Vulvar pruritus secondary to hemochromatosis

Background: While acute pruritus is often attributable to yeast vulvovaginitis, chronic pruritus can present as the result different conditions including manifestation of a systemic disorder. Case: A 27-year-old woman presented with a 3 year history of vulvar pruritus, burning, and dyspareunia consistent with contact dermatitis. She failed to improve despite treatment prompting evaluation for an underlying systemic disorder, such as iron deficiency anemia. Interestingly, elevated iron levels were identified leading to the diagnosis of hemochromatosis. Following treatment and near normalization of her serum iron levels, the patient’s vulvar symptoms improved. Conclusion: Vulvar pruritus is a symptom and not a disease. Thus it is important to search for the cause keeping in mind that dermatologic complaints such as pruritus can be the first manifestation of a systemic process

Evaluation of the VNTR region in the IDO promoter in women with preeclampsia

Indoleamine 2,3 – dioxygenase (IDO) is an enzyme that aids in immunosuppression and tolerance. Previous studies have shown decreased IDO activity in pregnancies affected by preeclampsia, but the mechanism for this altered activity is unknown. Our study was designed to analyze the promoter region of IDO in preeclamptic and control women and identify the frequency of a VNTR genotype that has been shown to be significantly correlated with tryptophan levels in women; a surrogate marker for IDO activity

Future treatment strategies of aggressive pituitary tumors

While surgery remains the first-line treatment of most aggressive pituitary adenomas, medical therapy is important as second-line or adjunctive therapy in a large proportion of patients. Dopamine agonists (DAs) are the best treatment for prolactinomas, but when DAs are not tolerated, new somatostatin receptor subtype 5 (SSTR5) inhibitors may offer an alternative in the future. Unfortunately, these are unlikely to be effective in DA-resistant prolactinomas. In acromegaly, the existing somatostatin analogs, octreotide and lanreotide, will remain the medical treatment of choice for the foreseeable future. There is an urgent need for medical therapies in Cushing’s disease, and the SSTR5 analogs could offer an effective treatment in a proportion of patients within the next few years. Finally, the medical management options for non-functioning pituitary adenomas are also very limited, and a new chimeric agent with activity towards dopamine receptors, SSTR5 and SSTR2 may help reduce adenoma recurrence in the future

Interferon-gamma DNA methylation is affected by mycophenolic acid but not by tacrolimus after T-cell activation

Immunosuppressive drug therapy is required to treat patients with autoimmune disease and patients who have undergone organ transplantation. The main targets of the immunosuppressive drugs tacrolimus and mycophenolic acid (MPA; the active metabolite of mycophenolate mofetil) are T cells. It is currently unknown whether these immunosuppressive drugs have an effect on DNA methylation-an epigenetic regulator of cellular function. Here, we determined the effect of tacrolimus and MPA on DNA methylation of the gene promoter region of interferon gamma (IFNγ), a pro-inflammatory cytokine. Total T cells, naive T cells (CCR7+CD45RO-), and memory T cells (CD45RO+ and CCR7-CD45RO-) were isolated from CMV seropositive healthy controls and stimulated with α-CD3/CD28 in the presence or absence of tacrolimus or MPA. DNA methylation of the IFNγ promoter region was quantified by pyrosequencing at 4 h, days 1, 3, and 4 after stimulation. In parallel, T-cell differentiation, and IFNγ protein production were analyzed by flow cytometry at days 1 and 3 after stimulation. Our results show that MPA induced changes in IFNγ DNA methylation of naive T cells; MPA counteracted the decrease in methylation after stimulation. Tacrolimus did not affect IFNγ DNA methylation of naive T cells. In the memory T cells, both immunosuppressive drugs did not affect IFNγ DNA methylation. Differentiation of naive T cells into a central-memory-like phenotype (CD45RO+) was inhibited by both immunosuppressive drugs, while differentiation of memory T cells remained unaffected by both MPA and tacrolimus. IFNγ protein production was suppressed by tacrolimus. Our results demonstrate that MPA influenced IFNγ DNA methylation of naive T cells after stimulation of T cells, while tacrolimus had no effect. Both tacrolimus and MPA did not affect IFNγ DNA methylation of memory T cells

Use of thymidine analogues to indicate vascular perfusion in tumours

Temporary reduction in blood-flow within tumour blood vessels can reduce oxygen supply leading to transient perfusion-limited hypoxia. Consequent selection of cells with mutations and reduced radiosensitivity can lead to disease progression and treatment-resistance. In the present study, we investigated whether heterogeneity of labelling after thymidine analogue administration is related to perfusion variations, and if so, could it be quantified and used as a perfusion indicator. Perfusion in murine RIF1 tumours was reduced by hydralazine or increased by nicotinamide and the mice subsequently injected with IdUrd. Tumours were halved for analysis by both flow cytometry and immunohistochemistry. Tumour sections were stained for vasculature and IdUrd. Each blood vessel was scored for the density of IdUrd-labelled cells surrounding it, using a semi-quantitative scoring system. Flow cytometry showed that the IdUrd labelling index and intensity decreased by approximately 50% after hydralazine. In tumour sections of control animals, 2.9% of vessels showed no IdUrd label. In contrast, after hydralazine almost 50% of vessels had no surrounding IdUrd labelling, whereas after nicotinamide there were fewer vessels with low labelling and a higher median score. In conclusion, changes of tumour perfusion by pharmacological agents is reflected in changes in tumour-cell labelling by the thymidine analogue IdUrd, suggesting that IdUrd labelling could be used to indicate perfusion in individual vessels in human tumours. © 2000 Cancer Research Campaig

Beheersing van valse meeldauw in Impatiens

De éénjarige zomerbloeier Impatiens walleriana vormt een belangrijk onderdeel in het assortiment van perkgoed. Ondermeer in 2007 waren er door de natte weersomstandigheden grote problemen met uitval door valse meeldauw in de consumentfase. Hierdoor kwam de vraag of er tijdens de opkweek niet meer preventieve maatregelen genomen kunnen worden om infectie door valse meeldauw onder vochtige omstandigheden te verminderen of te voorkomen. Daarnaast was het onbekend of de besmetting met valse meeldauw op Nederlandse locaties veroorzaakt wordt door één soort of meerdere soorten. In een literatuurstudie is alle beschikbare informatie over valse meeldauw en mogelijkheden voor beheersen/ bestrijding samengeva

The association of diabetes mellitus and insulin treatment with expression of insulin-related proteins in breast tumors

BACKGROUND: The insulin receptor (INSR) and the insulin growth factor 1 receptor (IGF1R) play important roles in the etiology of both diabetes mellitus and breast cancer. We aimed to evaluate the expression of hormone and insulin-related proteins within or related to the PI3K and MAPK pathway in breast tumors of women with or without diabetes mellitus, treated with or without insulin (analogues). METHODS: Immunohistochemistry was performed on tumor tissue of 312 women with invasive breast cancer, with or without pre-existing diabetes mellitus, diagnosed in 2000-2010, who were randomly selected from a Danish breast cancer cohort. Women with diabetes were 2:1 frequency matched by year of birth and age at breast cancer diagnosis to those without diabetes. Tumor Microarrays were successfully stained for p-ER, EGFR, p-ERK1/2, p-mTOR, and IGF1R, and scored by a breast pathologist. Associations of expression of these proteins with diabetes, insulin treatment (human insulin and insulin analogues) and other diabetes medication were evaluated by multivariable logistic regression adjusting for menopause and BMI; effect modification by menopausal status, BMI, and ER status was assessed using interactions terms. RESULTS: We found no significant differences in expression of any of the proteins in breast tumors of women with (n = 211) and without diabetes (n = 101). Among women with diabetes, insulin use (n = 53) was significantly associated with higher tumor protein expression of IGF1R (OR = 2.36; 95%CI:1.02-5.52; p = 0.04) and p-mTOR (OR = 2.35; 95%CI:1.13-4.88; p = 0.02), especially among women treated with insulin analogues. Menopause seemed to modified the association between insulin and IGF1R expression (p = 0.07); the difference in IGF1R expression was only observed in tumors of premenopausal women (OR = 5.10; 95%CI:1.36-19.14; p = 0.02). We found no associations between other types of diabetes medication, such as metformin, and protein expression of the five proteins evaluated. CONCLUSIONS: In our study, breast tumors of women with pre-existing diabetes did not show an altered expression of selected PI3K/MAPK pathway-related proteins. We observed an association between insulin treatment and increased p-mTOR and IGF1R expression of breast tumors, especially in premenopausal women. This observation, if confirmed, might be clinically relevant since the use of IGF1R and mTOR inhibitors are currently investigated in clinical trials

Variations in DNA methylation of interferon gamma and programmed death 1 in allograft rejection after kidney transplantation

Background: The role of DNA methylation in the regulation of the anti-donor-directed immune response after organ transplantation is unknown. Here, we studied the methylation of two mediators of the immune response: the pro-inflammatory cytokine interferon γ (IFNγ) and the inhibitory receptor programmed death 1 (PD1) in naïve and memory CD8+ T cell subsets in kidney transplant recipients receiving immunosuppressive medication. Both recipients experiencing an episode of acute allograft rejection (rejectors) as well as recipients without rejection (non-rejectors) were included. Results: CpGs in the promoter regions of both IFNγ and PD1 were significantly (p < 0.001) higher methylated in the naïve CD8+ T cells compared to the memory T cell subsets. The methylation status of both IFNγ and PD1 inversely c

Spelling errors and keywords in born-digital data: a case study using the Teenage Health Freak Corpus

The abundance of language data that is now available in digital form, and the rise of distinct language varieties that are used for digital communication, means that issues of non-standard spellings and spelling errors are, in future, likely to become more prominent for compilers of corpora. This paper examines the effect of spelling variation on keywords in a born-digital corpus in order to explore the extent and impact of this variation for future corpus studies. The corpus used in this study consists of e-mails about health concerns that were sent to a health website by adolescents. Keywords are generated using the original version of the corpus and a version with spelling errors corrected, and the British National Corpus (BNC) acts as the reference corpus. The ranks of the keywords are shown to be very similar and, therefore, suggest that, depending on the research goals, keywords could be generated reliably without any need for spelling correction