Being chronic, combination therapies in vitiligo are beneficial, especially in refractory cases. Fractional CO2 laser (FCL) delivery of 5-fluorouracil (5-FU) has been successful in stable vitiligo. Topical methotrexate (MTX) is a potential, safer alternative to systemic route in vitiligo.
To investigate efficacy/safety of FCL with MTX versus 5-FU in stable vitiligo, and to assess serum and lesional interleukin (IL)-23 as possible therapeutic markers.
A total of 42 patients with vitiligo were enrolled. FCL was applied at 50 and 100 mJ energies, followed by topical MTX in group I and 5-FU in group II for 3-monthly sessions. Modified Vitiligo Area Scoring Index (VASI) and photography evaluated response, along with evaluation of serum and lesional interleukin-23 (IL-23).
Both MTX and 5-FU with FCL produced significant reductions, without difference, in VASI. All groups exhibited considerable repigmentation by photography, with earlier response in higher energy FCL+5-FU after treatment and continuous improvement in FCL + MTX at follow-up. Post-treatment reductions in serum and lesional IL-23 occurred in all groups, with greater decrease in serum IL-23 with MTX and lesional IL-23 with higher-energy FCL.
MTX provides comparable efficacy and safety with 5-FU after FCL for stable, nonsegmental vitiligo. IL-23 is a new treatment biomarker in vitiligo.
Follicular T cells contribute to B-cell responses and antitumor immunity, yet their immune checkpoint expression and role in colorectal cancer (CRC) remain insufficiently characterized. We evaluated the distribution, activation status, and checkpoint expression of follicular helper and follicular cytotoxic T-cell subsets (Tfh and Tfc) in CRC patients and their association with clinicopathological features. Thirty-three CRC patients and 25 healthy controls were recruited from South Egypt Cancer Institute, Assiut University. Flow cytometry was used to assess follicular T-cell subsets and their expression of inducible T-cell costimulatory (ICOS), T-cell immunoreceptor with Ig and ITIM domains (TIGIT) and V-domain Ig Suppressor of T-cell Activation (VISTA). Tfh and Tfc cells were significantly increased in peripheral blood of CRC patients compared with controls (p < 0.001 and p = 0.006, respectively). Their frequencies were higher in tumor-infiltrating lymphocytes (TILs) than in normal colonic tissue (p = 0.002 and p < 0.001) and peripheral blood (p < 0.001). Their ICOS expression was significantly elevated in patients’ blood (p = 0.008 and p = 0.04) and highest in TIL (p = 0.02) compared to the normal tissue and peripheral blood of patients (p < 0.001). TIGIT⁺VISTA⁺ follicular T-cell subsets were significantly expanded in the peripheral blood of patients, with peak expression in TILs (p < 0.001). Follicular T cells are enriched and highly activated in CRC, particularly within the tumor microenvironment. The predominance of TIGIT+ VISTA+ subsets suggests a dual role in antitumor immunity and immune escape. These cells serve as biomarkers and potential targets for immunotherapy.
Objective: The principal purpose was to investigate the ability of 2D shear wave
elastography (2D SWE) in forecasting the early recurrence of hepatocellular
carcinoma (HCC) after transarterial chemoembolization (TACE).
Methods: A cohort of forty-eight participants diagnosed with hepatitis B or C virus-
associated HCC underwent initial 2D SWE to quantify liver stiffness before TACE.
Presponse one month after TACE were subjected to
a 12-month follow-up, which included triphasic abdominal CT imaging to detect any
recurrence. Both univariate and multivariate statistical analyses were utilized to
identify the pWaredictors of recurrence.
Results: HCC recurrence was observ
and inform therapeutic decisions for patients afflicted with HCC.