特应性皮炎患者PBMC产生eotaxin和CCR3表达的影响

目的:检测窄谱中波紫外线(NB-UVB)联合吡美莫司乳膏治疗前后,特应性皮炎(AD)患者外周血嗜酸性粒细胞活化趋化因子(eotaxin)与其相应受体CCR3的表达,以探讨其治疗特应性皮炎的相关机制。方法:采用窄谱中波紫外线联合吡美莫司乳膏治疗30例成人型AD患者,酶联免疫吸附试验检测治疗前后血清中eotaxin水平;同时用流式细胞仪分析外周血中CCR3的表达。结果:治疗前,AD患者血清eotaxin水平为(133. 86±42. 23) pg/m L,CCR3表达水平为(23. 10±6. 31)%;治疗后,AD患者血清eotaxin水平为(101. 54±35. 63) pg/m L,较治疗前明显降低(t=3. 20,P 0. 01);外周血CCR3表达水平为(16. 52±6. 59)%,较治疗前亦明显降低(t=3. 59,P 0. 01)。结论:窄谱中波紫外线联合吡美莫司乳膏可能通过降低eotaxin、CCR3表达,从而减少嗜酸性粒细胞的募集、活化,发挥其治疗特应性皮炎的作用。     

窄谱中波紫外线联合吡美莫司乳膏对成人型特应性皮炎患者PBMC产生eotaxin和CCR3表达的影响

 目的:检测窄谱中波紫外线（NB-UVB)联合吡美莫司乳膏治疗前后,特应性皮炎 (AD) 患者外周血嗜酸性粒细胞活化趋化因子(eotaxin)与其相应受体CCR3的表达，以探讨其治疗特应性皮炎的相关机制。方法: 采用窄谱中波紫外线联合吡美莫司乳膏治疗30例成人型AD患者,酶联免疫吸附试验检测治疗前后血清中eotaxin水平; 同时用流式细胞仪分析外周血中CCR3的表达。结果: 治疗前，AD患者血清eotaxin水平为(133.86±42.23) pg/mL，CCR3表达水平为(23.10±6.31)%；治疗后，AD患者血清eotaxin水平为(101.54±35.63) pg/mL，较治疗前明显降低(t=3.20,P＜0.01);外周血 CCR3表达水平为(16.52±6.59)%，较治疗前亦明显降低(t=3.59,P＜0.01)。结论: 窄谱中波紫外线联合吡美莫司乳膏可能通过降低eotaxin、CCR3表达，从而减少嗜酸性粒细胞的募集、活化,发挥其治疗特应性皮炎的作用。     

慢性自发性荨麻疹患者血清IL-17、IL-23水平的检测及意义

目的:探讨白细胞介素-17(Interlenkin-17,IL-17)、白细胞介素-23(Interleukin-23,IL-23)在慢性自发性荨麻疹患者中的表达及意义。方法:选取慢性自发性荨麻疹患者和健康献血者各30例,用酶联免疫吸附法检测血清中IL-17、IL-23水平,并分析它们与病情、病程之间的关系。结果:慢性自发性荨麻疹患者的血清IL-17水平[(19.3±8.1)pg/mL]、IL-23水平[(28.9±11.1)pg/mL]均高于对照组[(8.6±5.7)pg/mL,(10.9±6.2)pg/mL],组间比较差异有统计学意义(t值分别为5.92、7.72,P值均<0.01)。慢性自发性荨麻疹患者IL-17、IL-23与症状评分呈正相关关系(r=0.89、r=0.75,P值均<0.01),与病程无明显相关性(r=0.23、r=0.24,P值均>0.05),IL-17与IL-23呈正相关关系(r=0.81,P<0.01)。结论:IL-17、IL-23在慢性自发性荨麻疹发病机理中可能起着重要作用。     

特应性皮炎患者趋化因子及其受体的研究

目的 探讨几种重要的趋化因子及其受体的表达在特应性皮炎(AD)发病中的作用。方法 采用酶联免疫吸附试验检测39例AD患者及正常人血清中γ干扰素诱导蛋白-10(IP-10)、基质细胞衍生因子-1α(SDF-1α)、嗜酸粒细胞趋化因子、胸腺和活化调节的趋化因子(TARC)及巨噬细胞来源的趋化因子(MDC)等水平;同时用流式细胞仪分析外周血CD4⁺T细胞表面趋化因子受体CXCR3、CXCR4、CCR3、CCR4及CCR5的表达。结果 与正常人对照组相比,AD患者血清SDF-1α、TARC和MDC水平显著升高(P<0.001),IP-10及嗜酸粒细胞趋化因子水平则无明显改变(P>0.05),外周血CXCR3、CCR3、CCR4及CCR5在CD4⁺T细胞表达水平显著增加(P<0.001);血清TARC和MDC水平的变化与疾病严重程度相关(r分别为0.669及0.409,P分别为<0.001及<0.01)。结论 具有生物活性趋化因子及其受体介导的T细胞和嗜酸/嗜碱粒细胞的聚集、激活后释放的炎性介质在AD发病中起着重要作用。     

TARC与CCR4在特应性皮炎患者外周血中的表达

目的:检测胸腺和活化调节趋化因子(TARC)与其受体CCR4在特应性皮炎(AD)外周血中的表达.方法:酶联免疫吸附法检测45例AD患者及30名正常人血清TARC水平;流式细胞仪检测外周血单核细胞CCR4的表达.结果:AD患者血清TARC水平为(1169.1±106.5)pg/mL,显著高于对照组(337.3±45.6)pg/mL的水平(P<0.01).CCR4表达水平为(60.1± 2.4)%,较对照组显著升高(P<0.01);TARC和CCR4表达水平均与疾病严重程度呈正相关(均P<0.01).结论:TARC与CCR4在AD的发病机制中可能起一定作用.     

重度寻常型银屑病患者外周血CD8~+T淋巴细胞CCR6及上清液中IL-22、IL-17的表达

目的研究重度寻常型银屑病患者外周血CD8+T细胞表面趋化因子受体CCR6表达及上清液中白细胞介素(IL)-22、IL-17的水平。方法流式细胞仪检测25例重度寻常型银屑病患者外周血中CD8+T淋巴细胞表面趋化因子受体CCR6的表达率,ELISA检测CD8+T细胞培养后上清液中IL-22、IL-17的水平,分别与30例健康对照者进行比较。结果银屑病患者外周血中CD8+T细胞表面CCR6的表达率为(94.76±2.38)%,健康对照组为(72.56±8.33)%,差异有统计学意义(P0.05);经过anti-CD3单克隆抗体和anti-CD28单克隆抗体刺激后,10例银屑病患者外周血CD8+T细胞上清夜中IL-17、IL-22水平分别为(7.17±1.51)pg/m L、(102.42±15.34)pg/m L,健康对照组分别为为(2.68±1.12)pg/m L、(47.39±5.47)pg/m L,2组比较差异有统计学意义(均P0.01)。结论银屑病中CCR6可能促进外周血CD8+T细胞趋化至皮损中;银屑病患者外周血CD8+T细胞在活化的状态下可促进炎症细胞因子的表达增加,加重银屑病的炎症反应。     

雷公藤多甙对特应性皮炎患者PBMC中TARO与CCR4表达的影响

目的:检测雷公藤多甙对特应性皮炎患者外周血胸腺和活化调节趋化因子(TARC与相应受体CCR4表达的影响.方法:分别采用酶联免疫吸附试验和流式细胞仪分析法检测外周血胸腺和活化调节趋化因子(TARC)与相应受体CCR4水平.结果:45例患者血清TARC治疗前(1120.1±102.4)pg/mL,与治疗后(790.2±75.8)pg/mL,相比显著降低(P＜0.01);患者外周血CCR4表达水平治疗前(60.2±2.3)%与治疗后(53.5±2.1)%相比,显著降低(P＜0.01).结论:雷公藤多甙可能通过降低TARC与CCR4的表达从而减少Th2细胞的募集、活化而发挥其治疗特应性皮炎的作用.     

慢性荨麻疹患者血浆RANTES、嗜酸粒细胞趋化因子、TNF-α与白三烯B4水平的测定

目的 探讨慢性荨麻疹患者血浆中调节激活正常T细胞表达和分泌的细胞因子(RANTES)、嗜酸粒细胞趋化因子(eotaxin)、TNF-α及白三烯B4(LTB4)的水平及其意义.方法 对41例慢性荨麻疹患者进行临床评价,按症状积分将病情分为轻型、中型、重型3级.应用咪唑斯汀10 mg每日1次,连续治疗4周.采用ELISA法测定20例健康志愿者与41例患者治疗前后血浆中RANTES、eotaxin、TNF-α与LTB4的水平.结果 ①慢性荨麻疹组血浆中RANTES、eotaxin、TNF-α和LTB4水平分别为(52.5 ±10.2)μg/L、(58.4±16.1)μg/L、(35.1±9.6)ng/L和(109.4±21.7)ng/L,健康对照组水平分别为(33.7±9.4)μg/L、(48.3±13.6)μg/L、(21.3±8.9)ng/L和(77.8±11.6)ng/L,两组比较差异均有统计学意义,P值分别<0.01、<0.05、<0.01、<0.01.②血浆RANTES、eomxin、TNF-α、LTB4水平与临床表现的相关性分析显示:中、重型慢性荨麻疹患者的RANTES、eotaxin、TNF-α与LTB4血浆水平高于轻型患者,差别均有统计学意义,P<0.05;重型患者的RANTES、eotaxin、TNF-α与LTB4血浆水平较中型患者略有增高,但差异均无统计学意义,P>0.05.③咪唑斯汀治疗后慢性荨麻疹组血浆中RANTES、eotaxin、TNF-α和LTB4水平较前明显下降,分别为(36.3±8.9)μg/L、(46.3±10.2)μg/L、(23.2±7.5)ng/L和(83.1±14.2)ng/L,与治疗前比较差异有统计学意义,P值均<0.01,与健康对照组比较P值均>0.05.结论 慢性荨麻疹患者血浆RANTES、eotaxin、TNF-α吨与LTB4水平升高,并与病情的严重程度呈正相关趋势,咪唑斯汀治疗后血浆中RANTES、eotaxin、TNF-α和LTB4水平较前明显下降,提示RANTES、eotaxin、TNF-α与LTB4在慢性荨麻疹的发病过程中可能起一定作用.     

Cathepsin G在慢性自发性荨麻疹患者血清中的表达

目的:研究组织蛋白酶G(cathepsin G)在慢性自发性荨麻疹患者血清中的表达变化,并初步探讨其作用。方法:纳入30例就诊前未经治疗的慢性自发性荨麻疹患者,设为观察组;另纳入30例健康体检者作为对照组。ELISA法检测两组血清中cathepsin G表达水平并进行比较。结果:对照组血清中cathepsin G浓度为(32.2±12.3)ng/m L,慢性自发性荨麻疹患者血清中cathepsin G浓度上调为(260.4±26.9)ng/m L,差异有统计学意义(t=42.26,P0.01)。结论:慢性自发性荨麻疹患者血清cathepsin G表达明显上调,其可能通过与多种细胞因子及炎症介质相互作用,参与慢性自发性荨麻疹的发病机制。     

慢性荨麻疹患者外周血单一核细胞CC型趋化因子的表达

目的 研究CC型趋化因子家族中调节激活正常T细胞表达和分泌的细胞因子(RANTES)、单核细胞趋化蛋白-1(MCP-1)、单核细胞趋化蛋白-3(MCP-3)和巨噬细胞炎症蛋白(MIP-1α)的mRNA在慢性荨麻疹患者外周血单一核细胞中的表达情况及其相互关系;探讨CC型趋化因子的水平与慢性荨麻疹患者血清总IgE和嗜酸粒细胞阳离子蛋白水平的相关性.方法 逆转录聚合酶链反应(RT-PCR)方法检测31例慢性荨麻疹患者和22例正常人对照外周血单一核细胞中RANTES、MCP-1、MCP-3和MIP-1α的mRNA的表达水平.结果 ①与正常人对照相比,慢性荨麻疹患者外周血单一核细胞中RANTES、MCP-1、MCP-3和MIP-1α的mRNA表达水平均明显增高(P<0.001).②慢性荨麻疹患者中RANTESmRNA的表达水平与MCP-1、MCP-3、MIP-1α的水平呈正相关(P<0.05),MCP-1与MIP-1α的mRNA表达水平之间亦呈正相关(P<0.01),但MCP-1与MCP-3之间、MCP-3与MIP-1α之间的mRNA表达水平无显著相关(P>0.05).③慢性荨麻疹患者中RANTES的mRNA表达水平与血清总IgE和嗜酸粒细胞阳离子蛋白的水平呈负相关(P<0.05);MCP-1、MCP-3和MIP-1α的mRNA表达水平与血清总IgE和嗜酸粒细胞阳离子蛋白的水平之间无显著相关(P>0.05).结论 慢性荨麻疹患者外周血单一核细胞中RANTES、MCP-1、MCP-3和MIP-1α的mRNA表达水平的上调可能与荨麻疹的发病有关.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Medición del impacto psicológico en pacientes con psoriasis en tratamiento sistémico

Background and objectives

The negative impact of psoriasis on patient quality of life can be as important as the physical consequences of the disease. We could assume that clearance of the disease would also lead to an improvement in its psychosocial impact. The present study assesses the psychological state of patients with psoriasis receiving systemic treatment in a psoriasis unit, especially those with mild or no disease involvement.