Actigraphy-measured nocturnal wrist movements and assessment of sleep quality in patients with bullous pemphigoid: a pilot case-control study.

BACKGROUND: Bullous pemphigoid (BP) is a distressing autoimmune bullous disease strongly associated with severe pruritus; however, data concerning pruritus in BP are still scarce. No clinical research evaluating the effect of BP on sleep quality has been conducted. AIM: To evaluate the intensity of pruritus measured by nocturnal wrist movements (NWMs) and the sleep quality in patients with BP using actigraphy in comparison with nonpruritic healthy controls (HCs) with subsequent correlations with an itch visual analogue scale (VAS) as a subjective measure, disease severity [Bullous Pemphigoid Disease Area Index (BPDAI), urticaria/erythema, erosions/blisters] and serum total IgE level. METHODS: In total, 31 patients with newly diagnosed BP (mean ± SD age 75.4 ± 12.3 years) and 40 nonpruritic HCs (age 73.5 ± 11.7 years) were recruited. All participants wore a sleep monitor (ActiSleep+) on the dominant wrist. RESULTS: For patients with BP, median VAS score was 5.5 and median BPDAI was 43 (urticaria/erythema BPDAI was 16, erosions/blisters BPDAI was 29). Scratching, defined as bouts of NWMs, was significantly (P < 0.001) more intensive in patients with BP than in controls. Characteristic of BP was that scratching bouts corresponded with the slowest wrist movements. There were no correlations with VAS, BPDAI or total IgE level. Compared with HCs, patients with BP presented significant (P < 0.001) sleep disturbances, as determined by sleep efficiency, waking after sleep onset and average duration of awakening, and these were strongly correlated with urticaria/erythema BPDAI. CONCLUSION: Nocturnal wrist movements measured by actigraphy are more intensive in patients with BP than in nonpruritic HCs, and characteristically slow movements. Actigraphy method showed very low sleep quality in patients with BP, thus severity of BP has a negative impact on sleep.

Physiological and environmental factors associated with central fat distribution in pubertal girls.

The aim of the work was to determine a degree of explanation of the variation of central fat distribution described by the waist-to-height ratio (WHtR) and waist circumference (WC) by both environmental and biological factors, including hormonal ones. The authors also intended to define the factors which are connected with a risk of abdominal obesity in girls. The study material includes a cross-sectional sample of 297 girls aged 9­16 years, examined in sport and regular schools in Cracow, Poland. Direct anthropometric measurements were done, breast development was assessed (Tanner stage) and leptin and ghrelin concentration in blood serum was estimated (by RIA method). The girls' lifestyles and socio-economic status were investigated through survey questionnaires. The stepwise descending regression method was applied to evaluate a degree of WC, WHtR and BMI variation explanation. A logistic regression analysis was conducted to indicate factors connected with a risk of abdominal obesity (WHtR ³ 0.50) by calculating odds ratio (OR) and 95% confidence interval (CI). Variation of WC and WHtR was explained in, respectively, 53% and 44% by biological factors i.e. age, body height, the Tanner stage and blood serum leptin and ghrelin concentration as well as by environmental factors i.e. obesity prevalence in fathers and the girls' high physical activity. Variation of BMI was explained in 56% by a similar set of variables, excluding the level of physical activity. The biological factors were the highest determinants of an adipose tissue distribution type in the girls. Besides biological factors a significant role was also played by the environmental ones: obesity prevalence in fathers and high level of physical activity. The waist to height ratio seemed to be a more sensitive identifier of environmental behaviours than the general adiposity index.

Prevalence and risk factors of abdominal obesity in Polish rural children.

Secular trends of body mass index (BMI) and waist circumference indicate greater increase in abdominal obesity compared to general obesity. Determinants of obesity described by BMI are relatively well documented in various populations, unlike abdominal obesity described by waist-to-height ratio (WHtR). The aim of the study was to determine prevalence and abdominal obesity (WHtR) risk factors in a cohort of 3048 rural children aged 7-12 years from southern Poland. Biological, socio-demographic and lifestyle factors were analysed, and odds ratio and 95% confidence interval were calculated using a logistic regression analysis. The prevalence of abdominal obesity in rural boys and girls in the sample was 11% and 9% respectively. Obesity in both parents, irregular breakfasts, irregular meals during the day and regularly consumed tea were significant factors of abdominal obesity risks in rural girls. Being the only child, low number of people in a household, obesity in both parents, high energy-dense food index and no exercise significantly increased the risk of abdominal obesity in rural boys. The study demonstrated tendencies similar to other European countries in the prevalence of abdominal obesity among sexes. Lifestyle behaviours should be changed and adapted to each sex since risk factors differ between the sexes and indicate higher eco-sensitivity in boys.

Importance of luminal and mucosal zinc in the mechanism of experimental gastric ulcer healing.

Zinc has been reported to exert a gastroprotective action against various experimental gastric lesions suggesting that this trace element is involved in the integrity of the gastric mucosa. Compounds containing zinc, such as polaprezinc, were developed in Japan and used as an antiulcer drugs in the treatment of human peptic ulcer disease. However, the precise mechanism of Zn(2+) containing compounds and their effects on mucosal integrity, gastroprotection and ulcer healing remain unclear. We have determined the efficacy of zinc hydroaspartate, a compound containing Zn(2+), in the mechanism of gastric secretion and ulcer healing in rats with chronic gastric ulcers induced by acetic acid (initial ulcer area = 28 mm(2)). Rats with gastric ulcers were randomized into two groups: A) with gastric fistulas (GF) and B) without gastric fistulas and received a daily treatment with zinc hydroaspartate (32-130 mg/kg-d i.g.) for 3, 7 and 14 days. At the termination of each treatment, the area of gastric ulcers were examined by planimetry, the gastric blood flow (GBF) at ulcer margin was assessed by laser Doppler flowmetry and H(2)-gas clearance methods. The venous blood was withdrawn for a measurement of plasma gastrin levels by radioimmunoassay (RIA). The concentration of Zn(2+) in the gastric juice and mucosa at the ulcer margin were determined by differential pulse anodic stripping voltammetry (DPASV) and flame atomic absorption spectrometry (FAAS) methods and the gastric biopsy samples were taken for histopathological assessment of the quality of ulcer healing. The ulcers healed gradually, with the ulcer area in the vehicle control rats being diminished by 15%, 48% and 78% upon ulcer induction at 3, 7 and 14 days, respectively. Zinc hydroaspartate dose-dependently inhibited the area of gastric ulcer, the dose reducing this area by 50% (ID(50)) being about 60 mg/kg-d. The mucosal concentration of Zn(2+) significantly was unchanged from the baseline immediately after ulcer induction (day 0) and at day 3 but then it rose significantly at day 7 after ulcer induction. Treatment with zinc hydroaspartate (65 mg/kg-d i.g.), which significantly raised the gastric luminal and mucosal levels of Zn(2+), significantly accelerated ulcer healing at day 7 upon ulcer induction. The GBF, which reached a significantly higher value at the ulcer margin than the ulcer bed, was significantly increased in rats treated with zinc hydroaspartate compared with vehicle-controls. The gastric acid output was significantly inhibited in GF rats with gastric ulcer at day 3 then restored at day 14 followed by a significant rise in the plasma gastrin levels. Treatment with zinc hydroaspartate significantly inhibited gastric secretion and also significantly raised the plasma gastrin level when compared to vehicle-control rats. We concluded that 1) trace micronutrients such as Zn(2+) could be successfully measured in the gastric juice and gastric mucosa during ulcer healing; 2) compounds chelating of Zn(2+) can exert a beneficial influence on the ulcer healing via Zn(2+) mediated increase in gastric microcirculation, antisecretory activity and gastrin release, which may enhance the cell proliferation and differentiation during ulcer healing, ultimately exerting a trophic action on the ulcerated gastric mucosa.

[Anti-idiotypic antibodies against antibodies to HBsAg and against antibodies to pre-S1 and pre-S2 fragments of HBV in patients with chronic HBs antigenemia]. / Przeciwciala anty-idiotypowe skierowane przeciwko pezciwcialom dla HBsAg oraz przeciwcialom dla fragmentów pre-S1 i pre-S2 otoczki HBV u chorych z przewlekla antygenemia HBs.

Anti-idiotypic antibodies (anti-Id Ab) against antibodies to HBs, pre-S1 and pre-S2 antigenic domains of the HBV surface protein were searched for by enzyme-linked immunosorbent assay in single serum samples of 57 patients, chronic HBsAg carriers. IgG and/or IgM anti-Id Ab were detected in 15 patients (26%). IgG and / or IgM anti-[anti-HBs] anti-Id Ab were found in 8 serum samples (14%) and they appeared to occur more frequently in patients seropositive for HBeAg than in these seropositive for anti-HBe. IgG and / or IgM anti-[pre-S1] anti-Id Ab and IgG and / or IgM anti-[anti-pre-S2] anti-Id Ab were detected in 5 (9%) and 8 (14%) patients, respectively. Both these anti-Id Ab were found more frequently in patients seropositive for anti-HBe than in patients seropositive for HBeAg. Anti-[anti-pre-S2] anti-Id Ab occurred more frequently in patients with sever liver damage than in these with near normal liver or established cirrhosis.

TPA, tumor promoter-induced suppression of immunoglobulin secretion in human blood lymphocytes.

12-O-Tetradecanoylphorbol-13-acetate (TPA) modulates DNA synthesis and differentiation of normal and malignant human lymphoid cells. Using the reverse plaque forming assay and radioimmunoassay, we showed that nontoxic concentrations of TPA (5 to 10 ng/ml) inhibited Ig secretion of peripheral blood lymphocytes. This inhibition was dependent on T lymphocytes and not monocytes; TPA treatment of the B cell-enriched fraction slightly enhanced Ig secretion. Suppression was evident when the proportion of TPA-pretreated T lymphocytes exceeded 50%. TPA-induced suppressor cells were present in both OKT8+ (suppressor/cytotoxic) and OKT4+ ("helper/inducer") subpopulations. The suppression was diminished but not abolished by the irradiation of T lymphocytes. In addition, TPA treatment modulated the expression of OKT4 antigen, whereas the expression of OKT8, 9.6 (sheep erythrocyte receptors) and surface Ig remained unchanged. Modulation of OKT4 was energy dependent and was not blocked by a maximal saturation of TPA receptors at 4 degrees C. We postulate that TPA-induced suppression of Ig secretion is T cell dependent and is likely to be associated with proliferation and activation of OKT8+ and OKT4+ lymphocytes and the induction of OKT4+ suppressor cells.

Deficiency of short-lived suppressor cells controlling T-lymphocyte colony formation in acute lymphoblastic leukemia.

Short-lived suppressor cell (SLSC) activity controlling T-lymphocyte colony formation in vitro was evaluated in patients with acute lymphoblastic leukemia (ALL). No SLSC activity was found in patients in acute phase of the disease. On the other hand, patients in remission frequently had higher SLSC activity than controls. No correlation between colony count and thymidine incorporation as well as T-cell numbers was found in ALL patients.

HLA antigens in asymptomatic carriers of HBs antigen and in carriers of anti-HBs antibodies.

HLA antigens were typed in 42 asymptomatic carriers of HBs antigen and in 20 carriers of anti-HBs antibodies. An increased frequency of HLA-B8 antigen was detected in the group of HBs antigen carriers (p less than 0.025). For individuals with the antigen the relative risk (RR) of carrying HBs was increased to 2.3 at p (0.53 less than RR less than 1.89) greater than or equal 1-0.001.

Evaluation of immune response in chronically hemodialysed carriers of HB, antigen.

The presence of anti-HBs antibodies was studied by immunoelectroprecipitation and the presence of anti-HBc antibodies by an indirect immunofluorescence technique in sera of 15 HBs antigen (HBsAg) carriers chronically haemodialysed due to uremia, of whom 7 had suffered from acute viral hepatitis B. In the latter group, PHA-induced blast transformation of lymphocytes and leukocyte migration inhibition in the presence of HBsAg was estimated. In none of the cases could anti-HBs antibodies be detected while anti-HBc antibodies were present in all studied persons. Mitotic indices showed normal reactivity of lymphocytes to PHA. Except for 2 cases, the HBsAg carriers who once suffered from acute viral hepatitis B contained in their blood no HBsAg-sensitized lymphocytes. In 12 examined individuals ayw subtype of HBs was demonstrated and 3 persons had adw subtype.