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Objective:To evaluate the clinical efficacy and safety of omalizumab in the treatment of chronic spontaneous urticaria (CSU) .Methods:Clinical data were collected from 60 patients, who were diagnosed with CSU and received subcutaneous injections of omalizumab at a dose of 300 mg once every 4 weeks for 3 sessions in Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from March 2020 to September 2020, and retrospectively analyzed. At weeks 0, 2, 4, 6, 8, 10 and 12, urticaria activity score over 7 days (UAS7) and chronic urticaria quality of life (CU-Q2oL) score were used to evaluate clinical symptoms and quality of life of patients. Changes in the use of other drugs were evaluated before and after the treatment with omalizumab. Paired t test was used to compare UAS7 or CU-Q2oL score before and after treatment. Results:All the 60 CSU patients received 12 weeks of omalizumab treatment. The baseline UAS7 score was 22.37 ± 8.88 points; after one session of the treatment, the UAS7 score dropped to 2.01 ± 5.13 points, reaching the treatment plateau; at week 12, it dropped to 0.6 ± 2.63 points, and 0 point (complete control) in 93.3% of the patients, 1-6 points (favorable control) in 3.3%; the time required for UAS7 score to decrease to 0 point was 22.4 ± 3.2 days. The baseline CU-Q2oL score was 34.10 ± 15.01 points; after one session of the treatment, the CU-Q2oL score dropped to 2.41 ± 7.18 points, reaching the treatment plateau; at week 12, it was 0.56 ± 2.90 points; the time required for CU-Q2oL score to drop to 0 point was 21.15 ± 16.02 days. After the combination treatment with omalizumab, a gradual decrease in dosage or withdrawal of previous therapeutic drugs was realized. At week 12, 39 patients (65%) achieved complete control, and withdrew all therapeutic drugs except omalizumab. During the treatment and follow-up, omalizumab showed good safety, and no adverse reactions were observed.Conclusion:Omalizumab at a dose of 300 mg once every 4 weeks is markedly effective and safe for the treatment of CSU, providing a new treatment option for CSU patients with poor response to traditional therapy.
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Objective:To investigate the incidence of and risk factors for osteoporosis in patients with pemphigus treated with systemic glucocorticoids, and to analyze the current status of prevention and treatment of osteoporosis.Methods:Clinical data were collected from 101 inpatients with pemphigus treated in Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from January 2014 to January 2019, and these patients were divided into osteoporosis group ( n= 21) and non-osteoporosis group ( n= 80) according to their bone mineral density (BMD) values. Correlations of osteoporosis with patients′ general information, treatment duration and cumulative dose of glucocorticoids, application of immunosuppressive agents, diabetes mellitus, hypertension, hyperlipidemia, smoking, outdoor activity and other factors were analyzed, and the application status of calcium supplements, vitamin D and bisphosphonates was also analyzed. Enumeration data were compared by using chi-square test, measurement data were compared by using t test, and multiple factors influencing osteoporosis were analyzed by using non-conditional Logistic regression analysis. Results:Logistic regression analysis showed that age ( P= 0.001, OR= 1.08, 95% CI: 1.03- 1.14) and cumulative dose of glucocorticoids ( P<0.001, OR= 1.72, 95% CI: 1.18- 2.52) were risk factors for the occurrence of osteoporosis, while outdoor activity ( P<0.001, OR= 0.04, 95% CI: 0.01- 0.21) was a protective factor. Moreover, 13 (61.9%) patients in the osteoporosis group and 16 (21.6%) patients in the non-osteoporosis group received combination treatment with calcium supplements, vitamin D and bisphosphonates. Conclusions:Pemphigus patients treated with systemic glucocorticoids are prone to develop osteoporosis. Older age, cumulative dose of glucocorticoids may be risk factors for osteoporosis in patients with pemphigus, while outdoor activity may be a protective factor. The prevention and treatment of osteoporosis in pemphigus patients are still not standardized.
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Objective To investigate the prevalence of and risk factors for glucocorticoid-induced diabetes mellitus (GDM) in patients with pemphigus or pemphigoid receiving glucocorticoid therapy.Methods This study included 68 hospitalized patients with pemphigus or pemphigoid receiving glucocorticoid therapy in the Institute of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College from December 2011 to January 2013.Comparisons were carried out between patients with GDM and those without regarding multiple parameters,including age,sex,body mass index (BMI),pathological type,initial dose and maximum daily dose of glucocorticoids,family history of diabetes mellitus,immunosuppressive treatment,etc.Independent samples t test was used for intergroup comparisons,Chi-square test and Fisher exact probability test for the analysis of count data,and a logistic regression model for the determination of risk factors.Results Among the 68 patients,26 (38.2％) developed GDM during glucocorticoid therapy.Univariate logistic regression analysis showed that the initial dose of glucocorticoids (P ＜ 0.05,OR 1.023,95％ CI 1.002-1.044),maximum daily dose of glucocorticoids(P ＜ 0.01,OR 1.037,95％ CI 1.013-1.062),duration of glucocorticoid treatment (P ＜ 0.05,OR 1.143,95％ CI 1.028-1.271),BMI (P ＜ 0.01,OR 1.265,95％ CI 1.080-1.481) and dexamethasone use (P ＜ 0.01,OR 6.0,95％ CI 1.887-19.076) were risk factors for GDM in these patients.Multivariate logistic regression analysis showed that BMI (P ＜ 0.05,OR 1.223,95％ CI 1.017-1.471) and maximum daily dose of glucocorticoids (P ＜ 0.05,OR 1.037,95％ CI 1.009-1.065) were independent risk factors for GDM.Conclusions In this study,38.2％ of the patients with pemphigus or pemphigoid developed GDM during glucocorticoid therapy.BMI and maximum daily dose of glucocorticoids seem to be independent risk factors for GDM.
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Objective To analyze the STK11 gene mutation in a sporadic Chinese Datient with Peutz Jeghers syndrome(PJS)so as to provide a basis for the genetic diagnosis and counseling of PJS.Methods Whole blood samples were obtained from a female patient with PJS,her parents and sister.as well as from 100 unrelated,normal individuals as control.Genomic DNA was extracted,and the whole coding region of STK11 gene was amplified by PCR followed by direct sequencing.Results Molecular analysis revealed a novel het-erozygous mutation C73S in the patient,which resulted from the substitution of thymine(T)for adenine(A) at codon 217 in exon 1 of STK11 gene.However, the novel mutation was not found in unaffected family mem-bers or unrelated controls.Conclusion A novel missense mutation C73S,which may contribute to the devel-opment of PJS,is found in the patient.
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Objective To investigate the mRNA expressions of IFN-gamma receptor and TNF-alpha receptor in peripheral blood mononuclear cells (PBMCs) of patients with psoriasis vulgaris and their role in the pathogenesis of psoriasis. Methods Fifty patients with psoriasis vulgaris (37 cases of active psoriasis and 13 cases of stable psoriasis) and 24 healthy human controls were included in this study. PBMCs were isolated from blood samples obtained from all patients and controls. The mRNA expressions of IFN-gamma receptor and TNF-aipha receptor in PBMCs were detected by RT-PCR. The disease severity in patients was evaluated by psoriasis area and severity index (PASI). Results The mRNA expressions of IFN-gamma receptor and TNF-alpha receptor were observed in the PBMCs of all subjects. The mRNA expression levels of IFN-gamma receptor were 0.72 ± 0.17 in healthy controls, 1.11 ± 0.55 in all patients with psoriasis, 1.13 ±0.57 in patients with active psoriasis and 1.03 ± 0.52 in patients with stable psoriasis, respectively. A signifi-cant increase was observed in the expression levels of IFN-gamma receptor mRNA in all psoriatic patients and in patients with active psoriasis compared with those in healthy controls (both P < 0.05), but there was no significant difference between the healthy controls and patients with stable psoriasis (P ＞ 0.05). The expres-sion levels of TNF-alpha receptor mRNA were 2.05 ± 1.34 in healthy controls, 2.70 ± 3.80 in all psoriatic patients, 2.90 ± 4.40 in patients with active psoriasis, 2.14 ± 1.05 in patients with stable psoriasis, respectively;there was no significant difference between psoriatic patients and healthy controls (P ＞ 0.05). However, no correlation was found between the mRNA expression of IFN-gamma receptor, that of TNF-alpha receptor,and disease severity in psoriatic patients. Conclusions The mRNA expression of IFN-gamma receptor in PBMCs is up-regulated in patients with psoriasis vulgaris, which is unrelated to the activity of psoriasis.
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Objective To assess the association between the amino acid polymorphism (Arg64Gln)within the interferon-γ receptor 2 gene (IFN-γR2) and psoriasis vulgaris in Chinese Hans. Methods Blood samples were collected from 182 patients with psoriasis vulgaris and 114 healthy human controls in Jiangsu and Anhui provinces. The amino acid polymorphism (Arg64Gin) within the IFN- γR2 was examined by PCR-restriction fragment length polymorphism (RFLP) and DNA sequencing. Results No significant difference was observed in the amino acid polymorphism (Arg64GIn) within the IFN-γR2 between the psoriatic patients and healthy controls (P > 0.05 ). There was a significant difference between patients with nail involvement and those without in the frequency of Gln64/Gln64 genotype (57.5% vs 38.1%, X~2= 5.33, P < 0.05),andArg64 (Gln64)allele [19.3% (80.7%)vs30% (70%), X~2=5.03, P < 0.05]. The frequencies of Gln64/Arg64 genotype and Gln64/Gln64 genotype in psoriatic patients with nail involvement significantly differed from those in the controls (29.8% vs 49.1%,X~2 = 5.48, P < 0.05; 57.5% vs 35.1%, X~2= 6.23, P <0.05 ), while no significant difference was found between the psoriatic patients without nail involvement and controls. Moreover, significant difference was noted between patients with prior upper respiratory tract infection (as inducements) and those without in the frequency of Arg64/Arg64 genotype (33.3% vs 15.5%, X~2 =4.94, P < 0.05) and Gln64 (Arg64) allele [51.9% (48.1%) vs 35.2% (64.8%), X~2= 5.46, P < 0.05]. Condusion The amino acid polymorphism (Arg64Gln) within the IFN-γR2 may be associated with the nail involvement and upper respiratory tract infection in patients with psoriasis vulgaris.
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The unicellular red alga, Porphyridium , can be artificially cultivated. Some of very useful bioactive substances such as phycobiliproteins? polyunsaturated fatty acids (PUFA) and sulfated polysaccharides, which are synthesize by Porphyridium , have promising applications. This paper deals with the study of the character, production and application of Porphyridium.