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

Studio di prevalenza batterica e fungina su espettorati provenienti da pazienti con Fibrosi Cistica

Over the past 20 years there has been a grater interest in infection control in cystic fibrosis (CF).The epidemiology of pathogens in CF patients has become more complex; many common and complex pathogens species may be pathogens in patients with CF. In addition the number of different bacterial species isolated from respiratory specimens from this patient population are also numerous.The main objective when treating people who have CF is to prevent, eradicate or control all types of respiratory infection, particularly endobronchial and pulmonary infection. We examined 475 sputum of 69 patients with FC during 2003. Pseudomonas aeruginosa was prevalent, occurs in 85% of CF patients studied.The mucoid phenotype was isolated in 44,4% of patients.The prevalence of S. maltophilia, A. xylosoxidans, Burkholderia cepacia and Aspergillus spp. in our patients is 1,8%, 2,1%, 2,9% and 26,1% respectively. CF isolates are tested for antibiotic susceptibility for control of antimicrobial resistance and the emergence of multidrug-resistant organism.The choice of antibiotic depends on in vitro sensitivity pattern.The regular microbiological monitoring can contribute to extend life for many CF patients but also contribute to improving the quality of life for this population

Postoperative insulin-like growth factor 1 levels reflect the graft's function and predict survival after liver transplantation

Background The reduction of insulin-like growth factor 1 (IGF-1) plasma levels is associated with the degree of liver dysfunction and mortality in cirrhotic patients. However, little research is available on the recovery of the IGF-1 level and its prognostic role after liver transplantation (LT). Methods From April 2010 to May 2011, 31 patients were prospectively enrolled (25/6 M/F; mean age +/- SEM: 55.2 +/- 1.4 years), and IGF-1 serum levels were assessed preoperatively and at 15, 30, 90, 180 and 365 days after transplantation. The influence of the donor and recipient characteristics (age, use of extended criteria donor grafts, D-MELD and incidence of early allograft dysfunction) on hormonal concentration was analyzed. The prognostic role of IGF-1 level on patient survival and its correlation with routine liver function tests were also investigated. Results All patients showed low preoperative IGF-1 levels (mean +/- SEM: 29.5 +/- 2.1), and on postoperative day 15, a significant increase in the IGF-1 plasma level was observed (102.7 +/- 11.7 ng/ml; p65 years) or extended criteria donor grafts. An inverse correlation between IGF-1 and bilirubin serum levels at day 15 (r = -0.3924, p = 0.0320) and 30 (r = -0.3894, p = 0.0368) was found. After multivariate analysis, early (within 15 days) IGF-1 normalization [Exp(b) = 3.913; p = 0.0484] was the only prognostic factor associated with an increased 3-year survival rate. Conclusion IGF-1 postoperative levels are correlated with the graft's quality and reflect liver function. Early IGF-1 recovery is associated with a higher 3-year survival rate after LT

Mid-Regional Proadrenomedullin (MR-proADM) and Microcirculation in Monitoring Organ Dysfunction of Critical Care Patients With Infection: A Prospective Observational Pilot Study

: Introduction: Microvascular alterations are involved in the development of organ injury in critical care patients. Mid-regional proadrenomedullin (MR-proADM) may predict organ damage and its evolution. The main objective of this study was to assess the correlation between MR-proADM and microvascular flow index (MFI) in a small cohort of 20 adult critical care patients diagnosed with infection, sepsis, or septic shock. Further objectives were to evaluate the correlation between the clearance of MR-proADM and the variables of microcirculation and between MR-proADM and the Sequential Organ Failure Assessment (SOFA) score. Materials and Methods: This is a prospective observational pilot study. Inclusion criteria: consecutive adult patients admitted to intensive care unit (ICU) for or with infection-related illness. Daily measurement of MR-proADM and calculation of the SOFA score from admission in ICU to day 5. Repeated evaluations of sublingual microcirculation, collection of clinical data, and laboratory tests. Results: Primary outcome: MR-proADM was not significantly correlated to the MFI at admission in ICU. A clearance of MR-proADM of 20% or more in the first 24 h was related to the improvement of the MFIs and MFIt [percentual variation of the MFIs + 12.35 (6.01-14.59)% vs. +2.23 (-4.45-6.01)%, p = 0.005; MFIt +9.09 (4.53-16.26)% vs. -1.43 (-4.36-3.12)%, p = 0.002]. Conclusion: This study did not support a direct correlation of MR-proADM with the MFI at admission in ICU; however, it showed a good correlation between the clearance of MR-proADM, MFI, and other microvascular variables. This study also supported the prognostic value of the marker. Adequately powered studies should be performed to confirm the findings

Baseline recipients’ and donors’ characteristics.

<p>Continuous values are expressed as the mean ± standard error of the mean. LT, liver transplantation; MELD, Model for End-Stage Liver Disease; PBC, primary biliary cirrhosis; ECD, extended criteria donor; DMELD, donor age x recipient MELD.</p

(A) Serum levels of growth hormone (GH) and (B) insulin-like growth factor 1 (IGF-1) before and after liver transplantation.

<p>Values are expressed as the mean ± standard error of the mean. Student’s t test for paired samples was employed to investigate significant differences in hormonal values over time. * p <0.05 compared with the previous value; ^<b>Ω</b> p <0.01 compared with the pre-LT value. <b>Abbreviations:</b> IGF-1, insulin-like growth factor 1; LT, liver transplantation; GH, growth hormone.</p

Differences in insulin-like growth factor 1 (IGF-1) serum levels after liver transplantation according to (A) donor age and (B) extended criteria donor (ECD) score.

<p>Values are expressed as the mean ± standard error of the mean. Student’s t test for unpaired samples was employed to investigate significant differences between hormonal values at different time points. <b>Abbreviations:</b> IGF-1, insulin-like growth factor 1; LT, liver transplantation; ECD, extended criteria donor.</p

Univariate and multivariate analysis of risk factors affecting patient survival.

<p>IGF-1, insulin-like growth factor 1; LT, liver transplantation; ECD, extended criteria donor; DMELD, donor age x Model for End Stage Liver Disease; EAD, early allograft dysfunction; DRI, Donor Risk Index; HCV, hepatitis C virus; HCC, hepatocellular carcinoma; POD, postoperative day.</p

Actual 3-year survival analysis in patients showing normal (solid line) or low (dotted line) IGF-1 plasma levels on postoperative day 15.

<p>Survival differences were investigated by the Log Rank test. <b>Abbreviations:</b> IGF-1, insulin-like growth factor 1; LT, liver transplantation; POD, postoperative day.</p