Postepy Dermatologii I Alergologii最新文献

Introduction: Chronic urticaria requires well-defined treatment strategies in order to achieve a maximum treatment response and maintain the quality of life. Since 2014, omalizumab has been used in chronic urticaria. However, many studies showed that some patients are resistant to omalizumab.

Aim: To determine the effects of single nucleotide changes in the FCER1A and FCER1B genes, which are thought to be related to resistance mechanisms, in our population of patients who have not responded to omalizumab treatment.

Material and methods: We included 100 patients with chronic urticaria who were treated with omalizumab and 50 healthy individuals. Frequently observed gene polymorphisms, FCER1A (rs2251746) and FCER1B (rs569108), were examined in peripheral blood samples. The regions of rs2251746 and rs569108 gene polymorphisms were amplified using fluorescently labelled probes through real-time polymerase chain reaction (PCR). The analysis was performed bioinformatically via the SNP genotype profiling program.

Results: There was no statistically significant relationship between FCER1A (rs2251746) and FCER1B (rs569108) gene polymorphisms in patients and their clinical, demographic characteristics, and the resistance to treatment (p > 0.05). In our study, the mean patient age was found to be higher in the CT group (44.71 ±12.5 years) compared to the TT group (37.34 ±11.5 years) only in the rs2251746 polymorphism (p < 0.05).

Conclusions: In our study, there was no significant relationship between FCER1A and FCER1B gene polymorphisms and resistance to omalizumab therapy. Further, multicentre, large-scale studies are needed to support our results.

Introduction: Lichen planopilaris (LPP) is an inflammatory, primary scarring alopecia, however its pathogenesis is not completely elucidated. S100A7 is a multifunctional, antimicrobial protein with proinflammatory properties. Interleukin-17 (IL-17) is implicated in the development of various autoimmune skin diseases.

Aim: To determine the tissue expression of S100A7, S100A4 and IL-17 in LPP.

Material and methods: The immunohistochemical analysis was performed on biopsy specimens obtained from individuals with histologically confirmed lichen planopilaris (n = 23), alopecia areata (AA) (n = 11), and healthy controls (n = 14). The expression was evaluated using Zeiss Axio Imager A2 light microscope.

Results: The number of cells showing S100A7 expression was significantly higher in LPP lesional skin compared to AA lesional skin (p = 0.0002) and normal skin of healthy controls (p < 0.0001). The number of cells showing IL-17 expression was significantly higher in LPP lesional skin compared to normal skin of healthy controls (p < 0.0001) and the number of cells showing IL-17 expression was significantly higher in AA lesional skin compared to normal skin of healthy controls (p < 0.0001). The number of cells showing IL-17 expression was not significantly different in LPP lesional skin and in AA lesional skin (p > 0.05). The number of cells showing S100A4 expression was not significantly different in LPP lesional skin, AA lesional skin and in normal skin of healthy controls.

Conclusions: The results of our study suggest the possible role of S100A7 and IL-17 in the pathogenesis of LPP.

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder affecting the pilosebaceous unit in intertriginous body areas, and recent research suggests an association with periodontitis.

Aim: To assess oral health-related quality of life (OHRQoL) in patients with HS diagnosed additionally with periodontitis and to compare it to patients with periodontitis alone.

Material and methods: The study involved 55 HS patients, with 25 in the HS + P group (both HS and periodontitis) and matched controls in the periodontitis-only group (P group). Outcomes were assessed using the Oral Health Impact Profile (OHIP-14) questionnaire.

Results: No significant difference was observed in the mean OHIP-14 total score between the HS + P group and the P group. Patients with HS + P were less likely to undergo the dental evaluation and floss their teeth less frequently compared to the P group.

Conclusions: The findings reveal that the coexistence of HS in patients with periodontitis does not significantly influence OHRQoL. Lower dental evaluation frequency and less frequent flossing in HS+P patients suggest reduced attention to oral health practices.

Component-resolved diagnostics enables the detection of allergen-specific immunoglobulins E (asIgE) to house dust mite (HDM) proteins, which may help clinicians to face the difficulties in diagnostics of HDM allergy. Currently, almost 40 proteins of Dermatophagoides species, that are able to bind asIgE, have been identified, and this number will certainly increase. The association between sensitisation to particular molecules and allergy symptoms is extensively studied. This investigation enables us to identify HDM molecules that promote respiratory, skin, or food allergies, and it could help us predict the possible course of allergic diseases. The individual repertoire of asIgE improves our understanding of immunological response, which underlies allergy symptoms, and helps to form individual therapeutic regimens. This review provides clinicians with information on Dermatophagoides pteronyssinus proteins available in commercial arrays, and their role in the diagnostics and management of HDM allergy.

Introduction: Many studies have shown significant alterations in the gut microbiome of patients with psoriasis compared to healthy controls.

Aim: The primary objective of the current research was to explore the impact of gut microbiome composition on the progression and severity of plaque psoriasis.

Material and methods: A total of 20 patients with moderate-to-severe psoriasis and 20 healthy individuals were recruited and provided a stool sample to assess the gut microbiome. After the samples were prepared according to the NGS library preparation workflow, they were sequenced using the Illumina platform and the report was generated that underwent statistical analysis.

Results: The microbiome profiles of psoriasis patients exhibited significant differences compared to healthy controls as evidenced by the statistical analysis of various bacterial genera, with the median abundance significantly lower in psoriasis patients compared to healthy controls (p = 0.033). The analysis of the Firmicutes-to-Bacteroidetes ratio, a commonly evaluated marker of dysbiosis, did not reach statistical significance (p = 0.239). However, there was a noticeable trend towards a higher median ratio in psoriasis patients compared to healthy controls. The ratio did not show significant associations with PASI or BSA but trends towards significance with DLQI (B = -12.11, p = 0.095).

Conclusions: Overall, the above findings underscore the importance of the gut microbiome in psoriasis and suggest that modulation of specific bacterial genera, especially that with significant differences, could be a potential strategy for therapeutic intervention. Targeting these depleted genera through microbiome-based interventions, such as probiotic supplementation or faecal microbiota transplantation, could potentially help to restore gut homeostasis and alleviate the inflammatory burden in psoriasis.

Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterised by recurrent painful nodules, abscesses, fistulas and scarring. The primary distinguishing factor in the complex, yet still not fully understood, pathogenesis is an inflammation occurring within the hair follicle, followed by an immune response leading to further development of the skin lesions seen in HS. The treatment of patients with HS is very difficult due to the complexity of the lesions and the frequent tendency to recurrence, which also has a negative impact on the psychological state of patients and directly translates into a reduced quality of life. This review article addresses the pathogenesis, clinical presentation of HS and, in particular, explores the new therapeutic options available.

Introduction: Vitiligo (VL) is associated with several autoimmune diseases, especially Hashimoto's thyroiditis, VL and concomitant Hashimoto's thyroiditis (HT) up to 34% in VL.

Aim: To assess the predictive value of serum inflammatory factors in guiding treatment response among patients with concurrent VL and concomitant HT.

Material and methods: This retrospective study enrolled 67 cases of VL and concomitant HT, and the patients according to treatment outcomes were divided into the unsatisfied group and the satisfied group. The serum thyroid parameters, autoimmune markers, and inflammatory factor levels were analysed and the correlation analysis of serum inflammatory factors was made.

Results: The study analysis of serum thyroid parameters showed elevated levels of thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroperoxidase (TPO), and thyroglobulin (Tg) (p < 0.05) in the group with unsatisfactory treatment response. Patients in the unsatisfied group exhibited elevated inflammatory factor levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), and interleukin-10 (IL-10) (p < 0.05) compared to their counterparts in the satisfied group. Correlation analysis showed that the levels of the above inflammatory factors were significantly negatively correlated with the treatment response.

Conclusions: CRP, TNF-α, IL-6, IL-8, IL-10 showed the strongest correlation with VL and concomitant HT, and serum inflammatory factors levels can predict treatment response in patients with VL and concomitant HT.

Introduction: The pathogenesis of atopic dermatitis (AD) involves complex interactions between environmental factors, the skin microbiome, epidermal barrier defects, and altered immune responses that develop on a not fully understood specific genetic background.

Aim: We aimed to evaluate the contribution of single nucleotide polymorphisms (SNPs) in the IL-35 genes (IL-12A and EBI3) towards AD susceptibility and clinical characteristics of AD in the Polish population. Two SNPs (rs568408, rs582054) in IL-12A and one SNP (rs428253) in EBI3 were selected.

Material and methods: Blood samples were collected from 202 AD patients and 178 healthy individuals. SNPs in IL-35 genes were analysed by the polymerase chain reaction with sequence-specific primers (SSP-PCR) method.

Results: For IL-12A rs568408, the AA genotype was significantly linked to increased odds of AD (OR = 34.61; 95% CI: 2.06-579.97, p = 0.0137) and marginally associated with normal total serum IgE levels (OR = 2.82; 95% CI: 0.97-8.16; p = 0.05), while the GA genotype showed significantly reduced odds of AD (OR = 0.53; 95% CI: 0.34-0.81; p = 0.0035). In the context of IL-12A rs582054, TT genotype carriers had increased odds of AD (OR = 2.05; 95% CI: 1.08-3.85; p = 0.03). Patients with the GG genotype of EBI3 rs428253 had decreased odds of high total serum IgE levels (OR = 0.42; 95% CI: 0.20-0.86; p = 0.02) and milder pruritus severity compared to CC genotype carriers (4.12 vs. 7.50; p = 0.02).

Conclusions: IL-35 genetic variations appear to play a role in AD pathogenesis.

Introduction: Cannabidiol (CBD) exhibits neuroprotective, anti-inflammatory, and immunomodulatory properties, making it a promising candidate for addressing inflammatory skin disorders like atopic dermatitis.

Aim: This study aimed to (i) investigate CBD's impact on lymphocyte proliferation and lymphocyte viability; (ii) assess in vitro cytotoxicity U937 cells (a human promonocytic cell line) of CBD/cytotoxicity of CBD on U937 cells; (iii) provide insights into CBD immunomodulatory potential, and (iv) evaluate suitability of CBD for treating inflammatory skin conditions.

Material and methods: To this aim PBMCs from healthy donors were cultured with mitogen and two different CBD doses (0.1 and 1 mg/ml), assessing B and T cell proliferation through flow cytometry. CBD inhibited mitogen-induced lymphocyte proliferation, reducing the percentage of proliferating T and B cells. Notably, both CBD doses did not exhibit cytotoxicity on lymphocytes as revealed by viability assessment. We also analysed the effect of CBD on U937 cells using an optical microscopy approach. Interestingly, the higher dose of CBD exerted a cytotoxic effect on U937 cells, while the lower dose was well tolerated.

Results: We analysed the effect of an adjuvant treatment for atopic dermatitis with a CBD-containing cleansing cream in reducing itch. Notably, the treatment with the CBD-containing cleansing cream significantly reduced itch in patients suffering from atopic dermatitis.

Conclusions: These findings affirm CBD's immunomodulatory characteristics, emphasizing its potential therapeutic application in inflammatory skin disorders.

Introduction: Tuberculosis is a communicable illness and one of the leading causes of death, especially in developing countries like Turkey. One of the problems that must be managed well in the treatment of tuberculosis is drug hypersensitivity. The first-line agents are very important for the success of treatment. Alternative drugs are more toxic and less successful in treatment. Therefore, it is very important to be able to include first-line drugs in the post-hypersensitivity regimen. At this point, the success of desensitization comes to the fore. There are fewer studies on rapid drug desensitization in delayed-type drug hypersensitivity to anti-tuberculosis drugs.

Aim: The primary aim of the study was to determine the prevalence of delayed-type hypersensitivity reactions in drug-sensitive cases; the secondary aim was to determine the appropriate treatment management.

Material and methods: This was a retrospective study. Demographic features, tuberculosis diagnostic indicator, clinical signs of developing a hypersensitivity reaction, reaction time, desensitization scheme and treatment were evaluated.

Results: A total of 41 tuberculosis cases were included in the study. Twenty-six of the cases were male; mean age (mean ± SD) 55.44 ±16.93 years; 70.7% of them were diagnosed bacteriologically; 70.7% of them were diagnosed with pulmonary tuberculosis. The most common skin finding was maculopapular drug eruption. The development time (mean ± SD) of the reaction in patients who developed a reaction was 34.93 ±39.62 days. The responsible agent could be identified in 15 reactions. The most common drug responsible for the reaction was rifampicin. Successful desensitization was achieved in 19 (46.3%) cases with the sensitive regimen. The duration of treatment was 8.97 ±3.44 months. When evaluated in terms of treatment results, cure and treatment completion were accepted as treatment success. In this case, 30 (73.2%) patients successfully completed the treatment.

Conclusions: Our study is one of the largest series in which delayed-type hypersensitivity develops under tuberculosis treatment and the desensitization scheme is recommended. A practical, easy desensitization scheme had been shared in this paper.