ABSTRACT
Objective To investigate the clinical features of primary Sj(o)gren syndrome (pSS) with interstitial lung disease (pSS-ILD) so as to raise the clinical diagnosis Level. Methods The clinical data were collected from 58 patients with pSS,who were admitted from March 2006 to March 2009. The patients were divided into ILD group (27 cases) and non-ILD group (31 cases). Rheumatoid factor(RF),C-reactive protein (CRP), protein electrophoresis and complement C3, C4 in serum were measured by immunoturbidimetric methods. Antinuclear antibodies (ANA) and anti-ENA antibodies were measured by indirect immunofluorescence technique and western blot. CA125 was detected by enzyme-linked immunosorbent assay and erythrocyte sedimentation rate (ESR) was detected by WS method. Pulmonaly function tests and radiology examination were performed. Results Compared with those in non-ILD group,the percentages of dry mouth,dry eye, rampant caries and velcro crackles were significantly higher in ILD group,anti-SSA antibody, ESR,CRP, CA125 and title of γ-gloulin was significantly higher in ILD group. In ILD group,diffusion dysfunction was 18 cases (66.7%),restricted ventilation dysfunction was 14 cases (51.9%),blocked ventilation dysfunction was 6 cases (22.2%), incorporated ventilation dysfunction was 8 cases(29.6%), forced vital capacity, forced expiratory volume in one second, maximum midexpiratory flow, DLCO were significantly lower in ILD group than those in non-ILD group (P ＜ 0.01). Moreover,high resolution computerized tomography (HRCT) was more sensitive than chest X-ray in the diagnosis of pSS-ILD.Conclusions The presence of pSS-ILD highly associates with the activity of pSS. Pulmonary diffusion ventilation function and HRCT play an important role in the diagnosis of pSS-ILD.
ABSTRACT
Objective To study the expressions of keratin 10, 14 and 17 (KI0, K14, K17) in psoriatic lesions before and after the treatment with acitretin. Methods Thirty patients with moderate or severe plaque psoriasis were included in this study. The cohort consisted of 19 males and 11 females with an average age of 33.9 years, and disease course of 4 months to 30 years. Patients were treated with acitretin for 8 weeks which started with an initial dose of 20 mg per day for 1 week, then switched to 0.5-0.75 mg per kilogramme of body weight per day until symptom improvement, finally maintained at a dose of 10-30 mg per day. The expression of K10, K14 and K17 was detected by immunohistochemical technique before and after treatment with acitretin. The relationship between the disease severity and levels of keratins was evaluated. Results Prior to the treatment, increased expression of K14 and K17 was observed in lesions of patients along with the decreased expression of K10 compared with the normal controls. After treatment, the expression of K14 and KI7 significantly decreased (both P < 0.01), while that of K10 increased (P < 0.01), and there was still a statistical difference between the patients and normal controls (P < 0.01). A significant decrease was observed in the PASI score of patients (P < 0.01). The changes in the expression levels of K10, K14 and KI7 before and after treatment were somewhat correlated with the clinical course and severity of psoriasis. Conclusions Systemic aeitretin can affect the expression of K10, K14 and K17 in psoriatic lesions, but the extent of changes in their expression is not always consistent with the improvement of clinical manifestations.