Reduction of inflammatory slan (6‐sulfo LacNAc) dendritic cells in psoriatic skin of patients treated with etanercept

Dermal dendritic cells (DCs) play a central role in the immunopathology of psoriasis. We previously identified slanDCs as pro‐inflammatory TNF‐α, IL‐23‐ and IL‐12‐producing DCs in human blood and as prominent inflammatory dermal TNF‐α secreting and CD11c‐positive DC subset in psoriasis. Here, we ask for the effects of TNF‐α‐inhibition on inflammatory slanDCs in skin and blood of 10 patients with psoriasis during 24 weeks of treatment with etanercept. Treatment with etanercept reduced the frequency of dermal slanDCs but did not induce apoptosis as determined by lack of increased active caspase‐3‐expression. In parallel, we found increased frequencies of slanDCs in blood which expressed lower levels of HLA‐DR. Stimulating slanDCs isolated from the blood of healthy donors in vitro induced a strong production of IL‐1β, IL‐6, IL‐23 and IL‐12p70. This capacity was efficiently reduced in the presence of etanercept, thereby indicating that TNF‐α is an autocrine stimulus for maturation and pro‐inflammatory cytokine production of slanDCs. In vivo, we noticed that treatment with etanercept did reduce the number of dermal slanDCs in parallel to the overall expression of TNF‐α and IL‐23p19. However, successful treatment did not down‐regulated the percentage of dermal slanDCs that stained positive for TNF‐α and IL‐23p19 indicating that remaining slanDCs kept their pro‐inflammatory capacity. This study provides novel insights into the immune regulatory properties of etanercept at the level of inflammatory slanDCs in vivo in skin and blood as well as in vitro.     

Angeborene Krankheiten des Kohlenhydratstoffwechsels

Inborn errors of metabolism now represent a new challenge for internists. Many adult patients with inborn errors of carbohydrate metabolism need intensive treatment and monitoring. Complications must be diagnosed and treated early. Glycogen storage diseases are a heterogeneous group of metabolic diseases and patients suffering from glycogen storage disease type I have to follow a strict dietary regimen in order to avoid hypoglycemia. Complications include hepatic adenomas and nephropathy. Classical galactosemia can be targeted and diagnosed in newborn screening programs; however, despite early and optimal treatment complications, such as neurological symptoms, decreasing bone density and ovarian insufficiency can hardly be avoided. Hereditary fructose intolerance is typically manifested in the first year of life but hepatic and renal damage can be avoided by dietary restrictions. Due to unconscious adaptation of dietary habits patients can reach adulthood before a diagnosis is made.     

Cerebral microbleeds: a guide to detection and clinical relevance in different disease settings

Cerebral microbleeds have emerged as an important new imaging marker of cerebral small vessel disease. With the development of MRI techniques that are exquisitely sensitive to paramagnetic blood products, such as T2*-weighted gradient-recalled echo and susceptibility-weighted sequences, microbleeds have been detected in ever-increasing numbers of patients in stroke and cognitive clinics, as well as in healthy older people and in a variety of other rarer diseases and syndromes. Detection of cerebral microbleeds has clinical implications with respect to the diagnosis of the underlying small vessel disease, the safety of antithrombotic use, and the risk of symptomatic intracerebral haemorrhage, cognitive impairment and dementia. This article provides a guide to the detection and clinical relevance of cerebral microbleeds in different conditions based on a comprehensive review of the literature and own findings in research and clinical practice.     

Role of neoadjuvant chemotherapy in congenital intracranial haemangiopericytoma

Infantile haemangiopericytoma of the CNS is a rare entity. We report the first case of a congenital haemangiopericytoma successfully treated by preoperative chemotherapy. The patient presented shortly after birth with the diagnosis of a haemangiopericytoma. As neurosurgery was too risky due to size, location and age of the patient an anthracycline‐based chemotherapeutic regimen was applied and resulted in a significant decrease in tumour size, making a postchemotherapy complete surgical resection possible. Chemotherapy may benefit patients with congenital haemangiopericytoma especially if the tumour cannot initially be treated by complete neurosurgical resection. Pediatr Blood Cancer. 2010;56:161–163. © 2010 Wiley‐Liss, Inc.     

Distribution of Oxytocin‐ and Vasopressin‐Immunoreactive Neurons in the Brain of the Eusocial Mole Rat (Fukomys anselli)

Fukomys anselli, also known as Ansell's mole rat, is a subterranean, highly social (so‐called eusocial) rodent that lives in Africa. These mole rats typically form multigenerational families consisting of a single monogamous breeding pair and their nonreproductive offspring. Research on other mammals suggests that oxytocin (OT) and vasopressin (VP) as well as the distribution of OT‐ and VP‐receptors may influence social behavior and pair bonding. Recent studies on eusocial naked mole rats have shown a possible relation between sociality and OT‐immunoreactive (OT‐ir) processes. In this study, we examined expression patterns of OT and VP in the brains of F. anselli and the common Sprague‐Dawley (SD) laboratory rat. As in other species, the majority of OT‐ir and VP‐ir neurons was found in the paraventricular (Pa) and supraoptic (SO) nuclei, and scattered labeling throughout the preoptic and anterior hypothalamic areas. We found no difference in either quality or quantity of OT‐ and VP‐ir neurons between individuals of different social and reproductive ranks. Equally unexpected was the finding of specific OT‐immunoreactivity in neurons of the mammillary complex of F. anselli that was not found in SD rats. Further studies are needed to determine whether these mammillary OT‐ir neurons are causally related to monogamy in F. anselli and whether these correlates of monogamy are found in other species. Anat Rec, 2012. © 2012 Wiley Periodicals, Inc.     

Potential case of gynecomastia in mummified remains of an early modern period northern finnish vicar

We report possibly the oldest evidence of gynecomastia in mummified human remains. Computed tomography was performed on the mummified remains of an early 17th century Northern Finnish vicar. The examination of the scans revealed large bilateral subareolar irregular masses resembling female mammary glands. The nearly septuagenarian vicar appears to have had gynecomastia, as it is a common condition in elderly men, and is sometimes associated with obesity. Gynecomastia is the most likely explanation for these findings. Clin. Anat. 31:641–644, 2018. © 2018 Wiley Periodicals, Inc.