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JAAD Case Reports Jul 2024
PubMed: 38952858
DOI: 10.1016/j.jdcr.2024.05.005 -
Polish Archives of Internal Medicine Jul 2024There is little data on the development of dermal lesions in patients with inflammatory bowel disease (IBD) treated with anti - tumor necrosis factor-α (anti-TNF-α),...
Dermal lesions associated with anti-tumor necrosis factor-α therapy in patients with inflammatory bowel disease: findings from an inflammatory bowel disease tertiary center in Poland.
INTRODUCTION
There is little data on the development of dermal lesions in patients with inflammatory bowel disease (IBD) treated with anti - tumor necrosis factor-α (anti-TNF-α), while their characteristics, clinical course, and impact on treatment are of great concern.
OBJECTIVES
The aim of this study is to assess the prevalence, risk factors, and clinical sequelae of dermal lesions in IBD patients treated with anti-TNF-α antibodies.
PATIENTS AND METHODS
This retrospective, single-center study evaluated 541 IBD patients treated with anti-TNF-α drugs and compared them with 688 IBD anti-TNF-α-naïve patients.
RESULTS
A significant higher prevalence of dermal lesions was noted during the anti-TNF-α therapy of 30.9% patients versus 16.4% (P <0.001). Risk factors for dermal lesions were higher body mass index (BMI), Crohn's disease located in the small intestine, and longer duration of therapy. Some types of dermal lesions were associated with anti-TNF-α therapy: infusion reactions and injection site reactions, cutaneous infection, psorasiform reactions, and lupus-like symptoms. Dermal lesions (alopecia, lupus-like symptoms, melanoma, and psoriasis) occurred in 5.9% of patients who discontinued or changed anti-TNF-α therapy.
CONCLUSIONS
We observed a higher prevalence of dermal lesions in patients with IBD undergoing anti-TNF-α therapy, although the development of such lesions rarely necessitated a change in or discontinuation of treatment. Patients with IBD should undergo regular dermatological follow-up, which may improve the detection of dermal lesions. Moreover, biological therapy in IBD patients requires close collaboration with an experienced dermatologist.
PubMed: 38949562
DOI: 10.20452/pamw.16789 -
MedRxiv : the Preprint Server For... Jun 2024Individuals with Down syndrome (DS), the genetic condition caused by trisomy 21 (T21), display clear signs of immune dysregulation, including high rates of autoimmune...
Individuals with Down syndrome (DS), the genetic condition caused by trisomy 21 (T21), display clear signs of immune dysregulation, including high rates of autoimmune disorders and severe complications from infections. Although it is well established that T21 causes increased interferon responses and JAK/STAT signaling, elevated autoantibodies, global immune remodeling, and hypercytokinemia, the interplay between these processes, the clinical manifestations of DS, and potential therapeutic interventions remain ill defined. Here, we report a comprehensive analysis of immune dysregulation at the clinical, cellular, and molecular level in hundreds of individuals with DS. We demonstrate multi-organ autoimmunity of pediatric onset concurrent with unexpected autoantibody-phenotype associations. Importantly, constitutive immune remodeling and hypercytokinemia occur from an early age prior to autoimmune diagnoses or autoantibody production. We then report the interim analysis of a Phase II clinical trial investigating the safety and efficacy of the JAK inhibitor tofacitinib through multiple clinical and molecular endpoints. Analysis of the first 10 participants to complete the 16-week study shows a good safety profile and no serious adverse events. Treatment reduced skin pathology in alopecia areata, psoriasis, and atopic dermatitis, while decreasing interferon scores, cytokine scores, and levels of pathogenic autoantibodies without overt immune suppression. Additional research is needed to define the effects of JAK inhibition on the broader developmental and clinical hallmarks of DS. ClinicalTrials.gov identifier: NCT04246372 .
PubMed: 38946973
DOI: 10.1101/2024.06.13.24308783 -
Annals of Agricultural and... Jun 2024Photobiomodulation with the use of light-emitting diodes (LEDs) seems to be a promising option for long COVID. This retrospective study evaluates the efficiency of LED...
INTRODUCTION AND OBJECTIVE
Photobiomodulation with the use of light-emitting diodes (LEDs) seems to be a promising option for long COVID. This retrospective study evaluates the efficiency of LED irradiation in the treatment of TE in the course of long COVID in patients with and without androgenetic alopecia.
MATERIAL AND METHODS
A retrospective single-centre chart review of patients with post-COVID hair loss was performed. 140 patients enrolled to the study were divided into four groups depending on the type of alopecia and treatment: 1) telogen effluvium with LED therapy (TE LED+), 2) telogen effluvium without LED therapy (TE LED-), 3) telogen effluvium and androgenetic alopecia with LED therapy (TE+AGA LED+), and 4) telogen effluvium and androgenetic alopecia without LED therapy (TE+AGA LED-). Clinical and trichoscopic parameters were compared.
RESULTS
After 12 weeks, cessation of hair loss and a negative hair pull test were more common in TE LED+ and TE+AGA LED+ in comparison to the patients without LED therapy (p<0.001, p=0.035, respectively). An increased number of thick hairs and an increased number of hairs within follicular units were more common in patients treated with LED irradiation, regardless of the type of alopecia, compared to the patients without LED therapy.
CONCLUSIONS
The study revealed that LED therapy is safe, well tolerated and seems to be a promising therapeutic option for TE in patients with long COVID. It can be used as adjuvant therapy leading to faster reduction of hair loss, enhancing hair regrowth as well as hair shaft thickness and density.
Topics: Humans; Alopecia; Retrospective Studies; Female; Middle Aged; COVID-19; Male; Adult; SARS-CoV-2; Low-Level Light Therapy; Aged; Hair; Treatment Outcome; Phototherapy
PubMed: 38940108
DOI: 10.26444/aaem/177238 -
Clinical and Translational Radiation... Jul 2024Preoperative radiosurgery (SRS) of brain metastases (BM) aims to achieve cavity local control with a reduction in leptomeningeal relapse (LMD) and without additional...
PURPOSE
Preoperative radiosurgery (SRS) of brain metastases (BM) aims to achieve cavity local control with a reduction in leptomeningeal relapse (LMD) and without additional radionecrosis compared to postoperative SRS. We present the final results of a prospective feasibility trial of linac-based stereotactic radiosurgery (SRS) prior to neurosurgical resection of a brain metastasis (PREOP-1).
METHODS
Eligibility criteria included a BM up to 4 cm in diameter for elective resection. The primary endpoint was the feasibility of delivering linac-based preoperative SRS in all patients prior to anticipated gross tumour resection. Secondary endpoints included rates of LMD, local control and overall survival. Exploratory endpoints were the level of expression of immunological and proliferative markers.
RESULTS
Thirteen patients of median age 65 years (range 41-77) were recruited. Twelve patients (92 %) received preoperative radiosurgery and metastasectomy and one patient went directly to surgery and received postoperative SRS, thus the primary endpoint was not met. The median time between referral and preoperative SRS was 6.5 working days (1-10) and from SRS to neurosurgery was 1 day (0-5). The median prescribed dose was 16 Gy (14-19) to a median planning target volume of 12.7 cm (5.9-26.1). Five patients completed 12-month follow-up after preoperative SRS without local recurrence or leptomeningeal disease. The patient who received postoperative FSRT developed LMD after six months. There was one transient toxicity (grade 2 alopecia) and nine patients have died from extracranial causes. Patients reported significant improvement in motor weakness at 6 months (P = 0.04). No pattern in changes of marker expression was observed.
CONCLUSION
In patients with large brain metastasis without raised intracranial pressure, linac-based preoperative SRS was feasible in 12/13 patients and safe in 12/12 patients without any surgical delay or intracranial complications.
PubMed: 38938931
DOI: 10.1016/j.ctro.2024.100798 -
JAAD Case Reports Jul 2024
PubMed: 38938699
DOI: 10.1016/j.jdcr.2024.05.008 -
Frontiers in Pharmacology 2024Urothelial carcinoma (UC) is a refractory disease for which achieving satisfactory outcomes remains challenging with current surgical interventions. Antibody-drug...
Urothelial carcinoma (UC) is a refractory disease for which achieving satisfactory outcomes remains challenging with current surgical interventions. Antibody-drug conjugates (ADCs) are a novel class of targeted therapeutics that have demonstrated encouraging results for UC. Although there is a limited number of high-quality randomized control trials (RCTs) examining the use of ADCs in patients with UC, some prospective non-randomized studies of interventions (NRSIs) provide valuable insights and pertinent information. We aim to assess the efficacy and safety of ADCs in patients with UC, particularly those with locally advanced and metastatic diseases. A systematic search was conducted across PubMed, Embase, the Cochrane Library, and Web of Science databases to identify pertinent studies. Outcomes, such as the overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), adverse events (AEs), and treatment-related adverse events (TRAEs), were extracted for further analyses. Twelve studies involving 1,311 patients were included in this meta-analysis. In terms of tumor responses, the pooled ORR and DCR were 40% and 74%, respectively. Regarding survival analysis, the pooled median PFS and OS were 5.66 months and 12.63 months, respectively. The pooled 6-month PFS and OS were 47% and 80%, while the pooled 1-year PFS and OS were 22% and 55%, respectively. The most common TRAEs of the ADCs were alopecia (all grades: 45%, grades ≥ III: 0%), decreased appetite (all grades: 34%, grades ≥ III: 3%), dysgeusia (all grades: 40%, grades ≥ III: 0%), fatigue (all grades: 39%, grades ≥ III: 5%), nausea (all grades: 45%, grades ≥ III: 2%), peripheral sensory neuropathy (all grades: 37%, grades ≥ III: 2%), and pruritus (all grades: 32%, grades ≥ III: 1%). The meta-analysis in this study demonstrates that ADCs have promising efficacies and safety for patients with advanced or metastatic UC. https://www.crd.york.ac.uk/prospero/, identifier: CRD42023460232.
PubMed: 38933670
DOI: 10.3389/fphar.2024.1377924 -
Serum lipids may causally affect the occurrence of alopecia areata: A Mendelian randomization study.Skin Research and Technology : Official... Jul 2024The etiology of alopecia areata (AA) in relation to serum lipids remains unclear, thereby prompting our intention to do Mendelian study on this subject.
PURPOSE
The etiology of alopecia areata (AA) in relation to serum lipids remains unclear, thereby prompting our intention to do Mendelian study on this subject.
DESIGN
Two-sample Mendelian randomization (MR) analysis was performed in the study. The inverse variance-weighted method was used as the primary method.
METHODS
In our study, we integrated a set of 123 single-nucleotide polymorphisms (SNPs) into our analysis. These SNPs have been extensively studied and are known to exhibit associations with serum lipids. We sourced these SNPs from a variety of relevant studies and consortia that specifically focus on lipid-related research, such as the MRC Integrative Epidemiology Unit. These carefully curated SNPs were then utilized as instrumental variables in our analysis, allowing us to explore and evaluate the causal relationships between these genetic variants and serum lipids. By incorporating this comprehensive set of SNPs, we aimed to enhance the precision and robustness of our findings, shedding light on the intricate interplay between genetics and serum lipids.
RESULTS
In the MR analysis, a higher total lipid concentration in large low-density lipoprotein (LDL) particles (odds ratio [OR] = 1.502; 95% confidence interval [CI] = 1.086-1.953; p = 0.006), a greater ratio of cholesteryl esters to total lipids in chylomicrons and extremely large very LDL (VLDL) particles (OR = 2.174; 95% CI = 1.300-2.500; p = 0.010), and a greater ratio of cholesterol to total lipids in chylomicrons and extremely large VLDL particles (OR = 2.363;95% CI = 1.556-4.438; p = 0.004), were genetically predicted to be causally associated with an increased risk of AA, while patients with a higher triglyceride to total lipids ratio in chylomicrons and extremely large VLDL particles had a lower risk of AA (OR = 0.481; 95% CI = 0.191-1.270; p = 0.002).
CONCLUSION
This study found that serum lipids may be causally implicated in AA.
Topics: Alopecia Areata; Humans; Mendelian Randomization Analysis; Polymorphism, Single Nucleotide; Lipids; Genetic Predisposition to Disease
PubMed: 38932455
DOI: 10.1111/srt.13785 -
Pharmaceutics Jun 2024This comprehensive review consolidates insights from two sources to emphasize the transformative impact of scaffold-based drug delivery systems in revolutionizing oral... (Review)
Review
This comprehensive review consolidates insights from two sources to emphasize the transformative impact of scaffold-based drug delivery systems in revolutionizing oral cancer therapy. By focusing on their core abilities to facilitate targeted and localized drug administration, these systems enhance therapeutic outcomes significantly. Scaffolds, notably those coated with anti-cancer agents such as cisplatin and paclitaxel, have proven effective in inhibiting oral cancer cell proliferation, establishing a promising avenue for site-specific drug delivery. The application of synthetic scaffolds, including Poly Ethylene Glycol (PEG) and poly(lactic-co-glycolic acid) (PLGA), and natural materials, like collagen or silk, in 3D systems has been pivotal for controlled release of therapeutic agents, executing diverse anti-cancer strategies. A key advancement in this field is the advent of smart scaffolds designed for sequential cancer therapy, which strive to refine drug delivery systems, minimizing surgical interventions, accentuating the significance of 3D scaffolds in oral cancer management. These systems, encompassing local drug-coated scaffolds and other scaffold-based platforms, hold the potential to transform oral cancer treatment through precise interventions, yielding improved patient outcomes. Local drug delivery via scaffolds can mitigate systemic side effects typically associated with chemotherapy, such as nausea, alopecia, infections, and gastrointestinal issues. Post-drug release, scaffolds foster a conducive environment for non-cancerous cell growth, adhering and proliferation, demonstrating restorative potential. Strategies for controlled and targeted drug delivery in oral cancer therapy span injectable self-assembling peptide hydrogels, nanocarriers, and dual drug-loaded nanofibrous scaffolds. These systems ensure prolonged release, synergistic effects, and tunable targeting, enhancing drug delivery efficiency while reducing systemic exposure. Smart scaffolds, capable of sequential drug release, transitioning to cell-friendly surfaces, and enabling combinatorial therapy, hold the promise to revolutionize treatment by delivering precise interventions and optimized outcomes. In essence, scaffold-based drug delivery systems, through their varied forms and functionalities, are reshaping oral cancer therapy. They target drug delivery efficiency, diminish side effects, and present avenues for personalization. Challenges like fabrication intricacy, biocompatibility, and scalability call for additional research. Nonetheless, the perspective on scaffold-based systems in oral cancer treatment is optimistic, as ongoing advancements aim to surmount current limitations and fully leverage their potential in cancer therapy.
PubMed: 38931923
DOI: 10.3390/pharmaceutics16060802 -
Molecules (Basel, Switzerland) Jun 2024Androgenetic alopecia (AGA) causes thinning hair, but poor hair quality in balding areas and damage from UV radiation have been overlooked. Plant extracts like...
BACKGROUND
Androgenetic alopecia (AGA) causes thinning hair, but poor hair quality in balding areas and damage from UV radiation have been overlooked. Plant extracts like flavonoids (POFs) may improve hair quality in AGA. This study examines POFs' effectiveness in treating AGA-affected hair and repairing UV-induced damage.
METHODS
Hair samples were analyzed using scanning electron microscopy (SEM) to examine surface characteristics, electron paramagnetic resonance (EPR) spectroscopy to measure free radicals in the hair, and spectrophotometry to assess changes in hair properties.
RESULTS
POFs effectively removed hydroxyl radicals from keratinocytes and had antioxidant properties. They also reduced UV-induced damage to AGA hair by mitigating the production of melanin free radicals. Following POF treatment, the reduction in peroxidized lipid loss in AGA hair was notable at 59.72%, thereby effectively delaying the progression of hair color change. Moreover, protein loss decreased by 191.1 μ/g and tryptophan loss by 15.03%, ultimately enhancing hair's tensile strength.
CONCLUSION
compared to healthy hair, hair damaged by AGA shows more pronounced signs of damage when exposed to UV radiation. POFs help protect balding hair by reducing oxidative damage and slowing down melanin degradation.
Topics: Alopecia; Ultraviolet Rays; Humans; Antioxidants; Hair; Flavonoids; Plant Extracts; Melanins; Keratinocytes
PubMed: 38930941
DOI: 10.3390/molecules29122876