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Future issues throughout gastroenterology and hepatology, among improvements and also unmet wants: Any SIGE Youthful Editorial Board's point of view.
Until recently, step-up therapy in atopic dermatitis (AD) included primarily off-label use of phototherapy, systemic immunosuppressants and/or corticosteroids. These broadly impact the immune system and show efficacy across a gamut of inflammatory skin diseases, albeit with potential serious adverse-events. Recently, dupilumab was approved as the first biologic agent in AD and demonstrated better efficacy and safety than prior off-label therapies. This article is protected by copyright. All rights reserved.Interleukin (IL) - 17 inhibitors are increasingly used to treat psoriasis and psoriatic arthritis (PsA). There are presently three approved IL-17 inhibitors ixekizumab and secukinumab block IL-17A while brodalumab targets IL-17Rα (IL-17 receptor). Therapeutic monoclonal antibodies are known to occasionally paradoxically induce inflammatory diseases through poorly understood mechanism(s). selleck chemical Perhaps the most well-known example is TNF-α inhibitor induced psoriasis. Here we describe three patients that developed or had worsening of sarcoidosis while taking an IL-17 inhibitor. This article is protected by copyright. All rights reserved.Psoriasis is a chronic inflammatory disease, affecting up to 4% of the population.1 Despite the mounting evidence of increased rate of malignancy in psoriatics, studies report conflicting results on the specific types of cancer seen in this population.1-4 To provide insight into the risk of malignancy among psoriatics, we performed a retrospective population-based cohort study using a nationally-representative sample of the U.S. population. We further compared our results from the national database to a large cohort of patients seen at a tertiary level academic center. This article is protected by copyright. All rights reserved.Psoriasis is a chronic inflammatory disease associated with risk factors such as obesity, and tobacco smoking, and significant comorbidity including diabetes or periodontitis (1). Depression, bipolar mood disorder, anxiety, psychosis, cognitive impairment, personality disorders, eating disorders, and suicidal ideation have been linked to psoriasis (2). Because psoriasis does not manifest on mucosal surfaces the oral cavity is rarely inspected during routine dermatological investigations. This article is protected by copyright. All rights reserved.OBJECTIVE The study of cortical gyrification in Alzheimer's disease (AD) could help to further understanding of the changes undergone in the brain during neurodegeneration. Here we aimed to study brain gyrification differences between healthy controls (HC), mild cognitive impairment (MCI) patients, and AD patients, and explore how cerebral gyrification patterns were associated with memory and other cognitive functions. METHODS We applied surface-based morphometry techniques in two large, independent cross-sectional samples, obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) project. Both samples, encompassing a total of 1,270 participants, were analyzed independently. RESULTS Unexpectedly, we found that AD patients presented a more gyrificated entorhinal cortex than HC. Conversely, the insular cortex of AD patients was hypogyrificated. A decrease in the gyrification of the insular cortex was also found in older HC participants as compared with younger HC, which argues against the specificity of this finding in AD. However, an increased degree of folding of the insular cortex was specifically associated with better memory function and semantic fluency, only in AD patients. Overall, MCI patients presented an intermediate gyrification pattern. All these findings were consistently observed in the two samples. INTERPRETATION The marked atrophy of the medial temporal lobe observed in AD patients may explain the increased folding of the entorhinal cortex. We additionally speculate with alternative mechanisms that may also alter its folding. The association between increased gyrification of the insular cortex and memory function, specifically observed in AD, could be suggestive of compensatory mechanisms to overcome the loss of memory function. This article is protected by copyright. All rights reserved.Replacement therapy with plasma-derived or recombinant FVIII and FIX (pdFVIII/pdFIX or rFVIII/rFIX) concentrates is the standard of treatment in patients with hemophilia A and B respectively. Measurement of factor VIII (FVIIIC) or factor IX (FIXC) levels can be done by one-stage clotting assay (OSA) or chromogenic substrate assay (CSA). The French study group on the Biology of Hemorrhagic Diseases (a collaborative group of the GFHT and MHEMO network), presents a literature review and proposals for the monitoring of FVIIIC and FIXC levels in treated Hemophilia A and B patients respectively. The use of CSA is recommended for the monitoring of patients treated with pdFVIII or rFVIII including extended half-life (EHL) rFVIII. Execpt for rFVIII-Fc, great caution is required when measuring FVIIIC levels by OSA in patients substituted by EHL-rFVIII. The OSA is recommended for the monitoring of patients treated with pdFIX or rFIX. Large discordances in the FIXC levels measured for extended half-life rFIX (EHL-rFIX), depending on the method and reagents used, must lead to great attention when OSA is used for measuring FIXC levels in patients substituted by EHL-rFIX. Data of most of recent studies, obtained with spiked plasmas, deserve to be confirmed in plasma samples of treated patients. This article is protected by copyright. All rights reserved.AIMS Both maternal microbiota and helminth infection may alter offspring immunity but the relationship between these is underexplored. We hypothesized that maternal helminth exposure prior to pregnancy has lasting consequences on offspring intestinal microbiota and consequent immunity. METHODS Female BALB/c adult mice were infected with 500L3 Nippostrongylus brasiliensis (N.b). Infection was cleared by Ivermectin treatment and mice mated three weeks post infection (NbM). Control mice were not infected but were exposed to Ivermectin (NvM). We analyzed maternal gut microbiota during pregnancy, breastmilk microbiota as well as offspring fecal microbiota and immunity two weeks after delivery. RESULTS During pregnancy, NbM displayed significantly altered stool bacterial communities (R2=0.242; p=0.001), with increased abundance of Enterococcaceae versus NvM. Similarly, we observed a profound impact on breastmilk microbiota in NbM vs NvM. Moreover, NbM pups showed significantly altered gut microbial communities at 14 days of age versus those born to NvM with increased relative abundance of Coriobacteriaceae and Micrococcaceae.
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