Similar response patterns to topical minoxidil foam 5% in frontal and vertex scalp of men with androgenetic alopecia: a microarray analysis.

BACKGROUND: There are regional variations in the scalp hair miniaturization seen in androgenetic alopecia (AGA). Use of topical minoxidil can lead to reversal of miniaturization in the vertex scalp. However, its effects on other scalp regions have been less well studied. OBJECTIVES: To determine whether scalp biopsies from men with AGA show variable gene expression before and after 8 weeks of treatment with minoxidil topical foam 5% (MTF) vs. placebo. METHODS: A placebo-controlled double-blinded prospective pilot study of MTF vs. placebo was conducted in 16 healthy men aged 18-49 years with Hamilton-Norwood type IV-V thinning. The subjects were asked to apply the treatment (active drug or placebo) to the scalp twice daily for 8 weeks. Stereotactic scalp photographs were taken at the baseline and final visits, to monitor global hair growth. Scalp biopsies were taken at the leading edge of hair loss from the frontal and vertex scalp before and after treatment with MTF and placebo, and microarray analysis was performed using the Affymetrix GeneChip HG U133 Plus 2.0. RESULTS: Global stereotactic photographs showed that MTF induced hair growth in both the frontal and vertex scalp of patients with AGA. Regional differences in gene expression profiles were observed before treatment. However, MTF treatment induced the expression of hair keratin-associated genes and decreased the expression of epidermal differentiation complex and inflammatory genes in both scalp regions. CONCLUSIONS: These data suggest that MTF is effective in the treatment of both the frontal and vertex scalp of patients with AGA.

[Adult-Onset Still's Disease, an improbable differential diagnosis: a case report]. / Malattia di Still dell'adulto, un'improbabile diagnosi differenziale: caso clinico

Juvenile idiopathic arthritides (JIA) comprehend a heterogeneous group of inflammatory diseases of the joints, with an unknown aetiology, arising within 16 years of age, and lasting more than six weeks. The systemic form, known as Still's disease, represents from 4 to 17% of all the JIA. AOSD (Adult Onset Still's Disease) is a variant of JIA affecting adults, with identical clinical manifestations. Here we describe the case of a 36 year old woman, with a symptomatology characterized by fever, skin rash, arthralgies and lymphadenopathy. The arise of the fever in this case has uncommonly preceded by several weeks the arise of the other signs; this has determined a considerable delay in the diagnosis: Still's disease diagnosis is made hard as it shares its signs and symptoms with several infectious, immunological as well as tumoral diseases. In this case, the blossoming of the laboratory parameters at the sixth day of hospitalization with leucocytosis and neutrophilia represented the solving clue. Still's disease, though a rare nosographic entity, must be kept into consideration in unclear cases occurring in an internal medicine department.

[Atypical onset cryoglobulinemia: case report]. / Crioglobulinemia ad esordio atipico: caso clinico.

Cryoglobulinemia is a disease mediated by antibodies with the property to precipitate at temperatures below 37°C. It can be distinguished into a primitive form (also referred to as 'essential mixed cryoglobulinemia'), and a secondary form. In the essential mixed variant a key role is played by HCV infection. The pathogenesis of mixed cryoglobulinemia is mediated by immune complexes that are the most important cause of the vasculitic phenomena, typical of the disease. However, the severity of the clinical manifestations is not always related to the serum levels of cryoglobulins and immune complexes. In our case report, a 46-year old man came to our observation with asymmetric diffuse and invalidating arthralgies, with both substitutive and additive behaviour, located at pelvic girdle, inferior limbs and elbows, associated to skin lesion vascultis-like. The remote pathological anamnesis was characterized by a previous surgically treated non-Hodgkin lymphoma, and HCV infection. Despite several attempts were done, it was not possible to reveal cryoglobulins, nor reumatoid factor in the serum. Cryoglobulins resulted positive only after the third day of hospitalization, along with a new fever attack and a worsening of the vasculitic manifestations. In conclusion, this case demonstrated that cryoglobulinemia can occur with a totally atypical sequence of clinical manifestations which can be present before and in absence of the typical laboratory proofs.

[Lymphocytes Fox P3 and chronic C hepatitis: preliminary results]. / Ruolo dei linfociti FoxP3 nella infezione cronica da virus C. Risultati preliminari di un protocollo di studio clinico.

OBJECTIVES: Characterization of Treg lymphocytes (CD4+CD25+) in immune response in patients with chronic viral hepatitis C. MATERIALS AND METHODS: Two groups of patients were included: Group A (10 patients with chronic hepatitis C); Group B (10 healthy controls). In both groups, liver markers, liver function tests, lymphocyte typing, serum HCV-RNA were assessed. Liver biopsy was executed in Group A only. Peripheral venous samples were analyzed by citofluorimetric analysis, liver biopsy's samples were studied by immunohistochemistry. RESULTS: Group A patients showed a larger expression of Treg (CD4+CD25+) in peripheral blood than Group B with an ipo-expression of a subpopulation of Treg FoxP3+ (CD4+CD25hi). Group B patients showed a higher ratio (CD4+CD25hi/CD4+CD25+) than Group A. Liver biopsy samples showed a clear positivity for FoxP3+ Treg cells in the inflammatory infiltrated. CONCLUSION: Our study's preliminary results seem to indicate that Treg lymphocytes are really involved in flogistic process in course of chronic hepatitis C. Peripheral blood of infected patients (Group A) shows a low expression of Foxp3+ cells because they are sequestrated in the liver. These cells could be involved in the pathogenesis of the chronic disease and they would be employed how potential agents for a immunomodulatory therapy.

Matrix metalloproteinases and their inhibitors as markers of inflammation and fibrosis in chronic liver disease (Review).

Chronic liver disease (CLD) is a cause of morbidity and mortality worldwide, due to haemodynamic and metabolic complications of liver cirrhosis. During CLD the extracellular matrix undergoes a process of remodelling, leading to new collagen formation and deposition. Tissue remodelling is regulated by fine molecular mechanisms, involving proteases, inhibitors and growth factors. The major role in matrix degradation is played by matrix metalloproteinases (MMPs), a class of zinc and calcium-dependent enzymes, and their tissue inhibitors (TIMPs). Along with the progress in diagnostic techniques, leading to more precise and less invasive methods, the concept of monitoring has gained importance for the clinical management of CLD. At the present state of our knowledge, liver biopsy still represents an essential procedure for staging liver disease. However, despite its importance, liver biopsy presents some limitations: the risk of a disease underestimation is the most significant one, as hepatic lesions are often irregularly located within the liver. Parallel to the limitations of liver biopsy, clinical needs for an early identification of progressive fibrosis require additional non-invasive techniques to be developed. In this review we discuss the major problems concerning this important clinical necessity. Moreover, we focus on the role of MMPs and TIMPs in the pathogenesis of CLD, as well as their possible use as non-invasive serum markers for inflammation and fibrosis in this pathology.

Altered pattern of circulating matrix metalloproteinases -2,- 9 and tissue inhibitor of metalloproteinase-2 in patients with HCV-related chronic hepatitis. Relationship to histological features.

AIM: The aim of this paper was to assess circulating levels of metalloprotease2 (MMP2), metalloprotease9 (MMP9) and tissue inhibitor of metalloprotease2 (TIMP2) in patients with HCV-related chronic hepatitis to verify whether there was a relationship between these molecules and biochemical and histological features. METHODS: Forty-nine neodiagnosed and untreated patients affected by chronic C hepatitis and twenty healthy control subjects were investigated. In overall study series, circulating levels of MMP2, MMP9 and TIMP2 were assessed by ELISA commercial kit (R&D Systems). Patients with chronic hepatitis undergone to liver biopsy and histological features were examined according to Histological Activity Index (HAI). RESULTS: Mean values of MMP2 (1989+/-207 ng/mL. vs 1112+/-120 ng/mL), MMP9 (62.44+/-11.9 ng/mL vs 39.67+/-4.6 ng/mL) and TIMP2 (48.3+/-8.1 ng/mL vs 15.16+/-4.1 ng/mL) were significantly higher (P<0.001) in patients than in controls. Among investigated molecules, only MMP2 was independently related to inflammation and fibrosis according to grading (P=0.036) and staging (P=0.032) score. Moreover, MMP2 but not MMP9 and TIMP2 was related to AST (P=0.015), ALT (P=0.049) and AST/platelet ratio index (P=0.001). No relationship (P>0.05) was found between MMP2 and MMP9 or TIMP2. CONCLUSIONS: Our study confirms an altered pattern of metalloproteases and their tissue inhibitors in subjects with chronic C hepatitis and such alterations can contribute to development of liver fibrosis. In addition MMP2 is related to inflammation and fibrosis as assessed by liver biopsy and laboratory features. The serial detection of MMP2 could help to monitor evolution of disease and to predict onset of cirrhosis.

Meaning of elevated CA 19-9 serum levels in chronic hepatitis and HCV-related cirrhosis.

AIM: Carbohydrate 19-9 antigen (CA 19-9) has been used in the diagnosis and follow-up of gastrointestinal tumors. However, a remarkable reduction of specificity has been described in subjects with chronic diseases. Elevated CA 19-9 serum levels have been described in non neoplastic liver diseases, such as hepatic cirrhosis, where they correlate with the fibrosis grade and the disease severity. The aim of the study is to evaluate CA 19-9 levels in chronic hepatitis patients (CH) and hepatic cirrhosis patients, Hepatitis C Virus (HCV)-correlated. Our goal was to establish whether elevated CA 19-9 levels can be considered a non casual event in chronic liver disease and whether a correlation can be found between CA 19-9 levels and the severity of the disease. METHODS: 116 patients have been recruited (76 m, 40 f, average 54 years); 56 patients were affected by CH and 60 by hepatic cirrhosis (Child A). All patients were HCV+, genotype 1b. Patients positive to CA 19-9 high levels were subjected to abdominal echography, EGDS, colonscopy, abdominal CT. RESULTS: Fifty two percent presented high levels of CA 19-9. None was affected by intestinal or pancreatic neoplasia, or colestatic icterus. CA 19-9 levels were elevated in 46% of patients with chronic hepatitis, and in 54% in patients with hepatic cirrhosis. Furthermore, CA 19-9 levels in hepatic cirrhosis compared to CA 19-9 levels in chronic hepatitis was statistically significant (P>0.007). CONCLUSION: Increased serum levels of CA 19-9 are frequent in chronic viral hepatitis; this often does not indicate a contemporary neoplastic disease and correlates in a statistically significant way (P>0.007) with the severity of the disease.

Metabolism of 1-nitropyrene in mice: transport across the placenta and mammary tissues.

The distribution and metabolism of the environmental pollutant 1-nitropyrene was studied in C57B1/6N mice following oral or intraperitoneal dosing. When administered by gavage, 1-nitropyrene and its metabolites demonstrated biphasic elimination kinetics from the blood, with half-lives of 0.3 and 1.8 days and a distribution volume of 74 ml. Intraperitoneal administration resulted in similar biphasic elimination, with half-lives of 0.5 and 3 days and a distribution volume of 98 ml. Treating pregnant C57B1/6N (C3H sire) mice by gavage resulted in similar absorption and elimination kinetics of 1-nitropyrene and metabolites, except that the distribution volume increased to 123 ml. 1-Nitropyrene and/or its metabolites (0.7% of the administered dose) crossed the placenta and accumulated in the fetuses and amniotic fluid, with both C-oxidized and nitroreduced metabolites being detected. Suckling neonates accumulated 1-nitropyrene and its metabolites when their dams were administered 1-nitropyrene by gavage. Each neonate received approximately 0.1% of the administered dose and demonstrated the presence of both C-oxidized and nitroreduced metabolites. These results demonstrate that this environmental pollutant is capable of crossing the placenta or mammary tissues to expose the offspring to a potentially genotoxic compound.

Mutagenicity of the phenolic microsomal metabolites of 3-nitrofluoranthene and 1-nitropyrene in strains of Salmonella typhimurium.

The environmental pollutant 3-nitrofluoranthene is metabolized in vitro and in vivo to several products including the phenolic metabolites 3-nitrofluoranthen-6-ol (3NF-6-ol), 3-nitrofluoranthen-8-ol (3NF-8-ol), and 3-nitrofluoranthen-9-ol (3NF-9-ol). Similarly, 1-nitropyrene is metabolized to the phenolic metabolites 1-nitropyren-3-ol (1NP-3-ol), 1-nitropyren-6-ol (1NP-6-ol), and 1-nitropyren-8-ol (1NP-8-ol). The mutagenicity of these compounds was investigated using strains of Salmonella typhimurium deficient in either certain nitroreductases or the aryl hydroxylamine O-esterificase. In TA98, 3-nitrofluoranthene and 3NF-8-ol were equally mutagenic at approximately 10(3) revertants/nmole while 3NF-6-ol and 3NF-9-ol were 10-fold less mutagenic. 1-Nitropyrene and 1NP-3-ol likewise were equally mutagenic at approximately 700 revertants/nmole and 1NP-6-ol and 1NP-8-ol were 100-fold less mutagenic. The mutagenicity of 1-nitropyrene was dependent on the 'classical nitroreductase' which is absent in TA98NR, and that of 3-nitrofluoranthene, 3NF-8-ol, and 1NP-3-ol was less dependent on this nitroreductase. Using TA98/1,8DNP6, it was determined that the mutagenicity of 3-nitrofluoranthene, 3NF-8-ol, and 1NP-3-ol but not 1-nitropyrene was dependent on the presence of the O-esterificase. 3-Nitrofluoranthene and 3NF-8-ol were mutagenic in TA100, while 3NF-6-ol and 3NF-9-ol were considerably less mutagenic. 3-Nitrofluoranthene was not mutagenic in TA100NR nor in TA100-Tn5-1,8DNP1012. None of the phenolic metabolites of 3-nitrofluoranthene were mutagenic in TA100-TN5-1,8DNP1012 indicating a strong dependence for mutagenicity on the O-esterificase or the 1,8-dinitropyrene nitroreductase which is absent in this strain. These results are discussed in view of possible mechanisms for the differences in the mutagenicity of the phenolic metabolites of these two nitrated arenes.

Liver microsomal metabolism of the environmental carcinogen 3-nitrofluoranthene. I. Phenolic metabolites.

The liver microsomal metabolism of the environmental carcinogen 3-nitrofluoranthene has been investigated. Five phenolic metabolites were isolated and characterized by their mass and NMR spectra as: 3-nitrofluoranthen-1-ol, 3-nitrofluoranthen-6-ol, 3-nitrofluoranthen-(7 or 10)-ol, 3-nitrofluoranthen-8-ol and 3-nitrofluoranthen-9-ol. While the microsomes isolated from Sprague-Dawley rat liver and C57B16 mouse liver preferentially metabolized the 3-nitrofluoranthene to 3-nitrofluoranthen-8-ol and 3-nitrofluoranthen-9-ol, the microsomes from Hartley guinea-pig liver preferentially metabolized 3-nitrofluoranthene to 3-nitrofluoranthen-6-ol. 3-Nitrofluoranthen-1-ol was a minor metabolite in each of the incubations. The results indicate the presence of the nitro group on fluoranthene directs the metabolism away from the C1-C5 positions, and more towards the C6-C10 positions.

Differing effects of chronic ethanol consumption by mice on liver microsomal metabolism of xenobiotics: 1-nitropyrene, nicotine, aniline, and N-nitrosopyrrolidine.

The effect of ethanol consumption by male CF-1 mice on liver microsomal enzyme activities has been investigated. The total microsomal cytochrome P-450 content was increased by 38%, while cytochrome b5 was decreased by 31%, which are characteristic alterations in liver microsomes following ethanol consumption. Other alterations included a decreased NADPH cytochrome c reductase activity and increased NADPH-supported rates of N-nitrosopyrrolidine and aniline hydroxylation. While ethanol consumption did not alter the total metabolism of nicotine, the rates of N- and C-hydroxylation were differently affected. The 5'-hydroxylation of nicotine was increased by 83%, while the N'-oxidation was decreased by 31%. Changes in the microsomal metabolism of the environmental carcinogen 1-nitropyrene included a slight reduction in the overall metabolism, which can be accounted for by a reduction in the formation of one phenolic metabolite, 1-nitropyren-3-ol.