ALLELE-SPECIFIC TRANSCRIPTIONAL ACTIVITY OF THE VARIABLE NUMBER OF TANDEM REPEATS OF THE INDUCIBLE NITRIC OXIDE SYNTHASE GENE IS ASSOCIATED WITH IDIOPATHIC ACHALASIA

Background: Polymorphisms of genes involved in the regulation of the immune response are risk factors for achalasia, but their contribution to disease pathogenesis is unknown. Nitric oxide is involved in both immune function and inhibitory neurotransmission. Objective: to assess the association and the functional relevance of the CCTTT inducible Nitric Oxide Synthase (NOS2) gene promoter polymorphism in achalasia. Methods: Genomic DNA was isolated from 181 achalasia patients and 220 controls. Genotyping of the (CCTTT)n repeats was performed by PCR and capillary electrophoresis, and data analyzed by considering the frequency of the different alleles. HT29 cells were transfected with iNOS luciferase promoter-reporter plasmids containing different (CCTTT)n. Results: The alleles’ distribution ranged from 7 to 18, with a peak frequency at 12 repeats. Analysis of the allele frequencies revealed that individuals carrying 10 and 13 CCTTT repeats were respectively less and more frequent in achalasia (OR 0.5, 95% CI 0.3-0.5 and OR 1.6, 95% CI 1-2.4, all p<0.05). Long repeats were also significantly associated with an earlier onset of the disease (OR 1.69, 95% CI 1.13-2.53, p=0.01). Transfection experiments’ revealed a similar allele-specific iNOS transcriptional activity. Conclusion: The functional polymorphism (CCTTT) of NOS2 promoter is associated with achalasia, likely by an allele-specific modulation of nitric oxide production

Combined use of skin needling and an autologous platelet gel in acne scarring treatment

Introduction. Acne can produce permanent scars that are surprisingly difficult to treat. At present, there are many options available for acne scarring treatment. A relatively new treatment, called skin needling, seems to be appropriate for the treatment of rolling scars in acne. Autologous platelet gel is created by pheresing platelet-rich plasma from whole blood and combined it with thrombin and calcium or other activators to form a coagulum. Platelet gel contains autologous growth factors which act synergistically to accelerate the rate and degree of tissue regeneration, improving wound healing. The aim of this study was to demonstrate the usefulness of the combined use of skin needling and an autologous platelet gel in acne scarring treatment. Methods. 10 patients (6 female, 4 males; age range 18-45) with acne rolling scars were included. Each patient was treated with a specific tool in two session. Using digital cameras, photos of all patients were taken to evaluate scar depth and, in five patients, silicone rubber was used to make a microrelief impression of the scar.The photographic data were analized by using the Sign’s Test (alfa < 0.05); cutaneous’ casts data were analized by using the Fast Fourier Transform (FFT). Results. Analysis of the patient photographs, supported by the sign test and of the degree of irregularity of the surface microrelief, supported by FFT, showed that after only two sessions the severity grade of rolling scars in all patients was greatly reduced and there was an overall aesthetic improvement. Conclusion. The present study demonstrate that the combined use of skin needling and an autologous platelet gel has a great effect in improving acne rolling scars and has undisputable advantages over other procedures