Non-scarring patchy alopecia in patients with systemic lupus erythematosus differs from that of alopecia areata

Background

Non-scaring patchy alopecia associated with systematic lupus erythematosus (SLE) is sometimes mis-diagnosed as alopecia areata (AA).

Objectives

Our aim was to differentiate non-scarring patchy SLE alopecia features from patchy AA.

Methods

Clinical, dermatoscopic and histopathological data from 21 SLE patients with patchy alopecia were compared with data from 21 patients with patchy AA.

Results

Incomplete alopecia was common in SLE alopecia patches, while AA patches exhibited complete alopecia. Exclamation-mark hairs, black dots, broken hair and yellow dots were common to AA, while hair shaft thinning and hypopigmentation, angiotelectasis, peripilar sign, perifollicular red dots, white dots and honeycomb pigment patterns were more common in SLE. Interfollicular polymorphous vessels were the most common angiotelectasis presentation in the SLE alopecia patches, but interfollicular arborizing vessels were significantly more common in non-hair-loss-affected SLE regions and in AA hair-loss regions. During follow-up, increased vellus hair was the earliest feature that emerged after treatment both in SLE and AA, while the earliest feature that disappeared was hair shaft hypopigmentation in SLE and broken hair in AA. After treatment, no SLE patients had relapse of alopecia, while 41.7% of AA patients did.

Conclusion

Distinct clinical, dermatoscopic and histopathological features were found in SLE-associated alopecia regions, which were different from those of AA. Serological autoantibody tests are of value to confirm the differential diagnosis. Local angiotelectasis and vasculitis close to hair follicles may be involved in the pathogenesis of alopecia in SLE.

Nicotine induces alteration of H3K27 demethylase UTX in kidney cancer cell

Cigarette smoking is one of the most important risk factors for kidney cancer, but the molecular mechanism is poorly understood. To examine the expression change of histone H3 on lysine 27 trimethylase (H3K27me3) demethylases ubiquitously transcribed TPR gene on the X chromosome (UTX) in kidney cancer cell line 786-O after nicotine treatment, quantitative real-time-polymerase chain reaction and western blotting analysis were carried out. These results showed that nicotine can increase UTX messenger RNA and protein levels and also decrease the content of H3K27me3. The decreased content of H3K27me3 may activate specific gene expression and lead to kidney cancer. Future investigation on nicotine induced UTX expression and its epigenetic effect would deepen our understanding on nicotine toxicity and carcinogenicity.

Celecoxib attenuates systemic lipopolysaccharide-induced brain inflammation and white matter injury in the neonatal rats

Lipopolysaccharide (LPS)-induced white matter injury in the neonatal rat brain is associated with inflammatory processes. Cyclooxygenase-2 (COX-2) can be induced by inflammatory stimuli, such as cytokines and pro-inflammatory molecules, suggesting that COX-2 may be considered as the target for anti-inflammation. The objective of the present study was to examine whether celecoxib, a selective COX-2 inhibitor, can reduce systemic LPS-induced brain inflammation and brain damage. Intraperitoneal (i.p.) injection of LPS (2mg/kg) was performed in postnatal day 5 (P5) of Sprague-Dawley rat pups and celecoxib (20mg/kg) or vehicle was administered i.p. 5 min after LPS injection. The body weight and wire-hanging maneuver test was performed 24h after the LPS exposure, and brain injury was examined after these tests. Systemic LPS exposure resulted in an impairment of behavioral performance and acute brain injury, as indicated by apoptotic death of oligodendrocytes (OLs) and loss of OL immunoreactivity in the neonatal rat brain. Treatments with celecoxib significantly reduced systemic LPS-induced neurobehavioral disturbance and brain damage. Celecoxib administration significantly attenuated systemic LPS-induced increments in the number of activated microglia and astrocytes, concentrations of IL-1β and TNFα, and protein levels of phosphorylated-p38 MAPK in the neonatal rat brain. The protection of celecoxib was also associated with a reduction of systemic LPS-induced COX-2+ cells which were double labeled with GFAP+ (astrocyte) cells. The overall results suggest that celecoxib was capable of attenuating the brain injury and neurobehavioral disturbance induced by systemic LPS exposure, and the protective effects are associated with its anti-inflammatory properties.

Neonatal lipopolysaccharide exposure induces long-lasting learning impairment, less anxiety-like response and hippocampal injury in adult rats

Infection during early neonatal period has been shown to cause lasting neurological disabilities and is associated with the subsequent impairment in development of learning and memory ability and anxiety-related behavior in adults. We have previously reported that neonatal lipopolysaccharide (LPS) exposure resulted in cognitive deficits in juvenile rats (P21); thus, the goal of the present study was to determine whether neonatal LPS exposure has long-lasting effects in adult rats. After an LPS (1mg/kg) intracerebral (i.c.) injection in postnatal day 5 (P5) Sprague-Dawley female rat pups, neurobehavioral tests were carried out on P21 and P22, P49 and P50 or P70 and P71 and brain injury was examined at 66days after LPS injection (P71). Our data indicate that neonatal LPS exposure resulted in learning deficits in the passive avoidance task, less anxiety-like (anxiolytic-like) responses in the elevated plus-maze task, reductions in the hippocampal volume and the number of neuron-specific nuclear protein (NeuN)+ cells, as well as axonal injury in the CA1 region of the middle dorsal hippocampus in P71 rats. Neonatal LPS exposure also resulted in sustained inflammatory responses in the P71 rat hippocampus, as indicated by an increased number of activated microglia and elevation of interleukin-1β content in the rat hippocampus. This study reveals that neonatal LPS exposure causes persistent injuries to the hippocampus and results in long-lasting learning disabilities, and these effects are related to the chronic inflammation in the rat hippocampus.

Leukemoid reaction in malignant bone tumor patients - a retrospective, single-institution study

BACKGROUND

To the Authors' knowledge, the literature regarding leukemoid reaction in patients with malignant bone tumor is sparse, and most of patients with leukemoid reaction have poor prognosis.

AIM

To study the leukemoid reaction in malignant bone tumor patients.

MATERIALS AND METHODS

A total of 105 consecutive malignant bone tumor patients with a white blood cell count > 50,000/microL were retrospectively identified over a 4-years period (2007-2010). Those patients without a secondary cause of their leukocytosis were defined as having a paraneoplastic leukemoid reaction.

RESULTS

Three etiologies of the leukocytosis were found in those 105 patients: the major one was paraneoplastic leukemoid reaction which accounted for 56%; the second one was hematopoietic growth factors defect accounting for 30%; 14% patients were caused by infection and Tumor bone marrow involvement. The patients diagnosed with a paraneoplastic leukemoid reaction typically had neutrophil predominance (94.8%) and radiographic evidence of metastatic diseases (78%). They were clinically stable, but had a poor prognosis. 95% either died or were discharged to hospice within 12 weeks of their initial extreme leukocyte count. Both of the 2 (2%) patients who survived over 12 weeks received effective antineoplastic therapy.

CONCLUSIONS

Patients with typical paraneoplastic leukemoid reaction were clinically stable despite having large tumor burdens. However, clinical outcomes were poor unless receiving an effective antineoplastic treatment.

In-vivo effect of the combination of tnf and adriamycin against a human breast cell-line expressing the mdr-phenotype

The combined effect of tumor necrosis factor alpha (TNF) and adriamycin (ADR) on tumor cell killing was investigated in vivo. The human breast adenocarcinoma ADR-resistant MDA/ADR cells found to be resistant to in vitro TNF lysis and with an apparent index of resistance to ADR of 23 have been used. Treatment of MDA/ADR subcutaneous tumor bearing mice with PBS, TNF, ADR or the combination of TNF/ADR indicate that the combination of TNF and ADR treatment leads to a significant decrease in tumor growth while treatment with TNF was inactive and treatment with ADR was moderately active. Tumor cells were collected from mice treated with TNF/ADR combination and analysed by PCR for MnSOD and TNF ne expression. No induction of the expression of these genes, known to be involved in the regulation of TNF-induced cell killing, was noted following TNF/ADR combination treatment, suggesting that their products were not involved in the observed resistance.

PSGL-1/selectin and ICAM-1/CD18 interactions are involved in macrophage-induced drug resistance in myeloma

Chemoresistance is the major obstacle in multiple myeloma (MM) management. We previously showed that macrophages protect myeloma cells, on a cell contact basis, from melphalan or dexamethasone-induced apoptosis in vitro. In this study, we found that macrophage-mediated myeloma drug resistance was also seen with purified macrophages from myeloma patients' bone marrow (BM) in vitro and was confirmed in vivo using the human myeloma-SCID (severe combined immunodeficient) mouse model. By profiling differentially regulated and paired plasma membrane protein genes, we showed that PSGL-1 (P-selectin glycoprotein ligand-1)/selectins and ICAM-1/CD18 played an important role in macrophage-mediated myeloma cell drug resistance, as blocking antibodies against these molecules or genetic knockdown of PSGL-1 or ICAM-1 in myeloma cells repressed macrophages' ability to protect myeloma cells. Interaction of macrophages and myeloma cells via these molecules activated Src and Erk1/2 kinases and c-myc pathways and suppressed caspase activation induced by chemotherapy drugs. Thus, our study sheds new light on the mechanism of drug resistance in MM and provides novel targets for improving the efficacy of chemotherapy in patients.

Cellular stress response in Eca-109 cells inhibits apoptosis during early exposure to isorhamnetin

The flavonol aglycone isorhamnetin shows anti-proliferative activity in a variety of cancer cells. Previous work, from our laboratory showed that isorhamnetin inhibits the proliferation of human esophageal squamous carcinoma Eca-109 cells in vitro, but only after 72 h of exposure. This led us to propose that isorhamnetin exposure induces a cellular stress response that inhibits the antiproliferative and apoptotic effects of the compound during early exposure. To test this hypothesis, the present study examined the effects of isorhamnetin on Eca-109 cells during the first 72 h of exposure. Cell growth was assessed using the trypan blue exclusion assay, and expression of IκBα, NF-κB/p65, NF-κB/p50, phospho-Akt, Bcl-2, COX-2, Mcl-1, Bax, p53 and Id-1 were analyzed by Western blot. During the first 72 h of exposure, NF-κB/p65 and NF-κB/p50 accumulated in nuclei and expression of COX-2, Bcl-2 and Mcl-1 increased. In contrast, expression of IκBα and Bax fell initially but later increased. Expression of phospho-Akt and p53 showed no detectable change during the first 48 h. Pretreatment with the NF-κB inhibitor MG132 before exposure to isorhamnetin blocked the nuclear accumulation of p50 and p65, thereby inhibiting cell proliferation. These results show that during early exposure of Eca-109 cells to isorhamnetin, the NF-κB signaling pathway is activated and COX-2 expression increases, and this increase in expression partially inhibits isorhamnetin-induced apoptosis. Beyond 72 h of exposure, however, the apoptotic effect of isorhamnetin dominates, leading to inhibition of the NF-κB pathway and of cellular proliferation. These results will need to be taken into account when exploring the use of isorhamnetin against cancer in vivo.

Two-wave mixing in chiral dye-doped nematic liquid crystals

Two-wave mixing in nematic liquid crystals doped with dyes and chiral agents is studied. The photo-induced spatial modulation of the chiral structure, together with the diffusion anisotropy of the mixture, determine a relatively fast response time, a spatial resolution of 1 μm, and a maximum gain for circularly polarized interacting beams. The gain is insensitive to changes in linear polarization, while it varies with the grating period and with the pump-to-signal intensity ratio.

Design & control of a 3D stroke rehabilitation platform

An upper limb stroke rehabilitation system is developed which combines electrical stimulation with mechanical arm support, to assist patients performing 3D reaching tasks in a virtual reality environment. The Stimulation Assistance through Iterative Learning (SAIL) platform applies electrical stimulation to two muscles in the arm using model-based control schemes which learn from previous trials of the task. This results in accurate movement which maximises the therapeutic effect of treatment. The principal components of the system are described and experimental results confirm its efficacy for clinical use in upper limb stroke rehabilitation.

Severe diffuse non-scarring hair loss in systemic lupus erythematosus - clinical and histopathological analysis of four cases

BACKGROUND

Although diffuse non-scarring hair loss been found common in systemic lupus erythematosus (SLE), study that conduted on the severe type has been scarce.

OBJECTIVE

This study aims to explore the dermoscopic and pathological features of severe diffuse hair loss in SLE.

METHOD

Data including clinico-laboratory, dermoscopic and histopathological findings of four patients with SLE with severe diffuse hair loss were analysed retrospectively.

RESULTS

All four patients were women aged 41, 39, 14 and 48 with complaints of hair loss involving 55%, 100%, 60% and 55% of their scalp respectively. Common clinical findings observed in the patients were sparse scalp hair with clusters of newly regrown hair. Scalp dermoscopy showed scaling, perifollicular telangiectasia, increased numbers of short vellus hairs, focal atrichia and decreased hair shaft pigmentation. Scalp tissue histopathology revealed typical changes of SLE such as epidermal atrophy with focal liquefaction, degeneration of the basement membrane zone, pigment incontinence, mild focal perivascular and perifollicular lymphocytic infiltrates and deposition of immunoglobulins at the dermal-epidermal junction. Treatment and improvement in SLE disease activity indices had a favourable impact on hair regrowth.

CONCLUSION

The severe type of hair loss in patient with SLE presents a unique set of clinical, dermoscopic and histopathological features.

Cytomegalovirus infection in mesenchymal stem cells and their activation could be enhanced by nuclear factor-κB inhibitor pyrrolidinedithiocarbamate in vitro

Because of the central role of the transcription factor nuclear factor (NF)-κB in cell survival and proliferation in many kinds of cancer cells, NF-κB inhibitors may have a potential role in cancer therapy. Currently, many NF-κB inhibitors are used for immunosuppression to treat hematologic malignancy patients after stem cell transplantation (SCT). Human cytomegalovirus (HCMV) infection is one of the most common complications following SCT. Some workers have reported that HCMV infection has a close relationship to NF-κB activation; however, the specific effects of NF-κB inhibitors, such as pyrrolidinedithiocarbamate (PDTC), on infection with and activation of CMV in mesenchymal stem cells (MSCs) remain unknown. In our study, we isolated MSCs from the bone marrows of healthy human donors for infection with 1 tcid(50) of HCMV with or without 1 μmol/L PDTC. After 48 hours of culture in dmem supplemented with 10% (volume per volume) fetal calf serum, we tested MSCs using reverse transcription-polymerase chain reaction (RT-PCR) assays to detect messenger RNA (mRNA) expression of HCMV immediate early (IE) gene and the GAPDH gene. Flow cytometry was used to detect HCMV pp65 antigen-positive cells and transmission electron microscopy (TEM) for intra cellular HCMV particles. We observed that the shape of the MSCs changed in response to infection by 1 TCID(50) of HCMV. MSCs infected by 1 TCID(50) of HCMV in combination with 1 μmol/L of PDTC changed their shapes more profoundly; almost all cells went from a thin elongated profile to a round, thick ball. In contrast, the shape of cells treated with PDTC alone or the HCMV mock-infected elements did not change. The RT-PCR assay showed that there was a bright band corresponding to HCMV IE mRNA in MSCs infected with 1 TCID(50) of HCMV in combination with 1 μmol/L of PDTC, as compared with cells infected by only 1 TCID(50) of HCMV. The HCMV mock-infected MSCs did not express HCMV IE mRNA. Using flow cytometry, we detected more HCMV pp65 antigen-positive cells among MSCs infected with 1 TCID(50) of HCMV in combination with 1 μmol/L of PDTC. HCMV particles were observed by TEM in the nucleus and cytoplasm of MSCs infected with HCMV. There were more HCMV particles in cells infected by HCMV in combination with PDTC. In conclusion, NF-κB activation may affect HCMV infection efficiency of MSCs. An NF-κB inhibitor increased the infection by activation of HCMV in MSCs, thus we should pay close attention to HCMV infection when we prescribe an NF-κB inhibitor in clinical settings.