Th17-associated cytokines IL-17 and IL-23 in inflamed skin of Darier disease patients as potential therapeutic targets

Darier disease (DD) is a rare, inherited multi-organ disorder associated with mutations in the ATP2A2 gene. DD patients often have skin involvement characterized by malodorous, inflamed skin and recurrent, severe infections. Therapeutic options are limited and inadequate for the long-term management of this chronic disease. The aim of this study was to characterize the cutaneous immune infiltrate in DD skin lesions in detail and to identify new therapeutic targets. Using gene and protein expression profiling assays including scRNA sequencing, we demonstrate enhanced expression of Th17-related genes and cytokines and increased numbers of Th17 cells in six DD patients. We provide evidence that targeting the IL-17/IL-23 axis in a case series of three DD patients with monoclonal antibodies is efficacious with significant clinical improvement. As DD is a chronic, relapsing disease, our findings might pave the way toward additional options for the long-term management of skin inflammation in patients with DD.

Impact of PET/CT for Assessing Response to Immunotherapy-A Clinical Perspective

Cancer immunotherapy using immune-checkpoint inhibitors (ICI) has revolutionized the therapeutic landscape of various malignancies like non-small-cell lung cancer or melanoma. Pre-therapy response prediction and assessment during ICI treatment is challenging due to the lack of reliable biomarkers and the possibility of atypical radiological response patterns. Positron emission tomography/computed tomography (PET/CT) enables the visualization and quantification of metabolic lesion activity additional to conventional CT imaging. Various biomarkers derived from PET/CT have been reported as predictors for response to ICI and may aid to overcome the challenges clinicians currently face in the management of ICI-treated patients. In this narrative review, experts in nuclear medicine, thoracic oncology, dermatooncology, hemato- and internal oncology, urological and head/neck tumors performed literature reviews in their respective field and a joint discussion on the use of PET/CT in the context of ICI treatment. The aims were to give a clinical overview on present standards and evidence, to identify current challenges and fields of research and to enable an outlook to future developments and their possible implications. Multiple promising studies concerning ICI response assessment or prediction using biomarkers derived from PET/CT alone or as composite biomarkers have been identified for various malignancies and disease stages. Of interest, additional major incentives in the field may evolve from novel tracers specifically targeting immune-checkpoint molecules which could allow not only response assessment and prognosis, but also visualization of histological tumor cell properties like programmed death-ligand (PD-L1) expression in vivo. Despite the broad range of existing literature on PET/CT-derived biomarkers in ICI therapy, implications for daily clinical practice remain elusive. High-quality prospective data are urgently warranted to determine whether patients benefit from the application of PET/CT in terms of prognosis. At the moment, the lack of such evidence as well as the absence of standardized imaging methods and biomarkers still precludes PET/CT imaging to be included in the relevant clinical practice guidelines.

Effect of cold plasma on periodontal wound healing-an in vitro study

OBJECTIVES

Cold atmospheric plasma (CAP), a room temperate ionized gas, seems to be a possible way to enhance tissue recovery. An in vitro study was conducted to investigate the influence of medical CAP on the regenerative capacity of human periodontal ligament (PDL) cells.

MATERIAL AND METHODS

Human PDL cells were subjected to CAP at various intensities, distances, and durations. The effects of CAP on a number of specific markers were studied at transcriptional level using real-time PCR. Additionally, an in vitro wound healing assay was applied to PDL cell monolayers either in the presence or absence of CAP by using JuLI™ Br Live Cell Analyzer and software. Finally, cell viability of CAP-treated cells was analyzed by an XTT assay.

RESULTS

CAP treatment enhanced significantly the expression of the cytokines tumor necrosis factor (TNF)α, cyclooxygenase (COX)2, interleukin (IL)-1β, IL-6, IL-8, collagen (COL)1α, and matrix metalloproteinase (MMP)1, as well as the proliferation markers Ki67 and proliferating cell nuclear antigen (PCNA), but downregulated apoptotic markers Apaf1 and p53. Additionally, the in vitro wound healing rate was significantly enhanced after CAP application. Moreover, CAP treatment resulted in a significantly increased cell viability in the XTT assay.

CONCLUSION

This in vitro study shows that CAP has regulatable effects on markers of periodontal wound healing thereby underlining the potential use of CAP as a benefit treatment strategy.

CLINICAL RELEVANCE

Our study demonstrates the application of CAP in the treatment of oral pathologies suggesting a promising future treatment approach.

Korrelieren szintigraphisch ermittelte Knochenstoffwechselaktivitäten mit der Kalzium- und Phosphorbestimmung durch die Röntgen-Mikroanalyse?

An animal experiment on bone healing of dental implants offered the opportunity of comparing scintigraphic images with histological findings, specially with electron microscope results and analysis of the calcium and phosphorus values in different stages. The clear correspondence between the scintigraphic results and the calcification level of the new bone parts must be seen with reservation because of possible methodical mistakes of the radio-micro-analysis from surfaces and of intraindividual differences.

Clinical value of FDG Hybrid-PET in staging and restaging of malignant lymphoma – compared with conventional diagnostic methods

Aim of the present retrospective study was to validate the clinical value of F-18-FDG PET imaging in lymphoma patients with a dual head camera modified for coincidence detection. Staging before and after oncological treatment was compared with a conservative diagnostic approach. Methods: 48 patients (28 non-Hodgkin lymphoma, 20 Hodgkin’s disease) received FDG-Hybrid-PET scans. Pretherapeutic staging was realized in 28 patients, 9 of them had control studies after they had completed therapy. Totally 29 persons were examined for posttherapeutic restaging. Computed tomography imaging and lymph node sonography was performed in all cases. Results were validated by clinical follow-up, in three cases a récidivé was proven by biopsy. Results: CT and ultrasound detected 77 lesions in 28 patients compared with 100 visualized by PET, but this difference in pretherapeutic staging did not reach significance at p >0.05 by Fisher’s t-test. Hybrid-PET obtained a sensitivity of 93%, a specifity of 79%, a positive of 82% and a negative predictive value of 92% for detection of residual disease. The values for CT + US were 87%, 64%, 72% and 88% respectively. Conclusion: FDG Hybrid-PET is as or even more accurate than standard morphologic diagnostic methods for prestaging in malignant lymphoma. Additionally, there is a substancial benefit for therapy monitoring of residual disease using coincidence detection PET with a ¾-inch crystal gamma camera.

[Is supplemental ear acupuncture for surgical tooth removal with local anesthesia effective? : A pilot study]

BACKGROUND

The application of ear acupuncture can contribute to a reduction of acute pain. Data on the application of ear acupuncture following oral surgery in odontology is insufficient.

OBJECTIVE

This study investigated the effectiveness of ear acupuncture as an auxiliary analgesic treatment in addition to local anesthesia for operative tooth removal.

METHODS

In this prospective open non-randomized pilot study (in accordance with the CONSORT publication) 2 cohorts of 50 patients each with the indications for an operative tooth removal either with or without the application of ear acupuncture in addition to local anesthesia with articain were observed. Patients were allocated to the groups according to their preference. Pain intensity while resting and while chewing was recorded as the primary parameter for a period of 10 days. The secondary parameters were the subjective experience of anxiety and symptoms, such as headaches, dizziness and nausea.

RESULTS

The two groups did not differ significantly with respect to demographic variables or the use of local anesthetics. At the various measurement intervals, pain intensity while resting or chewing differed significantly between the two groups (ANOVA, p = 0.004, p = 0.007, respectively). Furthermore, the experience of anxiety (ANOVA, p = 0.0001), the number of patients taking analgesics (χ²-test, p = 0.017) and the total postoperative consumption of analgesics (t-test, 0.001) revealed significant differences. In both groups the numerical rating scales (NRS) for postoperative headaches, dizziness and nausea were low.

DISCUSSION AND CONCLUSION

Despite a potential bias and methodological limitations of the study design, the results of this investigation suggest that ear acupuncture influences the experience of pain and anxiety in the postoperative period after tooth removal. As a treatment method with low adverse effects ear acupuncture can contribute to postoperative pain control, especially in patients with preoperative anxiety.

[Pilot study of laser-doppler flowmetry measurement of oral mucosa blood flow]

OBJECTIVE

To explore and compare the perfusion pattern of oral mucosa on Han Chinese and Caucasian by laser-doppler flowmetry.

METHODS

A cross-sectional study was carried out, in 20 healthy Han Chinese adult subjects (average age: 28.4 years) and 20 healthy Caucasian (average age: 25.3 years) adult subjects, either gender with 10 subjects. Gingival perfusion was evaluated at 8 points (including upper incisor labial gingival, lower incisor labial gingival, palatal mucosa, cheek mucosa) using a laser-doppler flowmetry(O2C, Medizintechnik GmbH, Germany). Each measurement was carried out 25 seconds consisting 5 seconds of fore period and 20 seconds of work period, without pressure. The measurements were taken by two well- trained doctors, each measurement was exammed 3 times by an examiner, and the average value was recorded as final data. Each measurement has 4 parame ters: SpO₂(oxygen saturation), rHB (relative amount of hemoglobin), flow (the blood flow of unit interval), and velocity (blood flow velocity). We compared the data by different sites, different genders, and different races.

RESULTS

For palatal gingival, the average SpO₂ was 77.1%±10.9%, the average rHB 67.8±11.1, and the average flow 194.1±63.7, which presented significant lower values than other oral mucosa. There was no significant difference among other sites. There was some significant difference between the Caucasian and the Han Chinese: the maxillary central incisor oxygen saturation (SpO₂) which were averages of 75.6%±8.2% and 70.4%±7.6%; buccal mucosa hemoglobin (rHB) averages of 79.9±5.8 and 83.5±6.6, which had statistical differences. For most measurement points, the oxygen saturation on men was lower than that on women, which had significant difference.

CONCLUSION

To investigate microcirculation pattern, oral mucosa can be the good observation site. Laser-doppler flowmetry is a well-documented instrument to survey on microcirculation.There may be differences between the genders in hemoglobin oxygen-binding capacity, which may have some impact on the ability of soft tissue healing. Oral mucosa display more blood perfusion than attached gingival. As the recipient site of gingival graft, maxilla and mandible have slight difference in blood supply.

[Pilot study of laser-doppler flowmetry measurement of oral mucosa blood flow]

OBJECTIVE

To explore and compare the perfusion pattern of oral mucosa on Han Chinese and Caucasian by laser-doppler flowmetry.

METHODS

A cross-sectional study was carried out, in 20 healthy Han Chinese adult subjects (average age: 28.4 years) and 20 healthy Caucasian (average age: 25.3 years) adult subjects, either gender with 10 subjects. Gingival perfusion was evaluated at 8 points (including upper incisor labial gingival, lower incisor labial gingival, palatal mucosa, cheek mucosa) using a laser-doppler flowmetry(O2C, Medizintechnik GmbH, Germany). Each measurement was carried out 25 seconds consisting 5 seconds of fore period and 20 seconds of work period, without pressure. The measurements were taken by two well- trained doctors, each measurement was exammed 3 times by an examiner, and the average value was recorded as final data. Each measurement has 4 parame ters: SpO2(oxygen saturation), rHB (relative amount of hemoglobin), flow (the blood flow of unit interval), and velocity (blood flow velocity). We compared the data by different sites, different genders, and different races.

RESULTS

For palatal gingival, the average SpO2 was 77.1%±10.9%, the average rHB 67.8±11.1, and the average flow 194.1±63.7, which presented significant lower values than other oral mucosa. There was no significant difference among other sites. There was some significant difference between the Caucasian and the Han Chinese: the maxillary central incisor oxygen saturation (SpO2) which were averages of 75.6%±8.2% and 70.4%±7.6%; buccal mucosa hemoglobin (rHB) averages of 79.9±5.8 and 83.5±6.6, which had statistical differences. For most measurement points, the oxygen saturation on men was lower than that on women, which had significant difference.

CONCLUSION

To investigate microcirculation pattern, oral mucosa can be the good observation site. Laser-doppler flowmetry is a well-documented instrument to survey on microcirculation.There may be differences between the genders in hemoglobin oxygen-binding capacity, which may have some impact on the ability of soft tissue healing. Oral mucosa display more blood perfusion than attached gingival. As the recipient site of gingival graft, maxilla and mandible have slight difference in blood supply.

[Participation in Preventive Medical Examinations for Children in Saxony-Anhalt (Germany) at the Time of School Entry Medical Examination]

OBJECTIVE

The aim of this study is to present data concerning children's participation in the German preventive medical examinations for children ("U2" to "U8") in accordance with sections 26 and 92 of the German Social Code (Book V) as retrospectively recorded by the Public Health Service ("Öffentlicher Gesundheitsdienst") of the German Province of Saxony-Anhalt during school entry medical examinations. Also we wanted to analyse the additional variables recorded per child in the areas of social factors, diagnostic findings and levels of therapeutic care in connection with their degree of participation in the preventive medical examinations.

METHODOLOGY

The statistical analysis of 73 628 anonymised data sets from the health monitoring system of the German Province of Saxony-Anhalt that were collected by the 14 health authorities in Saxony-Anhalt during school entry medical examinations between 2008 and 2012. An analysis of the data for 20 variables per child was performed with regard to the influence of their degree of participation in the U2 to U8 medical examinations using differences in frequency in the examination groups and checking the significance of these differences by means of the chi-squared test.

RESULTS

99-96% of children in Saxony-Anhalt underwent the 5 preventive medical examinations U2-U6. As the children get older, the participation rates decrease (U2=98.7% down to U8=88.5%). By the time the school entry medical examinations are carried out (at an average age of 63 months), 83% of the children have -undergone all 7 preventive medical examinations for children, while 0.4% have not -undergone one single "U" examination. A child's gender has no influence on its parents' decision as to whether or not it should undergo the examinations. The results also reveal that children who attend day care -facilities are significantly more likely to have undergone all of the U examinations (84.8%) than children who are cared for at home (55.1%).

CONCLUSION

The retrospective comprehensive collection of data concerning the children's degree of participation in preventive medical examinations using the school entry medical examination is suitable for identifying connections between participation rates and the social factors, diagnostic findings and levels of therapeutic care of the children in question.

Small molecule cardiogenol C upregulates cardiac markers and induces cardiac functional properties in lineage-committed progenitor cells

BACKGROUND/AIMS

Cell transplantation into the heart is a new therapy after myocardial infarction. Its success, however, is impeded by poor donor cell survival and by limited transdifferentiation of the transplanted cells into functional cardiomyocytes. A promising strategy to overcome these problems is the induction of cardiomyogenic properties in donor cells by small molecules.

METHODS

Here we studied cardiomyogenic effects of the small molecule compound cardiogenol C (CgC), and structural derivatives thereof, on lineage-committed progenitor cells by various molecular biological, biochemical, and functional assays.

RESULTS

Treatment with CgC up-regulated cardiac marker expression in skeletal myoblasts. Importantly, the compound also induced cardiac functional properties: first, cardiac-like sodium currents in skeletal myoblasts, and secondly, spontaneous contractions in cardiovascular progenitor cell-derived cardiac bodies.

CONCLUSION

CgC induces cardiomyogenic function in lineage-committed progenitor cells, and can thus be considered a promising tool to improve cardiac repair by cell therapy.

Abstract PD02-02: Characterization of Mammary Stem Cells during Embryogenesis

Mammary stem cells (MaSCs) play a key role in the development and maintenance of the breast. MaSCs self-renew and generate the different cell types of the breast such that a single MaSC can regenerate an entire functional mouse mammary gland. Similarly, tumors are heterogeneous, with some cells exhibiting potent tumor forming ability in transplantation studies. These cells exhibit the stem cell properties of self-renewal and multi-lineage differentiation in that they can serially regenerate the cellular complexity of the original tumor. These cells, referred to as cancer stem cells (CSCs), have in some cases been shown to be more resistant to cancer therapies. Therefore, if even a single CSC survives chemotherapy, it could result in cancer relapse. Consequently, an important goal is to be able to prospectively identify CSCs and elucidate critical growth control pathways to enable development of effective targeted therapies. Unfortunately, pure MaSCs or breast CSCs have not been isolated, precluding the generation of reagents to detect or eliminate them. My research takes a new direction to identify, isolate, and characterize MaSCs using properties central to mammary gland development and stem cell function. We isolated MaSCs during development and found that they are naturally enriched late in embryogenesis. We sorted the mammary cells at E18.5 using cell surface proteins we previously found to be expressed in the rudiment at E18.5 and were able to obtain MaSCs purified to a significantly higher degree than reported in the literature. These fetal MaSCs express several genes implicated in cancer, including erbB2, which is found in a subset of dangerous human cancers. In addition, like human cancers that over-express erbB2, fetal MaSC growth is inhibited by the erbB2 antagonist Lapatinib.

The MaSC population isolated during fetal development is enriched for epithelial cells expressing both myoepithelial and luminal keratin markers as well as epithelial cells expressing neither of these markers. It is possible that either of these sub-populations contains the stem cell activity. We have focused on using high throughput single cell QPCR analysis to cluster the fetal MaSCs by their keratin marker expression pattern and identify cell surface markers that can be used to isolate viable cells for stem cell activity assays. Altogether, these experiments enabled isolation of highly enriched MaSC populations for elucidation of key growth pathways and set the stage for future in vivo analyses.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD02-02.

Zahnextraktionen unter Medikation mit Acetylsalicylsäure (ASS)

PURPOSE

The purpose of this prospective study was to show and analyze the bleeding complications after teeth extraction under therapy with 100 mg acetylsalicylic acid (ASA) and to compare them to bleeding complications after teeth extraction in patients with a healthy blood profile.

PATIENTS AND METHODS

In 65 patients under medication with 100 mg ASA and in 252 healthy patients, 151/ 543 teeth were extracted and the bleeding complications monitored.

RESULTS

The postoperative bleeding frequency was 1.54% in the ASA 100 group and 1.59% in the healthy control group without any medication. No serious or uncontrollable postoperative bleedings arose in either group. All bleedings could be easily handled. No obvious difference concerning the bleeding frequency between the two groups was observed. The small number of bleeding events and the complexity of affecting parameters did not permit statistical tests.

CONCLUSION

It is not necessary to interrupt the medication of 100 mg acetylsalicylic acid given to prevent thromboembolism before tooth extractions.

Case Report. Maxillary sinus infection due to Emericella nidulans

Fungal infections of the maxillary sinus are frequently caused by Aspergillus species, particularly A. fumigatus. In otherwise healthy persons there is an association with overfilling of dental root canals, when zinc-containing filling materials were used. Below, a maxillary sinus aspergilloma is reported in a young immunocompetent female patient caused by Aspergillus (Emericella) nidulans.

Expression of filarial-specific IgG subclasses under different transmission intensities in a region endemic for loiasis

Specific IgG subclasses were investigated in two villages (Okoumbi and Ndjokaye) in southeast Gabon with different Loa loa transmission intensities of approximately 9,000 and 1,300 infective larvae (L3) per person per year, respectively. IgG subclasses were measured by an enzyme-linked immunosorbent assay (ELISA) using extracts of L. loa L3, microfilariae (MF), or adult worms. Levels of L3-specific IgG3 were significantly higher in the village with low transmission (Ndjokaye) (P = 0.006). In contrast, MF-specific IgG2 was significantly higher in Okoumbi than in Ndjokaye (P = 0.0009). In the high-transmission village (Okoumbi), levels of both MF- and adult-specific IgG4 were significantly increased in MF carriers compared with amicrofilaremic subjects (P = 0.0015 and P = 0.003, respectively), while levels of L3- and MF-specific IgG1 were significantly higher in amicrofilaremic individuals compared with MF carriers (P = 0.04 and P = 0.03, respectively). Furthermore, among microfilaremic individuals, the level of the specific IgG1 subclass was much lower in Okoumbi than in Ndjokaye (P = 0.036). These results suggest that the expression of antigen-specific IgG3 and IgG2 is more likely to vary with transmission intensity, whereas antigen-specific IgG4 and IgG1 varies with adult worm and MF burden.