Exacerbation of pemphigus by rifampicin

Rifampicin therapy caused exacerbation of skin lesions, rising serum pemphigus antibody titres, and decreased serum betamethasone levels in a 59-year-old man with pemphigus vulgaris. Exacerbation of pemphigus was confined to the period of rifampicin therapy and seems to be best explained by the effect of rifampicin on the metabolism of betamethasone. Physicians prescribing rifampicin for the treatment of tuberculosis should be aware of its potential to produce such an important adverse reaction.

Ellagitannins from Punica granatum leaves suppress microsomal prostaglandin E synthase-1 expression and induce lung cancer cells to undergo apoptosis

Prostaglandin E₂ (PGE₂), which is a potent pro-inflammatory lipid mediator, is biosynthesized from arachidonic acid by cyclooxygenase-2 (COX-2) and microsomal PGE synthase-1 (mPGES-1). Non-steroidal anti-inflammatory drugs (NSAIDs) are used clinically as COX inhibitors, but they have gastrointestinal and cardiovascular side-effects. Thus, the terminal enzyme mPGES-1 holds promise as the next therapeutic target. In this study, we found that the ellagitannins granatin A and granatin B isolated from pomegranate leaves, and geraniin, which is their structural analog, selectively suppressed mPGES-1 expression without affecting COX-2 in non-small cell lung carcinoma A549 cells. The ellagitannins also down-regulated tumor necrosis factor α, inducible nitric oxide synthase, and anti-apoptotic factor B-cell chronic lymphocytic leukemia/lymphoma 2, and induced A549 cells to undergo apoptosis. These findings indicate that the ellagitannins have anti-inflammatory and anti-carcinogenic effects, due to their specific suppression of mPGES-1.Abbreviations: Bcl-2: B-cell chronic lymphocytic leukemia/lymphoma 2; COX: cyclooxygenase; CRE: cAMP response element; DHHDP: dehydrohexahydroxydiphenoyl; Et₂O: diethyl ether; EtOAc: ethyl acetate; GAPDH: glyceraldehyde 3-phosphate dehydrogenase; iNOS: inducible nitric oxide synthase; mPGES-1: microsomal prostaglandin E synthase-1; n-BuOH: water-saturated n-butanol; NSAIDs: non-steroidal anti-inflammatory drugs; NF-κB: nuclear factor-κB; PG: prostaglandin; TNF: tumor necrosis factor; TUNEL: terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling.

Red-kerneled rice proanthocyanidin inhibits arachidonate 5-lipoxygenase and decreases psoriasis-like skin inflammation

5-lipoxygenase is a key enzyme in the synthesis of leukotrienes from arachidonic acid. The produced leukotrienes are involved in inflammatory diseases including psoriasis, asthma, and atherosclerosis. A suitable 5-lipoxygenase inhibitor might be useful for preventing and improving the symptoms of leukotriene-related inflammatory diseases. Here, we investigate the mechanism underlying the anti-inflammatory effect of a proanthocyanidin found in red-kerneled rice. Red-kerneled rice proanthocyanidin exhibited potent mixed noncompetitive inhibition of human and rat 5-lipoxygenases, with an IC₅₀ values of 15.1 μM against human enzyme, and 7.0 μM against rat enzyme, respectively. This compound decreased leukotriene B₄ production in rat basophilic leukemia-2H3 cells. In imiquimod-induced psoriasis-like mouse skin, topical application of the proanthocyanidin suppressed hyperplasia, decreased inflammatory cell infiltration, and down-regulated expression of the psoriasis-associated genes Il17a, Il22, S100a9, and Krt1. Lipid metabolome analysis by electrospray ionization mass spectrometry showed that red-kerneled rice proanthocyanidin treatment of psoriasis-like mouse skin dose-dependently decreased the production of leukotriene B₄ but no other arachidonate metabolites. Red-kerneled rice proanthocyanidin inhibits 5-lipoxygenase, resulting in a decrease in leukotriene B₄ production and psoriasis-like mouse skin inflammation. These results suggest that this proanthocyanidin may be therapeutically effective for treating leukotriene-related diseases.

A clinicopathological study of lung cancer patients with occupational exposure to chrysotile asbestos fibers

OBJECTIVE

To summarize the features of asbestos-related lung cancer.

PATIENTS

Thirty-one lung cancer patients with occupational exposure to chrysotile asbestos fibers. They worked or had worked in one asbestos factory or its subcontracters.

RESULT

All patients were male with mean age of 60.6 when diagnosed, and all except one were current or ex-'heavy' smokers. Histological types were fairly evenly divided into adeno-, squamous and small cell carcinoma and 24 (78%) of patients showed 'peripheral type' lung cancers. Regarding clinical stages, 20 patients (65%) were classified as III or IV (advanced stage). Tumor shadow(s) was detected on chest X-ray in 22 patients (71%), and in 5 patients with 'negative' chest X-ray, chest CT was necessary to recognize a primary tumor. Seventeen patients (55%) did not undergo periodical check-ups.

CONCLUSION

Occupational asbestos exposure is interpreted as one of the important risks for lung cancer and frequent and accurate observation is necessary.

[Establishment of a simple fluorescent microscopy method for measurement of the CD4/CD8 ratio in BALF]

The authors established an easy fluorescent microscopy method to measure the ratio of CD4 (helper/inducer T lymphocytes) to CD8 (suppressor/cytotoxic T lymphocytes) (CD4/CD8 ratio) in bronchoalveolar lavage fluid (BALF) in patients with diffuse pulmonary diseases and measles pneumonia. The CD4/CD8 ratio determined by this method strongly correlated with the CD4/CD8 ratio obtained by flow cytometry in both peripheral blood lymphocytes and BALF lymphocytes. When the proportion of lymphocytes in BALF nuclear cells is more than 6%, the CD4/CD8 ratio in BALF was measurable. The CD4/CD8 ratio in peripheral blood was not significantly different among hypersensitive pneumonitis (HP), sarcoidosis (SAR), collagen vascular disease (CVD), idiopathic interstitial pneumonitis (IIP), and measles pneumonia (MP). However, the BALF CD4/CD8 ratio was 0.61 +/- 0.37 in HP, 6.83 +/- 2.73 in SAR, 0.77 +/- 0.40 in CVD, 1.49 +/- 0.29 in IIP. These results were consistent with previously published data. The CD4/CD8 ratio in patients with MP was as low as 0.39 +/- 0.34. In patients with summer type HP, this ratio was low in the acute phase, but became within normal range after moving or reconstructing their homes, accompanied with the improvement of subjective symptoms and the disappearance of inflammation. These data indicate that our method is very simple and useful in the diagnosis and the monitoring of diffuse pulmonary diseases.

A Thickening Agent Using Dioscorea japonica Powder Exhibits Suitable Properties for People with Dysphagia

In an aging society, the novel concept of added food functionality in a dysphagia diet is necessary for preventing diseases and maintain nutrition intake. The present study evaluated the utilization of Dioscorea japonica as a thickened liquid for people with dysphagia due to its unique physical properties and beneficial effects on chronic inflammation. The viscosity of the prepared thickened liquid using freeze-dried Dioscorea japonica powder was compared with those of xanthan gum and commercially available thickened liquids in selected conditions resembling to cooking. Dioscorea japonica powder showed high versatility, because the viscosity of its thickened liquid could be easily adjusted by modifying its blending amount and temperature. The thickened liquid of Dioscorea japonica had the most stable viscosity among the thickened liquids when NaCl was added and exhibited excellent resistance to α-amylase, similar to that of the other thickened liquids. The viscosity of the thickened liquid of Dioscorea japonica was relatively stable on changing the pH, but it was slightly unstable when the temperature changed. Overall, the thickened liquid of Dioscorea japonica powder has excellent viscosity stability, comparable to or better than commercially available thickened liquids, and is expected to be used as a new thickened liquid with added food functionality.