BACKGROUND/OBJECTIVES: Poorly regulated inflammation is believed to be the most predominant factor that can result in a wide scope of diseases including atopic dermatitis (AD). Despite many studies on the effect of pear pomace in obesity-related disorders including dysregulated gut microbiota, the protective effect of pear pomace in AD is still unknown. This study aimed to evaluate the effect of pear pomace ethanol extract (PPE) on AD by inhibiting inflammation.MATERIALS/METHODS: In the in vivo experiment, 2, 4-dinitrochlorobenzene (DNCB) was applied to NC/Nga mice to induce AD-like skin lesions. After the induction, PPE was administered daily by oral gavage for 4 weeks. The clinical severity score, serum IgE levels, spleen weight, histological changes in dorsal skin, and inflammation-related proteins were measured. In the cell study, RAW 264.7 cells were pretreated with PPE before stimulation with lipopolysaccharide (LPS). Nitrite oxide (NO) production and nuclear factor kappa B (NFkB) protein expression were detected. RESULTS: Compared to the AD control (AD-C) group, IgE levels were dramatically decreased via PPE treatment. PPE significantly reduced scratching behavior, improved skin symptoms, and decreased ear thickness compared to the AD-C group. In addition, PPE inhibited the DNCB-induced expression of inducible nitrite oxide synthase (iNOS), the receptor for advanced glycation end products, extracellular signal-regulated kinase (ERK) 1/2, and NF-κB.PPE inhibited the LPS-induced overproduction of NO and the enhanced expression of iNOS and cyclooxygenase-2. Moreover, the phosphorylation of ERK1/2 and NF-κB in RAW 264.7 cells was suppressed by PPE. CONCLUSIONS These results suggest that PPE could be explored as a therapeutic agent to prevent AD.

BACKGOUND: The late referral to nephrologist was founded as independent risk factor of poor survival in hemodialysis patients. Patients referred lately are prone to initiate dialysis urgently through temporary catheter and the use of catheter increase the incidence of catheter related complications. But patients' survival may be influenced by multiple and more complex factors beside referral pattern and use of catheter. So we planed to evaluate the effect of referral pattern on patients' survival and related factors. METHODS: This analysis included 629 incident hemodialysis patients in single center. Demographical, clinical, laboratory data were collected retrospectively. Early referral was defined as first nephrology visit over 3 months prior to initiation of dialysis. Clinical characteristics were compared between early (ER) and late referral groups (LR). Survival analysis and Cox models were performed to assess the relationship of referral pattern and mortality. Significant differences were defined as p value less than 0.05. RESULTS: ER included 269 patients and their mean age, male proportion were not different from those of LR. In ER, pre-dialysis education program and nutritional counseling were offered much more than LR and lesser catheter usage, higher serum albumin at the initiation of dialysis. ER survived longer but in Cox models, only older age, presence of diabetes, lower serum albumin at the initiation of dialysis were independent risk factor for death (odds ratio 1.047, 1.547, 0.615, respectively) CONCLUSION: Although early referral decrease catheter use at the initiation and urgent hemodialysis, classical risk factors such as old age, presence of diabetes, nutritional status at the initiation are more important in patients prognosis.
Catheters ; Counseling ; Dialysis ; Education ; Humans ; Incidence ; Male ; Mortality ; Nephrology* ; Nutritional Status ; Prognosis ; Proportional Hazards Models ; Referral and Consultation* ; Renal Dialysis* ; Retrospective Studies ; Risk Factors ; Serum Albumin