Improved thickness measurement method for choroidal hyperpermeability in central serous chorioretinopathy

AIM:To observe choroidal thickness changes in the choroidal hyperpermeability area(CHA)in patients with central serous chorioretinopathy(CSC)after photodynamic therapy(PDT)using indocyanine green angiography(ICGA)combined with optical coherence tomography(OCT).METHODS:This was a cohort study of 17 eyes(17 patients)with CSC.In all patients,the range of CHA was determined by ICGA.The patients were divided into two groups based on CHA covered the fovea(group A)or not(group B).All patients received half-dose verteporfin PDT over CHA in ICGA.Choroidal thickness was measured by OCT before,1,and 3 mo after treatment.The choroidal thickness values of the fovea and CHAs were obtained for each measurement.Secondary outcomes were changes in the best-corrected visual acuity(BCVA)and amount of subretinal fluid(SRF).RESULTS:The differences in center choroidal thickness at baseline and at 1 and 3 mo post-PDT were statistically significant in group A and all patients(both P<0.001).There was no significant difference in group B(P=0.059).The differences of thickness of CHA and BCVA at baseline and1 and 3 mo post-PDT were statistically significant in group A,group B,and all patients(all P<0.01).All patients showed complete SRF absorption at 3 mo post-PDT.CONCLUSION:Center choroidal thickness does not accurately reflect changes in CHA of patients whose CHA does not covered the fovea center.Using CHA as the observation target can make up for this limitation,expand the scope of application,and reduce bias.

Seabuckthorn Berries Extract Attenuates Pulmonary Vascular Hyperpermeability in Lipopolysaccharide-Induced Acute Lung Injury in Mice

Objective:To investigate the effect of seabuckthorn berries extract(SBE)on pulmonary vascular hyperpermeability in the mice model of acute lung injury(ALI)induced by lipopolysaccharide(LPS).Methods:Sixty Kunming mice were allocated into 6 groups by a random number table,including control,LPS,dexamethasone(Dex,1 mg/kg),and 120,240 and 480 mg/kg SBE groups,10 mice in each group.Except the control group,mice were pre-treated with Dex and SBE,respectively,for 7 days before LPS was intraperitoneally injected to induce ALl.Pulmonary vascular hyperpermeabilitywas evaluated by histopathologic observation and transvascular leakagedetermination.Tumor necrosis factor alpha(TNF-α)and interleukin-6(IL-6)levels in serum were measured using enzyme-linked immunosorbent assay.The expression of nuclear factor-kappa B(NF-k B)p65 in lung cells was determined by immunofluorescence analysis.The contents of cytoplasmic inhibitorof nuclear factor-kBkinase(IKK)and nuclearp65,as wellasdownstreamproteins of E-selectin(CD62E)and intercellular adhesion molecule-1(ICAM-1),were determined using Western blot analysis.Results:Histopathological observation confirmed SBEtreatment alleviatedmorphological lesion induced by LPS.Compared with the LPS group,480 mg/kg SBE significantly decreased the water content of lung,Evans blue accumulation in lung tissue,and protein concentration and neutrophils count in bronchoalveolar lavage fluid(P<o.01);moreover,480 mg/kg SBE significantly suppressed release of TNF-αand IL-6,and down-regulated expressions of IKK,nuclear p65,ICAM-1 and CD62E(P<0.01).Conclusion:SBE maintained alveolar-capillary barrier integrity under endotoxin challenge in mice by suppressing the key factors in the pathogenesis of ALl.

Chorioretinal response to intravitreal aflibercept injection in acute central serous chorioretinopathy

AIM: To evaluate chorioretinal responses to intravitreal aflibercept injection(IAI) in patients with acute central serous chorioretinopathy(CSC). METHODS: Seventy-one eyes from 71 patients with symptomatic CSC for less than six months were included. Thirty-five eyes received a single IAI and 36 eyes were observed without treatment. Best-corrected visual acuity(BCVA), central subfield foveal thickness(CSFT), and subfoveal choroidal thickness(SFCT) were assessed at baseline and at 1, 2, and 3 mo. RESULTS: The mean SFCT in the IAI group decreased at 1 mo, rebounded at 2 mo and remained stable at 3 mo compared to the baseline, while significant change was not noted in the observation group. The mean CSFT decreased significantly during the 3-month study period in both groups, and was significantly lower in the IAI group at 1 mo(P<0.001). A rebound of CSFT between 1 and 2 mo was noted in 14 eyes(40.0%) in the IAI group and in 1 eye(2.8%) in the observation group(P<0.001). The significant visual improvement was achieved from 1 mo in the IAI group, and from 2 mo in the observation group. The rate of complete absorption of subretinal fluid at 3 mo did not differ between the two groups.(45.7% vs 41.7%, P=0.813). CONCLUSION: A single IAI for acute CSC induce a transient decrease in SFCT and CSFT, which implies that IAI may have a pharmacological effect on the underlying hyperpermeable choroid in acute CSC.

Ameliorating effects of traditional Chinese medicine preparation, Chinese materia medica and active compounds on ischemia/reperfusion-induced cerebral microcirculatory disturbances and neuron damage

Ischemic stroke and ischemia/reperfusion(I/R) injury induced by thrombolytic therapy are conditions with high mortality and serious long-term physical and cognitive disabilities. They have a major impact on global public health. These disorders are associated with multiple insults to the cerebral microcirculation, including reactive oxygen species(ROS) overproduction, leukocyte adhesion and infiltration, brain blood barrier(BBB) disruption, and capillary hypoperfusion, ultimately resulting in tissue edema, hemorrhage, brain injury and delayed neuron damage. Traditional Chinese medicine(TCM)has been used in China, Korea, Japan and other Asian countries for treatment of a wide range of diseases.In China, the usage of compound TCM preparation to treat cerebrovascular diseases dates back to the Han Dynasty. Even thousands of years earlier, the medical formulary recorded many classical prescriptions for treating cerebral I/R-related diseases. This review summarizes current information and underlying mechanisms regarding the ameliorating effects of compound TCM preparation, Chinese materia medica,and active components on I/R-induced cerebral microcirculatory disturbances, brain injury and neuron damage.

Targeting the gut barrier for the treatment of alcoholic liver disease

Alcohol consumption remains one of the predominant causes of liver disease and liver-related death worldwide.Intriguingly,dysregulation of the gut barrier is a key factor promoting the pathogenesis of alcoholic liver disease(ALD).A functional gut barrier,which consists of a mucus layer,an intact epithelial monolayer and mucosal immune cells,supports nutrient absorption and prevents bacterial penetration.Compromised gut barrier function is associated with the progression of ALD.Indeed,alcohol consumption disrupts the gut barrier,increases gut permeability,and induces bacterial translocation both in ALD patients and in experimental models with ALD.Moreover,alcohol consumption also causes enteric dysbiosis with both numerical and proportional perturbations.Here,we review and discuss mechanisms of alcohol-induced gut barrier dysfunction to better understand the contribution of the gut-liver axis to the pathogenesis of ALD.Unfortunately,there is no effectual Food and Drug Administration-approved treatment for any stage of ALD.Therefore,we conclude with a discussion of potential strategies aimed at restoring the gut barrier in ALD.The principle behind antibiotics,prebiotics,probiotics and fecal microbiota transplants is to restore microbial symbiosis and subsequently gut barrier function.Nutrientbased treatments,such as dietary supplementation with zinc,niacin or fatty acids,have been shown to regulate tight junction expression,reduce intestinal inflammation,and prevent endotoxemia as well as liver injury caused by alcohol in experimental settings.Interestingly,saturated fatty acids may also directly control the gut microbiome.In summary,clinical and experimental studies highlight the significance and efficacy of the gut barrier in treating ALD.

Progression of the Wei-Qi-Ying-Xue Syndrome,Microcirculatory Disturbances,in Infectious Diseases and Treatment with Traditional Chinese Medicine

Lipopolysaccharide(LPS)-induced endotoxemia is a critical condition that initiates microcirculatory disturbance and may progress to multiple organ failure that threatens the lives of millions of people around the world each year.The pathology of endotoxemia involves multiple insults mediated by a range of signaling pathways.Multitarget management is required to relieve endotoxemia.Traditional Chinese medicine(TCM)is a type of therapeutic that commonly contains numerous components and,thus,exhibits multitarget potential.More importantly,some TCM formulas have been proposed and used for effective treatment of endotoxemia-like diseases.In the past 20 years,an increasing number of studies have explored the effects and mechanisms of these formulas and their major bioactive components on microcirculatory disturbance and organ injury caused by LPS.The results obtained thus far provide support for the clinical use of TCM and shed light on the underlying mechanisms.