Trudności terapeutyczne u pacjenta z pęcherzycą liściastą

A case of 49-year old male, who manifested extensive, varied in size, erythematous skin lesions with shallow erosions, on trunk. A diagnosis of pemphigus foliaceus was stated upon clinical manifestations, direct immunofluorescence examination, indirect immunofluorescence examination and enzyme-linked immunosorbant assay for desmoglein 1 antibodies in serum. The patient was initially treated with prednisone and azathioprine, according to consensus of Polish Dermatological Society. After two weeks of treatment, the patient was hospitalized in surgery ward, due to escalated stomach-ache. In the ward, esophageal mycosis and inflammation of the mucuous membrane of the stomach were observed and considered as treatment’s complications. Due to adverse events observed, second line therapy was administered: cyclophosphamide and methylprednisolone (initially in pulses, than orally). Improvement in clinical manifestations was noted.Przedstawiono przypadek 49-letniego pacjenta z rozległymi, różnej wielkości zmianami skórnymi o charakterze ognisk rumieniowych z powierzchownymi nadżerkami, zlokalizowanymi głównie na tułowiu. Na podstawie obrazu klinicznego oraz badań immunofluorescencyjnych (bezpośredniego i pośredniego oraz immunoenzymatycznego) rozpoznano u chorego pęcherzycę liściastą. Początkowo zalecono leczenie zgodne z obowiązującym konsensusem Polskiego Towarzystwa Dermatologicznego (prednizon i azatiopryna). Z powodu nasilonego bólu brzucha po dwóch tygodniach leczenia pacjent był hospitalizowany na oddziale chirurgii, gdzie rozpoznano powikłania leczenia w postaci grzybicy przełyku i zapalenia błony śluzowej żołądka. Ze względu na obserwowane objawy niepożądane zmodyfikowano leczenie ogólne. Po zastosowaniu leczeniu drugiego rzutu (cyklofosfamid oraz metyloprednizolon, początkowo w pulsach, następnie doustnie) nastąpiła poprawa

Opryszczkowate zapalenie skóry o nietypowym obrazie klinicznym

A case of 33-year old female with dermatitis herpetiformis, who manifested vast, erythema-edematous skin lesions with peripheral vesicles feston and rosette -shaped like. Skin lesions developed after dapson was discontinued in therapy. A diagnosis of dermatitis herpetiformis was verified, as clinical manifestations were suggesting a diagnosis of linear IgA bullous dermatosis. Direct immunofluorescence examination revealed granular IgA deposits (+++) in the dermal papillae. This result supported a diagnosis of dermatitis herpetiformis and excluded a diagnosis of linear IgA bullous dermatosis.    Przedstawiono przypadek 33-letniej pacjentki chorującej na opryszczkowate zapalenie skóry, u której po wyłączeniu z leczenia dapsonu wystąpił masywny wysiew zmian rumieniowo-obrzękowych i pęcherzyków o obrączkowatym i festonowatym (rozetowatym) układzie. Ze względu na obraz kliniczny sugerujący rozpoznanie linijnej IgA dermatozy pęcherzowej zdecydowano o weryfikacji diagnozy. W badaniu metodą immunofluorescencji bezpośredniej stwierdzono ziarniste złogi IgA (+++) ułożone w szczytach brodawek skórnych, co wykluczyło rozpoznanie linijnej IgA dermatozy pęcherzowej, potwierdziło zaś diagnozę opryszczkowatego zapalenia skóry

Expression of Selected Integrins and Selectins in Bullous Pemphigoid

Blister development in bullous pemphigoid (BP) results from destruction of hemidesmosomes and basement membrane components within the dermoepidermal junction by autoantibodies. Adhesion molecules can take part in pathogenesis of this disease. The aim of the study was to determine the localization and expression of L- and E-selectins and β1, β3, and β4 integrins by immunohistochemistry in skin lesions of 21 patients with BP, compared with 10 healthy subjects. Expression of L and E selectins and β1, β3 integrins was detected mainly in basal keratinocytes and in inflammatory infiltrates in the dermis, expression of β4 integrin was irregular and was detected mainly in dermal part of the blister, while in the control group only weak and single expression of the examined molecules was detected in basal keratinocytes and endothelium cells. The obtained results reveal the important role of selected selectins and integrins in development of skin lesions in BP

Isolation and characterization of a copalyl diphosphate synthase gene promoter from Salvia miltiorrhiza

The promoter, 5' UTR, and 34-nt 5' fragments of protein encoding region of the Salvia miltiorrhiza copalyl diphosphate synthase gene were cloned and characterized. No tandem repeats, miRNA binding sites, or CpNpG islands were observed in the promoter, 5' UTR, or protein encoding fragments. The entire isolated promoter and 5' UTR is 2235 bp long and contains repetitions of many cis-active elements, recognized by homologous transcription factors, found in Arabidopsis thaliana and other plant species. A pyrimidine-rich fragment with only 6 non-pyrimidine bases was localized in the 33-nt stretch from nt 2185 to 2217 in the 5' UTR. The observed cis-active sequences are potential binding sites for trans-factors that could regulate spatio-temporal CPS gene expression in response to biotic and abiotic stress conditions. Obtained results are initially verified by in silico and co-expression studies based on A. thaliana microarray data.The quantitative RT-PCR analysis confirmed that the entire 2269-bp copalyl diphosphate synthase gene fragment has the promoter activity.Quantitative RT-PCR analysis was used to study changes in CPS promoter activity occurring in response to the application of four selected biotic and abiotic regulatory factors; auxin, gibberellin, salicylic acid, and high-salt concentration

Osoczowe stężenia frakcji adiponektyny u kobiet z chorobą Alzheimera

ABSTRACT Introduction Alzheimer’s disease (AD) is a progressive and irreversible neurodegenerative disease. Typical features of AD include memory loss, social dysfunction and physical impairment. Although the pathological findings in the central nervous system are well established, the etiological factors are poorly known. Recent studies suggested the role of metabolic disturbances in the development of AD neurodegeneration. Adiponectin, an anti-inflammatory and metabolism regulating factor, was linked to AD. Aim The aim was to examine whether adiponectin fractions combined with insulin/insulin resistance-associated metabolic parameters correlate with AD progression. Material and methods The study comprised 98 women: 27 with moderate to severe AD, 31 with AD at early stage and 40 healthy controls, matched for age and BMI. To evaluate memory impairment, the MMSE was performed. Plasma total adiponectin and its high-, medium- and low molecular weights were measured with ELISA. Anthropometric, clinical and metabolic parameters were assessed. Correlations between adiponectin array and measured parameters were evaluated. Results In comparison to the controls, enhanced levels of total and medium molecular weight adiponectin characterized AD individuals. In AD, we found correlations between adiponectin array, and anthropometric and biochemical parameters. After adjustment to BMI, a significant increase of the total adiponectin and high- and medium molecular weight fractions was observed. A negative correlation between low molecular weight adiponectin and MMSE was found. Conclusions Our results indicate a possible link between adiponectin variations and AD. We hypothesize that changes in adiponectin profile observed in AD result from compensatory mechanism against neuropathological processes, as well as from adiponectin homeostasis impairment.Introduction: Alzheimer’s disease (AD) is a progressive and irreversible neurodegenerative disease. Typical features of AD include memory loss, social dysfunction, and physical impairment. Although the pathological findings in the central nervous system are well established, the aetiological factors are poorly known. Recent studies suggested the role of metabolic disturbances in the development of AD neuro­degeneration. Adiponectin, an anti-inflammatory and metabolism regulating factor, was linked to AD. The aim was to examine whether adiponectin fractions combined with insulin/insulin resistance-associated metabolic parameters cor­relate with AD progression. Material and methods: The study comprised 98 women: 27 with moderate to severe AD, 31 with AD at early stage, and 40 healthy con­trols, matched for age and BMI. To evaluate memory impairment, the Mini-Mental State Examination (MMSE) was performed. Plasma total adiponectin and its high, medium, and low molecular weights were measured with ELISA. Anthropometric, clinical, and metabolic parameters were assessed. Correlations between adiponectin array and measured parameters were evaluated. Results: In comparison to the controls, enhanced levels of total and medium molecular weight adiponectin characterised AD individu­als. In AD, we found correlations between adiponectin array, and anthropometric and biochemical parameters. After adjustment to BMI, a significant increase of the total adiponectin and high and medium molecular weight fractions was observed. A negative correlation between low molecular weight adiponectin and MMSE was found. Conclusions: Our results indicate a possible link between adiponectin variations and AD. We hypothesise that changes in adiponectin profile observed in AD result from compensatory mechanisms against neuropathological processes, as well as from adiponectin homeo­stasis impairment

Predictors of aortic stenosis severity reclassification using an imaging data fusion method in patients referred for transcatheter aortic valve implantation

Background: The use of imaging data fusion method (IDFM) with multislice computed tomography (MSCT) and two-dimensional transthoracic echocardiography (2D-TTE) in patients with aortic stenosis (AS) may result in reclassification of AS severity from severe to non-severe. Aim: We sought to establish potential predictors of AS severity reclassification using the IDFM method. Methods: A total of 54 high-risk patients (mean age 79 ± 7.9 years; 40.7% male) with severe AS by 2D-TTE (indexed aortic valve area [AVAi] < 0.6 cm2/m2), referred for transcatheter aortic valve implantation, were included in the analysis. AVAi was subsequently recalculated using IDFM by replacing 2D-TTE left ventricular outflow tract (LVOT) measurements with MSCT LVOT parameters. Results: Imaging data fusion method reclassified 20.4% patients into the potentially non-severe AS group. In a multivariable model including clinical variables, reclassification to non-severe AS by IDFM was independently associated with younger age and diabetes mellitus (DM), (odds ratio [OR] 0.864; 95% confidence interval [CI] 0.76–0.99; p < 0.035 and OR 19.259; 95% CI 2.28–162.41; p < 0.007, respectively). In a multivariable analysis of echocardiographic variables, reclassification was associ­ated with higher LVOT velocity time integral and lower aortic mean gradient (OR 1.402; 95% CI 1.07–1.84; p < 0.014 and OR 0.858; 95%: CI 0.760–0.968; p < 0.013, respectively). In addition, 24.1% of patients were reallocated from low-flow (< 35 mL/m2) to normal-flow AS. Conclusions: Imaging data fusion method reclassified a substantial proportion of patients with severe AS into a potentially moderate AS group and from a low-flow to a normal-flow AS group. Such regrouping calls for increased diagnostic prudence in AS patients, especially those with specific clinical and echocardiographic predictors of reclassification, such as DM or low aortic mean gradient

Ozonation of Whole Blood Results in an Increased Release of Microparticles from Blood Cells.

Autohemotherapy with ozonated blood is used in the treatment of a broad spectrum of clinical disorders. Ozone demonstrates strong oxidizing properties and causes damage to cell membranes. The impact of whole-blood ozonation on the release of microparticles from blood and endothelial cells and the concentration of selected markers in the hemostatic system (APTT, PT, D-dimer, fibrinogen) were investigated. Venous blood, obtained from 19 healthy men, was split into four equal parts and treated with air, 15 µg/mL ozone, or 30 µg/mL ozone, or left untreated. The number and types of microparticles released were determined using flow cytometry on the basis of surface antigen expression: erythrocyte-derived microparticles (CD235+), platelet-derived microparticles (CD42+), leukocyte-derived microparticles (CD45+), and endothelial-derived microparticles (CD144+). The study is the first to demonstrate that ozone induces a statistically significant increase in the number of microparticles derived from blood and endothelial cells. Although statistically significant, the changes in some coagulation factors were somewhat mild and did not exceed normal values

Therapeutic Approach in Pigmented Purpuric Dermatoses—A Scoping Review

Pigmented purpuric dermatoses (PPD) encompass a group of chronic skin conditions characterized by the presence of petechiae, purpura, and pigmentation changes. While generally benign, these dermatoses can be persistent and aesthetically bothersome. Key clinical features include red to brownish patches with a distinctive “cayenne pepper” appearance, predominantly localized on the lower extremities, particularly the shins. Subtypes include Schamberg disease, Majocchi’s disease, Gougerot–Blum disease, Ducas and Kapetanakis pigmented purpura, and lichen aureus. Diagnosis relies primarily on clinical evaluation of skin lesions, with biopsy as a confirmatory tool. Although the exact cause of PPD remains unclear, capillary fragility and red blood cell extravasation are implicated. Treatment strategies for PPD aim to alleviate symptoms, considering the generally benign and chronic nature of the condition. As there is no standardized treatment, various methods with varying efficacy are employed. After searching SCOPUS and PubMed databases, we assessed 42 original articles to present current knowledge regarding therapy of PPD. This review will compare treatment approaches specifically in Schamberg disease and other manifestations of pigmented purpuric dermatoses