Plasticity of immune system vs. memory therapy IST

BACKGROUND

Pharmacotherapy and immunotherapy are the main treatments for allergic diseases to inhalants.

OBJECTIVE

This study investigates whether to repeat short cycles of immunotherapy after 3 or 5 years the from interruption of the first therapeutic cycle, lasting 3-4 years, to maintain immune memory in individuals subjected to IST.

METHODS AND RESULTS

We have compared two groups, one of 452 patients who, after the first treatment for 3-4 years of IST, performed a cycle of four months after three and 10 years from the suspension, and a second group of 126 individuals who have performed only the IST treatment for 3-4 years. The best results were obtained in the first group.

CONCLUSIONS

These results are due to the immune system's plasticity, a very important concept in clinical practice.

Successful of subcutaneous and oral hyposensitizing therapy in 30 patients

Background. Pharmacotherapy and immunotherapy are the main treatment modalities for respiratory allergy. The aim of this paper has been to evaluate the efficacy and tolerability of subcutaneous and sublingual immunotherapy in association in allergic patients, and to demonstrate that the patients who have performed a second oral vaccination cycle after 4-5 years from the first subcutaneous treatment, derive benefits that may last for years. This is due to immune system's plasticity. Methods. The study was conducted in 30 allergic patients which had previously executed a full cycle of classical subcutaneous immunotherapy, with a partial remission of symptoms. After 4-5 years, they were subjected to sublingual immunotherapy for the same allergen, improving the results obtained. Results. All the patients reported a decrease or absence of clinical symptoms, a reduction in the use of anti-allergic drugs, and lower values of PRIST and RAST after the treatment. Conclusions. The results of this clinical study confirm the improvement of results when subcutaneous and sublingual immunotherapy are associated.

Fumarate-loaded electrospun nanofibers with anti-inflammatory activity for fast recovery of mild skin burns

In the biomedical sector the availability of engineered scaffolds and dressings that control and reduce inflammatory states is highly desired, particularly for the management of burn wounds. In this work, we demonstrate for the first time, to the best of our knowledge, that electrospun fibrous dressings of poly(octyl cyanoacrylate) (POCA) combined with polypropylene fumarate (PPF) possess anti-inflammatory activity and promote the fast and effective healing of mild skin burns in an animal model. The fibers produced had an average diameter of (0.8  ±  0.1) µm and they were able to provide a conformal coverage of the injured tissue. The application of the fibrous mats on the burned tissue effectively reduced around 80% of the levels of pro-inflammatory cytokines in the first 48 h in comparison with un-treated animals, and enhanced skin epithelialization. From histological analysis, the skin thickness of the animals treated with POCA : PPF dressings appeared similar to that of one of the naïve animals: (13.7  ±  1.4) µm and (14.3  ±  2.5) µm for naïve and treated animals, respectively. The density of dermal cells was comparable as well: (1100  ±  112) cells mm(-2) and (1358  ±  255) cells mm(-2) for naïve and treated mice, respectively. The results demonstrate the suitability of the electrospun dressings in accelerating and effectively promoting the burn healing process.

Safety, efficacy, and tolerability of differential treatment to prevent and treat vaginal dryness and vulvovaginitis in diabetic women

BACKGROUND

Problems affecting the vaginal tract in diabetic women are very often neglected. The efficacy and safety of three gynecological treatments in diabetic women have been assessed.

MATERIALS AND METHODS

A single-blind randomized progressive trial on 48 diabetic women affected by vaginal dryness, dyspareunia, and recurrent Candida infections was carried out. The ICIQ Vaginal Symptoms (ICIQ-VS) questionnaire was administered.

RESULTS

The analysis of the parameters of ICIQ-VS questionnaire among the three groups showed significant difference only for "dragging pain" (p = 0.0 19) and "soreness" (p = 0.028). In all groups and for all parameters of the questionnaire, improvement of symptoms was observed. In particular, in Group 1 for all symptoms a highly significant difference was observed, to support the already known benefits of the products and of the proposed combination. Significant improvement was also observed in Group 2.

CONCLUSIONS

The proposed treatment with DermoXEN® Ultracalming Special for diabetics and DermoXEN® Vitexyl vaginal gel exert effective moisturizing and soothing action. Indeed, the aforementioned products have been proven effective for the main gynecological problems of diabetic women.

Extremophiles survival to simulated space conditions: an astrobiology model study

In this work we investigated the ability of four extremophilic bacteria from Archaea and Bacteria domains to resist to space environment by exposing them to extreme conditions of temperature, UV radiation, desiccation coupled to low pressure generated in a Mars’ conditions simulator. All the investigated extremophilic strains (namely Sulfolobus solfataricus, Haloterrigena hispanica, Thermotoga neapolitana and Geobacillus thermantarcticus) showed a good resistance to the simulation of the temperature variation in the space; on the other hand irradiation with UV at 254 nm affected only slightly the growth of H. hispanica, G. thermantarcticus and S. solfataricus; finally exposition to Mars simulated condition showed that H. hispanica and G. thermantarcticus were resistant to desiccation and low pressure.

The role of basophil activation test in special populations with mastocytosis and reactions to hymenoptera sting

BACKGROUND

Systemic mastocytosis (SM) may be associated with hymenoptera allergy. In such cases, immunotherapy is a life-saving treatment, but a circumstantiated diagnosis is needed for its prescription. Patients with SM and previous reactions to stings, but with negative tests represent a diagnostic dilemma. The basophil activation test (BAT) may be helpful in refining the diagnosis.

OBJECTIVE

We assessed the usefulness of BAT in subpopulations of mastocytosis patients, including those with negative tests for insect allergy.

METHODS

Within a population of patients with mastocytosis and previous stings, we studied by BAT and augmented intradermal test (IDT) (10 µg/ml) two groups: (1) with reactions to stings and negative tests; (2) without reactions and negative tests. Basophil activation test was performed with different venoms, assessing at flow cytometry basophils' activation.

RESULTS

Sixty-three patients had mastocytosis and 52 had reactions to previous hymenoptera stings. Of them, seven proved negative to diagnostic tests. In six of seven of those patients, BAT was negative with all venoms, and in one, basophils resulted activated also with the negative control. In six patients without previous reactions and negative tests, BAT was totally negative in five of six patients and weakly positive to Hornet in one. Finally, the IDT at 10 µg/ml venom produced nonspecific positive results in most cases.

CONCLUSION

In patients with mastocytosis, the negative results of standard tests are reliable, because BAT and IDT at higher concentration do not add useful information.

Methyl-aminolevulinate photodynamic therapy for the treatment of actinic cheilitis: a retrospective evaluation of 29 patients

AIM

Multiple treatment modalities have been proposed for actinic cheilitis (AC), and topical photodynamic therapy (PDT) has recently been included among these modalities. We report our experience with PDT using methyl-aminolevulinate (MAL) in AC.

METHODS

We performed a retrospective analysis of 29 patients who had undergone MAL-PDT for treatment of AC: 4 patients received one single session and 25 patients two consecutive weekly sessions.

RESULTS

At 3 months, 21 patients (72%) obtained a complete clinical response, which was sustained over a follow-up period of 6-36 months (mean, 20 months) in 20 patients. Cosmetic outcome was generally rated as good or very good. Transient local adverse events related to the procedure were common and mild to moderate in the majority of cases.

CONCLUSION

Our preliminary experience suggests that MAL-PDT may be considered a valid modality for the treatment of AC, although long-term follow-up studies in large patient series are required to obtain precise data about clinical and histological recurrences.

Oral supplementation with a nutraceutical containing Echinacea, methionine and antioxidant/immunostimulating compounds in patients with cutaneous viral warts

AIM

The aim of thos paper was to determine the effect of oral supplementation (OS) with a nutraceutical, containing methionine, Echinacea, zinc, probiotics and other antioxidant and immunostimulating compounds, on the response of cutaneous warts to conventional standard therapy (CST).

METHODS

This was an open-label study in adults and adolescents aged 14 years or more and with a body weight ≥40 kg, who had at least one cutaneous viral wart. Eligible patients were consecutively allocated to CST (topical therapy with a preparation containing salicylic acid and lactic acid or liquid nitrogen cryotherapy) alone or CST combined with nutraceutical OS for 4 months.

RESULTS

A total of 172 patients were enrolled: 83 received CST alone and 89 CST+OS. During the 6-month observation period, a statistically significant reduction of the mean number of warts was obtained in each treatment group and subgroup. The addition of nutraceutical OS was associated with a significantly lower number of warts at 6 months as compared to CST alone. Complete remission was obtained in 54.5% and 86% of patients in the CST group and CST+OS arm, respectively (P<0.001). The influence of the nutraceutical on the response rate appeared to be more prominent in the subgroup of patients treated with topical therapy. The development of new warts during the study period occurred significantly less frequently with CST+OS compared to CST (9% versus 25%; P=0.004). No adverse events possibly related to the nutraceutical administration were observed.

CONCLUSION

Our pilot experience seems to suggest that nutraceutical OS is safe and beneficial in patients with cutaneous warts, and capable of enhancing the response to CST.

Methyl-aminolevulinate photodynamic therapy for the treatment of actinic keratoses and non-melanoma skin cancers: a retrospective analysis of response in 462 patients

AIM

Topical photodynamic therapy (PDT) with methyl-aminolevulinate (MAL) is widely used for the management of actinic keratoses (AK) and non-melanoma skin cancers (NMSCs). The authors report the results of a retrospective chart review showing the cumulative four-year experience with MAL-PDT in a hospital outpatient setting.

METHODS

The medical records selected concerned all patients who completed the MAL-PDT regimen (one single session for AK and two sessions one week apart for NMSCs) and who underwent post-treatment assessments over a follow-up period of at least 12 months.

RESULTS

Present case series included a total of 462 patients: 210 patients with AK, 228 subjects with 348 basal cell carcinomas (BCCs), 213 of nodular type (nBCC) and 135 of superficial type (sBCC), 17 patients with Bowen's disease and seven with squamous cell carcinoma. On the whole, following a single session, complete clearance of AK was achieved in 79% of patients at three months and in 68.1% at 12 months. As concerns BCCs, regardless of the clinical type, a complete response was observed in 71% of lesions at three months, with a rate of recurrence at 12 months of 15%. The risk of both initial treatment failure and recurrence was higher for nBCCs than sBCCs. Our results, even if obtained in very few cases, indicate that Bowen's disease is very responsive to MAL-PDT, unlike microinvasive or invasive SCC. Treatment was generally well tolerated.

CONCLUSIONS

Our experience confirms that MAL-PDT is a valid approach to patients with AK, BCC and Bowen's disease, with an acceptable tolerability profile and a very low risk of complications.

Morbidity of salivary gland digital sialography using a non-ionic dimeric contrast medium

AIM

Sialography is considered a low invasive procedure, due to cannulation of salivary duct orifice. The aim of this study was to evaluate the morbidity of sialography using a nonionic dimeric contrast medium.

METHODS

A questionnaire was proposed to 90 patients who underwent parotid and submandibular sialography to reveal related symptoms as: pain, swelling, impairment to daily activities and taste alteration. Pain and swelling intensity was assessed using a visual analogue scale (VAS).

RESULTS

Fifty-two out of ninety questionnaires were returned. Sialography was performed in 30/52 patients in the submandibular gland, 22/52 in the parotid gland. Pain during sialography was complained by 28/52 patients with a 2.4 mean VAS score. Pain after sialography, was reported by 17/52 patients with a 1.3 mean VAS score. Swelling was reported by 25/52 patients with a 2.4 mean VAS score; 48/52 patients returned immediately to daily activities; 8/52 complained different taste alterations.

CONCLUSION

Main related symptoms for submandibular and parotid sialography are pain and swelling, spontaneously resolving after 24-48 hours in most of cases. The statistical analysis also demonstrated in patients who underwent submandibular sialography the onset of pain during the procedure is significantly related to an increase of pain after the examination. Thus in patients, who referred severe pain during sialography, antiinflammatory drugs are recommended to control the onset of pain after sialography.

IL-16 serum level in children with atopic dermatitis

IL-16 is a natural ligand of CD4 molecules and induces chemotaxis in CD4-expressing cells. It amplifies the inflammatory reaction by stimulating cytokine production in monocytes and activating T-cells. There is evidence that IL-16 plays a role in the pathogenesis of atopic dermatitis, and increased serum levels of IL-16 have been detected in allergic diseases. However, few data are available on IL-16 serum levels in atopic dermatitis. The aim of our study is to measure IL-16 serum levels in childhood atopic dermatitis before and after treatment and to evaluate a possible correlation between IL-16 serum levels and disease severity. IL-16 serum levels were measured by an ELISA approach in 34 children (19 males and 15 females; mean age 6.8 years) with moderate to severe atopic dermatitis, at their first visit and after 3 months of treatment, and in 10 non-atopic healthy controls of the same age group. The severity of atopic dermatitis was measured by SCORAD index. IL-16 serum levels were significantly higher in patients affected by atopic dermatitis than in controls before and after treatment with tacrolimus ointment. No clear correlation was found between IL-16 serum levels and atopic dermatitis severity. IL-16 serum levels are increased in atopic dermatitis but do not seem to correlate with disease severity.

[Intestinal parasitosis: our series from 1992 to 1995]

From 1992 to 1995 in our Department 2236 researches of intestinal parasites (2194 on stool specimens, 34 on scotch tests, 8 on enterotests) were carried out on 1200 patients (703 HIV-Ab negative and 497 HIV-Ab positive). On the whole 387 samples (17.34%) of 203 subjects (16.92%) were found parasitized; 92 (13.08%) patients of them were HIV-Ab negative and 111 (22.33%) were HIV-Ab positive. We found more frequently Blastocystis hominis and Giardia intestinalis among HIV-Ab negative subjects and Cryptosporidium sp. and Blastocystis hominis among HIV-Ab positive patients. Isospora belli was found exclusively among HIV-Ab positive people, Cryptosporidium sp. in 54 HIV-Ab positive subjects and 3 HIV-Ab negative children. Strongyloides stercoralis was found only in HIV-Ab positive non-European people.

Accumulation of osmoprotectants and lipid pattern modulation in response to growth conditions by Halomonas pantelleriense

The effects of salinity, growth temperature, pH and composition of the medium on the accumulation of intracellular organic solutes, by nuclear magnetic resonance spectroscopy (NMR) in Halomonas pantelleriense were examined. The modulation of lipid pattern in different growth conditions was also reported. H. pantelleriense accumulated glycine betaine, ectoine, hydroxyectoine and glutamate. The type of osmoprotectant and the relative proportion depended on growth conditions. The main lipids identified by NMR studies were 1,2 diacylglycero-3-phosphorylethanolamine (PEA), 1,2 diacylglycero-3-phosphoryl-glycerol (PG) and cardiolipin, (DPG). The predominant fatty acids were C16:0 and C18:1, minor fatty acids were C16:1 and C18:0. The relative percentage of polar lipids and fatty acids were affected by growth conditions.

Purification and characterization of thermostable xylose(glucose) isomerase from Bacillus thermoantarcticus

Xylose isomerase produced by Bacillus thermoantarcticus was purified 73-fold to homogeneity and its biochemical properties were determined. It was a homotetramer with a native molecular mass of 200 kDa and a subunit molecular mass of 47 kDa, with an isoelectric point at 4.8. The enzyme had a K(m) of 33 mM for xylose and also accepted D-glucose as substrate. Arrhenius plots of the enzyme activity of xylose isomerase were linear up to a temperature of 85 degrees C. Its optimum pH was around 7.0, and it had 80% of its maximum activity at pH 6.0. This enzyme required divalent cations for its activity and thermal stability. Mn(2+), Co(2+) or Mg(2+) were of comparable efficiency for xylose isomerase reaction, while Mg(2+) was necessary for glucose isomerase reaction.

Lipid profile: a useful chemotaxonomic marker for classification of a new cyanobacterium in Spirulina genus

The morphological, physiological and genetic characteristics of an isolate cyanobacterium from hard sand of the lake Venere in the Pantelleria island (Italy) were described. The isolate with a small-size coiled helix shape, growing optimally at pH 9.2-9.5 at 30 degrees C under continuous illumination and aeration, possessed a 61.5 mol% of Guanine + Cytosine content of DNA. The lipid profile showed the presence of mono-, di-glycosyl, sulphoquinovolosyl and phosphatidyl (MGDG, DGDG, SQDG and PG). The fatty acid profile was also studied, characterized by the absence of gamma-linolenic acid and the presence of saturated and monounsaturated C16 and C18. The latter was also present as a dienoic component. The fatty acid composition was affected by growth temperature by increasing the degree of desaturation at a lower temperature and the biosynthesis of shorter acyl chains. The effects of growth conditions other than temperature, physical, nutritional and chemical on lipid composition were also studied. The overall features of the cyanobacterium isolated from Pantelleria clustered it into Spirulina genus.

The thermophilic yeast Hansenula polymorpha does not require trehalose synthesis for growth at high temperatures but does for normal acquisition of thermotolerance

The TPS1 gene from Hansenula polymorpha, which encodes trehalose-6-phosphate (Tre6P) synthase, has been isolated and characterized. The deletion of TPS1 rendered H. polymorpha cells incapable of trehalose synthesis under conditions where wild-type cells normally accumulate high levels of trehalose. Interestingly, the loss of Tre6P synthase did not cause any obvious growth defects on a glucose-containing medium, even at high temperatures, but seriously compromised the cells' ability to acquire thermotolerance.