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Identification of a non-S RNase, a possible ancestral form of S-RNases, in Prunus.

This study identifies and characterizes a basic non-S RNase in the styles with stigmas of sweet cherry (Prunus avium L.), a member of the Rosaceae subfamily Amygdaloideae, which has an RNase-based gametophytic self-incompatibility system. Internal sequences of putative non-S RNases (RNase PA1 and PA2) were determined, and a cDNA for PA1 was obtained. The deduced amino acid sequence of PA1 contained two conserved sequence motifs essential for T2/ S-type RNase activity. PA1 shows 20-30% sequence identity to S-RNases of Rosaceae, Solanaceae and Scrophulariaceae, and non-S RNases of higher plants. Transcription of the PA1 gene was specific to the styles with stigmas, and the gene was not expressed in other tissues. Although PA1 resembles RNase X2, a non-S RNase from Petunia inflata, the placement of PA1 and RNase X2 in the phylogenetic tree was quite different. Placement of PA1 was also distinct from that of rosaceous S-RNases, while RNase X2 was incorporated in the clade of S-RNases from the Solanaceae. The sole intron in the PA1 gene is located at a position equivalent to that of the second intron of amygdaloid S-RNase genes, and that of the only intron in most other S-RNase genes. Genomic Southern analysis revealed the presence of sequences homologous to PA1 in all of the other four Prunus species tested, suggesting that PA1 has an important physiological function. The significance of the discovery of PA1 is discussed in terms of the origin and evolution of S-RNases and self-incompatibility in Rosaceae.

Amino Acid Motifs↗

Tear and serum soluble leukocyte activation markers in conjunctival allergic diseases.

PURPOSE: To measure markers of leukocyte activation in patients with an exclusively ocular inflammatory or bacterial disease. METHODS: Neutrophil myeloperoxidase, eosinophil cationic protein, eosinophil neurotoxin, and soluble interleukin-2 receptor were measured in serum and tears of 17 patients with allergic vernal keratoconjunctivitis, seven with atopic keratoconjunctivitis, 11 with seasonal allergic conjunctivitis, seven with giant papillary conjunctivitis, 13 with rosacea blepharokeratoconjunctivitis, seven with bacterial conjunctivitis, and 13 normal subjects as controls. RESULTS: In serum of patients with vernal and atopic keratoconjunctivitis, levels of eosinophil cationic protein, eosinophil neurotoxin, and interleukin-2 receptor were significantly increased compared with control subjects but were not correlated with the severity of ocular symptoms. In tears of patients with vernal and atopic keratoconjunctivitis and seasonal allergic conjunctivitis, as well as in the nonallergic diseases, rosacea blepharokeratoconjunctivitis and bacterial conjunctivitis, levels of eosinophil cationic protein, neurotoxin, and interleukin-2 receptor were significantly increased compared with control subjects. The highest values of these markers were found in vernal keratoconjunctivitis samples. Neutrophil myeloperoxidase was significantly increased in vernal and atopic keratoconjunctivitis, rosacea blepharokeratoconjunctivitis, and bacterial conjunctivitis. In vernal keratoconjunctivitis, tear markers were correlated to the clinical score of the disease, but not with cytology. CONCLUSIONS: Tear histamine was measured in 10 allergic patients after allergen challenge. Although none of the above markers can be considered specific to a single disease, their measurement may still be useful for the quantification of local cell activation in ocular inflammatory diseases.

Adolescent↗

[Advantages of the in vivo HRT2 corneal confocal microscope for investigation of the ocular surface epithelia].

PURPOSE: To show the advantages of the in vivo HRT2 confocal microscope corneal module for studying the superficial and peripheral corneal and conjunctival epithelia. MATERIAL AND METHODS: We examined 15 patients whose superficial cornea was healthy and ten patients with keratoconjunctivitis sicca and/or rosacea. Some conjunctival imprints where taken on patients with superficial ocular disease and examined by immunofluorescence. RESULTS: We found superficial corneal epithelial cells, corneoconjunctival Langerhans and dendritic cells, goblet cells, limbic epithelial junction, new blood vessels, as well as deeper corneal structures such as Bowman's membrane, keratocytes, corneal nerves, and endothelium. We also observed pathological corneal epithelium in keratoconjunctivitis sicca and substantial inflammatory and vascular changes in rosacea. In two cases of stem cell deficiency associated with rosacea, we observed goblet cells in the corneal epithelium. An interesting anatomical-clinical parallelism between in vivo confocal microscopy images and those obtained by ex vivo immunofluorescence was observed. DISCUSSION: Central corneal pictures after explorations by in vivo HRT2 confocal microscopy are similar to those obtained with standard confocal microscopy. But conjunctiva, peripheral cornea and limbus are better examined at the surface and at medium depth with the HRT2. Diagnosis and therapy of superficial corneoconjunctival and limbal diseases are therefore made easier in vivo.

Conjunctiva↗

In vitro evaluation of the effects of metronidazole on rabbit corneal epithelial cells.

Because of its usefulness in treating facial rosacea, metronidazole may also be an effective treatment for ocular rosacea. The toxicity of metronidazole on the corneal epithelium has not previously been reported. In this study, the effects of metronidazole on rabbit corneal epithelium in vitro were evaluated. Epithelial cell cultures were exposed to various concentrations of metronidazole to determine its effect on cell morphology, viability, and wound healing. Both morphological changes and cell loss were seen after 1 day of incubation in media containing metronidazole at concentrations of > or = 3.0 mg/ml. In media with metronidazole at 1.0 mg/ml, these toxic effects were not seen. The effects of metronidazole on wound healing were determined by comparing the area of wounds in the epithelial cell layer for time periods of up to 44 h. There was no statistically significant delay in wound closure when cells were incubated in media containing metronidazole at a concentration of 2.0 mg/ml as compared with cultures incubated in media without metronidazole. However, a significant delay in wound closure occurred at concentrations of > or = 3.0 mg/ml. The results at these drug concentrations suggest that metronidazole has low corneal epithelial toxicity. Allowing for the dilutional effects of tears in patients with normal tear function, concentrations of 4.0-5.0 mg/ml (0.4-0.5%) would probably be tolerated by the corneal epithelium. Clinical safety and efficacy studies are necessary to determine if topical metronidazole will prove useful for the treatment of ocular rosacea.

Animals↗

The clinical importance of demodex folliculorum presenting with nonspecific facial signs and symptoms.

Demodex folliculorum (D. folliculorum), found in the pilosebaceous unit, is the most common ectoparasite of humans. Various clinical forms such as pustular folliculitis, papulopustular scalp eruptions, perioral dermatitis, and blepharitis have been defined, although in general, the disease has been classified into three main groups as "pityriasis folliculitis", "rosacea-like demodicidosis", and granulomatous rosacea-like "demodicidosis gravis". Our aim was to test for the presence of D. folliculorum in pathogenic numbers in patients who came to our clinic with non-specific symptoms such as facial itching with or without erythema, seborrheic dermatitis-like or perioral dermatitis-like lesions, papulopustular lesions, and an acneiform clinical appearance without telengiectasia or flushing. Twenty-eight (87.5%) female and 4 male (12.5%), patients and 33 age-and-sex matched healthy subjects enrolled in this study. D. folliculorum was sought in the lesion sites using the non-invasive method known as the Standardised Skin Surface Biopsy (SSSB). The discovery of more than five parasites in an area of 1 cm2, was evaluated as pathogenic. For treatment, 5% permethrine cream was applied twice daily for 15 to 30 days. The clinical symptoms of the patients were classified into clinical groups and evaluated as facial itching in 2 (6.3%), nonspecific erythema and itching in 21 (65.6%), erythema and pityriasiform squamous lesions in 3 (9.4%), acneiform in 3 (9.4%), papulopustular lesions in 1 (3.1%), granulomatous rosacea-like in 1 (3.1%), and perioral dermatitis-like symptoms in 1 (3.3%), D. folliculorum density was determined as 5>D/cm2 in all clinical lesions. A significant clinical healing and density of D. folliculorum at <=5 D/cm2 was determined in all but two patients after treatment. We consider that D. folliculorum presentation with different symptoms and signs than classical forms is not rare. For this reason, we suggest that it is useful to test for D. folliculorum in patients with non-classical presentations like facial itching, itching accompanied by non-specific erythema, itching and non-specific pityriasiform squamous lesions, and acneiform lesions.

Administration, Cutaneous↗

Hemangioma-associated rhinophyma. Report of a case with successful treatment using carbon dioxide laser surgery.

BACKGROUND: Rosacea is a disorder characterized by erythematous papules, pustules, and telangiectases involving the nose, chin, cheeks, and forehead that may progress to rhinophyma. Although the etiology of rosacea remains unclear, a common theme in pathogenesis is vasodilation. Rosacea has been associated with both idiopathic flushing as well as that induced secondarily. OBJECTIVE: To report clinical and histologic features of rhinophyma that developed in association with a longstanding cavernous hemangioma. RESULT: The patient is a 57-year-old Hispanic man with a congenital port-wine stain that had developed into a nodular, cavernous hemangioma over the course of years. Clinically, in the site of the angioma there was marked soft-tissue overgrowth with sebaceous hyperplasia. These changes were confined to the angiomatosis areas and were sharply demarcated from the surrounding normal skin. Histologically, there was marked fibroplasia; numerous small cysts, some with focal rupture and inflammation; dilated follicular ostia; and prominent sebaceous gland hyperplasia in addition to numerous ectatic blood vessels, which were a component of the hemangioma. In contrast, normal-appearing skin adjacent to this site revealed only normal sebaceous glands and no fibroplasia. Treatment consisted of CO2 laser excision of the nodular components of the hemangioma with a tightly focused beam, followed by resculpting of the natural facial contour with laser abrasion of hypertrophic soft tissues with a broad, unfocused beam. The treated area healed well, with a skin tone of a more natural color than the original hemangioma. CONCLUSION: Our findings suggest that rhinophyma may develop secondary to the vasodilation seen in large hemangiomas and that the CO2 laser offers excellent treatment for both the vascular and stromal components of the lesion.

Hemangioma, Cavernous↗

Failure of reticular erythematous mucinosis to respond to cyclosporine.

We describe a 48-year-old woman who had worsening psoriasis, photosensitive reticular erythematous mucinosis (REM), and acne rosacea. The psoriasis was unresponsive to etretinate, and the REM was unsuccessfully treated with hydroxychloroquine. Cyclosporine (6 mg/kg/day) successfully cleared the psoriasis in 8 weeks but did not improve the REM and acne rosacea. Possible causes for the lack of response of the REM to cyclosporine are discussed.

Cyclosporine↗

Minocycline effect on meibomian gland lipids in meibomianitis patients.

The objective of this research was to determine the effect of oral minocycline on the meibomian gland nonpolar and free fatty acid lipids of chronic blepharitis patients. Patients--seborrheic blepharitis (SBBL), acne rosacea (AR) without ocular involvement, and acne rosacea with meibomianitis (AR-MKC). Minocycline treatment--50mg orally for 2 weeks followed by 100mg to the end of 3 months; this was followed by 3 more months with no treatment. Meibomian gland secretions (meibum) were collected before treatment, at the end of the 3 months on treatment, and 3 months after stopping treatment. Lipids were separated and analyzed for wax and sterol esters, triglycerides, diglycerides, free cholesterol and free fatty acids. Data were analyzed statistically by ANOVA. Minocycline treatment resulted in decreased diglycerides and free fatty acids in the group AR-MKC, which continued into the second 3 months (off treatment) and was significant. Cholesterol decreased, but triglycerides initially decreased with treatment and then increased when treatment in the group was discontinued (second 3 months); these results, however, were not significant. Thus, minocycline has its greatest effect on lipid types, which result from degradation (lipase) reactions, suggesting a lipase inhibition effect and/or direct effect on ocular flora. This minocycline effect continues even after treatment is discontinued, suggesting a more lasting effect on ocular microflora. Minocycline may be most effective when the treatment period is longer than 3 months. These results give insight into disease mechanisms associated with chronic blepharitis.

Analysis of Variance↗

Complications of topical hydrocortisone.

Chronic and uninterrupted application of 1% hydrocortisone was followed by complications in six patients. Three developed a rosacea-like eruption for the first time and one also had perioral dermatitis. All of these responded to treatment and remained clear. Another patient had a severe exacerbation of rosacea following use and withdrawal of 1% hydrocortisone cream. Two female adults developed atrophy and telangiectasia of the eyelids following long-term application of 1% hydrocortisone cream. The severity of the complications reported was generally less than that found following use of more potent topical corticosteroids. However, the complications experienced by these patients would suggest that therapy with any effective topical corticosteroid should be intermittent. Particular care should be used in susceptible individuals and in vulnerable areas such as the eyelids.

Administration, Topical↗

[Cross-reactivity between fruit and vegetables].

Vegetable foods are the most frequent cause of food allergy after the age of 5 years. The most commonly implicated foods are fruit and dried fruits, followed in Spain by legumes and fresh garden produce. In patients allergic to fruit and garden produce, multiple sensitizations to other vegetable products, whether from the same family or taxonomically unrelated, are frequent, although they do not always share the same clinical expression. Furthermore, more than 75 % of these patients are allergic to pollen, the type of pollen varying in relation to the aerobiology of the area. The basis of these associations among vegetable foods and with pollens lies in the existence of IgE antibodies against "panallergens", which determines cross-reactivity. Panallergens are proteins that are spread throughout the vegetable kingdom and are implicated in important biological functions (generally defense) and consequently their sequences and structures are highly conserved. The three best-known groups are allergens homologous to Bet v 1, profilins, and lipid transfer proteins (LTP). Allergens homologous to Bet v 1 (major birch pollen allergen) constitute a group of defense proteins (PR-10), with a molecular weight of 17 kDa, which behave as major allergens in patients from northern and central Europe with allergy to vegetables associated with birch pollen allergy. In these patients, the primary sensitization seems to be produced through the inhalation route on exposure to birch pollen. The symptomatology characteristically associated with sensitization to this family of allergens is oral allergy syndrome (OAS). Profilins are highly conserved proteins in all eukaryotic organisms and are present in pollen and a wide variety of vegetable foods. They have a molecular weight of 14 kDa and present a high degree of structural homology as well as marked cross-reactivity among one another. The presence of anti-profilin IgE broadens the spectrum of sensitizations to vegetable foods detected through skin tests and/or in vitro tests but whether it correlates with the clinical expression of food allergy is unclear.LTPs are the most commonly implicated allergens in allergy to Rosaceae fruits in patients from the Mediterranean area without birch pollen sensitization. LTPs are a family of 9kDA polypeptides, widely found in the vegetable kingdom and implicated in cuticle formation and defense against pathogens (PR-14). They are thermostable and resistant to pepsin digestion, which makes them potent food allergens and explains the frequent development of systemic symptoms (urticaria, anaphylaxis) in patients allergic to Rosaceae fruits in Spain. LTPs have also been identified in other vegetable foods and in pollens and a marked degree of cross-reactivity among them has been demonstrated, which may explain (together with profilin) the frequency of individuals sensitized to vegetable foods in the Mediterranean area.

Allergens↗

Distribution and contents of phenolic compounds in eighteen Scandinavian berry species.

Berries contain a wide range of phenolic compounds in different conjugated forms, a fact that makes their simultaneous analysis a difficult task. In this work, soluble and insoluble phenolic compounds were identified and quantified in 18 species of berries by reversed phase high-performance liquid chromatography combined with diode array detection. The analytical results and literature data were used for the identification of the predominant conjugated hydroxycinnamic acids, flavonol glycosides, and anthocyanins in berries from six families, viz. Grossulariaceae, Ericaceae, Rosaceae, Empetraceae, Elaeagnaceae, and Caprifoliaceae. The study showed distinctive similarities among berry species of the same family in the distribution of conjugated forms of phenolic compounds but differences in chromatographic profiles of conjugates and compositions of aglycones especially in the case of anthocyanins. The chromatographic profiles of chokeberry and the related sweet rowanberry (Rosaceae) were exceptionally similar. These data are informative to studies on the authenticity of berry raw materials as well as to those on the evaluation of berries as sources of phenolic compounds.

Anthocyanins↗

Evidence for rare recombination at the gametophytic self-incompatibility locus.

The gametophytic self-incompatibility locus has been thought to be a nonrecombining genomic region. Inferences have been made, however, about the functional importance of different parts of the S-locus, based on differences in the levels of variability along the gene, and this is valid only if recombination occurs. It is thus important to test whether recombination occurs within and near the S-locus. Several recent attempts to test this have reached conflicting conclusions. In this study, we examine a large data set on sequence variation at the S-locus in several species with gametophytic self-incompatibility systems, in the Solanaceae, Rosaceae and Scrophulariaceae. We use the longest sequences available to test for recombination based on linkage disequilibrium between polymorphic sites in the S-locus. The relationship between linkage disequilibrium and physical distance between the sites suggests rare intragenic exchange in the evolutionary history of four species of Solanaceae and two species of Rosaceae.

Alleles↗

[Topical administration of metronidazole gel as an effective therapy alternative in chronic Demodex blepharitis--a case report].

BACKGROUND: Blepharoconjunctivitis is the commonest manifestation of ocular rosacea. Cilia epilation proves Demodex folliculorum, considered an etiologic factor in rosacea. Complications and differential diagnosis include dry eyes, seborrheic, bacterial and allergic blepharoconjunctivitis. Treatment involves lid scrubs and mercury ointment, its duration is limited to 6 weeks under frequent control due to corneal toxicity of mercury. HISTORY AND SIGNS: 30-year-old female with complaint of red, irritated eyes for 21 years, resistant to antibiotics and antiallergics. General medical history unremarkable, mercury allergy. Acuity: R/L 20/20. Biomicroscopy: red, thickened eyelid margins, crusty debris on rarefied, partially broken lashes, conjunctival telangiectasia, low tear meniscus, further ophthalmologic examination unremarkable. DIAGNOSIS: chronic Demodex blepharoconjunctivitis. THERAPY AND OUTCOME: Conventional treatment was contraindicated due to mercury allergy. Alternative oral minocycline 100 mg daily brought no subjective nor objective relief. Combination of lid scrubs and 2% Metronidazole gel relieved symptoms and halved number of mites after 1 month, lashes grew again after 2 months. Treatment was discontinued after 6 months as Demodex folliculorum proof remained negative. No relapse occurred during 1 year. CONCLUSIONS: Topical Metronidazole 2% proved to be an effective treatment of chronic Demodex blepharoconjunctivitis in our case and thus may offer a new and save alternative to existing therapies. Neither ocular nor systemic side effects occurred. Controversial theories on the aetiology of blepharitis are discussed.

Administration, Topical↗

Study on the inhibitory effects of Korean medicinal plants and their main compounds on the 1,1-diphenyl-2-picrylhydrazyl radical.

A 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical-generating system was used to evaluate the antioxidant properties of Korean medicinal plants that have been used widely as folk medicines for several disorders, as well as compounds isolated from them. Among the Rosaceae, Rosa rugosa and Rosa davurica showed strong DPPH radical-scavenging activity. The most effective medicinal plant from families other than Rosaceae was Cedrela sinensis, followed in order by Nelumbo nucifera, Eucommia ulmoides, Zanthoxylum piperitum, Cudrania tricuspidata and Houttuynia cordata. These results serve as a good index of the free radical-scavenging activities of Korean medicinal plants. Furthermore, the polyphenols isolated from these plants, procyanidin B-3, (+)-catechin, gallic acid, methyl gallate, quercetin, quercetin-3-O-beta-D-glucoside, quercetin-3-O-beta-galactoside, quercetin-3-O-rutinose and kaempferol, exerted strong DPPH radical-scavenging activity. These results suggest that the Korean medicinal plants and the polyphenols isolated from them that exhibited effective radical-scavenging activity may be promising agents for scavenging free radicals and treating diseases associated with excess free radicals.

Biflavonoids↗

Role of mild cleansing in the management of patient skin.

Routine everyday care of skin is an essential part of optimal patient management. Common problems such as xerosis, dermatitis, eczema, psoriasis, acne, rosacea, and photodamage leave the skin vulnerable to external insults, partly as a result of varying levels of barrier dysfunction. Cosmetic surgery procedures also typically damage the stratum corneum (SC) and leave skin with a very weak barrier during recovery phase. Cleansing is an important aspect of any skin care, since it not only removes unwanted dirt, soil, and bacteria from skin, but also removes dead surface cells, preparing skin to better absorb topically applied drugs/medication. Care must be taken to minimize any further weakening of the SC barrier during cleansing. Cleansers based on mild synthetic surfactants and/or emollients that cause minimal barrier perturbation are ideal for these patients. The present paper is a brief review of four clinical trials that evaluated the efficacy and compatibility of either mild syndet bars or cleansers in patients with atopic dermatitis, acne, rosacea, or patients who had received chemical peels or Retin-A(R) (tretinoin) treatment for sustained photodamage.

Acne Vulgaris↗

Elephantoid oedema of the eyelids.

We describe a male patient with rosacea who had a 2-year history of persistent bilateral oedema of the eyelids, leading to an elephantoid condition with blepharoptosis. An upper eyelid blepharoplasty was performed, but swelling progressively recurred over a few months. Based on the case history, clinical appearance and histological findings, rosaceous lymphoedema was considered to be the diagnosis. The latter is a bilateral, solid oedema of the mid-third of the face, regarded as a rare complication of rosacea. It is thought to occur as a result of chronic inflammation and lymphatic stasis, but its exact aethiopathogenesis remains elusive. Predominant eyelid involvement, causing severe visual impairment as in our patient, is unique.

Aged↗

Skin tolerance, efficacy, and quality of life of patients with red facial skin using a skin care regimen containing Licochalcone A.

BACKGROUND: Patients with rosacea and red facial skin often show sensitivity to skin care products which can exacerbate inflammation and subjective irritation. Besides pharmacologic management, special skin care is prudent to avoid cosmetically induced irritation and address cosmetic concerns. Appropriate skin care should provide gentle cleansing, UVA/UVB protection, effective moisturization, and concealing pigments to neutralize the appearance of redness. AIMS: To evaluate skin compatibility and efficacy of a skin care regimen containing licochalcone A (Lic A), an anti-irritant from the licorice plant Glycyrrhiza inflata, for subjects with mild to moderate facial redness. PATIENTS/METHODS: Sixty-two patients with mild to moderate red facial skin used a four-product skin care regimen for 8 weeks. Clinical assessments of erythema and subjective irritation, cross-polarized photography, and self-assessment questionnaires were completed at baseline, and after 4 and 8 weeks of use. A quality of life questionnaire was given at baseline and week 8. RESULTS: Clinical evaluations, subject response, and photography confirmed very good tolerability of the regimen and effective neutralization of redness by the pigmented products. Significant improvements in average erythema scores were observed at 4 and 8 weeks (P < 0.05), and an improvement in quality of life was confirmed by the patient questionnaires. DISCUSSION: The skin care regimen containing Lic A was found to be compatible with the sensitive facial skin of patients with rosacea and improved the appearance of persistent facial redness. The products were also observed to be compatible with daily metronidazole treatment.

Adult↗

Skin problems in workers using visual display terminals. A study of 201 patients.

201 patients with skin problems caused in their own opinion by working with visual display terminals (VDTs) were referred and examined. 18% claimed that their condition improved overnight and 21% that it did so over the weekend. In 25 patients, the skin problems occurred mainly on the cheek turned towards the VDT. Half the patients had rosacea, but their subjective skin symptoms were generally more severe than those in ordinary cases of rosacea, i.e., severe pain, itching and burning. The rest of the patients mainly had common facial dermatoses such as seborrhoeic eczema, acne vulgaris and atopic dermatitis. The patients' skin types, judged by their response to ultraviolet light, did not differ from those of a control population. 18% had non-specific skin problems, e.g., itching and redness. This latter group of patients most closely resembles those cases previously described amongst VDT-workers. An attempt to correlate skin problems with VDTs' electrostatic field strength was unsuccessful because of difficulties in eliminating it. Of 52 electrostatic shields placed in front of patients' VDTs, 38 were defective and 9 were wrongly earthed. The prevalence of migraine-like headache was 40%, which is much higher than in a control population. There was no great use of cosmetics by the study population. When followed up after an average of 8 months, 2/3 of the patients had fewer skin complaints. The question of whether the prevalence of skin problems in general is higher amongst individuals using VDTs than in a control population is addressed in a current study.

Adult↗