Immune-Mediated Dermatoses in Patients with Haematological Malignancies: A Comprehensive Review

Haematological malignancies induce important alterations of the immune system, which account for the high frequency of autoimmune complications observed in patients. Cutaneous immune-mediated diseases associated with haematological malignancies encompass a heterogeneous group of dermatoses, including, among others, neutrophilic and eosinophilic dermatoses, autoantibody-mediated skin diseases, vasculitis and granulomatous dermatoses. Some of these diseases, such as paraneoplastic pemphigus, are associated with an increased risk of death; others, such as eosinophilic dermatoses of haematological malignancies, run a benign clinical course but portend a significant negative impairment on a patient's quality of life. In rare cases, the skin eruption reflects immunological alterations associated with an unfavourable prognosis of the associated haematological disorder. Therapeutic management of immune-mediated skin diseases in patients with haematological malignancies is often challenging. Systemic corticosteroids and immunosuppressive drugs are considered frontline therapies but may considerably augment the risk of serious infections. Indeed, developing a specific targeted therapeutic approach is of crucial importance for this particularly fragile patient population. This review provides an up-to-date overview on the immune-mediated skin diseases most frequently encountered by patients with onco-haematological disorders, discussing new pathogenic advances and therapeutic options on the horizon

Feedback inhibition of the general phenylpropanoid and flavonol biosynthetic pathways upon a compromised flavonol-3-O-glycosylation

Flavonols, phenylalanine-derived secondary metabolites, have protective and regulatory functions in plants. In Arabidopsis thaliana, they are consecutively glycosylated at their 3-OH and 7-OH groups. UGT78D1 and UGT78D2 are the major flavonol 3-O-glycosyltransferases in Arabidopsis leaves. The ugt78d1 ugt78d2 double mutant, which was strongly compromised in the initial 3-O-glycosylation, showed a severe and specific repression of flavonol biosynthesis, retaining only one-third of the wild-type level. This metabolic phenotype was associated with a repressed transcription of several flavonol biosynthetic genes including the committed step chalcone synthase [(CHS) or TRANSPARENT TESTA 4 (TT4)]. Furthermore, the committed step of the upstream, general phenylpropanoid pathway, phenylalanine ammonia-lyase (PAL), was down-regulated in its enzyme activity and in the transcription of the flavonol-related PAL1 and PAL2. However, a complete blocking of flavonoid biosynthesis at CHS released PAL inhibition in a tt4 ugt78d1 ugt78d2 line. PAL activity was even enhanced in the flavonol synthase 1 mutant, which compromises the final formation of flavonol aglycones. The dependence of the PAL feedback inhibition on flavonols was confirmed by chemical complementation of tt4 ugt78d1 ugt78d2 using naringenin, a downstream flavonoid intermediate, which restored the PAL repression. Although aglycones were not analytically detectable, this study provides genetic evidence for a novel, flavonol-dependent feedback inhibition of the flavonol biosynthetic pathway and PAL. It was conditioned by the compromised flavonol-3-O-conjugation and a decrease in flavonol content, yet dependent on a residual, flavonol synthase 1 (FLS1)-related capacity to form flavonol aglycones. Thus, this regulation would not react to a reduced metabolic flux into flavonol biosynthesis, but it might prevent the accumulation of non-glycosylated, toxic flavonols

Response of mef2 Gene of Slow and Fast Twitch Muscles of Wistar Male Rats to One Bout of Resistance Exercise

Introduction: Myocyte Enhancer Factor 2 (mef2) gene relates with multiple myogenic transcriptional factors that induces activation Muscle-specific genes. MEF2 contributes in muscular cells development and differentiation as well as in fibers transition in response to stimulants. Therefore, the aim of this study was to evaluate the effect of one bout of resistance exercise (RE) on mef2 gene expression in fast and slow skeletal muscles of Wistar male rats. Methods: For this experimental study, 15 rats from Pasteur Institute were prepared and housed under natural conditions (temperature, light/dark (12:12) cycle, with ad libitum access to food and water) and then randomly divided assigned to RE (n=10) and control groups (n=5); the RE group performed one RE session. 3 and 6 hours following, the rats were anaesthetized and sacrificed, then the soleus and Extensor digitorum longus (EDL) muscles were removed. determine mef2 gene expression rate, the Quantitative Real time RT-PCR was used. Data were analyzed by one sample and independent samples t test. Results: In EDL muscle, in response to one RE session, the mef2 gene expression increased non significantly at 3 hour (p=0/093) and increased significantly (p=/008) at 6 hour after exercise, but in soleus muscle, the mef2 gene expression decreased significantly at 3 hour (p=0/01), and at 6 hour after RE session there was no observed significant change (p=0.247). Conclusion: Mef2 expression gene is differently changes in muscle fibers, which are likely associated with changes in fiber type in response to resistance exercise

The study of burnout frequency and its association with job performance among healthcare staff

Background: Occurs as a result of long-term exposure to stress, job burnout threatens the health of personnel. Objectives: Considering the important role of healthcare personnel in maintaining and promoting people’s health, the current study investigated the job burnout frequency and its association with job performance among healthcare personnel. Methods: This correlational and cross-sectional study was conducted among all healthcare personnel of urban/rural healthcare centers in Health Office of Islam Abad-e-Gharb, Iran. A total of 136 personnel participated in this study. Data were collected using Maslach Burnout Inventory (MBI) and Hersey and Goldsmith’s job performance scale. Descriptive statistics and Mann-Whitney, Kruskal-Wallis, and Spearman correlation coefficient tests were used to analyze the data (p≤0.05). Results: The mean (SD) frequencies of job burnout and job performance were found to be 45.96±17.77 and 52.5±9, respectively. There was a significant inverse correlation between job burnout and job performance (p=0.000, r=-0.249). However, there was no significant association between job burnout and age, gender, marital status, education, and smoking factors (p≥0.05). Conclusion: The findings showed that most of the personnel experienced moderate to low levels of job burnout. Besides, job burnout was found to be a factor affecting job performance. Hence, this study calls for useful interventions to reduce job burnout and increase job performance consequently

Immune-Mediated Dermatoses in Patients with Haematological Malignancies: A Comprehensive Review

Haematological malignancies induce important alterations of the immune system, which account for the high frequency of autoimmune complications observed in patients. Cutaneous immune-mediated diseases associated with haematological malignancies encompass a heterogeneous group of dermatoses, including, among others, neutrophilic and eosinophilic dermatoses, autoantibody-mediated skin diseases, vasculitis and granulomatous dermatoses. Some of these diseases, such as paraneoplastic pemphigus, are associated with an increased risk of death; others, such as eosinophilic dermatoses of haematological malignancies, run a benign clinical course but portend a significant negative impairment on a patient\u2019s quality of life. In rare cases, the skin eruption reflects immunological alterations associated with an unfavourable prognosis of the associated haematological disorder. Therapeutic management of immune-mediated skin diseases in patients with haematological malignancies is often challenging. Systemic corticosteroids and immunosuppressive drugs are considered frontline therapies but may considerably augment the risk of serious infections. Indeed, developing a specific targeted therapeutic approach is of crucial importance for this particularly fragile patient population. This review provides an up-to-date overview on the immune-mediated skin diseases most frequently encountered by patients with onco-haematological disorders, discussing new pathogenic advances and therapeutic options on the horizon