微量元素对银屑病的影响

银屑病的病因和发病机制至今尚未阐明.人的身体是由化学元素组成,占人体重万分之一以下的元素称为微量元素.微量元素有重要而复杂的生理功能,可从多方面参与机体的调节.目前许多研究发现,银屑病患者存在着微量元素的异常,文中从锌、铜、锰、铁、硒等方面分析微量元素与银屑病的影响.     

银屑病患者血浆七种微量元素的测定

由于银屑病的发病情况与地理纬度呈明显相关,特点是越近高纬度的极区则其患病率及发病率越高,严重三废污染的厂矿及城市其发病率亦然.为探求陕西省的发病情况,作者们曾进行过流行病学研究并对西安地区银屑病患者血浆7种微量元素(锌、铜、锂,钻、锰、铁及硒)值进行研究,现将结果报告于后.     

SLE患者血清、尿液和肾脏骨桥蛋白的检测及临床意义

目的 探讨骨桥蛋白(OPN)在SLE患者血清、尿液中的含量及与SLE脏器损害、活动性指标的关系.方法 收集100例SLE患者临床资料,ELISA方法检测OPN在100例SLE患者和30例正常人对照外周血清中的浓度,同时用ELISA检测OPN在57例SLE患者和15例正常人对照尿液中的浓度.免疫组化检测3例SLE患者肾脏组织中OPN蛋白的表达.结果 OPN在SLE患者血清和尿液中浓度显著升高,分别为(64.03±72.87)μg/L和(454.87±231.63)μg/L,与正常对照组[(29.88±11.28)μg/L,(122.67±39.47)μg/L]相比,差异有统计学意义(P<0.05), SLE活动组血清和尿液中OPN浓度显著升高,分别为(80.92±87.49)μg/L和(584.36±207.15)μg/L,与SLE非活动组[(36.43±23.48)μg/L,(281.08±131.92)μg/L]相比,差异有统计学意义(P<0.05).血清和尿液中OPN浓度均和SLEDAI积分呈正相关(r=0.462,0.901,P值均<0.01).尿液OPN浓度和尿免疫球蛋白G、尿微量白蛋白、尿α1微球蛋白、尿B2微球蛋白呈正相关(r=0.458,0.359,0.342,0.409,P值均<0.05).OPN在狼疮性肾炎患者肾小管上皮表达.结论 OPN与SLE及肾损有密切关系.     

系统性红斑狼疮患者微量元素的改变及其临床意义

用原子吸收光谱法测定30例健康人及40例SLE患者血清及头发中锌、铜、锰、铁含量,结果显示:SLE患者血清及头发锌含量均明显低于健康对照组(P<0.01),活动组患者血清锌进一步降低(P<0.01)。提示患者存在轻度低锌状态且与疾病活动性相关。作者认为SLE患者的微量元素变化不能归结于外源性皮质类固醇激素治疗的作用,而可能与LME引起的重分布有关。     

银屑病和红斑性狼疮并存

作者对27例银屑病与红斑性狼疮并存的患者进行了分析.27例中10例为系统性红斑狼疮(SLE),13例为盘状红斑狼疮(DLE),4例为药物所致红斑性狼疮(LE)或SLE样综合征.分析结果如下,27例中女性占17例(63%),男性10例(37%).银屑病和LE同时伴发者6例(1例SLE,5例DLE).有4例银屑病发病至少比SLE早5年(平均10.25年),在DLE中有3例在10年以上;平均22年.在     

脱发患者头发微量元素测定及临床意义探讨

本文用火焰原子吸收光谱法和原子荧光光谱法测定60例脱发患者及80例健康人头发8种微量元素含量,结果疾病组较对照组发铜、锌、锰值显著降低,发钙、镁、硒值显著增高,有统计学意义。不同脱发类型各元素值无显著差异。本文就检测结果作了初步分析。     

33例银屑病病人6种抗磷脂抗体的检测

目的：探讨抗磷脂抗体(APA)与银屑病的关系。方法：应用酶联免疫吸附试验(ELISA)检测33例银屑病和16例梅毒病人血中6种APA。结果：①银屑病病人IgG型aCL、aPA、aPS、aPC和aPI的A值和aPI的阳性率较正常人显著升高；IgM型APA的A值较正常人显著降低，均阴性；②梅毒病人IgG型aCL、aPA、aPE和aPI的A值和aCL、aPA的阳性率较正常人显著升高；IgM型aCL、aPS、aPE和aPC的A值和aCL、aPS、aPE、aPC和aPI的阳性率较正常人显著升高。结论：在银屑病时存在APA的机制与梅毒不同。     

银屑病患者血细胞参数、C反应蛋白及血脂的检测

目的:探讨银屑病患者血细胞相关参数、C反应蛋白(CRP)及血脂的变化在银屑病发病中的作用.方法:对89例寻常型银屑病患者血常规、CRP及血脂进行检测,并与正常对照组进行综合对比分析.结果:银屑病组与对照组比较:银屑病组平均红细胞体积(MCV)、红细胞体积分布宽度(RDW-CV)、血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW) 和大血小板比率(PCT)明显升高(P<0.05),进行期银屑病组显著升高(P<0.01);稳定期银屑病患者组CRP浓度与对照组比较差异有显著性(P<0.05);消退期银屑病患者组与对照组比较差异无显著性(P>0.05).血清TC、TG、LDL-c及APOB均明显升高(P<0.01),apoA1、HDL-c下降(P<0.01),脂蛋白a仅进行期银屑病组升高显著(P<0.05),其他两组轻度升高但差异无显著性(P>0.05).结论:银屑病患者血细胞相关参数、CRP水平及血脂均有明显变化,联合监测对于判断病情转归和指导临床治疗具有重要意义.     

PUVA治疗前后银屑病患者的免疫状态

本文对105例PUVA治疗的银屑病患者,于疗前测定其细胞免疫和体液免疫功能状态.发现:疗前LTT值较对照组低,有非常显著差异(P<0.01),血清IgG, IgM与对照组比较.前者水平明显升高.后者水平明显降低(P<0.01).此外,对其中31例银屑病患者进行了PUVA治疗前后的免疫指标变化观察,发现PUVA疗后患者血IgM及LTT值与疗前相比均有非常显著差异(P<0.01),前者较疗前明显升高,后者明显降低.可见PUVA疗法对银屑病患者的免疫功能有抑制现象,这就可能增加了癌症发生的危险性,也可能使银屑病的复发加重.     

寻常型银屑病患者血清锌、IL-2和TNF-α检测及分析

目的: 旨在观察寻常型银屑病患者进展期、稳定期、消退期血清锌、IL-2和TNF-α与银屑病病情的相关性,以探索银屑病的病因和发病机制.方法: 对40例银屑病各期行PASI评分;对银屑病各期和对照组用原子分光光度法检测血清锌值,用双抗夹心ELISA法检测IL-2和TNF-α.结果:(1)银屑病患者血清锌较对照组显著降低,各组间有显著性差异(P<0.01);(2)在各期患者中IL-2、TNF-α较对照组显著升高,IL-2、TNF-α与PASI评分呈正相关.结论: 银屑病患者存在着血清锌降低,而IL-2和TNF-α升高,这可能与疾病的发生发展有关.     

Prolyl hydroxylase and procollagen III peptide levels in the sera from patients with collagen diseases and psoriasis

Prolyl hydroxylase (PH) and procollagen III peptide (PIIIP) levels in 43 serum samples from various collagen diseases including 19 progressive systemic sclerosis (PSS) cases were simultaneously assayed and compared to those of 22 age-matched psoriasis patients and 20 healthy controls in order to examine whether they can serve as useful parameters of fibrotic changes, especially in the skin. Serum PH levels were determined with enzyme immunoassay and serum PIIIP levels with radioimmunoassay. The average values of PH were 109% (n = 3, (p less than 0.001; generalized morphea, GM), 104% (n = 1; overlap syndrome, OS), 57% (n = 6; mixed connective tissue disease, MCTD), 48% (p less than 0.05; PSS), 33% (n = 5; dermatomyositis, DM), 28% (psoriasis), and 9% (n = 9; systemic lupus erythematosus, SLE), higher than the control levels, while those of PIIIP were 82% (OS), 57% (MCTD), 42% (p less than 0.01; PSS), 11% (GM), and 5% (DM) higher and 22% (psoriasis) and 28% (SLE), lower than the controls. These results indicate that both values were higher in the diseases with skin fibrosis and lower in those without it, suggesting that both assays generally reflect the state of actual progression of fibrosis at the point of determination. These two values had considerable correlation; however, GM, psoriasis and SLE patients had relatively higher values of PH than of PIIIP. This result suggests that the PH assay may also reflect the state of connective tissue activation; therefore the PIIIP assay may be more specific for pathological fibrotic process.(ABSTRACT TRUNCATED AT 250 WORDS)     

Serum lipid peroxide levels in various dermatoses

In studies of physiological roles of lipid peroxide in cutaneous tissue, we examined serum lipid peroxide levels in 199 patients with various dermatoses such as psoriasis, eczema/prurigo, alopecia, bullous disorders, acne/seborrheic dermatitis, atopic dermatitis, SLE, urticaria, progressive systemic sclerosis, generalized morphea, and herpes zoster, by using the TBA (thiobarbituric acid) method and a new assay technique, called the MCDP (methyl carbamoyl-dimethylamino phenothiazine)-Hb method. The following results were obtained. By the TBA method, statistically significantly high serum lipid peroxide levels were noted in patients with psoriasis, eczema/prurigo, alopecia, SLE and generalized morphea. By the MCDP-Hb method, similarly high levels were found in patients with alopecia and atopic dermatitis, compared with those of the control group. The discrepancy between the results from the TBA and the MCDP-Hb methods is thought to be due to the fact that TBA method measures a secondary product of lipid peroxide, malondialdehyde, whereas the MCDP-Hb method measures lipid hydroperoxide itself. These results suggest some involvement of lipid peroxidation in the pathogenesis or, at least, in the enhancement and modification of the symptoms in these dermatoses.     

Plasma exchanges in psoriasis

Five patients with resistant psoriasis were treated with plasma exchanges performed ten times over a 4-week period. Improvement was noted after three exchanges in all five. One patient with erythrodermic psoriasis became paler but relapsed 2 days after treatment. Improvement in four patients was of short duration with relapses occurring in 2 to 4 weeks. Circulating immune complexes were elevated before treatment and fell after each exchange by 20 to 70% of the former values.     

Epigenetics and psoriasis

Increasing evidence indicates that epigenetic mechanisms are involved in the pathogenesis of autoimmune rheumatic diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). The pathogenesis of the organ-specific autoimmune disease psoriasis, however, remains poorly understood. Recent studies have shown that aberrant epigenetic patterns are present in patients with psoriasis, suggesting that epigenetic mechanisms may also be involved in this disease. Herein, we review relevant epigenetic findings associated with psoriasis, and provide clues and directions for further studies in this field.     

DNA-antibodies in sera from patients with systemic lupus erythematosus.

DNA-antibody determinations using the Farr technique and LE cell tests were performed on single serum samples from 55 patients with SLE according to well defined criteria. It was found that the DNA-antibody test was just as sensitive as the LE cell test, and studies of sera from patients with questionable SLE, discoid LE, other connective-tissue diseases, psoriasis, and from healthy persons, indicated that the DNA-antibody test is highly specific for SLE. Neither the DNA-antibody test nor the LE cell test could discriminate between SLE patients with active and inactive disease as estimated by clinical criteria or by the serum concentrations of complement C3 and C4.     

Efficacy of short-term cyclosporine treatment to control psoriasis-related events during efalizumab therapy

Efalizumab is a recombinant humanized anti-CD11a monoclonal antibody that blocks the activation, adhesion and trafficking of T cells and has been approved for the treatment of moderate-to-severe plaque psoriasis. To document management of the fluctuations in symptom control that patients with psoriasis sometimes experience during treatment, we performed a retrospective analysis of our experience using cyclosporine as an intercurrent treatment to control psoriasis-related adverse events (AEs) in 10 patients who had received continuous efalizumab therapy for 20-200 weeks prior to recurrence of symptoms. Combination therapy with cyclosporine and efalizumab was generally well tolerated and controlled the relapse effectively. There were no reports of severe AEs during combination treatment, and no clinically significant changes were noted in clinical and laboratory values. Although mild, localized psoriasis recurred in most of these patients after cyclosporine termination, no patient experienced rebound or psoriasis flare and all continued with long-term efalizumab treatment.     

Laboratory and oligobiopsy studies of the liver in patients with psoriasis treated by the combination of Tigason-PUVA-cignoline (RePUVA+C)

In 10 patients with generalized psoriasis treated by this method biochemical and histological examinations of liver biopsy specimens were done before and after 60 days of the treatment. In some cases a transient rise of A1AT activity, raised activity of alkaline phosphatase and gamma-glutamyltranspeptidase were noted. Histological examinations demonstrated slight hepatocellular damage with microfocal necrosis, fatty infiltration of some cells and increase in the structural elements of cytoplasm.     

系统免疫性疾病女性患者宫颈癌及癌前病变的风险研究

目的:对炎性肠病、牛皮癣、类风湿关节炎和系统性红斑狼疮患者宫颈癌及癌前病变的潜在风险进行评估。方法:将来我院就诊的893例系统免疫性疾病患者和420例非系统免疫性疾病患者作为研究对象,通过多变量Cox比例风险模型进行统计分析,探讨系统免疫性疾病与宫颈癌及癌前病变发生和发展的关系。结果:系统免疫性疾病组宫颈癌及癌前病变的发病率是1.01%,其中系统性红斑狼疮患者具有最高的宫颈癌及癌前病变的发病率(1.67%),牛皮癣患者有最低的发病率(0.83%),炎性肠病和类风湿性关节炎的发病率分别为1.01%和0.84%;非炎症患者宫颈癌及癌前病变的发病率为0.73%。基于多变量Cox比例风险模型,炎性肠病的危险比率为1.07(95%CI:0.79~1.45),牛皮癣的危险比率为0.96(95%CI:0.73~1.27),类风湿性关节炎的危险比率为1.49(95%CI:1.11~2.00),系统性红斑狼疮的危险比率为1.53(95%CI:1.07~2.19)。结论:类风湿性关节炎和系统性红斑狼疮患者宫颈癌及癌前病变的风险比非炎症女性患者高1.5倍。免疫抑制剂和类固醇药物的使用可能会增加炎性肠病患者罹患宫颈癌及癌前病变的风险。     

Differential expression of BAFF and its receptors in discoid lupus erythematosus patients

BackgroundB-cell activating factor of the TNF family (BAFF) promotes the maturation and survival of B cells. Because BAFF levels are elevated in systemic lupus erythematosus (SLE) patients, BAFF has been the target of emerging therapies for SLE, such as belimumab. Levels of BAFF and its receptors in discoid lupus erythematosus (DLE) patients are unknown.ObjectiveTo compare skin and blood mRNA and protein levels of BAFF and its receptors BAFF-R, TACI, and BCMA in DLE subjects with (DLE+/SLE+ (N = 28)) and without SLE (DLE+/SLE− (N = 35)), psoriasis subjects (N = 11), and normal subjects (N = 42).MethodsWe used quantitative real-time PCR to measure blood and skin BAFF, BAFF-R, TACI, and BCMA mRNA, sandwich ELISAs to measure sera BAFF, and immunohistochemistry to evaluate BAFF and BAFF-R skin protein expression.ResultsBAFF mRNA and protein levels were highest in DLE+/SLE+blood, followed by DLE+/SLE−, psoriasis, and normal blood. BAFF protein also correlated with anti-nuclear antibodies, and autoantibodies against double-stranded DNA, single-stranded DNA, and ribonucleoprotein, and Systemic Lupus Erythematosus Disease Activity Index scores in DLE patients. While showing no difference between DLE+/SLE+ and DLE+/SLE− skin, BAFF and its receptors mRNA were up-regulated in DLE skin vs. normal and psoriasis skin. DLE skin had higher percentages of BAFF-R⁺ inflammatory cells, likely T cells and macrophages, than psoriasis and normal skin.ConclusionsBAFF may be a serologic marker of systemic disease in DLE patients. BAFF and its receptors are elevated in DLE skin, suggesting that targeted therapies against these proteins could treat refractory DLE patients.     

IMMUNOGLOBULINES IN DERMATITIS HERPETIFORMIS AND VARIOUS OTHER SKIN DISEASES

SUMMARY.— Lowering of the mean IgM-globulin value and elevation of the mean IgA-globulin value were noted in a group of 21 patients with dermatitis herpetiformis. IgM levels determined before and after dapsone therapy revealed no clear evidence of a dapsone effect on this immunoglobulin. No relationship was noted between the IgM-globulin levels and the intestinal mucosa biopsy grading. Fluctuations in the IgM values were noted and in some patients a fall in this immunoglobulin occurred during an exacerbation the disease. Immunoglobulin patterns were studied in 7 other skin diseases. The abnormalities noted in psoriasis closely paralleled those found in dermatitis herpetiformis.