Effect of laser therapy on VEGF and TGF-beta expression in psoriasis

Objective: to study the extent of expression of vascular endothelial growth factor [VEGF] and transfomng growth factor-beta genes [TGF-beta] by RT-PCR then densitometry of ultraviolet transilluminated gel of PCR products from psoriatic plaque lesions in comparison to the extent of the gene expression in control skin samples. Moreover, the plasma levels of the two growth factors were also assessed by irnmunoassay. The effect of laser therapy on these growth factors was also Evaluated

Design: a randomized, group comparative, longitudinal, single center study

Setting: medical Biochemistry and Dermatology Departments, Faculty of Medicine, Cairo University

Main outcome measures: VEGF and TGF-cx genes and proteins

Results: results of this study demonstrated that there was a significant elevation of VEGF plasma level [p< 0.0001] as well as a significant elevation of gene expression of VEGF mRNA in psoriatic plaques [p< 0.0001] in comparison to control. On the other hand, there was a significant decrease of TGF-beta plasma level [p< 0.0001] as well as a significant decrease of TGF-alpha mRNA [p< 0.0001] in psoriatic plaques as compared to control. Furthermore, there was normalization of VEGF mRNA and TGF-beta mRNA gene expression as well as their plasma levels after effective laser therapy of psoriatic skin lesions

Conclusion: Upregulation of VEGF and downregulation of TGF-beta gene expression occur in psoriasis with subsequent aberrant epidermal proliferation and angiogenesis. These genes are downstream curative targets of laser therapy of psoriasis

Evaluation of portal hemodynamics in patients with refractory ascites before and after periteneo-venous shunt

Twenty patients with tense refractory ascites due to bilharzial and/or posthepatic cirrhosis [age ranged 30-60 years] were carefully selected for Denver peritoneojugular shunt [PJS] and followed up clinically and the portal vein was examined before and after shunt for evaluation of portal hemodynamics. The shunts were effective in relieving medically resistant ascites. The portal pressure increased, especially in the early postoperative period and then gradually decreased to the preoperative value. Denver peritoneovenous shunt has a higher patency rate and it is associated with fewer complications. Partial paracentesis, potent diuretics and beta blocker was recommended immediately before operation to minimize the incidence of variceal hemorrhage after shunt due to increase in portal pressure