Human endogenous retroviruses and chosen disease parameters in morphea.

INTRODUCTION: Morphea (localized scleroderma) is a relatively rare disease characterized by excessive skin fibrosis. Human endogenous retroviruses (HERV) are largely distributed within the human genome with hundreds of thousands of elements. The HERV have been widely studied in autoimmune disorders, yet hardly ever assessed in diseases with a good prognosis such as morphea. AIM: In this study we focus on the possible relations between the expression of chosen HERV and factors influencing the pathomechanism of the disease, such as age, sex, titres of anti-nuclear antibodies, as well as duration, activity, and severity of the disease (LoSSI index). MATERIAL AND METHODS: Real-time polymerase chain reaction (PCR) targeting six HERV sequences of interest were performed on samples derived from peripheral blood mononuclear cells (PBMC) and skin biopsies. RESULTS: In PBMC we found a statistically significant negative correlation between HERV-W env expression and LoSSI index (p = 0.01). Additionally, HERV-W env was downregulated in patients with the active form of morphea. In all other cases we found no correlation whatsoever nor statistically significant differences below the p = 0.05 threshold. CONCLUSIONS: Morphea seems to be an autoimmune disease where the impact of HERV is not so apparent. It seems that probing many patients for the expression of just a few sequences is not as effective as previously expected. For initial studies of HERV in other diseases we recommend high throughput techniques such as HERV-dedicated DNA microarrays or massive parallel sequencing.

Body image and depressive symptoms in person suffering from psoriasis. / Obraz wlasnego ciala oraz objawy depresyjne u osób chorych na luszczyce.

OBJECTIVES: The purpose of the research study was specifying the relationship between severity of psoriasis and body image and self-reported depressive symptoms, taking into account the differences between the sexes. METHODS: The research study involved 54 psoriasis patients, including 30 men and 24 women aged from 19 to 82. The level of depressive symptoms was assessed using the Beck Depression Inventory, and body image - using the Multidimensional Body-Self Relations Questionnaire. The disease severity was objectively assessed using the Psoriasis Area and Severity Index. RESULTS: The female psoriasis patients were more critical of their appearance than the men (p< 0.01), and at the same time they were more appearance-oriented (p< 0.05). The men rated their fitness level (p< 0.01) and care for good physical condition (p< 0.01) higher than the women. The women showed less satisfaction with their body parts than the men (p< 0.01) and more fear of obesity (p< 0.05) and overweight (p< 0.05). No statistically significant differences were found between men and women with regard to general evaluation of body image and self-reported depressive symptoms. Moreover, it was established that in the case of both women and men there was a correlation between lowered mood and psoriasis severity (R = 0.416), as well as body image (R = - 0.282). In relation to individual scales, there was a statistically significant relationship between self-reported depressive symptoms and appearance evaluation (R = - 0.519), health evaluation (R = - 0.585), satisfaction with body parts (R = - 0.462), as well as appearance orientation (R = 0.425). CONCLUSIONS: Distortion of body image is correlated with self-reported depressive symptoms in psoriasis patients.

Quality of Life and Optimism in Patients with Morphea.

Despite extensive knowledge about quality of life of people suffering from dermatological diseases, data on patients with morphea are scarce. The aim of our study was to compare the quality of life of healthy controls and morphea patients, as well as to determine the correlation of this variable with the level of dispositional optimism. The study included 47 patients with morphea and 47 healthy controls, matched for gender and age. Cantril's Ladder and Life Orientation Test-Revised were used to assess the levels of life satisfaction and dispositional optimism, respectively. LoSSI was used for the objective assessment. The anticipated level of life quality and the level of dispositional optimism were statistically significantly lower in morphea patients (p = 0.032 and p = 0.014, respectively) when compared to controls. There were no differences in the assessment of current (p = 0.168) and past (p = 0.318) levels of life quality. Also, we proved that type of morphea did not differentiate the current (p = 0.175), past (p = 0.620) and future (p = 0.356) assessment of the quality of life. In the group of morphea patients there was a statistically significant correlation between the level of dispositional optimism and current (p = 0.002, r = 0.43), as well as anticipated (p < 0.001, r = 0.57) levels of life quality. Current level of life quality of healthy controls and morphea patients is comparable, whereas the latter anticipate their future life situation to be significantly worse than the former. Higher level of life satisfaction correlates with higher level of optimism.

Hope as a Psychological Factor Affecting Quality of Life in Patients With Psoriasis.

Clinical observations and medical reports indicate that psoriasis has a tremendous impact on patients' lives, lowering their quality in many important areas. However, the vast majority of research deals only with health-related issues. This study aimed to compare the general quality of life of psoriasis patients and healthy volunteers by examining psychological variables thought to modify the quality of life. 42 patients with psoriasis and 42 healthy volunteers matched for gender, age and education level were tested. Flanagan Quality of Life Scale was used to evaluate general quality of life. Basic hope level was assessed with Basic Hope Inventory. Trait hope was estimated using Trait Hope Scale. Psoriasis Area Severity Index was used to assess the severity of the disease. Psoriasis patients have a significantly lower overall quality of life (p = 0.05), modified by Physical and Material Well-being (p = 0.01), Personal Development and Fulfillment (p = 0.03), and Recreation (p = 0.04). They also have lower levels of trait hope (p = 0.04) and its agency component (p = 0.01). There were moderate, negative significant correlations with basic hope and such components of quality of life as Physical and Material Well-being (p = 0.03, r = - 0.34) and Relations with other People (p = 0.02, r = - 0.35). These results support the hypothesis of a reduced general quality of life and trait hope in psoriatics. Thus, psychological help for people suffering from dermatological disorders might be as important as medical intervention. Basic hope can be treated as a resource in coping with these disorders and trait hope as a resource conducive to well-being.

Transforming growth factor-ß1 in plaque morphea.

INTRODUCTION: Morphea (localized scleroderma) is a rare cutaneous disease characterized by skin fibrosis of unknown pathogenesis. Transforming growth factor-ß (TGF-ß) is a potent profibrotic factor. The role of TGF-ß in morphea remains unclear. AIM: The goal of this study was to estimate the expression level of TGF-ß1 in skin and peripheral blood mononuclear cells as well as the plasma levels of TGF-ß1 in plaque morphea (MEP). MATERIAL AND METHODS: The study involved 20 MEP patients. Three control groups were involved: 1 - plasma: 36 healthy volunteers; 2 - PBMC: 47 healthy volunteers; 3 - skin biopsies: 13 samples collected during mastectomy (breast cancer was not skin involved). The analysis of TGF-ß1 plasma levels was performed with the use an adequate ELISA kit, while real-time polymerase chain reaction was employed for the expression of TGF-ß1 in peripheral blood mononuclear cells (PBMC) and skin. RESULTS: In our study we have not detected differences in TGF-ß 1 expression in PBMC, skin, nor in plasma levels of TGF-ß1 between MEP patients and healthy controls, regardless of disease activity and its duration. CONCLUSIONS: The results of our study contradict the claim of the substantial role of TGF-ß1 in the most common morphea subtype - MEP.

Expression of selected human endogenous retroviral sequences in skin and peripheral blood mononuclear cells in morphea.

INTRODUCTION: Morphea or localized scleroderma is a relatively rare disease whose main symptom is excessive skin fibrosis. Here we focus on the involvement of human endogenous retroviruses (HERVs) in morphea. The HERVs are a vast and intensely growing field in genomics. HERVs are of special interest as far as autoimmune disorders are concerned, yet little effort has been made until now to assess the possible changes of their expression in morphea. MATERIAL AND METHODS: Six sequences of particular interest were chosen for this study. Real-time polymerase chain reaction was performed on samples derived from peripheral blood mononuclear cells (PBMCs) and skin biopsies. The results were normalized to the level of glyceraldehyde 3-phosphate dehydrogenase (GAPDH) transcription. RESULTS: In PBMCs we found a statistically significant decrease of transcription of HERV-E pol, while HERV-K env, HERV-R pol-env, and HERV-W env were found to be up-regulated. In skin biopsies HERV-K env was strongly up-regulated. On the other hand, we noted a decrease of transcription of HERV-H env 62, HERV-K10 gag, HERV-R pol-env, and HERV-W env. In PBMCs we found a statistically significant decrease of transcription of HERV-E pol (-81.8%, p < 0.001), while HERV-K env (+94.1%, p = 0.010), HERV-R pol-env (+140.0%, p < 0.001), and HERV-W env (+97.7%, p < 0.001) were found to be up-regulated. In skin biopsies HERV-K env was strongly up-regulated (+713.0%, p = 0.003). On the other hand, we noted a decrease of transcription of HERV-H env 62 (-83.5%, p < 0.001, HERV-K10 gag (-33.7%, p = 0.044), HERV-R pol-env (-71.3%, p < 0.001), and HERV-W env (-59.3%, p = 0.029). CONCLUSIONS: The studied HERV sequences generally show an increase of transcription in PBMCs of morphea patients, while being down-regulated in their skin, with some exceptions for both types of tissue.

Selected aspects of the living situation of persons suffering from syphilis - Poznan study.

In the last years, a considerable increase in syphilis incidence was observed in Poland. This is a condition with serious health and psychosocial consequences. The research demonstrates that one of the events which significantly modify the course of human life is the somatic disease experience; hence, it was decided to examine selected aspects of the living situation of persons suffering from syphilis, which refer to the social position held by these persons. Materials for the research were collected based on the anonymous authors' survey composed of 16 questions. The research lasted for two years and covered a group of 42 syphilitic patients (35 males and 7 females). The mean age of male patients was 35.7 and of female patients 37.0 years. Among the participants, 8 persons had been subjected to treatment for a few years, 11 for about a year, and 22 persons had recently become ill. Patients assessed the attitude toward themselves mostly as invariable, followed by unstable; 45.2% of subjects considered their position in the family as average and 42.9% as high; 28.6% of patients assessed their occupational position as average and the same number admitted to be currently out of work. Most frequently, unemployed were patients who had been affected by the disease for several years (62.5%), whereas their social position was assessed either as high (47.6%) or average (45.2%). Irrespective of the duration of the disease, patients (during hospitalization) usually met a lot of people. It has been proven that most of the syphilitic patients do not have negative attitude toward themselves and do not assess their social position as inferior, regardless of the duration of the disease. Such a picture of the living situation may be a manifestation of the compensation for the negative mental state, activation of other defense mechanisms or proper strategy of coping with the stressor. The generally optimistic image of the studied group of syphilitic patients may constitute a warning against an increased risk from the infected persons.

Interleukin-17A and interleukin-23 in morphea.

INTRODUCTION: Morphea is a disease included in the group of scleroderma type autoimmune diseases. Interleukin (IL)-17A may play a role at every stage of its pathogenesis. The study aimed at evaluation of IL-17A and IL-23 (as the main cytokine which is supposed to stimulate and maintain synthesis of IL-17) in pathogenesis of morphea. MATERIAL AND METHODS: The studies were performed on 41 blood samples from patients with morphea. Skin was sampled from 29 patients. The evaluation included: (1) expression of IL-17A and IL-23 genes in peripheral blood mononuclear cells (PBMC) using real-time polymerase chain reaction (PCR), (2) plasma concentrations of IL-17A and IL-23 using ELISA, (3) expression of IL-17A and IL-23 genes in skin using real-time PCR. RESULTS: The results of gene expression are expressed as median number of copies per million copies of GAPDH. Higher expression of IL-17A has been demonstrated in PBMC of morphea vs. control group (2630 and 1906 respectively; p = 0.004), accompanied by absence of significant differences in its plasma concentration (10 pg/ml in both groups) and by lowered expression in affected skin (9119 and 19113 respectively; p = 0.036). The results failed to demonstrate elevated IL-23 plasma concentration in morphea vs. control group (5 pg/ml and 6 pg/ml respectively; p = 0.335) or its increased expression in the skin (292 vs. 427; p = 0.383), although we noted its increased expression in PBMC (4419 vs. 808; p < 0.001). CONCLUSIONS: BASED ON THE OBSERVED CORRELATIONS WE SUGGEST THAT: (1) IL-17A does not represent a factor which promotes tissue injury in morphea, (2) IL-23 may playa role in pathogenesis of morphea.