Diode laser-assisted inferior turbinoplasty in resistant cases of allergic rhinitis: a clinical and histopathological study

Chronic nasal obstruction owed to inferior nasal turbinate hypertrophy is one of the most common problems encountered in rhinology. When medical management fails, surgical reduction of hyperplastic inferior nasal turbinate is often used. Diode laser is appropriate for the use in the nasal turbinate. This study was designed to define the histopathologic changes in the inferior turbinate post diode laser turbinoplasty and evaluate the outcome in patients having allergic inferior turbinate hypertrophy that has not responded to the medical treatment. A prospective single-cohort study was carried out. Under general anesthesia, 18 patients underwent inferior turbinoplasty using diode laser 980 nm in the contact mode submucosally under guidance of a 4-mm nasal endoscope 0°. Inferior turbinate mucosa biopsy specimens were taken at the time of surgery, and after 3 months, they were histopathologically examined with assessment of the patients' symptoms. At 3 months postoperatively, histopathologic assessment demonstrated marked structural changes in diode laser-treated inferior turbinates including the predominance of fibrous tissue with diminution of seromucinous glands, venous sinusoids, and inflammatory cell infiltrate. Concurrently, 16 patients (89%) had no nasal obstruction, 15 patients (83%) had moderate-to-good improvement of rhinorrhea, whereas 13 patients (72%) had moderate-to-good improvement of sneezing. Diode laser produces histopathologic changes in the inferior turbinate soft tissues, providing excellent ablation of the soft tissue with controllable performance and good hemostasis. Therefore, it is a safe, minimally invasive, and effective procedure in relieving nasal obstruction secondary to inferior turbinate hypertrophy as well as other symptoms of allergic rhinitis.

Survivin and Programmed Death Ligand-1 as Possible Players in the Pathogenesis of Ulcerative Colitis: An Immunohistochemical Study

BACKGROUND: Ulcerative colitis (UC) is a relapsing chronic inflammatory disorder, with many catastrophic complications. The pathogenesis of UC is not yet well understood. Exploring the exact immunologic pathogenesis of UC may eventually offer new therapeutic options. AIM OF THE WORK: In this study, we proposed that survivin and programmed death ligand (PDL1) may have roles in the pathogenesis of UC. MATERIALS AND METHODS: The study examined the immunohistochemical expression of both markers in the colonic epithelial cells and lamina propria in 43 cases of UC and 43 cases of non-specific chronic colitis (non-inflammatory bowel disease colitis). RESULTS: The results uncovered that both survivin and PDL1 expression were significantly expressed in the colonic lamina propria cells in UC cases in comparison to colitis cases (p < 0.001). On the other hand, the expression of PDL1 was shown to be lost in the colonic mucosal cells in UC cases when compared to cases of the control group (p < 0.05). CONCLUSION: The study, therefore, concluded that both survivin and PDL1 may play an important role in the UC pathogenesis and hence may be a novel interest in new therapeutic trends.

Baseline HDAC6 and TFF3 proteins overexpression as prognostic markers of lupus nephritis relapse

Introduction: Lupus nephritis (LN) is a substantial manifestation of systemic lupus erythematosus (SLE). HDAC6 is overexpressed in various kidney diseases, and its inhibition slows kidney injury progression. Urinary TFF3 increases in chronic kidney diseases (CKDs) and may be associated with patient’s outcome. Objectives: This study aimed to examine the relationship between renal HDAC6 and TFF3 proteins expression and with clinicopathologic characteristics and outcome of LN. Patients and Methods: HDAC6 and TFF3 proteins’ expression was immunohistochemically detected in 56 cases of LN. They were correlated to patients’ age, gender, urinary 24 hours protein and serum creatinine levels at baseline and during follow up. Additionally, they were correlated to LN classes, activity index (AI) and chronicity index (CI) and relapse free survival (RFS). Results: HDAC6 overexpression was significantly associated with serum creatinine and 24 hours proteinuria levels at baseline (P = 0.041 and P =0.026 respectively) and during follow up (P < 0.001). It was associated with AI and CI of class III and IV LN (P = 0.047 and 0.003 respectively). TFF3 overexpression was associated with higher serum creatinine and more proteinuria at baseline (P = 0.015 and 0.001 respectively) and during follow up (P < 0.001). It was significantly associated with higher CI (P = 0.001). Both markers were associated with shorter RFS (P < 0.001). Conclusion: HDAC6 and TFF3 proteins are associated with clinicopathologic features of renal damage in LN. They are reliable predictors of patients’ RFS, which makes them good candidates for risk stratification of patients and targeted therapy.

Paeoniflorin in experimental BALB/c mansoniasis: A novel anti-angiogenic therapy

Chronic hepatic schistosomiasis causes portal hypertension, fibrosis and lethal hepatosplenic complications. Previous studies focused mainly on schistosomicidal drugs and neglected the therapeutic approaches against the vascular complications after portal hypertension. Investigating a novel anti-angiogenic therapy is an urgent. The current study is to evaluate the performance of Paeoniflorin (PAE) as an anti-angiogenic therapy, being a powerful anti-fibrotic, compared to artemether (ART) and praziqantel (PZQ) in schistosomiasis mansoni BALB/c mice. Thirty two laboratory bred male BALB/c Swiss albino mice. The mice were classified into four groups (8 mice each), control infected (CI), PZQ (300 mg/kg/12 h), ART (0.1 ml/mg/d) and PAE (50 mg/kg/d) treated groups for one month. All mice groups were sacrificed 15 weeks post infection for assessment of the drugs' efficacy by parasitological, histopathological and immunohistochemical studies. Our results in PAE group showed marked reduction in the mean egg count/gram stool, worm burden, egg count/gram liver tissue, granuloma diameter and pro-angiogenic factors as vascular endothelial growth factor (VEGF), Proliferating cell nuclear antigen (PCNA), alpha-smooth muscle actin (α-SMA) and CD34; conversely, there was an augmentation of the tissue inhibitor metalloproteinases-2 (TIMP-2) as an anti-angiogenic expression that was exceeded ART and PZQ treated groups compared to CI group (p˂0.001). Conclusively, PAE has an anti-angiogenic impact with no vascular proliferative activity or recanalization, no micro-vessel density (MVD) changes, granuloma resolution and fibrosis regression. PAE is predicted to be a potential therapy for chronic hepatic diseases associated with fibrosis and angiogenesis, hopeful in protecting from advanced serious complications; cancer and metastasis.