Paradoxical Effect on Epidermal Barrier of Anti-TNF-alpha Treatment for Psoriasis

BackgroundEpidermal barrier defects have been described in psoriatic lesions. Transepidermal water loss (TEWL) is the measure of steady-state water vapor flux crossing the skin to the external environment, and it has been used extensively to characterize skin barrier function. We evaluated how biological treatments impact TEWL in with psocratic patients.MethodsTEWL measurements were collected from psoriatic lesions and from adjacent unaffected skin areas before introducing a biological anti-tumor necrosis factor (TNF) alpha treatment and after six months of therapy.ResultsOur data show that the skin barrier function is restored after biologic therapy. Analysis of healthy skin values, indicated significant increases in TEWL.ConclusionA restoration of TEWL on psoriatic lesions was coupled with an alteration of this parameter in nonlesional skin of all patients, underscoring the general homeostatic effect of an anti-TNF on the integrity of skin barrier. These results suggest the need of an emollient therapy in patients with psoriasis undergoing systemic biological treatment.     

抗幽门螺杆菌治疗对寻常型银屑病患者疗效及血清IL-17的影响

目的 探讨抗幽门螺杆菌（Hp）治疗对Hp阳性寻常型银屑病患者疗效的影响及Hp感染与寻常型银 屑病发病的可能机制。方法 选取2019年12月-2021年9月重庆三峡医药高等专科学校附属医院皮肤科确诊 的50例Hp阳性寻常型银屑病患者,采用随机数字表法分成试验组与对照组,每组25例。试验组予以外用卤 米松乳膏、卡泊三醇软膏联合四联抗Hp治疗,对照组予以外用卤米松乳膏、卡泊三醇软膏治疗,比较两组 治疗前、治疗后1个月PASI评分以及血清IL-17水平。结果 两组治疗后PASI评分低于治疗前,且试验组低 于对照组,差异有统计学意义（P＜0.05）;两组治疗后IL-17水平低于治疗前,且试验组低于对照组,差 异有统计学意义（P＜0.05）。结论 对Hp阳性寻常型银屑病患者进行抗Hp治疗有利于提高患者临床疗效, Hp感染可能通过诱导血清IL-17水平升高而参与银屑病的发生与发展。     

卡铂三醇软膏联合卤米松乳膏治疗寻常型银屑病的效果

的 探讨卡泊三醇软膏联合卤米松乳膏治疗寻常型银屑病的效果。方法 选取2022年 1月-2023年3月我院收治的80例寻常型银屑病患者为研究对象,随机分为观察组与对照组,各40例。 对照组予以卤米松乳膏治疗,观察组予以卡泊三醇软膏联合卤米松乳膏治疗,比较两组临床症状缓 和时间、炎性因子水平、皮损程度、瘙痒程度及不良反应发生情况。结果 观察组皮损、红斑丘疹、 瘙痒、鳞皮屑缓和时间均低于对照组,差异有统计学意义（P＜0.05）;观察组治疗后TNF-α、IL-17 以及IL-6水平均低于对照组,差异有统计学意义（P＜0.05）;观察组治疗后PASI、VAS评分均低于对照 组,差异有统计学意义（P＜0.05）;两组不良反应发生率比较,差异无统计学意义（P＞0.05）。结论 予以寻常型银屑病患者卡泊三醇软膏联合卤米松乳膏治疗,降低炎性因子水平,缩短临床症状改善时 间,改善皮损、瘙痒状况,安全性较高,值得临床应用。     

皮敏消胶囊联合糠酸莫米松乳膏治疗寻常型银屑病的效果

的 探讨对寻常型银屑病患者采用皮敏消胶囊联合糠酸莫米松乳膏治疗的临床效果。方法 选取公安县中医医院皮肤科2018年8月-2022年7月收治的100例寻常型银屑病患者为研究对象,通过随机数字表法分为对照组和观察组,每组50例。对照组采用糠酸莫米松乳膏治疗,观察组采用皮敏消胶囊联合糠酸莫米松乳膏治疗,比较两组中医症状积分、皮损严重程度、炎性因子水平及不良反应发生情况。结果 观察组治疗后红斑瘙痒、烦躁乏力、舌红苔白评分及PASI评分均低于对照组（P＜0.05）;观察组治疗后IL-10、IL-17水平均低于对照组（P＜0.05）;观察组不良反应发生率为2.00%,低于对照组的18.00%（P＜0.05）。结论 皮敏消胶囊联合糠酸莫米松乳膏治疗寻常型银屑病的效果良好,不仅能够有效改善患者的临床症状,减轻其皮损严重程度,还能有效抑制炎性因子水平,降低不良反应的发生几率。     

Prophylactic use of the IL-2 receptor-specific monoclonal antibody LO-Tact-1 with cyclosporin A and steroids in renal transplantation

LO-Tact-1 is a rat anti-human monoclonal antibody which is directed to the 55-kD_a α-chain of the interleukin 2 (IL2) receptor. We conducted a pilot trial in 15 first-time cadaveric renal transplant patients undergoing for immunosuppression a 14-day course of LO-Tact-1 (10 mg IV daily) together with cyclosporine, low dose steroids (0.5 mg/kg) and azathioprine. Results showed a good immunosuppressive effect, as measured by the similar incidence of acute rejection episodes (0.6 per patient) when compared with 20 patients treated during the same period with our standard quadruple prophylactic combination with higher initial doses of steroids (2 mg/kg) and antilymphocyte globulin (ALG) instead of LO-Tact-1 (0.4 per patient). At 2 years post-transplant, graft survival was 93%, and only 1 patient lost his kidney by rejection. No local or general adverse effect of antibody administration was encountered, and haematological changes remained of minor importance. Local bacterial infection was observed in 3 patients, but viral diseases (including cytomegalovirus, CMV) remained exceptional. In contrast, severe clinical CMV infections occurred in 3 patients (15%) treated by ALG. Nine of 15 patients developed rat-specific antibodies, but only 4 before the completion of LO-Tact-1 treatment, without any correlation with the further development of acute rejection. Patients who suffered rejection had lower LO-Tact-1 levels and higher soluble IL2 receptor levels during the period of infusion, suggesting the crucial importance of pharmacokinetic monitoring to adjust individual doses.     

消银颗粒联合司库奇尤单抗治疗银屑病的效果

目的 探究消银颗粒联合司库奇尤单抗治疗银屑病的效果。方法 选取2021年2月-2022年8月我院 收治的94例银屑病患者作为研究对象,采用随机数字表法分为观察组和对照组,各47例。对照组采用司库 奇尤单抗治疗,观察组在对照组基础上加用消银颗粒治疗。比较两组疾病状况（PASI评分）、炎症因子水 平以及临床疗效。结果 观察组治疗后头部、上肢、躯干以及下肢症状评分均低于对照组,差异有统计学意 义（P＜0.05）;观察组治疗后IL-17、IL-22水平均低于对照组,差异有统计学意义（P＜0.05）;观察组治 疗总有效率高于对照组,差异有统计学意义（P＜0.05）。结论 消银颗粒结合司库奇尤单抗治疗银屑病的 效果良好,可有效降低炎症因子表达,改善患者皮肤症状,继而缓解病情,值得临床应用。     

Early Treatment Targets for Predicting Long-term Dermatology Life Quality Index Response in Patients with Moderate-to-Severe Plaque Psoriasis: A Post-hoc Analysis from a Long-term Clinical Study

BACKGROUND: Rapid improvements in health-related quality of life (HRQoL) and psoriasis severity have been reported in patients treated with ixekizumab (IXE), an interleukin (IL)-17A antibody. OBJECTIVE: We assessed the relationship between early Psoriasis Area and Severity Index (PASI) response and long-term Dermatology Life Quality Index (DLQI) improvement in patients in the randomized clinical trial IXORA-S (NCT0256186) treated with IXE or IL-12/23 (ustekinumab [UST]). METHODS: The proportion of patients achieving DLQI (0,1), an outcome equivalent to the patient’s skin condition having no impact on HRQoL after 52 weeks of IXE or UST by PASI response at Weeks 4, 12, and 24 was quantified. Optimal thresholds for PASI response by treatment to predict Week 52 DLQI (0,1) were calculated based on Youden’s Index. RESULTS: Early and higher levels of skin clearance were associated with improved patient outcomes regardless of treatment. Patients treated with IXE achieved faster and more pronounced PASI response than patients treated with UST. The optimal thresholds at Weeks 4, 12, and 24 for predicting DLQI (0,1) at Week 52 were ~PASI 75 for IXE versus ~PASI 50 for UST at Week 4, PASI 90 for IXE versus PASI 75 for UST at Week 12, and ~PASI 100 for IXE versus ~PASI 90 for UST at Week 24. Among patients achieving these thresholds, the probability of achieving a DLQI (0,1) was significantly higher. CONCLUSION: Earlier and higher levels of skin clearance are associated with improved patient outcomes over the long term, regardless of treatment.     

复方甘草酸苷与雷公藤多苷治疗银屑病的效果

目的 分析雷公藤多苷联合复方甘草酸苷治疗银屑病的效果。方法 选择2019年3月-2022年9月邹 城市人民医院收治的100例银屑病患者,随机分为对照组和研究组,每组50例。对照组予以单用复方甘 草酸苷治疗,研究组联用雷公藤多苷与复方甘草酸苷治疗,比较两组中医证候积分、临床疗效、不良 反应发生情况。结果 研究组总有效率为90.00%,高于对照组的72.00%（P ＜0.05）;研究组治疗后中 医证候各项积分低于对照组（P ＜0.05）;研究组不良反应发生率与对照组比较,差异无统计学意义 （P ＞0.05）。结论 联用复方甘草酸苷、雷公藤多苷治疗银屑病的效果确切,可有效改善皮损状况,缓解 中医症状,且不增加不良反应发生率,应用安全性较高。     

The Use of Brodalumab in Three Patients with Psoriasis and Psychiatric Comorbidities

Brodalumab, a first-in-class interleukin-17 (IL-17) receptor blocker, carries a black box warning for suicidal ideation and behavior, yet it is also one of the most powerful biologic agents in our armamentarium. We wish to highlight three patients with moderate-to-severe psoriasis and comorbid depression who were successfully treated with brodalumab. The patients were chosen by an expert panel comprising dermatologists, psychiatrists, and psychologists. Psoriasis disease severity was measured using the Psoriasis Area and Severity Index (PASI) score. All three patients experienced PASI 100 after treatment with brodalumab (N=3). Importantly, depressive symptoms improved or resolved in two out of three patients. One patient, who had a history of psychiatric hospitalizations, required in-patient psychiatric treatment during treatment. The use of brodalumab in patients with psoriasis can provide rapid-onset improvement in both skin and depressive symptoms.     

阿维A胶囊联合复方甘草酸苷治疗银屑病的效果和安全性

探讨使用阿维A胶囊联合复方甘草酸苷治疗银屑病的有效性及安全性。方法 选取2022年 1月-2023年1月容城县人民医院收治的82例银屑病患者为研究对象,将其随机分为对照组和研究组,每组 41例。对照组使用阿维A胶囊治疗,研究组使用阿维A胶囊联合复方甘草酸苷治疗,比较两组临床疗效、 生活质量和不良反应发生情况。结果 观察组治疗总有效率为97.56%,高于对照组的78.05%（P ＜0.05）; 两组治疗后生活质量各项评分均高于治疗前,且观察组高于对照组（P ＜0.05）;观察组不良反应发生率为 7.32%,低于对照组的26.83%（P ＜0.05）。结论 阿维A胶囊联合复方甘草酸苷治疗银屑病,可提高治疗效 果,改善患者生活质量,且安全性高。     

Plasma Exchange for Treatment of Intractable Psoriasis

Abstract: Hemofiltration and plasma exchange, using a plasma separator with membranes, were used in 14 psoriatic patients. The efficacies of the treatments were compared. Among the patients, 13 were treated with hemofiltration and/or direct hemoperfusion, 5 experienced complete remission, 5 improved, and 3 remained unaffected. In these 3 cases, plasma exchange was performed. The first patient, who suffered from psoriasis pustulosa with arthropathica, achieved complete remission with only two treatments of 2-L plasma exchange. Joint pain was also eliminated. Both skin lesions and joint pain were markedly improved in the second patient, who suffered from psoriasis vulgaris with arthropathica. The third patient showed marked improvement with only two plasma exchanges, and is under continuing observation.     

复方氨肽素片联合卤米松乳膏在银屑病患者中的应用效果

目的 探讨复方氨肽素片联合卤米松乳膏在银屑病患者中的应用效果。方法 选取2020年5月-2022年1月我院收治的82例银屑病患者为研究对象,采用随机数字表法分为对照组和观察组,各41例。对照组采用卤米松乳膏治疗,观察组联合复方氨肽素片治疗（两组均治疗3个月,并对患者完成12个月门诊随访）,比较两组症状消失时间、银屑病皮损面积和严重程度指数（PASI）评分、炎性因子、不良反应及复发率。结果观察组治疗3个月后皮损暗红、皮肤瘙痒、皮肤疼痛及皮损肥厚消失时间短于对照组（P ＜0.05）;观察组PASI评分、IL-6、TNF-α、VEGF及CRP水平低于对照组（P ＜0.05）;两组不良反应发生率比较,差异无统计学意义（P ＞0.05）;观察组停药12个月后复发率为2.44%,低于对照组的14.63%（P ＜0.05）。结论复方氨肽素片联合卤米松乳膏能缩短银屑病患者症状消失时间,降低PASI及炎性因子水平,且不增加不良反应,能降低远期复发率,值得临床应用。     

钙泊三醇倍他米松乳膏、卡泊三醇软膏序贯治疗银屑病的效果

探讨予以银屑病患者钙泊三醇倍他米松乳膏以及卡泊三醇软膏序贯治疗的效果。方法 选 取2022年4月-2023年4月容城县人民医院收治的80例银屑病患者为研究对象，将其随机分为对照组和研究 组，每组40例。对照组使用卡泊三醇软膏治疗，研究组使用钙泊三醇倍他米松乳膏联合卡泊三醇软膏序贯 治疗，比较两组临床疗效、皮损程度和不良反应发生情况。结果 研究组总有效率为92.50%，高于对照组 的72.50%（P ＜0.05）；两组治疗后银屑病面积和严重程度指数（PASI）评分低于治疗前，且研究组低于对 照组（P ＜0.05）；研究组不良反应发生率为5.00%，低于对照组的25.00%（P ＜0.05）。结论 银屑病患者 治疗过程中，联合应用钙泊三醇倍他米松乳膏与卡泊三醇软膏序贯治疗，可减轻患者皮损程度，促进临床 疗效提升，安全性高。     

丙酸氟替卡松乳膏与丁酸氢化可的松软膏治疗寻常型银屑病的美学效果

目的 探讨丙酸氟替卡松乳膏与丁酸氢化可的松软膏治疗寻常型银屑病的美学效果。方法 选取 2023年2月-2024年2月海原县中医医院收治的78例寻常型银屑病患者为研究对象,按随机数字表法将其分 为对照组与观察组,各39例。对照组采取丁酸氢化可的松软膏治疗,观察组采取丙酸氟替卡松乳膏治 疗,比较两组细胞沉降率（ESR）、C-反应蛋白（CRP）、白介素6（IL-6）及美学评价。结果 观察组 治疗后ESR、CRP、IL-6水平低于对照组（P ＜0.05）;观察组患者及医师对美学效果的评分高于对照组 （P ＜0.05）。结论 针对寻常型银屑病患者,采取丙酸氟替卡松乳膏治疗能够取得良好的效果,可减轻患 者炎症反应,改善临床症状,提高患者对美学效果的认可度。     

白介素-22在肾脏疾病中的作用研究进展

白介素-22(interleukin 22,IL-22)是白介素-10细胞因子超家族的成员,主要由固有淋巴样细胞和CD4+T辅助亚型如辅助性T细胞17(Th17)和辅助性T细胞22(Th22)产生,IL-22受体(in-terleukin-22 receptor,IL-22R)是IL-22R1和IL-10R2亚基组成的...     

B-cell markers in the human kidney

This report describes the reactivity of a panel of 89 monoclonal antibodies with the normal human kidney. The antibodies were all submitted to the B-cell panel of the Third Leukocyte Differentiation Workshop. Several different patterns of staining of renal structures were identified. Most antibodies clustered in defined CD groups showed the same pattern of reactivity in the kidney, but some, notably CD19 antibodies, showed heterogeneity of binding to the kidney. These findings are important for the use of monoclonal antibodies to define phenotype in cell culture and immunohistology experiments.