Day 2 :
- Track 3: Dermatology: Therapies & Advances
Track 4: Diagnostic Techniques in Dermatology
Track 5: Allergy
Location: Texas B
PCOM- School of Pharmacy
McGill University Health Center
PCOM- School of Pharmacy, USA
Time : 09:30 -09:50
Shashidharamurthy has completed his Ph.D from University of Mysore, Karnataka, India and postdoctoral studies from Vanderbilt and Emory University. He is Assistant Professor of Department of Pharmaceutical Sciences, PCOM-School of Pharmacy, Georgia campus. He has published more than 28 papers in peer reviewed journals and also serving as an external reviewer for many of the international peer reviewed journals. Dr. Shashidharamurthy research interest is in investigating the pathogenesis of chronic autoimmune/inflammatory disorders such as vasculitis and arthritis.
Lipocalin-2 (Lcn2), an innate immune protein, predominantly secreted by neutrophils is upregulated by several logs during inflammatory conditions including autoimmune diseases. However, the defined role of Lcn2 in autoimmune diseases is largely unknown. We investigated the role of Lcn2 in an acute model IC-mediated inflammation using Lcn2 knock out (Lcn2KO) and their wild type (WT) littermates. In an acute skin inflammation model, Lcn2KO mice demonstrated a 50% reduction in inflammation as evidenced by histopathological analysis which revealed strikingly reduced immune cell infiltration compared to WT mice. Administration of recombinant Lcn2 to Lcn2KO mice restored inflammation to levels observed in WT mice. Neutralization of Lcn2 using a monoclonal antibody significantly reduced inflammation in WT mice. In contrast, Lcn2KO mice developed more severe serum-induced arthritis compared to WT mice. Histological analysis revealed extensive tissue and bone destruction with significantly reduced neutrophil infiltration but considerably more macrophage migration in Lcn2KO mice when compared to WT. Moreover, we also observed a 16 fold increase of Lcn2 upregulation in lupus prone chronic autoimmune disease mice. Collectively, our studies demonstrate that targeting Lcn2 may be a promising approach for treating autoimmune inflammatory disorders.
H. Lee Moffitt Cancer Center, USA
Time : 09:50 -10:10
Pedro Horna is Assistant Member at H. Lee Moffitt Cancer Center and Assistant Professor at the University of South Florida, Tampa, FL. He practices as a hematopathologist in the Cancer Center, with a particular interest in cutaneous lymphomas and flow cytometry. In addition, he actively participates in basic immunology research at the H. Lee Moffitt Research Institute. Dr. Horna has authored several peer-reviewed publications and conference abstracts in immunology, flow cytometry and cutaneous lymphomas.
Morphologic evaluation of tissue biopsies and body fluids is often insufficient to establish a definitive diagnosis of cutaneous lymphoma. Multiparameter flow cytometry and immune receptor gene rearrangement studies provide an indispensable tool to demonstrate the neoplastic nature of lymphoid proliferations. At our Institution, we have evaluated the applicability of cell cluster analysis by flow cytometry to identify and quantify malignant T-cells separately from the reactive inflammatory background. We have demonstrated the applicability of flow cytometry on shave biopsies from patients with mycosis fungoides, revealing distinct clusters of malignant T-cells with frequent aberrant overexpression of CD26. On patients with advanced stage and peripheral blood involvement, we have shown the occasional occurrence of two distinct Sezary cell subpopulations, the gradual disappearance of benign residual T-helper cells, and the feasibility of calculating absolute Sezary cell counts by flow cytometry to predict survival. Flow cytometry and gene rearrangement studies are extremely useful tools that complement morphologic assessment and support a definitive diagnosis of B-cell and T-cell cutaneous malignancies. Knowledge of the applicability and limitations of both techniques are essential for adequate test utilization and interpretation of results.
Arterra Bioscience srl, Italy
Title: The use of a dermal equivalent system for the validation of the efficacy of cosmetic active ingredients
Time : 10:10 -10:30
Fabio Apone graduated in Biology in 1994 and obtained his Ph.D. title in Protistology (Biology of Unicellular Organisms) in 1998 at the University of Pisa, Italy. He worked for 3 years as Researcher in Italy and at the University of California San Diego, studying signal transduction mechanisms and Cell Biology. Later he was a Research Scientist at Arena Pharmaceuticals Inc, a Biotech Company located in San Diego, California, studying receptors and cell physiology in plants. Since 2004, he has been the Scientific Director and Project Coordinator at Arterra Bioscience, Italian Biotech company focused on the development of novel agrochemicals and innovative active ingredients for cosmetic and dermatological applications.
Prolonged and chronic exposure to UV radiations can cause serious alterations and damages to the different cell layers which compose the skin, leading to an increase of inflammation, connective tissue degradation and oxidative stress, all accompanied by a decrease of cellular metabolism and functionality. While the monolayer tissue culture model can be a suitable system to evaluate the response to stress insults at cellular level, it does not allow to observe an overall skin response to UV treatment. Several dermal equivalent models have been proposed to analyze the entity of UV damages in more details, and to detect the protection/repairing capacity of specific compounds, but they present several limitations and most of the times they cannot reproduced the scenario occurring when real skin is exposed to UV radiations. By using a proprietary dermal skin model, developed by inducing primary fibroblasts to synthetize their own ECM proteins and organize them in a 3D architecture, we measured the capacity of a plant extract (obtained by Dolichos biflorus cell suspension cultures through a biotechnological process) to assembly and correctly organize the collagen fibers in the ECM. Besides confirming all the data previously obtained by the cell based in-vitro bioassays, the skin equivalent model allowed to measure the entity of damages to the ECM protein organization caused by UV treatment, and the amount of damage recovery produced by the treatment with the plant cell extract. Together with the studies on skin cultured cells and in vivo tests, the proposed 3D dermal equivalent model represents a very useful tool to completely characterize new compounds or extracts for cosmetic and dermatological activities, and thus to provide always more effective and safer products for the market.
Montreal Childrens Hospital, Canada
Title: The effect of eczema, environmental and sociodemographic factors on the development of food allergy: A nested case-control study
Time : 10:45 -11:05
Ben-Shoshan graduated from The Sackler School of Medicine, Tel-Aviv, Israel and completed his fellowship in Pediatric Allergy/Clinical Immunology at Montreal Children's Hospital in 2009. Dr. Ben-Shoshan has been granted his M.Sc. degree in Epidemiology in McGill in 2011. In 2011 he was granted the Emerging Clinician Scientist fellowship award by AllerGen NCE and in 2013 the FRSQ junior 1 salary award. Dr Ben-Shoshan is currently a physician in the division of Allergy/Immunology at Montreal Childrens Hospital and is involved in research initiatives on anaphylaxis, chronic urticaria and immunodeficiency and has more than 30 publications related to these topics.
The prevalence of food allergy has increased substantially over the last decade. However, factors contributing to this increase are currently unknown. We aimed to determine the influence of the socio-demographic characteristics, lifestyle habits, and atopic factors on most common food allergies. We performed a cross-Canada, random telephone survey. Cases consisted of individuals with probable food allergy (i.e. self-report of convincing symptoms and/or physician diagnosis) to peanut, tree-nut, shellfish, fish, milk, egg, wheat, soy or sesame. Controls consisted of non-allergic individuals matched for age within the same household (when available) or non-allergic households. Cases and controls were queried on dietary habits during pregnancy, lactation and infancy, day-care attendance, vaccination, infections, pet ownership, living on a farm, and personal and family atopy. Multivariate logistic regressions were used to assess potential determinants. Between September 2010 and September 2011, 480 cases and 5,271 controls completed the questionnaire. For all 9 allergens, probable allergy was associated with maternal or sibling food allergies [odds ratio=OR, 2.9(95%CI, 2.0, 4.4), 2.8(2.1, 3.8) respectively] as well as personal history of eczema, asthma, hay fever or other food allergies [2.4(1.9, 3.0), 2.3(1.8, 3.0), 2.1(1.6, 2.6) and 1.9(1.3, 2.8)]. High income (top 20%) was associated with higher odds [1.6(1.2, 2.0)] while recent adult immigrants (< 5 years) had lower odds [0.4(0.2, 1.0)]. Individual food allergies had similar associations with personal and family atopy and especially personal history of eczema in infancy [2.3(1.5, 3.4)]. Our results reveal that atopy especially eczema, socioeconomic status, education, and immigration are associated with probable food allergy.
Universidade Federal de Goiás, Brazil
Title: Nanobiotechnological approaches to delivery of conventional antifungal drugs, DNA vaccine or peptides against fungal infection
Time : 11:05 -11:25
André C. Amaral is adjunct professor at Universidade Federal de Goias, Center East of Brazil, teaching Nanobiotechnology and Introduction to Biotechnology classes. He began his career as a research on the Biological Sciences while developed his graduation in Biology, and completed his Ph.D. at Catholic University of Brasilia, when he won the "2009 - Young Investigator Award" (FAP/DF, Distrito Federal, Brazil). He developed a postdoctoral stage at the University of Brasilia with the work plan "Technological development of amphotericin B-PLGA-DMSA nanoparticles: characterization (physical-chemical, morphology, biodistribution, and pharmacokinetics) and analysis for scaling up". He has experience on investigating nanostructured sustained delivery systems for antifungal drugs and on the experimental murine models for fungal diseases (paracoccidioidomycosis and vaginal candidiasis) and bioprospection of new bioactive molecules. His interests are on nanostructured delivery systems, pharmaceutical technology, drug development, identification of bioactive molecules, and experimental murine models of infectious diseases.
Human mycosis are infections that are usually difficult to treat, for different reasons, including the generally chronic state of the disease at the moment of diagnosis, the great resistance of the pathogens to many of the available drugs, and/or the long period of therapy that represents high costs in terms of antifungal agents. Likewise the growing number of the pathogen’s resistance mechanisms to conventional drugs significantly increased in the last decade, in part because of the increase of the immune-compromised patients. In some cases, due to the resistance problem only few drugs present the potency necessary to treat these opportunistic infections however some of these drugs, such as amphotericin B, have the disadvantage of excessive toxicity. During the last years my group has been working to develop new alternatives of treatment to fungal infections. One of these strategies is the sustained delivery system based on nanotechnology. The treatment of mice experimentally infected with Paracoccidioides brasiliensis with desoxycholate amphotericin B (D-AMB) coated on poly(lactic-co-glycolic acid) (PLGA) and dimercaptosuccinic acid (DMSA) polymeric blends (Nano-D-AMB) showed the same antifungal efficacy than free D-AMB but with reduced numbers of AMB administrations and genotoxicity and cytotoxic effects. Itraconazol is another antifungal drug that has been used in fungal therapies. Our results using itraconazol entrapped in PLGA showed increased antifungal activity and lower cytotoxicity compared with free drug. Another strategy used by our group is the utilization of plasmid DNA encoding sequences to express foreign antigens as DNAhsp65 from Mycobacterium leprae. The DNAhsp65, that can elicit a powerful immune response, was entrapped within liposomes or PLGA systems to deliver DNAhsp65 to treat paracoccidioidomycosis. Both formulations modulated a protective immune response and reduced the pulmonary fungal burden even in the groups receiving less than four times the amount of the DNAhps65. Similar results were observed when the treatment has done with combined chemotherapy and P10 nanotherapy. P10 is a 15-amino acid peptide that carries the T-cell epitope of the glycoprotein 43 kDa glycoprotein, the major diagnostic antigen secreted by Paracoccidioides brasiliensis. Our results showed a marked reduction of fungal load after the treatment. During the treatment schedule, the P10 entrapped within PLGA was more effective than 'free' P10 emulsified in Freund’s adjuvant. The combination of sulfamethoxazole/trimethoprim with the P10 peptide entrapped within PLGA demonstrated increased therapeutic efficacy against paracoccidioidomycosis and dramatically reduced the peptide amount necessary to elicit a protective effect. In summary, our results suggest that nanoscale controlled release systems represent a promising approach to deliver vaccines and present advantages over administering the conventional form of the naked plasmid DNA vaccine or conventional antifungal drugs.
Central Leather Research Institute, India
Time : 11:25 -11:45
Lonchin Suguna has completed her Ph.D. at the age of 27 years from University of Madras. She did her postdoctoral studies at ETH-Zentrum, Zurich, Switzerland. She is working as a Scientist in the Department of Biochemistry, Central Leather Research Institute, a Governmental organization in India. She has published more than 48 papers in reputed journals and serving as a reviewer for 12 journals and Editorial board member for 4 journals. She has received Mr. VV Swaminathan Diamond Jubilee Research Endowment award for the outstanding contribution in the scientific evaluation of medicinal properties of plants, by Indian Association of Biomedical Scientists, 2012 (Gold Medal).
The aim of this study was to develop a biodegradable film from pullulan and investigate its efficacy for wound healing. Many biomaterials like collagen fibrin, chitosan etc have been used in the form of films to enhance wound healing. In this study, biocompatible, biodegradable films were made from a biopolymer, pullulan and used to augment wound healing. A 2cm2 excision wound was made on the back of rats and the effectiveness of pullulan scaffolds on excision wounds was investigated by measuring different biochemical, biophysical and histological analyses. The mechanical properties like tensile strength, elongation at break were found to be increased in the wounds treated with pullulan films when compared to controls. Biochemical parameters like collagen, uronic acid and hexosamine were also observed to be increased in the granulation tissues of pullulan treated rats as compared to controls. Rate of contraction was found to be significantly increased. Epithelialization period was remarkably reduced from 22 days (control) to 11 days (treated). The adhesive property of the film was studied by assessing the rejoining of incision edges (3 cm long, not stitched). It was interesting to observe that the incisions treated with pullulan films healed within 6 days whereas the control wounds took more than 12 days. The tensile strength of the treated wounds was also significantly increased. Thus, our results strongly support that pullulan films could be used as a better wound dressing for both incision and excision wounds.
Shanghai University of TCM, China
Title: Alternative therapies for chronic and refractory skin ulcer - clinical managements and experience by traditional chinese medicine
Time : 11:45 -12:05
Fu-lun Li obtained his medical degree from Shanghai University of Traditional Chinese Medicine in 2004. He is specialized in dermatology and pharmacology of TCM. His research is focused on the mechanism of psoriasis, skin ulcer, wound healing and autoimmune disorders. He has been a post doctor at Colorado University for 3 years and currently is an associate chief physician of Yueyang Hospital affiliated to Shanghai University of TCM. He has published 9 papers in reputed journals including Nature medicine, American Journal of Pathology.
Chronic skin ulcer (CSU), including diabetic ulcers, venous ulcers, radiation ulcers, and pressure ulcers, remains a great challenge in the clinic. It seriously affects Patients quality of life and requires long-term dedicated care, causing immense socioeconomic costs. CSU causes the loss of the integrity of large portions of the skin, even leading to morbidity and mortality. Chinese doctors have used traditional Chinese medicine (TCM) for the treatment of CSU for many years and have accumulated much experience in clinical practice by combining systemic regulation and tropical treatment of CSU. Here, we discuss the classification and pathogenic process of CSU and strategies of TCM for the intervention of CSU, according to the theories of TCM. We also present several clinical cases showing effectiveness of Traditional Chinese herbs in the management of CSU. Finally, we summarie the potential intervenient strategies named as "qing-hua-bu" protocol with dynamic and combinational TCM therapies for different syndromes of CSU.
Hongmei Wang received the Ph.D. in dertatology in 2006 from Shanghai University of Traditional Chinese Medicine. She is specialized in dermatology and pharmacology of TCM. Currently, she works in Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital. As a dermatologist, she combines tradition Chinese and western medicine to treat the patients. At the same time, she have been conducting the research of psoriasis in immunity and epigenetic, and has published more than 20 papers in reputed journals. Besides, she has supervised postgraduates.
Pyodermatitis-pyostomatitis vegetans (PD-PSV) is a rare disorder characterized by mucocutaneous involvement and associated with inflammatory bowel disease. We describe here a 42-year-old woman with ulcerative colitis who manifested verrucous and pyogenic lesions on her scalp, neck, axillae, inguinal areas, umbilicus, trunk, and oral cavity for about 11 months. She also experienced general fatigue and swelling in her lower extremities. Histology revealed eosinophilic inflammation with microabscesses and pseudoepitheliomatous hyperplasia, but she was negative on direct immunofluorescence for IgA, IgG, and C3. She was diagnosed with PD-PSV and treated with infusions of 100 ml 20% human albumin for five days, followed by 40 mg/day methylprednisolone, with remission of lesions observed after one month. We discuss the differential diagnosis of PD-PSV and pemphigus vegetans.
Dermatovenerology & Clinical Pharmacology, Kosove
Title: Acne treatment with magisterial preparations and additional therapy to various clinical overviews from different causes
Time : 12:25 -12:45
Ylfete Shatri Mucaj, a clinical dermatovenerology and pharmacology specialist for specialization of clinical pharmacology is one of the first generations for basic specialization in this field in Balkans. She finished post-graduation and specialization studies in the University of Novi Sad. Currently, she works in UCC in Prishtina from 1981; as a specialist of clinical pharmacology she has treated for 4 years patients with chemotherapy near Internal Clinic - Department of Hematology in UCC. Sheled for many years the laboratory for magisterial preparations in the Center Pharmacy and Dermatovenerology Clinic near CUU in Prishtina. She worked for some years in the Institute of Biochemistry near Diagnostic Center of CUU. Since 2001 she is working as a Clinical Dermatovenerologist and Pharmacologist in KDV and now leads Dermatological polyclinic and laboratory for magisterial preparations for several skin diseases and and aesthetic issues by which she treats patients in the polyclinic "GENTIANA GreLorGen". She participated in many conferences and congresses in region and Europe with several scientific works in the field of clinical Dermatology, Oncology and Pharmacology and also as a lecturer of chemotherapy in the National Congress of Oncologists in Prishtina. She is a member of EADV and Kosovo Association of Dermatovenerologists and Oncologists.
Considering that Albanian population is a young population, more than 70% of skin diseases deal with acne problems. So, the purpose of this work - presentation in our professional experience is to confirm that acne beside family pre-disposition to the type of skin and hormonal revolution in the puberty stage, worsen as a result of various serious infections: whether urogenital, upper respiratory tract, digestive tract and hormonal disorders followed with the way of nutrition. Time period of treatment and research was 5 years (September 2009-2013). The genera number of treated patients was 2990;
They were categorized in 4 main groups:
1. Patients without problems with additional infections
2. Patients with additional infections
3. Patients with hormonal disorders
4. Patients with infections and hormonal disorders.
Local treatment with personal magisterial preparations, such as (ANTISEPV, DIADERM, TOSKA,-GENIII, ERITROVA-GEN, ERGEN, DEPEOR-GEN, LORGEN-ER, ARON-GEN, DERMACEA, VJOLLCA, etc - these magisterial preparations named by me for personal needs that serve during patient treatment in my clinic) is done to patients of all groups and also the symptomatic therapy with Vit. C and B6 and to some others with antibiotic: Doksicyclin and antibiotics according to antibiogram and protocol. To those with hormonal disorders and hormonal therapy and if necessary consults with colleagues of other profiles and additional treatments: physical cleaning, cryo-therapy, MKDB. We have verified the percentage of groups and as a result: According to this work and research we have concluded that acne are much more serious problem than we think and that many of people neglect. They are mirrors of many body infections, hormonal disorders, metabolism disorders and adequate nutricism. The treatment is complex and multidisciplinary and a fact to deal more seriously with this problematic.
Herlev University Hospital, Denmark
Title: Lymph node dissection in patients with malignant melanoma is associated with high risk of morbidity
Time : 13:30 -13:50
Ul-Mulk finished his medical degree in 2007 from Copenhagen Medical University. He is now a third year resident in Plastic Surgery, Reconstruction and Burns at Copenhagen University Hospital. He has published several papers and at the moment & is doing a study about "Breast reconstruction in Denmark in the periode 2007-2011, the frequency and methods". His interests are Head and Neck Reconstruction, cranio-facial surgery and melanoma.
Introduction: Malignant melanoma is one of the most rapidly increasing cancer types globally. Patients with a melanoma 1 mm in Breslow thickness are offered sentinel node (SN) biopsy and subsequent radical lymph node dissection if the biopsy is positive. The objective in the present paper was to describe post-operative complications in this group of patients. A standard operation and drainage regime was used.
Materials and Methods: This was a retrospective study based on 96 consecutive SN-positive patients with primary cutaneous malignant melanoma who underwent subsequent radical axillary or inguinal lymph node dissection.
Results: In all, 57 patients were male and 39 female. A total of 71 had an axillary and 25 an inguinal operation. The median drainage period was seven days (2-15 days). Forty patients developed seroma which needed puncture; three of these cases were chronic, there was no difference between the two groups. Seroma puncture was only associated with infection in the inguinal group (p = 0.04). 25% in the axillary group were diagnosed with lymph oedema after three months versus 48% in the inguinal group (p = 0.04). A body mass index? 25 kg/m2 was associated with a slight, but non-significant increase in complications (p = 0.08). No association was found for smoking or co-morbidity.
Conclusion: Patients undergoing axillary or inguinal lymph node dissection experience a significant number of complications, especially seroma and lymph oedema. Long-term complications are severe and can profoundly impact the patient's quality of life.
General Hospital Cakokovec, Croatia
Time : 13:50 -14:10
Tomislav Novinscak has graduated 1999 at Zagreb University School of Medicine, where also trained and qualified for surgeon in 2006. Meanwhile has completed his Ph.D. and postdoctoral studies from Zagreb University Faculty of Science at the age of 31 years. He is vascular surgeon and wound specialist. He was appointed 2010 to a senior Lecturer at Varazdin Nursing College. He has published numerous scientific and expert abstracts and papers in reputed journals, accomplished more postgraduate courses especially in wound healing, plastics and diabetic foot topics, participated and was invited as lecturer on more conferences. Active member of Croatian and European Wound Healing Associations as well as appointed Croatia representative in IDFWG. Since 2011 is Chief of the Board at regional Emergency County Department.
The vast majority of leg wounds presented in surgical clinics are chronic, particularly hard-to-heal wounds. They have been defined as ones that fail to heal with standard therapy in an orderly and timely manner independently of the wound type, time of onset and ethiology. When it comes to hard-to-heal wounds respectable incidence of odd final diagnosis could be revealed (i.e. calciphylaxis, carcinoma, pyoderma, vasculitis). Nonetheless, venous, ischaemic, decubital and diabetic ulceration are perceived as typical chronic leg wounds. There are many factors for delayed healing such as age, comorbidities, malnutrion, deficiencies, medications, reduced mobility, social environment, medical ignorance, location or wound bed bioburden. Frequently a combination of causes conducts to non-healing wound. Likewise the skill and knowledge of healthcare professionals (i.e. misdiagnose, naïve physician, overtreatment), available healthcare resources, product availability and other may significantly influence prolonged healing. The concept of permanent “wounding” leads to notably poorer patient quality of life with emotional and occupational issues just as it affects the ubiquitous worldwide problem of health economics. Treatment of a non-healing wound is very demanding on both the patient and specialist, and frequently requires considerable health system resources. From the surgical rather moderate aggressive point of view, thoughtfully and multidisciplinary treatment is required. Early and comprehensive diagnostics (holistic and target approach) and rapid elimination of plausible causes is mandatory. Furthermore promptly (i.e. revascularisation, phlebectomy, necrectomy, fibrinolysis) and/or regularly target surgical interventions (i.e. debridement, plastics, dressing, reassessment, evaluation) along with holistic treatment and symptoms control should inevitably alleviate suffering and achieve wound healing. Additionally the introduction of advanced therapies (NPWT, autologous full-thickness skin substitutes, components restitution (i.e. growth factors, PRP), waterjet/ultrasound debridement, modern dressings) can result in improved cost-effectiveness despite initial increased costs. Once these issues have been properly addressed follows incontestable and certain accomplishment. In addition rare, potentially fatal diabetic and hypertensive cruro-pedal wound is reported.
Shimane University Faculty of Medicine, Japan
Time : 14:10 -14:30
Kyaw Zaw Hein has completed his medical degree from University of Medicine Mandalay in 2008 and expects to graduate his Ph.D. from Shimane University Faculty of Medicine in 2014. His current research specializes on the epithelial immune system and anti-microbial peptides.
Despite the permanent exposure and colonization by various filamentous fungi and yeasts, human skin is rarely infected. Plants and insects seem to be well protected by antimicrobial peptides, the effector molecules of the innate immune system, such as RsAFP1 and drosomycin. However, it is largely unknown, how human body surfaces resist to fungal infection. Here, we show that the keratinocyte-secreted protein, S100 calcium-bind protein A7 (S100-A7), is the principle antifungal factor of human skin. It kills various potentially pathogenic fungi, including Aspergillus, Malassezia, Microsporum, Rhizopus and Trichophyton species. To kill these pathogens, the protein needs to change its shape, i.e., the oxidized protein to the reduced protein. Site-directed mutagenesis and derivatization revealed that the cysteine thiols of S100A7 are essential for its antifungal activity. Sensitivity to Zn2+-pretreatment, ultrastructural immuno-gold-analyses and functional analyses suggest that S100A7 protein kills fungi by inducing apoptosis via intracellular Zn2+-depletion. S100A7 is found on the skin and the mucosa of the respiratory, aerodigestive and genital tract. In vivo, in a lethal mouse Aspergillus lung infection model, treatment with S100A7 prevented death from Aspergillus infection in immuno-compromised mice. Thus, S100A7 may represent a key component of the human innate epithelial defense system in the control of a wide range of fungal pathogens.
Yeditepe University, Turkey
Title: Design of new cream formulations with natural products and assessing their effectiveness on wound healing by using in vivo animal model
Time : 14:30 -14:50
Derya was studied at Yeditepe University Faculty of Pharmacy, 2003-2008. Derya got a scholarship during 2007 to 2008 at Yeditepe University and graduated from the Faculty of Pharmacy among second of seventy students. The title of graduation project was 'Resveratrol liposome incorporated into the edible film'. She started to work as a Teaching and Research Assistant in the Pharmaceutical Technology Department at Yeditepe University Faculty of Pharmacy in 2008. In the same year, Derya was started to master programme of Cosmetology and her M.Sc. thesis entitled 'Design of New cream formulations and assessing their effectiveness on wound healing by using in-vivo animal model' under the supervision of Assist. Prof. Dr. Yasemin Yağan Uzuner. Derya has completed her master degree in 2011. At the same year, she was started to Ph.D programme of Pharmaceutical Technology at Istanbul University, Faculty of Pharmacy. Derya Algul is currently employed as Research and Teaching Assistant at Yeditepe University, Department of Pharmaceutical Technology and goes on the Ph.D programme.
Since ancient times, people have utilized some plants and their preparations in order to treat their wounds. Often their use is only based on tradition, without any scientific evidence of efficacy and little knowledge about default active compounds or their mode of actions. In this study, the balsam (Levant storax), produced by injuring the oriental sweeet gum trees, was formulated in a wound care cream to evaluate its wound healing effects. Another cream (Complex) was also designed to contain calendula oil, St. John's Wort extract, escin, freeze dried powder of Aloe vera (L.) Burm.f. leaf juice and allantoin to evaluate its wound healing potential. Following the development of cream formulations of Levant storax, complex and placebo (without active ingredients), the characterization and stability tests were performed at predetermined time and conditions. The wound healing potential of Levant storax and complex creams were tested against a reference cream Madecassol®, negative control and placebo cream by employing an in-vivo excision wound model on rats. Six male Sprague-Dawley rats were used for each treatment group by making six wounds on the back of the animals with 5 mm punches (Figure 1). All groups were treated by applying the test products topically once a day till the wounds of one of the groups were completely healed. The progressive changes in wound area were measured by a standard reference ruler and monitored by the means of the photographs taken from the wounds every other day. The wound areas were computed by using the Image J software and the wound contraction rates were calculated as a percentage of the reduction in wounded area and analyzed for statistical significance by using one way ANOVA. At the end of the treatment schedule, all groups were sacrificed by injection of high dose aneshesia and tissue specimens were isolated from the healed skin of each wound for histopathological examination. The histopathologic observations were analyzed by using Kruscall Wallis test for all histopathologic parameters and Mann-Whitney U test for variations between two groups. In statistical studies, P<0.05 was considered significant. In the stability studies, there were no noticeable changes in the organoleptic properties of the formulations in terms of appearance, colour and odour over the entire stability test period. In addition, measurement results of pH, viscosity and conductivity were not changed during stability studies. In the studies of excisional wound model, the percentage wound healing results gave significant changes. Due to the balsam of oriental sweet gum, Levant storax cream (LS) is more viscous than others and it has antimicrobial activity. Because of these properties, its effects on contraction of the wounds was the best among all groups (Figure 2). The complex cream (C) contains some very well recognized functional actives such as escin, Aloe vera, allantoin and calendula oil. All these actives bring fibroblast stimulating, anti-inflammatory and anti-oedema properties to the C which in turn resulted in statistically better contraction rates of complex cream compared to control group (Figure 2). Histopathological studies indicated that healing phase was complete for LS (Figure 3). These results indicate that histopathologically both experimental creams performed better than the reference cream, placebo cream and the control group. The studies indicated that Levant storax cream treated rats had the best healing rates compared to all the other groups, whereas the group that was treated with complex cream showed a better healing rate than control and placebo groups. However no significant difference was found between the complex and the reference groups.
Comenius University, Slovakia
Title: Management of psoriasis patients treated with infliximab based on the dynamics of infliximab levels and antibodies to infliximab
Time : 14:50 -15:10
Andrea Kovacikova Curkova is a European board certified dermato-venerologist since 2012. She has completed her residency in dermatology and venerology at the Department of Dermatology and Venerology, Comenius University Faculty of Medicine, Bratislava, Slovakia. She is in her last year of Ph.D. at Comenius University Faculty of Medicine in Bratislava with the research topic Psoriasis and Comorbidities. She is involved in various research projects on psoriasis in the role of a sub-investigator. She has been active in presenting lectures at national and international meetings. She has published 5 papers in reputed journals and won multiple awards for young dermatologists.
Infliximab is the fastest acting biologic agent due to intravenous administration and a well-conducted induction phase of treatment. The disadvantages include the risk of infusion reactions and the production of neutralizing antibodies that are responsible for loss of efficacy. The authors enrolled 30 patients with psoriasis treated with infliximab for a period of minimum 1 year at a dose of 5 mg/kg. Based on the clinical picture the patients were divided into responders (almost clear), partial responders (gradual appearance of new lesions towards the last weeks), and non-responders. Levels of infliximab and antibodies to infliximab were examined in venous blood samples taken in one maintenance interval. Infliximab levels were examined in week 0 (before infusion) and later in weeks 2, 4, 6, 7, and 8 of the maintenance interval. In week 8, blood was taken before the administration of infusion. Antibodies to infliximab were examined only in week 8, blood was taken before administering the infusion. According to the obtained data, we divided the patients into 4 groups - responders, responders with shortened period of efficacy, non-responders with production of antibodies, and non-responders without production of antibodies. The dynamics of infliximab levels and the production of antibodies to infliximab were characteristic for each group. An exact therapeutic management was created specifically for each group of patients. Monitoring of the dynamics of infliximab levels and antibodies to infliximab is not only of scientific importance, but it may be crucial in daily clinical practice enabling an objective management of infliximab treatment.
Central Leather Research Institute, India
Time : 15:10 -15:30
Vilvanathan Sangeetha Priya has completed her Master's degree in Biochemistry from University of Madras, Chennai. She has three years of experience as Project Assistant. Currently, she is doing her Ph.D. at University of Madras in the Department of Biochemistry, CLRI.
Wound healing occurs as a fundamental response to tissue injury. Amino acids play a key role in augmenting wound healing process. The role of some of the amino acids like arginine and proline has been well established. In this study, we have investigated the efficacy of a non-essential amino acid, glutamic acid, on cutaneous wound healing in rats. Male Wistar rats, weighing between 180 and 200 g were chosen for the study. Open excision wounds were made on the back of rats. The rats were divided into two groups comprising six rats in each group. Group I, control rats, treated with 200µl of phosphate buffered saline (PBS), and group II rats were treated with glutamic acid (200 mg dissolved in 200 µl of PBS) topically, once daily, until complete healing. Wounds treated with glutamic acid healed much faster as indicated by improved rates of contraction and decreased period of epithelialization. The biochemical analyses such as collagen, uronic acid and hexosamine were determined in the wound tissue. An increase in cellular proliferation and collagen synthesis was evidenced by significant increase in total collagen and uronic acid content. Histological evaluation was also carried which further substantiated the results. A marked increase in tensile strength (80%) and shrinkage temperature (24%) was observed in the wound tissues of glutamic acid treated rats. These results obviously substantiate that the topical application of glutamic acid enhance the rate of healing.
- Track 7: Cosmetic Dermatology
Track 16: Aging Dermatology
Location: Texas B
Merz Pharmaceuticals GmbH
Changi General Hospital
Jürgen Frevert graduated in chemistry and got his PhD in Biochemistry at Philipps-University, Marburg, Germany. After a postdoctoral fellowship at the University of California, Berkeley, USA he had several research position in biotech companies where he developed an artificial human skin for transplantation on chronic wounds and burn wounds. In cooperation with Merz Pharmaceuticals he developed the pure botulinum toxin. He is now head of botulinum toxin research of Merz Pharmaceuticals GmbH, Potsdam, Germany.
Botulinum toxin type A products are widely use in aesthetic medicine e.g. in the treatment of glabellar lines. Three botulinum toxin type A products are marketed on the European and US market: Botox (Allergan) is claimed to contain the purified 900 kD botulinum complex, Dysport (Medicis/Valeant/Ipsen) contains besides the 150 kD neurotoxin a different set of bacterial proteins. Apart from the 150 kD neurotoxin, there are no other bacterial proteins present in Xeomin. Different technical processes are used for the manufacturing of the products: Botox is produced by vacuum drying leaving a thin film as the final product whereas Dysport and Xeomin are produced by lyophilisation. Xeomin has demonstrated the highest stability allowing storage at room temperature whereas Botox and Dysport must be stored in the refrigerator. All products show a similar spread from the injected muscle provided that the dose is equivalent and the injection conditions are similar. Thus, the profile of adverse events should be comparable. Several head-to-head studies have demonstrated a 1:1 ratio between Botox and Xeomin confirmed in a recent Consensus paper. Although numerous studies are published with different ratios for Botox : Dysport a fixed ratio is not determined, yet. The load of bacterial proteins was claimed to have an impact on the immunogenic potential of the products. But it is not the protein load per se, it is the presence of complexing proteins in Botox and Dysport which influences the risk of an immune reaction.
Yong-Kwang Tay is presently a senior consultant and was the founding Chief (2002-2012) of the department of dermatology at Changi General Hospital, Singapore. Dr. Tay did his postgraduate training at the National Skin Centre, Singapore, University of Colorado School of Medicine at Denver, the Baylor College of Medicine at Houston, the Birmingham regional skin laser centre, UK and the Laser and Vascular Anomaly Section, Malmo University Hospital, Sweden. Dr. Tay has a special interest in the fields of dermatologic laser surgery and pediatric dermatology. He has more than a hundred publications in peer-reviewed journals and is the Editor of the 'Textbook of Laser and Light Dermatology in the Asian Skin'. He has written a chapter on hair disorders in the textbook of Pediatric Dermatology and a chapter on hypopigmentation disorders in the textbook of Neonatal Dermatology. He is a member of the editorial board of the Journal of the American Academy of Dermatology, Pediatric Dermatology and the Journal of Dermatological Treatment.
Melasma is very common in the Asian and Hispanic population and consists of light to dark brown symmetric patches on the face which may last for years. Predisposing factors include sunlight (major triggering factor), hormonal and genetic influences. Topical treatment using various lightening creams (e.g. hydroquinone cream, ascorbic acid cream, tretinoin cream) and sunscreen daily remains the mainstay of treatment. Tranexamic acid (250 mg twice daily), a plasmin inhibitor with antifibrinolytic activity is a useful adjunct in refractory melasma. Tranexamic acid (TXA) inhibits melanin synthesis by interfering with the interaction of melanocytes and keratinocytes through inhibition of the plasminogen/plasmin system. It also reduces erythema, vessel numbers and mast cell activity which are elevated in melasma. TXA is well tolerated, common side effects being gastrointestinal discomfort, hypomenorrhea, with many patients improving within 3 months of starting TXA. TXA can be used alone, or in combination with lasers (laser toning). Laser toning using low fluence (1.6-2.5 J/cm2), large spot size (e.g. 6 mm diameter), multiple passes QS 1064 nm Nd:YAG laser is useful for refractory melasma. Laser toning is safe, well tolerated, with multiple treatment sessions needed, the clinical end point being mild erythema. Side effects of laser toning include punctate depigmentation and rebound hyperpigmentation which can be reduced by using fewer passes and spacing out the treatment intervals (e.g. every 4 weeks). Electron microscopy studies have shown a reduction of melanosomes and melanocyte dendrites in melasma with the low fluences used in laser toning.
Kawasaki Medical School, Japan
Currently, Associate Professor, Department of Biochemistry, Kawasaki Medical School, Kurashiki, Japan. Akira Yamauchi graduated from Nagasaki University, School of Medicine (Nagasaki, Japan) in 1995 and trained at the Second Tokyo National Hospital (Tokyo, Japan). He got Ph.D. degree at Nagasaki University Graduate School in 2001 and joined Herman B Wells Center for Pediatric Research, Indiana University School of Medicine (Indianapolis, USA) as a post-doctoral fellow. And then he worked at the University of Tokyo (Tokyo, Japan) as an assistant professor and also at ECI, inc. as a director. Since 2010, he has been working at the current position. His major is analysis of host defense system and cell migration.
Melanocytes are key players for homeostasis in skin and hair by producing melanin for pigmentation. Since the migration of melanocyte plays an important role for physiological and pathological status in skin, to develop assay methods for melanocyte function is useful for research in Dermatology as well as for evaluating effects of chemicals on these cells. We established a small-scale but powerful assay method for human melanocyte migration in vitro utilizing the real time cell motility assay device(Exp Dermatol. 22(10):664-7) and evaluated human melanocyte migration to chemokines. We found that the melanocyte migration to CXCL12 was enhanced with extracellular matrix as a scaffolding molecule and that the migration was further enhanced by treating with chemical substances such as ciglitazone, FK506, and alpha melanocyte stimulating hormone. This method is useful for evaluation of melanocytes in various conditions and can contribute to regulation of melanocyte function.
Army Medical College, Pakistan
Zafar Shaikh is Professor of Dermatology at Army Medical College, and Consultant Dermatologist Military Hospital Pakistan. He is trained in Dermato-Venereology at University Hospitals, London and Manchester (UK), and in Cutaneous Laser Surgery at the Skin & Laser Surgery Center Boston, USA. He is member of the faculty of Dermatology College of Physicians & Surgeons Pakistan and an associate member of the American Society of Laser Medicine & Surgery. He is also member of the editorial boards of Journal of Pakistan Association of Dermatologists and Pakistan Armed Forces Medical Journal. He has published 30 research papers in indexed journals.
Melasma is acquired disorder of hypermelanosis with great psychosocial concern. The treatments with various conventional therapies are often unsatisfactory and recurrence following cessation of these treatments is frustrating both for physicians and patients. Lasers and light sources have been used to treat melasma, but in Asian skin with higher melanin content such treatments may be challenging. The pigment specific lasers such as QS Nd:YAG, QS Ruby and QS Alexandrite have shown variable results. A "confetti-like" hypopigmented macules and rebound hyperpigmentation were reported in Asian patients treated with low fluence QS Nd:YAG (1,064 nm) laser. Promising results were reported with fractional photothermolysis (1,550nm), but published data shows that this may not be the treatment of choice for darker complexions. Some studies documented favorable outcomes in melasma treated with Intense Pulsed Light but darkening and sloughing of skin at treated sites, and post-inflammatory dyspigmentation were noteworthy side effects. To improve the treatment outcome several trials combined lasers and light based therapies with topical bleaching agents like hydroquinone (modified Kligman's formula), azelaic acid and glycolic acid. Better results were observed with combination therapies than monotherapy. We conducted a clinical trial on 65 patients with refractory melasma and Fitzpatrick skin phototypes III to V, using Fluorescent Pulsed Light (570-950nm) and topical 5% magnesium ascorbyl phosphate. The results of our trial and most other studies on treatment of melasma with lasers and light based therapies demonstrated suppression of melanogenesis but the effect was not sustained and additional treatment sessions were recommended for maintenance.