News
Scientists grow cartilage to reconstruct nose
A research team from the University of Basel in Switzerland has reported that nasal reconstruction using engineered cartilage is possible. They used a method called tissue engineering where cartilage is grown from patients' own cells. This new technique was applied on five patients, aged 76 to 88 years, with severe defects on their nose after skin cancer surgery. One year after the reconstruction, all five patients were satisfied with their ability to breathe as well as with the cosmetic appearance of their nose. None of them reported any side effects.
Cells from the nasal septum
The type of non-melanoma skin cancer investigated in this study is most common on the nose, specifically the alar wing of the nose, because of its cumulative exposure to sunlight. To remove the tumor completely, surgeons often have to cut away parts of cartilage as well. Usually, grafts for reconstruction are taken from the nasal septum, the ear or the ribs and used to functionally reconstruct the nose. However, this procedure is very invasive, painful and can, due to the additional surgery, lead to complications at the site of the excision.
Together with colleagues from the University Hospital, the research team from the Department of Biomedicine at the University of Basel has now developed an alternative approach using engineered cartilage tissue grown from cells of the patients' nasal septum. They extracted a small biopsy, isolated the cartilage cells (chondrocytes) and multiplied them. The expanded cells were seeded onto a collagen membrane and cultured for two additional weeks, generating cartilage 40 times the size of the original biopsy. The engineered grafts were then shaped according to the defect on the nostril and implanted.
New possibilities for facial reconstruction
According to Ivan Martin, Professor for Tissue Engineering at the Department of Biomedicine at the University and University Hospital of Basel, "The engineered cartilage had clinical results comparable to the current standard surgery. This new technique could help the body to accept the new tissue better and to improve the stability and functionality of the nostril. Our success is based on the long-standing, effective integration in Basel between our experimental group at the Department of Biomedicine and the surgical disciplines at the University Hospital. The method opens the way to using engineered cartilage for more challenging reconstructions in facial surgery such as the complete nose, eyelid or ear."
Journal Reference:
1. Ilario Fulco, Sylvie Miot, Martin D Haug, Andrea Barbero, Anke Wixmerten, Sandra Feliciano, Francine Wolf, Gernot Jundt, Anna Marsano, Jian Farhadi, Michael Heberer, Marcel Jakob, Dirk J Schaefer, Ivan Martin. Engineered autologous cartilage tissue for nasal reconstruction after tumour resection: an observational first-in-human trial. The Lancet, 2014; DOI:10.1016/S0140-6736(14)60544-4
Nickel allergy: Dermatologists share tips to avoid exposure and reduce symptoms
According to board-certified dermatologists from the American Academy of Dermatology, nickel is one of the most common causes of allergic contact dermatitis: a skin rash or irritation caused by touching an allergen. In fact, it is estimated that more than 18 percent of people in North America are allergic to nickel, including 11 million children in the U.S., making it a widespread public health concern.
“If you have a nickel allergy, the best way to avoid symptoms is to avoid objects containing nickel,” said board-certified dermatologist Jenny Eileen Murase, MD, FAAD, assistant clinical professor of dermatology, University of California San Francisco (UCSF) Medical Center. “However, this can be challenging, since nickel is present in many common household items.”
To avoid exposure and reduce symptoms, Dr. Murase recommends the following tips:
1. Choose jewelry carefully. It’s common for a nickel allergy to develop from wearing jewelry containing nickel. Earrings, earring backs and watches are some of the biggest culprits; however necklaces, rings and bracelets containing nickel can also trigger symptoms. To avoid exposure, only wear jewelry that is nickel-free, hypoallergenic, or made from metals such as surgical-grade stainless steel, 18-, 22-, or 24-karat yellow gold, pure sterling silver, or platinum. In addition, wear watchbands made of leather, cloth or plastic.
2. Check your clothing. It’s also common for belt buckles, bra hooks, and metal buttons, zippers and snaps to contain nickel. If your clothing has these, replace them with ones that are plastic or plastic-coated. You can also create a barrier between these items and your skin by coating the items with clear nail polish. However, the nail polish will need to be re-applied often.
3. Cover electronics. Recent reports suggest that some electronic devices, including cell phones, laptops, and tablets, may contain nickel. To avoid exposure, always use a protective cover on your electronic devices.
4. Substitute household objects containing nickel with objects made of other materials. Examples include brass keys, titanium-coated or stainless steel razors, pots and pans with silicone handles, and titanium or plastic eyeglass frames.
5. Avoid foods containing nickel if you are extremely sensitive to nickel. Some foods that contain high amounts of nickel include soy products—such as soybeans, soy sauce, and tofu—licorice, buckwheat, cocoa powder, clams, cashews and figs.
These tips are demonstrated in “Nickel Allergy: How to Avoid Exposure and Reduce Symptoms,” a video posted to the AAD website and YouTube channel.
American Academy of Dermatology issues new guidelines of care for acne treatment
Acne is the most common skin condition in the United States, affecting up to 50 million people every year. Fortunately for these patients, there are several treatment options available to help them manage their condition, as outlined in the American Academy of Dermatology’s new “Guidelines of care for the management of acne vulgaris.” Published online in the Journal of the American Academy of Dermatology on Feb. 17, the evidence-based guidelines cover acne treatment recommendations for both adolescents and adults.
“There are a variety of effective treatments available for acne, and dermatologists have found that combining two or more treatments is the best option for the majority of patients,” says board-certified dermatologist Andrea Zaenglein, MD, FAAD, co-chair of the expert work group that developed the guidelines. “Recommended treatments include topical therapy, antibiotics, isotretinoin and oral contraceptives.”
When antibiotics are used for the treatment of moderate to severe acne, the guideline recommends that topical therapy be used at the same time. Once a course of antibiotics is complete, patients should continue using topical treatments to manage their condition. Topical medications, such as retinoids and benzoyl peroxide, also may be combined with one another to create an effective treatment regimen. Additionally, some female patients may see their acne improve with the use of oral contraceptives, which can be combined with other treatments.
For severe acne or moderate acne that does not respond to other therapy, the guidelines recommend oral isotretinoin. Because this medication carries a high risk of birth defects, females must take careful steps to prevent pregnancy while on isotretinoin, and all patients who take the drug must enroll in the federal iPledge program. While some studies have suggested a connection between oral isotretinoin and inflammatory bowel disease or depressive symptoms, the evidence is not conclusive; however, patients should be aware of these risks and carefully follow their doctor’s treatment advice.
Although limited data has shown that in-office procedures like laser treatments or chemical peels may improve acne, the guidelines do not recommend such procedures for routine acne treatment. The guidelines also indicate that there is not enough evidence to recommend treating acne with alternative therapies like tea tree oil.
Some research suggests that dairy products, particularly skim milk, and diets with a high glycemic index, such as those high in sugar and carbohydrates, may be linked to acne. According to the guidelines, however, there is not enough data to recommend dietary changes for acne patients.
Smoking ages skin across the body
Research in Archives of Dermatology observed the effect by looking at the upper part of the inner arm in smokers and non-smokers. Previous studies have focused on the face, where skin can also be damaged by exposure to the sun.
But the University of Michigan, Ann Arbour, team say this study shows smoking alone makes the skin age, which may help persuade some to quit.
The researchers photographed 82 people's upper inner right arms. Participants were aged 22 to 91: old and young skin.
Half of those studied had a history of smoking and had smoked, on average, for 24 years. Rangeof packs of cigarettes they smoked: from a quarter of a packet to four packs per day. The team created a nine-point scale to measure damage to skin which is not exposed to the light.
In those aged over 65, there was almost a two-point difference between smokers and non-smokers. In the over-45s, the difference was around a point.
Writing in Archives of Dermatology, the researchers led by Dr Yolanda Helfrich, said: "We found that the number of packs of cigarettes smoked per day, total years of smoking and pack-years of smoking [an average of packs per day over the number of years of smoking] were correlated with the degree of skin aging.
"After controlling for age and other variables, we found that only packs of cigarettes smoked per day was a major predictor of the degree of photo-protected skin ageing."
Dr Helfrich said: "Previous studies have shown that smokers have a greater degree of skin ageing, but those have looked at facial skin.
"There are some sceptics who said the sun was having some of the effect.
"We have demonstrated that there was a significant degree of damage just from smoking."
(…) "The evidence is certainly mounting up that smoking is not good for you. This just adds to all of that."
She said more research was needed to show exactly how smoking damaged the skin.
Indy Rihal, of the British Skin Foundation, said: "In addition to UV light from the sun and sun beds, cigarette smoke is a main environmental factor that causes changes in the skin often associated with 'looking old' such as coarse wrinkling and a sallow, leathery texture.
"There is strong evidence suggesting cigarette smoke has a negative effect on the appearance of skin.
"Smoking enhances an enzyme in the skin, matrix metalloproteinase-1, resulting in increased collagen breakdown and diminished collagen production. The overall effect causes wrinkling and inelasticity.
"In addition the constriction of tiny blood vessels in the skin caused by smoking reduces the oxygen supply to the skin negatively affecting skin health and appearance in general."
Signs of aging appear in mid-20s, study finds
The findings in the Proceedings of the National Academy of Sciences’ July 6 issue are based on a group of 954 people born in New Zealand in 1972 or 1973.
Researchers collected data on the subjects’ kidney, liver and lung function, dental health, the blood vessels in the eyes as well as their metabolism and immune system function at age 26, 32 and 38. They also measured cholesterol, fitness levels and the length of the telomeres, which are the protective caps at the end of chromosomes that have been found to shorten with age.
Using a total of 18 biological measurements, researchers determined a “biological age” for each participant at age 38 — with some registering under 30 and others appearing to be nearly 60.
When scientists looked closely at the ones who had aged more quickly, they found signs of deterioration were apparent at age 26, the age when the first set of biological measurements were taken. Most of those in the group were aging at the expected rate of one biological year per chronological year, or even less. Others were aging as fast as three biological years per chronological year.
Those whose bodies were aging faster also “scored worse on tests typically given to people over 60, including tests of balance and coordination and solving unfamiliar problems,” said the study. And when a group of university students at Duke (Durham, North Carolina) was asked to look at pictures of people in the group, they consistently rated as older those whose bodies were aging more quickly than the rest.
Study authors said their findings pave the way for future tests that may be easier and cheaper to implement, so that people can find out how fast they are aging in their 20s, when they might be able to do something about it and possibly prevent age-related diseases.
Previous research has shown that genes account for only about 20 percent of aging, leaving the rest up to health behaviors and the environment.
“That gives us some hope that medicine might be able to slow aging and give people more healthy active years,” said senior author Terrie Moffitt, professor of psychology and neuroscience at Duke University
Novel herpes virus isolated from bat cells
Researchers from Maryland and New York have identified a novel herpes virus in cells taken from a bat. The work, published this week inmSphere, the American Society for Microbiology's new open access journal, could lead to better understanding of the biology of these viruses and why bats serve as hosts for a number of viruses that can potentially transfer to humans.
The investigators set out to study bats' immune response to infection, looking at cells from a tumor taken from the wing of an adult female bat found in a cave in Texas. While using a laboratory technique called next-generation sequencing to study genetic material from the cells, they quickly noticed that a large number of genes expressed weren't bat genes but instead were genes related to herpes viruses.
Through further lab experiments, they isolated and characterized a novel bat gammaherpesvirus, bat gammaherpesvirus 8 (BGHV8). In humans, gammaherpesviruses like Epstein-Barr virus are known for causing diseases like infectious mononucleosis and some cancers. The researchers were able to assemble a genome of nearly 130,000 base pairs of genetic material for the virus, and to show that the virus was capable of multiplying in the lab and of infecting human and animal cell lines.
"The cool thing about this study is that it was so surprising," said senior study author Christopher Basler, PhD, a professor of microbiology at the Icahn School of Medicine at Mount Sinai, New York. "We didn't go looking for a virus and really, by accident, we found this new virus, and it turned out to be the first replicating bat gammaherpesvirus. We think it's exciting for people interested in studying how bats interact with viruses."
During the lab studies, investigators took liquid growing on top of the bat cell line and put it onto another line of cells called Vero cells that allow viruses to reproduce. Within 18 hours, the Vero cells were dead, said lead study author Reed Shabman, PhD, an assistant professor and infectious disease investigator at the J. Craig Venter Institute in Rockville, Md. BGHV8 cells also were able to infect isolated human lung and human liver cells. Not only could the researchers see viral particles in the bat cells using an electron microscope, but studying the virus' family tree, they determined that BGHV8 is similar to but distinct from other gammaherpesviruses.
"This is the first replicating bat gammaherpesvirus that's been isolated," Shabman said. "Most labs just have bits and pieces of a virus."
A big question is why bats are repeatedly associated with infections that transfer to humans, Basler said. "We have very few tools to study bats' immune response to viruses. This natural bat virus is actually going to prove to be useful in understanding and probing how bats respond to natural infections and microorganisms that can cause disease."
Herpes viruses encode many genes that help the viruses evade immune responses and persist, Basler added. Having the genome for BGHV8 will allow the team to probe specific antiviral functions to see how they work in bats and learn how these mechanisms are similar to or different from those of humans.
