Vernal keratoconjunctivitis in Thailand

A prospective, cross-sectional and randomized cross-over study was conducted to study the clinical features and treatment outcome among Thai patients with vernal keratoconjunctivitis (VKC). History-taking and eye examinations were performed. Mild cases of VKC were given topical antihistamine four times daily. Moderate and severe cases of VKC were treated with topical lodoxamide four times a day. Severe cases of VKC were given topical corticosteroids. Moderate and severe cases of VKC, which were refractory to treatment with either corticosteroids or a mast cell stabilizer had topical cyclosporine 0.5% instilled four times daily. Five patients were exposed to two different treatment regimens in sequence. As main outcome measures, itching, foreign body sensation, photophobia, conjunctival injection, papillae and chemosis were evaluated weekly. The patients with the palpebral type of VKC had daily symptoms, which were more severe and triggered by house-dust with a significant difference among the groups. Limbal VKC was associated with allergic rhinitis more commonly than palpebral VKC. Positive results of skin prick testing to acacia, careless weed, mold, Johnson grass and cow's milk were significantly more common in patients with palpebral VKC. The most common symptoms and signs were found in the mixed type of VKC. Purulent discharge, pannus and lid erythema were found in the palpebral type. Levocabastine hydrochloride was sufficient for mild cases of limbal VKC; lodoxamide for the limbal and mixed types. Prednisolone acetate was the drug of choice in severe cases of any type but only for a short period of time. The success rate of topical cyclosporine in the palpebral type was lower than in the limbal type due to an intolerable burning sensation. Topical cyclosporine used in 4 patients with limbal and palpebral type had a success rate of 100% which was greater than in the lodoxamide group (66.7%, 0%). Compared with topical corticosteroid-treated eyes in one patient, the success rate in topical cyclosporine-treated eyes was not success. Grading the severity of each type of VKC is crucial to obtain good response of any medication and compliance. Topical cyclosporine 0.5% can be an alternative drug to relieve symptoms and signs of VKC in order to avoid steroid-induced glaucoma.     

Engagement of Na,K-ATPase beta3 subunit by a specific mAb suppresses T and B lymphocyte activation

In order to identify new molecules involved in regulation of T cell proliferation, we generated various mAb by immunization of mice with the T cell line Molt4. We found one mAb (termed P-3E10) that down-regulated the in vitro T cell proliferation induced by CD3-specific OKT3 mAb. The P-3E10 mAb was also able to inhibit IFN-gamma, IL-2, IL-4 and IL-10 production of OKT3-activated T cells. The antigen recognized by P-3E10 mAb is broadly expressed on all hematopoietic as well as on all non-hematopoietic cell lines tested so far. Within peripheral blood leukocytes, the P-3E10 antigen was detected on lymphocytes, monocytes and granulocytes. Human umbilical vein endothelial cells (HUVEC) also scored positively. By evaluating the effect of P-3E10 mAb on these cell types we found that it also inhibited anti-IgM-induced B cell proliferation. However, it did not block growth factor-mediated proliferation of HUVEC, and spontaneous proliferation of SupT-1, Jurkat, Molt4 and U937 cell lines. Moreover, it did not influence phagocytosis of human blood monocytes and granulocytes. Biochemical analysis revealed that the P-3E10 antigen is a protein with a mol. wt of 45-50 kDa under non-reducing and 50-55 kDa under reducing conditions. By using a retroviral cloning system, the P-3E10 antigen was cloned. Sequence analysis revealed the P-3E10 antigen to be identical to the beta3 subunit of the Na,K-ATPase.     

Measurement of genotoxic air pollutant exposures in street vendors and school children in and near Bangkok

The effects of air pollution on human health are a great concern, particularly in big cities with severe traffic problems such as Bangkok, Thailand. In this study, exposure to genotoxic compounds in ambient air was studied by analysis of particle-associated polycyclic aromatic hydrocarbons (PAHs) and benzene through direct measurement of concentrations in air as well as through the use of different biomarkers of exposure: urinary 1-hydroxypyrene (1-OHP) for PAHs and urinary t,t-muconic acid (t,t-MA) for benzene. The study was conducted in various susceptible groups of the population with different occupations in 5 traffic-congested areas of Bangkok, as well as in primary school children. The level of total PAHs on the main roads at various sites ranged from 7.10 to 83.04 ng/m(3), while benzene levels ranged from 16.35 to 49.25 ppb. In contrast, ambient levels in nearby temples, the control sites, ranged from 1.67 to 3.04 ng/m(3) total PAHs and 10.16 to 16.25 ppb benzene. Street vendors selling clothes were exposed to 16.07 +/- 1.64 ng/m(3) total PAHs and 21.97 +/- 1.50 ppb benzene, levels higher than in monks and nuns residing in nearby temples (5.34 +/- 0.65 ng/m(3) total PAHs and 13.69 +/- 0.77 ppb benzene). Grilled-meat vendors in the same area were exposed to both total PAHs and benzene at even higher levels, possibly due to additional formation of PAHs during the grilling of meat (34.27 +/- 7.02 ng/m(3) total PAHs; 27.49 +/- 2.72 ppb benzene). At the end of the workday, urinary 1-OHP levels in street vendors (0.12 and 0.15 micromol/mol creatinine in clothes and grilled-meat vendors, respectively) were significantly higher than in controls (0.04 micromol/mol creatinine; P < 0.01). Afternoon urinary t,t-MA levels in both groups of street vendors (0.12 mg/g creatinine) were also significantly higher than in controls (0.08 mg/g creatinine; P < 0.05). School children from two schools in Bangkok were exposed to total PAHs and benzene at levels of 6.70 +/- 0.47 ng/m(3) and 4.71 +/- 0.25 ppb, respectively, higher than those to which children living outside the city were exposed (1.25 +/- 0.24 ng/m(3) total PAHs; 2.10 +/- 0.16 ppb benzene). At the end of the school day, levels of urinary 1-OHP and t,t-MA were significantly higher (P < 0.001 and P < 0.01, respectively) in Bangkok school children (0.23 micromol/mol creatinine and 0.27 mg/g creatinine, respectively) than in school children from outside Bangkok (0.10 micromol/mol creatinine and 0.08 mg/g creatinine, respectively).     

Psychogenic tremor disorders identified using tree-based statistical algorithms and quantitative tremor analysis.

Detecting psychogenic tremors (PsychT) is often challenging. As there are no laboratory investigations or imaging techniques that can confirm the diagnosis, PsychT is identified on a clinical basis. We present a tree-based statistical algorithm derived from quantitative computerized tremor recordings as a novel method to help in the recognition of PsychT. The goal of this study was to show that objective data from computerized tremor recordings, when processed through a tree-based statistical algorithm, can be used to determine whether a patient can be classified as having PsychT.     

Mechanisms Underlying Latent Disease Risk Associated with Early-Life Arsenic Exposure: Current Research Trends and Scientific Gaps

Background

Millions of individuals worldwide, particularly those living in rural and developing areas, are exposed to harmful levels of inorganic arsenic (iAs) in their drinking water. Inorganic As exposure during key developmental periods is associated with a variety of adverse health effects, including those that are evident in adulthood. There is considerable interest in identifying the molecular mechanisms that relate early-life iAs exposure to the development of these latent diseases, particularly in relationship to cancer.

Objectives

This work summarizes research on the molecular mechanisms that underlie the increased risk of cancer development in adulthood that is associated with early-life iAs exposure.

Discussion

Epigenetic reprogramming that imparts functional changes in gene expression, the development of cancer stem cells, and immunomodulation are plausible underlying mechanisms by which early-life iAs exposure elicits latent carcinogenic effects.

Conclusions

Evidence is mounting that relates early-life iAs exposure and cancer development later in life. Future research should include animal studies that address mechanistic hypotheses and studies of human populations that integrate early-life exposure, molecular alterations, and latent disease outcomes.

Citation

Bailey KA, Smith AH, Tokar EJ, Graziano JH, Kim KW, Navasumrit P, Ruchirawat M, Thiantanawat A, Suk WA, Fry RC. 2016. Mechanisms underlying latent disease risk associated with early-life arsenic exposure: current research trends and scientific gaps. Environ Health Perspect 124:170–175; http://dx.doi.org/10.1289/ehp.1409360     

Urinary and blood cadmium levels in relation to types of food and water intake and smoking status in a Thai population residing in cadmium-contaminated areas in Mae Sot

Human exposure to cadmium (Cd) produces a wide variety of toxic effects involving many organs and systems, but the kidney is the main organ affected among long-term Cd-exposed people. In the general population, the primary sources of Cd exposure are cigarette smoke and food (shellfish, offal and certain vegetables). The aims of the study were to investigate the association between urinary and blood Cd levels and personal habits relating to Cd intake (consumption of food stuff, water and tobacco smoking), levels of renal biomarkers in the urine or serum of 314 Thai subjects (85 males, 229 females) who resided in Cd-contaminated areas of Mae Sot District, Tak Province, Thailand. Based on the cut-off levels of 1 microg/g creatinine and 5 microg/l for urinary and blood Cd levels, respectively, nearly all subjects had urinary Cd levels lower than cut-off values for urine and blood (88.2 and 77.7%, respectively). Binary logistic backward stepwise regression analysis with five covariates (gender, residential areas, consumption of bamboo or chicken, and smoking status), and eight covariates (residential areas, consumption of beans, pork, fish or liver, types and sources of rice consumed and smoking status) best predicted urinary and blood Cd levels, respectively. For renal biomarkers, N-acetyl-beta-glucosaminidase (NAG) best predicted both urinary and blood Cd with good accuracy. A larger sample size with equal distribution of subjects with low (< 2 microg/g creatinine) and high (> 2 microg/g creatinine) urinary Cd levels should be studied to obtain the regression equation that would best predict Cd body burden.     

Pallidal stimulation in cervical dystonia: clinical implications of acute changes in stimulation parameters

Background and purpose:  Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is successful in dystonia, but the role of each electrical parameters of stimulation is unclear. We studied the clinical effects of acute changes of different parameters of GPi–DBS in cervical dystonia (CD).
Methods:  Eight CD patients with bilateral GPi–DBS at 28.6 ± 19.2 (mean ± SD) months after surgery were recruited. Mean improvement in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score was 54.5% compared to before surgery. Ten settings, including a combination of a wide range of pulse widths (PWs), low and high frequencies and voltage, were administered in a randomized double blinded fashion. Clinical benefit was assessed by two raters using the TWSTRS and by the patients using an analogue rating scale.
Results:  The TWSTRS severity scores were reduced by 56.7% with stimulation at the best settings. Improvement was significantly associated with high frequency (≥60 Hz) and high voltage. Stimulation at 130 Hz showed the best clinical improvement. Increasing PWs (from 60 to 450 μs) did not result in a significant improvement.
Conclusion:  Frequency and amplitude appear to be the most important factors in the acute anti-dystonic effects in GPi–DBS patients with CD.