The Role of Eosinophils in Bullous Pemphigoid: A Developing Model of Eosinophil Pathogenicity in Mucocutaneous Disease

Bullous pemphigoid (BP) is an autoimmune blistering disease which carries a significant mortality and morbidity. While historically BP has been characterized as an IgG driven disease mediated by anti-BP180 and BP230 IgG autoantibodies, developments in recent years have further elucidated the role of eosinophils and IgE autoantibodies. In fact, eosinophil infiltration and eosinophilic spongiosis are prominent features in BP. Several observations support a pathogenic role of eosinophils in BP: IL-5, eotaxin, and eosinophil-colony stimulating factor are present in blister fluid; eosinophils line the dermo-epidermal junction (DEJ) in the presence of BP serum, metalloprotease-9 is released by eosinophils at the site of blisters; eosinophil degranulation proteins are found on the affected basement membrane zone as well as in serum corresponding with clinical disease; eosinophil extracellular DNA traps directed against the basement membrane zone are present, IL-5 activated eosinophils cause separation of the DEJ in the presence of BP serum; and eosinophils are the necessary cell required to drive anti-BP180 IgE mediated skin blistering. Still, it is likely that eosinophils contribute to the pathogenesis of BP in numerous other ways that have yet to be explored based on the known biology of eosinophils. We herein will review the role of eosinophils in BP and provide a framework for understanding eosinophil pathogenic mechanisms in mucocutaneous disease

Environmental conditions of premarital relationships and marriages and giving opinion in cases of marriage annulment in Bishop Court

Aim of the work: Analysis of the premarital relationship with consideration of individual factors of the prospective spouses, their level of social acceptance and their influence on the image and duration of the engagement period and marriage. Evaluation of the relation between social situation of the spouses and the breakdown of marriage. Material and method:  Material included 68 cases of marriage annulment, which were proceeded by the Bishop Court in years 2007-2012. Complete court records and psychiatric-forensic examinations of complainants and defendants were analyzed. Information was coded in specially developed questionnaire, through which in systematical way the data was collected, classified, the frequency of occurrence of chosen factors was cataloged and essential correlations between them were examined by means of statistical analysis. Conclusions: The course of engagement period and decision about betrothal did not have connection with the examined environmental factors. Duration of the marriage did not have any connection with chosen material-domestic and environmental factors. Majority of couples did not dispose of own accommodation what did not result from the material situation. The younger men and women were while contracting a marriage the longer was its duration. Among the analyzed group of marriages there is no data to recognize the environmental factors, which are commonly considered to be attributable to the occurrence of mental disorders. Etiology of the disorders should be researched by expert witnesses in other spheres

Immoderate dependence of the spouse on the family of origin as the source of inability to assume the essential obligations of marriage

This paper aims at discussing possible conditioning of the future bridegroom’s overdependence on his generational family. Theories analyzing family life identify few possible variants of how such dependence may occur. According to systems theory, the young man’s separation from the family is due not so much to his personal features but the whole dynamic structure of the family. Sometimes to retain homeostasis (maintain family structure), the family strives to keep the future bridegroom within the family. Family loyalty theory elaborates such a hypothesis. Attachment theories reach even deeper into the structures of human psyche, assuming that the model of adult interpersonal relations –that should be fully realized in marriage – depends on the patterns of childhood contacts with one’s parents or legal guardians. If the future bridegroom depends too much on his parents, he may find it difficult to fulfill his marital obligations. The paper proposes to focus on the family structure of the future bridegroom before the marriage is solemnized. Just then, with the help of the church and therapeutic institutions, such family can be diagnosed and actions undertaken toward autonomy and independence of the future spouse, while maintaining satisfactory relations with his generational family

Rozbieżności w ocenie nieważności małżeństwa z powodu choroby psychicznej w orzecznictwie sądów kościelnych i cywilnych – analiza przypadku

Il caso descritto riguarda due processi, svoltisi contemporaneamente in due tribunali – civile ed ecclesiastico – sull’annullamento di un matrimonio con una persona affetta da schizofrenia. Sulla base di questo esempio, vengono descritte le differenze procedurali, che derivano da diverse normative di legge vigenti nei tribunali vescovili e civili su tale materia, nonché le norme per la nomina dei periti psichiatri, e le differenti aspettative che ciascuno dei tribunali pone davanti a sé. Viene presentata la proposta di utilizzo, da parte dei periti e delle corti, del modello della cosiddetta rete sociale, che consente di effettuare un’analisi più completa e approfondita delle relazioni familiari, soprattutto nelle situazioni in cui uno dei coniugi è malato di mente

IL-17 Expression in Dermatitis Herpetiformis and Bullous Pemphigoid

Dermatitis herpetiformis (DH) and bullous pemphigoid (BP) are skin diseases associated with eosinophilic and neutrophilic infiltrations. Although cytokines are critical for the inflammatory process, there are single findings concerning concentration of IL-17 in bullous diseases. The goal of this study was to assess IL-17 expression in DH and BP patients. Skin biopsies were taken from 10 DH, 14 BP patients and from 10 healthy subjects. The localization and expression of IL-17 was studied by immunohistochemistry and the serum concentration was measured by immunoassays. Expression of IL-17 in the epidermis and in influxed cells in dermis was detected in skin biopsies. Expression of IL-17 was statistically higher in epidermis and infiltration cells in specimens from BP than from DH patients. Examined interleukin expression was detected in perilesional skin of all patients but it was much lower than in lesional skin. The expression of IL-17 was not observed in biopsies from healthy people. Serum level of IL-17 was statistically higher in BP and DH groups as compared to control group. Our results provide the evidence that IL-17 may play an essential role in activating and recruiting eosinophils and neutrophils, which ultimately contribute to the tissue damage in DH and BP