Osteopontin: A New Facilitating Factor in Alopecia Areata Pathogenesis?

Osteopontin (OPN) is a multifunctional glycophosphoprotein secreted by many cell types, including osteoblasts, lymphocites, macrophages, epithelial cells, and vascular smooth muscle cells. It has been implicated in many physiological and pathological processes, such as cell-mediated immunity, inflammation, cell survival, and tumor invasion and metastasis. Osteopontin has multiple emerging roles in cutaneous biology and pathology and OPN involvement has been emphasized in Th1-mediated diseases such as psoriasis. Alopecia areata (AA) is a form of non-scarring hair loss affecting anagen stage hair follicles with a multifactorial autoimmune pathogenesis characterized by a prevalent Th1 cytokine profile. Given the role of osteopontin in Th1-mediated inflammation, we have postulated that OPN may be involved in AA pathogenesis. The aim of our study was to investigate plasma OPN level in alopecia areata before and after DPCP treatment. Our results showed that OPN plasma levels in patients with alopecia areata were higher than in healthy controls, but patients achieving complete recovery after DPCP treatment did not show a statistically significant reduction of OPN plasma levels.</p

Role of Daptomycin in Cutaneous Wound Healing: A Narrative Review

Daptomycin is active against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and the on-label indications for its use include complicated skin and skin structure infections (cSSSI). We performed a narrative review of the literature with the aim to evaluate the role of daptomycin in the skin wound healing process, proposing our point of view on the possible association with other molecules that could improve the skin healing process. Daptomycin may improve wound healing in MRSA-infected burns, surgical wounds, and diabetic feet, but further studies in humans with histological examination are needed. In the future, the combination of daptomycin with other molecules with synergistic action, such as vitamin E and derivates, IB-367, RNA III-inhibiting peptide (RIP), and palladium nanoflowers, may help to improve wound healing and overcome forms of antibiotic resistanc

MSCs and inflammation: not only a guardian role

  The literature on the relation between mesenchymal stem cells (MSCs) and inflammation is continuing to expand at a rapid rate with over 600 entries in PubMed under “MSCs and inflammation” starting from 2002. Inflammation is an essential part of the malignant microenvironment. Chemokines, leukocyte infiltration and cytokines are crucial elements, which contribute to cancer-related inflammation. Attracted by chemokines, MSCs are recruited at injury sites. After exposure to inflammatory factors in the local microenvironment, MSCs secrete several cytokines and vascular endothelial growth factor, which promote immunosuppression, angiogenesis and tumor growth. Here we compare by RT-PCR the expression of selected genes, related to inflammation, on MSCs derived from control (C-MSCs) and inflamed tissues (I-MSCs). First of all, an immunohistochemistry using anti-CD43 antibody was performed to better test the status of inflammation at the moment of tissues’ collection. CD43 is known as marker of inflammation, since it is expressed by most T cells, activated B cells, basophils, macrophages, monocytes and NK cells. Its expression was absent in “control” tissues, while it was strong in the “inflamed”. Subsequently, RNA was extracted, retro-transcribed and used for quantitative PCR. The genes were selected according to their role in inflammation: IL6 and IL8 (known as pro-inflammatory interleukins), TNFα (involved in systemic inflammation), CXCL2 (secreted by monocytes and macrophages and is chemotactic for polymorphonuclear leukocytes), CCL20 (strongly chemotactic for lymphocytes, its expression is induced by inflammatory cytokines), IFNγ (an important activator of macrophages) and TGFβ1 (promoting immunosuppression). Quantification of mRNA expression was calculated with the 2−ΔΔCt method, where ΔCt = Ct (gene of interest) − Ct (control gene) and Δ(ΔCt) = ΔCt (I-MSCs) − ΔCt (C-MSCs). The results revealed that the expression of all tested genes was higher in MSCs derived from inflamed tissues than in MSCs from control tissues (expressed as 1). This study underlines how MSCs are not inert guardians on inflammation, but as they play an active role

Patient satisfaction with calcipotriol/betamethasone dipropionate cutaneous foam for the treatment of plaque psoriasis: The LION real-life multicenter prospective observational cohort study

Topical treatment is the mainstay for mild or moderate psoriasis, but patients are generally little satisfied. Calcipotriol/betamethasone dipropionate (Cal/BD) cutaneous foam has shown to improve signs and symptoms in plaque psoriasis patients. This study assessed patient's satisfaction with Cal/BD foam in a real-life Italian dermatological clinical practice. A multicenter, 4-week observational prospective cohort study enrolled, in 17 Italian dermatology clinics, adult patients with plaque psoriasis on the body and/or scalp. Treatment satisfaction was assessed by 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9), preference over previous treatments by Patient Preference Questionnaire (PPQ), and change in disease state by Psoriasis Area Severity Index (PASI). Overall 256 patients were eligible, with a mean (SD) age of 55.6 (15.4) years, 59.4% were males. Psoriasis severity was mild in 52.0% of patients, moderate in 43.3%, and severe in 4.7%. Scalp involvement was present in 36.7% of patients. Previous antipsoriatic treatments had been received by 80.5% of patients. TSQM-9 median (25th-75th percentile) scores were 83.3 (66.7-88.9) for effectiveness, 77.8 (66.7-88.9) for convenience, and 78.6 (64.3-92.9) for global satisfaction. Mean (SD) PASI value decreased from 7.3 (4.8) to 2.1 (2.7) after 4 weeks. More than 90% of patients previously treated for psoriasis evaluated the Cal/BD foam more effective, easier to use and better tolerated compared to previous topical treatments at PPQ. This observational study provides real-life evidence of a high level of satisfaction with effectiveness and convenience of the Cal/BD foam in a cohort of plaque psoriasis patients, with an objective improvement in PASI

Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease

Immune-mediated inflammatory diseases (IMIDs) are chronic autoimmune conditions that share common pathophysiologic mechanisms. The optimal management of patients with IMIDs remains challenging because the coexistence of different conditions requires the intervention of several specialists. The aim of this study was to develop a series of statements defining overarching principles that guide the implementation of a multidisciplinary approach for the management of spondyloarthritis (SpA)-related IMIDs including SpA, psoriasis, psoriatic arthritis, Crohn's disease, ulcerative colitis and uveitis

Italian Guidelines in diagnosis and treatment of alopecia areata

Alopecia areata (AA) is an organ-specific autoimmune disorder that targets anagen phase hair follicles. The course is unpredictable and current available treatments have variable efficacy. Nowadays, there is relatively little evidence on treatment of AA from well-designed clinical trials. Moreover, none of the treatments or devices commonly used to treat AA are specifically approved by the Food and Drug Administration. The Italian Study Group for Cutaneous Annexial Disease of the Italian Society of dermatology proposes these Italian guidelines for diagnosis and treatment of Alopecia Areata deeming useful for the daily management of the disease. This article summarizes evidence-based treatment associated with expert-based recommendations