Genetic causal relationship between immune diseases and migraine: a Mendelian randomization study.

Background: Migraine has an increased prevalence in several immune disorders, but genetic cause-effect relationships remain unclear. Mendelian randomization (MR) was used in this study to explore whether immune diseases are causally associated with migraine and its subtypes. Methods: We conducted a two-sample bidirectional multivariate Mendelian randomization study. Single-nucleotide polymorphisms (SNP) for six immune diseases, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), type 1 diabetes mellitus (T1D), allergic rhinitis (AR), asthma and psoriasis, were used as genetic instrumental variables. Summary statistics for migraine were obtained from 3 databases: the International Headache Genetics Consortium (IHGC), UK Biobank, and FinnGen study. MR analyses were performed per outcome database for each exposure and subsequently meta-analyzed. Reverse MR analysis was performed to determine whether migraine were risk factors for immune diseases. In addition, we conducted a genetic correlation to identify shared genetic variants for these two associations. Results: No significant causal relationship was found between immune diseases and migraine and its subtypes. These results were robust with a series of sensitivity analyses. Using the linkage disequilibrium score regression method (LDSC), we detected no genetic correlation between migraine and immune diseases. Conclusion: The evidence from our study does not support a causal relationship between immune diseases and migraine. The mechanisms underlying the frequent comorbidity of migraine and several immune diseases need to be further elucidated.

Jianpi-Yangxue-Jiedu decoction improves the energy metabolism of psoriasis mice by regulating the electron transfer of oxidative phosphorylation.

ETHNOPHARMACOLOGICAL RELEVANCE: The inflammatory skin condition psoriasis is immune-related. The decoction of Jianpi-Yangxue-Jiiedu (JPYX) is a useful medication for psoriasis. However, the underlying mechanics of JPYX have not yet been clarified. AIM OF THE STUDY: The objective of this study was to investigate the mechanism underlying the efficacy of JPYX in the treatment of psoriasis in the context of a high-fat diet. MATERIALS AND METHODS: This work generated a high-fat feeding model of imiquimod (IMQ)-induced psoriasis-like lesion mice. The blood composition of JPYX was examined using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The mechanism of JPYX decoction for treating psoriasis was predicted using methods of network pharmacology, metabolomics, and transcriptomics. RESULTS: JPYX prevented the release of inflammatory cytokines, decreased keratinocyte proliferation, enhanced the percentage of Treg cells in the skin, lymph nodes, and thymus, and greatly alleviated psoriatic lesions. Network pharmacology predicted that IL-1ß, TNF, STAT3, and EGFR may be potential targets, and KEGG results showed that PI3K-AKT-mTOR may be a potential mechanism of action. Verification of experimental data demonstrated that the JPYX decoction dramatically decreased mTOR and AKT phosphorylation. According to metabolomics analysis, amino acids and their metabolites, benzene and its substitutes, aldehyde ketone esters, heterocyclic compounds, etc. were the primary metabolites regulated by JPYX. KEGG enrichment analysis of differential metabolites was performed. Fatty acid biosynthesis, Type I polyketide structures, Steroid hormone biosynthesis, Biosynthesis of unsaturated fatty acid, etc. Transcriptomic results showed that JPYX significantly regulated skin development, keratinocyte differentiation, and oxidative phosphorylation. Further experimental data verification showed that JPYX decoction significantly reduced the mRNA levels of mt-Nd4, mt-Nd5, mt-Nd1, Ifi205, Ifi211, and mt-Atp8. CONCLUSIONS: JPYX may improve psoriasis by regulating the metabolic pathways of fatty acids and electron transport of oxidative phosphorylation.

Botanical extracts in combination improve autosomal recessive woolly hair/hypotrichosis caused by LIPH mutations.

BACKGROUND: Mutation in the lipase H (LIPH) gene is a main reason for autosomal recessive woolly hair (ARWH)/hypotrichosis. Although some studies reported that topical minoxidil could improve ARWH, an effective treatment method for this disease is still lacking. AIM: We attempt to explore potential treatment options for ARWH. MATERIALS & METHODS: A female 6-year-old child was diagnosed with ARWH/hypotrichosis caused by LIPH mutations. And she was treated with combined treatment of botanical extracts. RESULTS: After 6 months of treatment, the patient's hair grew remarkably. After 4 years of treatment, the patient's hair remained dense. DISCUSSION: After the combination treatment, the patient saw a favorable clinical effect. However, the specific mechanisms of action for botanical extracts require further validation. In addition, some regenerative strategies may be considered as potential treatment options for ARWH. We should actively attempt treatment for ARWH patients and encourage prenatal diagnosis due to the great impact of hair loss. CONCLUSION: The combined therapy of botanical extracts may improve ARWH long-term with a sustainable therapeutic effect.

A Case of Acute Telogen Effluvium After SARS-CoV-2 Infection.

As the number of COVID-19 cases increasing, more and more patients are concerning about alopecia, a sequela after SARS-CoV-2 infection. We here report a case of a 38-year-old woman with a typical acute telogen effluvium (ATE) after recovery from COVID-19.

Multi-stage surgery combined with radiotherapy for treatment of giant anterior chest wall keloid: A case report.

RATIONALE: Giant keloids often have indications for surgical resection, but postoperative reconstruction of the skin and high recurrence of keloids are a challenge for clinical treatment. This article reports a rare successful treatment of a giant keloid in the anterior chest wall by multistage surgery combined with radiotherapy, which is why this case is meaningful. PATIENT CONCERNS: A 66-year-old woman presented a giant keloid with ulcerations and severe itching on the anterior chest wall. She had a history of keloid disease for more than 10 years, and had been treated by multiple operations, with no success. DIAGNOSES: The patient was diagnosed as keloid based on her history and symptoms. Histopathology findings supported our diagnosis. INTERVENTIONS: We successfully excised the keloid after 5 operations and 2 rounds of electron-beam radiotherapy, which was applied at 24 hours after the 4th and 5th operation. OUTCOMES: There was no sign of recurrence over the follow-up period of 24 months. LESSONS: The combination of multistage surgery and radiotherapy presents as a good choice for the treatment of giant keloids.