Herbal products have been in use for many years, but they are becoming more and more popular in recent years, and they are currently in widespread use throughout the world. In this review article we describe the histopathologic findings found after exposure to 12 dietary herbals in studies conducted in rodent model systems. Clear or some evidence for carcinogenic activity was seen with 6 herbals, with the liver being the most common organ affected. The intestine was affected by two herbals (aloe vera nondecolorized extract and senna), three had no clear evidence for carcinogenic activity and one was cardiotoxic (Ephedrine and Ephedra in combination with caffeine). Information from these studies can help to better understand potential target organs for further evaluation from exposure to various herbal products.

Objective: To 1) assess IL-6 levels in the serum of patients with rheumatoid arthritis (RA). 2) study IL-6 promoter -174 G>C "single nucleotide polymorphism (SNP)" as an imminent factor for the disease development. 3) find any relation between the level of serum IL-6 cytokine and other parameters such as age, gender, clinical severity of diseases and "disease activity scores (DAS28)". Materials & methods:This research was carried out through a case -control approach at "Ibn -Senna Teaching Hospital" in Mosul city between November 2020 and July 2021. It included 61 RA patients diagnosed according to "ACR / EULAR 2010 criteria" and 50 healthy individuals. IL-6 serum levels were ascertained by ELISA and genotyping of IL-6 promoter was accomplished by "sequence-specific primerpolymerase chain reaction (SSP-PCR)". Results: Mean IL-6 level in RA (69.42 ng /l ± 62.99) was elevated in comparison to healthy people (14.66 ng /l ± 23.58), P < 0.001. No age or gender effects on IL-6 concentration were noted. The ideal cut-off of IL-6 for discrimination of RA with best discriminative utility compared to healthy controls was 22.80 ng/l. At this value the IL-6 sensitivity was 91.8%, specificity 82.0% and accuracy rate 73.80%. G/G genotype was the most pervasive genotype in both RA patients and controls (70.5% in RA and 64% in healthy controls). However, it did not seem to be a risk factor for RA development compared to G/C or C/C genotypes "(OR = 1.3438, 95% CI=0.605-2.984,P=0.469)". The mean IL-6 level in patients with GG genotype was (73.70 ng / l ± 71.09) compared to (58.37 ng /l ± 37.86) in patients with GC genotype. There was no significant difference in the IL-6 level between patients with GG and patients with GC genotypes (P = 0.2375). Although higher IL-6 mean concentration was reported in severe RA, however, no significant difference was found between patients with mild, moderate and severe RA respectively. No correlation of serum levels of IL-6 with genetic promoter polymorphism, clinical severity of diseases or DAS 28 score were reported. Conclusion:The concentration of serum IL-6 was elevated in RA in regard to healthy controls which confirmed its pivotal role in RA pathogenesis. Our data did not support the role of IL-6 promoter -174 G> C polymorphism as a risk factor for RA, nor seem to play a major role in the increase of IL-6 level among our patients with RA.

Acral peeling skin syndrome (APSS) is a rare autosomal recessive disorder that typically presents in infancy or early childhood as painless, sometimes pruritic exfoliation of the acral skin that heals spontaneously without scarring. Triggering factors include trauma, exposure to water, occlusion, and sweating. Most reported cases of APSS are caused by mutations in the gene TGM5, encoding transglutaminase 5, a protein involved in the cross-linking of the cornified cell envelope in the superficial epidermis. Recently, loss-of-function mutations in the gene CSTA, encoding cystatin A, were linked to APSS with exfoliative ichthyosis. 1 APSS secondary to CSTA mutations is characterized by deeper acral peeling, while TGM5 mutations cause a more superficial form of acral peeling. 1 Cystatin A is a protease inhibitor found in the cornified cell envelope that has a multifunctional key role in the skin. In addition to its inhibiting action against endogenous proteases, it also protects the skin from exogenous proteases, such as dust mite allergens.Furthermore, a single nucleotide variant of Cystatin A (CSTA+344C) has also been associated with atopic dermatitis. 2 To this date, only five families have been reported with APSS due to mutations in CSTA. This report describes two new unrelated cases of APSS associated with exfoliative ichthyosis caused by a novel homozygous mutation in the gene CSTA.