系统性红斑狼疮患者外周血单一核细胞CD40/CD40配体mRNA的表达

目的探讨CD40及其配体(CD40L)在系统性红斑狼疮(SLE)发病机制中的作用及临床意义。方法应用逆转录-聚合酶链反应(RT-PCR)检测34例SLE患者外周血单一核细胞(PBMC)中CD40和CD40配体mRNA的表达水平。结果活动期SLE患者PBMC中CD40配体的阳性表达率为88.24％(30/34),明显高于正常人对照组(50.00％,15/30),差异有非常显著性(P<0.01);活动期SLE患者PBMC中CD40配体mRNA表达的平均水平(0.6970±0.1214)亦明显高于正常人对照组(0.2684±0.0795),差异有非常显著性(P<0.01)。活动期SLE患者PBMC中CD40的阳性表达率和CD40mRNA的表达水平与对照组相比差异均无显著性(P>0.05)。结论CD40配体的异常表达可能在SLE疾病活动和发展过程中起重要作用,检测SLE患者PBMC中CD40配体的表达水平可作为疾病的活动性指标之一。     

系统性红斑狼疮患者外周血单一核细胞CD80/CD86和CTLA-4mRNA的表达

目的 探讨CD80/CD86和CTLA-4在系统性红斑狼疮(SLE)发病机制中的作用及临床意义。方法 用逆转录-聚合酶链反应(RT-PCR)检测32例SLE患者外周血单一核细胞(PBMC)中CD80、CD86、CTLA-4mRNA的表达水平。结果 活动期SLE患者PBMC中CD86的阳性表达率为90.63%,正常人对照组为60%,两组差异有非常显著性(P<0.01)。CD86的mRNA表达的平均水平(0.6410±0.0174)亦明显高于正常人对照组(0.4510±0.0402),差异有非常显著性(P<0.001);活动期SLE患者PBMC中CTLA-4的阳性表达率为81.25%,其mRNA表达的平均水平为1.0020±0.0624,均明显高于正常人对照组,差异有显著性(P<0.01);活动期SLE患者PBMC中CD80的阳性表达率和CD80mRNA的表达水平与正常人对照组差异均无显著性(P>0.05)。结论 CD86和CTLA-4的异常表达可能在SLE疾病活动和发展过程中起重要作用。     

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.     

结缔组织疾病

20072978 DNA甲基转移酶与CD11a基因在SLE患者中的表达/施伟民(上海交大附属瑞金医院皮肤科),伍洲炜,施若非…∥中华皮肤科杂志.-2007,40(7).-431~433以半定量RT-PCR方法检测了SLE缓解期、活动期及正常人外周血单核细胞(PBMC)中DNA甲基转移酶(DNMT)及CD11a基因表达水平,并进行相关性分析。结果SLE缓解期患者PBMC中DNMT1的表达水平显著低于正常人对照组(P<0.0001);活动期的表达水平也显著低于对照组(P=0.0001);缓解期与活动期比较差异无统计学意义(P=0.089)。SLE缓解期、活动期及对照组PBMC中DNMT3A的表达水平差异无统…     

系统性红斑狼疮患者外周血单一核细胞白介素6受体水平的研究

目的 探讨白介素6(IL-6)及其受体(IL-6R)在系统性红斑狼疮(SLE)发病中的作用。方法 应用逆转录酶-聚合酶链反应(RT-PCR)检测89例SLE患者和30例正常人外周血单一核细胞(PBMC)中IL-6RmRNA的表达水平,用ELISA法检测血清中IL-6水平。结果 ①活动期SLE患者和非活动期SLE患者及正常人IL-6R阳性表达率为100%。②PBMC中,IL-6RmRNA表达水平:活动期SLE患者为0.902±0.273,非活动期SLE患者为0.519±0.11,正常人为0.573±0.24。活动期组和非活动期组和对照组比较,差异均有统计学意义(P=0.00),非活动期组和对照组比较差异无统计学意义(P=0.289)。③血清中IL-6水平:活动期组为71.89±20.02pg/mL,非活动期组为17.96±6.93pg/mL,对照组为0.035±0.035pg/mL。活动组显著高于非活动组和对照组(P=0.00),非活动组显著高于对照组(P=0.00)。活动期SLE患者和非活动期SLE患者血清中的IL-6水平与PBMC上的IL-6R的表达水平呈正相关(r=0.887和r=0.615,P<0.05)。结论 IL-6及其受体的异常表达可能在SLE疾病活动和发展过程中起重要作用。检测SLE患者PBMC中IL-6受体的表达水平可作为评估疾病活动性的参考指标之一。     

系统性红斑狼疮患者外周血单一核细胞趋化因子受体2和3 mRNA的表达

目的探讨趋化因子受体(CCR)2及CCR3在系统性红斑狼疮(SLE)患者外周血单一核细胞(PBMC)中的表达及与疾病的相关性.方法对93例SLE患者和30名健康对照者,应用半定量逆转录(RT)-PCR方法检测其CCR2、CCR3 mRNA表达水平,并应用SLE疾病活动性指数评分标准(SLEDAI)对SLE患者进行评分.结果①9例SLE患者活动期、非活动期及对照组PBMC CCR2与CCR3 mRNA表达水平分别为2.989±1.595与2.847±2.400、0.388±0.213与0.585±0.219、0.263±0.157与0.602±0.124,活动期与非活动期、对照组相比差异均有显著性(P值分别为0.013,0.004;0.000,0.007);非活动期与对照组相比差异无显著性(P＞0.01).②SLE患者PBMC中CCR2、CCR3 mRNA表达水平与SLEDAI分别作直线相关性分析,CCR2 mRNA、CCR3mRNA水平与SLEDAI均呈正相关.③具有肌炎临床表现的SLE患者其PBMC CCR2、CCR3表达水平较无肌炎表现时降低.血小板减少的SLE患者比不具有相应症状者CCR2 mRNA表达降低.结论SLE患者PBMC CCR2、CCR3表达均增加,且与疾病活动性呈正相关,而CCR2、CCR3为表达于Th2细胞的趋化因子受体,提示SLE患者Th2细胞占优势.CCR2可能参与SLE患者肌炎及血小板减少的发生,CCR3参与肌炎发生.     

系统性红斑狼疮患者外周血单一核细胞Caspase-1和Caspase-3mRNA的表达

目的 探讨系统性红斑狼疮(SLE)患者外周血淋巴细胞Caspase-1和Caspase-3的表达水平及其与淋巴细胞凋亡的关系。方法 应用逆转录-聚合酶链反应(RT-PCR)检测34例活动期SLE患者和30例正常人外周血单一核细胞(PBMC)中Caspase-1和Caspase-3mRNA的表达水平。结果 活动期SLE患者PBMC中Caspase-1mRNA的平均表达水平(1.20±0.33)明显高于正常人对照组(0.79±0.25),差异有非常显着性(P<0.01);Caspase-3mRNA的平均表达水平(0.87±0.16)高于正常人对照组(0.66±0.10),差异有显着性(P<0.05).活动期SLE患者PBMC中Caspase-1和Cas-pase-3的阳性表达率与正常人对照组相比差异无显着性(P>0.05).结论 活动期SLE患者外周血淋巴细胞Caspase-1和Caspase-3mRNA表达水平增高,Caspase级联反应可能参与了SLE患者淋巴细胞的凋亡过程。     

系统性红斑狼疮患者外周血CD4+、CD8+T细胞p16基因mRNA表达

目的:探讨p16基因mRNA在系统性红斑狼疮(SLE)患者CD4+、CD8+T细胞中的表达.方法:收集40例确诊的SLE患者(患者组)和30名正常人(对照组)外周血,应用免疫磁珠法分选CD4+、CD8+细胞并计数,提取RNA,应用实时定量RT-PCR方法检测外周血CD4+、CD8+T细胞中p16基因mRNA表达水平.结果:①p16基因mRNA在CD4+T细胞中的表达:分别与对照组(2.245±0.586)和SLE非活动期组(1.361±0.154)相比较,SLE活动期组(93.264±42.898)明显增加,差异均具有统计学意义;而非活动期组与对照组之间差异无统计学意义.②p16基因mRNA在CD8+T细胞中的表达:分别与对照组(4.323±0.735)和非活动期组(3.722±1.701)比较,SLE活动期组(92.926±38.102)明显增加,差异均具有统计学意义;而非活动期组和对照组之间差异无统计学意义.结论:SLE患者p16基因mRNA水平在CD4+、CD8+T细胞中增高,提示SLE患者存在p16基因表达异常.     

雷公藤对系统性红斑狼疮外周血单一核细胞CD40配体mRNA表达的影响

探讨雷公藤治疗系统性红斑狼疮 (SLE)的作用机制。采用逆转录聚合酶链反应 (RT -PCR)检测 2 3例活动期SLE患者及 2 0例正常对照组外周血单一核细胞 (PBMC)中CD4 0配体 (CD4 0L)mRNA的表达水平 ,以及雷公藤对SLE患者PBMC中CD4 0LmRNA表达的影响。结果 :活动期SLE患者PB MC中CD4 0LmRNA表达明显高于正常对照组 (P <0 .0 1) ,经雷公藤处理后 ,其CD4 0LmRNA表达明显降低 (P <0 .0 1) ,基本接近正常对照组 (P >0 .0 5 )。结论 :CD4 0L的异常表达可能是SLE发病的关键环节之一。雷公藤可通过抑制CD4 0L分子的表达 ,影响CD4 0 -CD4 0L信号的传导而发挥其免疫抑制作用。     

SLE患者外周血单个核细胞一氧化氮合酶mRNA的表达

探讨原生型一氧化氮合酶(cNOS)和诱生型一氧化氮合酶(iNOS)在系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)中的表达水平及其意义,应用逆转录-聚合酶链反应(RT-PCR)检测了34例活动期SLE患者和30名正常人PBMC中cNOS和iNOSmRNA的表达水平。结果表明,活动期SLE患者iNOS和cNOS的阳性表达率与正常人对照组相比均无明显差异(P>0.05);活动期SLE患者PBMC中iNOSmRNA的平均表达水平(0.7710±0.1050)明显高于正常人对照组(0.5249±0.0770),差异非常显著(P<0.01);活动期SLE组cNOS的平均表达水平与正常人对照组处于同一表达水平,差异无统计学意义(P>0.05)。提示活动期SLE患者外周血单个核细胞中iNOSmRNA的表达增加,可能通过诱导一氧化氮(NO)及其代谢产物的产生参与SLE的发病过程。特异性iNOS抑制剂的开发与研制可能是治疗SLE新药发展的一个方向。     

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.     

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.     

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.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

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.