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1.
Braz. j. med. biol. res ; 53(12): e10109, 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1132504

ABSTRACT

Psoriasis is a chronic inflammatory skin disorder in humans, and the inflammatory reaction plays an important role in development and onset of psoriasis. 4'-O-β-D-glucosyl-5-O-methylvisamminol (4GMV) is one of the major active chromones isolated from Saposhnikoviae divaricata (Turcz.) Schischk, which has been reported to exhibit excellent anti-inflammatory activities. However, the possible therapeutic effect on psoriasis and underlying mechanism has not been reported. Thus, the aim of this study was to investigate the protective effect of 4GMV on the imiquimod (IMQ)-induced psoriasis-like lesions in BALB/c mice and the anti-inflammatory effect on the lipopolysaccharide (LPS)-induced inflammation in RAW264.7 macrophages. The results demonstrated that 4GMV decreased IMQ-induced keratinocyte proliferation and inflammatory cell infiltration. Moreover, 4GMV treatment significantly inhibited the production of NO, PEG 2, and cytokines such as interleukin (IL)-1β, IL-6, interferon (IFN)-γ, and IL-22 in LPS-stimulated RAW264.7 macrophages. 4GMV also suppressed the LPS-upregulated protein expressions of iNOS and COX-2 in a dose-dependent manner. Furthermore, qRT-PCR analysis showed that 4GMV down-regulated the mRNA level of IL-1β and IL-6 expression. Further studies by western blot indicated that 4GMV inhibited the activation of upstream mediator NF-κB by suppressing the expression of TLR4 and the phosphorylation of IκBα and p65. The phosphorylation of JNK, p38, and ERK were also markedly reversed by 4GMV in LPS-treated RAW264.7 macrophages. Taken together, these results demonstrated that 4GMV showed a protective effect in IMQ-induced psoriasis-like mice and inhibited inflammation through the NF-κB and MAPK signaling pathways, indicating that 4GMV might be a potential therapeutic drug for psoriasis.


Subject(s)
Animals , Rabbits , Psoriasis/chemically induced , Psoriasis/drug therapy , Dermatitis , Lipopolysaccharides , Cytokines , NF-kappa B , Chromones , MAP Kinase Signaling System , Imiquimod , Glucosides , Inflammation , Mice, Inbred BALB C
2.
Einstein (Säo Paulo) ; 18: eRC5522, 2020.
Article in English | LILACS | ID: biblio-1142879

ABSTRACT

ABSTRACT We report a case of a 61-years-old woman in remission of psoriasis for 20 years. She presented recurrence of psoriasis in the form of plaques few days after taking L-methylfolate 15mg/day. The L-methylfolate was prescribed as an adjuvant for the treatment of depression in a patient with the methylenetetrahydrofolate reductase gene polymorphism (MTHFR).


RESUMO Paciente do sexo feminino, 61 anos, em remissão da psoríase por 20 anos. Apresentou recidiva de psoríase em forma de placas poucos dias após início de tratamento L-metilfolato na dose diária de 15mg. O L-metilfolato foi prescrito como terapêutica coadjuvante para tratamento de depressão em paciente portadora do polimorfismo do gene metilenotetrahidrofolato redutase.


Subject(s)
Humans , Female , Psoriasis/chemically induced , Quality of Life , Tetrahydrofolates/administration & dosage , Methylenetetrahydrofolate Reductase (NADPH2)/deficiency , Depression/drug therapy , Homocystinuria/complications , Muscle Spasticity/complications , Polymorphism, Genetic , Psychotic Disorders/complications , Recurrence , Tetrahydrofolates/therapeutic use , Treatment Outcome , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Middle Aged
3.
Biol. Res ; 53: 48, 2020. graf
Article in English | LILACS | ID: biblio-1142415

ABSTRACT

BACKGROUND: Psoriasis is a common chronic inflammatory skin disease. Keratinocytes hyperproliferation and excessive inflammatory response contribute to psoriasis pathogenesis. The agents able to attenuate keratinocytes hyper-proliferation and excessive inflammatory response are considered to be potentially useful for psoriasis treatment. Daphnetin exhibits broad bioactivities including anti-proliferation and anti-inflammatory. This study aims to evaluate the anti-psoriatic potential of daphnetin in vitro and in vivo, and explore underlying mechanisms. METHODS: HaCaT keratinocytes was stimulated with the mixture of IL-17A, IL-22, oncostatin M, IL-1α, and TNF-α (M5) to establish psoriatic keratinocyte model in vitro. Cell viability was measured using Cell Counting Kit-8 (CCK-8). Quantitative Real-Time PCR (qRT-PCR) was performed to measure the mRNA levels of hyperproliferative marker gene keratin 6 (KRT6), differentiation marker gene keratin 1 (KRT1) and inflammatory factors IL-1ß, IL-6, IL-8, TNF-α, IL-23A and MCP-1. Western blotting was used to detect the protein levels of p65 and p-p65. Indirect immunofluorescence assay (IFA) was carried out to detect p65 nuclear translocation. Imiquimod (IMQ) was used to construct psoriasis-like mouse model. Psoriasis severity (erythema, scaling) was scored based on Psoriasis Area Severity Index (PASI). Hematoxylin and eosin (H&E) staining was performed to examine histological change in skin lesion. The expression of inflammatory factors including IL-6, TNF-α, IL-23A and IL-17A in skin lesion was measured by qRT-PCR. RESULTS: Daphnetin attenuated M5-induced hyperproliferation in HaCaT keratinocytes. M5 stimulation significantly upregulated mRNA levels of IL-1ß, IL-6, IL-8, TNF-α, IL-23A and MCP-1. However, daphnetin treatment partially attenuated the upregulation of those inflammatory cytokines. Daphnetin was found to be able to inhibit p65 phosphorylation and nuclear translocation in HaCaT keratinocytes. In addition, daphnetin significantly ameliorate the severity of skin lesion (erythema, scaling and epidermal thickness, inflammatory cell infiltration) in IMQ-induced psoriasis-like mouse model. Daphnetin treatment attenuated IMQ-induced upregulation of inflammatory cytokines including IL-6, IL-23A and IL-17A in skin lesion of mice. CONCLUSIONS: Daphnetin was able to attenuate proliferation and inflammatory response induced by M5 in HaCaT keratinocytes through suppression of NF-κB signaling pathway. Daphnetin could ameliorate the severity of skin lesion and improve inflammation status in IMQ-induced psoriasis-like mouse model. Daphnetin could be an attractive candidate for future development as an anti-psoriatic agent.


Subject(s)
Humans , Animals , Mice , Rabbits , Psoriasis/chemically induced , Psoriasis/drug therapy , Umbelliferones/pharmacology , Adjuvants, Immunologic/adverse effects , Imiquimod/adverse effects , Inflammation/drug therapy , Anti-Inflammatory Agents/pharmacology , Keratinocytes , Cell Proliferation , Mice, Inbred BALB C
4.
An. bras. dermatol ; 91(5,supl.1): 137-139, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837917

ABSTRACT

Abstract The use of tumor necrosis factor antagonists (anti-TNF) has become a usual practice to treat various inflammatory diseases. Although indicated for the treatment of psoriasis, anti-TNF may paradoxically trigger a psoriasiform condition. We present a case of a female patient who, during the use of infliximab for rheumatoid arthritis, developed psoriasis. In an attempt to switch anti-TNF class, we observed a cumulative worsening of the lesions requiring suspension of the immunobiological agent and the introduction of other drugs for clinical control. The therapeutic challenge of this paradoxical form of psoriasis is the focus of our discussion. The use of another anti-TNF in these patients is a matter of debate among experts.


Subject(s)
Humans , Female , Adult , Arthritis, Rheumatoid/drug therapy , Psoriasis/chemically induced , Psoriasis/pathology , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Antirheumatic Agents/adverse effects , Infliximab/adverse effects , Skin/pathology , Adalimumab/adverse effects
5.
An. bras. dermatol ; 90(4): 557-560, July-Aug. 2015. ilus
Article in English | LILACS | ID: lil-759218

ABSTRACT

AbstractSevere cutaneous drug reactions include a wide spectrum of clinical manifestations ranging from mild morbilliform cutaneous rash, to severe forms of hypersensitivity. Special attention is given in this report to the acute generalized exanthematous pustulosis (AGEP), induced in 90% of cases by the use of systemic drugs, especially aminopenicillins and macrolides. The incidence of the disease is low, 1-5 cases per million patients / year. The main differential diagnosis is Von Zumbusch's Pustular Psoriasis. The prognosis is generally good and the disease self limited, after withdrawal of the triggering drug. In this report the authors describe a case of AGEP, triggered by ceftriaxone in a patient with psoriasis vulgaris.


Subject(s)
Aged , Humans , Male , Acute Generalized Exanthematous Pustulosis/etiology , Acute Generalized Exanthematous Pustulosis/pathology , Anti-Bacterial Agents/adverse effects , Ceftriaxone/adverse effects , Psoriasis/pathology , Biopsy , Diagnosis, Differential , Psoriasis/chemically induced
6.
An. bras. dermatol ; 90(3,supl.1): 197-199, May-June 2015. ilus
Article in English | LILACS | ID: lil-755757

ABSTRACT

Abstract

Lithium has been implicated in the exacerbation of pre-existing psoriasis, in the induction of psoriasis on previously uninvolved skin of psoriasis patients, and in the triggering of psoriasis for the first time in patients without a personal or family history. Lithium-induced psoriasis (and its resistance to treatment) is one of the major reasons for noncompliance in patients treated with lithium. We describe a male patient who developed generalized ostraceous psoriasis whose clinical appearance mimicked dermatitis neglecta, 10 months after starting therapy with lithium.

.


Subject(s)
Adult , Humans , Male , Dermatitis/pathology , Psoriasis/pathology , Biopsy , Diagnosis, Differential , Dermatologic Agents/therapeutic use , Drug Eruptions/etiology , Drug Eruptions/pathology , Lithium/adverse effects , Methotrexate/therapeutic use , Psoriasis/chemically induced , Skin/pathology , Treatment Outcome
7.
An. bras. dermatol ; 90(2): 232-235, Mar-Apr/2015. graf
Article in English | LILACS | ID: lil-741064

ABSTRACT

Biologic drugs represent a substantial progress in the treatment of chronic inflammatory immunologic diseases. However, its crescent use has revealed seldom reported or unknown adverse reactions, mainly associated with anti-tumor necrosis factor (anti-TNF). Psoriasiform cutaneous reactions and few cases of alopecia can occur in some patients while taking these drugs. Two cases of alopecia were reported after anti-TNF therapy. Both also developed psoriasiform lesions on the body. This is the second report about a new entity described as 'anti-TNF therapy-related alopecia', which combines clinical and histopathological features of both alopecia areata and psoriatic alopecia. The recognition of these effects by specialists is essential for the proper management and guidance of these patients.


Subject(s)
Adolescent , Adult , Female , Humans , Male , Alopecia/chemically induced , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Antibodies, Monoclonal/adverse effects , Crohn Disease/drug therapy , Psoriasis/chemically induced , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Alopecia/pathology , Dermoscopy , Drug Eruptions , Infliximab , Psoriasis/pathology , Scalp/pathology
9.
Indian J Dermatol Venereol Leprol ; 2014 May-Jun; 80(3): 204-213
Article in English | IMSEAR | ID: sea-154794

ABSTRACT

Psoriasis is a multifactorial chronic inflammatory disease. Research into the pathogenesis of this disease is hindered by the lack of a proper animal model. Over the past two decades, many scientists were involved in the development of animal models that nearly mirror the immunopathogenesis of psoriasis. One such model, which has opened doors to the study of molecular complexities of psoriasis as well as its treatment, is the severe combined immunodeficiency (SCID) mouse-human skin chimera model. This model not only mirrors the clinical and histopathological features of psoriasis but also help in the study of cell proliferation, angiogenesis, function of T cells, neurogenic inflammation and cytokines involved in inflammatory reactions. In this article, we have reviewed the prospects and the limitations of the SCID mouse model of psoriasis.


Subject(s)
Animals , Disease Models, Animal , Heterografts , Humans , Mice, SCID , Psoriasis/chemically induced , Psoriasis/pathology , Psoriasis/therapy , Skin Transplantation
11.
Indian J Dermatol Venereol Leprol ; 2013 Jul; 79(Suppl_7):s35-s46
Article in English | IMSEAR | ID: sea-154745

ABSTRACT

As elevated levels of tumor necrosis factor-alpha (TNF-α) are associated with disease severity in psoriasis and psoriatic arthritis, TNF-α antagonists are being used to treat moderate to severe disease in patients who have contraindications, fail to respond or develop side effects to conventional systemic therapies. It is of utmost importance to be well versed with the possible adverse effects and contraindications of TNF-α antagonists so that they can be used effectively and safely. Many of their adverse effects have been well studied in patients of rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) and may not be completely applicable in psoriasis. This is because patients with RA and IBD are on multiple immunosuppressants while those with psoriasis are mostly receiving single systemic therapy and often have comorbidities that distinguish them from those with RA or IBD. Also, some of the side effects are still controversial and debated. Long-term prospective randomized controlled studies are needed to better understand the associated risk in patients of psoriasis. Baseline screening and periodic monitoring during treatment can reduce and help in early identification and appropriate management of the adverse outcomes. This article reviews the side effects known to be associated with TNF-α antagonists, their pathomechanisms and management guidelines. Some of the common side effects include infusion and injection site reactions, infections particularly reactivation of tuberculosis, autoantibody formation and drug induced lupus erythematosus, liver function abnormalities, hematological, and solid organ malignancies.


Subject(s)
Abnormalities, Drug-Induced/etiology , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized/adverse effects , Drug Hypersensitivity/etiology , Drug Hypersensitivity/therapy , Humans , Immunoglobulin G/adverse effects , Injections/adverse effects , Latent Tuberculosis/chemically induced , Latent Tuberculosis/drug therapy , Liver/drug effects , Liver/physiopathology , Neoplasms/chemically induced , Nervous System Diseases/chemically induced , Psoriasis/chemically induced , Receptors, Tumor Necrosis Factor , Thrombocytopenia/chemically induced , Thromboembolism/chemically induced , Tumor Necrosis Factor-alpha/antagonists & inhibitors
12.
Indian J Dermatol Venereol Leprol ; 2013 July; 79 Suppl(): S35-46
Article in English | IMSEAR | ID: sea-147530

ABSTRACT

As elevated levels of tumor necrosis factor-alpha (TNF-α) are associated with disease severity in psoriasis and psoriatic arthritis, TNF-α antagonists are being used to treat moderate to severe disease in patients who have contraindications, fail to respond or develop side effects to conventional systemic therapies. It is of utmost importance to be well versed with the possible adverse effects and contraindications of TNF-α antagonists so that they can be used effectively and safely. Many of their adverse effects have been well studied in patients of rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) and may not be completely applicable in psoriasis. This is because patients with RA and IBD are on multiple immunosuppressants while those with psoriasis are mostly receiving single systemic therapy and often have comorbidities that distinguish them from those with RA or IBD. Also, some of the side effects are still controversial and debated. Long-term prospective randomized controlled studies are needed to better understand the associated risk in patients of psoriasis. Baseline screening and periodic monitoring during treatment can reduce and help in early identification and appropriate management of the adverse outcomes. This article reviews the side effects known to be associated with TNF-α antagonists, their pathomechanisms and management guidelines. Some of the common side effects include infusion and injection site reactions, infections particularly reactivation of tuberculosis, autoantibody formation and drug induced lupus erythematosus, liver function abnormalities, hematological, and solid organ malignancies.


Subject(s)
Abnormalities, Drug-Induced/etiology , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized/adverse effects , Drug Hypersensitivity/etiology , Drug Hypersensitivity/therapy , Humans , Immunoglobulin G/adverse effects , Injections/adverse effects , Latent Tuberculosis/chemically induced , Latent Tuberculosis/drug therapy , Liver/drug effects , Liver/physiopathology , Neoplasms/chemically induced , Nervous System Diseases/chemically induced , Psoriasis/chemically induced , Receptors, Tumor Necrosis Factor , Thrombocytopenia/chemically induced , Thromboembolism/chemically induced , Tumor Necrosis Factor-alpha/antagonists & inhibitors
13.
Arq. gastroenterol ; 49(2): 172-176, Apr.-June 2012. tab
Article in English | LILACS | ID: lil-640180

ABSTRACT

CONTEXT: Several paradoxical cases of infliximab-induced or-exacerbated psoriatic lesions have been described in the recent years. There is disagreement regarding the need to discontinue infliximab in order to achieve the resolution of these adverse cutaneous reactions specifically in inflammatory bowel disease (IBD) patients. OBJECTIVE: To systematically review the literature to collect information on IBD patients that showed this adverse cutaneous reaction, focusing mainly on the therapeutic approach. METHODS: A systematic literature review was performed utilizing Medline, Embase, SciELO and Lilacs databases. Published studies were identified, reviewed and the data were extracted. RESULTS: Thirty-four studies (69 IBD patients) met inclusion criteria for review. There was inconsistency in reporting of some clinical and therapeutic aspects. Most patients included had Crohn's disease (89.86%), was female (47.83%), had an average age of 27.11 years, and no reported history of psoriasis (84.05%). The patients developed primarily plaque-type psoriasis (40.58%). There was complete remission of psoriatic lesions in 86.96% of IBD patients, existing differences in the therapeutic approaches; cessation of infliximab therapy led to resolution in 47.83% of cases and 43.48% of patients were able to continue infliximab therapy. CONCLUSION: As increasing numbers of IBD patients with psoriasis induced or exacerbated by infliximab, physicians should be aware of its clinical manifestations so that appropriate diagnosis and treatment are properly established. The decision whether to continue or discontinue infliximab should be individualized.


CONTEXTO: Inúmeros casos paradoxais de lesões psoriásicas induzidas ou exacerbadas por infliximabe têm sido descritos nos últimos anos, existindo discordância quanto à necessidade de interromper o infliximabe, para se conseguir a resolução destas reações adversas cutâneas especificamente em pacientes com doença inflamatória intestinal (DII). OBJETIVO: Revisar sistematicamente a literatura para coletar informações sobre pacientes com DII, que apresentaram essa reação adversa cutânea, focando principalmente na abordagem terapêutica. MÉTODOS: Uma revisão sistemática da literatura foi realizada utilizando as bases de dados Medline, Embase, SciELO e Lilacs. Os estudos publicados foram identificados, analisados †e os dados extraídos. RESULTADOS: Trinta e quatro estudos (69 pacientes com DII) preencheram os critérios de inclusão para a revisão, existindo inconsistência no relato de alguns aspectos clínicos e terapêuticos. A maioria dos pacientes incluídos tinha doença de Crohn (89,86%), era do sexo feminino (47,83%), tinha idade média de 27,11 anos, e sem antecedentes de psoríase (84,05%). Os pacientes desenvolveram principalmente a psoríase tipo placa (40,58%). Houve remissão completa das lesões psoriásicas em 86,96% dos pacientes com DII, existindo diferenças nas abordagens terapêuticas; interrupção do infliximabe determinou a resolução em 47,83% dos casos e 43,48% dos pacientes continuaram recebendo o tratamento com infliximabe. CONCLUSÃO: Uma vez que cresce o número de pacientes com DII com psoríase induzida ou agravada por infliximabe, os médicos devem estar cientes de suas manifestações clínicas, para que o diagnóstico e tratamento adequados sejam devidamente estabelecidos. A decisão sobre continuar ou interromper o infliximabe deve ser individualizada.


Subject(s)
Female , Humans , Male , Antibodies, Monoclonal/adverse effects , Gastrointestinal Agents/adverse effects , Inflammatory Bowel Diseases/drug therapy , Psoriasis/chemically induced , Antibodies, Monoclonal/therapeutic use , Gastrointestinal Agents/therapeutic use
16.
Article in Korean | WPRIM | ID: wpr-40783

ABSTRACT

Infliximab, the monoclonal antibody to tumor necrosis factor, is indicated for refractory luminal and fistulizing Crohn's disease and rheumatoid arthritis. Infliximab treatment has adverse events including infusion reactions, opportunistic infections, and the potential for the event such as reactivation of latent tuberculosis. Cutaneous adverse reactions of TNF-alpha agents include skin rash, urticaria, pruritus, lupus-like eruption, and injection site reactions. Most of all, psoriasis or psoriasiform dermatitis induced by infliximab treatment for Crohn's disease is rarely reported in Korea. We report a case of psoriasis induced by infliximab treatment for Crohn's disease with a review of world literature.


Subject(s)
Anti-Inflammatory Agents/adverse effects , Antibodies, Monoclonal/adverse effects , Colonoscopy , Crohn Disease/diagnosis , Female , Humans , Psoriasis/chemically induced , Ultraviolet Rays , Young Adult
18.
Article in English | WPRIM | ID: wpr-152552

ABSTRACT

We report a case of 61-yr-old man with stable psoriasis who progressively developed generalized pustular eruption, erythroderma, fever, and hepatic dysfunction following oral terbinafine. Skin biopsy was compatible with pustular psoriasis. After discontinuation of terbinafine and initiating topical corticosteroid and calcipotriol combination with narrow band ultraviolet B therapy, patient's condition slowly improved until complete remission was reached 2 weeks later. The diagnosis of generalized pustular psoriasis (GPP) induced by oral terbinafine was made. To our knowledge, this is the first report of GPP accompanied by hepatic dysfunction associated with oral terbinafine therapy.


Subject(s)
Suppuration/chemically induced , Psoriasis/chemically induced , Naphthalenes/adverse effects , Middle Aged , Male , Liver Diseases/chemically induced , Humans , Antifungal Agents/adverse effects , Administration, Oral
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