Characterization of anticoagulant heparinoids by immunoprofiling

Heparinoids are used in the clinic as anticoagulants. A specific pentasaccharide in heparinoids activates antithrombin III, resulting in inactivation of factor Xa and–when additional saccharides are present–inactivation of factor IIa. Structural and functional analysis of the heterogeneous heparinoids generally requires advanced equipment, is time consuming, and needs (extensive) sample preparation. In this study, a novel and fast method for the characterization of heparinoids is introduced based on reactivity with nine unique anti-heparin antibodies. Eight heparinoids were biochemically analyzed by electrophoresis and their reactivity with domain-specific anti-heparin antibodies was established by ELISA. Each heparinoid displayed a distinct immunoprofile matching its structural characteristics. The immunoprofile could also be linked to biological characteristics, such as the anti-Xa/anti-IIa ratio, which was reflected by reactivity of the heparinoids with antibodies HS4C3 (indicative for 3-O-sulfates) and HS4E4 (indicative for domains allowing anti-factor IIa activity). In addition, the immunoprofile could be indicative for heparinoid-induced side-effects, such as heparin-induced thrombocytopenia, as illustrated by reactivity with antibody NS4F5, which defines a very high sulfated domain. In conclusion, immunoprofiling provides a novel, fast, and simple methodology for the characterization of heparinoids, and allows high-throughput screening of (new) heparinoids for defined structural and biological characteristics

Skin disease in paper mill workers

Background Paper mill workers have frequent and prolonged exposure to skin irritants and allergens and may have a higher risk of developing occupational dermatitis. Aims The aim of this study was to determine the extent of skin problems in a paper mill and how much was attributable to contact with allergens. Methods A cross-sectional study was carried out among 80 paper mill workers having daily exposure to skin irritants and allergens. They all completed a questionnaire, underwent a standard interview and physical examination. Workers whose history indicated possible contact allergy were patch tested and prick tested. Results Workers reported a high exposure to skin irritants, especially when carrying out tasks that caused the hands and feet to become wet from perspiration and having contact with process water. Atopic dermatitis was seen in 3% of the workers. Contact dermatitis was seen in 26% of the workers and 36% were diagnosed with mycosis of the feet. All cases of contact dermatitis and mycosis could be attributed to occupational exposure to skin irritants. No cases of relevant contact allergy were seen. Conclusion Occupational dermatitis in paper mills is primarily related to the exposure to skin irritants. Occupational physicians should be aware of the risk of occupational dermatitis in paper mill workers

Exposure of the hands to wet work in nurses

Prevention of hand dermatitis among nurses can be achieved by reduction of wet-work exposure. A preventive programme should be based on knowledge of exposure levels. An accurate method to assess such exposure levels is needed. Duration and frequency of wet-work activities were assessed by a questionnaire, in various parts of the health care sector. In addition, a randomly chosen sample from this population was observed for the duration and frequency of wet work. In contrast to the questionnaire, the observation method showed less than half the duration of wet work. Observation detected almost double the frequency that was reported with the questionnaire. Gloves were observed to be used daily in special care units for short time periods. A questionnaire does not accurately assess the quantity of wet-work activities. On regular wards, the exposure to irritants is mainly associated with the frequency of wet hands, rather than the duration of wet hands. We assume that the short-term use of gloves on special care units does not cause an increased risk of hand dermatitis. Preventive programmes can focus on decreasing the frequency of wet hands by encouraging the use of gloves; the use of gloves should not only be advised to prevent infections but also to protect against hand dermatitis