Hydrocortisone 1.5% / Neomycin 0.5% ear/eye ointment

BackgroundTopical steroids are used widely to manage excessive inflammation and hypergranulation in burns; however, their use is controversial, and current evidence is largely anecdotal. Topical KENACOMB is a steroid preparation consisting of triamcinolone acetonide, neomycin, gramicidin, and nystatin, and it is standard of care at the Royal Brisbane and Women's Hospital burns unit. To our knowledge, there is no published literature that reports the use of KENACOMB to treat wound-associated inflammation and hypergranulation.ObjectiveTo synthesise current evidence surrounding the efficacy and safety of topical steroid use in treating inflammation and hypergranulation in burns patients. We also describe the use of topical KENACOMB in our burns unit.MethodsA systematic review of PubMed, Cochrane, and EMBASE databases was performed. Articles published in English that reported the use of topical steroids for granulation tissue or inflammation in burn wounds or skin graft donor sites were included.ResultsWe identified 350 articles, of which six met inclusion criteria. Four studies presented primary patient data, and two studies reported the results of surveys of burns unit professionals. A total of 54 patients were included across all studies, and no control group was reported in any study. Studies reported rapid improvements in healing, with 86.6%-100% of wounds showing complete reepithelialisation following treatment. Reported adverse outcomes included skin thinning, atrophy of granulation tissue, systemic side effects, and local wound infection.ConclusionsThis review highlights the paucity of conclusive evidence on the outcomes of topical steroids in treating inflammation and hypergranulation in burns and donor sites. While KENACOMB has shown efficacy in treating these wound types in our local experience, there is limited research available on the product. There is a clear need for quality research on the use of topical steroids in burns patients to better inform its ongoing clinical use.

Abstract licence: CC BY-NC-ND

IntroductionMouse models of human filarial infections are not only urgently needed to investigate the biology of the nematodes and their modulation of the host's immunity, but will also provide a platform to screen and test novel anti-filarial drugs. Recently, murine Loa loa infection models have been stablished using immunocompromised mouse strains, whereas murine Mansonella perstans infections have not been implemented until now.MethodsTherefore, we aim to establish experimental M. perstans infections using the immunocompromised mouse strains RAG2IL-2Rγ-/- (lack B, T and natural killer cells), IL-4Rα/IL-5-/- (impaired IL-4/5 signalling and eosinophil activation) and NOD.Cg-PrkdcscidIl2rgtm1Wj l/SzJ (NOD scid gamma, NSG) BALB/c mice (lack mature lymphocytes) through subcutaneous (s.c.) or intraperitoneal (i.p.) inoculation of infective stage 3 larvae (L3) isolated from engorged vectors.ResultsIn total, 145 immunocompromised mice have been inoculated with 3,250 M. perstans, 3,337 O. volvulus, and 2,720 Loa loa L3 to comparatively analyse which immunocompromised mouse strain is susceptible to human filarial infections. Whereas, no M. perstans and O. volvulus L3 could be recovered upon 2-63 days post-inoculation, a 62-66% Loa loa L3 recovery rate could be achieved in the different mouse strains. Gender of mice, type of inoculation (s.c. or i.p.) or time point of analysis (2-63 days post inoculation) did not interfere with the success of L3 recovery. In addition, administration of the immune suppressants hydrocortisone, prednisolone and cyclophosphamide did not restore M. perstans L3 recovery rates.DiscussionThese findings show that RAG2IL-2Rg-/-BALB/c and C57BL/6, IL-4Rα/IL-5-/- BALB/c and NSG mice were not susceptible to M. perstans and O. volvulus L3 inoculation using the applied methods, whereas Loa loa infection could be maintained. Further studies should investigate if humanized immunocompromised mice might be susceptible to M. perstans. and O. volvulus.

Abstract licence: CC BY

Background/Objectives: The correlation between contact allergy (CA), atopic dermatitis (AD) and psoriasis is still debated. Therefore, the present study aims to retrospectively analyze the frequency of contact sensitization among patients with psoriasis and AD compared to controls, in order to further investigate the relationship between CA and the underlying immunological background. Methods: All data concerning patients who underwent patch testing from 2016 to 2022 in the dermatology clinic of a tertiary center in Southern Italy have been retrospectively collected. Only patients who underwent patch testing with the S.I.D.A.PA. standard series have been selected and divided into three groups: AD group, psoriasis group and control group. Acquired data were organized into database and underwent statistical examination. Results: A total of 2287 patients have been enrolled, including 377 AD patients, 127 psoriatic patients and 1783 controls. The most frequent allergens were nickel and balsam of Peru. Methylisothiazolinone (4.2% vs. 2.2%), paraben mix (0.3% vs. 0%) and neomycin (1.3% vs. 0.4%) significantly provided more positive reactions (PSR) in the AD group compared to the control one, and fragrance mix II displayed a higher rate of positivity in the atopic group compared to the psoriatic one (3.2% vs. 0%). Conclusions: Psoriasis turned out to be a possible protective factor for CA (odds ratio = 0.6), while AD seems to facilitate its development (odds ratio: 1.42). The limitations of this study mainly rely upon its retrospective nature which limited the acquisition of clinical relevance for PSR. Further studies are required to better investigate this topic.

Abstract licence: CC BY

Human papillomavirus (HPV) genomes replicate and partition as minichromosomes alongside host chromatin during persistent infection. However, it is difficult to monitor genome dynamics in living cells because the small and compact genome will not easily tolerate expression cassettes. Here, we use ANCHOR technology to detect HPV18 genomes in living cells. We incorporated the cis-element from ANCHOR technology into the late region of the HPV18 genome and expressed the ParB-GFP protein from an HPV18-dependent replicon. The replicon contains the HPV18 replication origin and viral transcriptional enhancer element and can replicate stably in keratinocytes when complemented by the HPV18 genome. This small replicon expresses the neomycin resistance gene in both bacteria and eukaryotic cells and has minimal prokaryotic elements that could induce innate immunity. This molecular tool enables us to indirectly monitor the presence of the virus by detecting these fluorescent proteins in live cells and allows for real-time tracking of replicating HPV18-ANCH3 genomes in proliferating keratinocytes to inform on models of HPV genome maintenance, tethering, and amplification. Here, we visualize the partitioning of the viral DNA in dividing cells and show that HPV18-ANCH genomes are distributed somewhat equally to daughter cells by attachment to host chromosomes.ImportanceIn persistent human papillomavirus (HPV) infection, the viral genome is maintained at a constant copy number, replicates in synchrony with host DNA during S-phase, and is partitioned into daughter cells. The exact method by which HPVs partition to daughter cells is not well understood, and the elucidation of such mechanisms may reveal relevant pharmacological targets to combat persistent HPV infection.

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PurposeRefractory periorbital dermatitis has a chronic course with exacerbations leading to discomfort and cosmetic issues, yet characterization of treatment options is limited.AimsThe objective was to present comprehensive demographic data and medical management of a series of patients with refractory periorbital dermatitis.Settings and designRetrospective review identified patients treated at a single institution from January 2010 to August 2020.MethodsDescriptive analyses were performed. Demographic data and treatment history were reviewed and data including medication, use, date of use and discontinued use, reason for discontinuation (if applicable), refractory status, formulation, concentration, and dose frequency were extracted.Statistical analysis usedDescriptive analyses.ResultsForty-five patients were included. The average age at first diagnosis was 60.3 years (sd 14.9). 82.2% were women and 84.4% identified as Caucasian. Triamcinolone cream was most frequently used followed by tobramycin-dexamethasone, tacrolimus, and neomycin-polymyxin-dexamethasone. Less than 30% of patients on triamcinolone were refractory. 13.3% of patients used topical hydrocortisone, with over 80% of these patients experiencing refractory episodes of persistent irritation and erythema. Most patients were refractory during initial use or the first recurrence of periorbital dermatitis flare.ConclusionsBy better characterizing the diverse treatment regimens in a unique subset of refractory patients, we hope to better inform potential courses of medical management for periorbital dermatitis.

Abstract licence: CC BY-NC-SA

Ammonia-oxidising archaea (AOA) are important microorganisms contributing towards the nitrogen flux in the environment. Unlike archaea from other major phyla, genetic tools are yet to be developed for the AOA, and identification of antibiotic resistance markers for selecting mutants is required for a genetic system. The aim of this study was to test the effects of selected antibiotics (hygromycin B, neomycin, apramycin, puromycin, novobiocin) on pure cultures of three well studied AOA strains, 'Candidatus Nitrosocosmicus franklandianus C13', Nitrososphaera viennensis EN76 and Nitrosopumilus maritimus SCM1. Puromycin, hygromycin B and neomycin inhibited some but not all tested archaeal strains. All strains were resistant to apramycin and inhibited by novobiocin to various degrees. As N. viennensis EN76 was relatively more resistant to the tested antibiotics, a wider range of concentrations and compounds (chloramphenicol, trimethoprim, statins) was tested against this strain. N. viennensis EN76 was inhibited by trimethoprim, but not by chloramphenicol, and growth recovered within days in the presence of simvastatin, suggesting either degradation of, or spontaneous resistance against, this compound. This study highlights the physiological differences between different genera of AOA and has identified new candidate antibiotics for selective enrichment and the development of selectable markers for genetic systems in AOA.

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