Photophysical basis of chemiluminescent labeling–a modern medical diagnostic tool

Increasing exposition of people on the factors which negatively affect health lead to the escalation in the incidence of many diseases. In the same time, this phenomenon causes the intensification in research focusing on new therapeutics but, on the other hand, the development of new diagnostic methods is also essential to facilitate the detection of infections in a human organism. One of the promising immunological diagnostic procedure is the chemiluminescent labeling. The high sensitivity of the method and ease of labeling enables the detection of even trace amounts (femtomole level (10–15 M)) of both extra- and intracorporeal macromolecules, among others, antibodies, antigens, enzymes, hormones, fragments of nucleic acids, pesticides, or antibiotics. The molecules which are capable of efficient chemiluminescence – chemiluminogens – are of crucial importance in the chemiluminescent labels enabling the content determination for the tested biomolecules. These chemiluminogens are subjected to the chemical reaction giving the electron-excited product, which subsequently while returning to the ground state generates the electromagnetic radiation. The chemiluminogens can be both organic and inorganic compounds. In case of the first group, the chemiluminescence process occurs mostly in the liquid phase (chemiluminescence of luminol or acridinium derivatives). However, in case of the second group the chemiluminescence occurs in the gas phase (for example, oxidation of the phosphorus vapour with the atomic oxygen). In the medical, chemical, or environmental analytics the procedures for the determination of macromolecules level, for example, α-fetoproteins, β-d-galactosidase, glucose-6-phosphate dehydrogenase, TSH, FT4, or anti-HIV antibodies, are utilised with chemiluminescent labels mainly based on the acridinium ester derivatives. The present article describes the photophysical aspects of the chemiluminescence phenomenon and one of the most rapidly developing tool for the immunological diagnostics – chemiluminescent labeling. Additionally, the present publication addresses the utilisation of the chemiluminometric methods and the perspectives to expand applications for these methods in the biological and environmental systems within the field of materials technology or biotechnology

Drug Persistence of Biologic Treatments in Psoriasis : A Swedish National Population Study

Introduction Biologic treatments for psoriasis are commonly switched. Treatment persistence represents an important parameter related to long-term therapeutic performance. The objective of the study was to analyse the real-world persistence with biologics over time in the treatment of psoriasis. Methods A retrospective observational study of adults with psoriasis was conducted based on Swedish national registry data from 2010 to 2018. Patients included were treated with a biologic between 2010 and 2018. Treatment episodes were identified from the drugs date of dispensation recorded in the Prescribed Drug Register to the end of supply of the drug. Median persistence was estimated by Kaplan-Meier survival curves for patients who received adalimumab, etanercept, secukinumab, ustekinumab and ixekizumab. Descriptive analysis of change in persistence over time for 3-year running cohorts was also carried out. Results A total of 2292 patients were analysed. Patients who received ustekinumab had the longest median persistence [49.3 months, 95% confidence interval (CI) 38.0-59.1] and etanercept the shortest (16.3 months, 95% CI 14.5-19.0). Median persistence was longer in biologic-naive than biologic-exposed patients. Persistence for ustekinumab decreased by almost 50% over the study period, from a median of 62.3 (95% CI 45.6-infinity) months in 2010-2011 to 32.7 (21.2-49.3) months in 2014-2016. Conclusions Persistence with biologics was, on average, relatively low, given the chronic nature of psoriasis. Changes in persistence over time seemed to be attributable to changes in the therapeutic landscape, providing patients with more options to switch biologic treatments if their current management was considered suboptimal.Funding Agencies|LEO Pharma A/SLEO Pharma</p