Atrophic Form Research Articles

Oral health-related quality of life in different clinical forms of oral lichen planus.

The aim of the study was to determine the prevalence of clinical forms in a group of oral lichen planus (OLP) patients and to investigate whether the oral health-related quality of life (OHRQoL) of patients with common clinical OLP forms differs significantly from that of other clinical forms of OLP and healthy patients, respectively. OHRQoL was assessed using the Romanian version of the short form of the Oral Health Impact Profile (OHIP-14). OLP patients rated the pain they were currently experiencing on a visual analog scale (VAS). Statistics was performed using parametric and non-parametric tests and multiple linear regression. Eighty OLP patients and 80 healthy controls were enrolled. The most prevalent OLP clinical form was keratotic form (n = 39, 48.75%, group 1), followed by atrophic (31.25%), erosive-ulcerative (17.5%), and bullous (2.5%) forms, which were included in group 2 (n = 41). The OHRQoL did not differ significantly between group 1 and the other two groups. A negative social impact was reported on psychological discomfort domain for both OLP groups, as compared with healthy controls. VAS scores were significantly associated with OHIP total scores in group 1 (rho = 0.41, n = 39, p = 0.009, Spearman's correlation coefficient). Within the same group, significantly higher OHIP total scores were recorded in patients lacking academic education (p = 0.0086, Mann-Whitney U test). Overall, the most common clinical OLP form did not impact significantly the OHRQoL of OLP patients. Psychological therapy and meeting the educational needs might improve the OHRQoL of patients with common clinical forms of OLP.

SUN-LB096 Hoffman Syndrome in Postpartum Thyroiditis

Introduction Hoffman’s syndrome is an extremely rare, potentially treatable, form of myopathy requiring high clinical suspicion for diagnosis with routine measurement of serum TSH. Presenting with increased muscular mass (pseudohypertrophy), proximal muscle weakness, stiffness, and cramping it may be complicated by renal failure and ATN. Calf muscles are typically affected in Hoffman’s; however, patient presented postpartum with proximal upper limb involvement. Case Presentation Caucasian 23 year old female presented with fatigue, generalized weakness, and severe muscle aches only bilaterally in upper extremities with low grade fever and numbness in arms and legs for 5 weeks, preceded by upper respiratory infection treated with Levaquin with no improvement. Her past medical history is significant for asthma and seasonal allergies. She had a normal vaginal delivery and gave birth to a full term healthy baby 4 months prior to this presentation. She had no symptoms of diplopia, ptosis, difficulty chewing, dysphagia, urinary or bowel function changes. Examination showed a well nourished, average height, normocephalic, with BMI of 31, no periorbital swelling, normal thyroid, cardiac, and respiratory exam. Musculoskeletal exam showed bilateral upper arm pseudohypertrophy and severe weakness with 2+ strength, with normal straight leg raise test. Labs showed TSH markedly elevated at 603.02, T3 uptake 21.6, total T4 0.5, and T7 extremely low at 0.1. CPK was 1,800. Liver function tests were nonspecific for transaminitis with SGOT 63 and SGPT 1529, creatinine and BUN were normal. Antinuclear antibody tested negative. Acetylcholine receptor binding antibody was less than 0.8 nmol per liter. Thyroid peroxidase autoantibodies > 1,000 IU per ml. Erythrocyte sedimentation rate was 9. Thyroid sonogram showed mildly enlarged heterogenous thyroid gland with no nodules, approximately 3.8x1.0x1.0cm on the right and 4.0x1.0x1.0cm on the left. Electromyography demonstrated trace fibrillations with increased muscle discharge, paramyotonic pattern, and delayed relaxation phase. By exclusion, diagnosis of severe hypothyroidism with neuromuscular dysfunction was made. Patient started 50mcg levothyroxine with profound improvement. Discussion There are 4 subtypes of myopathy associated with hypothyroidism: Hoffmann’s syndrome, myasthenic syndrome, atrophic form, and Kocher-Debre-Semelaigne syndrome (pediatric form of myopathy). The pathophysiology is explained by reduced glycolysis and oxidative phosphorylation within the muscle tissue, with decrease in ATP phosphorylation beyond a critical limit, generating a marked release in CPK. Lab findings include CK, TSH, FT3, FT4, FT7, TgAb, and TPOAb (determine the autoimmune links). EMG and electroneurography assess the degree of peripheral nerve impairment. Muscle MRI may differentiate hypothyroid myopathy from muscular dystrophy Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

Effects of ultraviolet treatment and alendronate immersion on osteoblast-like cells and human gingival fibroblasts cultured on titanium surfaces

In this study, we evaluated the effects of ultraviolet (UV) treatment and alendronate (ALN) immersion on the proliferation and differentiation of MG-63 osteoblast-like cells and human gingival fibroblasts (HGFs) cultured on titanium surfaces. MG-63 cells were used for sandblasted, large grit, and acid-etched (SLA) titanium surfaces, and HGFs were used for machined (MA) titanium surfaces. SLA and MA specimens were subdivided into four groups (n = 12) according to the combination of surface treatments (UV treatment and/or ALN immersion) applied. After culturing MG-63 cells and HGFs on titanium discs, cellular morphology, proliferation, and differentiation were evaluated. The results revealed that UV treatment of titanium surfaces did not alter the proliferation of MG-63 cells; however, HGF differentiation and adhesion were increased in response to UV treatment. In contrast, ALN immersion of titanium discs reduced MG-63 cell proliferation and changed HGFs into a more atrophic form. Simultaneous application of UV treatment and ALN immersion induced greater differentiation of MG-63 cells. Within the limitations of this cellular level study, simultaneous application of UV treatment and ALN immersion of titanium surfaces was shown to improve the osseointegration of titanium implants; in addition, UV treatment may be used to enhance mucosal sealing of titanium abutments.

Acute and chronic laryngitis in the subjects engaged in the voice and speech professions

Laryngitis is one of the commonest causes of dysphonia in the subjects engaged in the voice and speech professions. This condition can be either associated with the professional activities or related to voice fatigue. It is a common practice to distinguish between acute and chronic forms of occupational laryngitis. The main factors responsible for development of both conditions include the non-observance of directions concerning the protection and hygiene of the speaking and singing voice. The present study included 478 (100%) subjects engaged in the voice and speech professions presenting with the diagnosis of acute or chronic occupational laryngitis who applied for medical assistance to our Phoniatric Care Department. The clinical state of their larynx was evaluated with the use of the videoendostroboscopic technique. Acute laryngitis was diagnosed in 103 (21.5%) of the examined subjects while the remaining 375 (78.5%) ones presented with chronic laryngitis. A characteristic feature of acute occupational laryngitis documented in 38 (36.9%) examined professional voice users with this condition (practically healthy in all other respects) was the development of this disorder as a result of overloading the speech organs. On the contrary, viral and/or bacterial laryngitis revealed in 65 (63.1%) of the patients was preceded by acute respiratory symptoms. A total of 62 (16.5%) patients suffered from chronic occupational laryngitis attributable to overloading of the organs of speech during protracted periods. The remaining 313 examined professional voice users were found to present with various forms of chronic laryngitis including catarrhal laryngitis in 175 (46.7%) of them, edematous-polypoid and atrophic forms in 32 (8.5%) and 19 (5.1%) subjects respectively. The main etiological factors underlying the development of all the tree forms of chronic laryngitis were smoking, chronic tonsillitis, gastroesophageal reflux disease, bronchial asthma, and diabetes mellitus.

Clinical profile of 102 patients with oral lichen planus in Thailand.

BackgroundOral lichen planus (OLP) is a chronic inflammatory disease of the skin and mucous membrane presented with various clinical appearances. The aim of the present study was to elucidate the clinical profile of patients with OLP.Material and MethodsThe dental records of 102 patients who visited Oral Medicine Clinic, Dental Hospital, Naresuan University during 2002-2018 were retrospectively reviewed.ResultsThere were 75 (73.5%) women and 27 (26.5%) men, giving a female to male ratio of 2.8:1. The age of OLP patients ranged 20-81 years old with the mean age of 56.4 ± 13.2 years old. Seventy-eight patients (76.5%) had the history of systemic diseases and hypertension was the predominantly one. Most patients were non-smokers (98%), non-drinkers (86.3%) and non-betel nut chewers (98%). The atrophic form (93.1%) was the most common OLP. The lesions were mainly symptomatic (92.2%) and involved multiple locations (67.6%) where the buccal mucosa (79.4%) primarily affected. Only 2% were extraoral lesions detected on the skin. Patients had no family history of OLP or malignant transformation. Ninety-one patients (89.2%) were treated with topical steroid and only 4 patients were prescribed a combination of tropical and systemic steroid.ConclusionsThe results of the study indicated that most of characteristics are in accordance with previous studies. Since, OLP is a chronic inflammatory oral mucosal disease with high recurrence rate, early detection, accurately diagnosis, and long-term follow-up are necessary to evaluate the exacerbation and malignant transformation. Key words:Clinical profile, demographic, oral lichen planus, retrospective study.

Oral Lichen Planus-Treatment Planning

Lichen planus, a chronic autoimmune disease, affects the skin and mucous membrane. It is believed to represent an abnormal immune response in which epithelial cells are recognized as foreign, secondary to changes in the antigenicity of the cell surface. It is characterized by alternating periods of symptomatic remission and exacerbation. It has various oral manifestations, the reticular form being the most common. The erosive and atrophic forms of OLP are less common, yet are most likely to cause symptoms. Different treatment modalities have been tried with limited success. Topical corticosteroids constitute the mainstay of treatment for symptomatic lesions of OLP. Recalcitrant lesions can be treated with systemic steroids or other systemic medications. However, there is only weak evidence that these treatments are superior to placebo. The main objective of this paper is to review the current literature regarding the treatment of OLP.

Humoral factors of innate immunity in the saliva of patients with infectious inflammatory respiratory diseases

Introduction: In recently ears factors of innate immunity both cellular and humoral have been paid considerable attention as they are a protective barrier of a fast response and that is why they are largely concentrated at the intersection of the digestive tract and airways. The data concerning the activity level of factors of innate immunity in the upper airways affected by nonspecific inflammatory processes is insufficient and sparse and therefore the purpose of this research was to study the content of humoral factors of innate immunity in the oropharyngeal secretion (ORS) of patients with chronic infectious inflammatory diseases of the upper airways in remission. Materials and Methods: There was an examination of 16 patients with chronic rhinosinusitis (CRS) of bacterial genesis (15-40 years old), 12 patients with rhinopharyngitis of post-viral genesis (8-16 years old), 12 people with scleroma from 30 tо 52 years of age (atrophic form), 10 patients with chronic tonsillitis in remission (from 10 to 33 years of age) and 11 patients of a control group (practically healthy donors from 12 tо 40 years of age). The content of MIP-1b, defensin-1β, lactoferrin, lysozyme, α-interferon was studied in the nonstimulated OPS. Statistics were carried out using Mann-Whitney U-test. Results: The greatest number of deviations in the decrease in the content of the examined nonspecific protective factors was found in cases of scleroma, chronic tonsillitis and chronic rhinosinusitis (p<0,05). The lack of protective humoral factors of innate immunity can be evidence of local immunodeficiency even in remission, which is a pathophysiological component of the maintenance of chronic inflammation. Conclusion: The decrease int he quantitative composition of factors of innate immunity in the oropharyngeal secretion of patients with chronic infectious inflammatory diseases of the airways is an objective ground not only for a replacement therapy, but also for the use of immune response modifiers from photo-immune modulators to “genuine immune modulators” controlling the state of the factors of both innate immunity and immunoglobulins, primarily of secretory type, the level and functionality of various groups of immunocompetent and accessory cells.

A non-retinoid antagonist of retinol-binding protein 4 rescues phenotype in a model of Stargardt disease without inhibiting the visual cycle.

A primary pathological defect in the heritable eye disorder Stargardt disease is excessive accumulation of cytotoxic lipofuscin bisretinoids in the retina. Age-dependent accumulation of lipofuscin in the retinal pigment epithelium (RPE) matches the age-dependent increase in the incidence of the atrophic (dry) form of age-related macular degeneration (AMD) and therefore may be one of several pathogenic factors contributing to AMD progression. Lipofuscin bisretinoid synthesis in the retina depends on the influx of serum retinol from the circulation into the RPE. Formation of the tertiary retinol-binding protein 4 (RBP4)-transthyretin-retinol complex in the serum is required for this influx. Herein, we report the pharmacological effects of the non-retinoid RBP4 antagonist, BPN-14136. BPN-14136 dosing in the Abca4-/- mouse model of increased lipofuscinogenesis significantly reduced serum RBP4 levels and inhibited bisretinoid synthesis, and this inhibition correlated with a partial reduction in visual cycle retinoids such as retinaldehydes serving as bisretinoid precursors. BPN-14136 administration at doses inducing maximal serum RBP4 reduction did not produce changes in the rate of the visual cycle, consistent with minimal changes in dark adaptation. Abca4-/- mice exhibited dysregulation of the complement system in the retina, and BPN-14136 administration normalized the retinal levels of proinflammatory complement cascade components such as complement factors D and H, C-reactive protein, and C3. We conclude that BPN-14136 has several beneficial characteristics, combining inhibition of bisretinoid synthesis and reduction in retinaldehydes with normalization of the retinal complement system. BPN-14136, or a similar compound, may be a promising drug candidate to manage Stargardt disease and dry AMD.

Forms of scleroma – influence on the patients quality of life

Introduction. Despite world practice that problem of studying the quality of life in patients with scleroma remains virtually uninvestigated. Therefore the purpose of our study was to investigate changes in the quality of life of patients with scleroma and to evaluate this indicator in patients with different forms of the disease. Materials and methods. There have been examined 92 patients (33 males, 59 females) with scleroma at the age from 23 to 79 years (at an average 53,5±14,57 years) and the duration of the disease from 1 to 48 years (at an average 17,63±11,94 years). The study of patients included assessment of complaints, general clinical score, results of examination of ENT-organs, endoscopy of larynx, trachea, bronchi. Quality of life indices were determined from enquirer Short version of Health enquirer – 36 (The MOS 36-item Short Form Health Survey – SF-36) in the following groups: 1) comparison group – apparently healthy persons (n=20); 2) patients with predominantly infiltrative form of scleroma (n=31); 3) patients with predominantly atrophic form of the disease (n=30); 4) patients with predominantly cicatricial form (n=31). Results. The quality of life of patients with scleroma is accompanied by a significant decrease of an average of 18,4% compared with healthy individuals, mainly due to the physical component of health. Comparing the data of patients with predominantly infiltrative form of scleroma and healthy persons (control), significant differences were observed in the indicators of physical functioning (68,77±24,79% versus 93,75±7,58%; p <0,001) and social activity (69,22±25,97% versus 86,24±18,54%; p=0,014). This indicates the effect of the disease on the ability to with stand the physical activity during the day and the presence of problems in communicating with other people already at the initial stages of the disease. Mostly atrophic and cicatricial forms of scleroma lead to the most significant decrease in physical (39,35±10,89% and 37,26±9,73%, respectively) and the mental component of health (42,27±10,04% and 36,39±6,8%), as compared with healthy individuals and patients with predominantly infiltrative disease. Conclusions. The study of the quality of life of patients with scleroma in clinical practice allows to determine the disease effect on the physical, psychological and social functioning of the patient and, along with the general clinical methods of the study, allows us to give a comprehensive assessment of the patient's condition and the effectiveness of his treatment.

Association of increased eomesodermin, BCL6, and granzyme B expression with major clinical manifestations of Hashimoto’s thyroiditis – an observational study

ABSTRACT Purpose Studies of cytotoxic T cells and their respective lineage master regulators have been limited in Hashimoto’s thyroiditis (HT). It is unclear whether their transcriptomes are changed in HT patients and how these changes are associated with the thyroid damage, major clinical manifestations, and disease progression. Methods We explored the gene expression patterns of selected transcription factors [eomesodermin (EOMES), BACH2, BCL6, TCF1] and cytolytic molecules [granzyme B (GZMB)] in peripheral blood (PB) T cells of 10 healthy controls and 30 HT patients of various subtypes (hypothyroid, untreated HT; L-thyroxine (T4)-treated HT, and spontaneously euthyroid HT) using real-time quantitative PCR. Results EOMES (Mann–Whitney P = 0.044), GZMB (P = 0.028), and BCL6 mRNA (P = 0.001) were overrepresented in PB T cells from HT and showed levels varying by age, thyroid volume and disease severity. BCL6 transcripts were predominantly enriched in severely affected, hypothyroid cases, both on and off LT4. Increased EOMES RNA expression was associated with advancing age, lower thyroid volumes and higher peak adjusted TSH levels over the course of the disease. The body mass-adjusted, steady-state maintenance dose of LT4 increased with GZMB and BCL6 levels in PB T cells of hypothyroid cases, mostly postmenopausal women having long-standing, non-goitrous and atrophic disease form. Conclusions Our exploratory results suggest a role for GZMB, EOMES, and BCL6 in the context of HT, thyroid injury, and aggressive/advanced disease forms. Functions enriched within differentially expressed transcripts could be an important new target in understanding the pathogenesis of HT.

Oral Mini Pulse Therapy a Novel Therapy in a Management of Multivariant Oral Lichen Planus: An Unusual Case Report

Oral lichen planus (OLP) is a chronic mucocutaneous disease with an unknown aetiology, affecting 0.5%-2% of the population and with a predilection for females in fourth to fifth decade of life. Most oral lichen planus lesions are asymptomatic but the atrophic and erosive forms of OLP can cause symptoms ranging from spontaneous soreness to severe pain interfering with eating, speech and swallowing. Various drugs have been used for the treatment of OLP including corticosteroids and other immunomodulators. However, no therapy is considered as the single most effective and without side effects in the management of this enigmatic disease. This is a case report of successful management of extensive, symptomatic multivariant OLP with a novel treatment with oral mini pulse (OMP) therapy.

Clinical and Histopathologic observations in a cohort of Libyan patients with Oral Lichen Planus

This study describes the clinical and histological features in a cohort of 72 Libyans with a histologically confirmed oral lichen planus (OLP) seen in the academic department of Oral Medicine & Oral Pathology of dental faculty in Benghazi in the period between 1997 and 2015.The cases were followed up clinically from the time of first visit up to periods extending from 4-14 years. In addition, serial biopsies were taken (whenever it deemed necessary) for those patients diagnosed with epithelial dysplasia to monitor its behaviour within the lesion. All the epithelial dysplastic changes were found in erosive, atrophic and bullous form, and none was detected in the white keratotic types. Only One case had undergone malignant transformation after 14 years of the first presentation. Most of the cases responded invariably to management by topical corticosteroids, however, systemic corticosteroids were used for short periods in 5 cases, while benzydamine hydrochloride proven to be beneficial for the relief of mild to moderate pain that sometimes associates with OLP.

Topical Clotrimazole/Betamethasone use in Oral Erosive Lichen Planus

Oral Lichen Planus (OLP) is a mucosal subtype of lichen planus, a chronic inflammatory disorder that affects the skin and mucous membranes. The manifestations of oral lichen planus vary from reticular, white papules and plaques to erythematous, atrophic, and erosive, with frank ulcers. Reticular OLP is often asymptomatic, but atrophic and erosive form can cause symptoms from burning to severe pain. The buccal mucosa and gingiva are commonly involved. The specific pathology is not understood, however a common theory is that an immune reaction against an exogenous antigen triggers the onset of an aberrant immune response, resulting in the onset of the disease. Oral lichen planus is considered to be a T-cell mediated chronic inflammatory tissue reaction against epithelial basal cells. The pain and discomfort of this condition can significantly impair the quality of life of patients is often the reason most seek treatment[1]. Oral lichen planus is not a curable condition, and as such, treatment is mostly palliative and focused on alleviating symptoms and minimizing scarring. This includes both non-pharmacologic and pharmacologic therapy. Non-pharmacologic measures may help to reduce exacerbations of oral lichen planus, and include the following: good oral hygiene, elimination of mechanical irritation from dental equipment, avoidance of chewing on lips or mucosa, smoking cessation, and minimization of consumption of acidic, salty, spicy, hot, or sharp foods[1].

Recent developments in age-related macular degeneration: a review.

BackgroundVisual impairment in elderly people is a considerable health problem that significantly affects quality of life of millions worldwide. The magnitude of this issue is becoming more evident with an aging population and an increasing number of older individuals.ObjectiveThe objective of this article was to review the clinical and pathological aspects of age-related macular degeneration (AMD), diagnostic tools, and therapeutic modalities presently available or underway for both atrophic and wet forms of the disease.MethodsAn online review of the PubMed database was performed, searching for the key words. The search was limited to articles published since 1980 to date.ResultsSeveral risk factors have been linked to AMD, such as age (>60 years), lifestyle (smoking and diet), and family history. Although the pathogenesis of AMD remains unclear, genetic factors have been implicated in the condition. Treatment for atrophic AMD is mainly close observation, coupled with nutritional supplements such as zinc and antioxidants, whereas treatment of wet AMD is based on targeting choroidal neovascular membranes.ConclusionIdentification of modifiable risk factors would improve the possibilities of preventing the progression of AMD. The role of anti-vascular endothelial growth factor (anti-VEGF) agents has transformed the therapeutic approach of the potentially blinding disease “wet AMD” into a more favorable outcome.

Molecular mechanisms of cell death in retina during development of age-related macular degeneration

Age-related macular degeneration (AMD) is a chronic progressive disease characterized by damage to the central retina zone. Changes in choriocapillaries, retinal pigment epithelium (RPE), and Bruch’s membrane (typical for aging) underlie AMD pathogenesis; however, the mechanisms launching the transfer of typical age-related changes in the pathological process are unknown. The death of photoreceptors and irreversible loss of vision become the results of pathological changes in RPE and choroid. In spite of intensive studies of AMD pathogenesis, information on molecular genetic preconditions of the events leading to the death of photoreceptors (as well as about the pathways of their death) is extremely limited; this complicates the search for efficient methods of AMD treatment (first of all, the most widely spread atrophic (“dry”) form of the disease). Recent studies demonstrated that not only apoptotic but also autophagic and necrotic signaling cascades are involved in the cellular death of retinal cells. The published data on three main forms of the programmed cell death (apoptosis, necrosis, and autophagy) and their role in AMD pathogenesis are summarized in the present review.

Hashimoto's Thyroiditis in South Indian Centre.

To describe the clinical and investigatory profile of children with Hashimoto's thyroiditis (HT) presenting to the thyroid clinic of a referral children's hospital and study the course of children diagnosed as HT over a period of 6mo. Children aged 5-12 y with HT were recruited, their clinical and biochemical details were assessed and were started on standard therapy and followed up for a period of 6mo. Ninety-seven children (89 goitrous and 8 atrophic form) with mean age: 9.90±1.76 y; M:F 1:5.4 were recruited; 55.7% were asymptomatic;14.2% had familial clustering. The mean height, weight and BMI for age Z-scores were -1.0±1.0, -0.8±0.9 and -0.5±1.1 respectively. 16.4% had short stature; 4.1% had obesity; 72.2% had grade 2 goitre. 73.4%, 13.2%, 10.3% and 3.1% had overt hypothyroidism, sub-clinical hypothyroidism, euthyroidism and hyperthyroidism, respectively. On follow up, 38.5% of euthyroid and 80% of sub-clinical hypothyroid children developed overt hypothyroidism. Thyrotoxic symptoms resolved in all three Hashitoxic children by 6mo. A female preponderance, less familial clustering, higher paucity of clinical manifestations and quick progression to hypothyroidism (in those without) were noted in the present series.

Phenotypically non-suppressive cells predominate among FoxP3-positive cells in oral lichen planus.

Oral lichen planus (OLP) is a common T-cell-dominated oral chronic inflammatory disease occurring in periods of remission, quiescence, activity with pronounced inflammation, and acute ulceration. Cell infiltrates in OLP contain varying numbers of CD4+ T cells expressing the transcription factor FoxP3. FoxP3+ CD4+ T cells are, however, a heterogeneous cell population containing suppressive and non-suppressive cells, and their distribution in infiltrates from OLP is unknown. Biopsies were taken from normal oral mucosa (n = 8) and OLP lesions (n = 19), and a set of in situ methods for the determination of the functional phenotype of FoxP3+ CD4+ T cells was applied. Numbers of FoxP3+ CD4+ T cells were highest in the atrophic form of the disease, yet low in the ulcerative form. The main FoxP3+ CD4+ T-cell population observed was FoxP3+ CD45RA- CD25+ CD45RO+ and CD15s- , a phenotype delineating a non-suppressive subset. Numbers of cells with an actively suppressing phenotype (FoxP3+ CD45RA- CD25+ CD45RO+ and CD15s+ ) were, however, about twice as high in reticular lesions as compared with the atrophic form. Many FoxP3+ CD4+ T cells expressed T-bet, the hallmark transcription factor for IFN-γ-producing T cells, indicating that they may enhance immune and inflammatory responses rather than suppress them. The absence of actively suppressing FoxP3+ CD4+ T cells may in part explain why OLP is a remarkably persisting condition, in spite of the presence of substantially high numbers of FoxP3+ CD4+ T cells. The findings emphasize that it is crucial to examine not only numbers but also functional phenotype of FoxP3+ CD4+ T cells in human tissues.

Discoid Lupus Erythematosus in Saudi Arabia: A literature review

Background: Discoid lupus erythematous (DLE) is the most common type of chronic cutaneous lupus erythematosus with a small risk of progression to systemic lupus erythematous (SLE).DLE classically presents with erythematous to violaceous, scaly plaques with prominent follicular plugging that often results in scarring and atrophy. Although the diagnosis of classical DLE is generally clinical, histopathological study of skin biopsy is helpful to confirm the diagnosis in early or atypical DLE lesions. Objectives: We aim to analyse the available PubMed database and local journals (Journal of the Saudi Society of Dermatology & Dermatologic Surgery) literature on Discoid lupus erythematosus in a Saudi population: Clinical and histopathological study. Methods: We carried out a systemic search using the PubMed database and local journals (Journal of the Saudi Society of Dermatology & Dermatologic Surgery).The search was limited to the English language. The following search terms were used: discoid lupus erythematous in Saudi Arabia, chronic cutaneous lupus erythematous in Saudi Arabia, systemic lupus erythematous in Saudi Arabia, Lupus in Saudi Arabia. Results: The PubMed database and local journals (Journal of the Saudi Society of Dermatology & Dermatologic Surgery) search generated 10 papers related to DLE in Saudi Arabia. The incidence of DLE in adult SLE Saudi patients is around 14% and lower incidence rate 3.3% in children.11.8% of DLE patients progressed to SLE. Human leukocyte antigen (HLA-DQB1*3) was increased among SLE patients with skin manifestation. The mean age of onset was 36.5 years and female to male ratio was 1.5:1.Scalp and face were the most affected .Atrophic form was the most common type. 16.1% of DLE patients had positive antinuclear antibody and 14.3% of those patients had positive DsDNA. Sever lichenoid reaction, vacuolar degeneration, deep dermal and periappendageal lymphocytic infiltration may use as alarming for progression to more severe form of lupus. Conclusion: Despite the scanty of published papers about DLE in Saudi Population, the clinical and histopathological features of DLE in Saudi patients are comparable to those reported in the literatures. Further studies are required to demonstrate the clinical patterns, histopathological features and immunofluorescence of DLE to make accurate portray about the national status of DLE

What Does Genetics Tell Us About Age-Related Macular Degeneration?

Age-related macular degeneration (AMD) is a chronic degenerative disease of the central retina and a major cause of vision impairment and blindness with millions of people affected in the elderly population. In recent years, considerable efforts have been made to understand disease pathology with the long-term goal of designing novel and effective treatment options for this devastating disease. Although striking advances in treating the neovascular stage of late AMD have occurred, no therapy is available for almost half of all AMD patients, specifically those who are affected by the atrophic form of the disease. This review highlights current knowledge on the genetic factors associated with early- and late-stage forms of the disease. It also summarizes the findings regarding the extent to which these factors may play a role in the transition from one disease stage to another, and it emphasizes the need to explore further the underlying mechanisms for both development and progression of this disease as a starting point for designing innovative therapies for it.

Programmed cell removal biomarkers calreticulin and CD47 implicated in oral lichen planus.

To investigate the expression of the programmed cell removal markers, calreticulin (CRT) and CD47, known to be involved in various autoimmune diseases, in patients with oral lichen planus (OLP), and to investigate the association with clinical behavior. Biopsies of 78 patients with OLP were included. The clinical data were collected from patients' charts. The expression of CRT and CD47 was immunomorphometrically analyzed in the epithelial (CRTep, CD47ep) and inflammatory cells (CRTinf, CD47inf), and the results were correlated with the clinical presentation. The epithelial and inflammatory cells expressed CRT (2.83 ± 6.62 and 5.13 ± 3.72) and CD47 (7.92 ± 4.6 and 10.7 ± 7.16). The expressions of CD47ep and CD47inf were associated (R = 0.64, P < 0.0005) with one another. The expressions of CRTinf and CD47ep were higher in atrophic erosive forms (A/ELP) than in the keratotic form of patients with OLP (6.46 ± 0.76 and 9.38 ± 0.87 vs 4.2 ± 0.61 and 6.84 ± 0.91, respectively, P = 0.002 and P = 0.021). The expression of CRTep was associated with more localized lesions (P < 0.009) and more abundant in males (P = 0.049), and the expression of CRTinf was associated with the presence of skin lesions and symptoms (P < 0.034 and P = 0.047, respectively). Only in A/ELP patients, the expression of CRTep was associated with high expression of CD47ep (R = 0.6, P = 0.004), where both CD47ep and CD47inf were associated with lower age of the patients (R = -0.48, P = 0.03 and R = -0.54, P = 0.01). The pattern of expression of CRT and CD47 in OLP suggests a general programmed cell removal response in OLP. Symptomatic patients may benefit from CRT/CD47 targeted therapy in the future.