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Frontiers in Immunology 2023Circulating cytokines play a crucial role in the onset and progression of immune skin diseases. However, the causal relationships and the direction of causal effects...
BACKGROUND
Circulating cytokines play a crucial role in the onset and progression of immune skin diseases. However, the causal relationships and the direction of causal effects require further investigation.
METHODS
Two-sample Mendelian randomization (MR) analyses were conducted to assess the causal relationships between 41 circulating cytokines and six immune skin diseases including alopecia areata, chloasma, hidradenitis suppurativa (HS), lichen planus (LP), seborrheic dermatitis, and urticaria, using summary statistics from genome-wide association studies. Reverse MR analyses was performed to test for the reverse causation. Pleiotropy and heterogeneity tests were conducted to assess the robustness of the findings.
RESULTS
Twelve unique cytokines showed a suggestive causal relationship with the risk of six immune skin diseases. Among them, the causal effects between 9 unique cytokines and immune skin diseases have strong statistical power. Additionally, the concentrations of six cytokines might be influenced by LP and urticaria. After Bonferroni correction, the following associations remained significant: the causal effect of beta-nerve growth factor on HS (odds ratio [OR] = 1.634, 95% confidence interval [CI] = 1.226-2.177, p = 7.97e-04), interleukin (IL)-6 on LP (OR = 0.615, 95% CI = 0.481-0.786, p = 1.04e-04), IL-4 on LP (OR = 1.099. 95% CI = 1.020-1.184, p = 1.26e-02), and IL-2 on urticaria (OR = 0.712, 95% CI = 0.531-0.955, p = 2.33e-02).
CONCLUSION
This study provides novel perspectives on the relationship between circulating cytokines and immune skin diseases, potentially providing valuable insights into their etiology, diagnostic approaches, and treatment.
Topics: Humans; Cytokines; Genome-Wide Association Study; Mendelian Randomization Analysis; Urticaria; Lichen Planus; Hidradenitis Suppurativa; Interleukin-6; Immune System Diseases
PubMed: 37954607
DOI: 10.3389/fimmu.2023.1240714 -
Clinics in Dermatology 2022There has been an alarming rise in human monkeypox cases during these past few months in countries where the disease is not endemic. The recent COVID-19 pandemic and the...
There has been an alarming rise in human monkeypox cases during these past few months in countries where the disease is not endemic. The recent COVID-19 pandemic and the connection of the monkeypox virus with the smallpox-causing variola virus makes it highly likely to be a candidate for another human health emergency. The transmission mode is predominantly via sexual contact, especially among men who have sex with men (MSM); anogenital lesions are the most typical presentation. Although it is a disease with a self-limiting course, some patients require admission for severe anorectal pain, pharyngitis, eye lesions, kidney injury, myocarditis, or soft tissue superinfections. Antiviral therapy has been advocated, of which tecovirimat is promising in patients with comorbidities. Vaccines will be the mainstay for the present and future control of the disease.
Topics: Male; Humans; Homosexuality, Male; Pandemics; COVID-19; Sexual and Gender Minorities; Benzamides
PubMed: 35963500
DOI: 10.1016/j.clindermatol.2022.08.009 -
Annals of the Royal College of Surgeons... Sep 2008Pruritus ani is a common condition with many causes, predominately anorectal pathology. There are some new insights and therapies, but the most recommendations are based... (Review)
Review
INTRODUCTION
Pruritus ani is a common condition with many causes, predominately anorectal pathology. There are some new insights and therapies, but the most recommendations are based on low-level evidence.
PATIENTS AND METHODS
A literature search was carried out using Medline and the internet with the keywords 'pruritus ani' from 1950 to 2007.
RESULTS
A review of the evidence is presented and a management plan based on the elimination of irritants and scratching, general control measures and active treatment measures is offered.
CONCLUSIONS
Treatment of primary and secondary pruritus ani has a good prospect of regression of symptoms and skin changes.
Topics: Anti-Infective Agents; Clothing; Dermatitis, Allergic Contact; Dermatologic Agents; Diet; Feces; Humans; Hygiene; Infections; Irritants; Lichen Sclerosus et Atrophicus; Medical History Taking; Physical Examination; Pruritus Ani; Psoriasis; Skin Neoplasms
PubMed: 18765023
DOI: 10.1308/003588408X317940 -
World Journal of Gastrointestinal... Mar 2024Anal pruritus is a common anorectal symptom that can significantly impair a patient's quality of life, including their mental health. It can be one of the most difficult...
Anal pruritus is a common anorectal symptom that can significantly impair a patient's quality of life, including their mental health. It can be one of the most difficult proctological conditions to treat. Patients often delay seeking medical attention, since it is an embarrassing but non-life-threatening situation. Pruritus ani can be associated with idiopathic and secondary causes, such as anorectal diseases, cancer (anal or colorectal), dermatological and sexually transmitted diseases, fungal infections and systemic diseases. If patients are referred for a colonoscopy, this can sometimes provide the first opportunity to evaluate the perianal area. Classifications of anal pruritus are based on the abnormalities of the perianal skin, one of the most commonly used being the Washington classification. A proper digital anorectal examination is important, as well as an anoscopy to help to exclude anorectal diseases or suspicious masses. Endoscopists should be aware of the common etiologies, and classification of the perianal area abnormalities should be provided in the colonoscopy report. Information on treatment possibilities and follow-up can also be provided. The treatment normally consists of a triple approach: proper hygiene, elimination of irritants, and skin care and protection. Several topical therapies have been described as possible treatments, including steroids, capsaicin, tacrolimus and methylene blue intradermal injections.
PubMed: 38577644
DOI: 10.4253/wjge.v16.i3.112 -
Journal of Lower Genital Tract Disease Jul 2015The incidence of anal cancer is higher in women than men in the general population and has been increasing for several decades. Similar to cervical cancer, most anal... (Review)
Review
OBJECTIVE
The incidence of anal cancer is higher in women than men in the general population and has been increasing for several decades. Similar to cervical cancer, most anal cancers are associated with human papillomavirus (HPV), and it is believed that anal cancers are preceded by anal high-grade squamous intraepithelial lesions (HSIL). Our goals were to summarize the literature on anal cancer, HSIL, and HPV infection in women and to provide screening recommendations in women.
METHODS
A group of experts convened by the American Society for Colposcopy and Cervical Pathology and the International Anal Neoplasia Society reviewed the literature on anal HPV infection, anal SIL, and anal cancer in women.
RESULTS
Anal HPV infection is common in women but is relatively transient in most. The risk of anal HSIL and cancer varies considerably by risk group, with human immunodeficiency virus-infected women and those with a history of lower genital tract neoplasia at highest risk compared with the general population.
CONCLUSIONS
While there are no data yet to demonstrate that identification and treatment of anal HSIL leads to reduced risk of anal cancer, women in groups at the highest risk should be queried for anal cancer symptoms and required to have digital anorectal examinations to detect anal cancers. Human immunodeficiency virus-infected women and women with lower genital tract neoplasia may be considered for screening with anal cytology with triage to treatment if HSIL is diagnosed. Healthy women with no known risk factors or anal cancer symptoms do not need to be routinely screened for anal cancer or anal HSIL.
Topics: Anus Neoplasms; Early Detection of Cancer; Female; Humans; Papillomavirus Infections; Risk Factors; Squamous Intraepithelial Lesions of the Cervix
PubMed: 26103446
DOI: 10.1097/LGT.0000000000000117 -
Annals of the Royal College of Surgeons... Nov 2022Acute supralevator abscess (SLA) is an uncommon and complicated form of anorectal sepsis. Its correct management is crucial to avoid complex iatrogenic fistula... (Review)
Review
INTRODUCTION
Acute supralevator abscess (SLA) is an uncommon and complicated form of anorectal sepsis. Its correct management is crucial to avoid complex iatrogenic fistula formation. A comprehensive review of the literature was conducted to determine the incidence of SLA and the surgical outcome with particular reference to the direction of drainage.
METHODS
A search of Medline, PubMed and the Cochrane Library was performed to identify all studies reporting surgical drainage of SLA.
FINDINGS
A total of 19 studies were identified, including 563 patients. The only two prospective studies reported an incidence of SLA of 10% and 3% in 68 and 100 patients, respectively, with anorectal sepsis. In 17 retrospective studies, the incidence ranged from 0% to 28%. Magnetic resonance imaging (MRI) was performed routinely in only one study. The surgical anatomical classification of the abscess was described in six studies diagnosed at surgery. The direction of surgical drainage whether 'inwards' (into the lumen) or 'outwards' (into the ischioanal fossa) was stated in only six studies. In two of these, the direction of drainage was contradictory to the recommendation made by Parks . Recurrent sepsis was reported in eight studies and ranged from 0% to 53%.
CONCLUSIONS
Detailed and prospective data on acute SLA are lacking. Its real incidence is unclear and it is not possible to analyse surgical outcomes conclusively according to different direction of drainage. The routine use of MRI in complicated anorectal sepsis would specify the surgical anatomy of SLA before any drainage is carried out.
Topics: Humans; Abscess; Rectal Fistula; Prospective Studies; Retrospective Studies; Drainage; Sepsis
PubMed: 35133205
DOI: 10.1308/rcsann.2021.0257 -
Emerging Microbes & Infections Oct 2018Zika virus (ZIKV) has elicited global concern due to its unique biological features, unusual transmission routes, and unexpected clinical outcomes. Although ZIKV...
Zika virus (ZIKV) has elicited global concern due to its unique biological features, unusual transmission routes, and unexpected clinical outcomes. Although ZIKV transmission through anal intercourse has been reported in humans, it remains unclear if ZIKV is detectable in the stool, if it can infect the host through the anal canal mucosa, and what the pathogenesis of such a route of infection might be in the mouse model. Herein, we demonstrate that ZIKV RNA can be recovered from stools in multiple mouse models, as well as from the stool of a ZIKV patient. Remarkably, intra-anal (i.a.) inoculation with ZIKV leads to efficient infection in both Ifnar1 and immunocompetent mice, characterized by extensive viral replication in the blood and multiple organs, including the brain, small intestine, testes, and rectum, as well as robust humoral and innate immune responses. Moreover, i.a. inoculation of ZIKV in pregnant mice resulted in transplacental infection and delayed fetal development. Overall, our results identify the anorectal mucosa as a potential site of ZIKV infection in mice, reveal the associated pathogenesis of i.a. infection, and highlight the complexity of ZIKV transmission through anal intercourse.
Topics: Animals; Feces; Female; Humans; Immunity, Innate; Intestinal Mucosa; Male; Mice; Mice, Inbred C57BL; Pregnancy; Pregnancy Complications; Rectum; Virus Replication; Virus Shedding; Zika Virus; Zika Virus Infection
PubMed: 30333476
DOI: 10.1038/s41426-018-0170-6 -
Journal of the National Medical... Nov 1988The etiology of anorectal abscess and fistula-in-ano is discussed. The anatomy, which is vital to the understanding and treatment of the above, is reviewed, with two of... (Review)
Review
The etiology of anorectal abscess and fistula-in-ano is discussed. The anatomy, which is vital to the understanding and treatment of the above, is reviewed, with two of the more common classifications of fistula-in-ano presented. The different methods of treating each are discussed, and some of the common complications of the procedure are listed. A true understanding of the disease process and anatomy is needed before treatment of fistulous abscesses is begun, but, with it, successful outcomes will occur in most cases.
Topics: Abscess; Anus Diseases; Female; Humans; Male; Rectal Diseases; Rectal Fistula
PubMed: 3074175
DOI: No ID Found -
BMC Infectious Diseases Jul 2015While true antimicrobial resistance to Chlamydia trachomatis is a rare occurrence, repeat chlamydia infections continue to be reported following treatment with a single... (Review)
Review
While true antimicrobial resistance to Chlamydia trachomatis is a rare occurrence, repeat chlamydia infections continue to be reported following treatment with a single 1 g dose of azithromycin or week long doxycycline - with considerable more concern about azithromycin treatment failure. While most repeat positive cases are likely to be reinfections, emerging evidence indicates treatment failure may play a role. Current data suggests that there may are differences in the efficacy of the drugs between rectal and non-rectal sites of infection and factors such as immune response, drug pharmacokinetics, organism load, auto-inoculation from rectum to cervix in women and the genital microbiome may play a role in treatment failure. Other possible reasons for repeat infection include the low discriminatory power of NAAT tests to differentiate between viable and nonviable organisms and failure to detect LGV infection. This review will present the current evidence regarding the management challenges for urogenital and anorectal chlamydia infections and provide some suggestions for where future research efforts are needed to address important knowledge gaps in this area and provide stronger evidence for the development of robust treatment guidelines.
Topics: Anal Canal; Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Clinical Trials as Topic; Doxycycline; Drug Resistance, Bacterial; Female; Humans; Microbiota; Urogenital System
PubMed: 26220080
DOI: 10.1186/s12879-015-1030-9 -
BioRxiv : the Preprint Server For... Feb 2023The study described herein is a continuation of our work in which we developed a methodology to identify small foci of transduced cells following rectal challenge of...
The study described herein is a continuation of our work in which we developed a methodology to identify small foci of transduced cells following rectal challenge of rhesus macaques with a non-replicative luciferase reporter virus. In the current study, the wild-type virus was added to the inoculation mix and twelve rhesus macaques were necropsied 2-4 days after the rectal challenge to study the changes in infected cell phenotype as the infection progressed. Relying on luciferase reporter we noted that both anus and rectum tissues are susceptible to the virus as early as 48h after the challenge. Small regions of the tissue containing luciferase-positive foci were further analyzed microscopically and were found to also contain cells infected by wild-type virus. Phenotypic analysis of the Env and Gag positive cells in these tissues revealed the virus can infect diverse cell populations, including but not limited to Th17 T cells, non Th17 T cells, immature dendritic cells, and myeloid-like cells. The proportions of the infected cell types, however, did not vary much during the first four days of infection when anus and rectum tissues were examined together. Nonetheless, when the same data was analyzed on a tissue-specific basis, we found significant changes in infected cell phenotypes over the course of infection. For anal tissue, a statistically significant increase in infection was observed for Th17 T cells and myeloid-like cells, while in the rectum, the non-Th17 T cells showed the biggest temporal increase, also of statistical significance.
PubMed: 36865309
DOI: 10.1101/2023.02.22.529624