Eradication of damaged keratinocytes in cutaneous lichen planus forms demonstrated by evaluation of epidermal and follicular expression of CK15, indices of apoptosis and regulatory protein S100

Publisher Copyright: © 2016, Versalius University Medical Publisher.All rights reserved.The study of cytoskeleton arrangement and its contribution to survival of cell-to-cell contacts appears to be essential for understanding of numerous cellular and tissue processes. Applying CK15, S100 labeling and TUNEL reaction to cutaneous lichen planus subtypes, we found CK15 expression in the outer and inner root sheath of hair follicles, the basal epidermal layer, and eccrine glands. Its follicular expression was decreased in nearby inflammatory infiltrates. The CK15 immu-nopositivity was mostly described as weak (92.3%) for lichen planus but equally subdivided into weak, moderate and strong in lichen planopilaris (χ2 = 32.514; df = 4; p < 0.001). The greatly varying apoptotic index was the highest in the lichen planopilaris involving the scalp: 81.2 ±10.7; 87.8 ±10.7 and 88.0 ±10.5 for the basal, spinous and upper epidermal layers, respectively. S100 positive epidermal and follicular cells did not differ in the lesions demonstrated in the study groups; still immunoreactivity was more pronounced in the scalp region of lichen planopilaris. Damage of cell-to-cell contacts was confirmed by electron microscopy. Apart from immunocyte-mediated keratinocyte death, cytoskeleton-based injury and loss of cell-to-cell and matrix contacts may be of great importance, leading to eradication of degrading cells and thus contributing to the pathogenesis of lichen planus.publishersversionPeer reviewe

Immunological mechanisms of autoimmune thyroid diseases : A shift in the traditional TH1/TH2 paradigm

Funding Information: This work was supported by the Latvian Council of Science project No. lzp-2018/2-0059. Publisher Copyright: © 2019 Tatjana Zaķe et al., published by Sciendo 2019.Autoimmune thyroid diseases (AITD) mainly include Hashimoto's thyroiditis (HT) and Graves' disease (GD), which are characterised by the presence of circulating antibodies against various thyroid autoantigens and infiltration of the thyroid gland by autoreactive lymphocytes. Despite the significant advancement in the knowledge of AITD pathogenesis in the last decade, the specific immunological mechanisms responsible for development of the disease are not thoroughly understood. Classically, HT has long been considered as a T helper (Th)1-mediated disease, while a Th2-driven autoimmune response is dominant for GD development. However, this classification has changed due to the description of Th17 lymphocytes, which suggested participation of these cells in AITD, particularly HT pathogenesis. Moreover, a shift in the balance between Th17 and T regulatory (Treg) cells has been observed in thyroid autoimmunity. We have observed overexpression of IL-17, the prominent effector cytokine of Th17, within thyroid tissues from HT and GD patients in our studies. The present review will focus on recent data regarding the role of Treg and Th17 lymphocytes in AITD pathogenesis. In addition, the impact and proposed mechanisms of the predominant environmental factors triggering the autoimmune response to the thyroid will be discussed.publishersversionPeer reviewe

Heterogeneity of tissue IL-17 and tight junction proteins expression demonstrated in patients with autoimmune thyroid diseases

Funding Information: Funding/support: This study was supported in part by the Latvian National Research Program “BIOMEDICINE” No. 5.2.4. For the statistical analyses, the authors were assisted by the Department of Public Health and Epidemiology at Riga Stradins University. Publisher Copyright: Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.Th17 cells together with their hallmark cytokine interleukin (IL)-17 were identified as crucial contributing factors in the pathogenesis of thyroid autoimmunity. The cytokine-regulated tight junction (Tj) disruption is thought to be essential in the initiation and/or development of several diseases. Still, the role of IL-17 maintaining Tj integrity in autoimmune thyroid diseases (AITDs) has not yet been evaluated. We aimed to investigate integrity of the thyroid follicle by studying immunoexpression of cellular Tj - zonula occludens (ZO)-1 and claudin-1 proteins coupled to IL-17A and CD68 detection in AITD patients compared with controls. Thirty-five adult patients undergoing thyroidectomy and presenting 18 cases of Hashimoto thyroiditis (HT), 7 of Graves' disease (GD) as well as 10 subjects of colloid goiter without autoimmune component served as controls were enrolled in this study. An immunohistochemical analysis including IL-17A, ZO-1, claudin-1, and CD68 detection was performed in each case. The correlation of IL-17A with Tj and CD68 in patients with AITD was also analyzed. Apart from inflammatory cells, we evidenced a stronger expression level of IL17A in the thyroid follicular cells in HT patients when compared with GD or colloid goiter. A significant reduction of ZO-1 immunoreactivity was observed in the thyrocytes in HT patients, whereas no significant differences were found in claudin-1 expression in HT and GD compared with colloid goiter patients. A significantly higher number of thyroid follicles with CD68-positive cells was found in HT patients than that in patients with GD or colloid goiter. In HT patients, the expression of IL-17A in the follicular cells was positively correlated with CD68 immunopositivity, whereas no association with claudin-1 or ZO-1 expression was found. GD patients did not reveal any significant correlation of IL-17A with Tj and CD68. Strong overexpression of IL-17A observed in the thyroid epithelial cells is associated with the presence of intrafollicular CD68-positive cells in HT patients. We evidenced the changes in molecules of thyrocyte junctional complexes highlighting impairment of the thyroid follicle integrity in HT, but no association with IL-17A was found.publishersversionPeer reviewe

Pathological Complete Remission in Young Colon Cancer Patient with a Large Liver Metastasis after FOLFOX-4/Bevacizumab Treatment – A Case Report

publishersversionPeer reviewe

What factors empower general practitioners for early cancer diagnosis? A 20-country European Delphi Study.

BACKGROUND Some symptoms are recognised as red flags for cancer, causing the General Practitioner (GP) to refer the patient for investigation without delay. However, many early symptoms of cancer are vague and unspecific, and in these cases, a delay in referral risks a diagnosis of cancer that is too late. Empowering GPs in their management of patients that may have cancer is likely to lead to more timely cancer diagnoses. AIM To identify the factors that affect European GPs' empowerment in making an early diagnosis of cancer. METHODS This was a Delphi study involving GPs in 20 European countries. We presented GPs with 52 statements representing factors that could empower GPs to increase the number of early cancer diagnoses. Over three Delphi rounds, we asked GPs to indicate the clinical relevance of each statement on a Likert scale.The final list of statements indicated those that were considered by consensus to be the most relevant. RESULTS In total, 53 GPs from 20 European countries completed the Delphi process, out of the 68 GPs who completed round one. Twelve statements satisfied the pre-defined criteria for relevance. Five of the statements related to screening and four to the primary/secondary care interface. The other selected statements concerned information technology (IT) and GPs' working conditions. Statements relating to training, skills and working efficiency were not considered priority areas. CONCLUSION GPs consider that system factors relating to screening, the primary-secondary care interface, IT and their working conditions are key to enhancing their empowerment in patients that could have cancer. These findings provide the basis for seeking actions and policies that will support GPs in their efforts to achieve timely cancer diagnosis

What factors empower general practitioners for early cancer diagnosis? A 20-country European Delphi Study

Funding Information: The publication of the article in OA mode was financially supported by HEAL-Link. Publisher Copyright: © The Author(s), 2022.Background: Some symptoms are recognised as red flags for cancer, causing the General Practitioner (GP) to refer the patient for investigation without delay. However, many early symptoms of cancer are vague and unspecific, and in these cases, a delay in referral risks a diagnosis of cancer that is too late. Empowering GPs in their management of patients that may have cancer is likely to lead to more timely cancer diagnoses. Aim: To identify the factors that affect European GPs' empowerment in making an early diagnosis of cancer. Methods: This was a Delphi study involving GPs in 20 European countries. We presented GPs with 52 statements representing factors that could empower GPs to increase the number of early cancer diagnoses. Over three Delphi rounds, we asked GPs to indicate the clinical relevance of each statement on a Likert scale. The final list of statements indicated those that were considered by consensus to be the most relevant. Results: In total, 53 GPs from 20 European countries completed the Delphi process, out of the 68 GPs who completed round one. Twelve statements satisfied the pre-defined criteria for relevance. Five of the statements related to screening and four to the primary/secondary care interface. The other selected statements concerned information technology (IT) and GPs' working conditions. Statements relating to training, skills and working efficiency were not considered priority areas. Conclusion: GPs consider that system factors relating to screening, the primary-secondary care interface, IT and their working conditions are key to enhancing their empowerment in patients that could have cancer. These findings provide the basis for seeking actions and policies that will support GPs in their efforts to achieve timely cancer diagnosis.publishersversionPeer reviewe

Experience of young people with functional impairments in online drama therapy group sessions: interpretative phenomenological analysis

Mākslas terapijaVeselības aprūpeArt TherapyHealth CareMaģistra darbs tika izstrādāts ar mērķi detalizēti izpētīt jauniešu ar funkcionālajiem traucējumiem (FT) iegūto pieredzi drāmas terapijas (DT) tiešsaistes grupu sesijās, no kā izriet pētījuma pamatjautājums: Kā jaunieši ar FT apraksta savu DT tiešsaistes grupas sesiju pieredzi? Darba aktualitāti nosaka tas, ka pasaulē ir veikti salīdzinoši maz kvalitatīvā dizaina pētījumu jauniešiem ar FT par DT tiešsaistes sesiju lietderīgumu, iespējām, efektivitāti, kā arī trūkumiem. Pētījumā piedalījās septiņi jaunieši ar FT vecumā no 21– 30 gadiem, nevalstiskās organizācijas klienti. Lai gūtu dziļāku priekšstatu un detalizēti izpētītu jauniešu ar FT iegūto pieredzi, kā vispiemērotākā pētījumam tika izvēlēta kvalitatīvā pētījuma stratēģija ar fenomenoloģiju kā pētījuma dizainu un interpretatīvo fenomenoloģisko analīzi (IFA) kā datu analīzes metodi. Pētījuma empīriskajā daļā vispirms tika izstrādātas un realizētas 10 DT grupu sesijas Zoom tiešsaistes platformā. Pētījuma datu iegūšanai pēc sesijām tika veiktas individuālās daļēji strukturētas video intervijas ar sesiju dalībniekiem Zoom tiešsaistes platformā. Veicot datu analīzi, tika noteiktas sešas virstēmas, kurām katrai attiecīgi pakārtotas četras līdz sešas apakštēmas. Pētījuma rezultāti norāda, ka jaunieši DT tiešsaistes sesijās ir piedzīvojuši plašu un daudzpusīgu emociju gammu un guvuši jaunu pieredzi. Kopumā jāsecina, ka piedzīvoto raksturo liels skaits pozitīvu aspektu un plašs ieguvumu spektrs. Rezultāti liecina, ka tiešsaistes DT sesijas sniedz atbalstu krīzes apstākļos, kā arī norāda uz trūkumiem un iespējamiem riskiem darbam tiešsaistē ar jauniešiem ar FT. Intervijās dalībnieki atklāj, ka DT ir neaizmirstama pieredze, kas ļauj justies brīvāk, izteikt savas domas un viedokli, atklāt no jauna vai rosināt iztēli, radošumu, spontanitāti un spēju improvizēt. Veiktais pētījums un tā rezultāti varētu sniegt atbalstu jauniešiem ar FT un viņu aprūpētājiem, asistentiem, kā arī sociālajiem darbiniekiem, lai uzlabotu aprūpes kvalitāti, kā arī veicinātu drāmas terapeitu (DTt) un citu mākslas terapeitu (MTt) profesionālo attīstību darbā ar mērķgrupas jauniešiem.The Master Thesis was elaborated with an objective to study in detail the experience gained by young people with functional disorders (FD) in drama therapy (DT) online group sessions, from which the main question of the research arises: How young people with FD describe their experience gained during DT online group sessions? The topicality of the Thesis is determined by the fact that a relatively small number of qualitative design studies have been carried out worldwide involving young people with FD regarding usefulness, opportunities, efficiency, as well as deficiencies of DT online sessions. The research involves seven young people with FD aged from 21 – 30, who are clients of non-governmental organisation. To gain deeper insight and study in detail the experience gained by the young people with FD, the qualitative research strategy was selected as the most appropriate with phenomenology as the study design and interpretative phenomenological analysis (IPA) as the method for data analysis. In the empirical part of the research, initially 10 DT group sessions were created and implemented on Zoom online platform. For obtaining the research data, individual partially structured video interviews with participants of sessions were conducted on Zoom online platform. During the data analysis, six principal topics were defined, which contained respectively subordinated four to six sub-topics. The research results indicated that the young people have experienced a wide and diverse range of emotions, and have gained new experience. In general, the obtained results lead to a conclusion that this experience is characterised by a large number of positive aspects and an extensive spectrum of benefits. The results show that online DT sessions provide support in a crisis situation, and also show drawbacks and potential risks of working online with young people with FD. During the interviews, the participants revealed that DT is unforgettable experience, which allows feeling more free, express own thoughts and opinion, rediscover or stimulate imagination, creativity, spontaneity and improvisation skills.The conducted research and its results may provide support to young people with FD and their carers, assistants, as well as social workers, in order to improve the quality of care and promote professional development of drama therapists and other art therapists in working with young people within the target group

Upregulated tissue expression of T helper (Th) 17 pathogenic interleukin (IL)-23 and IL-1β in Hashimoto’s thyroiditis but not in graves’ disease

Funding Information: This study was supported in part by the Latvian National Research Program “ BIOM?DICIN? ” No. 5.2.4. Publisher Copyright: © The Japan Endocrine Society.T helper (Th) 17 cells and interleukin (IL)-17 play a significant role in the pathogenesis of autoimmune thyroid disease (AITD). However, it has recently become clear that Th17 cells are more heterogeneous and exhibit two different phenotypes, whereas IL-23 and IL-1β are crucial for the generation of pathogenic Th17 lymphocytes. We aimed to investigate the association between IL-17 and Th17-promoting cytokines in AITD by studying the immunoexpression patterns of IL-17, IL-23, and IL-1β in thyroid tissue. Following thyroidectomy, 29 patients with AITD (21 cases of Hashimoto’s thyroiditis (HT) and 8 cases of Graves’ disease (GD)) and 18 patients with colloid goiter, as controls, were enrolled in this study, and immunohistochemistry was performed. The expression level of IL-17 in thyrocytes was significantly higher in HT and GD patients than in colloid goiter patients. Immunopositivity for both IL-23 and IL-1β was significantly increased in HT patients compared to GD and colloid goiter patients. However, no difference was found between IL-23 or IL-1β expression in patients with GD and colloid goiter. A positive correlation between IL-17 and IL-23 as well as IL-17 and IL-1β expression was observed in HT patients (r = 0.574, p = 0.007 and r = 0.461, p = 0.036, respectively). In the GD group, IL-17 was positively correlated with IL-1β (r = 0.817, p = 0.013) but not with IL-23 expression. We found increased IL-23 and IL-1β expression in the HT group but not in the GD group. Furthermore, both interleukins were correlated with IL-17 immunopositivity in thyroid tissue, suggesting that pathogenic Th17-promoting cytokines may play a role in HT pathogenesis.publishersversionPeer reviewe

The Impact of Forest Fertilization on the Ecological Quality of Two Hemiboreal Streams

The present study aimed to detect any changes in concentrations of nutrients and evaluate the impact on the quality of two hemiboreal streams that collect a discharge from two fertilized Scots pine stands. In 2017, nitrogen-containing mineral fertilizer was spread in pine stands on mineral soil located near the first stream. In 2018, potassium containing wood ash was spread in pine stands on organic soil near the second stream. From 2017 to 2020, surveys of physico-chemical parameters, diatoms, macrophytes, and macroinvertebrates were performed to determine the possible effects of fertilization on the ecological quality of the streams. A control site upstream of the fertilized forest stand and a treatment site downstream of the fertilized forest stand was monitored at each stream. Water quality indices, chemical parameters of surface water, and indicator species analysis showed no short-term impact of forest soil improvement with wood ash and ammonium nitrate. We found no clear patterns before and after the fertilization events in both streams, although we did observe inter- and intra-annual differences in aquatic biota and stream ecological quality mainly caused by local environmental factors