Effect of Efalizumab on neutrophil and monocyte functions in patients with psoriasis.

We evaluated the effect of efalizumab on neutrophil and monocyte functions. The in vitro pre-incubation with efalizumab concentrations similar to those reached during in vivo therapy almost completely saturated CD11a binding sites without affecting the membrane expression of CD11b, CD128a or CD128b. There was a significant reduction in the chemotactic activity of the pre-treated cells toward three different chemo-attractants, whereas their phagocytic capacity and production of oxygen radicals remained unchanged. One month after the administration of efalizumab to five patients with psoriasis (T1) circulating neutrophil counts increased by 34% from pre-therapy (T0) with no change in the number of monocytes. In the same patients the CD11a binding sites on phagocytes were >90% saturated, and there was also a significant down-modulation on neutrophils (44% of T0) and monocytes (63% of T0). In line with in vitro results, efalizumab treatment caused a significant deficiency in the chemotactic properties of neutrophils and monocytes, but no changes in phagocytosis, oxidative burst, production of pro-inflammatory cytokines or the membrane expression of CD11b, CD128a and CD128b. Our findings suggest that neutrophils and monocytes may be among the targets of efalizumab activity in patients with psoriasis.

Disseminated granuloma annulare: efficacy of cyclosporine therapy.

Granuloma annulare is an anatomo-clinical entity that is frequently encountered in everyday dermatological practice. We report our experience regarding 4 patients with disseminated granuloma annulare. Each patient was treated with a cycle of cyclosporine therapy for six weeks. A cycle of systemic cyclosporine therapy was started at a dose of 4 mg/kg/day for four weeks, subsequently reduced by 0.5 mg/kg/day every two weeks. The clinical picture more or less completely resolved within three weeks in all of the patients, and there were no relapses during the dose-tapering period or the following 12 months. Cyclosporine was optimally tolerated by all four patients, none of whom experienced any therapy-related side effects. Cyclosporine is a valid therapeutic option for the treatment of disseminated granuloma annulare, although we recommend its use in a protected hospital environment that facilitates patient monitoring.

Treatment of classical Kaposi's sarcoma with gemcitabine.

BACKGROUND: Several drugs are active in aggressive classical Kaposi's sarcoma (CKS); chemotherapeutic agents with fewer side-effects, more rapid response and able to overcome resistance to previous treatment are advisable when treating patients in a second line. Gemcitabine, an analogue of deoxycytidine with cytotoxic activity in the treatment of solid tumours, has been found to have no serious side-effects. OBJECTIVE: To evaluate the usefulness of treating patients affected by aggressive CKS with gemcytabine. METHODS: Twelve patients with a recurrent aggressive form of CKS previously treated with chemotherapy were treated with gemcitabine. The drug was administered intravenously at the dose of 1.2 g/week for 2 weeks, followed by a 1-week interval, until maximal response was reached. Objective responses and toxicity were evaluated according to WHO criteria. RESULTS: Eleven evaluable patients achieved an objective response: CR in 1/11 and PR in 10/11. Toxicity was limited. CONCLUSION: This study shows the usefulness of treating patients affected with aggressive CKS with gemcitabine, in order to obtain control of the disease and to reduce the related symptoms as well as to overcome a possible resistance to previous treatments.

Human herpesvirus-8 infection among heterosexual partners of patients with classical Kaposi's sarcoma.

BACKGROUND: DNA sequences of human herpesvirus-8 (HHV8) are found in lesions of Kaposi's sarcoma (KS). OBJECTIVES: To verify the hypothesis of the sexual transmission of HHV8 infection. METHODS: We used the immunoperoxidase assay to study the prevalence of serum antibodies to HHV8-related antigens in 27 consorts of patients with classical KS, and in a control group of 25 healthy women. RESULTS: Forty-four per cent of the study group were positive, compared with 8% of the controls. CONCLUSIONS: The sexual route may be one of the possible ways of transmission of the HHV8 virus.

[Indomethacin and intra ocular implant (author's transl)]. / Indométacine et implant intra-oculaire. Efficacité d'un traitement prolongé.

The authors compare two series of I.O.L. The first group of patients was treated with oral indometacin: 75 mg per os during six weeks. The second group did not receive indometacin. Anterior segment fluorographic study proves the effectiveness of the therapy. Dye leakage is minimised with indometacin, prostaglandin synthesis is inhibited and decreases the rupture of the blood aqueous barrier.

[Optic disc nodules with haemorrhage (author's transl)]. / Druses de la papille avec hémorragies.

A thirteen year old boy has shown optic disc drusens with haemorrhages in his left eye. Then, his right eye was completely all right. But six years later, the same symptomatology can be seen in this one.