增殖诱导配体及IL-21在SLE患者血清中的表达

增殖诱导配体(a proliferation-inducing ligand, APRIL)是1998年发现的肿瘤坏死因子(TNF)家族的新成员,与另一种在SLE发病机制中发挥重要作用的肿瘤坏死因子-B淋巴细胞刺激因子(B lymphocyte stimulator, BLyS)具有高度同源性,其主要功能是促进细胞增殖,调节体液免疫,并在T、B细胞的成熟与活化中发挥一定的作用.1, 2 白细胞介素21(IL-21)是近年发现的来源于CD4+T细胞的γ链家族的细胞因子.3与APRIL相似,IL-21同样在T、B细胞的成熟中发挥重要作用,并调节T、B细胞及NK细胞的增殖.4本研究拟从蛋白水平检测与T、B淋巴细胞关系密切的APRIL及IL-21在SLE患者的表达情况,并分析其各自与SLE活动的相关性,以期能为SLE发病机制及治疗提供新的试验依据.     

IL-12家族细胞因子在系统性红斑狼疮发病机制中的研究进展

系统性红斑狼疮(SLE)是一种自身免疫性疾病,其特征是多器官受累和自身抗体的产生。尽管SLE的发病机制仍然未知,但其与T细胞和B细胞过度活跃以及自身抗体产生有关。细胞因子介导的T细胞和B细胞的活化,在包括SLE在内的各种自体免疫疾病的发病机理中都起着至关重要的作用。白介素12(IL-12)家族的异二聚体细胞因子,包括IL-12、IL-23、IL-27和IL-35,对免疫系统的调节具有多种生物学效应。在SLE的治疗中,针对IL-12和IL-23为靶点的研究也在近几年逐渐增多,IL-27和IL-35对T细胞分化的调节也为SLE的治疗提供了新思路。     

T细胞亚群和白细胞介素36在系统性红斑狼疮发病机制中的研究进展

在不同的细胞因子环境下,原始T细胞分化生成的Th1、Th2、Th17及Treg等细胞构成的细胞亚群及其细胞因子在系统性红斑狼疮等自身免疫性疾病的发病中发挥重要作用.白细胞介素36包括白细胞介素36α、363和36 γ,其免疫调节及免疫激活作用较传统白细胞介素1家族成员更强,通过激活丝裂原活化蛋白激酶和核因子κB,参与自身免疫性疾病的生理病理过程.白细胞介素36对T细胞分化的研究能进一步阐明系统性红斑狼疮的发病机制,为系统性红斑狼疮的治疗策略提供思路.     

IL-36及其与银屑病的相关研究进展

 IL-36是IL-1F家族重要成员，其三个受体激动剂在促进炎症发展中发挥着重要作用，而IL-36Ra为其激动剂的天然抗体，可有效抑制炎症的发生发展。目前IL-36的产生机制尚不十分明确，遗传、环境、微生物作用可能促使IL-36的产生。IL-36受体通路能够激活各种免疫细胞，对辅助性T 细胞的增殖分化也起着重要作用。本文介绍IL-36分子生物学特点及免疫学作用，并对IL-36与银屑病的研究进展作一综述。     

系统性红斑狼疮患者亲属中白介素-10产生的调节异常

该研究目的是证实SLE患者亲属中是否存在白介素-10(IL-10)产生的调节异常。 纳入研究的有16例SLE患者来自13个至少有2例SLE患者的多成员家族。并与这13个家族中70例健康成员、另30例其家族中无其他SLE患者的SLE病例及46例无亲缘关     

SLE患者外周血单个核细胞产生IL-1及lL-2的检测

本文对31例系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)产生 IL-1及 IL-2进行了检测。结果显示,与正常人对照组比较,SLE 患者 PBMC 产生 IL-2显著减少(P<0.01),IL-1的产生有降低趋势,但无统计学意义(P>0.05)。提示 SLE 患者存在淋巴细胞功能明显异常,IL-2产生缺陷在其发病机制起中重要作用。     

Th17细胞在系统性红斑狼疮发病中的作用

SLE是一种自身免疫性疾病。异常的T辅助细胞反应及其产生的细胞因子在SLE疮的发病机制中起着作用。Th17细胞通过分泌IL-17、IL-21等细胞因子引起炎症反应和靶器官损伤,亦参与T、B淋巴细胞的调控,促进抗体的形成。越来越多的研究表明,Th17细胞可能在SLE的发生发展过程中发挥作用。文中主要阐述Th17细胞的生物学特性及其与SLE的关系。     

SLE患者红细胞CR1与IL-8R的表达

目的:研究红细胞CR1和IL-8R在系统性红斑狼疮患者(SLE)中的表达及两者之间的相关性。方法:分别用V型板红细胞离心洗涤免疫酶联法和酶联免疫吸附试验检测活动期SLE患者44例、稳定期SLE42例红细胞CR1及IL-8R的表达,并与健康人作对照,CR1与IL-8R之间的相关性采用Sperman相关分析。结果:活动期SLE患者红细胞CR1和IL-8R较健康人对照组和稳定期SLE患者的表达水平显著下降(P<0.001);稳定期SLE组与健康人对照组比较,CR1和IL-8R分子的表达差异无显著性(P>0.05);活动期SLE的CR1表达与IL-8R的结合活性呈正相关,即活动期SLE的红细胞CR1数量表达和IL-8R的结合活性都显著降低。结论:活动期SLE患者的红细胞CR1免疫识别、黏附、清除CIC能力下降,可能是SLE免疫发病机制中的一个重要环节;CR1及IL-8R在SLE发病机制中可能起重要作用;CR1和IL-8R有可能作为SLE患者病情是否活动、药物疗效判断的一个有价值的辅助指标。     

SLE患者外周血单个核细胞IL—13mRNA的表达

探讨IL-13在系统性红斑狼疮(SLE)发病机制中的作用及其意义,应用逆转录-聚合酶链反应(RT-PGR)检测了34例活动期SLE患者和30名正常人外周血单个核细胞(PBMC)中IL-13mRNA的表达水平.结果表明,活动期SLE患者IL-13的阳性表达率与正常人对照组相比无明显差异(P＞0.05);活动期SLE患者PBMC中IL-13mRNA的平均表达水平(0.8983±0.1153)明显高于正常人对照组(0.6085±0.0903),差异非常显著(P＜0.001).提示高水平的IL-13表达可能与SLE患者外周血T细胞高度活化、功能异常有关,其通过刺激B细胞活化、分化与增殖或激活B细胞旁路,参与SLE的发病过程.     

SLE患者PBMC中IL-6mRNA和IL-10mRNA的表达

为了进一步了解TH2型细胞因子IL-6和IL-10在系统性红斑狼疮（SLE）患者外周血单核细胞（PBMC）中的基因表达情况，对7例SLE患者和4例年龄相匹配对照PBMC中IL-6mRNA和IL-10MRNA表达进行了原位杂交检测，并对检测结果进行计算机图象灰度扫描分析、结果SLE患者PBMC中IL-6mRNA和IL-10mRNA均明显高表达，并与患者ANA滴度及抗（ISDNA抗体有一定的相关性尤以IL-6为著。提示IL-6和IL-10作为B细胞刺激因子在SLE发病中具有重要病理性作用，阻止或减少其分泌可能有助于SIE治疗。     

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.     

Deutliche Einschränkung der Lebensqualität bei Patienten mit Pemphigus vulgaris: Ergebnisse der deutschen Bullous Skin Disease (BSD)‐Studiengruppe

Background: Pemphigus vulgaris is a potentially life‐threatening autoimmune disorder of the skin and mucous membranes characterized by antibodies against epidermal adhesion molecules. Clinically characteristic are painful chronic blisters or erosions of mucous membranes and skin. There are no published studies on the impact o this disease on quality of life. Patients and methods: This registration was performed within the scope of the German BSD (Bullous Skin Disease) study group, from November 1997 until January 2002. A total of 36 patients with the first diagnosis of pemphigus vulgaris were registered at the university hospitals of Dresden, Erlangen, Kiel, Mannheim, München and Würzburg. Thirty of the 36 (83 %) patients participated in the quality of life questionnaire utilizing the German version of ‘Dermatology Life Quality Index’ (DLQI) provided by A. Y. Finlay. The DLQI varies from 0 to 30 with an increased DLQI score indicating a decrease in quality of quality. Results: The overall DLQI total score of 10 ± 6,7 in the investigated pemphigus patients was significantly increased in comparison to other skin diseases. Conclusions: These results suggest that the DLQI can be a very useful additional outcome criteria for clinical studies with pemphigus vulgaris and in the treatment of these patients.     

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.     

Mutations in mevalonate pathway genes in patients with familial or sporadic porokeratosis

Porokeratosis comprises heterogeneous keratinization disorders that are characterized by one or more atrophic patches surrounded by a ridge‐like cornoid lamella. In this study, we evaluated seven families affected by porokeratosis and five sporadic patients of the disease in a Chinese population. We performed Sanger sequencing of exons and flanking intron–exon boundaries of mevalonate pathway genes (MVD, MVK, PMVK and FDPS) and of SLC17A9. In five familial and three sporadic patients, we detected six variations, including four novel mutations (MVD c.1A>G; p.Met1?, c.916G>A; p.Ala306Thr, c.1013+1G>A, and PMVK c.65A>G; p.Lys22Arg) and two recurrent mutations (MVD c.746T>C; p.Phe249Ser, and MVK c.1028T>C; p.Leu343Pro). We then applied I‐TASSER and iGEMDOCK to assess these variants for probable functional impacts. The findings of this study extend the mutation spectrum of porokeratosis and provide further evidence for the genetic basis of this disease.     

Occupational allergic contact dermatitis caused by decorative plants

12 cases of occupational allergic contact dermatitis caused by decorative plants were diagnosed in a 14-year period. The patients were middle-aged, and their average exposure time was 13 years. The plant families and plants causing occupational contact dermatitis were Compositae (5 patients: chrysanthemum, elecampane, gerbera, feverfew), Alstroemeriaceae (5 patients, Alstroemeria ), Liliaceae (4 patients; tulip, hyacinth). Amaryllidaceae (2 patients: narcissus) and Caryophyllaceae (2 patients; carnation, cauzeflower). The known chemical allergens causing dermatitis were tuliposide-A and sesquiterepene lactones, such as alantolactones and parthenolide, in the Liliaceae and Compositae families. 7 of the 12 patients were able to continue their work; 5 were not because of severe relapses of skin symptoms. The plant allergen and extract series currently available are of great help in the diagnosis.     

[Translated article] Pruritus in Dermatology: Part 1—General Concepts and Pruritogens

Pruritus is the most common symptom of dermatologic and systemic diseases. The diagnosis of pruritus is clinical, although additional tests may be necessary to identify or confirm the cause. Translational medicine has led to the discovery of new mediators of itch, or pruritogens, as well as new receptors. Knowing how to properly recognize the main pathway that mediates itch in each patient is the key to successful treatment. Although the histaminergic pathway predominates in conditions like urticaria or drug-induced pruritus, it is the nonhistaminergic pathway that predominates in nearly all other skin diseases covered in this review. Part 1 of this 2-part review discusses the classification of pruritus, additional testing, the pathophysiology of itch and the pruritogens implicated (including cytokines and other molecules), and central sensitization to itch.