Methotrexate and Adalimumab Decrease the Serum Levels of Cardiovascular Disease Biomarkers (VCAM-1 and E-Selectin) in Plaque Psoriasis.

Background and objectives: The shared pathogenesis of psoriasis and atherosclerosis may be determined by assaying the levels of endothelial activation molecules. This study aimed at evaluating vascular cell adhesion molecule 1 (VCAM-1) and E-selectin serum concentrations, and atherosclerosis severity in patients with plaque psoriasis. It also aimed to determine the effects of methotrexate/adalimumab treatment for 12 weeks on the plasma levels of the aforementioned molecules. Materials and Methods: The study included 34 psoriasis patients (17 treated with methotrexate and 17 treated with adalimumab) and eight controls. The 10-year risk of a fatal cardiovascular disease, body mass index, Psoriasis Area and Severity Index, and body surface area were calculated for each subject. VCAM-1 and E-selectin levels were determined via an enzyme-linked immunosorbent assay at baseline and after 12 weeks. Results: Baseline E-selectin and VCAM-1 levels were higher in the adalimumab group than in the methotrexate and control groups. VCAM-1 levels decreased in the adalimumab (p = 0.02) and methotrexate groups (p = 0.008), while E-selectin levels decreased in the methotrexate group (p = 0.004). Conclusions: The results indicate a correlation between systemic psoriasis treatment and E-selectin and VCAM-1 plasma concentrations, which may be associated with the risk of cardiovascular disease development.

Adalimumab and methotrexate affect the concentrations of regulatory cytokines (interleukin-10, transforming growth factor-ß1, and interleukin-35) in patients with plaque psoriasis.

Dysfunctional regulatory T lymphocytes are important for the pathogenesis of psoriasis and atherosclerosis. We analyzed the severity of atherosclerosis and the concentration of regulatory cytokines in patients with psoriasis who were administered methotrexate or adalimumab for 12 weeks. We included 34 patients with psoriasis (17 each, administered methotrexate or adalimumab) and eight healthy volunteers. BMI, psoriasis area and severity index (PASI), body surface area (BSA), and at least 75% and 90% improvements in PASI were observed. The 10-year risk of fatal cardiovascular disease was estimated using Systematic Coronary Risk Evaluation charts. The plasma interleukin (IL)-10, IL-35, and transforming growth factor ß1 (TGF-ß1) levels were determined using enzyme-linked immunosorbent assay before and after the 12-week treatment regimen. PASI (P = .0006) and BSA (P = .0001) were positively correlated with the BMI, IL-35 (-0.38), and IL-10 (0.48) levels. Baseline IL-35 concentrations were the highest in healthy volunteers; the IL-10 and TGF-ß1 level were the highest in the methotrexate group. IL-10 concentration decreased in both treatment groups (P = .02 for the methotrexate and P = .09 for adalimumab group), and IL-35 decreased in the adalimumab group (P = .019), consistent with skin lesion recovery. Thus, this study demonstrates the dysregulated secretion of regulatory cytokines in psoriatic patients under systemic treatment.

Characteristic Features of Wound Dressings Based on Butyric-Acetic Chitin Copolyesters-Results of Clinical Trials.

The article presents the results of clinical trials of wound dressings whose main ingredient is butyric-acetic chitin copolyester (BAC 90:10). It is a chitin derivative soluble in typical organic solvents. During the trial, the dressings were used on wounds resulting from venous insufficiency or diabetes. The trial evaluated the safety of use and efficacy of three forms of the dressing including porous membrane (Medisorb R Membrane), porous membrane with silver (Medisorb R Ag), and powder (Medisorb R Powder). The clinical trial had a multi-centre character. Three medical units were engaged in the study. The trial included 36 patients (12 men and 24 women). The mean age of the participants was 65 years of age (age range: 26-96). The choice of dressings was made on the basis of preliminary evaluation of the wound, clinical signs of infection, or risk of infection. Medisorb R Membrane dressing was used in 23 patients, Medisorb R Ag dressing was used in 15 patients, and Medisorb R powder was used in two patients. During the course of the trial, there were 10 control visits planned. The obtained results prove the safety and efficacy of dressings in question. The efficacy of treatment was evaluated as good. In the majority of patients, the ulceration was decreased both on the surface and in depth. The success of the treatment relied not only on the applied dressing, but also the stage of the basic disease, the accompanying diseases, and the age of the patient.

[Annular erythema as the skin manifestation of primary Sjögren's syndrome--case report]. / Rumien obraczkowaty jako skórny objaw pierwotnego zespotu Sjögrena--opis przypadku.

Annular erythema is a term used to identify skin lesions, in which the rash is erythema burgeoning peripherally and outgoing in the center. In this paper we present the case of 71-year old woman in whom diagnosis of possible causes of the development of annular erythema, led the team to identify primary Sjögren's syndrome (SS). Annular erythema was diagnosed on the basis of characteristic clinical picture and histopathological examination. Primary Sjögren's syndrome was diagnosed based on diagnostic criteria for primary SS and the exclusion of other autoimmune diseases. The patient in the study were the presence of characteristic subjective symptoms such as eye occurring for many years dry eyes and periodic feeling of sand in the eyes and dry mouth symptoms requiring frequent drinking of liquids to help swallow food. Changes within the eye was confirmed Schirmer's test, and the seizure of the salivary glands Saxon test. The serum showed the presence of autoantibodies Ro (SS-A) titer > 600 U/ml. The treatment recommended substitution of tears in order to protect the eye and the occasional use of preparations moisturizing mucous membrane of the nose and mouth. Due to the few reports of coexistence of annular erythema with primary Sjögren syndrome among Caucasians this case deserves special attention and calls for the implementation of diagnostic tests in each case, clinical suspicion of annular erythema in order to determine possible causes for its development.

[Lupus vulgaris as a complication of pulmonary tuberculosis--case report]. / Gruzlica toczniowa skóry jako powiklanie gruzlicy pluc--opis przypadku.

Tuberculosis is a contagious disease induced by Mycobacterium species, acid-fast bacilli. These are mostly human type--Mycobacterium tuberculosis, less often cattle type--mycobacterium bovis or other: mycobacterium avium, kansasii, marinom, scrofulaceum, heamophilium, gordonae. The infection can affect all organs, but pulmonary tuberculosis is the most common form. The importance of tuberculosis is definitely rising in the context of massive population migrations in regions affected by its higher incidence, increased HIV infections and AIDS development. Cutaneous tuberculosis is a particular tuberculosis form with differentiated clinical picture. Non-typicalness of skin changes and oligobacilleous course of extrapulmonary tuberculosis forms are repeatedly causing difficulties in adequate diagnosis and early treatment. In differential diagnostics of cutaneous tuberculosis one must take leishmaniasis, actinomycosis, leprosy, syphilis and deep mycosis (among others) into consideration. The study is presenting a case of lupus vulgaris as a complication of past pulmonary tuberculosis. In bacteriological diagnostics of skin changes bioptates, no tuberculosis mycobacteria were found. The disease was diagnosed based on specific granulation presence in histopathology test, tuberculin hypersensivity, bacilli DNA presence in polymerase chain reaction (PCR) test and skin changes regression after anti-mycobacterium treatment. According to authors of the study, the described case confirms the usefulness of PCR nucleonic acids amplification test in cutaneous tuberculosis diagnosis.