Breastfeeding Increases the Expression of TLR4, TNF-α, CCL2, and CCL3 in the Prepuce Tissue of Neonates.

INTRODUCTION: Innate immunity plays a significant role in the tissue repair process. It is well documented that breastfeeding may alter immune responses. Thus, this study was designed to evaluate the effects of breastfeeding on the levels of TLR1-4, TNF-α, TGF-ß, CCL2, and CCL3 in the prepuce tissue of neonates. MATERIAL AND METHODS: This study was conducted on 90 samples of prepuce tissue obtained from neonates (45 neonates who were breastfed with human milk [HM] and 45 neonates who were not breastfed and received non-human milk [NHM]). The tissues were homogenized and mRNA levels of TLR1-4 and protein levels of TNF-α, TGF-ß, CCL2, and CCL3 were analyzed using Real-Time PCR and ELISA techniques, respectively. RESULTS: Protein levels of TNF-α, CCL2 and CCL3, and mRNA levels of TLR4 were significantly lower in the NHM neonates than in the HM neonates. There was a significant negative correlation between duration of pregnancy and mRNA levels of TLR1 in the NHM neonates. CONCLUSION: These results indicate that breastfeeding may be associated with the regulated expression of TLR4 and its related cytokines/chemokines and that it may improve wound healing and aid in the fight against pathogens.

A brief look at the role of monocyte chemoattractant protein-1 (CCL2) in the pathophysiology of psoriasis.

Psoriasis (PsO) is a chronic skin disorder resulting from the imbalanced interactionbetween infiltrating immune cells and keratinocytes. These immune cells, including monocytes, are able to mediate the immune responses in inflamed skin lesions. Chemokines are responsible for the recruitment of leukocytes to sites of inflammation. In patients with PsO, the keratinocytes are the main source of monocyte chemotactic protein 1 (MCP-1/CCL2), which is a CC chemokine. After CCL2 binds to the chemokine receptor CCR2, which mainly is expressed on the surface of monocytes, the monocytes differentiate into macrophages and migrate from the blood stream to sites of inflammation. This process can cause the formation of lesions. Accordingly, it has been hypothesized that CCL2 could be a potential biomarker to monitor the progression of PsO. Thus, evidence suggests that there could be a potential role for CCR2 and CCL2 during treatment of PsO and to prevent its further development. For example, to modify the course of PsO, efforts have been made to inhibit or modulate the CCR2/CCL2 axis. However, before exploring the targeting of the CCR2/CCL2 axis in a clinical setting, better understanding of the different molecular aspects of PsO is required.

Corrigendum to "Topical Colchicine Gel versus Diclofenac Sodium Gel for the Treatment of Actinic Keratoses: A Randomized, Double-Blind Study".

[This corrects the article DOI: 10.1155/2016/5918393.].

Topical Colchicine Gel versus Diclofenac Sodium Gel for the Treatment of Actinic Keratoses: A Randomized, Double-Blind Study.

Introduction. Actinic keratoses (AKs), a premalignant skin lesion, are a common lesion in fair skin. Although destructive treatment remains the gold standard for AKs, medical therapies may be preferable due to the comfort and reliability .This study aims to compare the effects of topical 1% colchicine gel and 3% diclofenac sodium gel in AKs. Materials and Methods. In this randomized double-blind study, 70 lesions were selected. Patients were randomized before receiving either 1% colchicine gel or 3% diclofenac sodium cream twice a day for 6 weeks. Patients were evaluated in terms of their lesion size, treatment complications, and recurrence at 7, 30, 60, and 120 days after treatment. Results. The mean of changes in the size was significant in both groups both before and after treatment (<0.001). The mean lesion size before treatment and at 30, 60, and 120 days was not different between the two groups (p > 0.05). No case of erythema was seen in the colchicine group, while erythema was seen in 22.9% (eight cases) of patients in the diclofenac sodium group (p = 0.005). Conclusions. 1% colchicine gel was a safe and effective medication with fewer side effects and lack of recurrence of the lesion.

Comparison effect of azithromycin gel 2% with clindamycin gel 1% in patients with acne.

BACKGROUND: Acne vulgaris is the most common skin disease. Local and systemic antimicrobial drugs are used for its treatment. But increasing resistance of Propionibacterium acnes to antibiotics has been reported. MATERIALS AND METHODS: In a double-blind clinical trial, 40 patients with mild to moderate acne vulgaris were recruited. one side of the face was treated with Clindamycin Gel 1% and the other side with Azithromycin Topical Gel 2% BID for 8 weeks and then they were assessed. RESULTS: Average age was 21. 8 ± 7 years. 82.5% of them were female. Average number of papules, pustules and comedones was similarly reduced in both groups and, no significant difference was observed between the two groups (P > 0.05, repeated measurs ANOVA). The mean indexes of ASI and TLC also significantly decreased during treatment in both groups, no significant difference was observed between the two groups. (P > 0.05, repeated measurs ANOVA). Also, impact of both drugs on papules and pustules was 2-3 times greater than the effect on comedones. Average satisfaction score was not significant between the two groups (P = 0.6, repeated measurs ANOVA). finally, frequency distribution of complications was not significant between the two groups (P > 0.05, Fisher Exact test). CONCLUSION: Azithromycin gel has medical impact at least similar to Clindamycin Gel in treatment of mild to moderate acne vulgaris, and it may be consider as suitable drug for resistant acne to conventional topical therapy.

Treatment of Primary Axillary Hyperhidrosis by Fractional Microneedle Radiofrequency: Is it Still Effective after Long-term Follow-up?

BACKGROUND: Primary axillary hyperhidrosis (PAH) is a chronic idiopathic disorder causing major stress in patients. Among the common therapies for PAH, only surgical interventions have proven feasible as a permanent solution. OBJECTIVE AND AIM: The aim of this study was to evaluate the efficacy and safety of fractional microneedle radiofrequency (FMR) as an alternative permanent treatment for PAH with long-term follow-up. MATERIALS AND METHODS: This was a single-blind, sham-controlled comparative study. Twenty-five patients with severe PAH were provided three treatments of FMR at 3-week intervals (the treatment group), and a control group was provided the sham treatment. Clinical efficacy was evaluated using the hyperhidrosis disease severity scale (HDSS) at baseline and the end of the study, as well as during the 1 year follow-up phase. RESULTS: HDSS demonstrated significant improvement after treatment in the treatment group compared to the sham control. The mean (±standard deviation) of HDSS in the group being treated with radiofrequency was 2.50 (±0.88) after 1 year follow-up, and that of the control group was 3.38 (±0.49; P < 0.001). Follow-up results show that there were 10 patients (41.6%) with no relapse and 11 patients (45.9%) with relapse after 1 year. There was a significant correlation between HDSS changes in relapse and body mass index (BMI) (P = 0.03). CONCLUSION: Treatment of PAH with FMR is a safe and noninvasive procedure with a positive therapeutic effect on HDSS. It is recommended, however, that sessions of FMR be repeated after 1 year, particularly in overweight patients with high BMIs. CLINICAL TRIAL REGISTRATION: IRCT2013111915455N1. LEVEL OF EVIDENCES: Level II-1.

Promising Option for Treatment of Striae Alba: Fractionated Microneedle Radiofrequency in Combination with Fractional Carbon Dioxide Laser.

Background. A consistent treatment has not been proposed for treatment of Striae Alba (SA). The present study was designed to compare the fractionated microneedle radiofrequency (FMR) alone and in combination with fractional carbon dioxide laser (FMR + CO2) in the treatment of SA. Methods. Forty-eight pairs of SA from six patients were selected. Right or left SAs were randomly assigned to one of the treatment groups. The surface area of the SA before and after treatment and clinical improvement using a four-point scale were measured at the baseline, after one and three months. Results. The mean age of the patients was 30.17 ± 5.19 years. The mean difference of the surface area between pre- and posttreatment in the FMR + CO2 group was significantly higher than that in the FMR group (p = 0.003). Clinical improvement scales showed significantly higher improvement in the FMR + CO2 group than in the FMR group in the first and second follow-up (p = 0.002 and 0.004, resp.). There were no major persistence side-effects in both groups. Conclusions. The results showed that FMR + CO2 laser was more effective than FMR alone in the treatment of SA.

Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: A split-face randomized clinical trial.

BACKGROUND: Autologous platelet-rich plasma has recently attracted significant attention throughout the medical field for its wound-healing ability. AIMS: This study was conducted to investigate the potential of platelet-rich plasma combined with fractional laser therapy in the treatment of acne scarring. METHODS: Sixteen patients (12 women and 4 men) who underwent split-face therapy were analyzed in this study. They received ablative fractional carbon dioxide laser combined with intradermal platelet-rich plasma treatment on one half of their face and ablative fractional carbon dioxide laser with intradermal normal saline on the other half. The injections were administered immediately after laser therapy. The treatment sessions were repeated after an interval of one month. The clinical response was assessed based on patient satisfaction and the objective evaluation of serial photographs by two blinded dermatologists at baseline, 1 month after the first treatment session and 4 months after the second. The adverse effects including erythema and edema were scored by participants on days 0, 2, 4, 6, 8, 15 and 30 after each session. RESULTS: Overall clinical improvement of acne scars was higher on the platelet-rich plasma-fractional carbon dioxide laser treated side but the difference was not statistically significant either 1 month after the first treatment session (P = 0.15) or 4 months after the second (P = 0.23). In addition, adverse effects (erythema and edema) on the platelet-rich plasma-fractional carbon dioxide laser-treated side were more severe and of longer duration. LIMITATIONS: Small sample size, absence of all skin phototypes within the study group and lack of objective methods for the evaluation of response to treatment and adverse effects were the limitations. CONCLUSION: This study demonstrated that adding platelet-rich plasma to fractional carbon dioxide laser treatment did not produce any statistically significant synergistic effects and also resulted in more severe side effects and longer downtime.