Background. In stable vitiligo several techniques of autologous melanocyte transplantation are used. Punch grafting is the easiest and least expensive. Objective. To assess the effect of patient and treatment variables on results of punch grafting. Patients and methods. Thirty-two vitiligo lesions in twenty patients were treated by punch grafting. After grafting, 13 patients received PUVA and 7 patients received topical psoralen & sun (PUVASOL) for 3 months. Response was assessed according to extent of pigmentation (Excellent > 90%, very good 75 - 90%, good 50 - 75% and poor response ≤ 50%). Mean margin of pigment spread (MPS) in mm was calculated for each patient. The effect of different factors on the response and development of side-effects was assessed in lesions achieving > 50% pigmentation (good - excellent response). Results. Nine lesions (28%) showed excellent, 15 (47%) very good, 5 (16%) good and 3 (9%) a poor response. The mean MPS was 3.7 ± 0.78 mm. Age had a significant positive correlation with MPS (r = 0.488, p = 0.007) while skin type and region treated had none. Punch sizes and the difference between donor and recipient punches did not affect MPS statistically. Donor punch size (r = - 0.808, p = 0.000) and recipient punch size (r = - 0.801, p = 0.000) had a significant negative correlation with the number of grafts remaining in place. No significant difference in MPS was found between patients on PUVA vs PUVASOL therapy after grafting (p = 0.068). Cobble-stoning occurred in 5 lesions (16%). The smaller the donor (p = 0.002) and recipient (p = 0.003) punch sizes the less was the cobble-stoning.Conclusion. Punch grafting is an effective, easy and inexpensive treatment of localized stable vitiligo. Of the different studied variables, age had a significant positive correlation with MPS. Using smaller punch sizes improved the response and reduced cobble-stoning. No significant difference in MPS was found between patients receiving PUVA therapy vs topical PUVASOL after grafting, making this technique applicable for patients with no access to phototherapy centers. (J Egypt Women Dermatol Soc 2010; 7: 16 - 21)

Oxidative stress and accumulation of free radicals might play a role in the pathogenesis
of vitiligo. Glutathione S-transferase (GST) is a multigene family of enzymes that
detoxify oxidative stress products. In this study, genotyping by multiplex PCR of
GSTM1 and GSTT1 in 101 women with nonsegmental vitiligo vulgaris and 101 agematched
healthy female volunteers showed that only the GSTM1 null genotype
(P = 0.04) was significantly overexpressed in patients with vitiligo. Analysis of the
combined effect of GSTM1 and GSTT1 genotyping identified a significant association of
risk for vitiligo with the GSTT1 ⁄ GSTM1 double-null type only (P = 0.01; OR = 2.69;
95% CI 1.12–6.46). Age of onset of vitiligo was significantly earlier in patients with the
T1 null genotype (P < 0.01) and those with the T1) ⁄ M1+ and T1) ⁄ M1) combined
genotypes (P < 0.01 and P = 0.01, respectively). In conclusion, the GSTM1 gene and
the GSTM1 ⁄ GSTT1 double-null genotype may be a risk factor for vitiligo in Egyptian
patients. Inability to cope with oxidative stresses because of GST deficiency may cause
early disease onset.

Background: Alloimmunization to red blood cells' (RBCs) antigens and formation of autoantibodies against RBCs is a frequent complication among immunocompetent transfusion-dependent patients. Autoantibodies can result in clinical hemolysis and difficulty in cross-matching blood. The objective of this study was to evaluate the presence of alloantibodies and autoantibodies in regularly transfused ?-thalassemic patients and the factors influencing the development of alloantibodies.

Background. Skewing of the immune response towards T helper (Th)1 or Th17 and away from regulatory T cells (Tregs) and Th2 cells may be responsible for the development and progression of autoimmune disease. An autoimmune theory has been proposed in the pathogenesis of vitiligo. No previous reports have investigated
alterations in IL-17 produced by Th17 cells in lesional skin in vitiligo.
Aim. To investigate the role of IL-17 in the pathogenesis of vitiligo by assessing its
levels in lesional skin and serum of patients with vitiligo compared with controls.
Methods. In total, 30 patients with vitiligo and 20 controls matched for age and gender were enrolled in the study. Serum and tissue IL-17 levels were measured by ELISA and compared between both groups for correlations with age, gender, family history, disease duration, activity of vitiligo and percentage of involved body surface
area.
Results. A significant difference between patients and healthy controls was found for both serum and tissue IL-17 levels (P < 0.001 for both). Significant positive correlations were found between disease duration and IL-17 level in both serum (r = 0.42,
P = 0.02) and lesional skin (r = 0.45, P < 0.015); between extent of vitiligo and IL-17 levels in both serum (r = 0.65, P < 0.001) and skin (r = 0.48, P < 0.05); and between the serum and the tissue IL-17 levels in patients with vitiligo (r = 0.54,
P = 0.002).
Conclusions. Multiple factors have been implicated in the pathogenesis of vitiligo. The increased levels of IL-17 we found in serum and lesional skin suggest an important role for this cytokine in the pathogenesis of vitiligo

Although plant-based culture media enhances in vitro cultivation of rhizobacteria, studies assessing their biomass potential for large-scale applications are lacking. Here, we advance plant pellets (PPs) as a novel technology to unlock the potential of such vegan culture media for biomass production of Rhizobium leguminosarum. PP formulations were based on mixtures of Egyptian clover powder and the agro-byproducts glycerol and molasses. These mixtures were either contained or not contained in teabags during culture media preparation. Metrics of biomass included colony forming units, optical density (OD600nm), and cell dry weight (DW). Biomass comparisons between culture media based on PPs and standard yeast extract mannitol (YEM) revealed that the following PPs composition, contained in teabags, cultivated rhizobia at levels comparable to YEM: 16 g clover powder, 5% molasses, and 0.8% glycerol. This PPs composition enabled shorter generation times of rhizobia (PP: 3.83 h, YEM: 4.28 h). Strikingly, PPs mixtures supplemented with 10% molasses and not contained in teabags promoted rhizobia without apparent lag phases and produced 25% greater DW than YEM. PPs potentiate the use of dehydrated vegan feedstocks for both plant microbiota cultivation and biomass production and appear as cost-and labor-effective tools, easy to handle and store for plant-based culture media preparation. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Cancer is a fatal disease that is responsible for approximately 10 million deaths per year. This is due to complex mechanisms inside tumor microenvironment (TME) such as elevated GSH and hypoxia which reduce the curative effects of cancer therapies. The present review explores different approaches can target glutathione metabolic enzymes or their regulators to deplete GSH in cancer as well as overviewing role of natural compounds in disrupting GSH metabolism. Nanomedicine for many years was able to improve the efficacy and delivery of drugs using various forms of functionalized nanocarriers. Therefore, we summarize some of smart nanocarriers for chemotherapy, PDT, and SDT wither alone or combination used to reduce GSH level in TME with simultaneous rise of reactive oxygen species (ROS) levels. Furthermore, overcoming hypoxia and improving PDT could be accomplished by inhibiting hypoxia-induced factor – 1 (HIF-1), which is upregulated in TME, or using nanocarriers that deliver oxygen. Because SDT was able to replace PDT due to its deep penetration into tissues, its effectiveness was increased based on catalytic nanomedicine, which modulates TME via the efficient catalytic properties of nanoparticles. The current review offered future perspectives on the challenges, as well as potential solutions from various developed multifunctional nanoparticulate drug delivery systems to overcome elevated levels of GSH and hypoxia in TME.

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