Inflammatory and immune reactions associated with stratum corneum and neutrophils in sterile pustular dermatoses

In this review we present our own experimental findings as well as those from the literature related to the pathomechanisms for the inflammatory changes in psoriasis and its related diseases. A growing body of evidence has indicated that T cell-mediated immunity plays an important role in triggering and maintenance of psoriatic lesions. It has been revealed that lymphokines produced by activated T cells in psoriatic lesions have a strong influence on the proliferation of the epidermis. Characteristic neutrophil accumulation under the stratum corneum can be observed in the highly inflamed areas of psoriatic lesions. These neutrophils are chemotactically attracted and activated there by synergistic action of chemokines, IL-8 and Gro-alpha released by stimulated keratinocytes, and particularly by C5a/C5a des arg produced via the alternative complement pathway activation. We demonstrated that the infiltrating neutrophils adhere to iC3b-opsonized corneocytes to produce active oxygen and probably lysosomal enzymes. From a close relationship observed between neutrophil accumulation and high mitotic ratio of the lesional epidermis, we think that these stimulated neutrophils influence the growth and differentiation of epidermal keratinocytes. Aberrant expression of HLA-DR on neutrophils suggests their activation of infiltrating T cells in the presence of bacterial superantigen. These T cells in turn influence the transepidermal neutrophil migration through the effect of their cytokines on the keratinocyte production of proinflammatory mediators including IL-8 and C3. In this review we discuss the pivotal roles played by stratum corneum and neutrophils in several skin diseases, where neutrophils accumulate beneath the stratum corneum in a sterile condition.     

The initial clinical experience of using Ovosorb antiprotease hemosorbent in the combined treatment of dermatoses]

The new antiprotease hemosorbent Ovosorb was tested during the performance of blood perfusion (BP) used as part of multimodality treatment of 11 patients. Of these, 2 presented with disseminated psoriasis, 3 with arthropathic psoriasis, 1 with psoriatic erythrodermia, 4 with atopic dermatitis, and 1 with recurrent urticaria. BP with the use of the hemosorbent Ovosorb produced the highest effect in patients with atopic dermatitis, psoriatic erythrodermia and recurrent urticaria; BP with Ovosorb was less effective in disseminated psoriasis. The clinical effect was lacking in patients with arthropathic psoriasis. Ovosorb possesses remarkable detoxifying properties, good blood compatibility; it does not provoke any complications in patients with different forms of psoriasis, atopic dermatitis, and urticaria.     

Priming-phenomenon of neutrophils in patients with Flexner infection]

AIM: To study reproducibility of priming phenomenon of neutrophils in patients with acute Flexner's dysentery and its realization manifestation. MATERIAL AND METHODS: A chemiluminescent response of peripheral blood neutrophils was studied in patients with acute mild and moderate dysentery in the presence of luminol. Lipopolysaccharide Salmonella typhimurium at a final concentration of 20 ng/ml served as a priming substance of S-chemotype. Neutrophils were stimulated with phorbol myristate acetate in concentration 10(-6) M and isolated on Histopaque double gradient (Sigma reagents, USA). RESULTS: In reproduction of priming-phenomenon in vitro on neutrophils of patients with acute Flexner's dysentery chemiluminescence amplitude increased 1.29-1.69-fold vs control. CONCLUSION: Priming-phenomenon on neutrophils in acute dysentery is reproducible. This confirms modulating properties of lipopolysaccharides in conditions of systemic nonphysiological endotoxinemia. Priming phenomenon may be involved in both maintenance of homeostasis and pathophysiological processes.     

The cytochemical determination of lysosomal cationic proteins in the blood neutrophils in hypertrophic cardiomyopathy]

Examinations of 33 patients with hypertrophic cardiomyopathy have revealed Stages I-II circulation insufficiency in 15. The findings were compared with those in 20 untrained normal subjects and 8 athletes. Lysosomal cationic protein levels were measured in polymorphonuclear leukocytes by the cytochemical method at rest, at the peak of dosed exercise (permanently increasing bicycle spiroergometry) and over the course of the recovery period--in 3, 12, and 24 h after exercise. The neutrophil distribution was also estimated by the staining intensity. Lysosomal cationic protein levels in hypertrophic cardiomyopathy patients with and without circulation insufficiency were changed to a different degree; these characteristics essentially varied in the patients, normal untrained subjects, and athletes. Changed levels of lysosomal cationic proteins appear to reflect the microcirculation disorders and the augmenting hypoxemia in the patients with circulation insufficiency, and thus may be used as a criterion to assess the clinical course of hypertrophic cardiomyopathy.     

肝硬化患者中性粒细胞吞噬及细胞内杀菌功能的研究

目的 :探讨肝硬化患者中性粒细胞吞噬和细胞内杀菌功能。方法 :采用普通酵母菌对 44例肝硬化患者及 3 8例正常人进行中性粒细胞吞噬和细胞内杀菌功能试验。结果 :3 8例正常人中性粒细胞吞噬率和杀伤率均值分别为 (2 3± 7) %和 (3 9± 3 ) % ,44例肝硬化患者中性粒细胞吞噬率和杀伤率分别为 (15± 5 ) %和 (3 0± 7) % ,明显低于正常对照组。 2 4例失代偿期肝硬化患者与 12例代偿期肝硬化患者 ,及 8例肝硬化合并肝癌患者与 3 6例肝硬化非合并肝癌患者中性粒细胞吞噬及杀伤功能均无明显差异。结论 :肝硬化患者中性粒细胞吞噬和杀伤功能明显减退     

Determination of the reactive luminol-dependent chemiluminescence of neutrophils]

Reactive luminol-dependent neutrophilic chemiluminescence was estimated in 25 children aged 4 to 14. No essential differences in spontaneous and induced chemiluminescence of venous and capillary blood samples diluted 1:100 were detected. Therefore both methods may be used.     

Synergistic interaction of josamycin with human neutrophils bactericidal function in vitro

Josamycin, a 16-membered ring macrolide is concentrated up to 20-fold in phagocytic cells compared with serum. We have studied the in-vitro interaction of this drug with human neutrophils (PMN) bactericidal function by using two strains resistant to this antibiotic, Pseudomonas aeruginosa and Klebsiella pneumoniae, and a sensitive one, Staphylococcus aureus 209P. It was shown that josamycin-pretreated adherent PMN displayed an increased phagocytic activity (about 30 to 40%) for S. aureus or K. pneumoniae, mainly due to the recruitment of an additional phagocytizing subset of PMN. Furthermore, the bacterial killing was enhanced in josamycin-treated PMN in a dose-dependent manner for K. pneumoniae (60-130% increase in the range of concentration 0.1-25 mg/l) and independently of the dose for S. aureus (about 425-460% increase for josamycin 0.1-10 mg/l). P. aeruginosa killing by whole blood was also significantly increased in the presence of 10 and 1 mg/l of josamycin. Other PMN functions were not much altered by josamycin except an enhancement of the formyl-methionyl-leucyl-phenylalanine-induced oxidative response. Chemotaxis was only increased by the presence of a high concentration (100 mg/l) of josamycin. These data suggest that the bactericidal synergy between PMN and josamycin could be related, partly at least, to a direct enhancing effect of josamycin on some PMN functions such as phagocytosis, chemotaxis and FMLP-induced chemiluminescence. On the other hand, alterations of bacteria, either inside the phagolysosome or in the extracellular medium, could lead to an enhanced susceptibility to the phagocytes' microbial mechanisms.