Hemangiomas, which are strawberry like birthmarks commonly seen during early infancy, are usually harmless but can lead to distortion of tissue and vision obstruction in nearly 10 percent cases.

Problematic hemangiomas have been treated with corticosteroids like dexamethasone and prednisone since the 1960s but steroids can fail at times and their action mechanism against hemangioma has remained a mystery.

From Sciencedaily.com:

Greenberger, Bischoff and colleagues worked with hemangioma stem cells isolated from patient tissue samples provided by Mulliken, and showed that:

* When human hemangioma stem cells were pretreated with dexamethasone, then implanted in mice, the tumors that formed had far fewer blood vessels.

* Dexamethasone suppressed the stem cells’ production of VEGF-A, but did not suppress VEGF-A production by endothelial cells from the same hemangioma.

* When VEGF-A production was suppressed in hemangioma stem cells using shRNA silencing, then implanted in the mice, there was an 89 percent reduction in vessel growth.

* VEGF-A was detected in actively growing hemangiomas, but not in regressing (involuting) hemangiomas.

Earlier research in Bischoff’s lab and that of Bjorn Olsen, MD, PhD, of the Harvard School of Dental Medicine, indicates that hemangiomas may result from an in utero mutation in a stem cell destined to become an endothelial cell, causing a disruption in the normally well-ordered process of blood vessel development. Under a 2008 Translational Research Program grant from Children’s, Bischoff’s lab has been using hemangioma stem cells to test a library of existing medications that might specifically inhibit the proliferation of the hemangioma stem cells, and thereby limit growth of the hemangioma tumor.

The study was funded by the National Institutes of Health, the Translational Research Program at Children’s Hospital Boston, a Harvard Skin Diseases Pilot Study Grant, Sheba Medical Center (Israel), and the John Butler Mulliken Foundation.

Tags: corticosteroids, dexamethasone, Hemangiomas, Prednisone, steroids

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Patients suffering from psoriasis may find it difficult to the daily chores of dealing with the physical symptoms of this condition after a recent study disclosed that there is an association between psoriasis and two potentially serious medical conditions, atherosclerosis and diabetes.

Psoriasis is a chronic skin condition that is characterized by thick, scaly, and red plaques and resulting in itching and bleeding & leading to considerable discomfort and emotional stress for patients.

From Sciencedaily.com:

Specifically, the researchers noted that the association between diabetes and psoriasis was more prominent in women compared to men and in patients between the ages of 35 and 55. Similarly, the association between atherosclerosis and psoriasis was highest among women as compared with men and in patients between the ages of 35 and 55, and 65 and 75.

In addition, in patients with psoriasis, data analysis showed an association between diabetes and the overuse of extremely potent topical steroids or certain systemic medications for psoriasis. The researchers suggested that these observations could indicate that the prevalence of diabetes among psoriasis patients increases with the severity of psoriasis.

An association also was observed between the prevalence of atherosclerosis and the use of phototherapy, the medical light treatment administered by dermatologists for psoriasis. The researchers noted that it is possible that phototherapy is a marker for psoriasis severity rather than being the cause of atherosclerosis. Another possible explanation they offered is that phototherapy may be chosen as the treatment of choice for severe psoriasis patients who suffer from atherosclerosis rather than treating these patients with systemic medications.

A higher occurrence of diabetes and atherosclerosis in psoriasis patients compared to patients without psoriasis was noticed by dermatologist Michael David, MD, Dermatology Department at Rabin Medical Center, Tel Aviv, Israel, and his colleagues.

Tags: atherosclerosis, diabetes, phototherapy, psoriasis, steroids, topical steroids

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Thirty six percent of patients suffering from refractory systemic lupus erythematosus (SLE or lupus) remain well after undergoing B-cell depletion therapy (BCDT) without feeling or requiring the need of further standard immunosuppressive agents. This finding was disclosed by a study presented at EULAR 2007, the Annual European Congress of Rheumatology in Barcelona, Spain.

It is important to note here that minimizing the number of B-cells in the system by BCDT has been suggested as a potential therapy to SLE patients unresponsive to other treatments.

From Sciencedaily.com:

In this study, initiated in 2000, patients with refractory SLE were treated with BCDT (based on rituximab) using a combination protocol with cyclophosphamide and steroids. Of the 33 patients who had a minimum of 6 months follow-up duration at the time of analysis (mean duration 37 months, range 6-79), 12 patients remained well.

Median duration of B-cell depletion was 4 months (range 2-15), with 2 patients remaining depleted at time of analysis (73 and 8 months respectively). B-cell depletion was beneficial clinically, with a decrease of median global BILAG scores (clinical activity index — see Editors note) from 13 to 5 when measured between 5 and 8 months p<0.0001).

Autoantibody profiling was also examined during the study as a possible predictor of flare of disease. Patients with low baseline serum C3 (84%) had a shorter time to flare post-BCDT (a lower level is a strong indicator of high levels of disease activity) and patients with anti-ENA antibodies notably anti-Sm antibodies (63%) were more likely to flare at any time after BCDT with an odds ratio (OR) of 6 (p=0.03).

Co-author of the paper, Professor David Isenberg, from University College London in the United Kingdom, said that results are encouraging and suggest that B-cell depletion therapy is a promising therapeutic option for lupus patients besides reducing the need for continuous immunosuppressive therapy.

Tags: lupus, SLE, steroids, systemic lupus erythematosus

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According to researchers from the Medical College of Georgia, a powerful antioxidant in green tea can delay or prevent the onset of type 1 diabetes.

EGCG (Epigallocatechin Gallate), the predominant antioxidant in green tea, was tested by researchers on a laboratory mouse with type 1 diabetes and primary Sjogren’s syndrome that damages moisture-producing glands leading to dry mouth and eyes.

From Sciencedaily.com:

The proliferation phenomenon also can be observed in psoriasis, an autoimmune disease affecting the skin and joints, says Dr. Hsu. “Normal skin cells turn over every 30 days or so, but skin cells with psoriasis turn over every two or three days.” Dr. Hsu’s group previously found that green tea polyphenols, including EGCG, inhibited rapid proliferation in an animal model for human psoriasis.

“We never thought proliferation was going on to this extent in the salivary gland, but we now believe it is tightly associated with Sjogren’s syndrome,” he says.

The next step is to observe Sjogren’s syndrome in human salivary gland samples to determine whether the study findings hold up in humans.

“If the abnormal expression of these genes is the same in humans as in the animal model, then the second stage will be intervention and treatment with a pure form of EGCG,” says Dr. Hsu.

“The benefit of using green tea in preventing or slowing these autoimmune diseases is that it’s natural and not known to harm the body,” says Dr. Gillespie, periodontics chief resident at Fort Gordon’s Tingay Dental Clinic. “EGCG doesn’t have the negative side-effects that can be associated with steroids or other medications that could otherwise be prescribed.”

The study, published in an issue of Life Sciences, supports earlier research displaying impact of EGCG on helping prevent autoimmune diseases.

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A potential breakthrough has been announced by researchers at Queen Mary University London and the University of Leicester for treating a rare but devastating medical condition that can affect children and young people.

One patient has already been treated and experienced promising results by the clinicians and scientists from the two universities. The preliminary data was published as a letter in the New England Journal of Medicine.

From Sciencedaily.com:

“Affected patients have episodes of bleeding in the lungs, which often need hospital admissions, and in some cases it can be life threatening. This is normally combated by the use of continuous oral steroids (which can have major side effects).

“In a child local to Leicester, we were able to show, for the first time, that there was high levels of oxidative stress in the lungs. In addition, we treated the increased oxidative stress by using of an antioxidant, N-acetyl cysteine – which has no side effects. Since she has been on this treatment she has had no lung bleeds, and the steroid dose has been significantly reduced.”

Dr Marcus Cooke, Senior lecturer in the Radiation and Oxidative Stress Section at the University of Leicester, added: “It is a really good feeling to be involved in a project looking at oxidative stress, that can make such an enormous difference to a person’s quality of life.

Jonathan Grigg, Professor of Paediatric Respiratory and Environmental Medicine at Queen Mary University London, said idiopathic pulmonary haemosiderosis is a rare disease with an unknown cause.

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A protein critical to the development of inflammation during lung infection in patients with cystic fibrosis (CF) has been identified by scientists at Children’s Hospital of Pittsburgh of UPMC.

The protein, interleukin-23 (IL-23), is an important finding offering a specific target to the researchers for developing new therapies.

From Sciencedaily.com:

“Understanding the role IL-23 plays in the inflammatory pathway of CF patients is a major step forward that could lead to the development of new therapies to block this inflammation,” said Dr. Kolls, chief of the Division of Pulmonary Medicine, Allergy and Immunology at Children‘s and professor of Pediatrics and Immunology at the University of Pittsburgh School of Medicine. “For patients with chronic infections associated with CF, this eventually could mean a prolonged life span and an improved quality of life.”

Examining IL-23′s importance in the inflammation pathway is a “new and different” approach than that taken by other CF researchers, according to Dr. Dubin, an assistant professor of Pediatrics at the University of Pittsburgh School of Medicine. “Currently, the anti-inflammatory therapies that we have for CF patients, steroids and non-steroidal anti-inflammatory drugs, are non-specific and can cause debilitating side effects such as the exacerbation of diabetes and glucose intolerance, as well as bone loss. The identification of specific inflammatory mediators like IL-23 opens the door to developing targeted anti-inflammatory treatments which may have fewer side effects.”

This research by Dr. Kolls and Children’s pulmonologist Patricia Dubin, MD, highlights that IL-23 is an important mediator to an inflammatory response.

Tags: chronic infections, inflammation, lung infection, steroids

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Nearly three million Americans suffer from Body Dysmorphic Disorder (BDD) or dysmorphophobia, which is a hidden disease in the sense that patients try altering their appearance through plastic surgeries perceiving themselves to have a physical flaw or ugly.

Sanjaya Saxena, Ph.D., associate professor of psychiatry at the University of California, San Diego (UCSD) School of Medicine, is leading a study for identifying brain structure abnormalities that are associated with this complication besides determining how these abnormalities can be altered with treatment.

From Sciencedaily.com:

Saxena adds that the disorder is very different from vanity or narcissism. “Patients with BDD truly fear or even believe that they are ugly, and the condition is associated with shame and a high rate of depression and suicide,” he said. The disorder is found about equally often in men as in women. Some males suffer from a particular version known as muscle dysmorphia, characterized by extreme body workouts and use of steroids in men who wrongly view themselves as being weak and out of shape.

“Some patients make repeated visits to plastic surgeons and dermatologists for procedures but are never satisfied,” said Saxena, adding that about half of all BDD patients are delusional, while the others objectively know that they are okay, yet are unable to stop the compulsion to cover up or “fix” their flaws.

Psychiatric treatment for such patients is difficult, Saxena adds, but with therapy and/or medication such as serotonin uptake inhibitors (SRIs), even those who are delusional can recover.

Saxena hopes to find out if venlafaxine (Effexor), a drug commonly used to treat depression and anxiety disorders can be used to treat BDD, Obsessive-Compulsive Disorder (OCD), and Compulsive Hoarding.

Tags: BDD, body dysmorphic disorder, dysmorphophobia, steroids, venlafaxine

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Concentrations of the sex hormones, testosterone in men and estrogen in women can have a positive effect on the regenerative potential of cartilage tissue as per German researchers.

It was suggested by the study that hormone replacement in the joint fluid of men and women can be advantageous for treating late stages of human osteoarthritis (OA) by regenerating damaged tissue.

From Sciencedaily.com:

Nicolai Miosge, M.D., Ph.D., and colleagues from the August University in Goettingen, Germany examined the regenerative potential of chondrogenic progenitor cells (CPCs) that are present in arthritic tissue during the late stages of OA. The research team speculated that these CPCs might be influenced by sex steroids, and therefore hormone replacement therapy directed to the joint fluid could be beneficial in restoring damaged tissue. Tissue samples from 372 patients who underwent total knee replacement were analyzed. The mean age was 71 years of age for men and 72 years for women, with women representing 64.25% of participants.

Estrogens are known to influence bone metabolism and researchers found that 17β-estradiol (E2), which increases calcium deposition in both sexes, was present in the joint fluid of study participants. CPCs positive for estrogen receptors (ERα and ERβ) as well as androgen receptors were present in the OA tissue as well. Both estrogen and testosterone influenced the expression of all 3 receptor genes and the CPCs by regulating gene expression.

Details of this evidence-based study appeared in an issue of Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.

Tags: cartilage, Estrogen, hormone replacement, osteoarthritis, steroids, testosterone

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Allergy sufferers can finally have some respite as springtime mountain cedars and tree pollens have generally subsided but summertime is here.

Dr. David Khan, associate professor of internal medicine at UT Southwestern Medical Center, said limiting outdoor exposure during peak times, closing the windows, air conditioning, and mask wearing can help people avoid allergies to a significant extent.

From Sciencedaily.com:

Prescription antihistamines can offer more potency and be less sedating than over-the-counter measures, Dr. Khan said.

Corticosteroid anti-inflammatory nasal sprays can be used regularly, often once a day, and are generally safe and effective. These are not the same as anabolic steroids that athletes sometimes abuse and for which some school systems now test.

Antihistamines, decongestants and corticosteroids, however, do no more than depress symptoms. “Although you’ll be reducing the effect of the allergic reaction, you’ll still be just as allergic at the end of the day,” Dr. Khan said.

Shots are the most effective medical treatment, he said, actually making allergy sufferers less allergic.

Even though heat does not influence pollen amount in the air, it does stimulates the formation of ground-level ozone that can exacerbate symptoms of allergy.

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Telithromycin, an antibiotic made by sanofi-aventis and not currently used for treating asthma, can prove useful in treating acute asthma attacks and was recently termed as a potentially new method to help asthma patients by researchers.

The antibiotic can hasten the recovery time of patients who have had attacks of asthma by three days besides reducing the associated symptoms and improving lung function. Presently, steroids are used to control inflammation of the lungs.

From Sciencedaily.com:

Although most acute asthma attacks are recognised to be associated with viral infections, the researchers believe the positive effects of telithromycin may be a result of its impact on the atypical bacteria, Chlamydophila pneumoniae and Mycoplasma pneumoniae. They found 61 percent of the patients in the study were serologically positive for C. pneumoniae and/or M. pneumoniae, and believe the presence of these bacteria may increase the severity of asthma attacks. The researchers also believe the anti-inflammatory properties of telithromycin may play a part in reducing recovery time.

Professor Sebastian Johnston from Imperial College London, who led the research, said: “Traditionally antibiotics have not proven effective in treating asthma attacks, but this development could open up a whole new area of research in the treatment of asthma. Although we’re not sure about the exact mechanism which caused this antibiotic to be effective, this study indicates it does clearly have a beneficial effect. We still need further trials to confirm these results, to investigate the mechanisms of action of this treatment, to see if the same benefits are seen with other related antibiotics and to see which patients are most likely to benefit.”

The study investigated 278 patients at 70 centers around the world, including St Mary’s Hospital, London and the team included researchers from Imperial College London, the University of Milan, the University of Auckland, the National Jewish Medical Centre, USA, G.R. Micro Ltd, London, and sanofi-aventis, USA.

Tags: antibiotic, Asthma, steroids, Telithromycin

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