Sphingosine 1-Phosphate (S1P) in the Peritoneal Fluid Skews M2 Macrophage and Contributes to the Development of Endometriosis

Sphingosine 1-phosphate (S1P), an inflammatory mediator, is abundantly contained in red blood cells and platelets. We hypothesized that the S1P concentration in the peritoneal cavity would increase especially during the menstrual phase due to the reflux of menstrual blood, and investigated the S1P concentration in the human peritoneal fluid (PF) from 14 non-endometriosis and 19 endometriosis patients. Although the relatively small number of samples requires caution in interpreting the results, S1P concentration in the PF during the menstrual phase was predominantly increased compared to the non-menstrual phase, regardless of the presence or absence of endometriosis. During the non-menstrual phase, patients with endometriosis showed a significant increase in S1P concentration compared to controls. In vitro experiments using human intra-peritoneal macrophages (MΦ) showed that S1P stimulation biased them toward an M2MΦ-dominant condition and increased the expression of IL-6 and COX-2. An in vivo study showed that administration of S1P increased the size of the endometriotic-like lesion in a mouse model of endometriosis

HISTOPATHOLOGY OF LABIAL SALIVARY GLANDS IN SJOGREN’S SYNDROME

The histopathology of labial salivary glands of 20 patients with Sjögren’s syndrome was examined and compared with other clinical findings. All patients were women and their age ranged from 28 to 73. The diagnosis was based on clinical symptoms of dry mouth and dry eyes, and frequently rheumatoid arthritis. Sialography of the parotid gland was undertaken on 19 patients and showed characteristic sialectasis in 13 cases. Schirmer’s test and Rose-Bengal staining were all positive. Waaler-Rose and latex fixation tests were used for the demonstration of rheumatoid factor and 15 cases were assumed to have rheumatoid arthritis. The biopsy from labial salivary glands showed a variety of histopathologic appearances. The primary changes appeared to be periductal infiltration of lymphoid cells and dilatation of the ducts. As the lymphocytic infiltration increased in the glandular tissue, the secretary cells were beginning to disappear and the ducts became more prominent. Finally, the characteristic histopathological features of Sjögren’s syndrome, germinal center and epimyoepithelial island, were found in 6 cases. Results of examination on these cases suggested that the histopathology of the labial salivary glands would be a valuable diagnostic aid, if the results are considered with other clinical manifestations

Limited Effect of Rebamipide in Addition to Proton Pump Inhibitor (PPI) in the Treatment of Post-Endoscopic Submucosal Dissection Gastric Ulcers: A Randomized Controlled Trial Comparing PPI Plus Rebamipide Combination Therapy with PPI Monotherapy

BACKGROUND/AIMS: The ability of endoscopic submucosal dissection (ESD) to resect large early gastric cancers (EGCs) results in the need to treat large artificial gastric ulcers. This study assessed whether the combination therapy of rebamipide plus a proton pump inhibitor (PPI) offered benefits over PPI monotherapy. METHODS: In this prospective, randomized, multicenter, open-label, and comparative study, patients who had undergone ESD for EGC or gastric adenoma were randomized into groups receiving either rabeprazole monotherapy (10 mg/day, n=64) or a combination of rabeprazole plus rebamipide (300 mg/day, n=66). The Scar stage (S stage) ratio after treatment was compared, and factors independently associated with ulcer healing were identified by using multivariate analyses. RESULTS: The S stage rates at 4 and 8 weeks were similar in the two groups, even in the subgroups of patients with large amounts of tissue resected and regardless of CYP2C19 genotype. Independent factors for ulcer healing were circumferential location of the tumor and resected tissue size; the type of treatment did not affect ulcer healing. CONCLUSIONS: Combination therapy with rebamipide and PPI had limited benefits compared with PPI monotherapy in the treatment of post-ESD gastric ulcer (UMIN Clinical Trials Registry, UMIN000007435)