SAPHO Syndrome: Current Developments and Approaches to Clinical Treatment

SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) is a rare autoimmune disease which, due to its clinical presentation and symptoms, is often misdiagnosed and unrecognized. Its main features are prominent inflammatory cutaneous and articular manifestations. Treatments with immunosuppressive drugs have been used for the management of SAPHO with variable results. To date, the use of anti-TNF-α agents has proved to be an effective alternative to conventional treatment for unresponsive or refractory SAPHO cases. TNF-α is a pro-inflammatory cytokine and pivotal regulator of other cytokines, including IL-1 β, IL-6, and IL-8, involved in inflammation, acute-phase response induction, and chemotaxis. IL-1 inhibition strategies with anakinra have shown efficacy as first and second lines of treatment. In this review, we will describe the main characteristics of biological drugs currently used for SAPHO syndrome. We also describe some of the promising therapeutic effects of ustekinumab, an antibody against the p40 subunit of IL-12 and IL-23, after failure of multiple drugs including anti-TNF-α and anakinra. We discuss the use and impact of the new anti-IL-1 antagonists involved in the IL-17 blockade, in particular for the most difficult-to-treat SAPHO cases.     

The role of CE-MRA of the supraortic vessels in the detection of associated intracranial pathology

Neurological Sciences - Contrast-enhanced magnetic resonance angiography (CE-MRA) has become a very popular imaging technique in the evaluation of the extracranial vessels pathology, while it is...     

La inervación del disco intervertebral

Until very recently, intervertebral disc innervation was a subject of considerable debate.Nowadays, the introduction of inmunohistochemical techniques associated to specific antibodies and studies with retrograde tracers in nerves have allowed greater understanding of disc innervation in physiological and pathological conditions and also endings characteristics and their patterns of distribution in both situations. The existing controversies regarding structural basis of discogenic pain, have raised the interest of knowing the influence of innervation in back pain from discal origin and its characteristics.Today, we know that pathologic neoinnervation accompanying radial fissures is an important factor in the genesis of discogenic pain; within a complex mechanism in which other neurobiomechemical, inflammatory and biomechanical factors are involved.     

Mathematical and Pharmacokinetic Approaches for the Design of New 3D Printing Inks Using Ricobendazole

Pharmaceutical Research - 3D printing (3DP) makes it possible to obtain systems that are not achievable with current conventional methods, one of them, sustained release floating systems. Floating...     

Migration of titanium dioxide microparticles and nanoparticles through the body and deposition in the gingiva: an experimental study in rats

The aim of this experimental work was to evaluate deposition of titanium dioxide (TiO₂) microparticles and nanoparticles, which could originate from titanium bioimplants, in the gingiva. Wistar rats were injected intraperitoneally (i.p.) with a suspension of TiO₂ particles of different sizes (150, 10, or 5 nm). The rats were killed 12 months post‐injection, and the buccal and lingual gingivae were resected and evaluated using light and scanning electron microscopy. Energy‐dispersive X‐ray spectroscopy (EDS) was used to confirm the presence of titanium in deposits of microparticles and nanoparticles, and the concentration of titanium in tissues was measured using inductively coupled plasma–mass spectrometry (ICP‐MS). Histological examination showed that all experimental groups exhibited agglomerates, in the gingiva, of titanium particles of micrometer size range, with no associated inflammatory response. Higher concentrations of titanium traces were shown, by ICP‐MS, in both buccal and lingual tissues of all experimental groups compared with their matched controls. Titanium concentrations were significantly higher in the buccal gingiva than in the lingual gingiva, and after injection with 5‐nm particles than with 10‐nm particles in both localizations. Titanium microparticles and nanoparticles deposit in the gingiva, and mostly on the buccal side. Gingival deposition of titanium could be considered a tissue indicator of tribocorrosion processes of titanium bioimplants.     

Sézary Syndrome in a 17‐Year‐Old Boy: Clinicopathologic Features and Genomic Profile

We describe the case of a 17‐year‐old Hispanic boy who had had erythroderma and diffuse lymphadenopathy for approximately 6 months. A diagnosis of Sézary syndrome was made on the basis of the histologic features of the skin; the presence of the same T‐cell clone on the skin, blood, and bone marrow; and the high CD4⁺ lymphocyte count with an aberrant phenotype in peripheral blood; bone marrow involvement was also present. The patient was treated with systemic gemcitabine and achieved partial remission.