A role for decorin in cutaneous wound healing and angiogenesis

Decorin is known to influence tissue tensile strength and cellular phenotype. Therefore, decorin is likely to have an impact on tissue repair, including cutaneous wound healing. In this study, cutaneous healing of both excisional and incisional full‐thickness dermal wounds was studied in decorin‐deficient (Dcn^?/?) animals. A statistically significant delay in excisional wound healing in the Dcn^?/? mice occurred at 4 and 10 days postwounding and, in incisional wounds at 4, 10, and 18 days when compared with wild‐type (Dcn^?/?) controls. Fibrovascular invasion into polyvinylalcohol sponges was significantly increased by day 18 in Dcn^?/? mice relative to Dcn^+/+ mice. The 18‐day sponge implants in the Dcn^?/? mice showed a marked accumulation of biglycan when compared with the corresponding implants in Dcn^+/+ mice. Thus, regulated production of decorin may serve as an excellent therapeutic approach for modifying impaired wound healing and harmful foreign body reactions.     

An open-label efficacy pilot study with pimecrolimus cream 1% in adults with facial seborrhoeic dermatitis infected with HIV

BACKGROUND: Seborrhoeic dermatitis (SD) is a common dermatosis in human immunodeficiency virus (HIV)-positive patients, many of whom do not respond satisfactorily to conventional topical treatments such as corticosteroids and antifungals. OBJECTIVE: A pilot study to investigate the efficacy and tolerability of pimecrolimus cream 1% in HIV-positive patients with facial SD. METHODS: In a single-centre study, 21 HIV-infected patients with mild to severe SD were treated twice daily with pimecrolimus cream 1% for 14 days. Thereafter, treatment was discontinued and patients followed up for 5 weeks. Skin involvement at baseline and on days 7, 14, 21, 35 and 49 was assessed using a four-point clinical score and digital photography. MAIN OUTCOME MEASURES: Efficacy and safety of pimecrolimus cream 1% treatment and incidence of relapse in the follow-up phase. Results Marked improvement was seen in clinical parameters at day 7, with >or= 90% patients clear of symptoms at day 14. Relapse was observed at day 35 but signs were milder than at baseline. All patients responded to therapy, despite their immunological status. Pimecrolimus did not alter CD4(+) and CD8(+) T-cell counts or viral load during the treatment period. CONCLUSION: Pimecrolimus cream represents a new, effective therapeutic option for facial SD in HIV patients.     

Thrombin Inhibits the Migration of Human Liver Myofibroblasts

Scarring of the cornea, the transparent tissue at the front of the eyeball, is an important cause of visual impairment. A major chemokine upregulated in tear fluid after corneal injury is platelet‐derived growth factor (PDGF), which induces the stromal cells of the cornea (keratocytes) to assume a fibroblastic phenotype. We have investigated the role of PDGF in matrix contraction by human corneal fibroblasts (HCF) using the standard three‐dimensional (3D) fibroblast‐populated collagen matrix model (FPCM).
When stimulated with PDGF, HCF in monolayer (2D) display circular ruffles (CR) on their dorsal surface. Using immunolabeling, we found that CR contain proteins of the Arp2/3 complex, which is required for the assembly of filamentous actin during protrusive activity. This PDGF‐mediated ruffling ability is altered by antibodies or blocking peptides that specifically interfere with the Arp2/3‐mediated pathway of actin polymerization, as well as by the myosin light chain kinase inhibitor, ML9. Preincubation with anti‐PDGF‐BB antibody or with the tyrosine kinase inhibitor, AG1295, also inhibits CR. While PDGF efficiently stimulates HCF‐mediated cell protrusive activity and macroscopic collagen gel contraction in the 3D model, this effect is directly inhibited by all the substances which inhibit CR in 2D, demonstrating a direct involvement of the PDGF‐mediated CR pathway in tissue contraction. Thus, 3D PDGF‐induced matrix contraction by HCF involves the same players as CR, a phenomenon observed in 2D cell cultures: PDGF‐BB receptor, receptor tyrosine kinase, the machinery for filamentous actin assembly (Arp 2/3 complex, Scar and Wasp proteins), and myosin. The functional role of circular ruffling or its equivalent in three‐dimensional fibroblast‐populated collagen matrices seems to be a rapid reorganization of the actin cytoskeleton in preparation for cell‐matrix interaction.     

Renal clearance and protein binding of melphalan in patients with cancer

Summary The renal clearance of melphalan and the fraction unbound in plasma were determined after intravenous infusion of 5 mg/m² over 5 min in nine patients with cancer to obtain information regarding the mechanism of renal handling of melphalan. Four of the patients underwent bone marrow transplantation and also received an IV dose of 220 mg/m². Total melphalan clearance after the 5 mg/m² dose ranged from 66.0 to 272 ml/min per m²; the percentage of the dose excreted unchanged in urine, from 2.5% to 92.8%; renal clearance, from 4.1 to 188 ml/min per m²; the fraction unbound in plasma, from 0.0598 to 0.460; and t_1/2, from 39.4 to 84.3 min. Unbound melphalan clearance and renal clearance calculated from the unbound fraction in plasma for each patient ranged from 441 to 3356 ml/min per m² and 15 to 961 ml/min per m² respectively and were not related to serum albumin, serum creatinine or creatinine clearance. The percentage of the dose exctreted and melphalan renal clearance were not related to urine flow. There was evidence of active secretion of melphalan in the kidney an possible reabsorption. There were no significant paired differences in melphalan disposition between the high- and low-dose studies. Highly variable renal clearance involving active secretion may contribute in part to large interpatient differences in the total plasma clearance of melphalan in patients with cancer.This study was supported by a grant from The Queen Elizabeth Hospital Research Foundation