氟比洛芬酯在鲜红斑痣血卟啉单甲醚光动力疗法中镇痛效果的临床初步观察

目的观察氟比洛芬酯在鲜红斑痣血卟啉单甲醚光动力治疗过程中的镇痛效果。方法选择门诊大面积运用光动力治疗的面颈部鲜红斑痣成人患者20例,年龄18~30岁。第一次光动力治疗时不使用镇痛药物,术后5 min让患者用数字评分法对术中疼痛程度进行自我评估;第二次治疗前20 min静滴氟比洛芬酯注射液50 mg,术后5 min让患者再次评估术中疼痛程度。每次治疗后2个月对单次的疗效再进行评估。结果第二次治疗组(氟比洛芬酯组)疼痛评分低于第一次治疗组(对照组)的疼痛评分,差异具有统计学意义(P<0.001);两组治疗的单次疗效差异无统计学意义(P>0.05)。结论氟比洛芬酯用于鲜红斑痣血卟啉单甲醚光动力疗法的镇痛是安全有效的。     

血卟啉单甲醚光动力治疗

<正>血卟啉单甲醚(hematoporphyrin monomethyl ether,HMME)是一种纯化的单体卟啉,其主要成分为相对疏水性卟啉,较第一代光敏剂血卟啉衍生物(hematoporphyrin derivative,HpD)具有成分单一、组成稳定、组织选择性好、易被血管内皮吸收、光漂白速率高及治疗后的避光时间短等显著优点,在临床上可用于肺癌、膀胱癌等肿瘤的诊断,以及鲜红斑痣、脑胶质瘤的治疗。1 HMME的结构与性质     

光动力疗法治疗银屑病的研究进展

光动力疗法通过光敏剂产生一系列的反应并破坏靶细胞,从而达到治疗目的。它可以通过减少细胞因子分泌,抑制角质形成细胞增生,促使皮损区T细胞凋亡等机制治疗银屑病。光动力疗法特别适用于传统疗法治疗无效的顽固性银屑病,或传统疗法治疗副作用较大的情况。光动力疗法治疗银屑病还需制定统一的标准,以期得到更好、更安全的临床疗效。     

血管内皮细胞和角质形成细胞对血卟啉单甲醚吸收特性的比较

目的 探讨血管内皮细胞(ECV304)和角质形成细胞(HaCaT)对光敏剂血卟啉单甲醚(hematoporphyrin monomethyl ether,HMME)的吸收特性.方法 取对数生长期的ECV304和HaCaT细胞分别与50、100、150、200、250 mg/L HMME孵育16 h,或与150 mg/L HMME孵育15 min、30 min、1h、3h、8h、12h、24 h.激光扫描共聚焦显微镜检测孵育浓度及孵育时间对两种细胞吸收HMME的影响.结果 与上述5种浓度HMME孵育后,ECV304细胞的平均荧光强度分别为74.00、125.57、135.24、141.99、132.09,HaCaT细胞的平均荧光强度分别为93.88、102.45、112.59、108.23、104.70.与150 mg/LHMME孵育上述时间后,ECV304细胞的平均荧光强度分别为95.07、103.97、105.96、108.99、112.93、115.36、122.91,HaCaT细胞的平均荧光强度分别为104.25、106.60、108.72、113.75、117.66、114.90、118.14.结论 ECV304和HaCaT细胞对HMME的吸收在一定浓度范围和时间范围内均呈浓度和时间依赖性.     

银屑病的严重联合免疫缺陷小鼠模型的研究及应用

银屑病的发病机制和病理生理变化复杂 ,目前认为可能是一种Ｔ细胞介导的免疫性疾病[1 ] 。尽管许多不同的动物模型能复制银屑病的某个方面 ,并能解释部分病因[2 ] ,但长期以来缺乏一种能够研究所有有关的潜在因素的动物模型[3 ] 。银屑病患者皮损移植到严重联合免疫缺陷 (ＳＣＩＤ)小鼠后可保持银屑病的临床病理学特征 ,为银屑病的研究提供了非常有价值的动物模型。1　银屑病的动物模型银屑病的主要病理特征包括 :角质形成细胞特征性过度增殖及异常分化 ,炎性细胞浸润 ,真皮血管扩张纡曲。由于没有自然发生的动物疾病具有银屑病的免疫学和组…     

半胱氨酸天冬氨酸蛋白酶3在血卟啉单甲醚光动力学疗法中对瘢痕成纤维细胞的作用

目的 探讨半胱氨酸天冬氨酸蛋白酶3（caspase 3）在增生性瘢痕成纤维细胞（HSF）经光敏剂血卟啉单甲醚（HMME）诱导的凋亡效应中的作用。方法 将原代培养的HSF分为对照组、HMME-光动力疗法（PDT）组和caspase 3抑制剂（Z-DEVD-FMK）组,经caspase 3-异硫氰酸荧光素（FITC）-碘化丙啶（PI）染色后在荧光显微镜下观察各组细胞内caspase 3的荧光强度。收集各组细胞,在活性caspase 3-FITC单染后,经流式细胞术检测活性caspase 3阳性细胞百分率;在PI单染后,经流式细胞术检测细胞凋亡率。结果 对照组和caspase 3抑制剂组HSF胞质中caspase 3-FITC荧光微弱,PDT组荧光显著增强;对照组活性caspase 3阳性细胞百分率低,HMME-PDT组（30.86% ± 1.21%）上升,caspase 3抑制剂组（2.46% ± 0.18%）降低,后两组间比较,t = 21.76,P < 0.05。PI染色分析表明,对照组凋亡率（2.45% ± 0.22%）低,PDT组（30.54% ± 3.78%）显著升高,两组比较,t = 35.90,P < 0.05;caspase 3抑制剂组凋亡率（10.46% ± 2.15%）低于PDT组,但显著高于对照组（t = 27.97,P < 0.05）。结论 HMME-PDT诱导HSF发生的凋亡效应与caspase 3的激活密切相关,但该凋亡效应并不依赖于caspase 3。     

银屑病治疗展望

对近年来银屑病的基础研究所带来的治疗进展作一介绍，如在免疫学研究进展的基础上所研制的新药物、抗血管增生药物治疗银屑病以及针对核受体所发展的新型药物等，目前的研究有可能引起银屑病治疗方面的突破。     

华卟啉钠光动力疗法对细胞异常增殖影响的体内、外实验研究北大核心CSCD

目的观察华卟啉钠(DVDMS)光动力疗法(PDT)对细胞异常增殖的影响。方法采用小动物活体成像仪观察DVDMS在小鼠体内的吸收和分布;采用MTT法观察DVDMS-PDT对HaCaT细胞和人口腔表皮样癌细胞(KB)细胞增殖的影响;采用小鼠阴道上皮模型观察DVDMS-PDT对细胞异常增殖的影响。结果 DVDMS在小鼠皮肤组织中分布均匀,静脉注射和局部给药后在小鼠皮肤中均具有较高浓度;DVDMS-PDT可显著抑制HaCaT细胞和KB细胞的增殖,当光斑直径固定时,改变照射时间和输出功率对增殖抑制率和IC_(50)值影响不大;DVDMS-PDT可显著抑制己烯雌酚诱导的小鼠阴道上皮细胞过度增殖,一次PDT治疗即可达到较好的治疗效果。结论 DVDMS-PDT可显著抵制细胞异常增殖,作用机制尚需进一步研究。     

辣椒素对银屑病小鼠模型的作用

目的　研究辣椒素对银屑病小鼠模型的作用机制。方法　采用小鼠尾部鳞片表皮模型和阴道上皮细胞有丝分裂模型 ,观察辣椒素对表皮细胞分化及上皮细胞有丝分裂的影响。结果　辣椒素能促进小鼠尾部鳞片表皮颗粒层形成 (P <0 .0 1) ,显著抑制小鼠阴道上皮细胞的有丝分裂 (P <0 .0 1)。结论　辣椒素对银屑病小鼠模型的作用可能与促进表皮细胞正常分化和抑制表皮细胞增殖有关。     

银屑病患者治疗前后外周血单胺类物质含量测定

近年来研究表明，银屑病属于心身疾病范畴，心理因素通过神经-内分泌-免疫网络对该病的发生和发展起一定作用、单胺类神经递质是神经内分泌免疫调节网络的重要成分笔者对30例银屑病患者治疗前、后血清中单胺类物质，即去甲肾上腺素(NE)、多巴胺(DA)、5-羟吲哚乙酸(5-HIAA)的含量进行测定．并比较银屑病患者病情变化与单胺类物质含量之间的相互关系．结果报告如下。     

Photodynamic therapy in psoriasis: suppression of cytokine production in vitro and recording of fluorescence modification during treatment in vivo

Photodynamic therapy (PDT) consists of the combination of photosensitizers absorbing light mainly in the red spectral region and irradiation with light of corresponding wavelengths. We analysed its effects on the cytokine secretion (IL-1, TNF, IL-6) of freshly isolated peripheral mononuclear cells from six patients with chronic plaque-stage psoriasis in comparison with PUVA. PUVA treatment resulted in a decreased production of all three cytokines, but most pronounced in the case of IL-6. PDT caused a similar change in the cytokine pattern, but its effectiveness was lower. In vivo fluorescence recordings were performed on psoriatic plaque lesions after topical application of the photosensitizer Photosan-3. Under irradiation, progressive photobleaching was noted with increasing radiation dosage. This is the first reported study of photochemical reactions using on-line fluorescence recordings during PDT of psoriatic lesions in vivo. Our results demonstrate the capacity of PDT to cause immunomodulatory effects similar to PUVA, thus indicating its potential application to the treatment of this common disease.     

Generalized pustular psoriasis (von Zumbusch)

Generalized pustular psoriasis (von Zumbusch) is a rare and acute eruption characterized by multiple sterile pustules over an erythematous and edematous background, eventually associated with psoriasis vulgaris. Classically, it manifests as a potentially severe systemic picture and demands prompt diagnosis and intervention. The duration of each flare-up and intervals between the pustular episodes is extremely variable. Recently, genetic abnormalities have been identified mainly in the familial and early variants of this disease. The therapeutic arsenal is limited; however, new drugs being evaluated aim to control both pustular flare-ups and disease recurrences.     

84例泛发性脓疱性银屑病临床分析

目的 探讨泛发性脓疱性银屑病(GPP)的临床特征,比较不同治疗方法的疗效.方法 根据病情严重程度,分析近10年我科收治的84例GPP.结果 既往有银屑病史和初发即为脓疱性银屑病患者各占50.0%.16.6%患者发生并发症,部分GPP皮损存在继发感染,既往有银屑病史的患者发病多与糖皮质激素使用有关;实验室检查中常见血红蛋白下降,外周血白细胞升高,肝功能异常,血白蛋白下降.结合疗效和不良反应综合考虑,治疗GPP时,首选阿维A.对于重度GPP,除非病情非常严重,其他药物难以控制急性症状,一般不必加用糖皮质激素.结论 对泛发性脓疱性银屑病应先行诊断,其次评估病情严重程度,再合理选择药物治疗.     

Pan-selectin antagonism improves psoriasis manifestation in mice and man

The selectin family of vascular cell adhesion molecules is comprised of structurally related carbohydrate binding proteins, which mediate the initial rolling of leukocytes on the activated vascular endothelium. Because this process is one of the crucial events in initiating and maintaining inflammation, selectins are proposed to be an attractive target for the development of new antiinflammatory therapeutics. Here, we demonstrate that the synthetic pan-selectin antagonist bimosiamose is effective in pre-clinical models of psoriasis as well as in psoriatic patients. In vitro bimosiamose proved to be inhibitory to E- or P-selectin dependent lymphocyte adhesion under flow conditions. Using xenogeneic transplantation models, bimosiamose reduced disease severity as well as development of psoriatic plaques in symptomless psoriatic skin. The administration of bimosiamose in patients suffering from psoriasis resulted in a reduction of epidermal thickness and lymphocyte infiltration. The clinical improvement was statistically significant (P=0.02) as analyzed by comparison of psoriasis area and severity index before and after treatment. Assessment of safety parameters showed no abnormal findings. These data suggest that pan-selectin antagonism may be a promising strategy for the treatment of psoriasis and other inflammatory diseases.Markus Friedrich and Daniel Bock equally contributed to the study     

Psoriasiform architecture of murine epidermis overlying human psoriatic dermis transplanted onto SCID mice

Preliminary observations in a xenogeneic SCID mouse transplantation model indicated that murine epidermis overgrows human dermis from psoriatic skin but not that form normal skin. To investigate the effect of peripheral blood mononuclear cells on the differentiation of murine keratinocytes, we transplanted involved and uninvolved full-thickness skin from patients with psoriasis onto SCID mice and followed this with repeated subcutaneous injections of cells suspended in patient serum. After 6 weeks grafts were analysed morphologically and immunohistochemically. The epidermis in grafts from clinically uninvolved skin appeared normal. The persistence of a psoriasiform epidermis was noted in all grafts from affected sites despite a lack of lymphocytic infiltration. Staining for human and mouse MHC class I antigens revealed the murine origin of keratinocytes forming the psoriasiform epidermis, while the human dermis was retained. Our observations indicate that the defect underlying the pathogenesis of psoriasis is most likely located in the dermal rather than the epidermal compartment. This xenogeneic transplantation model may be useful for future studies of the pathogenesis and treatment of psoriasis.     

营养与生活习惯对银屑病的预防作用

银屑病与遗传、环境因素均有关,但病因尚有未知之处.近年来,人们开始关注营养、生活习惯与银屑病的关系,发现有很多营养元素,如维生素A、B、谷胶、硒等和生活习惯(吸烟、饮酒、运动等)对银屑病的发病有抑制或激发作用,但有些常识中认为有益或有害的食物被证明与银屑病无关.概述此领域的研究成果以及有争议的问题,为临床和进一步研究提供参考.     

The effect bathing in a thermal lagoon in Iceland has on psoriasis. A preliminary study

Objective To investigate if bathing in a unique thermal lagoon in Iceland has a therapeutic effect on psoriasis. Design An open study where twenty-seven psoriasis patients bathed for three weeks in the lagoon. Psoriasis Area and Severity Index (PASI) was used to evaluate the severity of the disease before during and after bathing. Results The mean PASI score decreased from 16.1 to 8.1 (p= 0.01). The PASI score decreased most in the first week. The area of the lesions did not diminish but scaling erythema and infiltration decreased. Only very limited UV-radiation was observed during the bathing period. Conclusions Bathing in the lagoon has a favourable effect on psoriasis although in some cases it may not be sufficient as a single treatment. Further studies over longer period are needed.     

饮食干预治疗银屑病的相关进展

【摘要】 本文综述银屑病患者的饮食特点,探讨无麸质饮食、地中海饮食、饮食干预导致的体重减轻对银屑病的影响,分析补充鱼油、维生素D、维生素B12、硒、益生菌等膳食补充剂治疗银屑病的疗效。     

银屑病基因-环境、基因-基因交互作用研究进展

目前认为银屑病主要由环境因素和遗传因素等共同作用所致。环境因素如吸烟、饮酒、外伤等可诱发或加重银屑病病情［１］。遗传学研究发现,PSORS1-9、HLA-Cw*0602、IL12B、IL23R、ERAP1等位点或基因与银屑病的易感性相关联［2］。近年来,研究者利用多种方法开展银屑病基因-环境、基因-基因交互作用方面的研究,阐明其在银屑病发病机制中的作用,取得了进展……