Hidradenitis suppurativa (HS)/acne inversa is a debilitating chronic disease that remains poorly understood and difficult to manage. Clinical practice is variable, and there is a need for ...international, evidence‐based and easily applicable consensus on HS management. We report here the findings of a systematic literature review, which were subsequently used as a basis for the development of international consensus recommendations for the management of patients with HS. A systematic literature review was performed for each of nine clinical questions in HS (defined by an expert steering committee), covering comorbidity assessment, therapy (medical, surgical and combinations) and response to treatment. Included articles underwent data extraction and were graded according to the Oxford Centre for Evidence‐based Medicine criteria. Evidence‐based recommendations were then drafted, refined and voted upon, using a modified Delphi process. Overall, 5310 articles were screened, 171 articles were analysed, and 65 were used to derive recommendations. These articles included six randomized controlled trials plus cohort studies and case series. The highest level of evidence concerned dosing recommendations for topical clindamycin in mild disease (with systemic tetracyclines for more frequent/widespread lesions) and biologic therapy (especially adalimumab) as second‐line agents (following conventional therapy failure). Good‐quality evidence was available for the hidradenitis suppurativa clinical response (HiSCR) as a dichotomous outcome measure in inflammatory areas under treatment. Lower‐level evidence supported recommendations for topical triclosan and oral zinc in mild‐to‐moderate HS, systemic clindamycin and rifampicin in moderate HS and intravenous ertapenem in selected patients with more severe disease. Intralesional or systemic steroids may also be considered. Local surgical excision is suggested for mild‐to‐moderate HS, with wide excision for more extensive disease. Despite a paucity of good‐quality data on management decisions in HS, this systematic review has enabled the development of robust and easily applicable clinical recommendations for international physicians based on graded evidence.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
How genomic selection enables species to adapt to divergent environments is a fundamental question in ecology and evolution. We investigated the genomic signatures of local adaptation in Atlantic cod ...(Gadus morhua L.) along a natural salinity gradient, ranging from 35‰ in the North Sea to 7‰ within the Baltic Sea. By utilizing a 12 K SNPchip, we simultaneously assessed neutral and adaptive genetic divergence across the Atlantic cod genome. Combining outlier analyses with a landscape genomic approach, we identified a set of directionally selected loci that are strongly correlated with habitat differences in salinity, oxygen, and temperature. Our results show that discrete regions within the Atlantic cod genome are subject to directional selection and associated with adaptation to the local environmental conditions in the Baltic- and the North Sea, indicating divergence hitchhiking and the presence of genomic islands of divergence. We report a suite of outlier single nucleotide polymorphisms within or closely located to genes associated with osmoregulation, as well as genes known to play important roles in the hydration and development of oocytes. These genes are likely to have key functions within a general osmoregulatory framework and are important for the survival of eggs and larvae, contributing to the buildup of reproductive isolation between the low-salinity adapted Baltic cod and the adjacent cod populations. Hence, our data suggest that adaptive responses to the environmental conditions in the Baltic Sea may contribute to a strong and effective reproductive barrier, and that Baltic cod can be viewed as an example of ongoing speciation.
Awarded Best Reference by the New York Public Library (2004), Outstanding Academic Title by CHOICE (2003), and AAP/PSP 2003 Best Single Volume Reference/Sciences by Association of American ...Publishers' Professional Scholarly Publishing Division, the first edition of Encyclopedia of Insects was acclaimed as the most comprehensive work devoted to insects. Covering all aspects of insect anatomy, physiology, evolution, behavior, reproduction, ecology, and disease, as well as issues of exploitation, conservation, and management, this book sets the standard in entomology. The second edition of this reference will continue the tradition by providing the most comprehensive, useful, and up-to-date resource for professionals. Expanded sections in forensic entomology, biotechnology and Drosphila, reflect the full update of over 300 topics. Articles contributed by over 260 high profile and internationally recognized entomologists provide definitive facts regarding all insects from ants, beetles, and butterflies to yellow jackets, zoraptera, and zygentoma. * 66% NEW and revised content by over 200 international experts * New chapters on Bedbugs, Ekbom Syndrome, Human History, Genomics, Vinegaroons * Expanded sections on insect-human interactions, genomics, biotechnology, and ecology * Each of the 273 articles updated to reflect the advances which have taken place in entomology research since the previous edition * Features 1, 000 full-color photographs, figures and tables * A full glossary, 1, 700 cross-references, 3, 000 bibliographic entries, and online access save research time * Updated with online access
Summary
Background
Chronic nonhealing or recurrent inflammatory lesions, reminiscent of infection but recalcitrant to antibiotic therapy, generally characterize biofilm‐driven diseases. Chronic ...lesions of hidradenitis suppurativa (HS) exhibit several characteristics, which are compatible with well‐known biofilm infections.
Objectives
To determine and quantify the potential presence of bacterial aggregates in chronic HS lesions.
Methods
In 42 consecutive patients with HS suffering from chronic lesions, biopsies were obtained from lesional as well as from perilesional skin. Samples were investigated using peptide nucleic acid–fluorescence in situ hybridization in combination with confocal laser scanning microscopy. In addition, corresponding histopathological analysis on haematoxylin and eosin slides was performed.
Results
Biofilms were seen in 67% of the samples of chronic lesions and in 75% of the perilesional samples. The mean diameter of aggregates in lesional skin was significantly greater than in perilesional skin (P = 0·01). Large biofilms (aggregates > 50 μm in diameter) were found in 42% of lesional samples and in only 5% of the perilesional samples (P = 0·009). The majority of the large biofilms were situated in sinus tracts (63%) or in the infundibulum (37%). The majority of the sinus tract samples (73%) contained active bacterial cells, which were associated with inflammation.
Conclusions
This study suggests that biofilm formation is associated with inflammation of chronic HS lesions. The aggregates most likely occur as a secondary event, possibly due to predisposing local anatomical changes such as sinus tracts (tunnels), keratinous detritus and dilated hair follicles.
What's already known about this topic?
Chronic lesions of hidradenitis suppurativa (HS) exhibit several similarities with well‐known biofilm infections. Biofilms have previously been found in approximately 20% of lesions.
What does this study add?
Biofilm aggregates occur in 67–75% of sinus tracts and infundibula, and are larger in lesional skin than in perilesional skin, suggesting they are associated with established chronic lesions.
Abundant keratinous debris may provide the nidus that promotes biofilm formation by commensal cocci in chronic HS lesions.
What is the translational message?
This study supports the association between bacterial biofilms and chronic HS lesions.
Combining medical therapy with early surgical excision of chronic HS lesions or even simple deroofing may reflect the effective removal of otherwise intractable biofilms.
Respond to this article
Linked Comment: Stoodley. Br J Dermatol 2017; 176:855–856
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
For decades, researchers have sought to clarify the nature of the social communication impairments in autism, highlighting impaired or atypical 'social attention' as a key measurable construct that ...helps to define the core impairment of social communication. In this paper, we provide an overview of research on social attention impairments in autism and their relation to deficiencies in neural circuitry related to social reward. We offer a framework for considering social attention as a potential moderator or mediator of response to early behavioral intervention, and as an early indicator of efficacy of behavioral and/or pharmacological treatments aimed at addressing the social impairments in autism.
The microbiome of tunnels in hidradenitis suppurativa patients Ring, H.C.; Sigsgaard, V.; Thorsen, J. ...
Journal of the European Academy of Dermatology and Venereology,
September 2019, 2019-Sep, 2019-09-00, 20190901, Volume:
33, Issue:
9
Journal Article
Peer reviewed
Background
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined by recurrent nodules, tunnels and scarring involving the intertriginous regions. Recent next‐generation ...sequencing (NGS) studies suggest genera such as Prevotella spp., Peptoniphilus spp. and Porphyromonas spp. are associated with chronic and early HS lesions. However, a systematic investigation of the bacterial microbiome in HS tunnels remains unexplored using NGS.
Objective
We aimed to investigate the bacterial composition of the luminal white gelatinous material found in HS tunnels using NGS.
Methods
An exploratory study of patients with diagnosis of HS (n = 32) with tunnels. The tunnels were present either in the groin (n = 17) or in the axilla (n = 15). During deroofing of the tunnels, a sterile E‐swab was taken of the luminal gelatinous material. The samples were investigated using NGS targeting 16S ribosomal RNA.
Results
The skin microbiome was characterized in 32 HS patients. Overall, five microbiome types were identified: Porphyromonas spp. (type I), Corynebacterium spp., (type II), Staphylococcus spp. (type III), Prevotella spp. (type IV) and Acinetobacter spp (type V). Porphyromonas spp. (type I) and Prevotella spp. (IV) were the most frequent genera found the tunnels.
Conclusion
This study points to a potential association between the presence of certain anaerobic bacteria (Porphyromonas spp., Prevotella spp.) and HS tunnels. It may be speculated that these two genera are associated with the pathogenesis in HS either as drivers or as biomarkers.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Summary
Background
Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease of the hair follicle defined by recurrent nodules, tunnels and scarring involving the intertriginous regions. ...HS is associated with microbial dysbiosis and immune dysregulation. In HS, an increasing number of studies have investigated antimicrobial peptides (AMPs).
Objectives
To provide an overview of the literature on AMPs in HS, and to discuss the potential role of AMPs in the pathogenesis of HS.
Methods
PubMed, Embase and the Cochrane Library were searched. The titles, s and full texts of all articles were manually screened. Additionally, the reference lists of the included articles were screened and hand searched for relevant studies.
Results
The final literature sample comprised 18 retrospective and prospective studies (no reviews or commentaries) published between 2009 and 2020.
Conclusions
This review demonstrates the multitude of AMPs in HS. Although the methodology of the studies varied, the included studies indicate a consistent overexpression of human β‐defensin (hBD)‐2, S100A7, S100A8 and S100A9 at both the mRNA and protein levels, and a decreased expression of hBD‐1. Overall, the studies point to a dysregulation of AMPs in both lesional and nonlesional HS skin.
What is already known about this topic?
Various studies have investigated the level of antimicrobial peptides (AMPs) in hidradenitis suppurativa (HS).
What does this study add?
The data presented in this systematic review point to a dysregulation of AMPs in both lesional and nonlesional skin in HS.
Linked Comment: S.L. Schell and A.M. Nelson. Br J Dermatol 2022; 186:204–205.
Plain language summary available online
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
9.
Neuropsychiatry of the basal ganglia Ring, H A; Serra-Mestres, J
Journal of Neurology, Neurosurgery and Psychiatry,
01/2002, Volume:
72, Issue:
1
Journal Article, Book Review
Peer reviewed
Open access
This review aims to relate recent findings describing the role and neural connectivity of the basal ganglia to the clinical neuropsychiatry of basal ganglia movement disorders and to the role of ...basal ganglia disturbances in “psychiatric”' states. Articles relating to the relevant topics were initially collected through MEDLINE and papers relating to the clinical conditions discussed were also reviewed. The anatomy and connections of the basal ganglia indicate that these structures are important links between parts of the brain that have classically been considered to be related to emotional functioning and brain regions previously considered to have largely motor functions. The basal ganglia have a role in the development and integration of psychomotor behaviours, involving motor functions, memory and attentional mechanisms, and reward processes.
Endocannabinoids (eCBs) function as retrograde signaling molecules at synapses throughout the brain, regulate axonal growth and guidance during development, and drive adult neurogenesis. There ...remains a lack of genetic evidence as to the identity of the enzyme(s) responsible for the synthesis of eCBs in the brain. Diacylglycerol lipase-alpha (DAGLalpha) and -beta (DAGLbeta) synthesize 2-arachidonoyl-glycerol (2-AG), the most abundant eCB in the brain. However, their respective contribution to this and to eCB signaling has not been tested. In the present study, we show approximately 80% reductions in 2-AG levels in the brain and spinal cord in DAGLalpha(-/-) mice and a 50% reduction in the brain in DAGLbeta(-/-) mice. In contrast, DAGLbeta plays a more important role than DAGLalpha in regulating 2-AG levels in the liver, with a 90% reduction seen in DAGLbeta(-/-) mice. Levels of arachidonic acid decrease in parallel with 2-AG, suggesting that DAGL activity controls the steady-state levels of both lipids. In the hippocampus, the postsynaptic release of an eCB results in the transient suppression of GABA-mediated transmission at inhibitory synapses; we now show that this form of synaptic plasticity is completely lost in DAGLalpha(-/-) animals and relatively unaffected in DAGLbeta(-/-) animals. Finally, we show that the control of adult neurogenesis in the hippocampus and subventricular zone is compromised in the DAGLalpha(-/-) and/or DAGLbeta(-/-) mice. These findings provide the first evidence that DAGLalpha is the major biosynthetic enzyme for 2-AG in the nervous system and reveal an essential role for this enzyme in regulating retrograde synaptic plasticity and adult neurogenesis.
PDF
