Autoimmuunitautien hoidon muuttuva kuva : Autoimmuunitaudit ovat yleistyneet ja lieventyneet, ja lääkehoidon kustannukset lisääntyneet

Teema : autoimmuunitaudi

Hydroksiklorokiini - vanhalla lääkkeellä on monitahoisia vaikutuksia

Vertaisarvioitu.Hydroksiklorokiinilla on todettu olevan immuunivastetta muuntavia ja tulehdusta estäviä, metabolisia, antitromboottisia, infektioita estäviä ja antineoplastisia vaikutuksia. Immuunivastetta muuntava teho sekä lääkkeen edulliset vaikutukset sydän- ja verisuonitauteihin ja niiden riskitekijöihin on osoitettu systeemisen lupus erythematosuksen (SLE) ja nivelreuman hoidossa. Hydroksiklorokiini vähentää SLE-potilaiden tromboottisia tapahtumia ja infektioita sekä ehkäisee pysyviä elinvaurioita ja parantaa elinajan odotetta. Vaikeammat haittavaikutukset, kuten retinopatia, neuromyopatia, kardiomyopatia ja sydämen johtumishäiriöt, ovat hyvin harvinaisia pitkäaikaiskäytössä suositelluilla annoksilla. Hydroksiklorokiinia voidaan käyttää myös primaarisen Sjögrenin oireyhtymän ja monien ihotautien hoidossa. Lääkkeen käyttö diabeteksen, sydän- ja verisuonitautien, infektioiden tai syöpien hoidossa on vielä kokeellista. Hydroksiklorokiini ei vähennä altistuneiden riskiä sairastua COVID-19-infektioon tai paranna tautiin sairastuneiden ennustetta.Peer reviewe

Niveltulehdusten diagnostiikka

English summar

Kalsiumpyrofosfaattikertymät aiheuttavat monenlaisia taudinkuvia

VertaisarvioituNivelrustoissa ja niveliä ympäröivissä rakenteissa esiintyvät kalsiumpyrofosfaatti (CPP) -kertymät ovat yleisiä iäkkäillä. Akuutissa artriitissa CPP-kiteet välittävät reumaattisen tulehduksen. Krooninen CPP-artropatia voi olla nivelrikon tai seronegatiivisen polyartriitin kaltainen. Tukirangan ja pehmytkudosten CPP-kertymät saattavat aiheuttaa yllättäviä taudinkuvia. Hoidossa voidaan käyttää tulehduskipulääkkeitä, kortikosteroideja, kolkisiinia, hydroksiklorokiinia, metotreksaattia ja interleukiini-1:n salpaajia.Peer reviewe

Alkaloid-Rich Crude Extracts, Fractions and Piperamide Alkaloids of Piper guineense Possess Promising Antibacterial Effects

Piper guineense is a food and medicinal plant commonly used to treat infectious diseases in West-African traditional medicine. In a bid to identify new antibacterial compounds due to bacterial resistance to antibiotics, twelve extracts of P. guineense fruits and leaves, obtained by sequential extraction, as well as the piperine and piperlongumine commercial compounds were evaluated for antibacterial activity against human pathogenic bacteria. HPLC-DAD and UHPLC/Q-TOF MS analysis were conducted to characterize and identify the compounds present in the extracts with promising antibacterial activity. The extracts, with the exception of the hot water decoctions and macerations, contained piperamide alkaloids as their main constituents. Piperine, dihydropiperine, piperylin, dihydropiperylin or piperlonguminine, dihydropiperlonguminine, wisanine, dihydrowisanine and derivatives of piperine and piperidine were identified in a hexane extract of the leaf. In addition, some new piperamide alkaloids were identified, such as a piperine and a piperidine alkaloid derivative and two unknown piperamide alkaloids. To the best of our knowledge, there are no piperamides reported in the literature with similar UV absorption maxima and masses. A piperamide alkaloid-rich hexane leaf extract recorded the lowest MIC of 19 mu g/mL against Sarcina sp. and gave promising growth inhibitory effects against S. aureus and E. aerogenes as well, inhibiting the growth of both bacteria with a MIC of 78 mu g/mL. Moreover, this is the first report of the antibacterial activity of P. guineense extracts against Sarcina sp. and E. aerogenes. Marked growth inhibition was also obtained for chloroform extracts of the leaves and fruits against P. aeruginosa with a MIC value of 78 mu g/mL. Piperine and piperlongumine were active against E. aerogenes, S. aureus, E. coli, S. enterica, P. mirabilis and B. cereus with MIC values ranging from 39-1250 mu g/mL. Notably, the water extracts, which were almost devoid of piperamide alkaloids, were not active against the bacterial strains. Our results demonstrate that P. guineense contains antibacterial alkaloids that could be relevant for the discovery of new natural antibiotics.Peer reviewe

Diversity and distribution of Finnish aphyllophoroid and heterobasidioid fungi (Basidiomycota) : An update

Biogeographical and ecological knowledge of aphyllophoroid fungi has increased substantially after the publication of the Finnish aphyllophoroid checklist. In this paper, we describe the occurrence and distributions of both aphyllophoroid and heterobasidioid fungi in Finland. We introduce 13 species new to Finland: Hyphoderma lapponicum, Mycostilla vermiformis, Proterochaete adusta, Pseudotomentella alobata, Pseudoxenasma verrucisporum, Sistotrema subtrigonospermum, Spiculogloea minuta, Tomentella botryoides, Tomentella neobourdotii, Tomentella subtestacea, Tomentella subpilosa, Tulasnella anguifera, and Tulasnella interrogans. Proterochaete and Pseudoxenasma are new genera to Finland. We also present the record of Caudicicola gracilis for only the second time globally. Furthermore, we present 115 new records (locations) of 53 rare or seldom collected species. In addition, we report 96 species considered new to a specific subzone of the boreal forest vegetation zone in Finland. The records contain notes on the substrata, and the ecology and distribution of nationally new species and are briefly discussed.Peer reviewe

Terminalia laxiflora and Terminalia brownii contain a broad spectrum of antimycobacterial compounds including ellagitannins, ellagic acid derivatives, triterpenes, fatty acids and fatty alcohols

AbstractEthnopharmacological relevance Terminalia laxiflora Engl. & Diels, (Sudanese Arabic name: Darout الدروت) and Terminalia brownii Fresen (Sudanese Arabic name: Alshaf ألشاف) (Combretaceae) are used in Sudanese traditional folk medicine and in other African countries for treatment of infectious diseases, TB and its symptoms, such as cough, bronchitis and chest pain. Aim of study Because of the frequent use of T. laxiflora and T. brownii in African traditional medicine and due to the absence of studies regarding their antimycobacterial potential there was a need to screen extracts of T. laxiflora and T. brownii for their growth inhibitory potential and to study the chemical composition and compounds in growth inhibitory extracts. Materials and methods The plant species were collected in Sudan (Blue Nile Forest, Ed Damazin Forestry areas) and selected according to their uses in traditional medicine for the treatment of bacterial infections, including TB. Eighty extracts and fractions of the stem bark, stem wood, roots, leaves and fruits of T. laxiflora and T. brownii and nine pure compounds present in the active extracts were screened against Mycobacterium smegmatis ATCC 14468 using agar diffusion and microplate dilution methods. Inhibition zones and MIC values were estimated and compared to rifampicin. HPLC-UV/DAD, GC/MS and UHPLC/Q-TOF MS were employed to identify the compounds in the growth inhibitory extracts. Results The roots of T. laxiflora and T. brownii gave the best antimycobacterial effects (IZ 22–27 mm) against Mycobacterium smegmatis. The lowest MIC of 625 µg/ml was observed for an acetone extract of the root of T. laxiflora followed by methanol and ethyl acetate extracts, both giving MIC values of 1250 µg/ml. Sephadex LH-20 column chromatography purification of T. brownii roots resulted in low MIC values of 62.5 µg/ml and 125 µg/ml for acetone and ethanol fractions, respectively, compared to 5000 µg/ml for the crude methanol extract. Methyl (S)-flavogallonate is suggested to be the main active compound in the Sephadex LH- 20 acetone fraction, while ellagic acid xyloside and methyl ellagic acid xyloside are suggested to give good antimycobacterial activity in the Sephadex LH-20 ethanol fraction. RP-18 TLC purifications of an ethyl acetate extract of T. laxiflora roots resulted in the enrichment of punicalagin in one of the fractions (Fr5). This fraction gave a five times smaller MIC (500 µg/ml) than the crude ethyl acetate extract (2500 µg/ml) and this improved activity is suggested to be mostly due to punicalagin. 1,18-octadec-9-ene-dioate, stigmast-4-en-3-one, 5α-stigmastan-3,6-dione, triacontanol, sitostenone and β-sitosterol were found in antimycobacterial hexane extracts of the stem bark of both studied species. Of these compounds, 1,18-octadec-9-ene-dioate, stigmast-4-en-3-one, 5α-stigmastan-3,6-dione, triacontanol, sitostenone have not been previously identified in T. brownii and T. laxiflora. Moreover, both plant species contained friedelin, betulinic acid, β-amyrine and two unknown oleanane-type triterpenoids. Of the listed compounds, friedelin, triacontanol and sitostenone gave a MIC of 250 µg/ml against M. smegmatis, whereas stigmasterol and β-sitosterol gave MIC values of 500 µg/ml. Conclusions Our results show that T. laxiflora and T. brownii contain antimycobacterial compounds of diverse polarities and support the traditional uses of various parts of T. laxiflora and T.brownii as decoctions for treatment of tuberculosis. Further investigations are warranted to explore additional (new) antimycobacterial compounds in the active extracts of T. laxiflora and T. brownii.Peer reviewe

Aphyllophoroid funga (Basidiomycota) of Finland : range extensions and records of nationally new and rare species

Knowledge of the Finnish aphyllophoroid funga has increased substantially in recent years. In this article, we present two species new to Finland: Spiculogloea subminuta Hauerslev and Typhula suecica I. Olariaga, G. Corriol, I. Salcedo & K. Hansen, and document Sistotrema luteoviride Kotir. & K.-H. Larss. for the third time globally. We also contribute 50 new records of 33 nationally rare species (with a maximum of ten previous records in Finland) and list 52 regionally new species, found for the first time in a certain subzone of the boreal vegetation zone in Finland. Each record is enclosed and contains notes on the substrate. Furthermore, the ecology of the nationally new species and the distribution of rare species are discussed

Polymorphisms in the tyrosine kinase 2 and interferon regulatory factor 5 genes are associated with systemic lupus erythematosus

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldSystemic lupus erythematosus (SLE) is a complex systemic autoimmune disease caused by both genetic and environmental factors. Genome scans in families with SLE point to multiple potential chromosomal regions that harbor SLE susceptibility genes, and association studies in different populations have suggested several susceptibility alleles for SLE. Increased production of type I interferon (IFN) and expression of IFN-inducible genes is commonly observed in SLE and may be pivotal in the molecular pathogenesis of the disease. We analyzed 44 single-nucleotide polymorphisms (SNPs) in 13 genes from the type I IFN pathway in 679 Swedish, Finnish, and Icelandic patients with SLE, in 798 unaffected family members, and in 438 unrelated control individuals for joint linkage and association with SLE. In two of the genes--the tyrosine kinase 2 (TYK2) and IFN regulatory factor 5 (IRF5) genes--we identified SNPs that displayed strong signals in joint analysis of linkage and association (unadjusted P<10(-7)) with SLE. TYK2 binds to the type I IFN receptor complex and IRF5 is a regulator of type I IFN gene expression. Thus, our results support a disease mechanism in SLE that involves key components of the type I IFN system