Mood color choice helps to predict response to hypnotherapy in patients with irritable bowel syndrome.
BMC Complement Altern Med. 2010;10:75. Epub 2010 Dec 7. PMID: 21138549
[No authors listed]
Department of Medicine, University of Manchester, Manchester, UK.
BACKGROUND: Approximately two thirds of patients with irritable bowel syndrome (IBS) respond well to hypnotherapy. However, it is time consuming as well as expensive to provide and therefore a way of predicting outcome would be extremely useful. The use of imagery and color form an integral part of the hypnotherapeutic process and we have hypothesised that investigating color and how it relates to mood might help to predict response to treatment. In order to undertake this study we have previously developed and validated a method of presenting colors to individuals for research purposes called the Manchester Color Wheel (MCW). Using this instrument we have been able to classify colors into positive, neutral and negative shades and this study aimed to assess their predictive role in hypnotherapy.
METHODS: 156 consecutive IBS patients (aged 14-74, mean 42.0 years, 127 (81%) females, 29 (19%) males) were studied. Before treatment, each patient was asked to relate their mood to a color on the MCW as well as completing the IBS Symptom Severity Score, the Hospital Anxiety and Depression (HAD) Scale, the Non-colonic Symptom Scale, the Quality of Life Scale and the Tellegen Absorption Scale (TAS) which is a measure of hypnotisability. Following hypnotherapy all these measures were repeated with the exception of the TAS.
RESULTS: For patients with a positive mood color the odds of responding to hypnotherapy were nine times higher than that of those choosing either a neutral or negative color or no color at all (odds ratio: 8.889; p = 0.042). Furthermore, a high TAS score and the presence of HAD anxiety also had good predictive value (odds ratio: 4.024; p = 0.092, 3.917; p<0.001 respectively) with these markers and a positive mood color being independent of each other. In addition, these factors could be combined to give an even stronger prediction of outcome. Twice as many responders (63, 77.8%) had a positive mood color or were anxious or had a high TAS score compared with 32 (42.7%) without these factors (p<0.001).
CONCLUSION: A positive mood color, especially when combined with HAD anxiety and a high TAS score, predict a good response to hypnotherapy.
Article Published Date : Jan 01, 2010
Effect of mud pack to eyes on psychological variables in healthy volunteers: a pilot randomized controlled trial.
J Complement Integr Med. 2018 Jul 18;:
Authors: Jogdand R, Mooventhan A, Manjunath NK
Background Mud pack is one of the fundamental therapeutic procedures used in naturopathy to treat various diseases. There is a lack of scientific evidence for the use of mud-pack application in psychological variables. The present study aims at evaluating the effect of mud pack to eyes on psychological variables in healthy volunteers. Materials and methods Sixty healthy individuals with the age varied from 18 to 21 years were recruited and randomly divided into either mud-pack group (n=30) or wet-pack group (n=30). Mud-pack group received mud pack to eyes and wet-pack group received wet pack to eyes for a duration of 30 min/session (a total of 15 sessions). Psychological assessments like Mindful Attention Awareness Scale (MAAS), Perservative Thinking Questionnaire (PTQ) and Positive and Negative Affect Scale (PANAS) were taken before and after the intervention. Statistical analysis was performed using statistical package for the social sciences, version 16. Results Result of this study showed a significant reduction in PTQ score and PANAS negative score in both mud-pack and wet-pack groups. But, a significant increase in MAAS score was observed only in the mud-pack group, unlike wet-pack group. However, there was no significant difference found in between group analysis. Conclusions Result suggests that though both mud pack and wet pack to eyes reduced the scores of PTQ and negative affects, only mud pack to eyes increased the state of mindfulness in healthy individuals.
PMID: 30020886 [PubMed - as supplied by publisher]
Interaction Between Phenolic Compounds and Lipase: The Influence of Solubility and Presence of Particles in the IC50 Value.
J Food Sci. 2018 Jul 18;:
Authors: Bustos AS, Håkansson A, Linares-Pastén JA, Penarrieta JM, Nilsson L
Obesity is one of the principal human health problems and one of the main treatments against it is the inhibition of pancreatic lipase, the main responsible enzyme of lipid digestion. For that purpose, previous studies have tested several phenolic compounds against lipase, without considering their aggregation behavior in aqueous solutions. Because of this, the present study focuses on understanding how the solubility and the presence of particles affect the IC50 value of the interaction between lipase and phenolic compounds present in beverages like fruit juices and teas. Therefore, the inhibitory capacity against pancreatic lipase and the aggregate formation of 9 phenolic compounds (quercetin, rutin, myricetin, catechin, epigallocatechin gallate, cyanidin, caffeic acid, chlorogenic acid, and vanillic acid) were analyzed. The results obtained together with the solubility data from literature were treated by principal component analysis and indicate that the IC50 value does not correlate with the solubility or aggregate formation of the phenolic compounds. However, the IC50 values of phenolic compounds which aggregate during the assay conditions have low reproducibility. This study shows that the aggregate formation of phenolic compounds plays an important role during in vitro assays for pancreatic lipase inhibition and should be considered in future experiments as it can lead to false positive results. In terms of particle formation, the flavonoids investigated in this study are more prone to aggregation compared to the phenolic acids.
PMID: 30020550 [PubMed - as supplied by publisher]
Prevalence and potential predictors of gambling disorder among people living with HIV.
AIDS Care. 2018 Jul 18;:1-6
Authors: Langan K, Wall M, Potts W, Himelhoch S
Specific subsets of the adult population are at an increased risk of problem gambling behaviors. Previous research among these subsets has found increased rates of disordered gambling among those with drug use, alcohol use, mood, anxiety, and personality disorders. To what extent this may apply to the HIV population, known to have a high burden of co-occurring substance use and mental disorders, is not known The current study also examined the effectiveness of The Brief Biosocial Gambling Screen (BBGS) for the diagnosis of gambling disorder. This study examined the prevalence of gambling behaviors and disordered gambling in patients enrolled in an urban HIV clinic. 100 people living with HIV (PLWH) were assessed on gambling behaviors, impulsivity, and criterion on disordered gambling. Screening for gambling disorder using the BBGS was compared to the American Psychiatric Association DSM-5 criterion. The mean age was 53, 44% were female, 60% completed high school or above, and 80% self-identified as unemployed/disabled. 13% met four or more criteria for gambling disorder according to DSM-5 criteria. Participants that met criteria were more likely to report marijuana (p = .044) and heroin (p = .002) use, and greater impulsivity (p < 0.00001) when compared to participants who did not meet criteria. The BBGS was able to effectively screen individuals for disordered gambling with a sensitivity of 100%, specificity of 90.8%, positive predictive value of 56.2%, and a negative predictive value of 100%. These results suggest that urban HIV clinics may need to consider actively screening for gambling disorders, and referring to appropriate counseling and treatment for those who screen positive.
PMID: 30019914 [PubMed - as supplied by publisher]
The influence of mood on visual perception of neutral material.
Acta Neurobiol Exp (Wars). 2018;78(2):163-172
Authors: Wyczesany M, Ligeza TS, Tymorek A, Adamczyk A
In the study we investigated how current mood affects spontaneous perceptual processes of neutral stimuli of low‑arousal, unrelated to any specific task. Two separate but similar procedures were carried out: one using functional magnetic resonance imaging (fMRI), the other using electroencephalography based source localization. In both experiments, sessions of passive viewing of neutral pictures were preceded by either a negative or positive mood induction. In response to neutral stimuli, we observed higher activation of visual areas after positive mood induction and lower activations in medial prefrontal and right frontotemporal regions after negative mood induction. We conclude that in relatively safe laboratory conditions, after being exposed to negative emotional content, automatic processes of affective control are recruited by the prefrontal cortex. This results in attenuation of processing of incoming stimuli, as the stimuli do not carry salient information with respect to bottom‑up or top‑down processes. The observed effects may therefore represent an implicit mechanism of perceptual modulation.
PMID: 30019707 [PubMed - in process]
GC-MS aroma characterization of vegetable matrices: focus on 3-Alkyl-2-Methoxypyrazines.
J Mass Spectrom. 2018 Jul 17;:
Authors: Mutarutwa D, Navarini L, Lonzarich V, Compagnone D, Pittia P
3-alkyl-2-methoxypyrazines (MPs) are a very important class of volatile organic compounds (VOCs), intensively characterizing the aroma of several food products including fruits and vegetables. Due to the very low orthonasal sensory threshold, low amounts of MPs may act as key positive or negative aroma compounds. The analysis of these volatiles in foods are, then, remarkably important and it may be very challenging as confirmed by the scarce literature focused on MPs, particularly with respect to quantitative data. In the attempt to fill this gap, in this work presence and quantification of MPs in four different vegetables, green bell pepper (Capsicum annum L. var. grossum), green pea (Pisum sativum L. and Pisum spp.), carrot (Daucus carota subsp. sativus), cucumber (Cucumis sativus L.) have been investigated. Two different volatiles extraction techniques (Solid Phase Micro Extraction, SPME, and Simultaneous Distillation-Extraction, SDE) in conjunction with VOCs qualitative analysis by GC-MS methods were applied. SPME coupled with GC-MS in single ion monitoring (SIM) mode showed the best performances in terms of sensitivity to detect MPs on the different vegetable matrices. Therefore, a headspace (HS) SPME-GC-MS quantitative method was developed and optimised, and dominant MPs quantified. 3-isopropyl-2-methoxypyrazine (IPMP), 3-sec-butyl-2-methoxypyrazine (sBMP) and 3-isobutyl-2-methoxypyrazine (IBMP) have been detected and quantified in all the vegetables. IPMP was the prevalent MP in peas and cucumber while IBMP in bell pepper. These MPs were detected for the first time in carrot and cucumber. Finally, sBMP has been confirmed to be the most important MP in carrot. The developed method allowed to characterise the VOCs pattern and, in particular, to quantify MPs in four vegetables. Results highlight the feasibility of further applications of the analytical approach to determine MPs in other food matrices where an excessive amount of these aromas may negatively affect their flavour (e.g. coffee).
PMID: 30019367 [PubMed - as supplied by publisher]
Regulation of the interferon-gamma (IFN-γ) pathway by p63 and Δ133p53 isoform in different breast cancer subtypes.
Oncotarget. 2018 Jun 26;9(49):29146-29161
Authors: Mehta SY, Morten BC, Antony J, Henderson L, Lasham A, Campbell H, Cunliffe H, Horsfield JA, Reddel RR, Avery-Kiejda KA, Print CG, Braithwaite AW
The TP53 family consists of three sets of transcription factor genes, TP53, TP63 and TP73, each of which expresses multiple RNA variants and protein isoforms. Of these, TP53 is mutated in 25-30% of breast cancers. How TP53 mutations affect the interaction of TP53 family members and their isoforms in breast cancer is unknown. To investigate this, 3 independent breast cancer cohorts were stratified into 4 groups based on oestrogen receptor (ER) and TP53 mutation status. Using bioinformatic methodologies, principal signalling pathways associated with the expression of TP53 family members were identified. Results show an enrichment of IFN-γ signalling associated with TP63 RNA in wild type TP53 (wtTP53), ER negative (ER-) tumours and with Δ133TP53 RNA in mutant TP53 (mTP53) ER positive (ER+) tumours. Moreover, tumours with low IFN-γ signalling were associated with significantly poorer patient outcome. The predicted changes in expression of a subset of RNAs involved in IFN-γ signalling were confirmed in vitro. Our data show that different members of the TP53 family can drive transcription of genes involved in IFN-γ signalling in different breast cancer subgroups.
PMID: 30018742 [PubMed]
Emotional Differences in Young and Older Adults: Films as Mood Induction Procedure.
Front Psychol. 2018;9:1110
Authors: Fernández-Aguilar L, Ricarte J, Ros L, Latorre JM
Film clips are proven to be one of the most efficient techniques in emotional induction. However, there is scant literature on the effect of this procedure in older adults and, specifically, the effect of using different positive stimuli. Thus, the aim of the present study was to examine emotional differences between young and older adults and to know how a set of film clips works as mood induction procedure in older adults, especially, when trying to elicit attachment-related emotions. To this end, we use this procedure to analyze differences in subjective emotional response between young and older adults. A sample of 57 older adults and 83 young adults watched a film set previously validated in young population. Their responses were studied in an individual laboratory session to elicit 6 target emotions (disgust, fear, sadness, anger, amusement and tenderness) and neutral state. Self-reported emotional experience was measured using the Self-Assessment Manikin (SAM). Our results show that film clips are capable of evoking positive and negative emotions in older adults. Furthermore, older adults experienced more intensely negative emotions than young adults, especially in response to disgust and fear clips. They also reported higher arousal than young adults, especially in the case of sadness, anger and tenderness clips. Nevertheless, the older adults recovered more easily from the effects of the emotion induction. The young adults reported higher arousal ratings than older adults in response to amusement film clips. On the other hand, this study reflects the importance of controlling the baseline state to study the real strength of mood induction. Overall, current data suggests significant differences occur in emotional response in adult age and that film clips are an effective tool for studying positive and negative emotions in aging research.
PMID: 30018584 [PubMed]
Syndrome 'Z': A Predictor of Angiographic Severity of Coronary Artery Disease in Patients of Acute Coronary Syndrome.
Heart Lung Circ. 2018 Jun 23;:
Authors: Sethi R, Gupta P, Pradhan A, Saran M, Singh BRK, Vishwakarma P, Bhandari M, Chaudhary G, Chandra S, Sharma A, Dwivedi SK, Narain VS
BACKGROUND: Owing to the growing evidence that the pathophysiology of obstructive sleep apnoea (OSA) and metabolic syndrome (MS) overlap considerably and both adversely impact cardiovascular health, we hypothesised that the presence of OSA with MS additively and adversely affect the severity of coronary artery disease (CAD). Exploration and understanding of this may have direct implications for the development of targeted, preventive strategies for CAD. Thus, this prospective study was aimed to determine the prevalence of 'Syndrome Z' in patients of MS who present with an acute coronary event and to correlate it with the angiographic severity of CAD in these patients.
METHODS: The present study was a single centre, cross sectional study conducted in a university teaching hospital. In a span of 6 months, 922 patients with acute coronary syndromes (ACS) were screened for the study. Among these, 861 patients had no evidence of MS. The remaining 61 patients who were diagnosed to have MS were then subjected to an overnight sleep study. Only 58 had good sleep data so were included for further analysis. Angiographic parameters in terms of number of vessels involved and culprit lesions were noted and correlated with presence and absence of OSA and also with its severity based on the Apnoea/Hypopnoea Index (AHI).
RESULTS: The prevalence of OSA positivity in patients with MS who presented with ACS was 34.5% (n=20). Most of the patients in the OSA negative group (78.9%, n=30) had disease limited to only one vessel while in the OSA positive group only a minority (15%, n=3) of patients had their disease limited to a single vessel (p=0.001). The number of lesions in the culprit vessel was also significantly less in the OSA negative group compared to the OSA positive group. While in the OSA negative group 68.4% (n=26) patients had a solitary lesion, followed by two and three lesions in 15.8% (n=6) of the patients each, multiple lesions were more common in OSA positive patients, involving 80% of cases (45.0%, n=9 with two lesions; 35.0%, n=7 with three lesions; only 20%, n=4 had a solitary lesion).
CONCLUSIONS: Prevalence of 'Syndrome Z' is high in patients having MS presenting with ACS and it correlates with the angiographic severity of CAD.
PMID: 30017635 [PubMed - as supplied by publisher]
Immediate weight bearing after plate fixation of fractures of the tibial plateau.
Injury. 2018 Jun 28;:
Authors: Williamson M, Iliopoulos E, Jain A, Ebied W, Trompeter A
BACKGROUND: Proximal articular fractures of the tibia are commonly stabilised with internal fixation using plates and screws. There is a lack of evidence and conflicting guidelines as to the most suitable post-operative rehabilitation regime including weight bearing status. There are numerous physiological and socioeconomic benefits of early weight bearing after orthopaedic surgery, but concerns remain around loss of fracture reduction. Therefore, the aim of this study is to investigate whether the weight bearing status after tibial plateau plate fixation is associated with any loss of reduction or articular collapse.
METHODS: We retrospectively analysed data from our prospectively collected major trauma centre database. All tibial plateau fractures that required open reduction and internal fixation with plate and screws were included. The immediate post-operative weight bearing status of these patients was recorded. Group I consisted of those patients that were either non-weight bearing or touch weight bearing for the first six post-operative weeks. Group II consisted of patients who were instructed to weight bear fully (as tolerated) immediately after the operation. Radiographs were taken on day one post-operation, at six weeks and at three months and analysed for fracture displacement and joint depression or loss of fixation.
RESULTS: A total of 90 patients were included in the study. Group I (non-weight bearing or touch weight bearing) consisted of 60 patients (67%). Group II (full weight bearing as tolerated) consisted of 30 patients (33%). The follow up radiographs demonstrated no failure of fixation in either study group. One patient from the weight bearing group had >1 mm joint depression (4 mm) identified at the first follow up, which did not progress.
CONCLUSIONS: This study shows immediate post-operative full weight bearing does not affect the fixation or cause articular collapse up to three months after surgery and thus we propose that patients should be allowed to weight bear immediately after surgical stabilisation of tibial plateau fractures. This will enable patients to benefit from the positive effects on fracture healing of early weight bearing post-surgery and avoid the complications of non-weight bearing without loss of fixation or articular collapse.
PMID: 30017182 [PubMed - as supplied by publisher]
A rapid review to identify physical activity accrued while playing golf.
BMJ Open. 2017 Nov 28;7(11):e018993
Authors: Luscombe J, Murray AD, Jenkins E, Archibald D
OBJECTIVE: To identify physical activity (PA) accrued while playing golf and modifiers of PA accrued.
DESIGN: A rapid review of primary research studies. Quality was assessed using the National Heart, Lung, and Blood Institute quality assessment tool for cohort and cross-sectional studies.
METHODS AND OUTCOMES: The following databases were searched from 1900 to March 2017: SPORTDiscus, Web of Science, PsycINFO, MEDLINE, Google Scholar, Google Advanced Search, ProQuest, WHO International Clinical Trials Registry Platform. All primary research investigating golf or golfers with any of the following outcomes was included: metabolic equivalent of task, oxygen uptake, energy expenditure, heart rate, step count, distance covered, strength, flexibility, balance, sedentary behaviour.
RESULTS: Phase one searching identified 4944 citations and phase two searching identified 170 citations. In total, 19 articles met inclusion criteria. Golf is primarily a moderate intensity PA, but may be low intensity depending on the playing population and various modifiers. Less PA is accrued by those who ride a golf cart compared with those walking the course.
CONCLUSIONS: Golf can be encouraged in order to attain PA recommendations. Further research is required into the relationship between golf and strength and flexibility PA recommendations and how modifiers affect PA accrued.
PROSPERO REGISTRATION NUMBER: CRD42017058237.
PMID: 29187418 [PubMed - indexed for MEDLINE]
Book. 2018 01 Authors:
Hypersensitivity reactions (HR) are immune responses that are exaggerated or inappropriate against an antigen or allergen. Coombs and Gell classified hypersensitivity reactions into four forms. Type I, type II, and type III hypersensitivity reactions are known as immediate hypersensitivity reactions (IHR) because occur within 24 hours. Antibodies including IgE, IgM, and IgG mediate them. Type I or Anaphylactic Response Anaphylactic Responseis mediated by IgE antibodies that are produced by the immune system in response to environmental proteins (allergens) such as pollens, animal danders or dust mites. These antibodies (IgE) bind to mast cells and basophils, which contain histamine granules that are released in the reaction and cause inflammation. Type I hypersensitivity reactions can be seen in bronchial asthma, allergic rhinitis, allergic dermatitis, food allergy, allergic conjunctivitis, and anaphylactic shock. Anaphylaxis Anaphylaxis is a medical emergency because can lead to an acute, life-threatening respiratory failure. It is an IgE-mediated process. It is the most severe form of an allergic reaction, where mast cells suddenly release a large amount of histamine and later on leukotrienes. In severe cases intense bronchospasm, laryngeal edema, cyanosis, hypotension, and shock are present. Allergic bronchial asthma Allergic bronchial asthma is an atopic disease, characterized by bronchospasm. It may also be a chronic inflammatory disease. In its etiology, and environmental factors along with a genetic background play an important role. The diagnosis is dependent on history and examination. In allergic bronchial asthma, IgE is elevated, and sputum eosinophilia is common. Epidemiologically, a positive skin prick test or specific IgE are risk factors for asthma. Allergic rhinitis Allergic rhinitis is another atopic disease where histamine and leukotrienes are responsible for rhinorrhea, sneezing and nasal obstruction. Allergens are similar to those found in bronchial asthma. Nasal polyps may be seen in chronic rhinitis. Allergic conjunctivitis Allergic conjunctivitis presents with rhinitis and is IgE-mediated. Itching and eye problems including watering, redness, and swelling always occur. Food allergy One must differentiate food allergy (IgE-mediated) from food intolerance that can be cause for a variety of etiology including malabsorption and celiac disease. It is more frequent in children as seen in cow's milk allergy. Food allergy symptoms mostly affect the respiratory tract, the skin, and the gut. Skin prick tests are helpful to test for food allergens that can trigger severe reactions, e.g., peanuts, eggs, fish, and milk. Atopic eczema Atopic eczema is an IgE-mediated disease that affects the skin and has an immunopathogenesis very similar to that of allergic asthma and allergic rhinitis, which are present in more than half of the diseased. Radioallergosorbent (RAST) may reveal the specificity of the IgE antibody involved but has little help in management. Drug allergy Drugs may cause allergic reactions by any mechanism of hypersensitivity. For example, penicillin may cause anaphylaxis, which is IgE-mediated but must responses be trivial. Penicillin cross-reacts with other semisynthetic penicillins including monobactams and carbapenems and may also cross-react with other antibiotics such as cephalosporins. Type II or Cytotoxic-Mediated Response IgG and IgM mediate cytotoxic-mediated response against cell surface and extracellular matrix proteins. The immunoglobulins involved in this type of reaction damages cells by activating the complement system or by phagocytosis. Type II hypersensitivity reactions can be seen in immune thrombocytopenia, autoimmune hemolytic anemia, and autoimmune neutropenia. Immune thrombocytopenia (ITP) ITP is an autoimmune disorder that occurs at any age. Phagocytes destroy sensitized platelets in the peripheral blood. Clinically, it manifests by thrombocytopenia with shortened platelet survival and increased marrow megakaryocytes. Sudden onset of petechiae and bleeding from the gums, nose, bowel, and urinary tract occurs. Bleeding can accompany infections, drug reactions, malignancy and other autoimmune disorders such as thyroid disease and SLE. Autoimmune hemolytic anemia (AIHA) There are two types of immune hemolytic anemia: IgG-mediated (warm AIHA) and IgM-mediated (cold AIHA). The warm type may be idiopathic autoimmune or secondary to other diseases such as malignancy affecting the lymphoid tissues. The cold type may be idiopathic or secondary to infections such as Epstein-Barr virus. The primary clinical sign of the two is jaundice. The laboratory diagnosis is made by a positive Coombs test, which identifies immunoglobulins and C3 on red blood cells. Autoimmune neutropenia Autoimmune neutropenia may be present with bacterial and fungal infections, or it may occur alone or with autoimmune diseases (SLE, RA, autoimmune hepatitis), infections and lymphoma. Bone marrow examination is needed if neutropenia is severe. For associated autoimmune disorders, an autoimmune antibody panel is necessary (ANA, ENA, and dsDNA). Hemolytic disease of the fetus and the newborn (erythroblastosis fetalis) The maternal immune system suffers an initial sensitization to the fetal Rh+ red blood cells during birth, when the placenta tears away. The first child escapes disease but the mother, now sensitized, will be capable of causing a hemolytic reaction against a second Rh+ fetus, which develops anemia and jaundice once the maternal IgG crosses the placenta. Myasthenia gravis Myasthenia gravis is an autoimmune disorder caused by antibodies to post-synaptic acetylcholine receptors that interfere with the neuromuscular transmission. It is characterized by extreme muscular fatigue, double vision, bilateral ptosis, deconjugate eye movements, difficulty swallowing, and weakness in upper arms. Babies born to myasthenic mothers can have transient muscle weakness due to pathogenic IgG antibodies that cross the placenta. Goodpasture syndrome Goodpasture syndrome is a type II hypersensitivity reaction characterized by the presence of nephritis in association with lung hemorrhage. In most patients, it is caused by cross-reactive autoantigens that are present in the basement membranes of the lung and kidney. A number of patients with this problem exhibit antibodies to collagen type IV, which is an important component of basement membranes. Pemphigus Pemphigus causes a severe blistering disease that affects the skin and mucous membranes. The sera of patients with pemphigus have antibodies against desmoglein-1 and desmoglein-3, which are components of desmosomes, which form junctions between epidermal cells. Pemphigus is strongly linked to HLA-DR4 (DRB1*0402), which is a molecule that presents one of the autoantigens involved in the immunopathogenesis of this disease (desmoglein-3). Type III or Immunocomplex Reactions These are also mediated by IgM and IgG antibodies that react with soluble antigens forming antigen-antibody complexes. The complement system becomes activated and releases chemotactic agents that attract neutrophils and cause inflammation and tissue damage as seen in vasculitis and glomerulonephritis. Type III hypersensitivity reactions can classically be seen in serum sickness and Arthus reaction. Serum sickness Serum sickness can be induced with massive injections of foreign antigen. Circulating immune complexes infiltrate the blood vessel walls and tissues, causing an increased vascular permeability and leading to inflammatory processes such as vasculitis and arthritis. It was a complication of anti-serum prepared in animals to which some individuals produced antibodies to the foreign protein. It was also experienced in the treatment with antibiotics such as penicillin. Arthus reaction Arthus reaction is a local reaction seen when a small quantity of antigens is injected into the skin repeatedly until detectable levels of antibodies (IgG) are present. If the same antigen is inoculated, immune complexes develop at the mentioned local site and in the endothelium of small vessels. This reaction is characterized by the presence of marked edema and hemorrhage, depending on the administered dose of the foreign antigen.