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Imiquimod reactivation of lichen planus

Thu, 11/13/2014 - 2:35pm

A 44-year-old man who was previously diagnosed with actinic cheilitis was prescribed imiquimod cream 5%, which resulted in thick hemorrhagic crusting of the lower lip after 4 applications. He subsequently noted the development of lichen planus lesions on his arms and legs for the first time in 15 years following imiquimod use. On follow-up he also was noted to have characteristic Wickham striae on his lower lip. Lichen planus is an autoimmune inflammatory condition in which autoreactive T lymphocytes attack keratinocytes. The mechanism of action for imiquimod is upregulation of IFN-alpha and IFN-beta. Treatment with clobetasol cream 0.05% led to resolution of his lichen planus lesions.

Modulation of cellular stress response via the erythropoietin/CD131 heteroreceptor complex in mouse mesenchymal-derived cells

Thu, 11/13/2014 - 10:32am

Tissue-protective properties of erythropoietin (EPO) have let to the discovery of an alternative EPO signaling via an EPO-R/CD131 receptor complex which can now be specifically targeted through pharmaceutically designed short sequence peptides such as ARA290. However, little is still known about specific functions of alternative EPO signaling in defined cell populations. In this study, we investigated effects of signaling through EPO-R/CD131 complex on cellular stress responses and pro-inflammatory activation in different mesenchymal-derived phenotypes. We show that anti-apoptotic, anti-inflammatory effects of ARA290 and EPO coincide with the externalization of CD131 receptor component as an immediate response to cellular stress. In addition, alternative EPO signaling strongly modulated transcriptional, translational, or metabolic responses after stressor removal. Specifically, we saw that ARA290 was able to overcome a TNFα-mediated inhibition of transcription factor activation related to cell stress responses, most notably of serum response factor (SRF), heat shock transcription factor protein 1 (HSF1), and activator protein 1 (AP1). We conclude that alternative EPO signaling acts as a modulator of pro-inflammatory signaling pathways and likely plays a role in restoring tissue homeostasis.

KEY MESSAGE: • Erythropoietin (EPO) triggers an alternative pathway via heteroreceptor EPO/CD131. • ARA290 peptide specifically binds EPO/CD131 but not the canonical EPO/EPO receptor. • Oxidative stress and inflammation promote cell surface expression of CD131. • ARA290 prevents tumor necrosis factor-mediated inhibition of stress-related genes. • Alternative EPO signaling modulates inflammation and promotes tissue homeostasis.

Missed Opportunities in HPV Vaccination

Wed, 11/12/2014 - 11:16am

Objective: To use the 3 dose Human Papillomavirus (HPV) vaccine administration (given at 0, 1-2 and 6 months) to quantify opportunities to improve efficacy in the delivery of preventive health services.

Methods: This was a retrospective, claims-based analysis using data provided by a single managed care plan. Female patients aged 9-26 who were continuously enrolled between 2009 through 2011 and received ≥ dose of the HPV vaccine during 2010 were analyzed. The proportion of initiators who did and did not completed the vaccine series, the timing and location of doses, and the number of outpatient visits during which the vaccine could have been given to non-completers were determined.

Results: 1,830 patients were analyzed in the 2010 sample. 843 (46%) were continuously enrolled during the three-year observation period. 500 (59%) completed 3 doses. Among completers, the interval range between doses 1 and 2 was 27-619 days (median 96 days). The interval range between doses 2 and 3 was 32-621 days (median 127 days). 261 (52%) completers received dose 2, and 139 (28%) received does 3 over 1 month late. Among the 343 non-completers, 137 (40%), and 206 (60%) completed 1 and 2 doses, respectively. 63% of single-dose recipients and 17% of 2-dose recipients had at least 1 visit within the eligible time period for administration.

Conclusion: Nearly half of HPV vaccine initiators do not complete the vaccine series. Of those who do, a large percentage complete it late. This example quantifies the potential for reminders, registries and outreach to improve on-time dosage and completion.

UMCCTS Newsletter, October 2014

Mon, 11/10/2014 - 3:51pm

This is the October 2014 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, September 2014

Mon, 11/10/2014 - 3:51pm

This is the September 2014 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, August 2014

Mon, 11/10/2014 - 3:51pm

This is the August 2014 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, July 2014

Mon, 11/10/2014 - 3:51pm

This is the July 2014 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, June 2014

Mon, 11/10/2014 - 3:51pm

This is the June 2014 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, May 2014

Mon, 11/10/2014 - 3:51pm

This is the May 2014 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, April 2014

Mon, 11/10/2014 - 3:51pm

This is the April 2014 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, March 2014

Mon, 11/10/2014 - 3:51pm

This is the March 2014 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, February 2014

Mon, 11/10/2014 - 3:50pm

This is the February 2014 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, January 2014

Mon, 11/10/2014 - 3:50pm

This is the January 2014 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, December 2013

Mon, 11/10/2014 - 3:26pm

This is the December 2013 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, November 2013

Mon, 11/10/2014 - 3:26pm

This is the November 2013 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.

UMCCTS Newsletter, October 2013

Mon, 11/10/2014 - 3:25pm

This is the October 2013 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.