-1A cells. Anchorage-independent growth, in vitro invasion capacity and proliferation of the resistant cells increased compared with the unexposed, sensitive cells. An epithelial marker E-cadherin was down-regulated and mesenchymal markers N-cadherin and vimentin were up-regulated in the resistant cells. Het-1A cells resistant to MSE or SSE consumed more glucose, and produced more lactate than the sensitive cells. The increased anchorage-independent cell growth of the resistant cells was suppressed by a glycolysis inhibitor, 2-deoxy-D-glucose, indicating that these cells are highly dependent on the glycolytic pathway for survival. Decreased mitochondrial membrane potential and ATP production in the resistant cells indicate the presence of mitochondrial dysfunction induced by chronic exposure of cigarette smoke extract. Increased expression of nuclear genes in the glycolytic pathway and decreased levels of mitochondrial genes in the resistant cells support the notion that cigarette smoking significantly contributes to the transformation of nonmalignant esophageal epithelial cells into a tumorigenic phenotype.

Assessment of exposure to secondhand smoke at outdoor bars and family restaurants in Athens, Georgia, using salivary cotinine

Exposure to secondhand smoke (SHS) in outdoor settings is a growing public health concern due to recent indoor smoking bans. The objective of this study was to measure salivary cotinine, a metabolite of nicotine, in subjects aged 21-30 exposed to SHS outside bars and restaurants in Athens, Georgia. Nonsmokers participated during 6-hr periods in outdoor standing or seating areas of bars and restaurants where indoor smoking was banned, as well as a control outdoor location with no smokers over six weekends during the summer and early fall of 2007. Pre- and post-exposure saliva samples (N = 25 person-days at the bar site, N = 28 person-days at the restaurant site, and N = 11 person-days at the control) were collected and analyzed for cotinine. The mean change in the response, (ln(post) - ln(pre)) salivary cotinine levels, was significantly impacted by the type of site (bar, restaurant, control) (F = 5.09; d.f. = 2, 6.7; p = 0.0455). The median percent increase in salivary cotinine from pre-test to post-test was estimated to be 162%, 102%, and 16% at the bar, restaurant, and control sites, respectively, values that were significant increases at bars (t = 4.63; d.f. = 9.24; p = 0.0011) and restaurants (t = 4.33; d.f. = 4.47; p = 0.0097) but not at the control sites. On average, these pre-test to post-test increases in salivary cotinine were significantly higher at bar sites than control sites (t = 3.05; d.f. = 9.85; p = 0.0176) and at restaurant sites compared with control sites (t = 2.35; d.f. = 5.09; p = 0.0461). Nonsmokers outside restaurants and bars in Athens, Georgia, have significantly elevated salivary cotinine levels indicative of secondhand smoke exposure.

Second-hand smoke stimulates lipid accumulation in the liver by modulating AMPK and SREBP-1

BACKGROUND/AIMS

The underlying mechanisms of steatosis, the first stage of non-alcoholic fatty liver disease (NAFLD) that is characterized by the accumulation of lipids in hepatocytes, remain unclear. Our study aimed to investigate the hypothesis that cigarette smoke is known to change circulating lipid profiles and thus may also contribute to the accumulation of lipids in the liver.

METHODS

Mice and cultured hepatocytes were exposed to sidestream whole smoke (SSW), a major component of "second-hand" smoke and a variety of cellular and molecular approaches were used to study the effects of cigarette smoke on lipid metabolism.

RESULTS

SSW increases lipid accumulation in hepatocytes by modulating the activity of 5'-AMP-activated protein kinase (AMPK) and sterol response element binding protein-1 (SREBP-1), two critical molecules involved in lipid synthesis. SSW causes dephosphorylation/ inactivation of AMPK, which contributes to increased activation of SREBP-1. These changes of activity lead to accumulation of triglycerides in hepatocytes.

CONCLUSION

These novel findings are important because they point to another risk factor of smoking, i.e., that of contributing to NAFLD. In addition, our results showing that both AMPK and SREBP are critically involved in these effects of smoke point to the potential use of these molecules as targets for treatment of cigarette smoke-induced metabolic diseases.

Delayed wound healing in sacrococcygeal pilonidal sinus coincides with an altered collagen composition

BACKGROUND

Although patients with pilonidal sinus are young and, thus, are expected to heal well, a delayed healing with high risk of recurrence frequently is observed. This study was initiated to test whether disorders in the extracellular matrix (ECM) may be detected in patients with pilonidal sinus and delayed wound healing or recurrent disease, respectively.

METHODS

In 48 patients, tissue specimens were obtained at the index operation. All patients were treated by local excision and primary wound closure. The collagen type I/III ratio, the expression of matrix metalloproteinase (MMP)-1, -9, and -13, as well as the proliferation index (Ki67) and the macrophage infiltrate (CD68) were measured. Patients with an uneventful wound healing by primary intention were compared with those in which the healing by primary intention fails (secondary healing), and patients suffering first onset of pilonidal sinus or to those patients who had undergone previous surgery for pilonidal sinus. Clinical parameters and comorbidity were evaluated.

RESULTS

Patients with secondary healing, exhibited at the index operation a significantly lower collagen type I/III ratio (2.34+/-0.4) compared with patients with problem-free wound healing (3.04+/-0.7). Furthermore, significantly higher expression of MMP-1, -9, and 13, and a significantly higher proliferation index (Ki67) were found in the specimens of the patients with secondary healing. In patients in whom the operation was performed because of a recurrence expression of both Ki67 and CD68 were significantly higher. Smokers had an increased risk for suffering recurrent disease, but did not show differences in the collagen ratio.

CONCLUSIONS

As a novel finding, this study indicates that disturbances of the ECM may predict a delayed wound healing after pilonidal sinus surgery.