WorldWideScience

Sample records for anti psoriasis therapies

  1. Chronic inflammatory demyelinating polyradiculoneuropathy complicating anti TNF α therapy for chronic plaque psoriasis.

    Science.gov (United States)

    Ahmed, Zahra; Powell, Robert; Llewelyn, Gareth; Anstey, Alex

    2011-12-01

    A 53-year-old woman with chronic plaque psoriasis treated with adalimumab (antitumour necrosis factor (anti TNF) α therapy) for 10 months presented with an 8 week history of hyperesthesia in a 'glove and stocking' distribution and clumsiness on walking. Nerve conduction studies confirmed the clinical diagnosis of a chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). She was admitted and treated with intravenous immunoglobulin and oral steroids and made an excellent recovery. To our knowledge, this is the first published report of CIDP associated with anti TNF α therapy given to treat psoriasis.

  2. Chronic inflammatory demyelinating polyradiculoneuropathy complicating anti TNF α therapy for chronic plaque psoriasis

    OpenAIRE

    Ahmed, Zahra; Powell, Robert; Llewelyn, Gareth; Anstey, Alex

    2011-01-01

    A 53-year-old woman with chronic plaque psoriasis treated with adalimumab (antitumour necrosis factor (anti TNF) α therapy) for 10 months presented with an 8 week history of hyperesthesia in a ‘glove and stocking’ distribution and clumsiness on walking. Nerve conduction studies confirmed the clinical diagnosis of a chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). She was admitted and treated with intravenous immunoglobulin and oral steroids and made an excellent recovery. To ...

  3. ANTI INFLAMMATORY EFFECT OF LEECH THERAPY IN THE PATIENTS OF PSORIASIS (EK KUSTHA

    Directory of Open Access Journals (Sweden)

    Singh Akhilesh Kumar

    2012-02-01

    Full Text Available Ek kustha is a type of kshudra kustha described in different Ayurvedic classics. It is a vata-kaphaj disorder. The clinical symptom of Ek kustha described in Ayurveda resembles with the clinical symptom of Psoriasis. The clinical feature of Ek kustha described by Kashyap represents remission, relapse and seasonal variation, which are present in Psoriasis. In modern medicine there is no definite treatment for this disease. The medicines, which are available to treat the disease, are not very effective and cannot be used for long-term management because of their local and systemic side effect as well as toxicity. Medicines, which are used in Ayurveda, are safe and being practiced since thousands of year. A large number of drugs and measures are described in Ayurveda for the treatment of Kustha. This study was designed to access the anti-inflammatory activity of Leech Therapy in the treatment psoriasis (Ek kustha. The study was randomized open phase clinical trial. The patients of age group 18 to 60 were selected on the basis of Ayurvedic signs and symptoms of Ek kustha. Observations were recorded for sharply defined erythemo-squamous lesions varying in size; presence of erythema, scaling and induration in the lesions; surface consists of non-coherent scales; positive Auspitz sign – (Bleeding occurs after scratching of scales; positive onion peeling sign/candle grease sign (after scratching the scales fall like peels of onion. Since the assessment criteria was Quantitative, paired 't' test was applied. In the current study the treatment was found significantly effective in treating psoriasis. So, we can conclude that leech therapy is effective in the treatment of psoriasis.

  4. ANTI INFLAMMATORY EFFECT OF BASTI THERAPY (MEDICATED ENEMA IN THE PATIENTS OF PSORIASIS (EK KUSTHA

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    Singh Akhilesh Kumar

    2012-01-01

    Full Text Available Ek kustha is a type of kshudra kustha described in different Ayurvedic classics. It is a vata-kaphaj disorder. The clinical symptom of Ek kustha described in Ayurveda resembles with the clinical symptom of Psoriasis. The clinical feature of Ek kustha described by Kashyap represents remission, relapse and seasonal variation, which are present in Psoriasis. Psoriasis like other skin disorders is challenge to the medical sciences. In modern medicine there is no definite treatment for this disease. The medicines, which are available to treat the disease, are not very effective and cannot be used for long-term management because of their local and systemic side effect as well as toxicity. Medicines, which are used in Ayurveda, are safe and being practiced since thousands of year. A large number of drugs and measures are described in Ayurveda for the treatment of Kustha. This study was designed to access the anti-inflammatory activity of Basti Therapy (Medicated Enema in the treatment of Ek kustha (psoriasis. The study was randomized open phase clinical trial. Basti planned for the therapy was Yoga-basti Karma in which Anuvasana basti was given using Mahanarayan tail while Niruh basti was given using Dashmula quath in accordance with Aharya Charak as mentioned in Siddhi Sthana 1/25. Keeping this view in mind we have started basti therapy in the patients of osteoarthritis and found encouraging results. The patients of age group 18 to 60 were selected on the basis of Ayurvedic signs and symptoms of Ek kustha. Observations were recorded for sharply defined erythemo-squamous lesions varying in size; presence of erythema, scaling and induration in the lesions; surface consists of non-coherent scales; positive Auspitz sign – (Bleeding occurs after scratching of scales; positive onion peeling sign/candle grease sign (after scratching the scales fall like peels of onion. The laboratory values of TLC, DLC, ESR and CRP were also recorded before and after the

  5. Biological therapy of psoriasis

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    Sivamani Raja

    2010-01-01

    Full Text Available The treatment of psoriasis has undergone a revolution with the advent of biologic therapies, including infliximab, etanercept, adalimumab, efalizumab, and alefacept. These medications are designed to target specific components of the immune system and are a major technological advancement over traditional immunosuppressive medications. These usually being well tolerated are being found useful in a growing number of immune-mediated diseases, psoriasis being just one example. The newest biologic, ustekinumab, is directed against the p40 subunit of the IL-12 and IL-23 cytokines. It has provided a new avenue of therapy for an array of T-cell-mediated diseases. Biologics are generally safe; however, there has been concern over the risk of lymphoma with use of these agents. All anti-TNF-α agents have been associated with a variety of serious and "routine" opportunistic infections.

  6. Alcohol, psoriasis, liver disease, and anti-psoriasis drugs.

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    Cassano, Nicoletta; Vestita, Michelangelo; Apruzzi, Doriana; Vena, Gino A

    2011-11-01

    Over the last years, data have been accumulating regarding a possible association between alcohol and psoriasis. While it is still unclear whether alcohol misuse represents a true risk factor or merely an epiphenomenon of the cutaneous disease, a number of studies support the role of ethanol and its metabolites as triggering factors of psoriasis. A drinking habit also appears to exacerbate a preexisting psoriasis, and the magnitude of alcohol consumption may be related to both a higher incidence and severity of psoriasis. Evidence also shows that deaths from alcohol-related causes are significantly more frequent in patients with psoriasis than in normal controls. Alcohol consumption may adversely affect psoriasis through multiple mechanisms, such as increased susceptibility to infections, stimulation of lymphocyte and keratinocyte proliferation, and production of proinflammatory cytokines. Moreover, alcohol misuse can predispose to a greater risk of liver disease and potential drug interactions. Alcoholic and non-alcoholic liver diseases have both been found to be common in psoriatic patients. Tumor necrosis factor (TNF)-alpha, a key cytokine in psoriasis pathogenesis, has been found to have a crucial role in alcoholic hepatitis, and small preliminary studies have evaluated the effect of anti-TNF therapy in this condition. However, the use of anti-TNF-α drugs in alcoholic hepatitis is still controversial and needs to be further investigated. In this review, the relationship between alcohol and psoriasis will be reviewed and discussed, taking also into account recent findings related to liver disease and therapeutic implications.

  7. Eruptive papules during efalizumab (anti-CD11a therapy of psoriasis vulgaris: a case series

    Directory of Open Access Journals (Sweden)

    Dummer Wolfgang

    2007-02-01

    Full Text Available Abstract Background Newer biological therapies for moderate-to-severe psoriasis are being used more frequently, but unexpected effects may occur. Case presentations We present a group of 15 patients who developed inflammatory papules while on efalizumab therapy (Raptiva, Genentech Inc, anti-CD11a. Immunohistochemistry showed that there were increased CD11b+, CD11c+ and iNOS+ cells (myeloid leukocytes in the papules, with relatively few CD3+ T cells. While efalizumab caused a decreased expression of CD11a on T cells, other circulating leukocytes from patients receiving this therapy often showed increased CD11b and CD11c. In the setting of an additional stimulus such as skin trauma, this may predispose to increased trafficking into the skin using these alternative β2 integrins. In addition, there may be impaired immune synapse formation, limiting the development of these lesions to small papules. There is little evidence for these papular lesions being "allergic" in nature as there are few eosinophils on biopsy, and they respond to minimal or no therapy even if efalizumab is continued. Conclusion We hypothesize that these papules may represent a unique type of "mechanistic" inflammatory reaction, seen only in the context of drug-induced CD11a blockade, and not during the natural disease process.

  8. Elevation of serum KL-6 in patients with psoriasis treated with anti-tumour necrosis factor-α therapy.

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    Higashi, Y; Tada, K; Shimokawa, M; Kawai, K; Kanekura, T

    2016-01-01

    We report three patients with psoriasis whose serum level of Krebs Von Den Lungen (KL)-6 increased during therapy with anti-tumour necrosis factor (TNF)-α. A diagnosis of early-phase or subclinical interstitial pneumonia was made in two patients, and their KL-6 level decreased after anti-TNF-α discontinuation. The rise in KL-6 in the other patient was attributed to methotrexate. We propose that serum KL-6 should be monitored routinely in patients treated with anti-TNF agents. PMID:25557847

  9. New Oral Therapies for Psoriasis

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    Lanoue, Julien; Dong, Joanna

    2016-01-01

    Conventional oral therapies for psoriasis, including methotrexate, cyclosporine, and acitretin, have generally unfavorable safety profiles and are not ideal for long-standing use. Thus, new oral therapies are necessary for patients with more moderate disease, patients who prefer oral treatments to injectable biologies, and patients who failed conventional therapies. The authors review here the clinical and safety evidence of phosphodiesterase 4 inhibitor, apremilast, janus kinase inhibitors, including tofacitinib, and fumarie acid esters as additional options in oral psoriasis therapy. PMID:27672415

  10. Psoriasis Therapy: A Current Perspective

    OpenAIRE

    Lowe, Nicholas J.

    1983-01-01

    Psoriasis is a common papulosquamous skin disease which frequently presents a therapeutic challenge to physicians. Topical therapy with steroids, coal tars and anthralin are effective when used properly for many patients. More severely affected patients may require phototherapy using coal tars and anthralin plus ultraviolet radiation. Systemic methotrexate administration is indicated for some patients with severe skin and arthropathic psoriasis. Treatment using psoralen and long-wavelength ul...

  11. Cardiovascular disease event rates in patients with severe psoriasis treated with systemic anti-inflammatory drugs

    DEFF Research Database (Denmark)

    Ahlehoff, O; Skov, L; Gislason, G;

    2013-01-01

    disease events. We therefore examined the rate of cardiovascular disease events in patients with severe psoriasis treated with systemic anti-inflammatory drugs. DESIGN, SETTING AND PARTICIPANTS: Individual-level linkage of nationwide administrative databases was used to assess the event rates associated......OBJECTIVES: Psoriasis is a chronic inflammatory disorder associated with cardiovascular morbidity and mortality. Systemic anti-inflammatory drugs, including biological agents, are widely used in the treatment of patients with moderate to severe psoriasis and may attenuate the risk of cardiovascular...... cardiovascular disease event rates compared to patients treated with other anti-psoriatic therapies....

  12. Psoriasis: improving adherence to topical therapy.

    NARCIS (Netherlands)

    Feldman, S.R.; Horn, E.J.; Balkrishnan, R.; Basra, M.K.; Finlay, A.Y.; McCoy, D.; Menter, A.; Kerkhof, P.C.M. van de

    2008-01-01

    Topical therapy has an important role in psoriasis treatment. It is efficacious and has a favorable safety profile as demonstrated in clinical trials. However, poor treatment outcomes from topical therapy regimens likely result from poor adherence and ineffective use of the medication. The Internati

  13. Therapy of moderate and severe psoriasis

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    Werfel, Thomas

    2006-04-01

    Full Text Available Objective and methods: This health technology assessment (HTA report synthesises systematically randomized controlled studies (RCT on the therapy of moderate and severe psoriasis vulgaris which were published between 1999 and 2004; it includes some important clinical studies which have been published after 2004 and thus updates the English HTA report by Griffiths et al. [1]. The major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany. Results: The major conclusions from the results of medical RCT on moderate and severe psoriasis vulgaris are: Oral fumarates are effective in the treatment of moderate to severe psoriasis vulgaris. However, fumarates quiet frequently cause moderate side effects. Cyclosporine and methotrexate are both effective in the treatment of severe psoriasis vulgaris. Both substances have a different spectrum of side effects which may limit the individual applicability. Acetritin is only moderately effective in the treatment of severe psoriasis of the plaque type. Calcipotriol or UV-radiation used at the same time can increase the clinical effectiveness of acetritin. Systemic PUVA, balneo-PUVA and UVB therapy are all effective for the treatment of severe psoriasis. The combination of UV therapy with vitamin D3 analogues or with topical steroids is more effective than the treatment with UV radiation alone. Saltwater baths increase the effectiveness of UVB therapy. No RCT on the therapeutical effects of topical tar or of dithranol in combination with UV therapy have been published so far. A continuous therapy with PUVA should not be applied due to its proven photocarcinogenicity. Three substances from the group of biologicals (Efalizumab, Etanercept, and Infliximab are now available in Europe and a further substance (Alefacept is available in the USA for the treatment of moderate to severe psoriasis. All biologicals have been

  14. [Pruritus in psoriasis : Profile and therapy].

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    Tsianakas, A; Mrowietz, U

    2016-08-01

    Psoriasis is a common chronic inflammatory disease with an incidence of about 0.5-3 %. Previously psoriasis was not primarily regarded to be associated with pruritus; however, this perception has changed in recent years. Meanwhile data conclusively show that between 64 and 97 % of patients report about pruritus that can be severe in a number of cases. Apart from suffering from psoriasis, the presence of pruritus causes additional stress and leads to a significant impairment of health-related quality of life. Neurogenic inflammation at least in part contributes to the development of pruritus in psoriasis skin lesions. A number of neuropeptides including substance P and calcitonin gene related peptide can act as pro-inflammatory mediators. There is evidence for a dysbalance between κ‑ and µ‑opioid receptors in lesional skin favoring inflammation and pruritus. After clearing of psoriasis lesions, pruritus is relieved as well. Therefore, specific treatment of pruritus is not necessary in general. In cases where severe pruritus is a prominent symptom, targeted therapy with mirtazapin or doxepin or neuroleptic compounds such as pregabalin or gabapentin or drugs affecting the κ‑ und µ‑opioid receptor balance can be administered. Today the importance of pruritus as a prominent symptom of psoriasis lesions has been widely accepted. In recent and running clinical trials with new drugs, pruritus at baseline and the effect of these drugs on pruritus is always assessed. This awareness also fuels basic research about pruritus in psoriasis. PMID:27376751

  15. Progress in psoriasis therapy via novel drug delivery systems

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    Nitha Vincent

    2014-09-01

    Full Text Available Psoriasis is a lifelong condition which is caused by the negative signals produced by immune system, which leads to hyper proliferation and other inflammatory reactions on the skin. In this case, keratinocytes which are the outermost layer of skin possess shortened life cycle and results in the alteration of desquamation process where the cytokines will come out through lesions of affected patients and as a result, scaling marks appears on the skin. These conditions may negatively affect the patient’s quality of life and lead to psychosocial stress. Psoriasis can be categorized as mild, moderate and severe conditions. Mild psoriasis leads to the formation of rashes, and when it becomes moderate, the skin turns into scaly. In severe conditions, red patches may be present on skin surface and becomes itchy. Topical therapy continues to be one of the pillars for psoriasis management. Drug molecules with target effect on the skin tissues and other inflammations should be selected for the treatment of psoriasis. Most of the existing drugs lead to systemic intoxication and dryness when applied in higher dose. Different scientific approaches for topical delivery are being explored by researches including emollient, modified gelling system, transdermal delivery, spray, nanogels, hydrogels, micro/nano emulsion, liposomes, nano capsules etc. These topical dosage forms are evaluated for various physico chemical properties such as drug content, viscosity, pH, extrudability, spreadability, toxicity, irritancy, permeability and drug release mechanism. This review paper focus attention to the impact of these formulation approaches on various anti-psoriasis drugs for their successful treatment.

  16. Psoriasis

    Science.gov (United States)

    Plaque psoriasis; Psoriasis vulgaris; Guttate psoriasis; Pustular psoriasis ... and insect bites Some medicines, including antimalaria drugs, beta-blockers, and lithium Stress Too little sunlight Too ...

  17. Therapy of moderate and severe psoriasis

    OpenAIRE

    Werfel, Thomas; von der Schulenburg, Johann-Matthias; Greiner, Wolfgang; Kulp, Werner; Claes, Christa

    2006-01-01

    Objective and methods: This health technology assessment (HTA) report synthesises systematically randomized controlled studies (RCT) on the therapy of moderate and severe psoriasis vulgaris which were published between 1999 and 2004; it includes some important clinical studies which have been published after 2004 and thus updates the English HTA report by Griffiths et al. [1]. The major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost...

  18. Therapie der mittelschweren und der schweren Psoriasis

    OpenAIRE

    Claes, C; Kulp, W; Greiner, W; von der Schulenburg, JM; Werfel, T.

    2006-01-01

    Objective and methods This health technology assessment (HTA) report synthesises systematically randomized controlled studies (RCT) on the therapy of moderate and severe psoriasis vulgaris which were published between 1999 and 2004; it includes some important clinical studies which have been published after 2004 and thus updates the English HTA report by Griffiths et al. . The major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost eff...

  19. Cardiovascular outcomes and systemic anti-inflammatory drugs in patients with severe psoriasis

    DEFF Research Database (Denmark)

    Ahlehoff, O; Skov, L; Gislason, Gunnar Hilmar;

    2015-01-01

    during long-term follow-up compared to patients treated with other antipsoriatic therapies. The treatment strategy in patients with severe psoriasis may have an impact on cardiovascular outcomes and randomized trials to evaluate the cardiovascular safety and efficacy of systemic antipsoriatic therapies......BACKGROUND: Psoriasis is a common disease and is associated with cardiovascular diseases. Systemic anti-inflammatory drugs may reduce risk of cardiovascular events. We therefore examined the rate of cardiovascular events, i.e. cardiovascular death, myocardial infarction and stroke, in patients...... with severe psoriasis treated with systemic anti-inflammatory drugs. METHODS: Individual-level linkage of administrative registries was used to perform a longitudinal nationwide cohort study. Time-dependent multivariable adjusted Cox regression was used to estimate hazard ratios (HRs) with 95% confidence...

  20. Anti-IL-17 Medications Used in the Treatment of Plaque Psoriasis and Psoriatic Arthritis: A Comprehensive Review.

    Science.gov (United States)

    Canavan, Theresa N; Elmets, Craig A; Cantrell, Wendy L; Evans, John M; Elewski, Boni E

    2016-02-01

    Our ability to successfully treat patients with moderate to severe psoriasis has improved significantly over the last several years with the development of more targeted therapies. IL-17A, a member of the IL-17 family of interleukins, is involved in regulating the innate and adaptive immune systems and has been identified as a key cytokine involved in the pathogenesis of psoriasis and psoriatic arthritis. In this review, we summarize our understanding of IL-17 and its role in psoriasis and psoriatic arthritis, as well as key findings from clinical trials using anti-IL-17 medications for the treatment of the aforementioned diseases. Secukinumab, ixekizumab, and brodalumab are three anti-IL-17 medications used for treating psoriasis, of which only secukinumab is FDA approved; ixekizumab and brodalumab remain under clinical development. Results from clinical trials show that these three medications are highly effective in treating psoriasis and appear to be as safe as other biologic treatments that are FDA approved.

  1. Factors impacting the combination of topical corticosteroid therapies for psoriasis: perspectives from the international psoriasis council

    NARCIS (Netherlands)

    Kerkhof, P.C. van de; Kragballe, K.; Segaert, S.; Lebwohl, M.

    2011-01-01

    Corticosteroids are the mainstay of topical therapies for the treatment of mild to moderate psoriasis. Selection of vehicle, concentrations of corticosteroid and coadministered medications, and frequency of administration are critical factors that enhance bioavailability of topical corticosteroids.

  2. New Oral Therapies for Psoriasis: A Comprehensive Review.

    Science.gov (United States)

    Goldenberg, Gary; Lanoue, Julien; Dong, Joanna

    2016-08-01

    Conventional oral therapies for psoriasis, including methotrexate, cyclosporine, and acitretin, have generally unfavorable safety profiles and are not ideal for long-standing use. Thus, new oral therapies are necessary for patients with more moderate disease, patients who prefer oral treatments to injectable biologies, and patients who failed conventional therapies. The authors review here the clinical and safety evidence of phosphodiesterase 4 inhibitor, apremilast, janus kinase inhibitors, including tofacitinib, and fumarie acid esters as additional options in oral psoriasis therapy. PMID:27672415

  3. Cardiovascular risk factors in high-need psoriasis patients and its implications for biological therapies.

    NARCIS (Netherlands)

    Driessen, R.J.B.; Boezeman, J.B.M.; Kerkhof, P.C.M. van de; Jong, E.M.G.J. de

    2009-01-01

    BACKGROUND: The associations between psoriasis and cardiovascular risk factors are reported to be stronger as psoriasis severity increases. This makes studying cardiovascular risk factors in high-need psoriasis patients, eligible for biological therapy, interesting. OBJECTIVE: To survey the prevalen

  4. Identification of key research needs for topical therapy treatment of psoriasis - a consensus paper by the International Psoriasis Council.

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    Wu, J J; Lynde, C W; Kleyn, C E; Iversen, L; van der Walt, J M; Carvalho, A; Kirby, B; Bissonnette, R

    2016-07-01

    In this age of expanding choices of therapy for psoriasis, topical therapies still play an important part in the management of patients. There are many knowledge gaps in topical therapy for psoriasis with regard to efficacy and safety as well as various combinations including topical therapy with phototherapy or with systemic agents. Councillors of the International Psoriasis Council comprised a topical therapy working group to describe these gaps in order to help direct future research endeavours. Herein, we present the results of this analysis, discuss topical agents in clinical development and the attributes of the ideal topical treatment for psoriasis.

  5. Ultraviolet B radiation therapy for psoriasis: Pursuing the optimal regime.

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    Matos, Tiago R; Ling, Tsui C; Sheth, Vaneeta

    2016-01-01

    Psoriasis is a chronic and common disease mediated by resident memory T cells that negatively affects a broad range of people worldwide. One of the oldest and most commonly used treatments is phototherapy. We reviewed the existing literature on the four main ultraviolet B (UVB) modalities of phototherapy in the management of psoriasis: heliotherapy, broadband UVB, narrowband UVB, and excimer laser and lamp. Despite the many studies done on these therapies, there is significant variation in their prescription and use. Phototherapy remains one of the most effective and safest treatments for psoriasis. We provide an updated comprehensive overview of UVB phototherapy for psoriasis to help physicians optimize their choice of modality and dosing regimen to ensure optimal outcomes for psoriasis patients. © 2016 Elsevier Inc. All rights reserved. PMID:27638437

  6. Tailor systemic therapy to the patient with severe psoriasis.

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    Van de Velde, Vanessa; Tidman, Michael J

    2016-02-01

    There is no standard definition regarding the severity of psoriasis, and a number of factors should be considered, including the extent and stability of skin disease, involvement of joints, response to treatment, and impact on quality of life. Erythrodermic psoriasis and pustular psoriasis are severe conditions and the patient may be systemically unwell and febrile. NICE recommends that four key areas should be evaluated and recorded when assessing patients: severity, using the static Physician's Global Assessment (sPGA); disease impact on physical, psychological and social wellbeing using the Dermatology Life Quality Index (DLQI); the presence of psoriatic arthritis; and comorbidities. Ideally, patients should be assessed annually for psoriatic arthritis: the Psoriasis Epidemiology Screening Tool is a validated tool to screen for psoriatic arthritis in primary and secondary care. Patients with severe psoriasis should undergo cardiovascular risk assessment at presentation and every five years, or more frequently if indicated. Referral to secondary care should be made for patients with any type of psoriasis with poor response to topical therapy (after 2 or 3 months according to SIGN) and for extensive psoriasis. Cases where the psoriasis is having a significant physical or psychological impact on an individual's quality of life warrant early referral, as do those where the diagnosis is uncertain. Patients with generalised pustular psoriasis or erythroderma should be referred urgently for same-day specialist input. Patients with acute guttate psoriasis who may require phototherapy should also be referred. Children and adolescents with any type of psoriasis should be referred to a specialist at initial presentation.

  7. Psoriasis vulgaris flare during efalizumab therapy does not preclude future use: a case series

    Directory of Open Access Journals (Sweden)

    Krueger James G

    2005-08-01

    Full Text Available Abstract Background Severe psoriasis vulgaris can be extremely difficult to treat in some patients, even with the newer biological therapies available today. Case presentations We present two patients with severe chronic plaque psoriasis who received numerous systemic anti-psoriatic therapies with varied results. Both responded well to initial treatment with efalizumab (anti-CD11a, but then experienced a flare of their disease after missing a dose. However, after disease stablization, both patients responded well to re-introduction of efalizumab, one patient requiring concurrent treatment with infliximab (anti-TNF-α. Conclusion These cases are presented to characterize this "flare" reaction, and to inform health care providers that efalizumab can still be administered after disease flare, and again may be a successful therapy.

  8. Radiation therapy and Koebner effect in cancer patients with psoriasis

    International Nuclear Information System (INIS)

    Radiation therapy (XRT) may initiate skin side effects that occur more often in patients with skin disorders. One of such diseases is psoriasis - a common disorder in the western communities. In the past Grenz rays and superficial XRT were used to treat psoriatic patients and were reported to initiate the Koebner effect, which is an exacerbation of the underlying disease following a skin trauma. Recently, several case reports revealed a similar response in cancer patients receiving megavoltage XRT. Hence, one may assume that irradiation should be re-considered or re-modified in order to spare the involved skin. To report our experience in radiotherapy of cancer patients with psoriasis. Six patients with prostate adenocarcinoma (3), breast cancer (2) and soft tissue sarcoma (1) suffering from psoriasis were referred for radiotherapy as a part of their anti-cancer treatment. In all patients the irradiation fields included the psoriatic lesions. The irradiation was delivered using linear accelerators operated through 6-8 MV photon and 8 MeV electron beams. The total XRT dose varied from 50 to 70 Gy and the daily fraction was 1.8-2.0 Gy. A close monitoring during and after completion of irradiation was carried out and standard skin care was advised. No change in the irradiated psoriatic lesions as well as in the surrounding area was observed in all patients during the irradiation. Subsequent follow up (up to 24 months) revealed no new skin lesions and no worsening of existing plaques. Megavoltage XRT in a conventional daily fraction has no effect on psoriatic skin lesions

  9. Psoriasis Induced by Anti-Tumor Necrosis Factor Alpha Agents: A Comprehensive Review of the Literature.

    Science.gov (United States)

    Ciccarelli, Fedra; De Martinis, Massimo; Sirufo, Maria Maddalena; Ginaldi, Lia

    2016-08-01

    Tumor necrosis factor alpha (TNF-α) inhibitors revolutionized the management of patients affected by autoimmune diseases such as inflammatory bowel diseases, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and psoriasis. The biologic agents targeted to block TNF-α such as infliximab, adalimumab, certulizumab pegol, etanercept, and golimumab, have a good safety profile; however, with increasing, broader, and prolonged use, patients could be exposed to an increased risk of adverse reactions including a wide spectrum of dermatological conditions of different etiology and morphology. Among these, of particular interest is the development of skin immune-mediated diseases that seem to be the consequence of the paradoxical inflammation induced by anti-TNF-α therapy. The majority of these lesions are identified as psoriasiform with three main morphologies and different frequency: pustular psoriasis, signs of psoriasis, and guttate; although erythrodermic or inverted psoriasis, among others, may be observed with less frequency. The increased incidence of these dermatological immune-mediated lesions highlight the importance of the skin as a main target of the side effect of anti-TNF-α agents, while the immunopathogenetic hypothesis of these paradoxical effects are quite intriguing. The aim of this review is to collect and to analyze existing knowledge to better understand the pathogenetic mechanism of these complications and suggest new fields of investigation, improve therapeutic strategies of autoimmune diseases, and prevent and/or better address such complications. PMID:27663916

  10. Emerging Therapies for the Treatment of Psoriasis

    OpenAIRE

    Patel, Mahir; Day, Antoinette; Warren, Richard B.; Menter, Alan

    2012-01-01

    Psoriasis is an immune-mediated disease that affects 1%–2% of the European and North American population. While topical agents such as corticosteroids and vitamin D derivatives are prescribed for mild disease, they are generally unable to adequately control patients with more severe disease. Over the past decade, research into the immunopathogenesis of psoriasis, including investigations into the role of tumor necrosis factor-alpha and more recently interleukins (IL) 12/23, has led to the adv...

  11. Targeted UV therapy in the treatment of psoriasis.

    Science.gov (United States)

    Stein, Kevin R; Pearce, Daniel J; Feldman, Steven R

    2008-01-01

    Ultraviolet (UV) light is an effective treatment for extensive psoriasis and some other inflammatory skin conditions. Because the predominant effect of UV is a local one (as opposed to a systemic effect on immunity), localized delivery of ultraviolet B radiation (UVB) may be a useful treatment for localized variants of psoriasis and other conditions. The article reviews the literature regarding use of localized UV therapy. A theoretical benefit of localized UV therapy is reduced toxicity compared with whole-body therapy. Practical benefits in psoriasis treatment include higher efficacy and more appealing cosmesis compared with topicals. The 308-nm excimer laser is effective for psoriasis with fewer UVB treatments and lower total UVB exposure than needed for total body UV treatment. Other methods of localized UV delivery include quartz lamps, hand-held home UV devices, and non-laser intense photo sources. Other conditions treated with localized UV include vitiligo and lichen planus. Localized UV therapy is a useful modality for the treatment of localized variants of psoriasis with growing use for other dermatologic diseases. PMID:17934935

  12. Therapeutic moisturizers as adjuvant therapy for psoriasis patients.

    Science.gov (United States)

    Gelmetti, Carlo

    2009-01-01

    At any point in time, psoriasis affects 2-3% of the world's population and has one of the biggest impacts on quality of life of any dermatological disorder. Treatment is extremely costly and prevention of disease progression in severity and extent is crucial. Psoriasis treatment should include skin hydration (regular use of moisturizers and emollients), careful, gentle skin cleansing, and identification and avoidance of Koebner phenomenon triggers (excoriation, maceration) and infectious foci (Streptococcus pyogenes). Moisturizers have been shown to significantly improve skin conditions and quality of life for psoriasis patients. They are a valuable first-line treatment, as dry skin is common and adds to the irritability of the diseased skin. Most patients respond well to topical treatment with topical corticosteroids, emollients, coal tar, anthralin (dithranol) or calcipotriol. Emollients are the most prescribed products, providing transient relief from irritation and some possessing anti-inflammatory properties. Moisturizers and emollients should be used in the following cases: minimal psoriasis, napkin psoriasis, psoriasis of the folds, psoriatic skin damaged by previous local treatments, and in pregnancy or women of childbearing age.

  13. Psoriasis

    Science.gov (United States)

    ... in Residency Young Physician Focus Dermatology Daily AAD Buyer's Guide Awards, grants, and scholarships AAD Annual Meeting ... take control. Learn about psoriasis . Knowledge really is power. Learning about psoriasis will help you manage the ...

  14. Psoriasis

    Science.gov (United States)

    ... used to prevent malaria) Skin irritations Cold weather Smoking Treatment How is psoriasis treated? There are a number of treatments for psoriasis. Your doctor will help you decide which one is best ...

  15. Inverse Psoriasis

    Science.gov (United States)

    ... occasionally require UVB (ultraviolet B) light therapy or biologic medications to control the condition. Menu Donate Register Search Home Psoriasis About Psoriasis Causes and Known Triggers Related Conditions Life with Psoriasis Genes & ... Oral Treatments Systemics Phototherapy Topicals Complementary & Alternative ...

  16. An update on topical therapies for mild-moderate psoriasis

    NARCIS (Netherlands)

    Kerkhof, P.C.M. van de

    2015-01-01

    Topical therapies are the mainstream treatment of psoriasis because most patients have mild disease. First-line treatments are vitamin D derivatives and corticosteroids. These treatments are usually given in combination schedules. For topical treatments the selection of the most appropriate vehicle

  17. Psoriasis

    Science.gov (United States)

    ... may increase your risk for non-melanoma skin cancers. Oral medications may be used for extensive psoriasis, including acitretin (made from vitamin A), methotrexate, and cyclosporine. If you are prescribed any of ...

  18. Psoriasis

    Science.gov (United States)

    ... severe psoriasis may feel self-conscious about their appearance. Psychological distress can lead to depression and social ... in the folds of the skin near the genitals, under the breasts, or in the armpits. The ...

  19. Efficacy and safety of adalimumab in patients with psoriasis previously treated with anti-tumour necrosis factor agents

    DEFF Research Database (Denmark)

    Ortonne, J-P; Chimenti, S; Reich, K;

    2011-01-01

    Few large clinical studies have evaluated whether switching tumour necrosis factor antagonists (anti-TNFs) is likely to improve psoriasis in patients with prior anti-TNF treatment.......Few large clinical studies have evaluated whether switching tumour necrosis factor antagonists (anti-TNFs) is likely to improve psoriasis in patients with prior anti-TNF treatment....

  20. Angiogenic activity in patients with psoriasis is significantly decreased by Goeckerman's therapy

    Energy Technology Data Exchange (ETDEWEB)

    Andrys, C.; Borska, L.; Pohl, D.; Fiala, Z.; Hamakova, K.; Krejsek, J. [Faculty Hospital, Hradec Kralove (Czech Republic). Dept. of Clinical Immunology & Allergy

    2007-03-15

    Goeckerman's therapy (GT) of psoriasis is based on daily application of pharmacy grade coal tar on affected skin with subsequent exposure to UV light. Goeckerman's therapy is still the first line therapy of psoriasis in the Czech Republic because of its low cost and long-term efficacy. Disturbances in angiogenic activity are characteristic for the immunopathogenesis of psoriasis. An abnormal spectrum of cytokines, growth factors and proangiogenic mediators is produced by keratinocytes and inflammatory cells in patients suffering from the disease. The aim of this study was to evaluate the influence of GT of psoriasis on angiogenic activities by comparing serum levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in 44 patients with psoriasis in peripheral blood samples collected before and after therapy. It was found that the angiogenic potential which is abnormally increased in patients with psoriasis is significantly alleviated by GT.

  1. Studies of Internal Environment of Psoriasis and Its Therapy

    Institute of Scientific and Technical Information of China (English)

    XU; Han-qing

    2001-01-01

    Psoriasis is a kind of refractory disease, though it is less serious than cancer. The etiology is not clear, the morbidity is high, and it cannot be radically cured. It is an urgent problem that needs to be solved. Since 1980, the authors have studied the pathogenic mechanisms of psoriasis from aspects of pathology, biochemistry, pharmacology, and immunology. It was proved that abnormalities in biochemical components, neural media, immunological state and cell metabolism existed in psoriatic cases. We have published more than ten articles, and formulated two anti-psoriasis drugs, which is reported as follows:    1. The levels of serum zinc, copper, calcium, magnesium, iron, selenium, ceruloplasmin, vitamin A and vitamin E in 138 psoriatic patients were measured by atomic absorption spectrometry. The results showed that serum copper level in the progressive and stable stage was decreased significantly (P<0.01). The levels of serum calcium and vitamin E lowered too. The levels of serum ceruloplasmin, selenium and iron were considerably higher in psoriatic than those in the normal control. This is an evidence that there are biochemical abnormalities in the internal environment of psoriatic patients.……

  2. Studies of Internal Environment of Psoriasis and Its Therapy

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@  Psoriasis is a kind of refractory disease, though it is less serious than cancer. The etiology is not clear, the morbidity is high, and it cannot be radically cured. It is an urgent problem that needs to be solved. Since 1980, the authors have studied the pathogenic mechanisms of psoriasis from aspects of pathology, biochemistry, pharmacology, and immunology. It was proved that abnormalities in biochemical components, neural media, immunological state and cell metabolism existed in psoriatic cases. We have published more than ten articles, and formulated two anti-psoriasis drugs, which is reported as follows:   1. The levels of serum zinc, copper, calcium, magnesium, iron, selenium, ceruloplasmin, vitamin A and vitamin E in 138 psoriatic patients were measured by atomic absorption spectrometry. The results showed that serum copper level in the progressive and stable stage was decreased significantly (P<0.01). The levels of serum calcium and vitamin E lowered too. The levels of serum ceruloplasmin, selenium and iron were considerably higher in psoriatic than those in the normal control. This is an evidence that there are biochemical abnormalities in the internal environment of psoriatic patients.

  3. Psoriasis

    Science.gov (United States)

    ... groups also can help. Right now, there's no cure for psoriasis, but lots of good options are available to treat the symptoms. Smart choices, such as keeping a healthy diet and weight, also can help. Even just getting a little bit of natural sunlight can make the symptoms better. Your doctor ...

  4. Topical Therapies for Psoriasis: Improving Management Strategies and Patient Adherence.

    Science.gov (United States)

    Stein Gold, Linda F

    2016-03-01

    Psoriasis is a chronic disease that has a substantial effect on quality of life of patients and often needs long-term treatment. Topical treatments for psoriasis include corticosteroids, vitamin D derivatives, tazarotene, anthralin, tacrolimus, pimecrolimus, and newer formulations of tar. Although many of these treatments are effective, they must be prescribed appropriately and used consistently for a period of weeks to months before clinical evidence of improvement can be seen and patients perceive that the treatment is working. As such, medication dosage/schedule, choice of vehicle, and especially patient adherence to medication are key factors for a treatment to be effective. Addressing patient preferences about treatments and concerns about treatment-related toxicities and managing their expectations represent additional aspects of patient care. Therapies such as calcipotriene and betamethasone dipropionate (Cal/BD) fixed combination foam and new drugs and vehicles continuously enhance the treatment landscape for psoriasis. Because adherence to topical treatment can be a major difficulty, keeping the treatment regimen simple and using new and sophisticated treatment vehicles that are acceptable to patients can likely improve treatment outcomes. PMID:27074696

  5. Topical Therapies for Psoriasis: Improving Management Strategies and Patient Adherence.

    Science.gov (United States)

    Stein Gold, Linda F

    2016-03-01

    Psoriasis is a chronic disease that has a substantial effect on quality of life of patients and often needs long-term treatment. Topical treatments for psoriasis include corticosteroids, vitamin D derivatives, tazarotene, anthralin, tacrolimus, pimecrolimus, and newer formulations of tar. Although many of these treatments are effective, they must be prescribed appropriately and used consistently for a period of weeks to months before clinical evidence of improvement can be seen and patients perceive that the treatment is working. As such, medication dosage/schedule, choice of vehicle, and especially patient adherence to medication are key factors for a treatment to be effective. Addressing patient preferences about treatments and concerns about treatment-related toxicities and managing their expectations represent additional aspects of patient care. Therapies such as calcipotriene and betamethasone dipropionate (Cal/BD) fixed combination foam and new drugs and vehicles continuously enhance the treatment landscape for psoriasis. Because adherence to topical treatment can be a major difficulty, keeping the treatment regimen simple and using new and sophisticated treatment vehicles that are acceptable to patients can likely improve treatment outcomes.

  6. Genotoxic and apoptotic effects of Goeckerman therapy for psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Borska, L.; Andrys, C.; Krejsek, J.; Hamakova, K.; Kremlacek, J.; Palicka, V.; Ranna, D.; Fiala, Z. [Charles University Prague, Prague (Czech Republic). Faculty of Medicine

    2010-03-15

    Goeckerman therapy (GT) for psoriasis is based on cutaneous application of crude coal tar (polycyclic aromatic hydrocarbons (PAH)) and exposure to ultraviolet radiation (UVR). PAH and UVR are mutagenic, carcinogenic and immunotoxic agents that promote apoptosis. We evaluated dermal absorption of PAH as well as the genotoxic and apoptotic effects of GT in 20 patients with psoriasis, by determining numbers of chromosomal abnormalities in peripheral lymphocytes, and levels of 1-hydroxypyrene (1-OHP), p53 protein and soluble FasL (sFasL) in urine and/or blood, before and after GT. Psoriasis Area and Severity Index (PASI) score was used to evaluate clinical efficacy of GT. Compared with pre-treatment levels, there was a significant increase in urine 1-OHP, indicating a high degree of dermal absorption of PAH (P <0.01). We also found a significant increase in the number of chromosomal abnormalities in peripheral blood lymphocytes (P <0.001), suggesting that GT is genotoxic; significantly increased p53 protein in plasma (P <0.05), an indicator of cell response to DNA damage; and significantly increased sFasL in serum (P <0.01), an indicator of apoptosis. The PASI score was significantly decreased after GT (P <0.001), confirming clinical benefit of this treatment. Our results demonstrate high dermal absorption of PAH during GT and provide evidence that GT promotes genotoxicity and apoptosis.

  7. Treating Psoriasis: Complementary and Alternative Therapies

    Science.gov (United States)

    ... physical therapies, exercise and the ancient arts of acupuncture and tai chi. Much of the evidence supporting ... your risk of heart disease and type 2 diabetes. Your risk for heart disease and type 2 ...

  8. A pilot study examining mindfulness-based cognitive therapy in psoriasis.

    Science.gov (United States)

    Fordham, B; Griffiths, C E M; Bundy, C

    2015-01-01

    A sub-population of people with psoriasis have strong causal beliefs about stress, high levels of emotional distress (anxiety and depression) and an impaired quality of life (QoL). Mindfulness-based cognitive therapy has been found to reduce levels of stress and distress and to improve QoL. This pilot study in people with psoriasis aimed to test the hypothesis that mindfulness could reduce stress and thereby lessen psoriasis severity, improve QoL and reduce distress. Twenty-nine people with psoriasis (22-70-years old; 16 females; 13 males) were randomised to an eight-week mindfulness treatment as an adjunct to their usual psoriasis therapy or to a control group which continued with usual psoriasis therapy alone. All subjects completed self-reported measurements of psoriasis severity, perceived stress, distress and QoL, at baseline and again post-intervention. The mindfulness group reported statistically lower psoriasis severity (Self-Assessed Psoriasis Area Severity Index; z = 1.96, p = .05) and QoL impairment scores (Dermatology Life Quality Index; z = 2.30, p = .02) than the control group. There was no significant difference between groups on perceived stress (Perceived Stress Scale; z = .07, p = .94) or distress scores (Hospital Anxiety Depression Scale; z = 1.60, p = .11). People with psoriasis who received mindfulness as an adjunct to their usual therapy reported a significant improvement in both psoriasis severity and QoL. These pilot results suggest that a full randomised control trial is justified to examine the effectiveness of mindfulness as an adjunctive treatment for people with psoriasis.

  9. Diagnosis of drug-induced psoriasis.

    Science.gov (United States)

    Abel, E A

    1992-12-01

    Certain drugs have been reported to precipitate or to exacerbate psoriasis. These cases occur mostly in patients with a history of psoriasis, although occasionally the new onset of psoriasis has followed treatment with certain drugs. The suspect drugs include lithium, beta adrenergic antagonists, antimalarials, and non-steroidal anti-inflammatory drugs (NSAID), in addition to various miscellaneous agents, including tetracycline. Evidence for these reports must be critically examined based on clinical and histological data, time course between drug intake and psoriasis exacerbation or resistance to psoriasis therapy, and response to drug rechallenge when available. The clinical context must be taken into consideration, including effects of concomitant antipsoriatic therapy, and the possible role of other triggering factors, such as infection. Controlled, prospective studies of the use of NSAID in patients with psoriasis may help to clarify their varied cutaneous effects. Further knowledge of the mechanisms involved in drug exacerbation of psoriasis may help to elucidate the etiopathogenesis of this chronic skin disorder.

  10. Remission of psoriasis and psoriatic arthritis during bevacizumab therapy for renal cell cancer

    Directory of Open Access Journals (Sweden)

    Ananaya Datta-Mitra

    2014-01-01

    Full Text Available Bevacizumab, a monoclonal antibody against vascular endothelial growth factor (VEGF, is employed for treatment of several cancers and retinopathies. Although previous reports of remission of psoriasis with bevacizumab do exist, but its current experience for psoriatic arthritis (PsA is still limited. In this report, we describe a patient with metastatic renal cell cancer, psoriasis and PsA, who experienced a complete remission of psoriasis and PsA during bevacizumab therapy without any other management for psoriasis and PsA. We also found a flare up of his psoriatic disease after switching to other kinase inhibitors like sorafenib or sunitinib. This suggests that bevacizumab might have a promising future in the treatment of psoriasis and PsA.

  11. Study of efficacy of bath PUVA therapy in the treatment of generalized plaque type psoriasis

    Directory of Open Access Journals (Sweden)

    Azadeh S

    1999-09-01

    Full Text Available Psoriasis is a chronic, inflammatory scaling disorder of the skin. Different patterns of psoriasis exist including plaque type, erythrodemic, pustular, palmoplantar and guttate. The most commonly involved sites are the elbows, knees, lumbosacral area and scalp. PUVA (Psoriasis Plus UVA therapy [administration of oral psoralen followed by exposure to UVA (320 to 440 nm] is widely used to treat severe psoriasis. Oral PUVA produces some adverse effects that may limit its applicability in a number of patients. The carcinogenic potential limits its use in patients with psoriasis who probably receive other carcinogenic treatments. Oral PUVA may induce complications such as nausea, vomiting and headache. In light of these problems Bath PUVA therapy is an important alternative to oral PUVA therapy. Bath PUVA is a kind of photochemotherapy in which UVA radiation after administration of topical psoralen in a warm water bath is used. We treated 30 patients with generalized plaque type psoriasis with 8-Mop Bath PUVA in Razi hospital. Bath PUVA cleared psoriasis more rapidly than oral PUVA and required fewer treatments (mean number of sessions: (17.6±2.1 and lower cumulative UVA dose. (49.2±15.4 J/cm². 83.3 percent of our patients showed complete response to treatment and 13.4 percent showed good response.

  12. Anti-interleukin-17 monoclonal antibody ixekizumab in chronic plaque psoriasis

    DEFF Research Database (Denmark)

    Leonardi, Craig; Matheson, Robert; Zachariae, Claus;

    2012-01-01

    Type 17 helper T cells have been suggested to play a pathological role in psoriasis. They secrete several proinflammatory cytokines, including interleukin-17A (also known as interleukin-17). We evaluated the safety and efficacy of ixekizumab (LY2439821), a humanized anti-interleukin-17 monoclonal...

  13. Role of T-cell-mediated inflammation in psoriasis: pathogenesis and targeted therapy

    Directory of Open Access Journals (Sweden)

    Flatz L

    2013-02-01

    Full Text Available Lukas Flatz, Curdin ConradDepartment of Dermatology, University Hospital of Lausanne (CHUV, Lausanne, SwitzerlandAbstract: Psoriasis is one of the most common chronic, inflammatory, T-cell-mediated autoimmune diseases. Over the past decade, increased knowledge of disease pathogenesis has fundamentally changed psoriasis treatment, with the introduction of biologics, and this has led to a multitude of improved selective targets providing potential therapeutic options. Indeed, numerous pathogenesis-based treatments are currently in development, as psoriasis has also become increasingly relevant for proof-of-concept studies. The purpose of this review was to summarize current knowledge of psoriasis immunopathogenesis, focusing on the T-cell-mediated immune response and its initiation. The authors describe recent advances in psoriasis treatment and discuss pathogenesis-based therapies that are currently in development or which could be envisioned for the future. Although current biologics are well tolerated, several issues such as long-term efficacy, long-term safety, and high costs keep driving the search for new and better therapies. With further advances in understanding disease pathogenesis, more genomic data from psoriasis patients becoming available, and potentially the identification of autoantigens in psoriasis, current research should lead to the development of a growing arsenal of improved targeted treatments and to further breakthrough immunotherapies.Keywords: autoimmunity, autoimmune disease, immune response, immunopathogenesis

  14. Low-dose ciclosporin therapy of erythrodermic psoriasis

    Directory of Open Access Journals (Sweden)

    Ryszard Galus

    2014-07-01

    Full Text Available Psoriasis is a chronic, recurrent inflammatory skin disease which affects around 2% of the population and is characterized by erythematous and scaly macules and papules of greatly varying degree of involvement. Ciclosporin (Cs is a therapeutic agent rarely used in the treatment of erythrodermic psoriasis as a monotherapy [1].

  15. Use of Biologic Agents in Combination with Other Therapies for the Treatment of Psoriasis

    OpenAIRE

    Cather, Jennifer C.; Crowley, Jeffrey J.

    2014-01-01

    Psoriasis is a chronic inflammatory skin disorder, which is associated with a significant negative impact on a patient’s quality of life. Traditional therapies for psoriasis are often not able to meet desired treatment goals, and high-dose and/or long-term use is associated with toxicities that can result in end-organ damage. An improved understanding of the involvement of cytokines in the etiology of psoriasis has led to the development of biologic agents targeting tumor necrosis factor (TNF...

  16. Topical therapy for psoriasis: a promising future. Focus on JAK and phosphodiesterase-4 inhibitors.

    Science.gov (United States)

    Rafael, Adilia; Torres, Tiago

    2016-01-01

    Psoriasis is a common, chronic and disabling skin disorder affecting approximately 2% of the population, associated with significant negative impact on the patient's quality of life. Approximately 80% of those affected with psoriasis have mild-to-moderate forms and are usually treated with topical therapy, whereas phototherapy and systemic therapies are used for those with severe disease. In the past three decades, the major advances in psoriasis therapy have been in systemic agents for the treatment of moderate-to-severe psoriasis, particularly new immunomodulatory and biological molecules, while topical therapies have remained relatively unchanged over the past decades. Indeed, topical corticosteroids and vitamin D3 analogs are still the gold standard of therapy for mild-to-moderate psoriasis. Thus, there is a need to develop new and more effective topical agents in the short and long term, with a better efficacy and safety profile than corticosteroids and vitamin D3 analogs. Over the past five years, investigation into topical therapy has expanded, with exciting new drugs being developed. Preliminary results of these emerging agents that selectively target disease-defining pathogenic pathways seem to be promising, although long-term and large-scale studies assessing safety and efficacy are still lacking. The aim of this article was to review the clinical and research data of some emerging topical agents, focusing on Janus kinase-signal transducer and activator of transcription and phosphodiesterase type 4 inhibitors, which are currently being investigated.

  17. Topical therapy for psoriasis: a promising future. Focus on JAK and phosphodiesterase-4 inhibitors.

    Science.gov (United States)

    Rafael, Adilia; Torres, Tiago

    2016-01-01

    Psoriasis is a common, chronic and disabling skin disorder affecting approximately 2% of the population, associated with significant negative impact on the patient's quality of life. Approximately 80% of those affected with psoriasis have mild-to-moderate forms and are usually treated with topical therapy, whereas phototherapy and systemic therapies are used for those with severe disease. In the past three decades, the major advances in psoriasis therapy have been in systemic agents for the treatment of moderate-to-severe psoriasis, particularly new immunomodulatory and biological molecules, while topical therapies have remained relatively unchanged over the past decades. Indeed, topical corticosteroids and vitamin D3 analogs are still the gold standard of therapy for mild-to-moderate psoriasis. Thus, there is a need to develop new and more effective topical agents in the short and long term, with a better efficacy and safety profile than corticosteroids and vitamin D3 analogs. Over the past five years, investigation into topical therapy has expanded, with exciting new drugs being developed. Preliminary results of these emerging agents that selectively target disease-defining pathogenic pathways seem to be promising, although long-term and large-scale studies assessing safety and efficacy are still lacking. The aim of this article was to review the clinical and research data of some emerging topical agents, focusing on Janus kinase-signal transducer and activator of transcription and phosphodiesterase type 4 inhibitors, which are currently being investigated. PMID:26552963

  18. Circulating levels of sphingosine-1-phosphate are elevated in severe, but not mild psoriasis and are unresponsive to anti-TNF-α treatment

    Science.gov (United States)

    Checa, Antonio; Xu, Ning; Sar, Daniel G.; Haeggström, Jesper Z.; Ståhle, Mona; Wheelock, Craig E.

    2015-07-01

    Sphingolipids are bioactive molecules with a putative role in inflammation. Alterations in sphingolipids, in particular ceramides, have been consistently observed in psoriatic skin. Herein, we quantified the circulating sphingolipid profile in individuals with mild or severe psoriasis as well as healthy controls. In addition, the effects of anti-TNF-α treatment were determined. Levels of sphingoid bases, including sphingosine-1-phosphate (S1P), increased in severe (P fatty acid chain length-dependent manner. These alterations were also observed in psoriasis skin lesions and were associated with changes in mRNA levels of ceramide synthases. The lack of S1P response to treatment may have pathobiological implications due to its close relation to the vascular and immune systems. In particular, increased levels of sphingolipids and especially S1P in severe psoriasis patients requiring biological treatment may potentially be associated with cardiovascular comorbidities. The fact that shifts in S1P levels were not ameliorated by anti-TNF-α treatment, despite improvements in the skin lesions, further supports targeting S1P receptors as therapy for severe psoriasis.

  19. Biologic therapy with or without topical treatment in psoriasis: what does the current evidence say?

    Science.gov (United States)

    Jensen, J Daniel; Delcambre, Macey Renault; Nguyen, Gloria; Sami, Naveed

    2014-10-01

    Biologic therapy represents a relatively new class of drugs which have revolutionized the treatment of psoriasis and are used with increasing frequency in order to control this chronic, systemic inflammatory disease. However, it is unclear what role there is for combination therapy of biologics with traditional topical agents. The purpose of this article is to assess the literature on the role of topical agents as adjuvants to biological treatments in the treatment of psoriasis and identify areas for further research. A MEDLINE search was performed in order to identify English-language publications from 1996 to 2014 examining combination biologic therapy with topical medications in the treatment of psoriasis. Data from these clinical studies are summarized and the outcomes are discussed. In general, the addition of adjuvant topical therapy to systemic biologic therapy allowed for a reduction in dosage and side effects of both agents, maintenance of initial response to biologics, treatment of recalcitrant lesions in partial responders, and potential acceleration of response to biologic therapies. The current data, though limited, suggest that using topical therapies as adjunct treatment to biologics is a well tolerated and effective means of controlling psoriasis and improving quality of life for patients. However, the treating physician should remain attentive to signs of adverse events and seek opportunities to reduce the dose or treatment frequency during chronic use.

  20. The Power of Combination Topical Therapy for Psoriasis.

    Science.gov (United States)

    Kircik, Leon H; Zografos, Panagiotis

    2015-10-01

    Psoriasis is a chronic inflammatory skin disease where the use of topical corticosteroids is a mainstream treatment. However, the continuous use of high potency topical corticosteroids is limited by a variety of well known adverse events which include, atrophy, and telangiectasia. Also, inhibition of lipid synthesis by steroids can cause impairment of the epidermal barrier, which is already disrupted in most of the inflammatory cutaneous disorders such as psoriasis. This will further lead to increase transepidermal water loss (TEWL), decreased hydration, dry skin, and irritation. On the other hand, topical vitamin D analogs directly affect keratinocyte proliferation and differentiation as well as modulation of epidermal lipids and antimicrobial peptides. Although the exact mechanism of action of topical vitamin D analogs is not well understood in the treatment of psoriasis, their efficacy and safety has been shown in several clinical trials over the years and they are widely used for psoriasis. Therefore, combination of topical steroids and vitamin D analogs may be a logical option for the treatment of psoriasis.

  1. Apremilast in the therapy of moderate-to-severe chronic plaque psoriasis

    Directory of Open Access Journals (Sweden)

    Gisondi P

    2016-05-01

    Full Text Available Paolo Gisondi, Giampiero Girolomoni Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy Abstract: Chronic plaque psoriasis presents clinically as an inflammatory disease of the skin, which is often associated with comorbidities and responsible for a poor quality of life. It can widely vary among patients because of different age of onset, type of symptoms, areas of involvement, and disease severity. The choice of the treatment of psoriasis should be person­alized according to the specific needs of the patients. Apremilast is a well-tolerated and effective phosphodiesterase type 4 inhibitor that is indicated for the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis. In this article, the pharmacological, clinical, and safety aspects of apremilast are reviewed. Based on these data, apremilast could be indicated for patients with a Psoriasis Area and Severity Index score <10 but with a significant impact on quality of life and seems to be an appropriate treatment for elderly patients also. Keywords: psoriasis, apremilast, therapy, psoriasis severity

  2. Biologic therapy improves psoriasis by decreasing the activity of monocytes and neutrophils.

    Science.gov (United States)

    Yamanaka, Keiichi; Umezawa, Yoshinori; Yamagiwa, Akisa; Saeki, Hidehisa; Kondo, Makoto; Gabazza, Esteban C; Nakagawa, Hidemi; Mizutani, Hitoshi

    2014-08-01

    Therapy with monoclonal antibodies to tumor necrosis factor (TNF)-α and the interleukin (IL)-12/23 p40 subunit has significantly improved the clinical outcome of patients with psoriasis. These antibodies inhibit the effects of the target cytokines and thus the major concern during their use is the induction of excessive immunosuppression. Recent studies evaluating the long-term efficacy and safety of biologic therapy in psoriasis have shown no significant appearance of serious adverse effects including infections and malignancies. However, the immunological consequence and the mechanism by which the blockade of a single cytokine by biologics can successfully control the activity of psoriasis remain unclear. In the current study, we investigated the effect of biologic therapy on cytokine production of various lymphocytes and on the activity of monocytes and neutrophils in psoriatic patients. Neutrophils, monocytes and T cells were purified from heparinized peripheral venous blood by Ficoll density gradient centrifugation, and γ-interferon, TNF-α and IL-17 production from lymphocytes was measured by flow cytometer. The activation maker of neutrophils and the activated subsets of monocytes were also analyzed. Biologic therapy induced no significant changes in the cytokine production by lymphocytes from the skin and gut-homing T cells. However, neutrophil activity and the ratio of activated monocyte population increased in severely psoriatic patients were normalized in psoriatic patients receiving biologic therapy. The present study showed that biologic therapy ameliorates clinical symptoms and controls the immune response in patients with psoriasis. PMID:25099154

  3. Childhood psoriasis.

    Science.gov (United States)

    Farber, E M; Nall, L

    1999-11-01

    Psoriasis is a common skin disease in infants, children, and adolescents. A review of the clinical, epidemiologic, genetic, and therapeutic aspects of childhood psoriasis is presented. Population studies indicate that the first signs of psoriatic lesions occur in the pediatric age group, birth to 18 years of age, and that both genetic and environmental factors interact to precipitate the development of psoriasis. Koebner reactions are the result of external or internal triggering factors, such as physical injury to the skin, low humidity, and certain drugs. The most frequently observed variant to psoriasis is the plaque type, followed by guttate psoriasis, and juvenile psoriatic arthritis. Pustular psoriasis and erythrodermic psoriasis are rare forms of the disease, but are seen in children from infancy to adolescence. The scalp is the most frequently affected site of involvement in pediatric psoriasis, followed by the appearance of lesions on the extensor surfaces of the extremities, trunk, and nails. Although not common in adult psoriasis, the face and ears are often involved. Topical medications such as corticosteroids, calcipotriol, coal tar preparations, anthralin formulations, and ultraviolet B are recommended in monotherapy or in combination therapy, whereas psoralen plus ultraviolet A, methotrexate, and retinoids should only be administered in crisis situations. The treatment objectives in childhood psoriasis are to preserve skin surfaces, to afford physical relief from the disease, and to employ treatments that do not endanger the health or future development of the child.

  4. [Pustular psoriasis].

    Science.gov (United States)

    Weisenseel, P; Wilsmann-Theis, D; Kahl, C; Reich, K; Mössner, R

    2016-06-01

    A number of pustular skin diseases share clinical, pathogenetic, and epidemiological aspects with plaque-type psoriasis, and their classification as a separate clinical entity or as a subtype of psoriasis remains controversial, which is also reflected in the multitude of their names. They include generalized pustular psoriasis with its subtypes, acrodermatitis continua suppurativa (Hallopeau), acute pustulosis palmopantaris, palmoplantar pustular psoriasis, and pustular variants of a mostly TNF-blocker triggered paradoxical psoriasiform dermatitis. In this article, the epidemiology, clinical picture, pathogenesis, genetics, and therapy of these pustular skin diseases are described. PMID:27240667

  5. Goeckerman's therapy for psoriasis with special reference to serum pentraxin 3 level

    Energy Technology Data Exchange (ETDEWEB)

    Ctirad, A.; Lenka, B.; David, P.; Zdenek, F.; Kveta, H.; Karel, E.; Jan, K. [Charles University Prague, Hradec Kralove (Czech Republic). University Hospital

    2008-10-15

    Goeckerman's therapy (GT) of psoriasis is based on daily application of pharmacy grade coal tar on affected skin with subsequent exposure to UV light. Pentraxin 3 (PTX3) is a newly identified acute phase reactant with non redundant functions in innate immunity. PTX3 has been shown to be a reliable prognostic marker in patients with various inflammatory disorders including rheumatoid arthritis, vasculitis, and psoriasis. The aim of this study was to evaluate the influence of Goeckerman's therapy of psoriasis on levels of two pentraxins: long pentraxin PTX3 and C reactive protein in 49 patients with chronic plaque psoriasis. CRP was assessed by immunonephelometry on IMMAGE 800 (Beckman, USA). PTX3 was detected using sandwich ELISA detection set (Alexis Biochemicals, Switzerland). The serum levels of both parameters (expressed as average {+-} 1 SD) were significantly diminished after GT. The level of PTX3 dropped from 1.92 {+-} 0.72 ng/ml before GT to 1.66 {+-} 0.58 ng/ml after GT (P = 0.0396) and the level of CRP fell from 4.64 {+-} 3.93 mg/l to 1.66 {+-} 0.58 mg/l (P {lt} 0.0001). Comparing to healthy controls, the serum levels of both parameters before GT were significantly higher than those found in healthy blood donors and remained significantly increased after GT. Increased serum concentrations of pentraxin 3 and CRP are alleviated by GT in patients with psoriasis.

  6. CYCLOSPORIN A (SANDIMMUN NEORAL IN THERAPY FOR PSORIASIS AND PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Yulia Leonodovna Korsakova

    2010-01-01

    Full Text Available The involvement of immune mechanisms in the pathogenesis of psoriatic arthritis (PA is noted to give grounds to use immunoactive compounds (disease- modifying agents - basic anti-inflammatory drugs -BAIDs, such as cyclosporin A (CsA, in this disease. The data available in the literature permit a high assessment of CsA as one of the BAIDs in the treatment of PA and psoriasis. CsA is stated to monitor the course of this disease, acts on inflamed peripheral joints, decreases the clinical and laboratory activity of PA, positively affects the PA-afflicted skin, and can induce remission of psoriasis.

  7. Paradoxical psoriasiform reactions to anti-TNFα drugs are associated with genetic polymorphisms in patients with psoriasis.

    Science.gov (United States)

    Cabaleiro, T; Prieto-Pérez, R; Navarro, R; Solano, G; Román, M; Ochoa, D; Abad-Santos, F; Daudén, E

    2016-08-01

    Paradoxical psoriasiform reactions to anti-tumor necrosis factor α (TNFα) agents have been described. We aimed to study the association between these reactions and polymorphisms in genes previously associated with psoriasis or other autoimmune diseases. A total of 161 patients with plaque-type psoriasis treated with anti-TNFα drugs were genotyped for 173 single-nucleotide polymorphisms (SNPs) using the Illumina Veracode genotyping platform. Among the 161 patients, 25 patients developed a paradoxical psoriasiform reaction consisting of a change in morphology, mostly to guttate psoriasis (88%). These lesions developed 9.20±13.52 months after initiating treatment, mainly with etanercept (72%). Psoriasis type and a Psoriasis Area and Severity Index (PASI) 75 response to treatment were not associated with lesions. Multivariate logistic regression revealed that five SNPs (rs11209026 in IL23R, rs10782001 in FBXL19, rs3087243 in CTLA4, rs651630 in SLC12A8 and rs1800453 in TAP1) were associated with paradoxical reactions. This is the first study to show an association between genetic polymorphisms and paradoxical reactions in patients with psoriasis treated with anti-TNFα drugs.The Pharmacogenomics Journal advance online publication, 21 July 2015; doi:10.1038/tpj.2015.53. PMID:26194362

  8. Biological therapies in the systemic management of psoriasis : International Consensus Conference

    NARCIS (Netherlands)

    Sterry, W.; Barker, J.; Boehncke, W.H.; Bos, J.D.; Chimenti, S.; Christophers, E.; Brassinne, M. de la; Ferrandiz, C.; Griffiths, C.E.; Katsambas, A.; Kragballe, K.; Lynde, C.; Menter, A.; Ortonne, J.P.; Papp, K.A.; Prinz, J.C.; Rzany, B.; Ronnevig, J.; Saurat, J.H.; Stahle, M.; Stengel, F.M.; Kerkhof, P.C.M. van de; Voorhees, J.

    2004-01-01

    Psoriasis is a chronic, immune-mediated disorder that usually requires long-term treatment for control. Approximately 25% of patients have moderate to severe disease and require phototherapy, systemic therapy or both. Despite the availability of numerous therapeutic options, the long-term management

  9. Apremilast and Secukinumab Combined Therapy in a Patient With Recalcitrant Plaque Psoriasis.

    Science.gov (United States)

    Rothstein, Brooke E; McQuade, Brianna; Greb, Jacqueline E; Goldminz, Ari M; Gottlieb, Alice B

    2016-05-01

    We report a 67-year-old Caucasian man with a long-term history of recalcitrant plaque psoriasis and psoriatic arthritis who was initiated on a treatment regimen of apremilast and secukinumab after failing multiple topical, photo, and systemic therapies. This combination provided significant skin improvement with minimal drug side effects. J Drugs Dermatol. 2016;15(5):648-649. PMID:27168275

  10. Pilot study of sexual dysfunction in patients with psoriasis: Influence of biologic therapy

    Directory of Open Access Journals (Sweden)

    Ricardo Ruiz-Villaverde

    2011-01-01

    Full Text Available Background: Psoriasis is a chronic skin disease that affects 1 to 3% of the population in most industrialized countries. It is commonly associated with a variety of psychological problems including low self-esteem, depression, suicidal thoughts, and sexual dysfunction. Materials and Methods : We have performed a pilot study in which we have tried to assess the impact on sexual dysfunction in patients with psoriasis who have started treatment with biological therapy using validated indexes in Spanish: International Index of Erectile Function for men and female sexual function index in women. Results : Considering the men and women from our study, an improvement in FSFI by an average of 9.5 and 6.3 points is observed, respectively. Conclusion: We considered our series as a first step for a more detailed approach to the study of sexual function in patients with psoriasis.

  11. Responses to ustekinumab in the anti-TNF agent-naïve vs. anti-TNF agent-exposed patients with psoriasis vulgaris

    DEFF Research Database (Denmark)

    Clemmensen, A; Spon, M; Skov, L;

    2010-01-01

    Background  Approximately 20-30% of patients with psoriasis treated with anti-tumour necrosis factor α (TNFα) agents will discontinue treatment within 2 years due to loss of efficacy or side-effects. Switching to another anti-TNFα agent produces clinical responses inferior to previously untreated...... with TNFα inhibitors and anti-TNFα-naïve patients. Methods  Patients receiving either ustekinumab (n = 71) or the subcutaneous TNFα inhibitors adalimumab or etanercept (n = 108) were identified through the registry of psoriasis patients in our Institutions. Efficacy effect outcome was a 75% improvement...... in the psoriasis area severity index (PASI75). Kaplan-Meier statistics evaluated the adherence to the treatments expressed as drug survival rate. Results  PASI75 was achieved in 80% of the ustekinumab-treated patients after a median time of 112 days. There was no difference in efficacy in anti-TNFα-naïve patients...

  12. Responses to ustekinumab in the anti-TNF agent-naïve vs. anti-TNF agent-exposed patients with psoriasis vulgaris

    DEFF Research Database (Denmark)

    Clemmensen, A; Spon, M; Skov, L;

    2010-01-01

    Background Approximately 20-30% of patients with psoriasis treated with anti-tumour necrosis factor a (TNFa) agents will discontinue treatment within 2 years due to loss of efficacy or side-effects. Switching to another anti-TNFa agent produces clinical responses inferior to previously untreated...... with TNFa inhibitors and anti-TNFa-naïve patients. Methods Patients receiving either ustekinumab (n = 71) or the subcutaneous TNFa inhibitors adalimumab or etanercept (n = 108) were identified through the registry of psoriasis patients in our Institutions. Efficacy effect outcome was a 75% improvement...... in the psoriasis area severity index (PASI75). Kaplan-Meier statistics evaluated the adherence to the treatments expressed as drug survival rate. Results PASI75 was achieved in 80% of the ustekinumab-treated patients after a median time of 112 days. There was no difference in efficacy in anti-TNFa-naïve patients...

  13. Scalp psoriasis.

    Science.gov (United States)

    Kircik, Leon H; Kumar, Sandeep

    2010-08-01

    Psoriasis is a chronic, debilitating disease that commonly involves the scalp. Despite a wide range of therapy options, scalp psoriasis remains difficult to treat, highlighting a long-standing unmet need for the safe and effective treatment of scalp psoriasis. Many topical therapies for scalp psoriasis are also difficult or unpleasant to apply, resulting in decreased adherence and efficacy. In brief, the high level of patient dissatisfaction with currently available treatments for psoriasis supports the need for new, effective and well-tolerated treatment options for scalp psoriasis. This article aims to review the efficacy and safety of new formulations and treatment options available to control scalp psoriasis. For example, a new formulation of calcipotriene/betamethasone scalp solution has a rapid onset of action with once daily dosing that improves compliance. The CalePso study examines the safety profile of otherwise established Clobetasol propionate (CP) shampoo 0.05%, and reports that CP shampoo is safe and efficacious in the long-term management of scalp psoriasis. A new foam formulation of coal tar is shown to be cosmetically acceptable and easier to apply.

  14. Guidelines of care for the management of psoriasis and psoriatic arthritis Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies

    Energy Technology Data Exchange (ETDEWEB)

    Menter, A.; Korman, N.J.; Elmets, C.A.; Feldman, S.R.; Gelfand, J.M.; Gordon, K.B.; Gottlieb, A.; Koo, J.Y.M.; Lebwohl, M.; Lim, H.W.; Van Voorhees, A.S.; Beutner, K.R.; Bhushan, R. [University of Texas South West Medical Center Dallas, Dallas, TX (United States)

    2009-04-15

    Psoriasis is a common, chronic, inflammatory, multi-system disease with predominantly skin and joint manifestations affecting approximately 2% of the Population. In this third of 6 sections of the guidelines of care for psoriasis, we discuss the use of topical medications for the treatment of psoriasis. The majority of patients with psoriasis have limited disease (<5% body surface area involvement) and can be treated with topical agents, which generally provide a high efficacy-to-safety ratio. Topical agents may also be used adjunctively for patients with more extensive psoriasis undergoing therapy with either ultraviolet light, systemic or biologic medications. However, the use of topical agents as monotherapy in the setting of extensive disease or in the setting of limited, but recalcitrant, disease is not routinely recommended. Treatment should be tailored to meet individual patients' needs. We will discuss the efficacy and safety of as well as offer recommendations for the use of topical corticosteroids, vitamin D analogues, tazarotene, tacrolimus, pimecrolimus, emollients, salicylic acid, anthralin, coal tar, as well as combination therapy.

  15. A Patient with Refractory Psoriasis Who Developed Sebaceous Carcinoma on the Neck during Cyclosporine Therapy and Showed Rapid Progression

    Science.gov (United States)

    Shima, Tomoko; Yamamoto, Yuki; Okuhira, Hisako; Mikita, Naoya; Furukawa, Fukumi

    2016-01-01

    We report a patient who developed sebaceous carcinoma on the neck during therapy with immunosuppressive agents (cyclosporine, corticosteroid, methotrexate) for refractory psoriasis vulgaris, which showed rapid enlargement, leading to a fatal outcome. Multiple-organ metastases were detected. Weekly carboplatin + paclitaxel therapy resulted in the disappearance of tumor cells, but the patient died of febrile neutropenia. The development of sebaceous carcinoma is rare among psoriasis patients receiving immunosuppressive agents including cyclosporine. PMID:27462222

  16. Development and characterization of nanocarriers for topical treatment of psoriasis by using combination therapy.

    Science.gov (United States)

    Parnami, Nupur; Garg, Tarun; Rath, Goutam; Goyal, Amit K

    2014-12-01

    Psoriasis is an autoimmune, chronic, inflammatory skin disease characterized by epidermal hyperplasia, proliferation of blood vessels, and infiltration of leukocytes in dermis and epidermis. Several immunosuppressants such as methotrexate (MXT) and cyclosporine are used but they are associated with adverse effects due to down regulation of immune system. Numerous approaches have been explored to overcome the problems of conventional topical system such as high frequency of application, impermeability to skin barrier, and limited efficacy. Photodynamic therapy is another non-invasive technique currently used for skin diseases. The combination of two drugs is also commonly observed to achieve more effective therapy. In the present study, antipsoriatic activity of niosomal formulations for the treatment of psoriasis in combination with narrow and broad band UV radiation had been explored in experimental animal model.

  17. [Skin symptoms of psoriasis associated with spondylarthropathies].

    Science.gov (United States)

    Menzinger, Sébastien; Boehncke, Wolf-Henning

    2016-03-01

    The term spondylarthropathy summarizes a heterogenous group of diseases with spinal involvement as the common denominator. In this paper, we will primarily focus on cutaneous manifestations of psoriasis, as this dermatosis is associated with psoriatic artrhritis, one of the major diseases classified as spondylarthropathy. We will describe the clinical manifestations of psoriasis as well as the underlying pathophysiology, the latter allowing to understand the differences in efficacy of numerous Disease Modifying Anti-Rheumatic Drugs (DMARDs) on joint versus skin symptoms. Additionally, we address the exacerbation of pre-existing psoriasis under DMARD therapy.

  18. Vitamin B12ointment containing avocado oil in the therapy of plaque psoriasis

    OpenAIRE

    Stücker, Markus; Memmel, Ulrike; Hoffmann, Matthias; Hartung, Joachim; Altmeyer, Peter

    2001-01-01

    Background: There are already many effective topical therapies available for use in the treatment of chronic plaque psoriasis. Unfortunately, these treatments are often associated with a not insignificant risk of undesirable effects. Objective and methods: In the randomized, prospective clinical trial discussed in the following, the therapeutic effects of the standard vitamin D3 analog calcipotriol were evaluated against those of a recently developed vitamin B12 ointment containing avocado oi...

  19. Iatrogenic Cushing's Syndrome After Topical Steroid Therapy for Psoriasis.

    Science.gov (United States)

    Sahıp, Birsen; Celık, Mehmet; Ayturk, Semra; Kucukarda, Ahmet; Mert, Onur; Dıncer, Nejla; Guldıken, Sıbel; Tugrul, Armagan

    2016-01-01

    Glucocorticoids are used for the treatment of many diseases, such as inflammatory, allergic, autoimmune, and neoplastic diseases. They can be used in the form of topical, oral, inhalable, rectal, and intra-articular agents. Many topical steroid-related iatrogenic Cushing's syndrome cases affecting especially children have been reported in the literature. Topical steroid-related Cushing's syndrome is rarely seen in adults. In this report, we present the case of a 32-year-old male patient with iatrogenic Cushing's syndrome related to long-term clobetasol propionate treatment for psoriasis. In the context of such treatment, the glucocorticoid withdrawal problem has to be overcome. At present there is no consensus on steroid withdrawal. Patients on long-term glucocorticoid treatment must be evaluated for potential adverse effects and withdrawal symptoms by their physician and their endocrinologist.

  20. Estimated UV doses to psoriasis patients during climate therapy at Gran Canaria in March 2006

    Directory of Open Access Journals (Sweden)

    L. T. N. Nilsen

    2008-01-01

    Full Text Available Psoriasis is a chronic inflammatory disease involving about 2–3% of the Norwegian population. Sun exposure has a positive effect on most psoriasis lesions, but ultraviolet (UV radiation also causes a direct DNA damage in the skin cells and comprises a carcinogenic potential. UV exposure on the skin causes a local as well as a systemic immune suppressive effect, but the relation between sun exposure and these biological effects is not well known. In March 2006 a study was carried out to investigate possible therapeutic outcome mechanisms in 20 psoriasis patients receiving climate therapy at Gran Canaria. This paper presents estimates of their individual skin UV-doses based on UV measurements and the patients' diaries with information on time spent in the sun.

    On the first day of exposure the patients received on average 5.1 Standard Erythema Doses (SED: median=4.0 SED, range 2.6–10.3 SED estimated to the skin. During the 15 days study they received 165.8 SED (range 104.3–210.1 SED. The reduction in PASI score was 72.8% on average, but there was no obvious relation between the improvement and the UV dose. The UV doses were higher than those found from climate therapy studies at other locations. It seems beneficial to use more strict exposure schedules that consider the available UV irradiance, depending on time of the day, time of the year and weather conditions.

  1. Climate therapy of psoriasis patients at Gran Canaria. High UV doses

    International Nuclear Information System (INIS)

    Psoriasis is a chronic inflammatory disease involving about 2-3% of the European population. Sun exposure has a positive effect on most psoriasis lesions, but ultraviolet (UV) radiation also causes a direct DNA damage in the skin cells and comprises a carcinogenic potential. UV exposure on the skin causes a local as well as a systemic immune suppressive effect, but the relation between sun exposure and these biological effects is not well known. In March 2006 a study was carried out to investigate possible therapeutic outcome mechanisms in 20 psoriasis patients receiving climate therapy at Gran Canaria. This paper presents estimates of their individual skin UV doses based on UV measurements and patients' diaries with information on time spent in the sun. On the first day of exposure the patients received on average 5.1 Standard Erythema Doses (SED) estimated to the skin. During the 15 days study they received 166 SED. There was no significant correlation between the therapeutic improvement and the UV dose. The UV doses were higher than if they had followed the prescribed exposure schedule and also higher than doses found from climate therapy studies at other locations. It seems beneficial to focus on the prescribed exposure schedules. (author)

  2. Anti-Inflammatory Dimethylfumarate: A Potential New Therapy for Asthma?

    Directory of Open Access Journals (Sweden)

    Petra Seidel

    2013-01-01

    Full Text Available Asthma is a chronic inflammatory disease of the airways, which results from the deregulated interaction of inflammatory cells and tissue forming cells. Beside the derangement of the epithelial cell layer, the most prominent tissue pathology of the asthmatic lung is the hypertrophy and hyperplasia of the airway smooth muscle cell (ASMC bundles, which actively contributes to airway inflammation and remodeling. ASMCs of asthma patients secrete proinflammatory chemokines CXCL10, CCL11, and RANTES which attract immune cells into the airways and may thereby initiate inflammation. None of the available asthma drugs cures the disease—only symptoms are controlled. Dimethylfumarate (DMF is used as an anti-inflammatory drug in psoriasis and showed promising results in phase III clinical studies in multiple sclerosis patients. In regard to asthma therapy, DMF has been anecdotally reported to reduce asthma symptoms in patients with psoriasis and asthma. Here we discuss the potential use of DMF as a novel therapy in asthma on the basis of in vitro studies of its inhibitory effect on ASMC proliferation and cytokine secretion in ASMCs.

  3. Zinc therapy on children with Psoriasis modulates trace elements in serum and tissue

    International Nuclear Information System (INIS)

    This study illustrates the effect of zinc therapy on some trace elements in either serum and skin which has been done on twenty patients with psoriasis with age range between 4 -13 years. They were under medical treatment with 5 milligram; oral zinc sulfate for 12 weeks. A significant increase in both serum and tissue copper and iron levels was detected by atomic absorption spectrophotometer . In addition, a significant decrease in both serum and tissue calcium and magnesium in psoriatic patients. It has been concluded that zinc therapy could be valuable through modulation of copper, calcium, iron and magnesium in psoriatic patients.

  4. Off-label biologic regimens in psoriasis: a systematic review of efficacy and safety of dose escalation, reduction, and interrupted biologic therapy.

    Directory of Open Access Journals (Sweden)

    Elizabeth A Brezinski

    Full Text Available OBJECTIVES: While off-label dosing of biologic treatments may be necessary in selected psoriasis patients, no systematic review exists to date that synthesizes the efficacy and safety of these off-label dosing regimens. The aim of this systematic review is to evaluate efficacy and safety of off-label dosing regimens (dose escalation, dose reduction, and interrupted treatment with etanercept, adalimumab, infliximab, ustekinumab, and alefacept for psoriasis treatment. DATA SOURCES AND STUDY SELECTION: We searched OVID Medline from January 1, 1990 through August 1, 2011 for prospective clinical trials that studied biologic therapy for psoriasis treatment in adults. Individual articles were screened for studies that examined escalated, reduced, or interrupted therapy with etanercept, adalimumab, infliximab, ustekinumab, or alefacept. DATA SYNTHESIS: A total of 23 articles with 12,617 patients matched the inclusion and exclusion criteria for the systematic review. Data were examined for primary and secondary efficacy outcomes and adverse events including infections, malignancies, cardiovascular events, and anti-drug antibodies. The preponderance of data suggests that continuous treatment with anti-TNF agents and anti-IL12/23 agent was necessary for maintenance of disease control. Among non-responders, dose escalation with etanercept, adalimumab, ustekinumab, and alefacept typically resulted in greater efficacy than standard dosing. Dose reduction with etanercept and alefacept resulted in reduced efficacy. Withdrawal of the examined biologics led to an increase in disease activity; efficacy from retreatment did not result in equivalent initial response rates for most biologics. Safety data on off-label dosing regimens are limited. CONCLUSION: Dose escalation in non-responders generally resulted in increased efficacy in the examined biologics used to treat moderate-to-severe psoriasis. Continuous treatment with anti-TNF agents and anti-IL12/23 agent

  5. Childhood psoriasis

    Directory of Open Access Journals (Sweden)

    Dogra Sunil

    2010-01-01

    Full Text Available Psoriasis is a common dermatosis in children with about one third of all patients having onset of disease in the first or second decade of life. A chronic disfiguring skin disease, such as psoriasis, in childhood is likely to have profound emotional and psychological effects, and hence requires special attention. Psoriasis in children has been reported to differ from that among adults being more frequently pruritic; plaque lesions are relatively thinner, softer, and less scaly; face and flexural involvement is common and guttate type is the characteristic presentation. Whether onset in childhood predicts a more severe form of psoriasis is a matter of controversy, it may cause significant morbidity particularly if it keeps relapsing. Most children have mild form of psoriasis which can be generally treated effectively with topical agents such as emollients, coal tar, corticosteroids, dithranol, calcipotriol etc. according to age and the sites affected. Narrow band UVB is the preferred form of phototherapy in children for moderate to severe disease or in patients not responding to topical therapy alone. Systemic therapies are reserved for more severe and extensive cases that cannot be controlled with topical treatment and/or phototherapy such as severe plaque type, unstable forms like erythrodermic and generalized pustular psoriasis and psoriatic arthritis. There are no controlled trials of systemic therapies in this age group, most experience being with retinoids and methotrexate with favorable results. Cyclosporine can be used as a short-term intermittent crisis management drug. There is an early promising experience with the use of biologics (etanercept and infliximab in childhood psoriasis. Systemic treatments as well as phototherapy have limited use in children due to cumulative dose effects of drugs, low acceptance, and risk of gonadal toxicity. More evidence-based data is needed about the effectiveness and long-term safety of topical

  6. Emerging treatment options for psoriasis

    Directory of Open Access Journals (Sweden)

    Taheri A

    2014-08-01

    Full Text Available Arash Taheri,1 Laura F Sandoval,1 Sara Moradi Tuchayi,1 Hossein Alinia,1 Parisa Mansoori,2 Steven R Feldman1–3 1Center for Dermatology Research, Department of Dermatology, 2Department of Pathology, 3Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA Abstract: The treatment of psoriasis has evolved over the years, with the recent focus largely on the use of biologics and anti-interleukin-17 agents. With treatment options expanding, practitioners and patients may find control of psoriasis more convenient and safer to achieve. In this article, we review the literature on emerging medications for the treatment of psoriasis. Although some of the new medications under development, such as the anti-interleukin-17 agents, are being shown to be very efficacious in the treatment of psoriasis in premarketing trials, more information regarding their long-term use is needed to demonstrate their superiority over available modalities. Keywords: psoriasis, therapy, interleukin-17, biologics, emerging, treatment

  7. Serum levels of the pro-inflammatory cytokine interleukin-12 and the anti-inflammatory cytokine interleukin-10 in patients with psoriasis treated by the Goeckerman regimen

    Energy Technology Data Exchange (ETDEWEB)

    Borska, L.; Andrys, C.; Krejsek, J.; Hamakova, K.; Kremlacek, J.; Ettler, K.; Fiala, Z. [Charles University Prague, Hradec Kralove (Czech Republic)

    2008-08-15

    The Goeckerman regimen (GR) involves the dermal application of a crude coal tar (polycyclic aromatic hydrocarbon, PAH) and exposure to ultraviolet (UV) radiation. Both PAH and UV radiation exhibit immunosuppressive activity. This study describes the changes in the serum levels of the pro-inflammatory cytokine interleukin-12 (IL-12) and the anti-inflammatory cytokine IL-10 in patients with psoriasis (n = 55) treated with GR. The serum levels of IL-12 and IL-10 were compared before and after GR. In addition, the IL-12 and IL-10 levels in psoriatic patients were compared with those in a control group of healthy blood donors (n = 47). The Psoriasis Area and Severity Index (PASI) was used to evaluate the efficacy of GR. When compared with the control group, both IL-12 and IL-10 were significantly higher in psoriatic patients in all cases (P < 0.001). When compared before and after GR, the IL-12 and IL-10 levels (P < 0.01) and PASI value (P < 0.001) were significantly lower after GR. The decrease in the serum level of IL-12 and IL-10 after GR was related to the entry value before GR (IL-12, r = 0.60, P < 0.001; IL-10, r = 0.36, P < 0.01). There was a significant correlation between the IL-10 level before GR and the PASI value after GR = -0.39; P < 0.01). The results indicate a strong pro-inflammatory effect of IL-12 in the immunopathogenesis of psoriasis, and confirm the immunosuppressive and anti-inflammatory effect of GR. IL-10 seems to be a promising individual marker for a positive effect of GR therapy.

  8. Long term efficacy and safety of etanercept in the treatment of psoriasis and psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Kivelevitch D

    2014-04-01

    Full Text Available Dario Kivelevitch, Bobbak Mansouri, Alan Menter Department of Dermatology, Baylor University Medical Center, Dallas, TX, USA Abstract: Psoriasis is a chronic, immune-mediated inflammatory disease affecting both the skin and joints. Approximately 20% of patients suffer a moderate to severe form of skin disease and up to 30% have joint involvement. Standard therapies for psoriasis include topical medications, phototherapy, and both oral systemic and biological therapies whereas therapies for psoriatic arthritis include nonsteroidal anti-inflammatory drugs followed by disease modifying antirheumatic drugs and/or tumor necrosis factor (TNF-α inhibitors and interleukin-12/23p40 inhibitors. Treatment of both diseases is typically driven by disease severity. In the past decade, major advances in the understanding of the immunopathogenesis of psoriasis and psoriatic arthritis have led to the development of numerous biological therapies, which have revolutionized the treatment for moderate to severe plaque psoriasis and psoriatic arthritis. Anti-TNF-α agents are currently considered as first line biological therapies for the treatment of moderate to severe psoriasis and psoriatic arthritis. Currently approved anti-TNF-α agents include etanercept, adalimumab, and infliximab for psoriasis and psoriatic arthritis as well as golimumab and certolizumab for psoriatic arthritis. In this article, we aim to evaluate the long term safety and efficacy of etanercept in psoriasis and psoriatic arthritis. Keywords: psoriasis, psoriatic arthritis, etanercept, biological therapy, tumor necrosis factor, safety

  9. Infliximab-induced intertriginous psoriasis in patient with Crohn's desease

    Directory of Open Access Journals (Sweden)

    Federica Mola

    2011-10-01

    Full Text Available Tumor necrosis factor-α (TNFα inhibition is an effective treatment of moderate-to-severe psoriasis and other diseases (rheumatoid arthritis, ankylosing spondylitis, psoriasis or Crohn’s disease. We report a case of a 32- years-old patient affected by Crohn’s disease since the age of 25 who started infliximab infusion after four years of treatment with prednisone and azathioprine per os without improvement. After the fifth infusion of infliximab, he developed a form of intertriginous psoriasis which was approached with topical steroid cream. The patient never presented psoriasis in the past. New onset of psoriasis in patients without history for skin diseases (as in our case is a quite uncommon complication of TNFα inhibitor therapy. The increased production of IFNα during TNFα inhibitor therapy is a possible pathophysiologic explanation for this paradoxical effect of the anti-TNFα.

  10. Glucagon-like peptide-1 analogue therapy for psoriasis patients with obesity and type 2 diabetes: a prospective cohort study.

    LENUS (Irish Health Repository)

    Ahern, T

    2012-06-13

    Background  Diabetes and obesity are more prevalent amongst psoriasis patients as is disturbance of the innate immune system. GLP-1 analogue therapy considerably improves weight and glycaemic control in people with type 2 diabetes and its receptor is present on innate immune cells. Objective  We aimed to determine the effect of liraglutide, a GLP-1 analogue, on psoriasis severity. Methods  Before and after 10 weeks of liraglutide therapy (1.2 mg subcutaneously daily) we determined the psoriasis area and severity index (PASI) and the dermatology life quality index (DLQI) in seven people with both psoriasis and diabetes (median age 48 years, median body mass index 48.2 kg\\/m(2) ). We also evaluated the immunomodulatory properties of liraglutide by measuring circulating lymphocyte subset numbers and monocyte cytokine production. Results  Liraglutide therapy decreased the median PASI from 4.8 to 3.0 (P = 0.03) and the median DLQI from 6.0 to 2.0 (P = 0.03). Weight and glycaemic control improved significantly. Circulating invariant natural killer T (iNKT) cells increased from 0.13% of T lymphocytes to 0.40% (P = 0.03). Liraglutide therapy also effected a non-significant 54% decrease in the proportion of circulating monocytes that produced tumour necrosis factor alpha (P = 0.07). Conclusion  GLP-1 analogue therapy improves psoriasis severity, increases circulating iNKT cell number and modulates monocyte cytokine secretion. These effects may result from improvements in weight and glycaemic control as well as from direct immune effects of GLP-1 receptor activation. Prospective controlled trials of GLP-1 therapies are warranted, across all weight groups, in psoriasis patients with and without type 2 diabetes.

  11. Experience of Phototherapy in Dermatological Praxis in Complex Therapy of Psoriasis Patients

    Directory of Open Access Journals (Sweden)

    Hartmane Ilona

    2016-02-01

    Full Text Available Psoriasis is a chronic relapsing skin disease presenting with erythematous and papulous lesions with infiltration and extensive desquamation on the skin surface. It is a genetically determined, multifactorial dermatosis where genetic, immune, and environmental factors play significant roles in its development. In Latvia in treatment of different forms of extensively spreading psoriasis, PUVA (psoralen and ultraviolet A light therapy, a combined method, is administered, applying long-wave UVA radiation with wavelength 320–400 nm in combination with photosensibilisator 8-metoxypsoralen and medium wave length UVB radiation narrow-band phototherapy — 311 nm using specialised TL-01 lamps. The aim of our clinical investigation was to determine the efficacy of narrow-band phototherapy (UVB 311 nm in the complex treatment of patients with different severity of extensive psoriatic lesions treated in the Clinical Centre of Skin and Sexually Transmitted Diseases. Cases of clinical data of 260 patients with widely spread psoriasis were analysed. In the Group 1 (n = 102 receiving narrow-band UVB therapy, the mean and cumulative UVB dosage was 1.8 ± 0.6 and 21.5 ± 3.8 J/cm2, respectively, whereas in Group 2 (n = 91 it was 2.2 ± 0.1 and 27.7 ± 8.0 J/cm2. To obtain clinical recovery, 18 to 30 procedures were necessary (average 22 ± 4.1 with total irradiation dose received 110 ± 4.6 J/cm2. In 67 patients of the control group, PUVA therapy was administered, and positive therapeutic efficacy was observed in all patients. Clinical recovery was obtained in 86.2% in patients of the Group 1, in 82.4% — of Group 2, and in 80% — in 67 patients of the control group. Narrow-band (311 nm UVB phototherapy is currently one of the leading pathogenetical methods of treatment of patients with widespread psoriasis. It has high efficacy, good tolerability, does not have severe side effects and restrictions in use, in comparison with traditional PUVA therapy.

  12. Pentraxin 3 levels in psoriasis, their relationship with disease severity and the efficacy of narrow-band ultraviolet B therapy

    Directory of Open Access Journals (Sweden)

    Tuğba Zorlu

    2015-12-01

    Full Text Available Background and Design: Pentraxin 3 (PTX 3, an acute phase protein, plays an important role in activation of innate immunity and in the regulation of inflammatory reactions. Thus, considering the importance of PTX 3 in immune and inflammatory responses, it has been suggested that PTX 3 may play a role in the pathogenesis of psoriasis. The aim of this study was to evaluate plasma PTX 3 levels in patients with psoriasis and their relationship with the disease severity and the effect of narrowband ultraviolet B (nbUVB therapy on PTX 3 levels. Materials and Methods: The study comprised 40 patients with psoriasis and 88 age-and sex-matched healthy controls. Dermatological examinations and psoriasis area severity index (PASI were performed. The patients received 20 courses of nbUVB therapy with a mean value of 13 joule/cm2. The efficacy of nbUVB was evaluated using PASI scores. Plasma PTX 3 levels in the patient group were measured before and after therapy by sandwich enzyme-linked immunosorbent assay in patients with the diagnosis of psoriasis and were compared with that in the control group. Results: The mean plasma PTX3 level in the patient group (1.24±0.83 was statistically significantly increased compared to that in the control group (0.55±0.26 (p0.05. Conclusion: We found that plasma PTX3 levels that are increased in patients with psoriasis were not correlated with disease severity and that they significantly decreased after nbUVB therapy.

  13. Amelioration of psoriasis by anti-TNF-alpha RNAi in the xenograft transplantation model

    DEFF Research Database (Denmark)

    Jakobsen, Maria; Stenderup, Karin; Rosada, Cecilia;

    2009-01-01

    Tumor necrosis factor-alpha (TNF-alpha) is upregulated in psoriatic skin and represents a prominent target in psoriasis treatment. The level of TNF-alpha-encoding mRNA, however, is not increased in psoriatic skin, and it remains unclear whether intervention strategies based on RNA interference...... skin in the psoriasis xenograft transplantation model by the use of lentiviral vectors. TNF-alpha shRNA treatment leads to amelioration of the psoriasis phentotype in the model, as documented by reduced epidermal thickness, normalization of the skin morphology, and reduced levels of TNF-alpha m...... molecule for a potential persistent RNA-based treatment of psoriasis and establish the use of small RNA effectors as a novel platform for target validation in psoriasis and other skin disorders....

  14. Anti-Inflammatory Action of Keratinocyte-Derived Vaspin: Relevance for the Pathogenesis of Psoriasis.

    Science.gov (United States)

    Saalbach, Anja; Tremel, Jenny; Herbert, Diana; Schwede, Katharina; Wandel, Elke; Schirmer, Christine; Anderegg, Ulf; Beck-Sickinger, Annette G; Heiker, John T; Schultz, Stephan; Magin, Thomas; Simon, Jan C

    2016-03-01

    Impaired cross talk between keratinocytes (KCs) and immune cells is believed to contribute to the pathogenesis of chronic inflammatory skin diseases, such as psoriasis. We have previously identified KCs as a rich source of the serpin protease inhibitor vaspin (serpinA12), originally described as an adipokine in adipose tissue. Herein, we studied whether dysregulated vaspin expression in KCs contributes to the pathogenesis of psoriasis. We found vaspin expression to be closely associated to epidermal differentiation, with low levels in proliferating KCs and high levels in differentiated cells. Consistently, in human psoriasis and in a mouse model of a psoriasis-like skin inflammation, epidermal vaspin expression was significantly down-regulated. Down-regulation of vaspin in KCs resulted in decreased expression of differentiation-associated genes and up-regulation of interferon-inducible and inflammation-associated psoriasis signature genes. Vaspin was also shown to modulate the communication between KCs and inflammatory cells under co-culture conditions. A decrease in vaspin expression in KCs stimulated the secretion of tumor necrosis factor-α, IL-1β, IL-6, IL-8, and monocyte chemoattractant protein-1 by co-cultured dendritic cells, macrophages, monocytes, and neutrophils. Consequently, the application of vaspin inhibited myeloid cell infiltration in a mouse model of a psoriasis-like skin inflammation. In conclusion, vaspin expression by maturing KCs modulates cutaneous immune responses and may be involved in the pathogenesis of psoriasis.

  15. Anti-Inflammatory Effects of GLP-1-Based Therapies beyond Glucose Control

    Directory of Open Access Journals (Sweden)

    Young-Sun Lee

    2016-01-01

    Full Text Available Glucagon-like peptide-1 (GLP-1 is an incretin hormone mainly secreted from intestinal L cells in response to nutrient ingestion. GLP-1 has beneficial effects for glucose homeostasis by stimulating insulin secretion from pancreatic beta-cells, delaying gastric emptying, decreasing plasma glucagon, reducing food intake, and stimulating glucose disposal. Therefore, GLP-1-based therapies such as GLP-1 receptor agonists and inhibitors of dipeptidyl peptidase-4, which is a GLP-1 inactivating enzyme, have been developed for treatment of type 2 diabetes. In addition to glucose-lowering effects, emerging data suggests that GLP-1-based therapies also show anti-inflammatory effects in chronic inflammatory diseases including type 1 and 2 diabetes, atherosclerosis, neurodegenerative disorders, nonalcoholic steatohepatitis, diabetic nephropathy, asthma, and psoriasis. This review outlines the anti-inflammatory actions of GLP-1-based therapies on diseases associated with chronic inflammation in vivo and in vitro, and their molecular mechanisms of anti-inflammatory action.

  16. Long term efficacy and safety of etanercept in the treatment of psoriasis and psoriatic arthritis

    OpenAIRE

    Kivelevitch, Dario; Mansouri, Bobbak; Menter, Alan

    2014-01-01

    Psoriasis is a chronic, immune-mediated inflammatory disease affecting both the skin and joints. Approximately 20% of patients suffer a moderate to severe form of skin disease and up to 30% have joint involvement. Standard therapies for psoriasis include topical medications, phototherapy, and both oral systemic and biological therapies whereas therapies for psoriatic arthritis include nonsteroidal anti-inflammatory drugs followed by disease modifying antirheumatic drugs and/or tumor necrosis ...

  17. About Psoriasis

    Science.gov (United States)

    ... Tips" to find out more! Email * Zipcode About Psoriasis Psoriasis is an autoimmune disease that causes raised, red, ... about psoriasis in children? How do I get psoriasis? While scientists do not know what exactly causes ...

  18. Ustekinumab treatment for psoriasis in 119 patients maintained on therapy for a minimum of one year: a review.

    Science.gov (United States)

    Wilder, Elizabeth G; Patel, Mahir; Hebeler, Katherine; Menter, Alan

    2014-08-01

    Ustekinumab is a human IgG1κ monoclonal antibody that binds with high affinity and specificity to the p40 protein subunit shared by both the interleukin-12 and interleukin-23 cytokines. This study reviews clinical response and adverse events in 119 psoriasis patients who have received ustekinumab for a minimum of 1 year. The medical records of 119 psoriasis patients treated with ustekinumab at our referral clinic in Dallas between 2009 and 2013 were reviewed for response rates, side effects, and concomitant therapies. Of 119 patients, 117 (98%) had plaque type psoriasis, with 40 (34%) patients having psoriasis affecting either their palms and/or soles. Forty-four (37%) patients had psoriatic arthritis. The median follow-up period was 31 months. Fifty-six (47%) of the 119 patients obtained near complete clearance (response of more than 90% of initial body surface area involvement) upon the final follow-up visit or at the time of ustekinumab treatment discontinuation. Concomitant systemic treatments, primarily methotrexate, were given to 59 (50%) patients. Twenty-three (19%) patients discontinued treatment, primarily for sub-optimal response or loss of response. Fifty (42%) patients required either an increase in the dose of ustekinumab to 90 mg and/or administration more frequently than every 12 weeks to achieve and maintain psoriasis clearance.

  19. Role of anti-depressant fluoxetine in the puva treatment of psoriasis vulgaris

    Directory of Open Access Journals (Sweden)

    Mitra A

    2001-11-01

    Full Text Available Severity of psoriasis vulgaris is known to be modified by psychological stress. The objective of this study was to evaluate the role of fluoxetine in the PU VA treatment of psoriasis. Twenty patients with progressive disease having more than thirty per cent body area involvement were included in a randomized, double blinded, placebo- controlled, age and sex matched study. All patients were on PUVA treatment, half of patients were given fluoxetine 20 mgs daily whereas the ten were given placebo. Assessment was done by Psoriasis Area and Severity Index (PASI scoring after every 5 exposures of PUVA treatment till 20 treatments. All ten patients who took fluoxetine along with PUVA treatment showed better response and quicker remission. Fluoxetine may be used as an adjuvant in PUVA treatment of psoriasis.

  20. Role of anti-depressant fluoxetine in the puva treatment of psoriasis vulgaris

    Directory of Open Access Journals (Sweden)

    Mitra A

    2003-03-01

    Full Text Available Severity of Psoriasis Vulgaris is known to be modified by psychological stress. The objective of this study was to evaluate the role of Fluoxetine in the PUVA treatment of Psoriasis. Twenty patients with progressive disease having more than thirty per cent body area involvement were included in a randomized, double blinded, placebo-controlled, age and sex matched study. All patients were on PUVAtreatment; half of the patients were given Fluoxetine 20 mgms daily whereas the other ten were given placebo. Assessment was done by Psoriasis Area and Severity Index (PASI scoring after every 5 exposures of PUVA treatment till 20 treatments. All ten patients who took Fluoxetine along with PUVA treatment showed better response and quicker remission. Fluoxetine may be used as an adjuvant in PUVA treatment of Psoriasis.

  1. Association of Trabecular Bone Score with Inflammation and Adiposity in Patients with Psoriasis: Effect of Adalimumab Therapy

    Directory of Open Access Journals (Sweden)

    José L. Hernández

    2016-01-01

    Full Text Available Studies on trabecular bone score (TBS in psoriasis are lacking. We aim to assess the association between TBS and inflammation, metabolic syndrome features, and serum adipokines in 29 nondiabetic patients with psoriasis without arthritis, before and after 6-month adalimumab therapy. For that purpose, adjusted partial correlations and stepwise multivariable linear regression analysis were performed. No correlation was found between TBS and disease severity. TBS was negatively associated with weight, BMI, waist perimeter, fat percentage, and systolic and diastolic blood pressure before and after adalimumab. After 6 months of therapy, a negative correlation between TBS and insulin resistance (p=0.02 and leptin (p=0.01 and a positive correlation with adiponectin were found (p=0.01. The best set of predictors for TBS values at baseline were female sex (p=0.015, age (p=0.05, and BMI (p=0.001. The best set of predictors for TBS following 6 months of biologic therapy were age (p=0.001, BMI (p<0.0001, and serum adiponectin levels (p=0.027. In conclusion, in nondiabetic patients with moderate-to-severe psoriasis, TBS correlates with metabolic syndrome features and inflammation. This association is still present after 6 months of adalimumab therapy. Moreover, serum adiponectin levels seem to be an independent variable related to TBS values, after adalimumab therapy.

  2. Association of Trabecular Bone Score with Inflammation and Adiposity in Patients with Psoriasis: Effect of Adalimumab Therapy.

    Science.gov (United States)

    Hernández, José L; López-Mejías, Raquel; Blanco, Ricardo; Pina, Trinitario; Ruiz, Sheila; Sierra, Isabel; Ubilla, Begoña; Mijares, Verónica; González-López, Marcos A; Armesto, Susana; Corrales, Alfonso; Pons, Enar; Fuentevilla, Patricia; González-Vela, Carmen; González-Gay, Miguel Á

    2016-01-01

    Studies on trabecular bone score (TBS) in psoriasis are lacking. We aim to assess the association between TBS and inflammation, metabolic syndrome features, and serum adipokines in 29 nondiabetic patients with psoriasis without arthritis, before and after 6-month adalimumab therapy. For that purpose, adjusted partial correlations and stepwise multivariable linear regression analysis were performed. No correlation was found between TBS and disease severity. TBS was negatively associated with weight, BMI, waist perimeter, fat percentage, and systolic and diastolic blood pressure before and after adalimumab. After 6 months of therapy, a negative correlation between TBS and insulin resistance (p = 0.02) and leptin (p = 0.01) and a positive correlation with adiponectin were found (p = 0.01). The best set of predictors for TBS values at baseline were female sex (p = 0.015), age (p = 0.05), and BMI (p = 0.001). The best set of predictors for TBS following 6 months of biologic therapy were age (p = 0.001), BMI (p < 0.0001), and serum adiponectin levels (p = 0.027). In conclusion, in nondiabetic patients with moderate-to-severe psoriasis, TBS correlates with metabolic syndrome features and inflammation. This association is still present after 6 months of adalimumab therapy. Moreover, serum adiponectin levels seem to be an independent variable related to TBS values, after adalimumab therapy. PMID:27293954

  3. Centralised Biological Therapy Registry for Moderate to Severe Plaque Psoriasis – Overview and Methodology

    Directory of Open Access Journals (Sweden)

    Sutka R

    2016-04-01

    Full Text Available The introduction of new pharmacotherapy entities in the last decade accentuate the necessity to set up treatment guidelines based on real life evidence. Randomized controlled trials remain golden standard of a research. Data derived from studies aiming on daily clinical practice should bring needed, added value. Disease prevalence growth, due to increased life expectancy, better diagnostic procedures and earlier medical intervention, as well as ever growing demand for highly priced, sophistically produced drugs put stress on healthcare budgets even in developed countries. Large databases commonly called - therapy registries are implemented to collect data on therapy effectivity in terms of effectiveness, safety and patient long-term on therapy survival. Registries importance rose together with biological therapies introduction. New in class molecules entered the market conditionally being obliged to provide additional e.g. safety data. Such procedures require involvement of many different professionals, e.g. physicians, professional medical bodies, IT experts, database administrators, statisticians and government institutions. Paper based, followed by computer based forms were distributed among physicians to collect these data. eHealth technologies provide physicians with centralized, more intuitive applications. The particularities of different diagnosis caused great variations within each specific registry launched. Important information was missing since they were pointed out as optional and many were redundant causing frustration among physicians due to inadequate administrative workload. The main objective of this work was to set up the therapy registry standards and procedures. Methodology of „ideal“ moderate to severe plaque psoriasis biology therapy registry development, introduction, administration and evaluation was prepared to assist any government institution or professional body when planning registry deployment. Electronic

  4. VEGF Spliced Variants: Possible Role of Anti-Angiogenesis Therapy

    Directory of Open Access Journals (Sweden)

    Caroline Hilmi

    2012-01-01

    Full Text Available Angiogenesis has been targeted in retinopathies, psoriasis, and a variety of cancers (colon, breast, lung, and kidney. Among these tumour types, clear cell renal cell carcinomas (RCCs are the most vascularized tumours due to mutations of the von Hippel Lindau gene resulting in HIF-1 alpha stabilisation and overexpression of Vascular Endothelial Growth Factor (VEGF. Surgical nephrectomy remains the most efficient curative treatment for patients with noninvasive disease, while VEGF targeting has resulted in varying degrees of success for treating metastatic disease. VEGF pre-mRNA undergoes alternative splicing generating pro-angiogenic isoforms. However, the recent identification of novel splice variants of VEGF with anti-angiogenic properties has provided some insight for the lack of current treatment efficacy. Here we discuss an explanation for the relapse to anti-angiogenesis treatment as being due to either an initial or acquired resistance to the therapy. We also discuss targeting angiogenesis via SR (serine/arginine-rich proteins implicated in VEGF splicing.

  5. Anti cytokine therapy in chronic inflammatory arthritis.

    Science.gov (United States)

    Thompson, Charlotte; Davies, Ruth; Choy, Ernest

    2016-10-01

    This is a review looking at anti cytokine therapy in Rheumatoid Arthritis (RA), Psoriatic Arthritis (PSA) and Ankylosing Spondylitis (AS). The review explores the similarities and differences in the clinical features, as well as treatments and cytokines involved in the development and propagation of the disease. Particular attention is paid to TNFα inhibitors IL-1ra, IL-6 and JAK kinase Inhibitors, anti IL23 and IL-12 and the new developments with anti-IL-17. PMID:27497159

  6. Psoriasis and Sleep Apnea

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Khalid, Usman; Gislason, Gunnar Hilmar;

    2016-01-01

    , socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression. RESULTS: There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval......STUDY OBJECTIVES: Psoriasis and sleep apnea are associated with significant morbidity and mortality. Although both diseases have been linked with systemic inflammation, studies on their potential bidirectional association are lacking. We investigate the potential association between psoriasis......) for sleep apnea were 1.30 (1.17-1.44), 1.65 (1.23-2.22), and 1.75 (1.35-2.26) in subjects with mild and severe psoriasis, and psoriatic arthritis, and IRRs for mild and severe psoriasis, and psoriatic arthritis in sleep apnea without continuous positive airway pressure (CPAP) therapy were 1.62 (1...

  7. Psoriasis and Sleep Apnea

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Khalid, Usman; Gislason, Gunnar Hilmar;

    2015-01-01

    , socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression. RESULTS: There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval......STUDY OBJECTIVES: Psoriasis and sleep apnea are associated with significant morbidity and mortality. Although both diseases have been linked with systemic inflammation, studies on their potential bidirectional association are lacking. We investigate the potential association between psoriasis......) for sleep apnea were 1.30 (1.17-1.44), 1.65 (1.23-2.22), and 1.75 (1.35-2.26) in subjects with mild and severe psoriasis, and psoriatic arthritis, and IRRs for mild and severe psoriasis, and psoriatic arthritis in sleep apnea without continuous positive airway pressure (CPAP) therapy were 1.62 (1...

  8. Itolizumab – a humanized anti-CD6 monoclonal antibody with a better side effects profile for the treatment of psoriasis

    Directory of Open Access Journals (Sweden)

    Menon R

    2015-04-01

    Full Text Available Roshni Menon, Brinda G David Department of Dermatology, Venereology and Leprosy, Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur, Pondicherry, India Abstract: Management of psoriasis is a challenge to the treating physician. The chronic inflammatory state of psoriasis with exacerbations and remissions necessitate “on-and-off” treatment schedules. The safety profiles of drugs and tolerability issues for patients are important factors to be considered during treatment. Various biological agents targeting T-cells and the inflammatory cytokines are available for systemic treatment of psoriasis. However, major causes of concern while using these drugs are risk of susceptibility to infection and development of anti-drug antibodies, which will affect the pharmacokinetic properties, efficacy, and safety profile of the drug. Itolizumab, a humanized anti-CD6 monoclonal antibody, is a new molecule that acts by immunomodulating the CD6 molecule. CD6 is a co-stimulatory molecule required for optimal T-cell stimulation by the antigen-presenting cells. This step is crucial in T-cell proliferation to form Th1 and Th17 cells, which play a major role in the pathogenesis of psoriasis. This article deals with the properties of Itolizumab and its role in the treatment of psoriasis. Based on the available published data, Itolizumab seems to have a better adverse effects profile and at the same time comparatively less efficacy when compared to other biological agents available for treating psoriasis. Larger studies with longer duration are required to clearly depict the long-term side effects profile. Keywords: Itolizumab, CD6, psoriasis, monoclonal antibody, biologicals 

  9. Vascular endothelial growth factor inhibitors: investigational therapies for the treatment of psoriasis

    Directory of Open Access Journals (Sweden)

    Weidemann AK

    2013-09-01

    Full Text Available Anja K Weidemann,1 Ania A Crawshaw,2 Emily Byrne,3 Helen S Young1 1The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UK; 2Royal Sussex County Hospital, Brighton, UK; 3University Hospital of South Manchester, Manchester, UK Abstract: Psoriasis is a common inflammatory autoimmune condition in which environmental factors and genetic predisposition contribute to the development of disease in susceptible individuals. Angiogenesis is known to be a key pathogenic feature of psoriasis. Local and systemic elevation of vascular endothelial growth factor (VEGF-A has been demonstrated in the skin and plasma of patients with psoriasis and is known to correlate with improvement following some traditional psoriasis treatments. A number of VEGF inhibitors are licensed for the treatment of malignancies and eye disease and isolated case reports suggest that some individuals with psoriasis may improve when exposed to these agents. The small number of cases and lack of unified reporting measures makes it difficult to draw generalizations and underline the heterogeneity of psoriasis as a disease entity. Though not yet licensed for the treatment of psoriasis in humans, experimental data supports the potential of VEGF inhibitors to influence relevant aspects of human cell biology (such as endothelial cell differentiation and to improve animal models of skin disease. Given the multi-factorial nature of psoriasis it is unlikely that VEGF inhibitors will be effective in all patients, however they have the potential to be a valuable addition to the therapeutic arsenal in selected cases. Current VEGF inhibitors in clinical use are associated with a number of potentially serious side effects including hypertension, left ventricular dysfunction, and gastrointestinal perforation. Such risks require careful consideration in psoriasis populations particularly in light of growing concerns linking psoriasis to increased

  10. Pediatric psoriasis: an update

    Directory of Open Access Journals (Sweden)

    Nanette B Silverberg

    2009-10-01

    Full Text Available Nanette B SilverbergPediatric and Adolescent Dermatology, St. Luke’s-Roosevelt Hospital Center, New York, NY, USAAbstract: Pediatric psoriasis consists broadly of 3 age groups of psoriatic patients: infantile psoriasis, a self-limited disease of infancy, psoriasis with early onset, and pediatric psoriasis with psoriatic arthritis. About one-quarter of psoriasis cases begin before the age of 18 years. A variety of clinical psoriasis types are seen in childhood, including plaque-type, guttate, erythrodermic, napkin, and nail-based disease. Like all forms of auto-immunity, susceptibility is likely genetic, but environmental triggers are required to initiate disease activity. The most common trigger of childhood is an upper respiratory tract infection. Once disease has occurred, treatment is determined based on severity and presence of joint involvement. Topical therapies, including corticosteroids and calcipotriene, are the therapies of choice in the initial care of pediatric patients. Ultraviolet light, acitretin and cyclosporine can clear skin symptoms, while methotrexate and etanercept can clear both cutaneous and joint disease. Concern for psychological development is required when choosing psoriatic therapies. This article reviews current concepts in pediatric psoriasis and a rational approach to therapeutics. Keywords: psoriasis, autoimmunity, Streptococcus, etanercept, calcipotriene, topical corticosteroids

  11. Dimethylfumarate for psoriasis: Pronounced effects on lesional T-cell subsets, epidermal proliferation and differentiation, but not on natural killer T cells in immunohistochemical study.

    NARCIS (Netherlands)

    Bovenschen, H.J.; Langewouters, A.M.G.; Kerkhof, P.C.M. van de

    2010-01-01

    BACKGROUND: T-cell infiltration, epidermal hyperproliferation, and disturbed keratinization are pathologic hallmarks of plaque psoriasis. Oral fumaric acid esters are an effective therapy for psoriasis and are believed to exert their effects mainly through their anti-inflammatory properties. OBJECTI

  12. Psoriasis - resources

    Science.gov (United States)

    Resources - psoriasis ... The following organizations are good resources for information about psoriasis : American Academy of Dermatology -- www.aad.org/skin-conditions/dermatology-a-to-z/psoriasis National Institute of ...

  13. Pustular Psoriasis

    Science.gov (United States)

    ... Tips" to find out more! Email * Zipcode Pustular Psoriasis Pustular [PUHS-choo-lar] psoriasis is characterized by ... medications or potent topical steroids Types of Pustular Psoriasis Von Zumbusch can appear abruptly on the skin. ...

  14. The anti-inflammatory target A(3) adenosine receptor is over-expressed in rheumatoid arthritis, psoriasis and Crohn's disease.

    Science.gov (United States)

    Ochaion, A; Bar-Yehuda, S; Cohen, S; Barer, F; Patoka, R; Amital, H; Reitblat, T; Reitblat, A; Ophir, J; Konfino, I; Chowers, Y; Ben-Horin, S; Fishman, P

    2009-01-01

    The Gi protein associated A(3) adenosine receptor (A(3)AR) was recently defined as a novel anti-inflammatory target. The aim of this study was to look at A(3)AR expression levels in peripheral blood mononuclear cells (PBMCs) of patients with autoimmune inflammatory diseases and to explore transcription factors involved receptor expression. Over-expression of A(3)AR was found in PBMCs derived from patients with rheumatoid arthritis (RA), psoriasis and Crohn's disease compared with PBMCs from healthy subjects. Bioinformatics analysis demonstrated the presence of DNA binding sites for nuclear factor-kappaB (NF-kappaB) and cyclic AMP-responsive element binding protein (CREB) in the A(3)AR gene promoter. Up-regulation of NF-kappaB and CREB was found in the PBMCs from patients with RA, psoriasis and Crohn's disease. The PI3K-PKB/Akt signaling pathway, known to regulate both the NF-kappaB and CREB, was also up-regulated in the patients' PBMCs. Taken together, NF-kappaB and CREB are involved with the over-expression of A(3)AR in patients with autoimmune inflammatory diseases. The receptor may be considered as a specific target to combat inflammation. PMID:19426966

  15. Comparison of weekly low-dose and high-dose incremental protocols of narrow band ultraviolet B therapy for psoriasis

    Directory of Open Access Journals (Sweden)

    Mehtap Ünlü Bıçak

    2015-06-01

    Full Text Available Background and design: Considering the probable long-term side-effects of narrowband UVB (NB-UVB therapy, various studies have been conducted to provide more effective and reliable protocols by applying the different initial doses, numbers of sessions or dose increments. The aim of this study is to compare the clinical effectiveness of weekly low-dose increments and weekly high-dose increments of NB-UVB therapy in psoriasis. Materials and methods: Twenty-nine patients with psoriasis vulgaris underwent NB-UVB therapy with a weekly low-dose (20% increment protocol (group 1; n=14 or weekly high-dose (40% increment protocol (group 2; n=15. Patients were monitored weekly for 12 weeks and evaluated by the Psoriasis Area Severity Index (PASI. Results: The PASI scores prior to the therapy and during the 12-weeks of therapy for each week between the groups were compared and no statistically significant difference was found except week 12. The mean PASI scores at week 12 was significantly lower in patients from group 2 than in patients from group 1 (p=0.045. The mean number of patients and therapy sessions required with ≥50%, ≥75% and ≥90% PASI reduction did not differ between both groups. Although comparison of the two groups according to the mean cumulative doses with ≥50% and ≥90% PASI reduction did not reveal a statistically significant difference; however, those of patients with ≥75% PASI reduction and at the end of the 12-week therapy were significantly higher in the group with a weekly high-dose increment than in the group with a weekly low-dose increment (p=0.014 and p=0.00, respectively. Conclusion: Although we are aware that our results may need to be supported with large-series studies, we suggest that a weekly low-dose increment regime of NB-UVB therapy is preferable in the treatment of psoriasis as it produces nearly similar effects as a weekly high-dose increment regime but with the lower cumulative doses.

  16. Palmoplantar Psoriasis and Palmoplantar Pustulosis: Current Treatment and Future Prospects.

    Science.gov (United States)

    Raposo, Inês; Torres, Tiago

    2016-08-01

    Palmoplantar psoriasis and palmoplantar pustulosis are chronic skin diseases with a large impact on patient quality of life. They are frequently refractory to treatment, being generally described as a therapeutic challenge. This article aims to review the definitions of palmoplantar psoriasis and palmoplantar pustulosis, highlighting the similarities and differences in terms of epidemiology, clinical presentation, genetics, histopathology, and pathogenesis, as well as treatment options for both entities. Classical management of mild to moderate palmoplantar pustulosis and palmoplantar psoriasis relies on use of potent topical corticosteroids, phototherapy, and/or acitretin. Nevertheless, these drugs have proven to be insufficient in long-term control of extensive disease. Biologic therapy-namely, anti-interleukin-17 agents and phosphodiesterase type 4 inhibitors-has recently shown promising results in the treatment of palmoplantar psoriasis. Knowledge of the pathophysiologic pathways of both entities is of utmost importance and may, in the future, allow development of molecularly targeted therapeutics. PMID:27113059

  17. Management of cardiovascular disease in patients with psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Skov, Lone

    2016-01-01

    lifestyle factors such as smoking and alcohol abuse. AREAS COVERED: In this manuscript we describe the evidence associating psoriasis with CV disease, as well as the pharmacological and non-pharmacological treatment of CV risk factors including the CV effects of anti-psoriatic therapy and vice versa. EXPERT...... OPINION: Current guidelines recommend that patients with psoriasis are screened for CV risk factors, and recommend smoking cessation, reduced alcohol consumption, altering of lifestyle to move to a normal-weight body-mass index, exercising 3 times a week for 30 minutes, and monitoring and modifying......INTRODUCTION: Patients with psoriasis have an increased incidence and prevalence of cardiovascular (CV) risk factors, and CV undertreatment in these patients is a well-established problem. The link between psoriasis and CV disease is present on a pathogenic level, as well as due to modifiable...

  18. Novel agents for anti-platelet therapy

    Directory of Open Access Journals (Sweden)

    Ji Xuebin

    2011-11-01

    Full Text Available Abstract Anti-platelet therapy plays an important role in the treatment of patients with thrombotic diseases. The most commonly used anti-platelet drugs, namely, aspirin, ticlopidine, and clopidogrel, are effective in the prevention and treatment of cardio-cerebrovascular diseases. Glycoprotein IIb/IIIa antagonists (e.g., abciximab, eptifibatide and tirofiban have demonstrated good clinical benefits and safety profiles in decreasing ischemic events in acute coronary syndrome. However, adverse events related to thrombosis or bleeding have been reported in cases of therapy with glycoprotein IIb/IIIa antagonists. Cilostazol is an anti-platelet agent used in the treatment of patients with peripheral ischemia, such as intermittent claudication. Presently, platelet adenosine diphosphate P2Y(12 receptor antagonists (e.g., clopidogrel, prasugrel, cangrelor, and ticagrelor are being used in clinical settings for their pronounced protective effects. The new protease-activated receptor antagonists, vorapaxar and atopaxar, potentially decrease the risk of ischemic events without significantly increasing the rate of bleeding. Some other new anti-platelet drugs undergoing clinical trials have also been introduced. Indeed, the number of new anti-platelet drugs is increasing. Consequently, the efficacy of these anti-platelet agents in actual patients warrants scrutiny, especially in terms of the hemorrhagic risks. Hopefully, new selective platelet inhibitors with high anti-thrombotic efficiencies and low hemorrhagic side effects can be developed.

  19. Traditional Chinese Medicine Fumigation Therapy in Treating Psoriasis Vulgaris%中药熏蒸疗法治疗寻常型银屑病

    Institute of Scientific and Technical Information of China (English)

    刘静; 蔡希

    2013-01-01

    目的:探讨中药熏蒸疗法治疗寻常型银屑病的临床疗效.方法:通过寻常型银屑病病因病机的概述、中药熏蒸作用机理的阐释及验案举例说明中药熏蒸疗法在寻常型银屑病中的应用.结果:中药熏蒸疗法治疗寻常型银屑病,能更有效地发挥药物的治疗作用,提高疗效,缩短治疗周期.结论:中药熏蒸疗法治疗寻常型银屑病疗效显著.%Objective: To explore clinical curative effects of traditional Chinese medicine fumigation therapy in treating psoriasis vulgaris. Methods: Illustrated the application of traditional Chinese medicine fumigation therapy in treating psoriasis vulgaris through overview the etiological factors and pathogenesia of psoriasis vulgaris, interpretation mechanism of traditional Chinese medicine fumigation therapy, and cases for example. Results:Traditional Chinese medicine fumigation therapy in treating psoriasis vulgaris could play a more effective therapeutical action, improve curative effects, and reduce the treatment cycle. Conclusion: Traditional Chinese medicine fumigation therapy in the tretment of psoriasis vulgaris has distinct curative effects.

  20. Role of T-cell-mediated inflammation in psoriasis: pathogenesis and targeted therapy

    OpenAIRE

    Conrad, Curdin

    2013-01-01

    Lukas Flatz, Curdin ConradDepartment of Dermatology, University Hospital of Lausanne (CHUV), Lausanne, SwitzerlandAbstract: Psoriasis is one of the most common chronic, inflammatory, T-cell-mediated autoimmune diseases. Over the past decade, increased knowledge of disease pathogenesis has fundamentally changed psoriasis treatment, with the introduction of biologics, and this has led to a multitude of improved selective targets providing potential therapeutic options. Indeed, numerous pathogen...

  1. Comorbidities in psoriasis

    Directory of Open Access Journals (Sweden)

    Sanjeev J Aurangabadkar

    2013-01-01

    Full Text Available Moderate to severe psoriasis is associated with concomitant diseases that may have a significant impact on patients. It is necessary for the treating physician to recognize these concomitant diseases, known as comorbidities, early as they influence the management options. Important comorbidities are psoriatic arthritis, metabolic syndrome, Crohn′s disease, depression, and cancer. Patients with severe psoriasis may be at an increased risk for myocardial infarction and this subgroup of patients tends to have a reduced life expectancy. The presence of co-morbid diseases is associated with an increase in concomitant medication, some of which may worsen psoriasis; conversely, systemic treatment of psoriasis with certain drugs may impact the co-morbid conditions. As dermatologists are the primary health-care providers for psoriasis, adequate knowledge of comorbidities helps in choosing the appropriate therapy as well as timely intervention.

  2. Anti-Integrin Therapy for Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Eiji Kawamoto

    2012-01-01

    Full Text Available Integrins are the foremost family of cell adhesion molecules that regulate immune cell trafficking in health and diseases. Integrin alpha4 mediates organ-specific migration of immune cells to the inflamed brain, thereby playing the critical role in the pathogenesis of multiple sclerosis. Anti-alpha4 integrin therapy aiming to block infiltration of autoreactive lymphocytes to the inflamed brain has been validated in several clinical trials for the treatment of multiple sclerosis. This paper provides readers with an overview of the molecular and structural bases of integrin activation as well as rationale for using anti-alpha4 integrin therapy for multiple sclerosis and then chronicles the rise and fall of this treatment strategy using natalizumab, a humanized anti-alpha4 integrin.

  3. TNF-α in a molecularly targeted therapy of psoriasis and psoriatic arthritis.

    Science.gov (United States)

    Wcisło-Dziadecka, Dominika; Zbiciak-Nylec, Martyna; Brzezińska-Wcisło, Ligia; Mazurek, Urszula

    2016-03-01

    Psoriasis is a chronic immunological skin disease and patients with this disorder typically experience a significant decrease in their quality of life. The disease is traditionally managed with topical and systemic agents (retinoids, ciclosporin A, methotrexate), but these treatment options are often long-term and their effects can be inconsistent and not ideal. The use of biological drugs in dermatological treatment is relatively new and began in the early 2000s. It should be noted that, in most countries, in order for biological treatment to be administered, specific criteria must be met. The current treatment options for psoriasis and psoriatic arthritis include tumour necrosis factor alpha (TNF-α) blockers, interleukin (IL)-12 and IL-23 inhibitors, T cell inhibitors and B cell inhibitors. These classes of biological drugs are characterised by protein structure as well as high molecular weight and their effectiveness is evaluated based on the Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA) and the Dermatology Life Quality Index (DLQI). TNF-α antagonists are one such class of biological drugs which includes infliximad, etanercept and adalimumab. Infliximab is a chimeric protein that is administered via intravenous infusions as a monotherapy in psoriasis vulgaris. Etanercept is indicated for use in both psoriasis vulgaris and psoriatic arthritis and it is the only drug that can be used as a treatment for children under the age of 8 with psoriasis. The drug is administered subcutaneously. Finally, adalimumab is a fully human monoclonal antibody that neutralises both free and membrane-bound TNF-α and is used in the treatment of psoriasis vulgaris and psoriatic arthritis. This article reviews the latest research in the use of TNF-α for the treatment of moderate to severe psoriasis and psoriatic arthritis. The results of research in this field are promising and confirm the effectiveness and safety of biological drugs as dermatological treatments

  4. Living with psoriasis

    DEFF Research Database (Denmark)

    Bak, Kirsten Tarri

    2004-01-01

    Living with psoriasis is a considerable burden and quality of life in patients is deeply affected, yet compliance with therapy is a major problem. The literature is abundant in quantitative studies stating the incidence of decrease in quality of life and related, measurable terms, and in efforts...... directed at the improvement of therapies. However, it is sparse concerning the experiences of patients. This study aims to promote an understanding of the daily life of patients with psoriasis with particular regard to how they manage the disease, ultimately to improve nursing care to these patients....... A qualitative, collective case study design was applied. The participants were 4 adult patients with a long and complicated psoriasis history. They were interviewed in depth focusing on their experiences related to psoriasis and its treatment. The patients suffered physically from itch and pain. However...

  5. Turkey Psoriasis Treatment Guide-2016

    Directory of Open Access Journals (Sweden)

    Melih Akyol

    2016-08-01

    Full Text Available Psoriasis is a common, chronic, recurrent, inflammatory disease of the skin with unknown etiology. In addition to skin involvement, joint involvement is often seen in psoriasis; however as comorbidities including metabolic syndrome, cardiovascular diseases, psychological/psychiatric disorders and inflammatory bowel disease accompany psoriasis, the inflammatory process underlying has been shown to damage several organs. It is also known that the risk of mortality is increased in patients with severe psoriasis. What’s more, psoriasis significantly affects the patients quality of life. According to physical/psychological examinations, the quality of life is affected from psoriasis as much as other chronic diseases like cancer or diabetes. Psoriasis leads to massive performance loss because of time and work loss at business and daily life as a result of either disease itself or its treatment. Psoriasis has several treatment modalities either topical or systemic. Topical treatment is sufficient and successful for mild psoriasis but early systemic therapy is recommended for moderate and severe psoriasis to prevent comorbidites due to increased inflammatory effect and to manage psoriatic arthritis. Topical treatment is usually applied alone for mild cases and in combination with systemic therapy or phototherapy for moderate or severe cases. Indications for the systemic therapy includes erythrodermic psoriasis, generalized pustular psoriasis, psoriatic arthritis and moderate-severe plaque psoriasis that causes serious decrease at quality of life which is irresponsive-incompatible to topical modalities or phototherapy. As the role of the immunology in pathophysiology of psoriasis is better understood, new generation of biological therapies affecting molecular mechanisms which take role at onset of psoriasis have been developed. Today, cyclosporine, methotrexate, and acitretin are used systemically; etanercept, infliximab, adalimumab or ustekinumab are

  6. Psoriasis inversa

    DEFF Research Database (Denmark)

    Omland, Silje Haukali; Gniadecki, Robert

    2015-01-01

    Psoriasis is a chronic skin disorder affecting approximately 2% of the European and American population. The most common form of psoriasis is the chronic plaque type. Inverse psoriasis, also named flexural or intertriginous psoriasis, is not considered a separate disease entity but rather a special...... site of involvement of plaque psoriasis, characterized by its localization to inverse/intertriginous/flexural body sites. We review current evidence and establish whether inverse psoriasis is a separate disease entity based on characteristics in terms of epidemiology, pathogenesis, clinical...

  7. Itch in Psoriasis Management.

    Science.gov (United States)

    Szepietowski, Jacek C; Reich, Adam

    2016-01-01

    Psoriasis is a common chronic inflammatory skin disease observed in about 1-3% of the general population. About 60-90% of patients with psoriasis suffer from itching. Interestingly, in the past itch was not considered as an important symptom of psoriasis. Despite the high frequency of itch in psoriasis, the pathogenesis of this symptom is still not fully elucidated. Although most studies indicate neurogenic inflammation and the role of neuropeptides, other mediators may be important as well. The majority of psoriatic patients consider itch as the most bothersome symptom of the disease as it significantly alters daily functioning and psychosocial well-being. Patients with itch showed greater impairment of their health-related quality of life compared to those without itch, and the intensity of itch correlated with the degree of quality-of-life reduction. However, treatment options for itch in psoriasis are limited. Therapy of itch in patients with psoriasis should be directed toward the resolution of skin lesions, as disease remission usually is linked with itch relief. Recent studies have clearly pointed to an important role of apremilast and biologic agents in itch intensity reduction in subjects suffering from psoriasis. Other treatment modalities include antihistamines, especially with a sedative effect, narrowband ultraviolet B, and antidepressants (doxepin, mirtazapine, paroxetine). Support by family members and/or health professionals may also be of importance in helping psoriatic subjects cope with itch. PMID:27578078

  8. Update on retinoid therapy of psoriasis in: an update on the use of retinoids in dermatology.

    NARCIS (Netherlands)

    Kerkhof, P.C.M. van de

    2006-01-01

    Both in the topical and systemic treatment of psoriasis, retinoids are mainstays. In this chapter the history and modes of actions of retinoids are presented. Tazarotene and acitretin are the only retinoids that are available in both topical and systemic formulations. A more extensive description of

  9. Psoriasis and hepatitis C virus.

    Science.gov (United States)

    Yamamoto, T; Katayama, I; Nishioka, K

    1995-11-01

    We have analyzed 8 patients (6 men and 2 women, aged 52 to 70 years) with psoriasis associated with hepatitis C virus (HCV) infection among 79 psoriatic patients. Psoriasis preceded in 6 cases. One patient had generalized pustular psoriasis (GPP), and the others had psoriasis vulgaris (PV). The psoriasis area and severity index (PASI) score ranged from 2.7 to 32.4. Two of the patients were treated with interferon-gamma. Anti-HCV antibodies were detected in all cases by second generation enzyme-linked immunosorbent and recombinant immunoblot assay. HCV messenger RNA was demonstrated by reverse transcriptase polymerase chain reaction in the tissue sections of the lesions of 1 of the patients with PV and the patient with GPP, providing evidence for active viral replication in the skin lesion. HCV-related chronic active hepatitis might cause several immunological abnormalities. It is suggested that this infection might be one of the triggering factors of psoriasis.

  10. Options and opportunities for clinical management and treatment of psoriasis.

    Science.gov (United States)

    Agrawal, Udita; Gupta, Madhu; Dube, Devyani; Vyas, Suresh P

    2013-01-01

    Psoriasis is a complex, multifactorial disease that appears to be influenced by immune-mediated components. For many years the pathogenesis of psoriasis has been discordant; the clinical picture suggested that the psoriasis was secondary to abnormal keratinocyte proliferation and differentiation, but later the role of the T cell was revealed. A variety of treatment options range from topical agents (e.g., coal tar, dithranol, and emollients for milder forms) to systemic agents (i.e., methotrexate or cyclosporin), and phototherapy. Recently, biologics have been added to this list that target particular steps in the immune or inflammatory pathways. Various nanocarriers (e.g., liposomes, niosomes, and microemulsions) have been successfully exploited for the delivery of several antipsoriatic drugs. This review provides insight into various psoriasis treatment strategies-from conventional to novel-currently in use or in development as well as the novel targets that have been explored and/or investigated for anti-psoriatic therapy. The pathogenesis of psoriasis and some of the topical, systemic biological, and novel approaches currently in use or in development are reviewed here. The pros and cons of each treatment strategy are presented, as are some of the animal models used to study features reminiscent of psoriasis. This information can be used to better the understanding of treatment options for this disease. PMID:23510110

  11. [Psoriasis migrans : Erythema migrans as Koebner phenomenon in psoriasis].

    Science.gov (United States)

    Ständer, S; Ständer, M; Thomas, P; Prinz, J C; Wolf, R

    2016-07-01

    Psoriasis is a chronic inflammatory disorder of the epidermis, which can be induced by systemic factors, such as streptococci infections or drugs. In addition, psoriasis can be caused by a local cutaneus trauma, known as Koebner phenomenon. Here, we describe a woman with psoriasis in remission, who developed a new psoriatic lesion due to a cutaneous infection with Borrelia burgdorferi. After causal therapy with doxycycline, the erythema migrans and psoriasis lesions disappeared. PMID:27106503

  12. Psoriasis: Pathogenesis, Assessment, and Therapeutic Update.

    Science.gov (United States)

    Schleicher, Stephen M

    2016-07-01

    Psoriasis is a chronic condition that affects more than 7 million Americans. This article explores the pathogenesis and physical signs of psoriasis. Over the past 2 decades enhanced understanding of the immunologic basis of psoriasis has led to the development of new systemic agents that have revolutionized the management of this disease, and these modalities, along with traditional therapies, are described.

  13. The effectiveness and safety of short-contact dithranol therapy in paediatric psoriasis: a prospective comparison of regular day care and day care with telemedicine

    NARCIS (Netherlands)

    Oostveen, A.M.; Beulens, C.A.; Kerkhof, P.C.M. van de; Jong, E.M.G.J. de; Seyger, M.M.B.

    2014-01-01

    BACKGROUND: Evidence on the effectiveness and safety of short-contact dithranol therapy in paediatric psoriasis is sparse and based only on retrospective data. The best results are achieved in a time-consuming day-care setting. OBJECTIVES: To study prospectively the effectiveness and safety of short

  14. Management of psoriasis in adolescence

    Directory of Open Access Journals (Sweden)

    Fotiadou C

    2014-03-01

    Full Text Available Christina Fotiadou, Elizabeth Lazaridou, Demetrios Ioannides First Department of Dermatology–Venereology, Aristotle University Medical School, Thessaloniki, Greece Abstract: Psoriasis is a chronic inflammatory cutaneous disorder affecting 2%–4% of the world's population. The prevalence of the disease in childhood and adolescence ranges between 0.5% and 2%. The management of psoriasis in adolescence is an intriguing and complicated task. Given the paucity of officially approved therapies, the very limited evidence-based data from randomized controlled trials, and the absence of standardized guidelines, physicians must rely on published experience from case reports both from the field of dermatology as well as from the application of these drugs for other pediatric conditions coming from the disciplines of rheumatology, gastroenterology, and oncology. Psoriatic adolescents deal with a potentially disfiguring and lifelong disease that could permanently impair their psychological development. It must be clarified to them that psoriasis does not have a permanent cure, and therefore the main goal of treatments is to establish disease control and prolonged periods between flares. The majority of adolescents suffer from mild psoriasis, and thus they are treated basically with topical treatment modalities. Phototherapy is reserved for adolescents with mild-to-moderate plaque disease and/or guttate psoriasis when routine visits to specialized centers do not create practical problems. Systemic agents and biologics are administered to patients with moderate-to-severe plaque psoriasis, pustular psoriasis, or erythrodermic psoriasis. Keywords: adolescent psoriasis, pediatric psoriasis, treatment, systemic treatment, biologic agents

  15. Efficacy, Safety, and Out-of-pocket Costs are the Most Important Factors to Patients in Choosing a Psoriasis Therapy

    OpenAIRE

    Secrest, Aaron M.; Matinrazm, Ali; Ferris, Laura K.

    2014-01-01

    Objective: To determine which factors (i.e., cost, efficacy, safety, and method of delivery) influence choice of psoriasis treatment by patients and how patients obtain information regarding treatment options. Design: Anonymous survey. Setting: Specialty Psoriasis Clinic at an academic dermatology department over a six-month period. Participants: Convenience sample of 40 psoriasis patients. Measurements: Participant demographics, psoriasis treatment history, sources of information about treat...

  16. The effect of psoriasis treatment on body composition, components of metabolic syndrome and psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Funda Tamer

    2015-03-01

    Full Text Available Background and Design: Psoriasis is a chronic inflammatory immun mediated skin disorder with unknown etiology. The chronic inflammation in psoriasis have role in the development of metabolic and vascular disorders related with associating comorbidities. Recent studies have suggested a strong association exists between metabolic syndrome, obesity and complexity of the association between psoriasis, body mass index (BMI and psoriasis tratment. In this study, our aim was to investigate the effect of psoriasis treatment with methotrexate, cyclosporine and biological agents on body composition, comorbidities and associated laboratory findings. Materials and Methods: Seventy-nine patients treated with methotrexate, cyclosporin and biological agents were included in our study. Demographic characteristics, body composition analysis, psoriasis related comorbidities and laboratory examinations were evaluated before and after 12 weeks of systemic treatment. Results: Comorbidities and metabolic syndrome tended to be more frequent in the anti tumor necrosis factor alpha (anti-TNF-α treated group. Increase in body fat and weight detected in patiens receiving biologic drug therapy. Conclusion: The results of our study showed that severe psoriasis patients with longer disease duration were more likely to have metabolic syndrome because of severe and long term inflammation in pathogenesis of comorbidities.

  17. The potential of the essential fatty acid-deficient hairless rat as a psoriasis screening model for topical anti-proliferative drugs

    DEFF Research Database (Denmark)

    Jensen, Mette; Groth, L.; Holmer, G.;

    2002-01-01

    with calcipotriol. Dithranol and its coal tar-containing vehicle also showed a reductive effect on epidermal thickness. EFAD hairless rats possess various histological changes resembling psoriasis. These histological changes normalise during treatment with anti-psoriatic drugs as calcipotriol, dithranol and coal......The objective of this study was to establish essential fatty acid deficiency (EFAD) in hairless rats and investigate the potential of this model as a psoriasis screening model by testing the effects of calcipotriol and dithranol on differentiation and proliferation in the epidermis. Hairless rats...... were fed with a fat-free diet lacking linoleic acid. The EFAD condition was established within 8 weeks. In order to ensure that this condition had been established, several parameters were measured and observed, i.e. animal weight, water consumption, transepidermal water loss, clinical skin symptoms...

  18. Advances in psoriasis physiopathology and treatments: Up to date of mechanistic insights and perspectives of novel therapies based on innovative skin drug delivery systems (ISDDS).

    Science.gov (United States)

    Sala, M; Elaissari, A; Fessi, H

    2016-10-10

    Psoriasis is a chronic inflammatory disease affecting mainly the skin but which can be complicated by psoriatic arthritis (PsA).This autoimmune skin disorder concerns 2-5% of the world population. To date, the physiopathology of psoriasis is not still completely elucidated but many researches are ongoing which have led for example to the discovery of the Th17/Th22 pathway. The conventional therapeutic approaches (local or systemic route) appeal to various classes of drugs with complex mechanisms of action and non-negligible side effects. Although there is no therapy capable to cure psoriasis, the current goal is to relieve symptoms as longer as possible with a good benefit/risk ratio. That is one of the principal limits of conventional antipsoriatic drugs. New formulations based on nanoencapsulation are a promising opportunity to answer to this limit by offering an optimization of the conventional antipsoriatic drug use (higher activity, lower side effects and frequency of application, etc.). Herein, we tried to put in perspective the mechanistic insights (histological and immunological views) proposed into scientific literature these last years in order to have a better comprehension of psoriasis physiopathology resulting in skin lesions and PsA. The therapeutic armamentarium and the different strategies in the management of psoriasis are discussed in greater details. To finish, the field of encapsulation in nanoparticles is broached in order to put forward recent advances in innovative skin drug delivery systems (ISDDSs) of antipsoriatic active agents for a better efficacy, safety and compliance.

  19. Vascular endothelial growth factor inhibitors: investigational therapies for the treatment of psoriasis

    OpenAIRE

    Weidemann AK; Crawshaw AA; Byrne E; Young HS

    2013-01-01

    Anja K Weidemann,1 Ania A Crawshaw,2 Emily Byrne,3 Helen S Young1 1The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UK; 2Royal Sussex County Hospital, Brighton, UK; 3University Hospital of South Manchester, Manchester, UK Abstract: Psoriasis is a common inflammatory autoimmune condition in which environmental factors and genetic predisposition contribute to the development of disease in susceptible individuals. Angiogenesis is known to be ...

  20. CLINICAL EVALUATION OF VIRECHAN THERAPY AND HARIDRADI VATI AND OIL FOR THE MANAGEMENT OF KITIBH KUSHTHA (PSORIASIS

    Directory of Open Access Journals (Sweden)

    P.S. Byadgi

    2013-04-01

    Full Text Available It is generally an accepted concept in medicine that the skin can develop signs of internal disease. In reality, concise differential diagnosis and the identification of these disorders are actually difficult for the nondermatologist because he or she is not well-versed in the recognition of cutaneous lesions or their spectrum of presentations. The skin is the largest organ of our body. It is one of the five ‘Gyanendriyas’ as described in Ayurvedic texts, which is responsible for ‘Sparsha Gyan’ or touch sensation. Therefore, it plays a major role in physical and mental well being of any individual. In Ayurveda, all the skin disease has been described under the umbrella of Kushtha. They are further classified into Mahakushtha and Kshudrakushtha. According to Charaka Kitibh is Vat-Kapha predominant and according to Sushruta, it is Pitta predominant Kshudrakushtha. Kitibh Kushtha may be correlated to Psoriasis due to their more or less similar clinical presentations. Therefore, in this clinical trial we have planned to study the clinical effect of Virechan therapy (for elimination of Pitta and Haridradi Vati and oil (for Samshaman of Vat-Kapha in Kitibh Kushtha. Kitibh Kushtha is characterized by patches which are blackish brown in colour, rough and coarse in nature, exudative, round, thick along with severe itching. Psoriasis is one of the most common dermatologic diseases affecting up to 2.5% of the world’s population. It is a non-infectious chronic inflammatory skin disorder clinically characterised by pink-red, silvery scale, sharply demarcated lesions on the skin surface especially over elbows, knees, scalp and presacral areas. Present clinical study comprises of randomly selected eighteen registered cases of Psoriasis (Kitibh Kushtha from OPD and IPD of Kayachikitsa, Sir Sundarlal Hospital, B.H.U.,Varanasi, have been treated with Virechan therapy and Haridradi Vati and oil (containing Haridra , Bakuchi , Guduchi and Gomutra to

  1. Psoriasis in the pediatric population

    International Nuclear Information System (INIS)

    A scientific and updated bibliographic review is realized for handling and care of a pediatric patient with psoriasis disease. Health personnel related with this pathology must to know the different perspectives and angles of psoriasis, as well as clinical criteria, therapeutic and emotional in the treatment of patients. The incidence of psoriasis is recognized globally. Ethnic groups have developed with most frequently this disorder. The different clinical faces of psoriasis are studied. The morphological and topographical manifestations have presented a variety very similar to that of adults, and have made for the doctor difficult to make the diagnostic. Clinical studies that were realized in the last years, have reported etiological and pathogenic evidence, both genetic and immunological of this illness. Children with psoriasis usually have presented a mild illness, where psoriasis type plaque has been the predominant variant. Psoriasis in the population has required a special attention in triggers or aggravating factors of this disease such as infections, exposure to snuff, obesity, stress and interactions with other drugs. The discovery and use of new drugs have led to different etiological factors for the handling of psoriasis; so it is important to know the function, availability and adverse effects that can to cause new therapies. Treatments must to include the provision of a safe and effective therapy for the maintenance for free long periods of lesions, reducing the severity of the disease, and inhibiting structural damage of joints. The topical treatment has been the therapy of first choice in mild psoriasis and localized. An interrogatory is recommended to decide objectively a systemic treatment, because the infant population has been a sensitive group of possible adverse effects. Methotrexate has been the treatment of choice for psoriasis related to arthropathy both adults and children. Phototherapy, including UVB, PUVA light and excimer laser is

  2. Promising New Treatments for Psoriasis

    Directory of Open Access Journals (Sweden)

    Sarah Dubois Declercq

    2013-01-01

    Full Text Available Psoriasis is a chronic, proliferative, and inflammatory skin disease affecting 2-3% of the population and is characterized by red plaques with white scales. Psoriasis is a disease that can affect many aspects of professional and social life. Currently, several treatments are available to help control psoriasis such as methotrexate, ciclosporin, and oral retinoids. However, the available treatments are only able to relieve the symptoms and lives of individuals. The discovery of new immunological factors and a better understanding of psoriasis have turned to the use of immunological pathways and could develop new biological drugs against specific immunological elements that cause psoriasis. Biological drugs are less toxic to the body and more effective than traditional therapies. Thus, they should improve the quality of life of patients with psoriasis. This review describes new psoriasis treatments, which are on the market or currently in clinical trials that are being used to treat moderate-to-severe plaque psoriasis. In addition, this paper describes the characteristics and mechanisms in detail. In general, biological drugs are well tolerated and appear to be an effective alternative to conventional therapies. However, their effectiveness and long-term side effects need to be further researched.

  3. Childhood psoriasis

    OpenAIRE

    Dogra Sunil; Kaur Inderjeet

    2010-01-01

    Psoriasis is a common dermatosis in children with about one third of all patients having onset of disease in the first or second decade of life. A chronic disfiguring skin disease, such as psoriasis, in childhood is likely to have profound emotional and psychological effects, and hence requires special attention. Psoriasis in children has been reported to differ from that among adults being more frequently pruritic; plaque lesions are relatively thinner, softer, and less scaly; face and flexu...

  4. The potential of the essential fatty acid-deficient hairless rat as a psoriasis screening model for topical anti-proliferative drugs

    DEFF Research Database (Denmark)

    Jensen, M.; Groth, L.; Fullerton, A.;

    2002-01-01

    , histology of the epidermis and fatty acid analysis of serum and skin. Immediately after the EFAD condition had been established, the animals were treated with dithranol ointment or different concentrations of calcipotriol solution. A reduction in epidermal thickness of 15-20% was seen after the treatment...... with calcipotriol. Dithranol and its coal tar-containing vehicle also showed a reductive effect on epidermal thickness. EFAD hairless rats possess various histological changes resembling psoriasis. These histological changes normalise during treatment with anti-psoriatic drugs as calcipotriol, dithranol and coal...

  5. Tratamiento biológico en psoriasis: Revisión bibliográfica Biologic therapy of psoriasis: Literature review

    Directory of Open Access Journals (Sweden)

    MS Lorenzetti

    2012-06-01

    Full Text Available El tratamiento de la psoriasis moderada a grave es difícil, debido a la variable respuesta clínica y a los efectos adversos del tratamiento sistémico convencional, el que suele resultar insatisfactorio para numerosos pacientes. Puesto que los tratamientos actualmente disponibles tienen un efecto supresor de la enfermedad y no curativo, el control adecuado de los signos y síntomas requiere un tratamiento continuado a largo plazo, que en el caso de los tratamientos sistémicos tradicionales, conlleva un riesgo elevado de toxicidad acumulativa (daño hepático-metabólico-hemático-renal y riesgo de neoplasias. La misma fototerapia tiene sus límites por el hecho que en general, hay que concurrir tres veces por semana a una institución, la misma eventual toxicidad del 8-MOP y el riesgo de neoplasias Los tratamientos biológicos en la psoriasis van dirigidos contra citocinas o proteínas de superficie de los linfocitos, que actúan en los mecanismos fisiopatogénicos de la psoriasis. Se efectuó una investigación de tipo bibliográfica, para conocer la experiencia internacional con especial dedicación a etanercept, infliximab y adalimumab, los que demostraron ser efectivos, con una seguridad relativa respecto de complicaciones infecciosas y neoplásicas.The treatment of moderate to severe psoriasis is difficult, due to the variable clinical response and the adverse events emerging from the conventional systemic treatment and it is generally unsatisfactory to numerous patients. Given that the currently available treatments have a suppressor and not a curative effect on the disease, the adequate signs and symptoms control requires a long-term continued treatment which, in the case of traditional systemic treatments, conveys a high risk of accumulative toxicity (hepatic-metabolic-hematic-renal failure and risk of neoplasia. Phototherapy itself is limited by the fact that, generally, the patient has to visit an institution three times a week

  6. Comparison of ethosomes and liposomes for skin delivery of psoralen for psoriasis therapy.

    Science.gov (United States)

    Zhang, Yong-Tai; Shen, Li-Na; Wu, Zhong-Hua; Zhao, Ji-Hui; Feng, Nian-Ping

    2014-08-25

    Recent reports have indicated that psoriasis may be caused by malfunctioning dermal immune cells, and psoralen ultraviolet A (PUVA) is an effective treatment for this chronic disease. However, conventional topical formulations achieve poor drug delivery across patches of psoriasis to their target sites. The present study describes the development of a novel psoralen transdermal delivery system employing ethosomes, flexible vesicles that can penetrate the stratum corneum and target deep skin layers. An in vitro skin permeation study showed that the permeability of psoralen-loaded ethosomes was superior to that of liposomes. Using ethosomes, psoralen transdermal flux and skin deposition were 38.89±0.32 μg/cm(2)/h and 3.87±1.74 μg/cm(2), respectively, 3.50 and 2.15 times those achieved using liposomes, respectively. The ethosomes and liposomes were found to be safe following daily application to rat skin in vivo, for 7 days. The ethosomes showed better biocompatibility with human embryonic skin fibroblasts than did an equivalent ethanol solution, indicating that the phosphatidylcholine present in ethosome vesicles improved their biocompatibility. These findings indicated that ethosomes could potentially improve the dermal and transdermal delivery of psoralen and possibly of other drugs requiring deep skin delivery. PMID:24907596

  7. Comparison of ethosomes and liposomes for skin delivery of psoralen for psoriasis therapy.

    Science.gov (United States)

    Zhang, Yong-Tai; Shen, Li-Na; Wu, Zhong-Hua; Zhao, Ji-Hui; Feng, Nian-Ping

    2014-08-25

    Recent reports have indicated that psoriasis may be caused by malfunctioning dermal immune cells, and psoralen ultraviolet A (PUVA) is an effective treatment for this chronic disease. However, conventional topical formulations achieve poor drug delivery across patches of psoriasis to their target sites. The present study describes the development of a novel psoralen transdermal delivery system employing ethosomes, flexible vesicles that can penetrate the stratum corneum and target deep skin layers. An in vitro skin permeation study showed that the permeability of psoralen-loaded ethosomes was superior to that of liposomes. Using ethosomes, psoralen transdermal flux and skin deposition were 38.89±0.32 μg/cm(2)/h and 3.87±1.74 μg/cm(2), respectively, 3.50 and 2.15 times those achieved using liposomes, respectively. The ethosomes and liposomes were found to be safe following daily application to rat skin in vivo, for 7 days. The ethosomes showed better biocompatibility with human embryonic skin fibroblasts than did an equivalent ethanol solution, indicating that the phosphatidylcholine present in ethosome vesicles improved their biocompatibility. These findings indicated that ethosomes could potentially improve the dermal and transdermal delivery of psoralen and possibly of other drugs requiring deep skin delivery.

  8. Treatment Options for Pediatric Psoriasis.

    Science.gov (United States)

    Madiraca, Dora; Šitum, Mirna; Prkačin, Ivana; Ožanić Bulić, Suzana

    2016-08-01

    Psoriasis is a multifactorial inflammatory papulosquamous disease affecting 0.5% to 2% of the pediatric population. Pediatric psoriasis, presenting similar to adult psoriasis, significantly reduces patient quality of life, often requiring an individualized treatment approach for each patient. Combination and rotational therapy are helpful in reducing toxicity and maximizing efficacy. Patients with mild and limited disease severity respond well to topical treatment with steroids or vitamin D analogues, unlike moderate and severe psoriasis where sufficient remission is rarely achieved. Therefore phototherapy, systemic immunomodulators, or biologic agents are the next line of treatment to be considered. There is limited data available on the use and long-term safety of biologics in the pediatric population. Biologic agents must be administered by experienced dermatologists, only in patients with moderate-to-severe plaque psoriasis who are intolerant or refractory to other systemic conventional disease-modifying treatment or phototherapy, or if those treatments are contraindicated. PMID:27663917

  9. Psoriasis and Nutrition Interactions

    Directory of Open Access Journals (Sweden)

    Leyla Tevfikoğlu Alceylan

    2015-06-01

    Full Text Available Psoriasis is a chronic complex inflammatory disease affected by both genetic and environmental factors. Nutrition and diet has been suggested to play a role in the etiology and pathogenesis of psoriasis. Diets poor in energy and saturated fatty acids and rich in polyunsaturated fatty acids have positive effects on the treatment of psoriasis. Vitamin A and D modulate immune system and their receptors shows an anti-inflammatory effect by inhibiting the proliferation of keratinocytes. Patients with psoriasis are often Vitamin D deficient, they should be therefore evaluated considering their vitamin D levels. If they take a vitamin D supplementation, they should be monitored for side effects. Consumption levels of minerals such as copper, zinc and iron, and antioxidant compounds, including carotenoids and flavonoids involve in antioxidant reactions should be followed-up. A diet including a variety of vegetables and fruit can help reduce the risk of oxidative stress. Selenium levels are lower in patients, and selenium is effective in the prognosis of the disease when combined with antioxidant treatment. Alcohol consumption has a negative impact on the nutrition of the patients and the prognosis of the disease and should be avoided. The follow-up of the disease at an early stage, adequate and balanced nutrition are important in the treatment of psoriasis. Weight controls should be provided and diets with individual specific nutrition variety should be set.

  10. Psoríase eritrodérmica com regressão após profilaxia com isoniazida e terapia antidepressiva: relato de caso Erythrodermic psoriasis with regression after prophylaxis with isoniazid and antidepressant therapy: case report

    Directory of Open Access Journals (Sweden)

    Isabella Portela Redighieri

    2011-08-01

    Full Text Available Mulher idosa apresentou psoríase em placas do tipo grave, com tendência eritrodérmica, e foi submetida a tratamento de acordo com o algoritmo consensual (fototerapia, acitretina, ciclosporina. Resultados clínicos insuficientes, recorrência e agravamento do quadro laboratorial orientaram no sentido da introdução de terapia biológica. A avaliação preliminar revelou PPD de 30mm. A resolução completa das lesões se verificou quando realizada profilaxia antituberculose e administrado antidepressivoAn 83 year old woman, exhibiting severe psoriasis, was treated conventionally (phototherapy, acitretin, and cyclosporine. After poor clinical results and significant changes in laboratory procedures, those treatments were suspended. She was then being prepared to be submitted to biological treatment, when preliminary results disclosed a 30mm PPD. Complete improvement occurred [only] after introducing prophylactic therapy for tuberculosis and anti-depressive medication

  11. Erythrodermic Psoriasis

    Science.gov (United States)

    ... and psoriatic arthritis. Email * Zipcode The National Psoriasis Foundation (NPF) is a non-profit organization with a mission to drive efforts to cure psoriatic disease and improve the lives of those affected. Copyright © 1996-2015 National Psoriasis Foundation/USA Bottom Menu About NPF About Us Annual ...

  12. Guttate Psoriasis

    Science.gov (United States)

    ... and psoriatic arthritis. Email * Zipcode The National Psoriasis Foundation (NPF) is a non-profit organization with a mission to drive efforts to cure psoriatic disease and improve the lives of those affected. Copyright © 1996-2015 National Psoriasis Foundation/USA Bottom Menu About NPF About Us Annual ...

  13. Plaque Psoriasis

    Science.gov (United States)

    ... and psoriatic arthritis. Email * Zipcode The National Psoriasis Foundation (NPF) is a non-profit organization with a mission to drive efforts to cure psoriatic disease and improve the lives of those affected. Copyright © 1996-2015 National Psoriasis Foundation/USA Bottom Menu About NPF About Us Annual ...

  14. Systemic combination treatment for psoriasis: a review

    DEFF Research Database (Denmark)

    Jensen, Peter; Skov, Lone; Zachariae, Claus

    2010-01-01

    exist for the use of systemic combination therapy. Therefore, our aim was to review the current literature on systemic anti-psoriatic combination regimens. We searched PubMed and identified 98 papers describing 116 studies (23 randomized) reporting on the effect of various systemic combination......Psoriasis is a chronic inflammatory skin disease, which affects approximately 2.6% of the population in Northern Europe and Scandinavia. In order to achieve disease control, combinations of systemic treatments are sometimes needed for variable time periods. However, no evidence-based guidelines...

  15. [Pathogenesis of psoriasis].

    Science.gov (United States)

    Schäkel, K; Schön, M P; Ghoreschi, K

    2016-06-01

    Psoriasis is an inflammatory T cell-mediated autoimmune disease of skin and joints that affects 2-4 % of the adult population and 0.1-1 % of children. Genetic susceptibility, environmental triggering factors, and innate immune processes initiate psoriasis pathogenesis that results in an adaptive autoreactive response. The T cell response is orchestrated by CD 8(+) T cells in the epidermis and by CD 4(+) T cells in the dermis that predominantly produce interleukin-17 (IL‑17). Research of the past 15 years unraveled cellular and molecular mechanisms as well as cytokines like TNF-α or IL‑23 that contribute to psoriatic inflammation. This knowledge has been translated into clinical practice and a number of antipsoriatic small molecules and immunobiologics are now available. Here, we discuss the current principles of psoriasis pathogenesis in the context of modern therapies.

  16. Itch and scratching as predictors of time to clearance of psoriasis with narrow-band ultraviolet B therapy.

    NARCIS (Netherlands)

    Evers, A.W.M.; Kleinpenning, M.M.; Smits, T.; Boezeman, J.B.M.; Kerkhof, P.C.M. van de; Kraaimaat, F.W.; Gerritsen, M.J.P.

    2009-01-01

    BACKGROUND: Narrow-band ultraviolet (UV) B phototherapy is an effective treatment for psoriasis. However, there is considerable variability in the number of treatment sessions needed to achieve psoriasis clearance. While several clinical and treatment-related factors predict time to clearance, the e

  17. Psoriasis triggered by mefloquine.

    Science.gov (United States)

    Pace, Joseph L

    2010-01-01

    A 46-year-old Caucasian man living on the central Mediterranean island of Gozo (Malta) was started on mefloquine 250 mg once weekly before a trip to lower Egypt. He took his medication 1 week before starting his holiday and was advised to continue it for 4 weeks after returning. He did not take any other medication and enjoyed the holiday, which he initially intended to repeat in the near future. His medical history revealed a number of episodes of psoriasis for which he sought dermatologic advice. He had been given systemic therapy on at least one occasion, but the condition had been fairly quiescent for some time and he had not needed to consult a dermatologist for more than 4 years. Soon after the third tablet of mefloquine and effectively just after his return home to Gozo, the patient noticed that the psoriasis was "creeping back." He noted progressive deterioration in his skin problem but nevertheless finished the recommended course of therapy considering that "being sure about not developing malaria was far more important than a touch of psoriasis." The psoriasis worsened to the extent that he had taken off work for 2 weeks from his job as a self-employed carpenter at the time of referral. On examination, clearly there was a significant flare up of his psoriasis with severe involvement of the hands (Figure 1) and feet and less so over the rest of his body. He had been off work and matters were steadily getting worse in spite of topical treatment with a combination of calcipotriol-betamethasone ointment. Oral methotrexate 15 mg once weekly was commenced together with topical therapy with good results (Figure 2). PMID:21137644

  18. Psoriasis triggered by mefloquine.

    Science.gov (United States)

    Pace, Joseph L

    2010-01-01

    A 46-year-old Caucasian man living on the central Mediterranean island of Gozo (Malta) was started on mefloquine 250 mg once weekly before a trip to lower Egypt. He took his medication 1 week before starting his holiday and was advised to continue it for 4 weeks after returning. He did not take any other medication and enjoyed the holiday, which he initially intended to repeat in the near future. His medical history revealed a number of episodes of psoriasis for which he sought dermatologic advice. He had been given systemic therapy on at least one occasion, but the condition had been fairly quiescent for some time and he had not needed to consult a dermatologist for more than 4 years. Soon after the third tablet of mefloquine and effectively just after his return home to Gozo, the patient noticed that the psoriasis was "creeping back." He noted progressive deterioration in his skin problem but nevertheless finished the recommended course of therapy considering that "being sure about not developing malaria was far more important than a touch of psoriasis." The psoriasis worsened to the extent that he had taken off work for 2 weeks from his job as a self-employed carpenter at the time of referral. On examination, clearly there was a significant flare up of his psoriasis with severe involvement of the hands (Figure 1) and feet and less so over the rest of his body. He had been off work and matters were steadily getting worse in spite of topical treatment with a combination of calcipotriol-betamethasone ointment. Oral methotrexate 15 mg once weekly was commenced together with topical therapy with good results (Figure 2).

  19. Itolizumab – a humanized anti-CD6 monoclonal antibody with better side effects profile for the treatment of psoriasis [Corrigendum

    Directory of Open Access Journals (Sweden)

    Menon R

    2015-06-01

    Full Text Available Menon R, David BG. Clinical, Cosmetic and Investigational Dermatology. 2015;8:215–22.On page 215, please note correspondence should have been listed as:   Roshni Menon, D II/17,JIPMER Campus, Dhanvanthri Nagar,Pondicherry, India 605006Tel +91 944 320 8140Email roshnijagdish@gmail.com.On page 215, the first sentence of the Introduction was “Psoriasis is a chronic inflammatory disease of the skin characterized by exacerbations and remissions affecting 1%–3% of the world’s population, and approximately 20% of patients have moderate to severe disease.1,2” however should have been “Psoriasis is a chronic inflammatory disease of the skin characterized by exacerbations and remissions affecting 1%–3% of the world’s population. Approximately 20% of patients have moderate to severe disease.1,2”On page 217, 219, and 221 the running header was “Itolizumab – aCD6 monoclonal antibody for the treatment of psoriasis” however should have been “Itolizumab – a humanized anti CD6 monoclonal antibody for the treatment of psoriasis”.On page 218, Table 1, the second column heading was listed as “Anand et al25 n=40 (moderate–severe psoriasis” however should have been “Anand et al25 n=40/32 weeks (moderate–severe psoriasis”.Read the original article 

  20. Psoriasis - guttate

    Science.gov (United States)

    ... look like teardrops Spots may be covered with silver, flaky skin called scales Spots usually occur on ... or recent infection, your doctor may give you antibiotics. Mild cases of guttate psoriasis are usually treated ...

  1. The combination of etanercept and methotrexate increases the effectiveness of treatment in active psoriasis despite inadequate effect of methotrexate therapy

    DEFF Research Database (Denmark)

    Zachariae, C.; Mork, N.J.; Reunala, T.;

    2008-01-01

    Many patients with moderate-to-severe plaque psoriasis do not respond adequately to methotrexate monotherapy. This pilot study, with a small patient population, was performed to evaluate the effectiveness and safety of etanercept and methotrexate combination in patients with plaque psoriasis...... and inadequate response to methotrexate. Outpatients with plaque psoriasis (Psoriasis Area and Severity Index >= 8 and/or body surface area > 10%), despite methotrexate treatment (>= 3 months; >= 7.5 mg/ week) were randomized to either etanercept with methotrexate tapered and discontinued (n = 28) or etanercept...... with continuous methotrexate (n = 31). Significantly more patients had a Physicians' Global Assessment of "clear"/"almost clear" in the combination group compared with etanercept/methotrexate taper (66.7 vs. 37.0%, respectively; p = 0.025). Adverse events were similar for both groups, with no cases...

  2. The combination of etanercept and methotrexate increases the effectiveness of treatment in active psoriasis despite inadequate effect of methotrexate therapy

    DEFF Research Database (Denmark)

    Zachariae, Claus; Mørk, Nils-Jørgen; Reunala, Timo;

    2008-01-01

    Many patients with moderate-to-severe plaque psoriasis do not respond adequately to methotrexate monotherapy. This pilot study, with a small patient population, was performed to evaluate the effectiveness and safety of etanercept and methotrexate combination in patients with plaque psoriasis...... and inadequate response to methotrexate. Outpatients with plaque psoriasis (Psoriasis Area and Severity Index > or = 8 and/or body surface area > 10%), despite methotrexate treatment (> or = 3 months; > or = 7.5 mg/week) were randomized to either etanercept with metho nottrexate tapered and discontinued (n = 28......) or etanercept with continuous methotrexate (n = 31). Significantly more patients had a Physicians' Global Assessment of "clear"/"almost clear" in the combination group compared with etanercept/methotrexate taper (66.7 vs. 37.0%, respectively; p = 0.025). Adverse events were similar for both groups...

  3. A new look at anti-Helicobacter pylori therapy

    Institute of Scientific and Technical Information of China (English)

    Seng-Kee Chuah; Feng-Woei Tsay; Ping-I Hsu; Deng-Chyang Wu

    2011-01-01

    With the rising prevalence of antimicrobial resistance, the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e., 80% or less) in most countries. Therefore, several treatment regimens have emerged to cure Helicobacter pylori (H .pylori)infection. Novel first-line anti-H. pylorii therapies in 2011 include sequential therapy, concomitant quadruple therapy, hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy. After the failure of standard triple therapy, a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI), bismuth, tetracycline and metronidazole can be employed as rescue treatment. Recently, triple therapy combining a PPI, levofloxacin and amoxicillin has been proposed as an alternative to the standard rescue therapy. This salvage regimen can achieve a higher eradication rate than bismuth-containing quadruple therapy in some regions and has less adverse effects. The best second-line therapy for patients who fail to eradicate H. pylori with first-line therapies containing clarithromycin, amoxicillin and metronidazole is unclear. However, a levofloxacin-based triple therapy is an accepted rescue treatment. Most guidelines suggest that patients requiring third-line therapy should be referred to a medical center and treated according to the antibiotic susceptibility test. Nonetheless, an empirical therapy (such as levofloxacin-based or furazolidone-based therapies) can be employed to terminate H. pylorii infection if antimicrobial sensitivity data are unavailable.

  4. 银屑病全身治疗的遗传药理学进展%Advances in pharmacogenetics of systemic therapies for psoriasis

    Institute of Scientific and Technical Information of China (English)

    孟祥光; 倪文琼; 王超; 马登轩; 李智; 周宏灏

    2012-01-01

    Psoriasis is an inflammatory hy-perproliferative skin disease with a strong genetic susceptibility and influenced by genetic, im-munological and environmental factors. Because most patients with moderate to severe psoriasis cannot benefit from the topical treatment, they have to treat with systemic agents. While the systemic treatment is characterized of high medical cost and large inter-individual variations in efficacy and adverse reaction, the studies on pharmacogenetics of systemic therapies for Psoriasis play an important role in clinic. This review summarizes the correlations between genetic factors and systemic agents to provide the theoretical guidance for the personalized medication in psoriasis.%银屑病是一种炎症过度增生性皮肤病,有强烈的遗传易感性.主要受到遗传、免疫和环境的影响.由于部分患者病情处于中重度,局部治疗效果不佳,所以必须施以全身治疗.但全身治疗费用高且疗效和毒性个体化差异大,因此,涉及银屑病全身治疗的遗传药理学研究意义重大.本文主要对近几年银屑病全身治疗和遗传的关系进行一个较为全面的综述,以期为银屑病患者的个体化医学提供理论指导.

  5. Efficacy, tolerability and safety of switching from etanercept to infliximab for the treatment of moderate-to-severe psoriasis: A multicenter, open-label trial (TANGO).

    Science.gov (United States)

    Ayala, Fabio; Lambert, Julien

    2015-01-01

    Biologic anti-tumor necrosis factor-α (anti-TNF-α) therapies have revolutionized the management of psoriasis. However, despite similar mechanisms of action, inter-patient variability in the clinical responses to therapy remain unexplained. Possible differences between agents include stability or bioavailability and anti-drug antibody development, and patient factors such as compliance may play a role. As a result, it is not uncommon for physicians to switch a patient from one anti-TNF-α agent to another when initial response is inadequate. This multicenter, single-arm, observational, Phase IV study assessed the efficacy and safety of infliximab therapy in patients with moderate-to-severe psoriasis who had not responded to 24 weeks' etanercept treatment. Drug efficacy was assessed using specific psoriasis indexes; health-related quality of life (HRQoL) was measured using the Dermatology Life Quality Index and the Skindex-29. A total of 48 patients were screened, 38 were treated with infliximab and 31 completed the study. Of these, 71% achieved Psoriasis Area and Severity Index 75 after 10 weeks, and improvement in HRQoL was documented. The results of this study showed that patients with moderate-to-severe psoriasis could be successfully switched from etanercept to infliximab, with improvements in both clinical parameter and HRQoL. PMID:25231176

  6. Management of childhood psoriasis.

    Science.gov (United States)

    Cordoro, Kelly M

    2008-01-01

    Treating children with psoriasis represents one of the most rewarding yet constantly challenging endeavors in dermatology. These patients require time, energy, enthusiasm, empathy, and current, comprehensive knowledge of the unique clinical presentations in children and available therapies, including clinical action spectrum, mechanism of action, potential toxicity, and monitoring. Longitudinal trials examining the epidemiology and natural history of psoriasis, as well as the safety and efficacy of current and emerging treatments, are desperately needed in the pediatric population. Partner with the patient, family, and other multidisciplinary providers to form an educational and therapeutic alliance. Early in the course of disease, schedule frequent visits for reinforcement of the therapeutic plan, education, clinical and treatment monitoring, and support. As the disease and the patient's physical, psychosocial and emotional level of functioning evolve, so too will the requirement for follow-up and monitoring. Patient advocacy and education groups, such as the National Psoriasis Foundation (www.psoriasis.org; 800-723-9166) are excellent resources and can serve as an extension of your comprehensive care. PMID:19256308

  7. Successful treatment of psoriasis vulgaris with targeted narrow-band ultraviolet B therapy using a new flat-type fluorescent lamp.

    Science.gov (United States)

    Nishida, Emi; Furuhashi, Takuya; Kato, Hiroshi; Kaneko, Natsumi; Shintani, Yoichi; Morita, Akimichi

    2011-10-01

    Narrow-band ultraviolet B (NB-UVB) therapy is widely used for refractory skin diseases. Targeted phototherapy is now being used to reduce the number of sessions and to avoid exposing normal skin. We developed a targeted NB-UVB therapy using a flat-type lamp emitting a wavelength similar to that of the TL-01 fluorescent lamp. Six Japanese patients with psoriasis were recruited and treated with the flat-type NB-UVB device with an initial dose of 70% of the minimal erythema dose, with a 20% increase at each subsequent session. The plaque severity score was determined. All lesions of the tested patients were responsive to NB-UVB therapy using the flat-type lamp. The mean percent reduction of the lesion was 58.3 ± 17.7%. The mean cumulative dose was 20.8 ± 10.8 J/cm². No side effects were observed during treatment. The flat-type targeted NB-UVB device is compact and convenient, and highly effective for the treatment of limited psoriasis lesions.

  8. Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR).

    Science.gov (United States)

    Warren, Richard B; Smith, Catherine H; Yiu, Zenas Z N; Ashcroft, Darren M; Barker, Jonathan N W N; Burden, A David; Lunt, Mark; McElhone, Kathleen; Ormerod, Anthony D; Owen, Caroline M; Reynolds, Nick J; Griffiths, Christopher E M

    2015-11-01

    Drug survival reflects a drug's effectiveness, safety, and tolerability. We assessed the drug survival of biologics used to treat psoriasis in a prospective national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register (BADBIR)). The survival rates of the first course of biologics for 3,523 biologic-naive patients with chronic plaque psoriasis were compared using survival analysis techniques and predictors of discontinuation analyzed using a multivariate Cox proportional hazards model. Data for patients on adalimumab (n=1,879), etanercept (n=1,098), infliximab (n=96), and ustekinumab (n=450) were available. The overall survival rate in the first year was 77%, falling to 53% in the third year. Multivariate analysis showed that female gender (hazard ratio (HR) 1.22; 95% confidence interval (CI): 1.09-1.37), being a current smoker (HR 1.19; 95% CI: 1.03-1.38), and a higher baseline dermatology life quality index (HR 1.01; 95% CI: 1.00-1.02) were predictors of discontinuation. Presence of psoriatic arthritis (HR 0.82; 95% CI: 0.71-0.96) was a predictor for drug survival. As compared with adalimumab, patients on etanercept (HR 1.63; 95% CI: 1.45-1.84) or infliximab (HR 1.56; 95% CI: 1.16-2.09) were more likely to discontinue therapy, whereas patients on ustekinumab were more likely to persist (HR 0.48; 95% CI: 0.37-0.62). After accounting for relevant covariates, ustekinumab had the highest first-course drug survival. The results of this study will aid clinical decision making when choosing biologic therapy for psoriasis patients. PMID:26053050

  9. Screening for Latent Tuberculosis in the Patient With Moderate to Severe Psoriasis Who Is a Candidate for Systemic and/or Biologic Therapy.

    Science.gov (United States)

    Martínez-López, A; Rodriguez-Granger, J; Ruiz-Villaverde, R

    2016-04-01

    Screening to detect latent tuberculosis infection (LTBI) is essential before patients with moderate to severe psoriasis start treatment with biologics and vigilance will continue to be needed during and after such treatment. The most recently analyzed statistics from the BIOBADADERM registry show a 20.5% prevalence of LTBI in psoriasis patients treated with biologics in Spain. Various screening protocols are in effect in different countries according to their levels of endemic TB and bacillus Calmette-Guérin (BCG) vaccination, and there is no consensus on a gold-standard approach to the diagnosis of LTBI. Tuberculin skin testing (TST) continues to be the diagnostic method of choice in spite of its limited sensitivity, mainly in immunocompromised patients. Additional problems include the TST's well-established lack of specificity, errors in application, subjectivity in the interpretation of results (which must be read during a second visit), and lack of privacy; the main advantages of this test are its low cost and ease of application. Most cost-benefit studies are therefore inclined to favor using interferon-γ release assays to detect LTBI because they minimize false positives (especially in BCG-vaccinated individuals), thereby eliminating the extra costs and side effects of unnecessary chemoprophylaxis. We review the methods used for LTBI screening in psoriasis patients who are candidates for biologic therapy. Additionally, given the fact that most guidelines do not currently consider it necessary to screen patients about to start conventional systemic therapy, we discuss the reasons underlying the need for such screening. PMID:26651325

  10. A Preliminary, Open Label, Single-arm Study of Calcipotriene/Betamethasone Topical Suspension as a Supplement to Non-biologic Systemic Therapy for Psoriasis

    Science.gov (United States)

    Kupetsky, Erine; Houston, Neil A.M.

    2016-01-01

    Background: Calcipotriene/betamethasone topical suspension is a topical therapy that is often used as monotherapy as a first-line treatment for plaque psoriasis. The objective of this preliminary, open label, single arm study was to determine the efficacy of adding a topical suspension to a traditional systemic therapy for psoriasis, either methotrexate or acitretin. Methods: In this exploratory study, eight patients with chronic plaque psoriasis who were on stable methotrexate or acitretin treatment without clearance were treated with once-daily calcipotriene/betamethasone topical suspension. Subjects completed five study visits over 12 weeks. Primary outcome measure was improvement of two or more points in Investigator Global Assessment. Secondary endpoints included change in Body Surface Area, Dermatology Life Quality Index, and Patient’s Global Assessment from baseline to Week 12. Results: Overall, the median decrease in Investigator Global Assessment over 12 weeks was 1.5 points, with 50 percent of subjects experiencing a drop of two or more points in Investigator Global Assessment. All eight subjects had a reduction in Body Surface Area and Patient’s Global Assessment. There was a mean decrease in Dermatology Life Quality Index score of 78.9 percent, showing improved patient quality of life. In addition, all patients tolerated the treatment well and 6 of 8 patients had improved satisfaction level with their treatment by the end of the study. Conclusion: The topical suspension was effective and well-tolerated in conjunction with stable methotrexate or acitretin treatment in all eight patients in this study. These results support the feasibility of a larger scale study to further investigate the efficacy of these treatment combinations. The trial is registered at ClinicalTrials.gov, number NCT01761019. PMID:27462386

  11. Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR).

    Science.gov (United States)

    Warren, Richard B; Smith, Catherine H; Yiu, Zenas Z N; Ashcroft, Darren M; Barker, Jonathan N W N; Burden, A David; Lunt, Mark; McElhone, Kathleen; Ormerod, Anthony D; Owen, Caroline M; Reynolds, Nick J; Griffiths, Christopher E M

    2015-11-01

    Drug survival reflects a drug's effectiveness, safety, and tolerability. We assessed the drug survival of biologics used to treat psoriasis in a prospective national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register (BADBIR)). The survival rates of the first course of biologics for 3,523 biologic-naive patients with chronic plaque psoriasis were compared using survival analysis techniques and predictors of discontinuation analyzed using a multivariate Cox proportional hazards model. Data for patients on adalimumab (n=1,879), etanercept (n=1,098), infliximab (n=96), and ustekinumab (n=450) were available. The overall survival rate in the first year was 77%, falling to 53% in the third year. Multivariate analysis showed that female gender (hazard ratio (HR) 1.22; 95% confidence interval (CI): 1.09-1.37), being a current smoker (HR 1.19; 95% CI: 1.03-1.38), and a higher baseline dermatology life quality index (HR 1.01; 95% CI: 1.00-1.02) were predictors of discontinuation. Presence of psoriatic arthritis (HR 0.82; 95% CI: 0.71-0.96) was a predictor for drug survival. As compared with adalimumab, patients on etanercept (HR 1.63; 95% CI: 1.45-1.84) or infliximab (HR 1.56; 95% CI: 1.16-2.09) were more likely to discontinue therapy, whereas patients on ustekinumab were more likely to persist (HR 0.48; 95% CI: 0.37-0.62). After accounting for relevant covariates, ustekinumab had the highest first-course drug survival. The results of this study will aid clinical decision making when choosing biologic therapy for psoriasis patients.

  12. Psoriasis: Pregnancy and Nursing

    Science.gov (United States)

    ... to find out more! Email * Zipcode Pregnancy and Nursing In general, psoriasis does not affect the male ... psoriasis and birth » Treating psoriasis while pregnant or nursing There is little research on the impact of ...

  13. What Is Psoriasis?

    Science.gov (United States)

    ... Information Psoriasis Find a Clinical Trial Journal Articles Psoriasis PDF Version Size: 54 KB Audio Version Time: ... Size: 6.4 MB November 2014 What Is Psoriasis? Fast Facts: An Easy-to-Read Series of ...

  14. Naevoid psoriasis

    Directory of Open Access Journals (Sweden)

    Mittal R

    1999-01-01

    Full Text Available A 6-year-old male child had linear scaly erythematous band on the penis, undersuface of penis, extending to the scrotum since birth. He was diagnosed clinically as well as histopathologically as a case of naevoid psoriasis.

  15. Systemic Treatment of Pediatric Psoriasis: A Review.

    Science.gov (United States)

    Napolitano, Maddalena; Megna, Matteo; Balato, Anna; Ayala, Fabio; Lembo, Serena; Villani, Alessia; Balato, Nicola

    2016-06-01

    Psoriasis is a chronic, immune-mediated, inflammatory skin disease, affecting 1-3% of the white population. Although the existence of two psoriasis incidence peaks has been suggested (one in adolescence before 20 years of age and another in adulthood), its onset may occur at any age, including childhood and adolescence, in which the incidence is now estimated at 40.8 per 100,000. As for adult psoriasis, pediatric psoriasis has recently been associated with obesity, metabolic syndrome, increased waist circumference percentiles and metabolic laboratory abnormalities, warranting early monitoring and lifestyle modifications. In addition, due to psoriasis' chronic nature and frequently occurring relapses, psoriatic patients tend to have an impaired quality of life, often requiring long-term treatment. Therefore, education of both pediatric patients and their parents is essential to successful and safe disease management. Given the lack of officially approved therapies, the very limited evidence-based data from randomized controlled trials, and the absence of standardized guidelines, to date, pediatric psoriasis treatment is primarily based on published case reports, case series, guidelines for adult psoriasis, expert opinions and experience with these drugs in other pediatric disorders coming from the disciplines of rheumatology, gastroenterology and oncology. This review focuses on the use of systemic treatments in pediatric psoriasis and their specific features, analyzing the few literature evidences available, expanding the treatment repertoire and guiding dermatologists in better managing of recalcitrant pediatric psoriasis. PMID:27085539

  16. Gene Therapy of Cancer: Induction of Anti-Tumor Immunity

    Institute of Scientific and Technical Information of China (English)

    ChengQian; JesusPrieto

    2004-01-01

    Many malignancies lack satisfactory treatment and new therapeutic options are urgently needed. Gene therapy is a new modality to treat both inherited and acquired diseases based on the transfer of genetic material to the tissues. Different gene therapy strategies against cancers have been developed. A considerable number of preclinical studies indicate that a great variety of cancers are amenable to gene therapy. Among these strategies, induction of anti-tumor immunity is the most promising approach. Gene therapy with cytokines has reached unprecedented success in preclinical models of cancer. Synergistic rather than additive effects have been demonstrated by combination of gene transfer of cytokines/chemokines, costimulatory molecules or adoptive cell therapy. Recent progress in vector technology and in imaging techniques allowing in vivo assessment of gene expression will facilitate the development of clinical applications of gene therapy, a procedure which may have a notorious impact in the management of cancers lacking effective treatment. Cellular & Molecular Immunology. 2004;1(2):105-111.

  17. Gene Therapy of Cancer: Induction of Anti-Tumor Immunity

    Institute of Scientific and Technical Information of China (English)

    Cheng Qian; Jesus Prieto

    2004-01-01

    Many malignancies lack satisfactory treatment and new therapeutic options are urgently needed. Gene therapy is a new modality to treat both inherited and acquired diseases based on the transfer of genetic material to the tissues. Different gene therapy strategies against cancers have been developed. A considerable number of preclinical studies indicate that a great variety of cancers are amenable to gene therapy. Among these strategies,induction of anti-tumorimmunity is the most promising approach. Gene therapy with cytokines has reached unprecedented success in preclinical models of cancer. Synergistic rather than additive effects have beendemonstrated by combination of gene transfer of cytokines/chemokines, costimulatory molecules or adoptive cell therapy. Recent progress in vector technology and in imaging techniques allowing in vivo assessment of gene expression will facilitate the development of clinical applications of gene therapy, a procedure which may have a notorious impact in the management of cancers lacking effective treatment.

  18. Hodgkin′s lymphoma in a patient of psoriasis treated with long-term, low-dose methotrexate therapy

    Directory of Open Access Journals (Sweden)

    Khopkar Uday

    2008-01-01

    Full Text Available Methotrexate (MTX is used in the treatment of a variety of diseases such as rheumatoid arthritis, dermatomyositis, juvenile rheumatoid arthritis and chronic plaque psoriasis. It has been well documented that there is a risk of development of lymphomas in these patients although none have been reported in patients of psoriasis treated with methotrexate. A 58-year-old male patient, a known case of psoriasis since 1994, had been receiving treatment with a low dose of MTX, 5 mg weekly for ten years intermittently (7-8 months/year. The cumulative dose of MTX taken was 1.5 gm. He developed high-grade fever with cervical lymphadenopathy that was nonresponsive to routine line of management. Lymph node biopsy revealed the presence of mixed cellularity type of Hodgkin′s lymphoma. CT scan showed cervical, mediastinal and abdominal lymphadenopathy. The patient responded well to withdrawal of MTX and chemotherapy. This is the first case of lymphoma occurring in a patient of psoriasis treated with low-dose MTX.

  19. Balneotherapy of Psoriasis

    Directory of Open Access Journals (Sweden)

    Golušin Zoran

    2014-09-01

    Full Text Available Application of different kinds of mineral waters and peloids on the skin exerts mechanical, thermal and chemical effects. Significant reduction of inflammation and increased differentiation of keratinocytes may explain why balneotherapy has positive clinical effects in psoriatic patients. In vitro models have shown that thermal water stimulates interleukin-2 production after cell stimulation by staphylococcal enterotoxin B, and reduces interleukin-4 secretion. After balneotherapy, a significant decrease in Psoriasis Area Severity Index (PASI, associated with a significant reduction of interleukin-8, Staphylococcus aureus colonization and enterotoxin N, have been reported in patients with psoriasis. Mineral water was found to have inhibitory in vitro effects on substance P, TNF-α release and antigen-induced cell degranulation. Immunomodulatory effects of water depend on its content. Sulfur waters have beneficial anti-inflammatory, keratolytic, and antipruriginous effects and also possess antibacterial and antifungal properties. The effectiveness of balneotherapy in the treatment of psoriasis has been reported in many studies conducted all over the world. The majority of studies were conducted at the Dead Sea coast. Investigations showed that balneotherapy factors are important therapeutic factors in the treatment of psoriatic patients. The first and only comparable study of this kind in Serbia, was conducted in Prolom Spa with satisfactory therapeutic results.

  20. Anti-B cell antibody therapies for inflammatory rheumatic diseases

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Jayne, David R W

    2014-01-01

    Several monoclonal antibodies targeting B cells have been tested as therapeutics for inflammatory rheumatic diseases. We review important observations from randomized clinical trials regarding the efficacy and safety of anti-B cell antibody-based therapies for rheumatoid arthritis, systemic lupus...... erythematosus, antineutrophil cytoplasmic antibody-associated vasculitis, polymyositis/dermatomyositis, and primary Sjögren's syndrome. For some anti-B cell agents, clinical benefits have been convincingly demonstrated, while other B cell-targeted therapies failed to improve outcomes when added to standard...... and functions in rheumatic disorders. Future studies should also evaluate how to maintain disease control by means of conventional and/or biologic immunosuppressants after remission-induction with anti-B cell antibodies....

  1. Psoriasis in pregnancy: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Vena GA

    2015-05-01

    Full Text Available Gino Antonio Vena,1 Nicoletta Cassano,1 Gilberto Bellia,2 Delia Colombo,2 1Dermatology and Venereology Private Practice, Bari and Barletta, 2Novartis Farma SpA, Origgio, Varese, Italy Abstract: The available information about the effects of pregnancy on psoriasis and those of psoriasis on pregnancy is almost limited, despite the high frequency of the disease in the general population, as well as in women in reproductive years. Considering the existing evidence, pregnancy does not tend to have a negative influence on psoriasis, as in most women who experience a change in the severity and course of their psoriasis during pregnancy, the change is more likely to be reported as an improvement. This assumption can be applied more convincingly to plaque-type psoriasis, while an exception may be represented by generalized pustular psoriasis, which has been somehow linked to impetigo herpetiformis. Conflicting findings emerged from the few available studies that explored the effect of psoriasis on pregnancy outcomes. Recent studies found an association between moderate-to-severe psoriasis and some pregnancy complications, including pregnancy-induced hypertensive diseases, and have emphasized a trend toward a newborn with low birth weight in patients with psoriasis, especially in those suffering from severe forms. The safety profile during pregnancy is not completely known for many drugs used to treat psoriasis. Moisturizers and low- to moderate-potency topical steroids or ultraviolet B phototherapy represent the first-line therapy for pregnant patients. Many dermatologists may, however, recommend discontinuing all drugs during pregnancy, in consideration of medico-legal issues, and also taking into account that common forms of psoriasis do not compromise the maternal and fetal health. Anyway, for those women whose psoriasis improves during pregnancy, the interruption of any therapy for psoriasis can be a reasonable strategy. The objective of this paper

  2. Research Advances in the Biological Therapies for Psoriasis%银屑病的生物治疗研究进展

    Institute of Scientific and Technical Information of China (English)

    王育珏

    2011-01-01

    Substantial advances being made in the pathogenesis of psoriasis these years, especially in the molecular and immunologic basis,had led to new agents that target these specific steps. This review was intend to introduce the new therapeutic approach that was mainly classified as T cell inhibitors and anti-cyto-kine agents in the management of moderate-to-severe psoriasis and psoriatic arthritis. Besides the satisfied short-term efficacy,the long-term efficacy and safety of these agents should be further studied to improve rational administration for the dermatologists.%近年来,随着在银屑病发病机制研究上取得的实质性进展,尤其是对分子免疫学基础的认识不断深入,出现了一系列新的靶向干预制剂--新型生物制剂.它们主要分为两类:抗细胞因子治疗和抗T细胞治疗,且主要用于治疗中-重度银屑病及银屑病型关节炎患者.虽然,生物制剂的短期疗效尚令人满意,但它们的长期疗效和安全性还有待进一步研究,以便更好地指导临床医师合理用药.

  3. Safety profiles and efficacy of infliximab therapy in Japanese patients with plaque psoriasis with or without psoriatic arthritis, pustular psoriasis or psoriatic erythroderma: Results from the prospective post-marketing surveillance.

    Science.gov (United States)

    Torii, Hideshi; Terui, Tadashi; Matsukawa, Miyuki; Takesaki, Kazumi; Ohtsuki, Mamitaro; Nakagawa, Hidemi

    2016-07-01

    A large-scale prospective post-marketing surveillance was conducted to evaluate the safety and efficacy of infliximab in Japanese patients with plaque psoriasis, psoriatic arthritis, pustular psoriasis and psoriatic erythroderma. This study was conducted in all psoriasis patients treated with infliximab after its Japanese regulatory approval. Infliximab was administrated at 5 mg/kg at weeks 0, 2 and 6, and every 8 weeks thereafter. Patients were serially enrolled and observed for 6 months to evaluate the safety and efficacy. The safety and efficacy were evaluated in 764 and 746 patients, respectively. Incidences of any and serious adverse drug reactions were 22.51% and 6.94%, respectively, and those of any and serious infusion reactions were 6.15% and 1.31%, respectively, which were comparable with the results in the post-marketing surveillance with 5000 rheumatoid arthritis patients in Japan. Major adverse drug reactions during the follow-up period were infections (5.10%) including pneumonia, cellulitis and herpes zoster, however, no tuberculosis was observed. The safety profiles were equivalent, regardless of the psoriasis types. No new safety problems were identified. The response rates on global improvement and median improvement rate of Psoriasis Area and Severity Index in all patients were 88.0% and 85.0%, respectively. Of note, the efficacy was equivalent for each psoriasis type as well as for each body region. Infliximab was also effective in pustular psoriasis symptoms, joint symptoms and nail psoriasis, as well as improvement of quality of life. Infliximab was confirmed to be highly effective and well tolerated in treating refractory psoriasis, including pustular psoriasis and psoriatic erythroderma. PMID:26704926

  4. Safety and tolerability of tumor necrosis factor-α inhibitors in psoriasis: a narrative review.

    Science.gov (United States)

    Semble, Ashley L; Davis, Scott A; Feldman, Steven R

    2014-02-01

    Tumor necrosis factor (TNF)-α inhibitors are an alternative to oral systemic therapies for psoriasis. Data regarding the safety of TNF-α inhibitors from randomized clinical trials may not fully reflect the effects on the clinic patient population receiving the therapy, but other sources of information are available. We performed a literature review to assess the safety and tolerability of the treatment of moderate-to-severe plaque psoriasis with TNF-α inhibitors. A literature search was conducted using PubMed for articles dating from January 2000 to October 2013. Randomized controlled, cohort, open-label, and observational studies were included, as well as case reports and letters to the editor. Articles found on PubMed describing the safety of anti-TNF-α therapy in psoriasis patients were included, while studies highlighting interleukin (IL)-12 and IL-23 inhibitors were excluded, as were non-English articles. In total, 58 articles were included in the review. TNF-α inhibitors exhibit both efficacy and tolerability in patients with moderate-to-severe plaque psoriasis. Adverse effects associated with these medications are not common and can be minimized with routine clinical monitoring and patient education. While the risk of severe adverse events is low, the lack of very large, long-term, randomized safety trials limits the ability to fully define the safety of these agents. TNF-α inhibitors have a good efficacy/safety ratio for use in patients with moderate-to-severe psoriasis. Serious adverse effects are not common, and common injection-site reactions are usually manageable. The benefits of TNF-α inhibitors outweigh the risks for moderate-to-severe psoriasis; however, there are potential adverse effects and the patient populations at highest risk include the elderly and those with a history of malignancy.

  5. Infliximab in the treatment of plaque type psoriasis

    Directory of Open Access Journals (Sweden)

    Rosita Saraceno

    2009-04-01

    Full Text Available Rosita Saraceno, Andrea Saggini, Lucia Pietroleonardo, Sergio ChimentiDepartment of Dermatology, University of Rome Tor Vergata, Rome, Viale Oxford 81, Rome, ItalyAbstract: Psoriasis is a chronic and immunomediated skin disease characterized by erythematous scaly plaques. Psoriasis affects approximately 1% to 3% of the Caucasian population. Tumor necrosis factor alpha (TNF-α is a proinflammatory cytokine that plays a critical role in the pathogenesis of psoriasis. Infliximab is an anti-TNF-α drug widely used for the treatment of plaque type psoriasis and psoriatic arthritis. Controlled clinical trials demonstrated that infliximab is characterized by a high degree of clinical response in moderate to severe plaque psoriasis. Moreover infliximab showed rapid efficacy in nail psoriasis which represents a therapeutic challenge for dermatologists and a relevant source of distress for patients with plaque psoriasis. This anti-TNF-α has an encouraging safety profile, especially as long as physicians are watchful in prevention and early diagnosis of infections and infuse reactions. The efficacy, tolerability and safety profiles suggest infliximab as a suitable anti-psoriatic drug in the long-term treatment of a chronic disease such as plaque-type psoriasis.Keywords: psoriasis, nail psoriasis, infliximab, long-term treatment

  6. BEHANDLING AV MODERAT TIL ALVORLIG PSORIASIS; : GAMMEL VERSUS NY BEHANDLING.

    OpenAIRE

    2007-01-01

    BACKGROUND: Psoriasis is a common, chronic, inflammatory disease. Psoriasis requires long time therapy to maintain disease control and psoriasis patients deserve long-term controlled treatment of their disease with optimal safety. Traditional treatment like phototherapy or systemic therapy with cyclosporin, metotrexate and retinoids are not always effective or cause long-term side effects. New biological, which targets pathologic T cell activity, agents like tumor necrosis factor alpha inhib...

  7. Translating the Science of Psoriasis.

    Science.gov (United States)

    Gordon, Kenneth B

    2016-06-01

    Knowledge about the pathophysiology of psoriasis has evolved substantially in recent years, since the identification of the T helper 17 (Th17) cells. Cytokines produced by these cells appear to play major roles in psoriatic inflammation. The cytokine interleukin (IL)-23 appears to promote regulatory T cells to differentiate into Th17 cells. Available and investigational therapies act on targets within these pathways.

  8. Recognizing Guttate Psoriasis and Initiating Appropriate Treatment.

    Science.gov (United States)

    Vence, Lacey; Schmitt, Amanda; Meadows, Charles E; Gress, Todd

    2015-01-01

    Guttate psoriasis is a less common form of psoriasis. It manifests with numerous small, teardrop shaped, scaly plaques on the trunk and extremities. The etiology includes both environmental and genetic factors. It commonly arises 3-4 weeks following a beta hemolytic streptococcal infection. In some cases, it may be misdiagnosed as an allergy to the antibiotics being used to treat the streptococcal infection. The treatment of guttate psoriasis can vary by severity, but the mainstay treatment includes photo therapy and topical steroids. This case report presents the etiology, clinical findings and current treatment options of guttate psoriasis. It also discusses importance of differentiating guttate psoriasis from an antibiotic allergy. The confusion between the two can often delay and make treatment more difficult.

  9. A gold nanoparticles-based colorimetric test to detect single nucleotide polymorphisms for improvement of personalized therapy of psoriasis

    Science.gov (United States)

    Marsella, Alessandra; Valentini, Paola; Tarantino, Paolo; Congedo, Maurizio; Pompa, Pier Paolo

    2016-04-01

    We report a simple, rapid and low-cost test, based on gold nanoparticles, for the naked-eye colorimetric detection of a signature of single nucleotide polymorphisms (SNPs) relevant for the personalized medicine of psoriasis patients. We validated the colorimetric assay on real-world DNA samples from a cohort of 30 psoriasis patients and we compared the results, in double-blind, with those obtained with two state-of-the-art instrumental techniques, namely reverse dot blotting and direct sequencing, finding 100% agreement. We demonstrated high accuracy, sensitivity and specificity of the colorimetric test that can be easily adapted for the genotypization of different SNPs, important for the pharmacogenomics of various diseases, and in other fields, such as food traceability and population structure analysis.

  10. Established treatments of psoriasis.

    NARCIS (Netherlands)

    Kerkhof, P.C.M. van de; Vissers, W.H.P.M.

    2004-01-01

    Psoriasis is a complex disease with a spectrum of clinical manifestations. Psoriasis may express as a few coin-sized erythemato-squamous plaques up to widespread disease covering the entire body surface (erythrodermic psoriasis). Psoriasis may present as a few stable plaques or unstable disease, rap

  11. Anti-platelet therapy in small animal medicine.

    Science.gov (United States)

    Thomason, J; Lunsford, K; Mackin, A

    2016-08-01

    Thromboembolism is a significant complication in many commonly encountered diseases, and can be a devastating sequel to otherwise treatable conditions. Platelets play an essential role in the hemostatic process and, consequently, are associated with thrombus formation. Platelets adhere to denuded vascular subendothelium, recruit additional platelets and cells, aggregate, and provide the catalytic surface for thrombin production and fibrin formation. Therapy to prevent unwanted thrombus formation and thromboembolic crises is essential in the management of hypercoagulable patients. Unfortunately, many of the medications used in veterinary medicine that inhibit or modulate coagulation factors, such as the heparins, are cost prohibitive, only effective when administered by injection or require frequent drug monitoring, and are therefore poor choices for long term at home therapy. While the role of the platelet in pathologic thrombus formation is not fully understood, veterinarians often resort to anti-platelet therapy in the management of patients at risk for thromboembolic complications, because many anti-platelet medications are inexpensive, require minimal drug monitoring, and can be given orally. The aim of this review is to discuss the anti-platelet therapies that are currently being used or being considered for use to inhibit platelet function and reduce thromboembolic complications in hypercoagulable dogs and cats. PMID:26969126

  12. Pseudoainhum associated with Psoriasis vulgaris

    Directory of Open Access Journals (Sweden)

    Mrinal Gupta

    2015-10-01

    Full Text Available Pseudoainhum is the term applied to constricting bands around the digits or the limb which are either congenital or secondary to another disease. Progression of the constriction bands can lead to irreversible damage and autoamputation of the affected digit. Congenital pseudoainhum usually results due to amniotic bands or adhesions in utero while acquired pseudoainhum is usually secondary to trauma, neuropathy, systemic sclerosis or infections like leprosy. Psoriasis is a rare cause of acquired pseudoainhum with only five cases reported till date. We report a case of pseudoainhum secondary to psoriasis vulgaris in a 45 year old male which was successfully treated with topical corticosteroids and systemic methotrexate therapy.

  13. Adalimumab (TNFα Inhibitor) Therapy Exacerbates IgA Glomerulonephritis Acute Renal Injury and Induces Lupus Autoantibodies in a Psoriasis Patient

    OpenAIRE

    Wei, S. S.; Sinniah, R.

    2013-01-01

    Adalimumab (Humira) is a tumour necrosis factor α (TNF α ) inhibitor that is approved for the treatment of rheumatoid arthritis, psoriasis, psoriatic arthritis, Crohn's disease, ankylosing spondylitis, and juvenile idiopathic arthritis (Sullivan and Preda (2009), Klinkhoff (2004), and Medicare Australia). Use of TNF α inhibitors is associated with the induction of autoimmunity (systemic lupus erythematosus, vasculitis, and sarcoidosis or sarcoid-like granulomas) (Ramos-Casals et al. (2010)). ...

  14. Use of amino terminal type III procollagen peptide (P3NP) assay in methotrexate therapy for psoriasis

    OpenAIRE

    Khan, S; Subedi, D; Chowdhury, M M U

    2006-01-01

    Hepatic fibrosis continues to be a risk in patients receiving methotrexate for psoriasis. Measurement of amino terminal levels of type III procollagen (P3NP) has been advocated as an effective non‐invasive test for ongoing hepatic fibrogenesis that could avoid liver biopsies. An audit was conducted to assess the practice of P3NP monitoring using guidelines produced by Manchester and whether the agreed levels correlate with histological severity. Sixty five patients with 174 P3NP assays and 30...

  15. Adalimumab (TNFα Inhibitor Therapy Exacerbates IgA Glomerulonephritis Acute Renal Injury and Induces Lupus Autoantibodies in a Psoriasis Patient

    Directory of Open Access Journals (Sweden)

    S. S. Wei

    2013-01-01

    Full Text Available Adalimumab (Humira is a tumour necrosis factor α (TNFα inhibitor that is approved for the treatment of rheumatoid arthritis, psoriasis, psoriatic arthritis, Crohn's disease, ankylosing spondylitis, and juvenile idiopathic arthritis (Sullivan and Preda (2009, Klinkhoff (2004, and Medicare Australia. Use of TNFα inhibitors is associated with the induction of autoimmunity (systemic lupus erythematosus, vasculitis, and sarcoidosis or sarcoid-like granulomas (Ramos-Casals et al. (2010. We report a patient with extensive psoriasis presenting with renal failure and seropositive lupus markers without classical lupus nephritis after 18 months treatment with adalimumab. He has renal biopsy proven IgA nephritis instead. Renal biopsy is the key diagnostic tool in patients presenting with adalimumab induced nephritis and renal failure. He made a remarkable recovery after adalimumab cessation and steroid treatment. To our knowledge, this is a unique case of a psoriasis patient presenting with seropositive lupus markers without classical lupus nephritis renal failure and had renal biopsy proven IgA glomerulonephritis after receiving adalimumab.

  16. The management of psoriasis through diet

    Directory of Open Access Journals (Sweden)

    Duarte G

    2012-08-01

    Full Text Available Gleison Duarte,1 Luan Oliveira Barbosa,2 Maria Elisa A Rosa11Dermatology Division, Alergodermoclin, Salvador, Bahia, Brazil; 2Escola Bahiana de Medicina e Saúde Pública Salvador, Bahia, BrazilAbstract: Diet is an important factor in the management of several dermatological diseases, such as dermatitis herpetiformis, acne vulgaris, gout, phrynoderma, pellagra, psoriasis, and acrodermatitis enteropathica. New concepts have emerged concerning the influence of diet on psoriasis. For example, diet has an adjuvant role in the management of several cardiovascular comorbidities that exhibit a higher-than-expected prevalence in psoriatic patients. Functional foods, such as yellow saffron and fish oil, may exert favorable effects on immune and cardiovascular functions. A gluten-free diet may promote significant clinical and histologic improvement. Folate supplementation may induce clinical improvement of psoriasis, but side effects may also occur. Diets rich in fresh fruits and vegetables are associated with a lower prevalence of psoriasis, and vegetarian diets were associated with clinical improvement. Additionally, many drug-diet interactions (retinoids, methotrexate, cyclosporine must be considered in patients with psoriasis. Therefore, in addition to current nutritional advice given to psoriasis patients, further studies are necessary in the role of diet in psoriasis therapy.Keywords: diet, lifestyle, psoriasis, recommendations, supplementation

  17. Management of guttate psoriasis in patients with associated streptococcal infection

    Directory of Open Access Journals (Sweden)

    Karabudak Abuaf O

    2012-11-01

    Full Text Available Özlem Karabudak Abuaf, Bilal DoganDepartment of Dermatology, GATA Haydarpasa Teaching Hospital, Istanbul, TurkeyAbstract: Psoriasis is a T cell-mediated inflammatory skin disease. It can be provoked or exacerbated by environmental factors, particularly medications and infections. Guttate psoriasis is a distinctive acute form of psoriasis that generally occurs in children and young adults. The association between guttate psoriasis and Streptococcus pyogenes is well established in medical literature; however, the exact mechanism can only be theorized. Treatment guidelines are not established, and it is unclear how necessary antibiotics are for acute state guttate psoriasis. Many dermatologists have recommended using antibiotic therapy or tonsillectomy, especially for patients with recurrent streptococcal infections. This paper briefly summarizes the possible mechanisms of pathogenesis and the recent research results on this topic and examines under what conditions a curative treatment of streptococcal infection by tonsillectomy or antibiotic treatment may benefit psoriasis patients.Keywords: guttate, psoriasis, treatment, Streptococcus pyogenes

  18. PEGylation in anti-cancer therapy: An overview

    OpenAIRE

    Prajna Mishra; Bismita Nayak; R. K. Dey

    2016-01-01

    Advanced drug delivery systems using poly(ethylene glycol) (PEG) is an important development in anti-cancer therapy. PEGylation has the ability to enhance the retention time of the therapeutics like proteins, enzymes small molecular drugs, liposomes and nanoparticles by protecting them against various degrading mechanisms active inside a tissue or cell, which consequently improves their therapeutic potential. PEGylation effectively alters the pharmacokinetics (PK) of a variety of drugs and dr...

  19. Practical guidance on immunogenicity to biologic agents used in the treatment of psoriasis: What can be learnt from other diseases?

    Science.gov (United States)

    Lambert, Jo; Nast, Alexander; Nestle, Frank O; Prinz, Jörg C

    2015-01-01

    The clinical efficacy of biologic agents for the treatment of moderate to severe psoriasis is well proven in clinical studies, but patients may lose response over time. Loss of response may be due to immunogenicity and the formation of anti-drug antibodies (ADA). Although data on the immunogenicity of drugs used to treat psoriasis are now emerging, more information on the impact of factors, such as dosing regimens and concomitant immunosuppressive therapy is needed. Exploring research from other disease areas where immunogenicity has long been recognised as a significant clinical issue may help in developing future strategies for using drug level and ADA measurements to help tailor biologic therapy to meet individual needs. To this end, we analyse what is known about biologics and immunogenicity in psoriasis. In order to learn from other indications, we then address the issue of immunogenicity for three different types of biologic treatments. First, factor VIII-substitution in haemophilia, where the immune system is newly exposed to a physiologic but formerly absent protein. Second, the use of biologics in inflammatory bowel disease, where similar treatment challenges apply as observed in psoriasis. Third, immunogenicity in multiple sclerosis caused by therapeutic antibodies or interferons. Immunogenicity strategies used in other disease areas will need to be tested in psoriasis before they can be widely adopted in routine clinical practice.

  20. Health Conditions Associated with Psoriasis

    Science.gov (United States)

    ... Zipcode Comorbidities Associated with Psoriatic Disease People with psoriasis and psoriatic arthritis are at an elevated risk ... conditions. Psoriasis and Psoriatic Arthritis Psoriasis Psoriatic Arthritis Psoriasis and Psoriatic Arthritis Cancer A number of studies ...

  1. Biologic therapy with anti-TNFa in rheumathoid atrhritis

    Directory of Open Access Journals (Sweden)

    G. Ferraccioli

    2011-09-01

    Full Text Available Objective: To evaluate the efficacy, the tolerability, and treatment survival of the association of anti-TNFa (Infliximab, Etanercept, Adalimumab plus Methotrexate vs Methotrexate as monotherapy in patients with reumathoid arthritis (RA. Methods: Review of published controlled randomized clinical studies on the association of anti-TNFa plus Methotrexate vs Methotrexate alone in patients with rheumathoid arthritis (RA. Results in terms of remission and progression of radiologic damage, and clinical response expressed in terms of ACR 50 or ACR 70 were reviewed in the different studies. Results: In patients with RA the association of anti-TNFa plus Methotrexate led to a greater remission of radiologic damage and marked improvement of clinical response expressed as ACR 50 or ACR 70 compared to therapy with Methotrexate only. Conclusions: In the absence of controlled studies, review of the published studies showed that in RA patients the association of anti-TNFa plus Methotrexate is extremely more efficacious than therapy with Methotrexate only. Choice of the drug depends on the activity of the disease, the necessity of a fast response, the presence of side effects, the schedule of treatment and consequently the direct and indirect costs of the drug, and the easiness on supply and distribution.

  2. Review of ustekinumab, an interleukin-12 and interleukin-23 inhibitor used for the treatment of plaque psoriasis

    Directory of Open Access Journals (Sweden)

    Nora Koutruba

    2010-03-01

    Full Text Available Nora Koutruba, Jason Emer, Mark LebwohlMount Sinai School of Medicine, New York, USAAbstract: The pathogenesis of psoriasis is unknown, although it is generally accepted that this chronic inflammatory skin disorder is a complex autoimmune condition similar to other T-cell mediated disorders. Psoriasis imposes a heavy burden on the lifestyle of those affected due to the psychological, arthritic, and cutaneous morbidities; thus significant research has focused on the genetic and immunologic features of psoriasis in anticipation of more targeted, efficacious, and safe therapies. Recently, CD4+ T helper (Th 17 cells and interleukins (IL-12 and -23 have been important in the pathogenesis of T-cell mediated disorders such as psoriasis and has influenced the development of medications that specifically target these key immunological players. Ustekinumab is a monoclonal antibody belonging to a newly developed class of biological, anti-cytokine medications that notably targets the p40 subunit of both IL-12 and -23, both naturally occurring proteins that are important in regulating the immune system and are understood to play a role in immune-mediated inflammatory disorders. Ustekinumab’s safety and efficacy has been evaluated for the treatment of moderate-to-severe plaque psoriasis in 3 phase III clinical trials, 2 placebo-controlled (PHOENIX 1 and 2, and 1 comparator-controlled (ACCEPT study which proved advantageous in patients who were treatment-naive, previously failed other immunosuppressive medications including cyclosporine or methotrexate, were unresponsive to phototherapy, or were unable to use or tolerate other therapies. Ustekinumab has also been investigated for other indications such as psoriatic arthritis, Crohn’s disease, and relapsing/remitting multiple sclerosis. We present a concise review evaluating the evidence that supports the use of ustekinumab in the treatment of plaque psoriasis and other conditions.Keywords: ustekinumab

  3. Getting under the skin: Report from the International Psoriasis Council workshop on the role of stress in psoriasis

    Directory of Open Access Journals (Sweden)

    Julia eSchwartz

    2016-02-01

    Full Text Available Psoriasis is a chronic inflammatory skin condition with significant physical and psychosocial comorbidity. A workshop of leading experts in dermatology and psychology with the purpose of better understanding the current role of psychological comorbidities in psoriasis was held by the International Psoriasis Council in November 2013. The role of stress reactivity with a focus on the hypothalamic-pituitary-adrenal axis was emphasized. While cognitive behavioral therapy remains the most extensively studied and successful treatment strategy in patients with psoriasis and various psychological comorbidities, new and innovative interventions such as online-based therapies have recently emerged. Strategies and recommendations towards approaching psychological comorbidities are discussed.

  4. Psoriasis y dermatomicosis Psoriasis ad dermatomycosis

    Directory of Open Access Journals (Sweden)

    Maria E. Vargas

    1994-01-01

    onicomycosis that was not associated with age, sex, occupation or psoriasis therapy; 4 men suffered from E. floccosum infection and in one woman T. tonsurans was found in interdigitallesions of the feet. Statistically significant association was found between dermatophytic infection and the use of systemic steroids (p = 0.021 . Dermatophyte growth was not obtained from the psoriatic plaque and histological changes typical of the disease were not seen In the mycotic lesion. In conclusion: the frequency of dermatomycosis is low in psoriasis patients; the skin infected with fungi is free from psoriatic changes and the risk of acquiring dermatophytic mycosis Increases about 30 times In patients receiving systemic steroids.

  5. [A short history of anti-rheumatic therapy. II. Aspirin].

    Science.gov (United States)

    Pasero, G; Marson, P

    2010-01-01

    The discovery of aspirin, an antipyretic, anti-inflammatory and analgesic drug, undoubtedly represents a milestone in the history of medical therapy. Since ancient times the derivatives of willow (Salix alba) were used to treat a variety of fevers and pain syndromes, although the first report dates back to 1763 when the English Reverend Edward Stone described the effect of an extract of the bark willow in treating malaria. In the XIX century many apothecaries and chemists, including the Italian Raffaele Piria and Cesare Bertagnini, developed the biological processes of extraction and chemical synthesis of salicylates, and then analyzed their therapeutic properties and pharmacokinetic and pharmacodynamic characteristics. In 1899 the Bayer Company, where Felix Hoffmann, Heinrich Dreser and Arthur Eichengrün worked, recorded acetyl-salicylic acid under the name "Aspirin". In the XX century, besides the definition of the correct applications of aspirin in the anti-rheumatic therapy being defined, Lawrence L. Crawen identified the property of this drug as an anti-platelet agent, thus opening the way for more widespread uses in cardiovascular diseases.

  6. A review on treating psoriasis vulgaris by TCM therapy%浅谈寻常型银屑病采用中医外治法治疗的临床进展

    Institute of Scientific and Technical Information of China (English)

    韦贞舟

    2015-01-01

    Psoriasis was an inflammatory skin disease, characterized by slow onset, easy to relapse, and longer course. Patients’ health was seriously impacted, and the quality of life was decreased. Typical lesions of psoriasis was scaly erythema, and was divided into ordinary type, pustule type, joint type and erythrodermic type in clinical. In this article, the pathogenesis of psoriasis, and dialectical classification criteria of psoriasis vulgaris were introduced firstly. The type of syndrome was blood heat, blood stasis, dryness syndrome. Then, the therapy for psoriasis vulgaris was described, including acupuncture therapy, acupoint catgut embedding, etc.%银屑病是一种炎症性皮肤病,特点为慢发且易复发,病程较长,给患者的身心健康造成严重的影响,使患者的生活质量下降。银屑病典型皮损为鳞屑性红斑,临床上常分为寻常型、脓包型、关节型和红皮型。本文首先介绍了银屑病的病因病机以及寻常型银屑病的辨证分型标准,其基本证型为血热证、血瘀证、血燥证。然后阐述了寻常型银屑病的治疗方法,主要为中药外治,比如针灸治疗、穴位埋线法等治疗方法。

  7. Novel anti-inflammatory therapies for the treatment of atherosclerosis.

    Science.gov (United States)

    Khan, Razi; Spagnoli, Vincent; Tardif, Jean-Claude; L'Allier, Philippe L

    2015-06-01

    The underlying role of inflammation in atherosclerosis has been characterized. However, current treatment of coronary artery disease (CAD) predominantly consists of targeted reductions in serum lipoprotein levels rather than combating the deleterious effects of acute and chronic inflammation. Vascular inflammation acts by a number of different molecular and cellular pathways to contribute to atherogenesis. Over the last decades, both basic studies and clinical trials have provided evidence for the potential benefits of treatment of inflammation in CAD. During this period, development of pharmacotherapies directed towards inflammation in atherosclerosis has accelerated quickly. This review will highlight specific therapies targeting interleukin-1β (IL-1β), P-selectin and 5-lipoxygenase (5-LO). It will also aim to examine the anti-inflammatory effects of serpin administration, colchicine and intravenous HDL-directed treatment of CAD. We summarize the mechanistic rationale and evidence for these novel anti-inflammatory treatments at both the experimental and clinical levels.

  8. Implantable synthetic cytokine converter cells with AND-gate logic treat experimental psoriasis.

    Science.gov (United States)

    Schukur, Lina; Geering, Barbara; Charpin-El Hamri, Ghislaine; Fussenegger, Martin

    2015-12-16

    Psoriasis is a chronic inflammatory skin disease characterized by a relapsing-remitting disease course and correlated with increased expression of proinflammatory cytokines, such as tumor necrosis factor (TNF) and interleukin 22 (IL22). Psoriasis is hard to treat because of the unpredictable and asymptomatic flare-up, which limits handling of skin lesions to symptomatic treatment. Synthetic biology-based gene circuits are uniquely suited for the treatment of diseases with complex dynamics, such as psoriasis, because they can autonomously couple the detection of disease biomarkers with the production of therapeutic proteins. We designed a mammalian cell synthetic cytokine converter that quantifies psoriasis-associated TNF and IL22 levels using serially linked receptor-based synthetic signaling cascades, processes the levels of these proinflammatory cytokines with AND-gate logic, and triggers the corresponding expression of therapeutic levels of the anti-inflammatory/psoriatic cytokines IL4 and IL10, which have been shown to be immunomodulatory in patients. Implants of microencapsulated cytokine converter transgenic designer cells were insensitive to simulated bacterial and viral infections as well as psoriatic-unrelated inflammation. The designer cells specifically prevented the onset of psoriatic flares, stopped acute psoriasis, improved psoriatic skin lesions and restored normal skin-tissue morphology in mice. The antipsoriatic designer cells were equally responsive to blood samples from psoriasis patients, suggesting that the synthetic cytokine converter captures the clinically relevant cytokine range. Implanted designer cells that dynamically interface with the patient's metabolism by detecting specific disease metabolites or biomarkers, processing their blood levels with synthetic circuits in real time, and coordinating immediate production and systemic delivery of protein therapeutics may advance personalized gene- and cell-based therapies. PMID:26676608

  9. Implantable synthetic cytokine converter cells with AND-gate logic treat experimental psoriasis.

    Science.gov (United States)

    Schukur, Lina; Geering, Barbara; Charpin-El Hamri, Ghislaine; Fussenegger, Martin

    2015-12-16

    Psoriasis is a chronic inflammatory skin disease characterized by a relapsing-remitting disease course and correlated with increased expression of proinflammatory cytokines, such as tumor necrosis factor (TNF) and interleukin 22 (IL22). Psoriasis is hard to treat because of the unpredictable and asymptomatic flare-up, which limits handling of skin lesions to symptomatic treatment. Synthetic biology-based gene circuits are uniquely suited for the treatment of diseases with complex dynamics, such as psoriasis, because they can autonomously couple the detection of disease biomarkers with the production of therapeutic proteins. We designed a mammalian cell synthetic cytokine converter that quantifies psoriasis-associated TNF and IL22 levels using serially linked receptor-based synthetic signaling cascades, processes the levels of these proinflammatory cytokines with AND-gate logic, and triggers the corresponding expression of therapeutic levels of the anti-inflammatory/psoriatic cytokines IL4 and IL10, which have been shown to be immunomodulatory in patients. Implants of microencapsulated cytokine converter transgenic designer cells were insensitive to simulated bacterial and viral infections as well as psoriatic-unrelated inflammation. The designer cells specifically prevented the onset of psoriatic flares, stopped acute psoriasis, improved psoriatic skin lesions and restored normal skin-tissue morphology in mice. The antipsoriatic designer cells were equally responsive to blood samples from psoriasis patients, suggesting that the synthetic cytokine converter captures the clinically relevant cytokine range. Implanted designer cells that dynamically interface with the patient's metabolism by detecting specific disease metabolites or biomarkers, processing their blood levels with synthetic circuits in real time, and coordinating immediate production and systemic delivery of protein therapeutics may advance personalized gene- and cell-based therapies.

  10. National Psoriasis Foundation

    Science.gov (United States)

    ... handle bullies in the classroom. Previous Next National Psoriasis Foundation provides you with the help you need to best manage your psoriasis or psoriatic arthritis, while promoting research to find ...

  11. EUGENOL FUNCTIONALIZED MAGNETITE NANOSTRUCTURES USED IN ANTI-INFECTIOUS THERAPY

    Directory of Open Access Journals (Sweden)

    Alexandru Mihai Grumezescu

    2013-12-01

    Full Text Available This paper reports newly antimicrobial nanostructures based on magnetite and eugenol (Fe3O4@E with an average diameter of 7 nm. Prepared functionalized magnetite nanostructures were characterized by TEM, SAED, XRD and TG analysis. Also, antimicrobial profile was evaluated. The antimicrobial assay revealed that Fe3O4@E have a good antimicrobial effect against both Gram positive (Staphylococcus aureus and Gram negative (Pseudomonas aeruginosa tested strains. These results highlight the impact of magnetite nanostructures on antimicrobial therapy and represents a promising approach for the development of alternative antibiotic-free anti-microbial strategies.

  12. The unmet treatment need for moderate to severe psoriasis: results of a survey and chart review.

    NARCIS (Netherlands)

    Christophers, E.; Griffiths, C.E.; Gaitanis, G.; Kerkhof, P.C.M. van de

    2006-01-01

    BACKGROUND: Conventional systemic therapies and phototherapy for psoriasis are limited by safety concerns that may preclude long-term treatment with these agents. OBJECTIVES: To estimate the unmet need for safe and effective treatments for psoriasis. METHODS: A survey was conducted at three psoriasi

  13. short history of anti-rheumatic therapy. IV. Corticosteroids

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available In 1948 a corticosteroid compound was administered for the first time to a patient affected by rheumatoid arthritis by Philip Showalter Hench, a rheumatologist at the Mayo Clinic in Rochester, Minnesota (USA. He was investigating since 1929 the role of adrenal gland-derived substances in rheumatoid arthritis. For the discovery of cortisone and its applications in anti-rheumatic therapy, Hench, along with Edward Calvin Kendall and Tadeusz Reichstein, won the 1950 Nobel Prize for Medicine. In this review we summarize the main stages that led to the identification of the so-called compound E, which was used by Hench. We also consider the subsequent development of steroid therapy in rheumatic diseases, through the introduction of new molecules with less mineralocorticoid effects, such as prednisone, and more recently, deflazacort.

  14. Low-dose, short-term ciclosporin (Neoral®) therapy is effective in improving patients' quality of life as assessed by Skindex-16 and GHQ-28 in mild to severe psoriasis patients.

    Science.gov (United States)

    Okubo, Yukari; Natsume, Shoko; Usui, Kae; Amaya, Misato; Tsuboi, Ryoji

    2011-05-01

    Therapies for psoriasis have focused not only on ameliorating the severity of the skin lesions, but also on the quality of life (QOL). Here, the efficacy of low-dose, short-term administration of ciclosporin (Neoral®, as CyA) was investigated. Forty-one psoriasis patients were given CyA orally (3 mg/kg per day) twice daily before breakfast and dinner until the psoriatic area and severity index (PASI) scores decreased by at least 75%. Surveys were conducted before and after the therapy to ascertain QOL, itch, nail condition, joint pain, stress associated with topical application and therapy satisfaction. QOL was assessed by using the Japanese version of Skindex-16 specific to skin diseases, and the Japanese version of the GHQ-28, which assesses mental health. Data collected from 35 patients were analyzed. Remission was achieved in 26 patients (74%), and the average length required to achieve remission was 101.5 days. The average PASI score significantly decreased from 17.8 to 3.3 after the therapy. Remission lasted 6 months or longer in 40% of the patients. The average length of time before restarting systemic therapy was 182.0 days. This duration for patients with PASI scores of Skindex-16 score significantly decreased especially in the "emotions' and "functioning" categories. GHQ scores also significantly decreased in "somatic symptoms,"anxiety and insomnia," and "depression". With regard to patients' satisfaction with their therapy, 88.5% of the patients reported "satisfied" or "slightly satisfied". These results demonstrate that low-dose, short-term administration of CyA (3 mg/kg per day) is one of the best therapies for psoriasis patients with PASI scores of <13, while QOL assessment is a very useful tool for evaluating the value of therapy. PMID:21352289

  15. Psoriasis og aterotrombotisk sygdom

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar H; Skov, Lone;

    2010-01-01

    Psoriasis and atherosclerosis share immunoinflammatory mechanisms and patients with psoriasis may carry an excess of cardiovascular risk factors (hypercholesterolemia, hypertension, obesity, metabolic syndrome, diabetes mellitus, smoking etc.) and increased risk of atherothrombotic disease....... The current review summarises the available evidence in this area of research and calls for increased awareness of cardiovascular risk assessment and treatment in patients with psoriasis....

  16. JAK Inhibitors: Treatment Efficacy and Safety Profile in Patients with Psoriasis

    OpenAIRE

    Leeyen Hsu; Armstrong, April W.

    2014-01-01

    Janus kinase (JAK) pathways are key mediators in the immunopathogenesis of psoriasis. Psoriasis treatment has evolved with the advent of targeted therapies, which inhibit specific components of the psoriasis proinflammatory cascade. JAK inhibitors have been studied in early phase trials for psoriasis patients, and the data are promising for these agents as potential treatment options. Tofacitinib, an oral or topically administered JAK1 and JAK3 inhibitor, and ruxolitinib, a topical JAK1 and J...

  17. Lasers for the treatment of psoriasis

    Science.gov (United States)

    Piruzian, A.; Korsunskaya, I.; Goldenkova, I.; Hertsen, A.; Sarkisova, M.; Egorenkova, L.

    2005-08-01

    Psoriasis is a chronic, genetically-determined disease, characterized by an immuno-mediated pathogenesis. Treatment of psoriasis is often complicated and remains a challenge. Along with the many new immunomodulatory approaches, various laser systems have been employed for chronic plaque psoriasis treatment. Recently, it has been demonstrated that the light produced by xenon-chloride excimers (generated by sophisticated devices with peak emission of 308 nm) is effective in the treatment of several psoriasis forms. We treated patients, ranging in age from 35 to 55 years, affected by plaque-type psoriasis vulgaris with monochromatic excimer light (MEL). We used MEL in a complex with basic treatment. Therapy was administered three times a week. At the end of the 3th week of treatment all patients showed an improvement, as evidenced by flattening of plaques, decreased scaling and erythema, and decreased vesicle and pustule formation. Unwanted side effects such as pain, blistering was not observed. Minimal erythema and a hyperpigmentation were noted in some patients. It was concluded that the MEL therapy may be a valuable option for treatment of plaque-type psoriasis vulgaris in shorter time compare with traditional NB UVB, with exposure to lower cumulative doses

  18. Psoriasis remission after gastric bypass surgery: a case report

    Directory of Open Access Journals (Sweden)

    Ornella De Pità

    2014-03-01

    Full Text Available Case reports suggest that gastric bypass surgery in patients with psoriasis may result in complete remission of the disease. A substantial weight loss is achieved in the months following surgery, which is likely to reduce psoriasis symptoms and risk of comorbidities. A 50-year-old man was followed in our Department for several years. He had severe plaque psoriasis requiring superpotent topical steroids and methotrexate. His medical history included morbid obesity (138 kg, dyslipidemia , hypertension and positive family history for psoriasis. He underwent gastric bypass surgery on November 2011. Eight months later, his weight decreased to 86 kg, and he noted a marked improvement in his psoriasis, with reduction of body surface area involvement. In our opinion weight loss may be a useful adjunctive therapy for obese patients with psoriasis.http://dx.doi.org/10.7175/cmi.v8i1.898  

  19. Clinical improvement in psoriasis with specific targeting of interleukin-23

    DEFF Research Database (Denmark)

    Kopp, Tamara; Riedl, Elisabeth; Bangert, Christine;

    2015-01-01

    Psoriasis is a chronic inflammatory skin disorder that affects approximately 2-3% of the population worldwide and has severe effects on patients' physical and psychological well-being. The discovery that psoriasis is an immune-mediated disease has led to more targeted, effective therapies; recent...

  20. Biologisk behandling af psoriasis og psoriasisartritis

    DEFF Research Database (Denmark)

    Kragballe, Knud; Deleuran, Bent

    2008-01-01

    Psoriasis is an immune-mediated inflammatory skin disease which may be associated with psoriatic arthritis. Biological therapy is indicated in patients who do not respond to, or are intolerant to, or have contraindication against traditional therapy. TNFalpha antagonists are used for both skin...

  1. Treating Psoriasis During Pregnancy

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Rørbye, Christina; Skov, Lone

    2015-01-01

    Psoriasis is a chronic inflammatory disease with a well-documented negative effect on the quality of life of affected patients. Psoriasis often occurs in the reproductive years, during which the issue of pregnancy needs to be addressed. The course of psoriasis during pregnancy is unpredictable......, and many patients face the challenge of needing treatment during pregnancy. In this review we provide an overview of the key considerations for managing psoriasis in pregnant women, covering the potential effects of active psoriasis and co-morbid conditions on the health of the mother and fetus, as well...

  2. LYMPHOCYTE APOPTOSIS IN PSORIASIS

    Directory of Open Access Journals (Sweden)

    О. M. Kapuler

    2006-01-01

    Full Text Available Abstract. Forty-two patients with progressive vulgar psoriasis (PASI = 19.7 ± 1.5 and 40 healthy volunteers were under investigation. Psoriatic patients were characterized by increased number of CD4+ CD95+ peripheral blood T lymphocytes, which correlates with clinical psoriatic score, and by increased levels of soluble Fas (sFas in serum, as compared to controls (resp., 1868.1 ± 186.8 pg/ml vs. 1281.4 ± 142.5 pg/ml, PLSD = 0.019. The levels of spontaneous lymphocyte apoptosis and anti-Fas (Mab-induced apoptosis in psoriatic patients did not differ from the controls. However, apoptosis induced by “oxidative stress” (50 M Н202, 4 hrs was depressed in the patients. Moreover, a simultaneous assessment of cell cycle structure (metachromatic staining with Acridine Orange, apoptosis and Fas receptor expression (AnnV-FITC/antiFas mAbs-PE staining following a short-term mitogenic stimulation (PHA-P, 5 µg/ml, 24 hrs were performed. We found no marked differences in mitogenic reactivity, activation-induced apoptosis, and activation-induced Fas receptor expression when studying lymphocytes from healthy donors and psoriatic patients. However, PHA-activated lymphocytes from psoriatic patients displayed a significantly decreased ratio of AnnV+CD95+ to the total AnnV+ subpopulation, thus suggesting a decreased role of Fas-dependent mechanisms of apoptosis during the cell activation. The data obtained confirm a view, that an abnormal lymphocyte “apoptotic reactivity”, which plays a crucial role in the mechanisms of autoimmunity, may also of importance in the pathogenesis of psoriasis.

  3. Use of amino terminal type III procollagen peptide (P3NP) assay in methotrexate therapy for psoriasis

    Science.gov (United States)

    Khan, S; Subedi, D; Chowdhury, M M U

    2006-01-01

    Hepatic fibrosis continues to be a risk in patients receiving methotrexate for psoriasis. Measurement of amino terminal levels of type III procollagen (P3NP) has been advocated as an effective non‐invasive test for ongoing hepatic fibrogenesis that could avoid liver biopsies. An audit was conducted to assess the practice of P3NP monitoring using guidelines produced by Manchester and whether the agreed levels correlate with histological severity. Sixty five patients with 174 P3NP assays and 30 liver biopsies were reviewed between the years 1999 and 2003. Total number of patient‐methotrexate years was 278.9 and the mean cumulative dose of methotrexate received was 2000 (SD 1838) mg. A higher cumulative dose of methotrexate correlated significantly with high mean and maximum P3NP levels. Of the 30 liver biopsies, 26 (86.6%) showed normal histology or mild to moderate steatosis, three had focal fibrosis, and one had early cirrhosis. A median P3NP value of 5.8 μg/l or higher had a stronger correlation with histological severity. It is concluded that P3NP assay is a valuable adjunct to the clinical management of patients receiving long term methotrexate that can avoid or reduce unnecessary liver biopsies. PMID:16679477

  4. CRITICAL APPRAISAL OF VIRECHANA KARMA IN PSORIASIS

    Directory of Open Access Journals (Sweden)

    M Ashvini Kumar

    2013-08-01

    Full Text Available Psoriasis in one of the commonest skin disease characterized by raised silvery scaly lesions. Though many treatments are tried in the management of psoriasis, cure is not been possible till date. Patients with Psoriasis approach various healthcare systems with a hope to get cure. Though, complete and prolonged clearance is the preferred outcome, resolution of disease is the primary therapeutic objective for patients as well as health providers. Psoriasis can be understood as a variety of Kushta (skin disease and correlated to many sub divisions of Kushtha. Ayurveda advocates Shamana (palliative and Shodhana (purificatory measures for its prevention as well as curative aspect. Virechana (therapeutic purgation is one among the commonly advocated Shodhana therapy in the management Kushta. Moreover, Virechana is frequently administered in the management of psoriasis and it is believed to normalize the basic pathologic factor viz Pitta and Rakta. Preoperative, operative and post operative care during Virechana Karma is more important to yield better outcome. An attempt is made to compile and analyze few researches carried out on Virechana on psoriasis to ascertain the modality.

  5. Transcriptome classification reveals molecular subtypes in psoriasis

    Directory of Open Access Journals (Sweden)

    Ainali Chrysanthi

    2012-09-01

    Full Text Available Abstract Background Psoriasis is an immune-mediated disease characterised by chronically elevated pro-inflammatory cytokine levels, leading to aberrant keratinocyte proliferation and differentiation. Although certain clinical phenotypes, such as plaque psoriasis, are well defined, it is currently unclear whether there are molecular subtypes that might impact on prognosis or treatment outcomes. Results We present a pipeline for patient stratification through a comprehensive analysis of gene expression in paired lesional and non-lesional psoriatic tissue samples, compared with controls, to establish differences in RNA expression patterns across all tissue types. Ensembles of decision tree predictors were employed to cluster psoriatic samples on the basis of gene expression patterns and reveal gene expression signatures that best discriminate molecular disease subtypes. This multi-stage procedure was applied to several published psoriasis studies and a comparison of gene expression patterns across datasets was performed. Conclusion Overall, classification of psoriasis gene expression patterns revealed distinct molecular sub-groups within the clinical phenotype of plaque psoriasis. Enrichment for TGFb and ErbB signaling pathways, noted in one of the two psoriasis subgroups, suggested that this group may be more amenable to therapies targeting these pathways. Our study highlights the potential biological relevance of using ensemble decision tree predictors to determine molecular disease subtypes, in what may initially appear to be a homogenous clinical group. The R code used in this paper is available upon request.

  6. COEXISTENCE OF SYPHILIS AND PSORIASIS

    OpenAIRE

    Senthil Kumar; Saradha; Anandan; Manisurya Kumar; Kalpana

    2016-01-01

    Psoriasis is a chronic inflammatory skin disease with various triggering factors. Here we report a case of psoriasis coexisting with secondary syphilis which could have been a possible trigger for exacerbation of psoriasis.

  7. COEXISTENCE OF SYPHILIS AND PSORIASIS

    Directory of Open Access Journals (Sweden)

    Senthil Kumar

    2016-06-01

    Full Text Available Psoriasis is a chronic inflammatory skin disease with various triggering factors. Here we report a case of psoriasis coexisting with secondary syphilis which could have been a possible trigger for exacerbation of psoriasis.

  8. Duration of Anti-Tuberculosis Therapy and Timing of Antiretroviral Therapy Initiation: Association with Mortality in HIV-Related Tuberculosis

    Science.gov (United States)

    Cortes, Claudia P.; Wehbe, Firas H.; McGowan, Catherine C.; Shepherd, Bryan E.; Duda, Stephany N.; Jenkins, Cathy A.; Gonzalez, Elsa; Carriquiry, Gabriela; Schechter, Mauro; Padgett, Denis; Cesar, Carina; Madero, Juan Sierra; Pape, Jean W.; Masys, Daniel R.; Sterling, Timothy R.

    2013-01-01

    Background Antiretroviral therapy (ART) decreases mortality risk in HIV-infected tuberculosis patients, but the effect of the duration of anti-tuberculosis therapy and timing of anti-tuberculosis therapy initiation in relation to ART initiation on mortality, is unclear. Methods We conducted a retrospective observational multi-center cohort study among HIV-infected persons concomitantly treated with Rifamycin-based anti-tuberculosis therapy and ART in Latin America. The study population included persons for whom 6 months of anti-tuberculosis therapy is recommended. Results Of 253 patients who met inclusion criteria, median CD4+ lymphocyte count at ART initiation was 64 cells/mm3, 171 (68%) received >180 days of anti-tuberculosis therapy, 168 (66%) initiated anti-tuberculosis therapy before ART, and 43 (17%) died. In a multivariate Cox proportional hazards model that adjusted for CD4+ lymphocytes and HIV-1 RNA, tuberculosis diagnosed after ART initiation was associated with an increased risk of death compared to tuberculosis diagnosis before ART initiation (HR 2.40; 95% CI 1.15, 5.02; P = 0.02). In a separate model among patients surviving >6 months after tuberculosis diagnosis, after adjusting for CD4+ lymphocytes, HIV-1 RNA, and timing of ART initiation relative to tuberculosis diagnosis, receipt of >6 months of anti-tuberculosis therapy was associated with a decreased risk of death (HR 0.23; 95% CI 0.08, 0.66; P=0.007). Conclusions The increased risk of death among persons diagnosed with tuberculosis after ART initiation highlights the importance of screening for tuberculosis before ART initiation. The decreased risk of death among persons receiving > 6 months of anti-tuberculosis therapy suggests that current anti-tuberculosis treatment duration guidelines should be re-evaluated. PMID:24066096

  9. The sensitivity of patch test in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Yavuz Yeşilova

    2010-09-01

    Full Text Available Objectives: Allergic diseases play an important role in the natural course of psoriasis. Atopic sensitization and con-tact dermatitis are common in patients with psoriasis. Since the symptoms are prolonged in patients who are resistant to therapy and exposure to itchy and external factors are common among these patients, the effects of contact aller-gens on triggering psoriasis are investigated. Contact allergens have an important role in activation and remission of psoriasis. We aimed to investigate contact sensitization rates in patients with psoriasis in the study.Material and Methods: Contact sensitization was investigated with the application of European standard series in twenty patients with psoriasis, twenty patients with contact dermatitis, and twenty healthy persons. Results: Among the whole study cases, positivity rate of patch test against one allergen at least was 25%. rate of patch test was 25% in patients with psoriasis, 35% in patients with contact dermatitis, and 15% in healthy persons. There were no significant differences between the groups according to sensitization to one or more allergens (p>0.05. There were no significant difference in clinical subgroup of psoriatic patients according to contact sensitiza-tion (p>0.05. The allergens in patients with psoriasis on patch test were as the followings: phenyldiamine, potassium dichromat, nickel, and cobalt.Conclusion: We think that the patch test has a major role in the diagnosis and elimination of allergens in patients with the chronic and resistant diseases and palmoplantar and flexural psoriasis.

  10. Off-Label Biologic Regimens in Psoriasis: A Systematic Review of Efficacy and Safety of Dose Escalation, Reduction, and Interrupted Biologic Therapy

    OpenAIRE

    Elizabeth A. Brezinski; Armstrong, April W.

    2012-01-01

    OBJECTIVES: While off-label dosing of biologic treatments may be necessary in selected psoriasis patients, no systematic review exists to date that synthesizes the efficacy and safety of these off-label dosing regimens. The aim of this systematic review is to evaluate efficacy and safety of off-label dosing regimens (dose escalation, dose reduction, and interrupted treatment) with etanercept, adalimumab, infliximab, ustekinumab, and alefacept for psoriasis treatment. DATA SOURCES AND STUDY SE...

  11. Tattoo-induced psoriasis

    OpenAIRE

    Orzan, OA; Popa, LG; Vexler, ES; Olaru, I; Voiculescu, VM; Bumbăcea, RS

    2014-01-01

    Koebner phenomenon represents the development of several inflammatory skin lesions (psoriasis, lichen planus, vitiligo, etc.) in uninvolved skin following various traumatic insults. The case of a 27-year-old male patient with scalp psoriasis who was referred to our clinic for generalized psoriatic lesions developed two weeks after tattooing his skin at the age of 18 was presented; the case illustrated the possibility of Koebner phenomenon induced by skin tattooing in patients with psoriasis.

  12. Immunotherapy: Beyond Anti-PD-1 and Anti-PD-L1 Therapies.

    Science.gov (United States)

    Antonia, Scott J; Vansteenkiste, Johan F; Moon, Edmund

    2016-01-01

    Advanced-stage non-small cell lung cancer (NSCLC) and small cell lung cancer are cancers in which chemotherapy produces a survival benefit, although it is small. We now know that anti-PD-1/PD-L1 has substantial clinical activity in both of these diseases, with an overall response rate (ORR) of 15%-20%. These responses are frequently rapid and durable, increase median overall survival (OS) compared with chemotherapy, and produce long-term survivors. Despite these very significant results, many patients do not benefit from anti-PD-1/PD-L1. This is because of the potential for malignancies to co-opt myriad immunosuppressive mechanisms other than aberrant expression of PD-L1. Conceptually, these can be divided into three categories. First, for some patients there is likely a failure to generate sufficient functional tumor antigen-specific T cells. Second, for others, tumor antigen-specific T cells may be generated but fail to enter into the tumor parenchyma. Finally, there are a large number of immunosuppressive mechanisms that have the potential to be operational within the tumor microenvironment: surface membrane immune checkpoint proteins PD-1, CTLA-4, LAG3, TIM3, BTLA, and adenosine A2AR; soluble factors and metabolic alterations interleukin (IL)-10, transforming growth factor (TGF)-β, adenosine, IDO, and arginase; and inhibitory cells, cancer-associated fibroblasts (CAFs), regulatory T cells, myeloid-derived suppressor cells (MDSCs), and tumor-associated macrophages. In this article, we discuss three strategies to generate more tumor-reactive T cells for patients: anti-CTLA-4, therapeutic tumor vaccination, and adoptive cellular therapy, with T cells redirected to tumor antigens using T-cell receptor (TCR) or chimeric antigen receptor (CAR) gene modification. We also review some of the various strategies in development to thwart tumor microenvironment immunosuppressive mechanisms. Strategies to drive more T cells into tumors remain a significant challenge.

  13. Plant extracts for the topical management of psoriasis: a systematic review and meta-analysis.

    Science.gov (United States)

    Deng, S; May, B H; Zhang, A L; Lu, C; Xue, C C L

    2013-10-01

    Patients with psoriasis frequently use preparations of plant extracts. Physicians need to be aware of the current evidence concerning these products. This review evaluates the efficacy and safety of preparations of plant extracts used topically for psoriasis. Searches were conducted in PubMed, Embase, the Cochrane library, two Chinese databases and article reference lists. Randomized controlled trials investigating extracts of single plants were included. Preparations of multiple plants and combinations of plant extracts plus conventional therapies were excluded. Two authors conducted searches, extracted data and assessed risk of bias. Outcomes used in meta-analyses were: clinical efficacy, Psoriasis Area and Severity Index score, and quality of life and symptom scores. The 12 included studies investigated extracts of: Mahonia aquifolium (n = 5), Aloe vera (n = 3), indigo naturalis (n = 2), kukui nut oil (n = 1) and Camptotheca acuminata nut (n = 1). Methodological quality was variable. Six studies provided data suitable for meta-analysis of clinical efficacy, and five were vs. placebo (relative risk 3·37, 95% confidence interval 1·36-8·33). Experimental studies indicate components of indigo naturalis, Mahonia and Camptotheca have anti-inflammatory, antiproliferative and other actions of relevance to psoriasis. The clinical trial evidence provides limited support for preparations containing extracts of M. aquifolium, indigo naturalis and Aloe vera for the topical management of plaque psoriasis based on multiple studies. No serious adverse events were reported. Because of the small size of most studies and methodological weaknesses, strong conclusions cannot be made. The magnitudes of any effects cannot be measured with accuracy, so it is difficult to assess the clinical relevance of these preparations.

  14. Plant extracts for the topical management of psoriasis: a systematic review and meta-analysis.

    Science.gov (United States)

    Deng, S; May, B H; Zhang, A L; Lu, C; Xue, C C L

    2013-10-01

    Patients with psoriasis frequently use preparations of plant extracts. Physicians need to be aware of the current evidence concerning these products. This review evaluates the efficacy and safety of preparations of plant extracts used topically for psoriasis. Searches were conducted in PubMed, Embase, the Cochrane library, two Chinese databases and article reference lists. Randomized controlled trials investigating extracts of single plants were included. Preparations of multiple plants and combinations of plant extracts plus conventional therapies were excluded. Two authors conducted searches, extracted data and assessed risk of bias. Outcomes used in meta-analyses were: clinical efficacy, Psoriasis Area and Severity Index score, and quality of life and symptom scores. The 12 included studies investigated extracts of: Mahonia aquifolium (n = 5), Aloe vera (n = 3), indigo naturalis (n = 2), kukui nut oil (n = 1) and Camptotheca acuminata nut (n = 1). Methodological quality was variable. Six studies provided data suitable for meta-analysis of clinical efficacy, and five were vs. placebo (relative risk 3·37, 95% confidence interval 1·36-8·33). Experimental studies indicate components of indigo naturalis, Mahonia and Camptotheca have anti-inflammatory, antiproliferative and other actions of relevance to psoriasis. The clinical trial evidence provides limited support for preparations containing extracts of M. aquifolium, indigo naturalis and Aloe vera for the topical management of plaque psoriasis based on multiple studies. No serious adverse events were reported. Because of the small size of most studies and methodological weaknesses, strong conclusions cannot be made. The magnitudes of any effects cannot be measured with accuracy, so it is difficult to assess the clinical relevance of these preparations. PMID:23909714

  15. Treatment of psoriasis with biologic agents in Malta

    OpenAIRE

    Mercieca, Liam; Boffa, Michael J.; Clark, Eileen; Scerri, Lawrence; Aquilina, Susan

    2016-01-01

    Introduction: Biologic therapy has revolutionalised the treatment of moderate to severe psoriasis leading to improved clinical outcomes and quality of life scores. This study aims to determine current biologic use in psoriatic patients at our Dermatology department at Sir Paul Boffa hospital, Malta. Method: All patients who were administered biologic therapy for psoriasis in Malta until the end of 2014 were included. Data included demographic details, disease dur...

  16. Is anti-platelet therapy interruption a real clinical issue? Its implications in dentistry and particularly in periodontics

    OpenAIRE

    Kumar A; Kumari M; Arora Nupur; Haritha A

    2009-01-01

    The use of anti-platelet therapy has reduced the mortality and morbidity of cardiovascular disease remarkably. A considerable number of patients presenting before a dentist or periodontist give a history of anti-platelet therapy. A clinical dilemma whether to discontinue the anti-platelet therapy or continue the same always confronts the practitioner. Diverse opinions exist regarding the management of such patients. While one group of researchers advise continuation of anti-platelet therapy r...

  17. A Clinician's Guide to the Diagnosis and Treatment of Candidiasis in Patients with Psoriasis.

    Science.gov (United States)

    Armstrong, April W; Bukhalo, Michael; Blauvelt, Andrew

    2016-08-01

    Many of the molecular pathways associated with psoriasis pathogenesis are also involved in host defense mechanisms that protect against common pathogens. Candida can stimulate the production of cytokines that trigger or exacerbate psoriasis, and many systemic psoriasis treatments may put patients at increased risk for developing oral, cutaneous, and genitourinary candidiasis. Therefore, dermatologists should regularly screen patients with psoriasis for signs of Candida infection, and take steps to effectively treat these infections to prevent worsening of psoriasis symptoms. This review provides an overview of candidiasis epidemiology in patients with psoriasis, followed by a primer on the diagnosis and treatment of superficial Candida infections, with specific guidance for patients with psoriasis. Candidiasis in patients with psoriasis typically responds to topical or oral antifungal therapy. While biologic agents used to treat moderate-to-severe psoriasis, such as tumor necrosis factor-α inhibitors and interleukin-17 inhibitors, are known to increase patients' risk of developing localized candidiasis, the overall risk of infection is low, and candidiasis can be effectively managed in most patients while receiving systemic psoriasis therapies. Thus, the development of candidiasis does not usually necessitate changes to psoriasis treatment regimens. PMID:27435194

  18. A Clinician's Guide to the Diagnosis and Treatment of Candidiasis in Patients with Psoriasis.

    Science.gov (United States)

    Armstrong, April W; Bukhalo, Michael; Blauvelt, Andrew

    2016-08-01

    Many of the molecular pathways associated with psoriasis pathogenesis are also involved in host defense mechanisms that protect against common pathogens. Candida can stimulate the production of cytokines that trigger or exacerbate psoriasis, and many systemic psoriasis treatments may put patients at increased risk for developing oral, cutaneous, and genitourinary candidiasis. Therefore, dermatologists should regularly screen patients with psoriasis for signs of Candida infection, and take steps to effectively treat these infections to prevent worsening of psoriasis symptoms. This review provides an overview of candidiasis epidemiology in patients with psoriasis, followed by a primer on the diagnosis and treatment of superficial Candida infections, with specific guidance for patients with psoriasis. Candidiasis in patients with psoriasis typically responds to topical or oral antifungal therapy. While biologic agents used to treat moderate-to-severe psoriasis, such as tumor necrosis factor-α inhibitors and interleukin-17 inhibitors, are known to increase patients' risk of developing localized candidiasis, the overall risk of infection is low, and candidiasis can be effectively managed in most patients while receiving systemic psoriasis therapies. Thus, the development of candidiasis does not usually necessitate changes to psoriasis treatment regimens.

  19. Safety of anti-tumor necrosis factor therapy in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Frank Hoentjen; Ad A van Bodegraven

    2009-01-01

    Inflammatory bowel disease (IBD), in particular Crohn's disease refractory to conventional therapy, fistulizing Crohn's disease and chronic active ulcerative colitis, generally respond well to anti-tumor necrosis factor (TNF) therapy. However, serious side effects do occur, necessitating careful monitoring of therapy. Potential side effects of anti-TNF therapy include opportunistic infections, which show a higher incidence when concomitant immunosuppression is used. Furthermore, antibody formation against anti-TNF is associated with decreased efficacy and an increased frequency of infusion reactions. The hypothesis of a slightly increased risk of lymphomas in IBD patients treated with anti TNF-therapy is debatable, since most studies lack the specific design to properly address this issue. Alarmingly, the occurrence of hepatosplenic T-cell lymphomas coincides with combined immunosuppressive therapy. Despite the potential serious side effects, anti- TNF therapy is an effective and relatively safe treatment option for refractory IBD. Future research is needed to answer important questions, such as the long-term risk of malignancies, safety during pregnancy, when to discontinue and when to switch anti-TNF therapy, as well as to determine the balance between therapeutic and toxic effects.

  20. Psoriasis and Obesity

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Gürer

    2012-03-01

    Full Text Available In recent years, it has been thought that a strong association exists between metabolic syndrome, specifically obesity, and psoriasis. Obesity is a multifactorial disease affected by both genetic and environmental factors. Adipokines (e.g. leptin secreted by the adipose tissue are believed to play a role in the pathogenesis of psoriasis. The main role of leptin is to adjust metabolism by controlling appetite. Serum leptin levels in patients with severe and moderate psoriasis were found to be higher than in normal control groups. In many similar studies, leptin secretion has been found to stimulate keratinocyte proliferation, which is one of the characteristics of psoriasis. Although many studies showed increased prevalence of obesity in psoriasis patients, few others reported development of obesity in psoriasis patients. Additionally, obesity was found to affect treatment responses not only in classical systemic/topical treatment approaches in psoriasis, but also in newer biological treatments. Overall, increasing epidemiological evidence suggests strong association between obesity and psoriasis, increase in serum leptin levels is thought to have a major role, and weight loss may have significant impact on response to treatment.

  1. Laserbehandeling bij psoriasis

    NARCIS (Netherlands)

    Sewbaransingh. A., [No Value

    2000-01-01

    Aan de Wetenschapswinkel Geneeskunde en Volksgezondheid werd een vraag voorgelegd van de Nederlandse Bond van Psoriasis Patiënten Verenigingen (NBPV) betreffende een folder genaamd 'de behandeling van psoriasis met laser' (zie Bijlage I). De vraag van de NBPV was om na te gaan in hoeverre de in de f

  2. Psoriasis: Comorbidity and Treatment

    NARCIS (Netherlands)

    M. Wakkee (Marlies)

    2010-01-01

    textabstractPsoriasis is universal in occurrence, although the worldwide prevalence varies between 0.6% and 4.8%.The prevalence of psoriasis in people of Caucasian descend is approximately 2%. In the Netherlands it is therefore estimated that approximately 300,000 people are diagnosed as having psor

  3. PUVA-induced Bullous Pemphigoid in Psoriasis.

    Science.gov (United States)

    Caca-Biljanovska, Nina; Arsovska-Bezhoska, Irina; V'lckova-Laskoska, Marija

    2016-08-01

    The association between psoriasis vulgaris and bullous pemphigoid is due to the still unclear autoimmune process. The common disease site is the dermo-epidermal junction or basal membrane zone (BMZ), with specific alterations for both diseases. Photochemotherapy (PUVA) is one of the therapeutic modalities for psoriasis and can trigger production of autoantibodies against antigens in the BMZ in patients with subclinical bullous pemphigoid. Furthermore, PUVA therapy can alter the immunological milieu and hence can contribute to the expression of bullous pemphigoid in patients with psoriasis. We observed a bullous eruption compatible with bullous pemphigoid in a psoriatic patient treated with PUVA. We speculate that the cumulative dose of PUVA sufficient for triggering blister formation is individually determined. PMID:27663923

  4. Pegylated interferon, ribavirin, and frequent supportive therapy with growth factors. Which pathogenesis for a severe psoriasis complicating the treatment of chronic HCV hepatitis?

    Directory of Open Access Journals (Sweden)

    Roberto Manfredi

    2009-12-01

    Full Text Available One of the most effective treatments for HCV and HBV infection is the combination of pegylated IFN-alpha and ribavirin. However, both IFN-alpha and ribavirin can induce hematologic toxicity, which can compromise treatment adherence and dose maintenance and could, therefore, influence outcomes. Hematopoietic growth factors (e.g. filgrastim can provide significant benefits in the treatment of this toxicity, but they can also exacerbate cutaneous psoriasis. We report a case of a 54-year-old woman with chronic, progressive hepatitis C, treated with long-term pegylated interferon plus ribavirin, associated with multiple cycles of filgrastim for a severe, recurring granulocytopenia. The patient developed an extensive and severe psoriasis, which improved only after specific treatment with cyclosporin. The case highlights the importance of treatment adherence and dose maintenance to obtain a sustained virologic response, and underlines the difficulties of the management of this disease when side effects, such as hematologic toxicity and psoriasis, are present.

  5. Curative effect observation of water,medicine,light and psychology therapy for 67 patients with psoriasis%四联疗法治疗银屑病67例疗效观察

    Institute of Scientific and Technical Information of China (English)

    林果; 李振鲁

    2015-01-01

    Objective to observe cLinicaL effect of the water,medicine,Light and psychoLogy therapy on psoriasis. Methods Sixty-seven patients with stationary phase of psoriasis were treated respectiveLy by soaking in thermaL water,externaL medicine,narrow-band uvb,psychotherapy. two period of treatment were observed,the situation of skin Lesion before and after treatment recorded,and PaSI was scored and the effect of the treatment was evaLuated. Results PaSI score of the 67 cases of patients with stationary phase of psoriasis decreased significantLy after quadrupLe therapy;the cure rate was 14. 9%,the effectuaL rate was 68. 7%,the effective rate was 13. 4%,the invaLid rate was 3. 0%,and the totaL effectuaL rate was 83. 6%. Conclusion Soaking in Nanjing tangshan thermaL water quatet therapy for stationary phase of psoriasis has good curative effect.%目的:观察水、药、光、心四联疗法治疗银屑病的临床效果。方法对静止期银屑病患者67例采用温泉水浸泡、外用药物、窄谱中波紫外线、心理治疗四联疗法进行治疗,共观察2个疗程,分别记录治疗前后的皮损情况,进行PaSI评分,并评价治疗效果。结果67例静止期银屑病患者经四联疗法治疗后 PaSI评分均显著降低;治愈14.9%,显效68.7%,有效率13.4%,无效3.0%,总显效率83.6%。结论南京汤山温泉浸泡四联疗法治疗静止期银屑病有较好的疗效。

  6. Listeria monocytogenes as a vector for anti-cancer therapies.

    LENUS (Irish Health Repository)

    Tangney, Mark

    2012-01-31

    The intracellular pathogen Listeria monocytogenes represents a promising therapeutic vector for the delivery of DNA, RNA or protein to cancer cells or to prime immune responses against tumour-specific antigens. A number of biological properties make L. monocytogenes a promising platform for development as a vector for either gene therapy or as an anti-cancer vaccine vector. L. monocytogenes is particularly efficient in mediating internalization into host cells. Once inside cells, the bacterium produces specific virulence factors which lyse the vaculolar membrane and allow escape into the cytoplasm. Once in the cytosol, L. monocytogenes is capable of actin-based motility and cell-to-cell spread without an extracellular phase. The cytoplasmic location of L. monocytogenes is significant as this potentiates entry of antigens into the MHC Class I antigen processing pathway leading to priming of specific CD8(+) T cell responses. The cytoplasmic location is also beneficial for the delivery of DNA (bactofection) by L. monocytogenes whilst cell-to-cell spread may facilitate access of the vector to cells throughout the tumour. Several preclinical studies have demonstrated the ability of L. monocytogenes for intracellular gene or protein delivery in vitro and in vivo, and this vector has also displayed safety and efficacy in clinical trial. Here, we review the features of the L. monocytogenes host-pathogen interaction that make this bacterium such an attractive candidate with which to induce appropriate therapeutic responses. We focus primarily upon work that has led to attenuation of the pathogen, demonstrated DNA, RNA or protein delivery to tumour cells as well as research that shows the efficacy of L. monocytogenes as a vector for tumour-specific vaccine delivery.

  7. Clinical outcomes of anti-androgen withdrawal and subsequent alternative anti-androgen therapy for advanced prostate cancer following failure of initial maximum androgen blockade

    OpenAIRE

    MOMOZONO, HIROYUKI; Miyake, Hideaki; TEI, HIROMOTO; Harada, Ken-ichi; Fujisawa, Masato

    2016-01-01

    The present study aimed to investigate the significance of anti-androgen withdrawal and/or subsequent alternative anti-androgen therapy in patients with advanced prostate cancer (PC) who relapsed after initial maximum androgen blockade (MAB). The present study evaluated the clinical outcomes of 272 consecutive advanced PC patients undergoing anti-androgen withdrawal and/or subsequent alternative anti-androgen therapy with flutamide following the failure of initial MAB using bicalutamide. With...

  8. [Comorbidity in psoriasis].

    Science.gov (United States)

    Gerdes, S; Mrowietz, U; Boehncke, W-H

    2016-06-01

    Psoriasis is a systemic chronic inflammatory disease associated with comorbidity. Many epidemiological studies have shown that psoriasis is associated with psoriatic arthritis as well as cardiovascular and metabolic diseases. Furthermore, obesity and psychological diseases such as depression and anxiety disorders are linked with psoriasis and play a central role in its management. The association of psoriasis and its comorbidity can be partly explained by genetic and pathophysiological mechanisms. Approximately 40 psoriasis susceptibility loci have been described with the majority linked to the innate and adaptive immune system. In some associated diseases, such as psoriatic arthritis, an overlap of their genetic susceptibility exists. Pathophysiologically the "psoriatic march" is a model that describes the development of metabolic and cardiovascular diseases due to the presence of underlying systemic inflammation. Dermatologists are the gatekeepers to treatment for patients with psoriasis. The early detection and the management of comorbidity is part of their responsibility. Concepts for the management of psoriasis and tools to screen for psoriatic comorbidity have been developed in order to support dermatologists in daily practice. PMID:27221798

  9. Factors affecting response to biologic treatment in psoriasis.

    Science.gov (United States)

    Karczewski, Jacek; Poniedziałek, Barbara; Rzymski, Piotr; Adamski, Zygmunt

    2014-01-01

    Psoriasis is a chronic, immune-mediated inflammatory skin disease, affecting approximately 2-4% of the population in western countries. Patients with a more severe form of the disease are typically considered for systemic therapy, including biologics. In spite of the overall superiority of biologic agents, the treatment response may differ substantially among individual patients. As with other medical conditions, a range of factors contribute to response heterogeneity observed in psoriasis. Proper identification of these factors can significantly improve the therapeutic decisions. This review focuses on potential genetic and nongenetic factors that may affect the treatment response and outcomes in patients with psoriasis.

  10. Heredity of psoriasis

    Directory of Open Access Journals (Sweden)

    Belić Dobrila

    2004-01-01

    Full Text Available INTRODUCTION Epidemiological studies of twins show that there is a genetic predisposition to psoriasis. Researches conducted so far show that psoriasis is a multifactorial polygenetic disease with reduced gene penetration. They also show that heredity is more significant than the "trigger" factor whose influence is limited to the exchange of phenotypes. Researches in USA, Canada and Europe identified four most important loci (psoriasis susceptibility - 1-4. At least one is in MHC (major histocompatibility complex due to the connection between psoriasis and alleles of human leukocyte antigen (HLA. OBJECTIVE Our study included 117 patients and examined the indicators of genetic predisposition to psoriasis: frequency of psoriasis among relatives of psoriatic probands; frequency of psoriasis among relatives (I and II degree of psoriatic patients; age of probands and other relatives at the onset of illness. Material and methods We have used a structured questionnaire for collection of data about existence of psoriasis in relatives of I and II degree of psoriatic probands and about the age of probands and relatives at the time of onset. Results and discussion Twenty six (21.85% probands have at least one ill relative. The examined patients who have diseased relatives get ill much earlier than those who do not. Probands with two or more diseased relatives get ill much earlier than those who have just one diseased relative. Analysis of our sample shows a significant statistical difference regarding the onset of illness of diseased parents and their children. Children get ill earlier. CONCLUSIONS We have concluded that in our sample there is a hereditary component which is related to frequency and onset of psoriasis.

  11. Alopecia secondary to anti-tumor necrosis factor-alpha therapy *

    OpenAIRE

    Ribeiro, Lara Beatriz Prata; Rego, Juliana Carlos Gonçalves; Estrada, Bruna Duque; Bastos, Paula Raso; Piñeiro Maceira, Juan Manuel; Sodré, Celso Tavares

    2015-01-01

    Biologic drugs represent a substantial progress in the treatment of chronic inflammatory immunologic diseases. However, its crescent use has revealed seldom reported or unknown adverse reactions, mainly associated with anti-tumor necrosis factor (anti-TNF). Psoriasiform cutaneous reactions and few cases of alopecia can occur in some patients while taking these drugs. Two cases of alopecia were reported after anti-TNF therapy. Both also developed psoriasiform lesions on the body. This is the s...

  12. COST-EFFECTIVENESS ANALYSIS OF ANTI-DIABETIC THERAPY IN A UNIVERSITY TEACHING HOSPITAL

    OpenAIRE

    Giwa Abdulganiyu; Tayo Fola

    2014-01-01

    Purpose: To conduct cost-effectiveness analysis of anti-diabetic therapy in a University Teaching Hospital in 2010. Methods: A retrospective review of selected case-notes was conducted. World Health Organization Defined Daily Dose Method of evaluating drug use and probability method for potential effectiveness of antidiabetic therapeutic options from literature analysis was employed in determining cost-effectiveness of each anti-diabetic therapeutic option identified from anti-diabetic dru...

  13. Recent insights in nanotechnology-based drugs and formulations designed for effective anti-cancer therapy

    OpenAIRE

    Piktel, Ewelina; Niemirowicz, Katarzyna; Wątek, Marzena; Wollny, Tomasz; Deptuła, Piotr; Bucki, Robert

    2016-01-01

    The rapid development of nanotechnology provides alternative approaches to overcome several limitations of conventional anti-cancer therapy. Drug targeting using functionalized nanoparticles to advance their transport to the dedicated site, became a new standard in novel anti-cancer methods. In effect, the employment of nanoparticles during design of antineoplastic drugs helps to improve pharmacokinetic properties, with subsequent development of high specific, non-toxic and biocompatible anti...

  14. Narrowband ultraviolet B therapy in psoriasis: randomized double-blind comparison of high-dose and low-dose irradiation regimens.

    NARCIS (Netherlands)

    Kleinpenning, M.M.; Smits, T.; Boezeman, J.B.M.; Kerkhof, P.C.M. van de; Evers, A.W.M.; Gerritsen, M.J.P.

    2009-01-01

    BACKGROUND: Ultraviolet (UV) B phototherapy is an established treatment option for psoriasis. The optimum dosage regimen still has to be determined. Within-subject comparisons do not take into account the systemic effects of UVB phototherapy. The area of the body treated with low-dose UVB may benefi

  15. Combination of nitric oxide therapy, anti-oxidative therapy, low level laser therapy, plasma rich platelet therapy and stem cell therapy as a novel therapeutic application to manage the pain and treat many clinical conditions

    Science.gov (United States)

    Halasa, Salaheldin; Dickinson, Eva

    2014-02-01

    From hypertension to diabetes, cancer to HIV, stroke to memory loss and learning disorders to septic shock, male impotence to tuberculosis, there is probably no pathological condition where nitric oxide does not play an important role. Nitric oxide is an analgesic, immune-modulator, vasodilator, anti-apoptotic, growth modulator, angiogenetic, anti-thrombotic, anti-inflammatory and neuro-modulator. Because of the above actions of nitric oxide, many clinical conditions associated with abnormal Nitric oxide (NO) production and bioavailability. Our novel therapeutic approach is to restore the homeostasis of nitric oxide and replace the lost cells by combining nitric oxide therapy, anti-oxidative therapy, low level laser therapy, plasma rich platelet therapy and stem cell therapy.

  16. Management of Psoriasis

    Directory of Open Access Journals (Sweden)

    Tülin Ergun

    2015-09-01

    Full Text Available Current data has led to better understanding of impact of psoriasis on quality of life as well as its physical and psychosocial co-morbidities. Consequently, holistic approach is mandatory in appropriate management of patients with psoriasis. Dermatologists should not only treat dermatological findings and symptoms but also screen patients regularly for co-morbidities and be active in coordinating the treatment if co-morbidities exist. Current review highlights main steps in management of psoriasis with a special emphasis on important practical points.

  17. Cardiovascular comorbiditiy in psoriasis

    Directory of Open Access Journals (Sweden)

    Gurcharan Singh

    2011-01-01

    Full Text Available The chronic inflammatory nature of psoriasis is also thought to predispose patients to other diseases with an inflammatory component, the most notable being cardiovascular and metabolic (cardiometabolite disorders. This concept is supported by studies showing that psoriasis is associated with cardiovascular risk factors like diabetes, obesity, hypertension, dyslipidemia, smoking and diseases including MI. Given the increased prevalence of cardiovascular co morbidities in patients, dermatologists treating psoriasis need to approach the disease as a potentially multisystem disorder and must alert these patients to the potentially negative effects of their disease.

  18. Development of Combination Therapy with Anti-Cancer Drugs

    NARCIS (Netherlands)

    Leijen, S.

    2013-01-01

    This thesis describes early clinical trials with anti-cancer drugs in combination with commonly applied and registered chemotherapy and single agent studies with compounds that are intended for use in combination with registered or other targeted anti-cancer drugs. Gemcitabine is a prodrug that fi

  19. What are carbon nanotubes’ roles in anti-tumor therapies?

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Since their discovery,carbon nanotubes(CNTs) have become one of the most promising nanomaterials in many industrial and biomedical applications.Due to their unique physicochemical properties,CNTs have been proposed and actively exploited as multipurpose innovative carriers for cancer therapy.The aim of this article is to provide an overview of the status of applications,advantages,and up-to-date research and development of carbon nanotubes in cancer therapy with an emphasis on drug delivery,photothermal therapy,gene therapy,RNAi,and immune therapy.In addition,the issues of risk and safety of CNTs in cancer nanotechnology are discussed briefly.

  20. The Risk of Chronic Pancreatitis in Patients with Psoriasis: A Population-Based Cohort Study

    Science.gov (United States)

    Chiang, Yi-Ting; Huang, Weng-Foung; Tsai, Tsen-Fang

    2016-01-01

    Background Psoriasis is a chronic systemic inflammatory disorder, and studies have revealed its association with a variety of comorbidities. However, the risk of chronic pancreatitis (CP) in psoriasis has not been studied. This study aimed to investigate the risk of CP among patients with psoriasis. Methods Using the Taiwan National Health Insurance Research Database, this population-based cohort study enrolled 48430 patients with psoriasis and 193720 subjects without psoriasis. Stratified Cox proportional hazards models were used to compare the risks of CP between the patients with and without psoriasis. Results The incidence of CP was 0.61 per 1000 person-years in patients with psoriasis and 0.34 per 1000 person-years in controls during a mean 6.6-year follow-up period. Before adjustment, patients with psoriasis had a significantly higher risk of CP (crude hazard ratio (HR) = 1.81; 95% confidence interval (CI) = 1.53–2.15), and the risk remained significantly higher after adjustments for gender, age group, medications, and comorbidities (adjusted HR (aHR) = 1.76; 95% CI = 1.47–2.10). All psoriasis patient subgroups other than those with arthritis, including those with mild and severe psoriasis and those without arthritis, had significantly increased aHRs for CP, and the risk increased with increasing psoriasis severity. Psoriasis patients taking nonsteroidal anti-inflammatory drugs (aHR = 0.33; 95% CI = 0.22–0.49) and methotrexate (aHR = 0.28; 95% CI = 0.12–0.64) had a lower risk of developing CP after adjustments. Conclusions Psoriasis is associated with a significantly increased risk of CP. The results of our study call for more research to provide additional insight into the relationship between psoriasis and CP. PMID:27467265

  1. Anti-tumor immune response after photodynamic therapy

    Science.gov (United States)

    Mroz, Pawel; Castano, Ana P.; Wu, Mei X.; Kung, Andrew L.; Hamblin, Michael R.

    2009-06-01

    Anti-tumor immunity is stimulated after PDT due a number of factors including: the acute inflammatory response caused by PDT, release of antigens from PDT-damaged tumor cells, priming of the adaptive immune system to recognize tumor-associated antigens (TAA), and induction of heat-shock proteins. The induction of specific CD8+ T-lymphocyte cells that recognize major histocompatibility complex class I (MHC-I) restricted epitopes of TAAs is a highly desirable goal in cancer therapy as it would allow the treatment of tumors that may have already metastasized. The PDT killed tumor cells may be phagocytosed by dendritic cells (DC) that then migrate to draining lymph nodes and prime naÃve T-cells that recognize TAA epitopes. We have carried out in vivo PDT with a BPD-mediated vascular regimen using a pair of BALB/c mouse colon carcinomas: CT26 wild type expressing the naturally occurring retroviral antigen gp70 and CT26.CL25 additionally expressing beta-galactosidase (b-gal) as a model tumor rejection antigen. PDT of CT26.CL25 cured 100% of tumors but none of the CT26WT tumors (all recurred). Cured CT26.CL25 mice were resistant to rechallenge. Moreover mice with two bilateral CT26.CL25 tumors that had only one treated with PDT demonstrated spontaneous regression of 70% of untreated contralateral tumors. T-lymphocytes were isolated from lymph nodes of PDT cured mice that recognized a particular peptide specific to b-gal antigen. T-lymphocytes from LN were able to kill CT26.CL25 target cells in vitro but not CT26WT cells as shown by a chromium release assay. CT26.CL25 tumors treated with PDT and removed five days later had higher levels of Th1 cytokines than CT26 WT tumors showing a higher level of immune response. When mice bearing CT26WT tumors were treated with a regimen of low dose cyclophosphamide (CY) 2 days before, PDT led to 100% of cures (versus 0% without CY) and resistance to rechallenge. Low dose CY is thought to deplete regulatory T-cells (Treg, CD4+CD25+foxp

  2. Ichthyotherapy as Alternative Treatment for Patients with Psoriasis: A Pilot Study

    OpenAIRE

    Martin Grassberger; Hoch, W

    2006-01-01

    Ichthyotherapy (therapy with the so-called ‘Doctorfish of Kangal’, Garra rufa) has been shown to be effective in patients with psoriasis in the Kangal hot springs in Turkey. This study evaluates the efficacy and safety of ichthyotherapy in combination with short-term ultraviolet A sunbed radiation in the treatment of psoriasis under controlled conditions. We retrospectively analyzed 67 patients diagnosed with psoriasis who underwent 3 weeks of ichthyotherapy at an outpatient treatment facil...

  3. Depression and Insomnia in Patients With Psoriasis and Psoriatic Arthritis Taking Tumor Necrosis Factor Antagonists

    OpenAIRE

    Wu, Chun-Ying; Chang, Yun-Ting; Juan, Chao-Kuei; Shen, Jui-Lung; Lin, Yu-Pu; Shieh, Jeng-Jer; Liu, Han-Nan; Chen, Yi-Ju

    2016-01-01

    Abstract Psoriasis patients with moderate to severe disease often present with depression and insomnia. Treatment targeting both psoriasis and psychological comorbidities is needed to improve the quality of life of these patients. In this nationwide cohort study, a total of 980 patients with psoriatic arthritis or psoriasis who had received nonbiological disease-modifying antirheumatic drugs and biologics therapy between 2009 and 2012 were identified. The prevalence rates of patients taking m...

  4. A Nonimmunosuppressant Approach on Asia Psoriasis Subjects: 5-Year Followup and 11-Year Data Analysis

    OpenAIRE

    Tony Yuqi Tang

    2012-01-01

    Mono- or combine immunosuppressants are commonly used for psoriasis; however the side effect caused by potent systemic immunosuppressants frequently incurred; moreover the inflammation flares up shortly after immunosuppressants are discontinued. An alternative nonimmunosuppressive therapy was introduced to psoriasis subjects. A retrospective observational study consisted of 1583 psoriasis patients who were treated with Herose Psoria capsule 1440 mg three times daily at two clinical centres, o...

  5. Extensive psoriasis induced by interferon alfa treatment for chronic hepatitis C

    OpenAIRE

    Taylor, C; Burns, D.; WISELKA, M

    2000-01-01

    A 47 year old man with chronic hepatitis C was treated with interferon alfa, 3 million units three times a week, and developed widespread plaque psoriasis within weeks of starting interferon therapy. There was no previous history of psoriasis. The psoriasis was characterised by extensive nail involvement and plaques at the interferon injection sites. The patient relapsed after a total of 12 months of interferon and was subsequently treated with interferon and tribavirin (ribavirin) with recur...

  6. VEGF involvement in psoriasis.

    Science.gov (United States)

    Marina, Mihaela Elena; Roman, Iulia Ioana; Constantin, Anne-Marie; Mihu, Carmen Mihaela; Tătaru, Alexandru Dumitru

    2015-01-01

    Vascular endothelial growth factor (VEGF) is a key growth factor, regulating the neovascularization, during embryogenesis, skeletal growth, reproductive functions and pathological processes. The VEGF receptors (VEGFR) are present in endothelial cells and other cell types, such as vascular smooth muscle cells, hematopoietic stem cells, monocytes, neurons, macrophages, and platelets. Angiogenesis is initiated by the activation of vascular endothelial cells through several factors. The excess dermal vascularity and VEGF production are markers of psoriasis. The pathological role of VEGF/VEGFR signaling during the psoriasis onset and evolution makes it a promising target for the treatment of psoriasis. Antibodies and other types of molecules targeting the VEGF pathway are currently evaluated in arresting the evolution of psoriasis. PMID:26609252

  7. Genes and Psoriasis

    Science.gov (United States)

    ... Diet Tips" to find out more! Email * Zipcode Genes and Psoriasis Genes hold the key to understanding ... is responsible for causing psoriatic disease. How do genes work? Genes control everything from height to eye ...

  8. Cell Targeting in Anti-Cancer Gene Therapy

    OpenAIRE

    Lila, Mohd Azmi Mohd; Siew, John Shia Kwong; Zakaria, Hayati; Saad, Suria Mohd; Ni, Lim Shen; Abdullah, Jafri Malin

    2004-01-01

    Gene therapy is a promising approach towards cancer treatment. The main aim of the therapy is to destroy cancer cells, usually by apoptotic mechanisms, and preserving others. However, its application has been hindered by many factors including poor cellular uptake, non-specific cell targeting and undesirable interferences with other genes or gene products. A variety of strategies exist to improve cellular uptake efficiency of gene-based therapies. This paper highlights advancements in gene th...

  9. Multiple Sclerosis And Psoriasis

    OpenAIRE

    Özışık, Handan Işın; Kızkın, Sibel; Hazneci, Ersoy; Özcan, Cemal

    2005-01-01

    Natural and recombinant interferons are increasingly being used to treat patients with multiple sclerosis and various inflammatory, infectious, and neoplastic processes. Adverse reactions are usually limited to headache, fever, and myalgia, but occasional unexpected problems can be severe enough to limit use of the drug. One such problem is the exacerbation of psoriasis. In our clinic, two patients with multiple sclerosis who were receiving injections of interferon had a psoriasis...

  10. Guttate psoriasis outcomes.

    Science.gov (United States)

    Pfingstler, Lisa F; Maroon, Michele; Mowad, Christen

    2016-02-01

    Guttate psoriasis (GP) typically occurs following an acute infection such as streptococcal pharyngitis. It is thought to have a better prognosis than chronic plaque psoriasis (PP). This retrospective cohort study of 79 patients with GP aims to assess the likelihood of developing PP after the first episode of GP as well as compare clinical and laboratory data in patients with GP who do and do not develop PP. PMID:26919501

  11. Psoriasis, a Systemic Disease?

    OpenAIRE

    Nilgün Atakan; Sibel Doğan

    2012-01-01

    Psoriasis is a chronic inflammatory disease which is characterized by plaques with shiny white desquamation on the skin. It affects 1 to 3% of different ethnic populations. The disease significantly lowers the quality of life for the patients as the lesions appear on visible regions such as the scalp, face and extremities causing pruritus and extensive use of topical agents with a poor rate of recovery and the disease has a recurrent course with frequent attacks. Psoriasis was previously assu...

  12. Cyclosporin A in psoriasis

    OpenAIRE

    Heule, Freerk

    1991-01-01

    textabstractAlthough a large therapeutic arsenal of conventional drugs is available to treat patients with psoriasis, a group of patients still exists that fulfill the inherent exclusion criteria or present with subjective or objective side-effects. This necessitates the need for controlled studies with potential new antipsoriatic drugs like cyclosporin A. In this thesis patientoriented studies on the treatment of severe psoriasis vulgaris with systemic low-dose and topical cyclosporin A are ...

  13. Anti-VEGF Cancer Therapy in Nephrology Practice

    Directory of Open Access Journals (Sweden)

    Hassan Izzedine

    2014-01-01

    Full Text Available Expanded clinical experience with the antivascular endothelial growth factor (VEGF agents has come with increasing recognition of their renal adverse effects. Although renal histology is rarely sought in antiangiogenic-treated cancer patients, kidney damage related to anti-VEGF is now established. Its manifestations include hypertension, proteinuria, and mainly glomerular thrombotic microangiopathy. Then, in nephrology practice, should we continue to perform kidney biopsy, and what should be done with the anti-VEGF agents in case of renal toxicity?

  14. Psoriasis, a Systemic Disease?

    Directory of Open Access Journals (Sweden)

    Nilgün Atakan

    2012-09-01

    Full Text Available Psoriasis is a chronic inflammatory disease which is characterized by plaques with shiny white desquamation on the skin. It affects 1 to 3% of different ethnic populations. The disease significantly lowers the quality of life for the patients as the lesions appear on visible regions such as the scalp, face and extremities causing pruritus and extensive use of topical agents with a poor rate of recovery and the disease has a recurrent course with frequent attacks. Psoriasis was previously assumed to be a cutaneous disease resulting from epidermal cell hyperproliferation for a long time. However, studies conducted on the etiopathogenesis of the disease revealed that psoriasis is a chronic autoinflammatory disease which is caused by immune system dysregulation. Recently, the frequent association of psoriasis with other autoinflammatory diseases, comorbidities and complications which indeed shorten life expectancy concluded that psoriasis is a systemic disease and created a major difference in its treatment and follow-up modalities. In this review, the comorbidities, which are shown to be related to systemic inflammation and which also share a common pathogenesis with psoriasis, will be discussed. (Turk J Dermatol 2012; 6: 119-22

  15. Adiponectin level in psoriasis and its association with disease severity

    Directory of Open Access Journals (Sweden)

    Seher Bilgili Tutkun

    2014-03-01

    Full Text Available Objectives Psoriasis is a chronic inflammatory disease in which pathogenesis has not been completely understood yet. Adiponectin(AN produced by adipocytes has antidiabetic, antiatherogenic and anti-inflammatory effects. Recent studies demonstrated that metabolic syndrome is related with low levels of AN. In literature, a few studies have been found that investigate AN levels in psoriasis. In this study, we purposed to investigate the levels of AN in psoriasis. Materials and Methods: Forty six patients with psoriasis and age and sex matched 40 healthy individuals as a control group were included in our study. Dermatological examinations were performed and psoriasis area severity index (PASI was calculated. In both groups, demographic features were questioned and body mass index were defined. Serum AN and C-reactive protein (CRP levels were determined in both groups and were compared statistically. Results: The mean serum AN levels were numerically lower in patients than in control group, but no significant statistical difference was detected between groups. Serum levels of AN were not found to be associated with age, age at onset of disease and disease duration. It was demonstrated that as levels of CRP increased, levels of AN decreased in psoriasis group. As PASI increased, a significant statistically difference was observed in levels of serum AN levels. No statistical difference was detected between PASI and body mass index. Conclusion Serum levels of AN in psoriasis may be an indicator of comorbidities such as metabolic syndrome. Also it can be used for assessing the severity of disease in psoriasis. But, for assessing the role of AN in the pathogenesis of psoriasis and to clarify this association, studies in different clinical models are needed.

  16. IκBζ: A key protein in the pathogenesis of psoriasis.

    Science.gov (United States)

    Johansen, Claus

    2016-02-01

    Psoriasis is an immune-mediated chronic inflammatory skin disease with a complex etiology. The proinflammatory cytokine IL-17A is known to play key role in the pathogenesis of psoriasis, and recently anti-IL-17A antibodies have been approved for psoriasis treatment. Here, we discuss our recent findings demonstrating that IκBζ, a transcriptional co-activator, plays a crucial role in the development of psoriasis by mediating IL-17A-driven effects. These findings have significant implications as they uncover a novel crucial regulatory mechanism involved in psoriasis development, and identify IκBζ as a possible future target in the treatment of psoriasis and other IL-17A-driven diseases.

  17. Psoriasis and comorbidities. Epidemiological studies

    DEFF Research Database (Denmark)

    Egeberg, Alexander

    2016-01-01

    as well. Indeed, approximately one-third of patients with psoriasis develop psoriatic arthritis, and patients with severe psoriasis have a shortened life expectancy. Although our knowledge of the pathogenesis of psoriasis has advanced significantly in the past decade, as have the pharmacological treatment......Psoriasis is a prevalent chronic inflammatory disease whose exact aetiology is not fully understood, but both genetic and environmental factors have been implicated in the onset and progression of the disease. At the skin level, psoriasis is characterized by localized or widespread thick raised...... silvery-white scaling and pruritic plaques and studies have shown that psoriasis negatively affects patients' quality of life, and depression occurs more often in patients with psoriasis. However, data have shown that psoriasis is a systemic disease which affects the joints, vasculature, and other tissues...

  18. Criticality of timing for anti-HIV therapy initiation.

    Directory of Open Access Journals (Sweden)

    Filippo Castiglione

    Full Text Available The time of initiation of antiretroviral therapy in HIV-1 infected patients has a determinant effect on the viral dynamics. The question is, how far can the therapy be delayed? Is sooner always better? We resort to clinical data and to microsimulations to forecast the dynamics of the viral load at therapy interruption after prolonged antiretroviral treatment. A computational model previously evaluated, produces results that are statistically adherent to clinical data. In addition, it allows a finer grain analysis of the impact of the therapy initiation point to the disease course. We find a swift increase of the viral density as a function of the time of initiation of the therapy measured when the therapy is stopped. In particular there is a critical time delay with respect to the infection instant beyond which the therapy does not affect the viral rebound. Initiation of the treatment is beneficial because it can down-regulate the immune activation, hence limiting viral replication and spread.

  19. Cyclosporine as Monotherapy for Psoriasis in the Setting of Chronic HCV Infection: A Forgotten Therapeutical Option

    Directory of Open Access Journals (Sweden)

    Alexandra Maria Giovanna Brunasso

    2012-05-01

    Full Text Available Background: Treatment of psoriasis in the setting of chronic hepatitis C virus (HCV infection is diffcult, because standard therapies like methotrexate are associated with increased hepatic toxicity. Due to the HCV suppressive effect. Cyclosporine may represent a valid systemic alternative for psoriatic-HCV patients.Objectives: In this study, we report the successful usage of intermittent cycles of cyclosporine in the setting of chronic HCV infection and we try to call the attention once again in a very effective and forgotten therapeutic option for severe chronic plaque psoriasis.Observation: We describe a 48 years - old patient who has a 20 year history of severe chronic plaque psoriasis and HCV infection (aminotransferase levels are three times normal; HCV genotype 2a-2c and HCV-RNA titer of 2.050.000 UI-ml. Five courses (range of duration of three to six months of oral cyclosporine (5 mg/kg/day were followed during a 38 month period. The viral load and the transaminases’ levels diminished during the 38 months of intermittent cyclosporine therapy to the lowest level measured at 36th month. The good psoriatic response was associated to a slight improvement of the liver condition, even though the HCV-RNA was reduced by less than 1 log10 without normalization of aminotransferase’ levels.Conclusions: The reduced liver toxicity, the potential anti-HCV properties and the well-known systemic anti-inflammatory effect, make cyclosporine a good alternative for recalcitrant psoriatic patients with HCV-liver disease.

  20. Patient-relevant treatment goals in psoriasis.

    Science.gov (United States)

    Blome, Christine; Gosau, Ramona; Radtke, Marc A; Reich, Kristian; Rustenbach, Stephan J; Spehr, Christina; Thaçi, Diamant; Augustin, Matthias

    2016-03-01

    Patient-oriented care requires therapeutic decisions to agree with the patients' treatment needs and goals. This study addressed the following questions: What is important to psoriasis patients starting systemic treatment? How stable are these preferences within the first year of treatment? Are treatment goals associated with age, gender, or treatment success? The importance of treatment goals was assessed for patients with moderate-to-severe psoriasis in the German Psoriasis Registry (PsoBest) at baseline (onset of a systemic treatment; n = 3066) and at a 1-year follow-up (n = 1444) using the Patient Benefit Index (PBI). Treatment success was measured with PBI global score and Psoriasis Area Severity Index (PASI). Patients with moderate-to-severe psoriasis pursued a wide range of different goals. The most general treatment goals were rated most relevant, including skin healing and quick skin improvement (94.8/94.5 % "quite" or "very" important), confidence in the therapy (93.0 %), control over the disease (92.3 %), and a clear diagnosis and therapy (89.6 %). Further important goals related to not being in fear of the disease getting worse (84.8 %), reduction in itching (83.9 %), burning (70.6 %), and pain (60.6 %) as well as attaining a normal everyday life (78.4 %) and low treatment burden (64.2-77.9 %). Goals were mostly not associated with sex and gender. Goal importance slightly increased with treatment success. In a substantial proportion of patients (30.3-54.7 %) goal importance changed within 1 year after onset of systemic treatment. We conclude that treatment goal importance should be assessed in clinical practice on a regular basis. PMID:26688112

  1. The Curative Effect Analysis of Using"Acitretin unite NB-UVB'to Therapy Psoriasis Vulgaris%阿维A联合NB-UVB治疗寻常型银屑病的疗效分析

    Institute of Scientific and Technical Information of China (English)

    吕焱

    2014-01-01

    Objective:to observe the healing efficacy and safeness of using the method of "acitretin unite NB-UVB'to therapy psoria-sis.Methods:parting 60 psoriasis vulgaris patients into two groups and receiving the shine from NB -UVB three times a week .At the same time, the treatment group take oral treatment of acitretin two times a day with the dose of 10 mg .Then we decide the healing efficacy of the two groups after they receiving the therapy of 8 weeks.Results:the effective rate of treatment group is 90%, however, the control group 63.34%.The discrepancy has statistical significance .Conclusion:the method of “acitretin unite NB-UVB”to therapy psoriasis has good clinical efficacy with little untoward effect and deserve popularizing .%目的:观察阿维A联合NB-UVB照射治疗寻常型银屑病的疗效及安全性。方法:60例寻常银屑病患者随机分为2组,均予NB-UVB照射,3次/周。治疗组同时口服阿维A10mg(2次/d)。2组均治疗8周后判定疗效和随访6个月。结果:治疗组有效率90.0%,对照组63.34%,差异有统计学意义(P<0.05)。结论:阿维A联合NB-UVB照射治疗银屑病有很好的临床疗效,不良反应小,值得推广应用。

  2. Recent insights in nanotechnology-based drugs and formulations designed for effective anti-cancer therapy.

    Science.gov (United States)

    Piktel, Ewelina; Niemirowicz, Katarzyna; Wątek, Marzena; Wollny, Tomasz; Deptuła, Piotr; Bucki, Robert

    2016-01-01

    The rapid development of nanotechnology provides alternative approaches to overcome several limitations of conventional anti-cancer therapy. Drug targeting using functionalized nanoparticles to advance their transport to the dedicated site, became a new standard in novel anti-cancer methods. In effect, the employment of nanoparticles during design of antineoplastic drugs helps to improve pharmacokinetic properties, with subsequent development of high specific, non-toxic and biocompatible anti-cancer agents. However, the physicochemical and biological diversity of nanomaterials and a broad spectrum of unique features influencing their biological action requires continuous research to assess their activity. Among numerous nanosystems designed to eradicate cancer cells, only a limited number of them entered the clinical trials. It is anticipated that progress in development of nanotechnology-based anti-cancer materials will provide modern, individualized anti-cancer therapies assuring decrease in morbidity and mortality from cancer diseases. In this review we discussed the implication of nanomaterials in design of new drugs for effective antineoplastic therapy and describe a variety of mechanisms and challenges for selective tumor targeting. We emphasized the recent advantages in the field of nanotechnology-based strategies to fight cancer and discussed their part in effective anti-cancer therapy and successful drug delivery. PMID:27229857

  3. Adalimumab (TNF α Inhibitor) Therapy Exacerbates IgA Glomerulonephritis Acute Renal Injury and Induces Lupus Autoantibodies in a Psoriasis Patient.

    Science.gov (United States)

    Wei, S S; Sinniah, R

    2013-01-01

    Adalimumab (Humira) is a tumour necrosis factor α (TNF α ) inhibitor that is approved for the treatment of rheumatoid arthritis, psoriasis, psoriatic arthritis, Crohn's disease, ankylosing spondylitis, and juvenile idiopathic arthritis (Sullivan and Preda (2009), Klinkhoff (2004), and Medicare Australia). Use of TNF α inhibitors is associated with the induction of autoimmunity (systemic lupus erythematosus, vasculitis, and sarcoidosis or sarcoid-like granulomas) (Ramos-Casals et al. (2010)). We report a patient with extensive psoriasis presenting with renal failure and seropositive lupus markers without classical lupus nephritis after 18 months treatment with adalimumab. He has renal biopsy proven IgA nephritis instead. Renal biopsy is the key diagnostic tool in patients presenting with adalimumab induced nephritis and renal failure. He made a remarkable recovery after adalimumab cessation and steroid treatment. To our knowledge, this is a unique case of a psoriasis patient presenting with seropositive lupus markers without classical lupus nephritis renal failure and had renal biopsy proven IgA glomerulonephritis after receiving adalimumab.

  4. Infliximab for the treatment of plaque psoriasis

    Directory of Open Access Journals (Sweden)

    Jennifer S Gall

    2008-03-01

    Full Text Available Jennifer S Gall, Robert E KalbState University of New York at Buffalo, School of Medicine and Biomedical Sciences, Department of Dermatology, NY, USAAbstract: Infliximab is a monoclonal antibody that targets tumor necrosis factor-α (TNFα. It is used in the treatment of a number of inflammatory disorders including severe plaque psoriasis. TNFα is thought to have a major role in psoriasis by promoting an inflammatory infiltrate into the skin and inducing keratinocyte proliferation and preventing keratinocyte apoptosis, which directly contributes to the characteristic plaque skin lesions. Based on four randomized, placebo-controlled, double-blind clinical trials and nine open-label uncontrolled trials of the use of infliximab in plaque psoriasis, it was found that infliximab is a highly efficacious, rapid, sustainable, and relatively safe therapy. Yet as with any biologic, caution is recommended in its use as infusion reactions, lupus-like syndromes, infections, malignancies including lymphomas, as well as other rare events have been reported.Keywords: infliximab, psoriasis, plaque

  5. Clinical characteristics associated with illness perception in psoriasis.

    Science.gov (United States)

    Wahl, Astrid K; Robinson, Hilde S; Langeland, Eva; Larsen, Marie H; Krogstad, Anne-Lene; Moum, Torbjørn

    2014-05-01

    Knowledge of illness perception may aid the identification of groups of patients with a higher risk of coping poorly with the demands of their illness. This study aims to investigate associations between illness perception, clinical characteristics, patient knowledge, quality of life and subjective health in persons with psoriasis. The present study was based on cross-sectional data from patients awaiting climate therapy in Gran Canaria. We included 254 eligible patients (74%) who completed a questionnaire including the revised Illness Perception Questionnaire, the Psoriasis Knowledge Questionnaire, and the Dermatological Life Quality Index. Disease severity was measured using the Psoriasis Area and Severity Index. Several statistically significant associations between clinical characteristics, knowledge and various illness perception dimensions were found. Illness perception was also significantly related to disease-specific quality of life and subjective health. These findings contradict previous findings, which suggested that objective disease factors are not relevant to illness perception in psoriasis.

  6. Using microgravity for defining novel anti-atherosclerotic therapy

    NARCIS (Netherlands)

    Verhaar, A; Krishnadath, KK; Peppelenbosch, MP

    2005-01-01

    Among the most important insights into coronary and inflammatory disease is that the formation of vessel occluding placques is its essence an inflammatory process, that is counteracted by anti-inflammatory drugs Current therapeutical options of dealing with the increased challenge to public health p

  7. Long-term, continuous dosing of etanercept in patients with plaque psoriasis

    DEFF Research Database (Denmark)

    Papp, K.A.; Krueger, G.G.; Jemec, G.B.E.;

    2011-01-01

    Psoriasis, a chronic inflammatory skin disease, is characterized by periods of remission and relapse of lesions. Etanercept is approved for treatment of moderate-to-severe plaque psoriasis (25 mg twice weekly or 50 mg weekly). This review of three clinical trials evaluated the efficacy and safety...... of long-term, continuous (≥48 weeks) etanercept therapy in 1887 subjects with moderate-to-severe psoriasis (total exposure: 2458.0 subject-years). Efficacy end points across the three studies included: percent subjects achieving improvement of ;ge75% from baseline in the Psoriasis Area and Severity Index......; mean percentage improvement from baseline of Psoriasis Area and Severity Index; mean Physician's Global Assessment psoriasis score; and Dermatology Life Quality Index total score (mean percentage improvement from baseline). Safety was also assessed. This article summarizes the sustained efficacy...

  8. Definition of treatment goals for moderate to severe psoriasis: a European consensus

    NARCIS (Netherlands)

    U. Mrowietz; K. Kragballe; K. Reich; P. Spuls; C.E.M. Griffiths; A. Nast; J. Franke; C. Antoniou; P. Arenberger; F. Balieva; M. Bylaite; O. Correia; E. Daudén; P. Gisondi; L. Iversen; L. Kemény; M. Lahfa; T. Nijsten; T. Rantanen; A. Reich; T. Rosenbach; S. Segaert; C. Smith; T. Talme; B. Volc-Platzer; N. Yawalkar

    2011-01-01

    Patients with moderate to severe psoriasis are undertreated. To solve this persistent problem, the consensus programme was performed to define goals for treatment of plaque psoriasis with systemic therapy and to improve patient care. An expert consensus meeting and a collaborative Delphi procedure w

  9. Definition of treatment goals for moderate to severe psoriasis: A European consensus

    NARCIS (Netherlands)

    U. Mrowietz (Ulrich); K. Kragballe (Knud); K. Reich (Reich, K.); P. Spuls; C.E.M. Griffiths; A. Nast (Alexander); J. Franke; A.C. Antoniou (Antonis); P. Arenberger (Petr); F. Balieva (Flora); M. Bylaite (Matilda); O. Correia; E. Daudén (Esteban); P. Gisondi (Paolo); L. Iversen; L. Kemény (Lajos); M. Lahfa (Mourad); T.E.C. Nijsten (Tamar); T. Rantanen; A. Reich; T. Rosenbach; S. Segaert (Siegfried); C. Smith; T. Talme (Toomas); B. Volc-Platzer (Beatrice); N. Yawalkar (Nikhil)

    2011-01-01

    textabstractPatients with moderate to severe psoriasis are undertreated. To solve this persistent problem, the consensus programme was performed to define goals for treatment of plaque psoriasis with systemic therapy and to improve patient care. An expert consensus meeting and a collaborative Delphi

  10. Combined anti-tumor necrosis factor-α therapy and DMARD therapy in rheumatoid arthritis patients reduces inflammatory gene expression in whole blood compared to DMARD therapy alone

    Directory of Open Access Journals (Sweden)

    Carl K Edwards

    2012-12-01

    Full Text Available Periodic assessment of gene expression for diagnosis and monitoring in rheumatoid arthritis (RA may provide a readily available and useful method to detect subclinical disease progression and follow responses to therapy with disease modifying anti-rheumatic agents (DMARDs or anti-TNF-α therapy. We used quantitative real-time PCR to compare peripheral blood gene expression profiles in active ("unstable" RA patients on DMARDs, stable RA patients on DMARDs, and stable RA patients treated with a combination of a DMARD and an anti-TNF-α agent (infliximab or etanercept to healthy human controls. The expression of 48 inflammatory genes were compared between healthy controls (N=122, unstable DMARD patients (N=18, stable DMARD patients (N=26, and stable patients on combination therapy (N=20. Expression of 13 genes was very low or undetectable in all study groups. Compared to healthy controls, patients with unstable RA on DMARDs exhibited increased expression of 25 genes, stable DMARD patients exhibited increased expression of 14 genes and decreased expression of five genes, and combined therapy patients exhibited increased expression of six genes and decreased expression of 10 genes. These findings demonstrate that active RA is associated with increased expression of circulating inflammatory markers whereas increases in inflammatory gene expression are diminished in patients with stable disease on either DMARD or anti-TNF-α therapy. Furthermore, combination DMARD and anti-TNF-α therapy is associated with greater reductions in circulating inflammatory gene expression compared to DMARD therapy alone. These results suggest that assessment of peripheral blood gene expression may prove useful to monitor disease progression and response to therapy.

  11. Psoriasis and psoriatic arthritis: Topical issues

    Directory of Open Access Journals (Sweden)

    Yulia Leonidovna Korsakova

    2012-09-01

    Full Text Available The topical issues of the diagnosis and treatment of psoriasis (Ps and psoriatic arthritis (PsA are discussed. The characteristics and treatments of Ps and the methods for the diagnosis of PsA in Ps are presented; the extraarticular manifestations of PsA, its radiological signs, criteria for a treatment response, the current principles of therapy, and prognosis in these patients are described.

  12. Amplification of the MET receptor drives resistance to anti-EGFR therapies in colorectal cancer

    Science.gov (United States)

    Bardelli, Alberto; Corso, Simona; Bertotti, Andrea; Hobor, Sebastijan; Valtorta, Emanuele; Siravegna, Giulia; Sartore-Bianchi, Andrea; Scala, Elisa; Cassingena, Andrea; Zecchin, Davide; Apicella, Maria; Migliardi, Giorgia; Galimi, Francesco; Lauricella, Calogero; Zanon, Carlo; Perera, Timothy; Veronese, Silvio; Corti, Giorgio; Amatu, Alessio; Gambacorta, Marcello; Diaz, Luis A.; Sausen, Mark; Velculescu, Victor E.; Comoglio, Paolo; Trusolino, Livio; Di Nicolantonio, Federica; Giordano, Silvia; Siena, Salvatore

    2014-01-01

    EGFR targeted monoclonal antibodies are effective in a subset of metastatic colorectal tumors (mCRC). Inevitably, all patients develop resistance, which occurs through emergence of KRAS mutations in approximately 50% of the cases. We show that amplification of the MET proto-oncogene is associated with acquired resistance in patients who do not develop KRAS mutations during anti-EGFR therapy. Amplification of the MET locus was present in circulating tumor DNA before relapse was clinically evident. Functional studies demonstrate that MET activation confers resistance to anti-EGFR therapy both in vitro and in vivo. Notably, in patient-derived CRC xenografts, MET amplification correlated with resistance to EGFR blockade which could be overcome by MET kinase inhibitors. These results highlight the role of MET in mediating primary and secondary resistance to anti-EGFR therapies in CRC and encourage the use of MET inhibitors in patients displaying resistance as a result of MET amplification. PMID:23729478

  13. Bone scintigraphy in psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.

    1980-08-01

    Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones.

  14. Does prolonged anti-inflammatory therapy reduce number of unnecessary repeat saturation prostate biopsy?

    OpenAIRE

    Giuseppe Candiano; Pietro Pepe; Francesco Pietropaolo; Francesco Aragona

    2013-01-01

    Introduction. The effect of a prolonged oral anti-inflammatory therapy on PSA values in patients with persistent abnormal PSA values after negative prostate biopsy (PBx) was evaluated. Material and methods. From September 2011 to September 2012, 70 patients (medi- an age 62 years), with persistent abnormal PSA values after negative extended PBx, were given an herbal extract with anti-inflammatory activity for 3 months (Lenidase®; 1 tablet daily constituted of baicalina, bromelina and esci...

  15. Toward Repurposing Metformin as a Precision Anti-Cancer Therapy Using Structural Systems Pharmacology

    OpenAIRE

    Thomas Hart; Shihab Dider; Weiwei Han; Hua Xu; Zhongming Zhao; Lei Xie

    2016-01-01

    Metformin, a drug prescribed to treat type-2 diabetes, exhibits anti-cancer effects in a portion of patients, but the direct molecular and genetic interactions leading to this pleiotropic effect have not yet been fully explored. To repurpose metformin as a precision anti-cancer therapy, we have developed a novel structural systems pharmacology approach to elucidate metformin’s molecular basis and genetic biomarkers of action. We integrated structural proteome-scale drug target identification ...

  16. Relation between the Peripherofacial Psoriasis and Scalp Psoriasis

    Science.gov (United States)

    Kim, Kyung Ho; Ahn, Ji Young; Park, Mi Youn

    2016-01-01

    Background Facial involvement of psoriasis is known to be one of the clinical manifestations that indicate the severity of the psoriasis and thought to be more closely associated with certain distribution. Centrofacial (CF) psoriasis has been suggested to be related with severity of systemic disease while peripherofacial (PF) psoriasis has been thought to have connection with scalp psoriasis. Objective To analyze the epidemiologic characteristics, clinical features and subjective feelings of patients with facial psoriasis and to find out relationship between scalp psoriasis and facial involvement according to the facial types. Methods One hundred nineteen facial psoriasis patients were categorized into 3 types according to the distribution: PF type, CF type and mixed facial (MF) type. Onset and duration of facial and scalp psoriasis, and their relationship were questioned. Severity and extent of psoriasis on whole body, face, and scalp were rated by clinicians. Results There was no significant difference of whole body psoriasis area and severity index (PASI) and body surface area (BSA) score but scalp PASI and BSA was much higher in PF psoriasis compared to CF psoriasis (scalp PASI, 17.9 vs. 10.1; p=0.005) (scalp BSA, 40.9 vs. 22.2; p=0.002). According to the questionnaire, patient's objective feeling about the spreading of scalp lesion to facial area was markedly more prominent in the patients with peripheral involvement (PF+MF, 90.1%; CF, 54.2%; ppsoriasis, PF psoriasis is closely associated with spreading of scalp lesion into the face rather than reflecting the disease severity. PMID:27489422

  17. Anti-VEGF Therapy and the Retina: An Update

    Directory of Open Access Journals (Sweden)

    Vikas Tah

    2015-01-01

    Full Text Available Ocular angiogenesis and macular oedema are major causes of sight loss across the world. Aberrant neovascularisation, which may arise secondary to numerous disease processes, can result in reduced vision as a result of oedema, haemorrhage, and scarring. The development of antivascular endothelial growth factor (anti-VEGF agents has revolutionised the treatment of retinal vasogenic conditions. These drugs are now commonly employed for the treatment of a plethora of ocular pathologies including choroidal neovascularisation, diabetic macular oedema, and retinal vein occlusion to name a few. In this paper, we will explore the current use of anti-VEGF in a variety of retinal diseases and the impact that these medications have had on visual outcome for patients.

  18. microRNAs in Psoriasis.

    Science.gov (United States)

    Hawkes, Jason E; Nguyen, Giang Huong; Fujita, Mayumi; Florell, Scott R; Callis Duffin, Kristina; Krueger, Gerald G; O'Connell, Ryan M

    2016-02-01

    Psoriasis is a chronic inflammatory skin condition resulting from a complex interplay among the immune system, keratinocytes, susceptibility genes, and environmental factors. However, the pathogenesis of psoriasis is not completely elucidated. microRNAs represent a promising class of small, noncoding RNA molecules that function to regulate gene expression. Although microRNA research in psoriasis and dermatology is still relatively new, evidence is rapidly accumulating for the role of microRNAs in the pathogenesis of psoriasis and other chronic inflammatory conditions. In this article, we present a comprehensive review of what is known about microRNAs and their role in the pathogenesis of psoriasis.

  19. Psoriasis and Co-morbidities

    Directory of Open Access Journals (Sweden)

    Ayla Gülekon

    2008-12-01

    Full Text Available Psoriasis is a chronic inflammatory skin disorder affecting about 1-3% of general population, is defined among Immune Mediated Inflammatory Disease (IMID since it develops with immune associated mechanisms. It has been proposed that the chronic inflammation in psoriasis have role in the development of metabolic and vascular disorders related with psoriasis and recent studies have focused on the psoriasis associating comorbidities and their mechanisms. Psoriasis comorbidities include psoriatic arthritis, Crohn’s disease, pustular disorders, metabolic syndrome, malignities, comorbidities related to treatments, pulmonary diseases, smoking, infections, impact on life quality and depression, and alcohol.

  20. Clinical efficacy and drug resistance of anti-epidermalgrowth factor receptor therapy in colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Colorectal cancer (CRC) ranked third in cancer relateddeath and its incidence has been increasing worldwide.In recent decades important therapeutic advances havebeen developed in treatment of metastatic CRC (mCRC),such as monoclonal antibodies against epidermal growthfactor receptor (anti-EGFR), which provided additionalclinical benefits in mCRC. However, anti-EGFR therapieshave limited usage due to approximately 95% ofpatients with KRAS mutated mCRC do not response toanti-EGFR treatment. Thus, KRAS mutation is predictiveof nonresponse to anti-EGFR therapies but it alone is nota sufficient basis to decide who should not be receivedsuch therapies because; approximately fifty percent(40%-60%) of CRC patients with wild-type KRASmutation also have poor response to anti-EGFR basedtreatment. This fact leads us to suspect that there mustbe other molecular determinants of response to anti-EGFR therapies which have not been identified yet. Currentarticle summarizes the clinical efficacy of anti-EGFRtherapies and also evaluates its resistance mechanisms.

  1. Isolated linear blaschkoid psoriasis.

    Science.gov (United States)

    Nasimi, M; Abedini, R; Azizpour, A; Nikoo, A

    2016-10-01

    Linear psoriasis (LPs) is considered a rare clinical presentation of psoriasis, which is characterized by linear erythematous and scaly lesions along the lines of Blaschko. We report the case of a 20-year-old man who presented with asymptomatic linear and S-shaped erythematous, scaly plaques on right side of his trunk. The plaques were arranged along the lines of Blaschko with a sharp demarcation at the midline. Histological examination of a skin biopsy confirmed the diagnosis of psoriasis. Topical calcipotriol and betamethasone dipropionate ointments were prescribed for 2 months. A good clinical improvement was achieved, with reduction in lesion thickness and scaling. In patients with linear erythematous and scaly plaques along the lines of Blaschko, the diagnosis of LPs should be kept in mind, especially in patients with asymptomatic lesions of late onset. PMID:27663156

  2. Varicella zoster meningitis complicating combined anti-tumor necrosis factor and corticosteroid therapy in Crohn's disease.

    Science.gov (United States)

    Ma, Christopher; Walters, Brennan; Fedorak, Richard N

    2013-06-01

    Opportunistic viral infections are a well-recognized complication of anti-tumor necrosis factor (TNF) therapy for inflammatory bowel disease (IBD). Cases of severe or atypical varicella zoster virus infection, both primary and latent reactivation, have been described in association with immunosuppression of Crohn's disease (CD) patients. However, central nervous system varicella zoster virus infections have been rarely described, and there are no previous reports of varicella zoster virus meningitis associated with anti-TNF therapy among the CD population. Here, we present the case of a 40-year-old male with severe ileocecal-CD who developed a reactivation of dermatomal herpes zoster after treatment with prednisone and adalimumab. The reactivation presented as debilitating varicella zoster virus meningitis, which was not completely resolved despite aggressive antiviral therapy with prolonged intravenous acyclovir and subsequent oral valacyclovir. This is the first reported case of opportunistic central nervous system varicella zoster infection complicating anti-TNF therapy in the CD population. This paper also reviews the literature on varicella zoster virus infections of immunosuppressed IBD patients and the importance of vaccination prior to initiation of anti-TNF therapy.

  3. Preclinical Assessment of the Efficacy of Anti-Angiogenic Therapies in Hepatocellular Carcinoma.

    Science.gov (United States)

    Barral, Matthias; Raballand, Annemilaï; Dohan, Anthony; Soyer, Philippe; Pocard, Marc; Bonnin, Philippe

    2016-02-01

    Diffuse hepatocellular carcinoma (HCC) is a complex affliction in which comorbidities can bias global outcome of cancer therapy. Better methods are thus warranted to directly assess effects of therapy on tumor angiogenesis and growth. As tumor angiogenesis is invariably associated with changes in local blood flow, we assessed the utility of ultrasound imaging in evaluation of the efficacy of anti-angiogenic therapy in a spontaneous transgenic mouse model of HCC. Blood flow velocities were measured monthly in the celiac trunk before and after administration of sorafenib or bevacizumab at doses corresponding to those currently used in clinical practice. Concordant with clinical experience, sorafenib, but not bevacizumab, reduced microvascular density and suppressed tumor growth relative to controls. Evolution of blood flow velocities correlated with microvascular density and with the evolution of tumor size. Ultrasound imaging thus provides a useful non-invasive tool for preclinical evaluation of new anti-angiogenic therapies for HCC. PMID:26626491

  4. Long term efficacy and safety of etanercept in the treatment of psoriasis and psoriatic arthritis

    OpenAIRE

    Menter, Alan

    2014-01-01

    Dario Kivelevitch, Bobbak Mansouri, Alan Menter Department of Dermatology, Baylor University Medical Center, Dallas, TX, USA Abstract: Psoriasis is a chronic, immune-mediated inflammatory disease affecting both the skin and joints. Approximately 20% of patients suffer a moderate to severe form of skin disease and up to 30% have joint involvement. Standard therapies for psoriasis include topical medications, phototherapy, and both oral systemic and biological therapies whereas therapies for p...

  5. Treating moderate to severe psoriasis - best use of biologics.

    LENUS (Irish Health Repository)

    Lynch, Maeve

    2014-02-01

    This review focuses on the efficacy, safety and best use of biologic agents in moderate-to-severe psoriasis. Recommendations from two recent guidelines are summarised. The NICE Guidelines 2012 provide recommendations on best practice for prescribing biologics. The German S3 Guidelines are based on a systematic review of published studies and report the efficacy of biologics and guidelines for treatment. Data on the safety of biologics are available for up to 5 years in psoriasis and are on the whole reassuring. Registry data is evolving and will provide data on safety to help inform long-term monitoring of patients with psoriasis on biologics agents. New anti-interleukin-17 (IL17) and anti-IL17RA biologics are in Phase 3 clinical trials and may prove to be more effective than existing biologics.

  6. THE MICROBIOLOGICAL EFFICACY ESTIMATION OF DIFFERENT TYPES OF CHRONIC PERIODONTITIS’ ANTI-INFLAMMATORY THERAPY

    Directory of Open Access Journals (Sweden)

    O.B. Ryba

    2008-09-01

    Full Text Available The article deals with microbiological status of patients with chronic generalized periodontitis of medium severity. On the basis of clinical and microbiological data the analysis of different methods efficacy of anti-inflammatory therapy was carried out. We studied antimicrobial effect of laser therapy, ozonotherapyandcombinations oflaser- ozonotherapyin comparison with influence ofchlorhexidine 0,2%. Combined laser and ozone influence on periodontium provided high antibacterial effect with increased local nonspecific resistance, and it extended remission term of patients with chronic periodontitis.

  7. Targeted treatment of psoriasis with adalimumab: a critical appraisal based on a systematic review of the literature

    OpenAIRE

    Jochen Schmitt; Gottfried Wozel

    2009-01-01

    Jochen Schmitt, Gottfried WozelDepartment of Dermatology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, GermanyAbstract: Psoriasis is a chronic inflammatory disease affecting 2% to 3% of the population in Western countries. Psoriasis is associated with limited quality of life, cardiovascular disease, and depression. The approval of injectable biological agents has revolutionized the management of moderate to severe psoriasis. Adalimumab is a human monoclonal anti...

  8. Advances in Pharmacogenetics of Topical Therapies for Psoriasis%银屑病局部治疗和遗传药理学的关系

    Institute of Scientific and Technical Information of China (English)

    孟祥光; 李智; 王先猛; 周宏灏

    2012-01-01

    Psoriasis is an inflammatory hy-perproliferative skin disease with a strong genetic susceptibility and influenced by genetic, im-munological and environmental factors. Because the topical treatment is characterized of low cost, proper efficiency and high safety , it is commonly selected for most patients with mild to moderate psoriasis. However, the pharmacogenetics studies on the topical treatment are sparse. This review summarizes the correlations between genetic factors and topical agents to provide the theoretical guidance for the personalized medication in psoriasis.%银屑病是一种炎症过度增生性皮肤病,有强烈的遗传易感性,主要受到遗传、免疫和环境的影响.由于大部分患者病情处于轻中度,所以相比全身治疗,局部治疗具有费用低、用药方便且安全性高的特点,因此具有更大的临床意义.然而,目前涉及银屑病局部治疗的遗传药理学研究却很少.本文主要对近几年银屑病局部治疗反应和遗传因素的关系进行一个较为全面的综述,以期为银屑病患者的个体化医学提供理论指导.

  9. Cell-wall-deficient bacteria: a major etiological factor for psoriasis?

    Institute of Scientific and Technical Information of China (English)

    WANG Guo-li; LI Xiu-yun; WANG Ming-yi; XIAO De-gui; ZHANG Yong-yu; YUAN Xiao-yan; WANG Qi-you; SONG Jian-jing

    2009-01-01

    Background Psoriasis is a common inflammatory skin disease, yet knowledge of the factors that may induce, trigger, or exacerbate psoriasis is not fully delineated. Recent advances have improved our understanding of the link between psoriasis and cell-wall-deficient bacteria (CWDB) infections. In the present study we assessed the prevalence of CWDB infection in patients with psoriasis.Methods The carriage rate of CWDB in the tonsil or pharynx of psoriasis patients, chronic tonsillitis patients and controls were investigated using hypertonic medium. Psoriasis patients with CWDB were randomly assigned to two groups and respectively treated with antibiotics or systemic therapy without antibiotic. Human peripheral blood mononuclear cells (PBMC) from psoriasis patients, chronic tonsillitis patients and control subjects were stimulated with bacteria antigens and extra-cellular levels of interferon-γ (IFN-γ) and interleukin (IL)-10 were measured in the supernatants using the ELISA technique, in vitro. Meanwhile, the proliferation ability of PBMC to respond to bacteria antigens was detected by MTT assay.Results CWDB were isolated from 74.2% of psoriasis patients, 23.5% of chronic tonsillitis patients and only 6.3% of controls. Antibiotic therapy was appropriate for approximately 80% of psoriasis patients with CWDB infection, and in only 8.9% psoriasis patients CWDB infection was detected after antibiotic therapy. Meanwhile, our study showed that CWDB and wide-type bacteria did remarkably enhance the production of IFN-γ, in vitro, and PBMC proliferation. Conclusion CWDB infection may be a virtual triggering factor in psoriasis by regulating T-cell activation.

  10. Anti-TNF therapy in Jordan: a focus on severe infections and tuberculosis

    Directory of Open Access Journals (Sweden)

    Alawneh KM

    2014-04-01

    Full Text Available Khaldoon M Alawneh,1 Mahmoud H Ayesh,1 Basheer Y Khassawneh,1 Salwa Shihadeh Saadeh,1 Mahmoud Smadi,2 Khaldoun Bashaireh31Department of Medicine, College of Medicine, King Abdullah University Hospital, 2College of Science, 3Department of Special Surgery, College of Medicine, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, JordanBackground: A high rate of infection has been reported in patients receiving treatment with anti-tumor necrosis factor (anti-TNF. This study describes the rate of and risk factors for serious infections in patients receiving anti-TNF agents in Jordan.Methods: This retrospective observational study was conducted at a large tertiary referral center in the north of Jordan. Between January 2006 and January 2012, 199 patients who received an anti-TNF agent (infliximab, adalimumab, or etanercept were included. Patients received the anti-TNF treatment for rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease, or other conditions. A serious infection was defined as any bacterial, viral, or fungal infection that required hospitalization, administration of appropriate intravenous antimicrobial therapy, and temporary withholding of anti-TNF treatment.Results: The mean duration of anti-TNF treatment was 26.2 months. Steroids were used in 29.1% of patients, while 54.8% were given additional immunosuppressant therapy (methotrexate or azathioprine. Only one anti-TNF agent was given in 70.4% of patients, while 29.6% received different anti-TNF agents for the duration of treatment. Serious infections were documented in 39 patients (19.6%, including respiratory tract infections (41%, urinary tract infections (30.8%, and skin infections (20.5%, and extrapulmonary tuberculosis in three patients (7.7%. Exposure to more than one anti-TNF agent was the only factor associated with a significant increase in the rate of infection (relative risk 1.9, 95% confidence interval 1.06–4.0, P=0

  11. Anti-angiogenesis therapies: their potential in cancer management

    OpenAIRE

    Andrew Eichholz; Shairoz Merchant; Gaya, Andrew M

    2010-01-01

    Andrew Eichholz, Shairoz Merchant, Andrew M GayaDepartment of Clinical Oncology, Guy’s and St. Thomas’ NHS Foundation Trust, London, United KingdomAbstract: Angiogenesis plays an important role in normal animal growth and development. This process is also vital for the growth of tumors. Angiogenesis inhibitors have a different mechanism of action to traditional chemotherapy agents and radiation therapy. The angiogenesis inhibitors can act synergistically with conventional ...

  12. Development of HIV vectors for anti-HIV gene therapy.

    OpenAIRE

    Poeschla, E; Corbeau, P; Wong-Staal, F

    1996-01-01

    Current gene therapy protocols for HIV infection use transfection or murine retrovirus mediated transfer of antiviral genes into CD4+ T cells or CD34+ progenitor cells ex vivo, followed by infusion of the gene altered cells into autologous or syngeneic/allogeneic recipients. While these studies are essential for safety and feasibility testing, several limitations remain: long-term reconstitution of the immune system is not effected for lack of access to the macrophage reservoir or the pluripo...

  13. Effect of weight loss on the severity of psoriasis

    DEFF Research Database (Denmark)

    Jensen, P; Zachariae, Claus; Christensen, R;

    2013-01-01

    Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis.......Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis....

  14. Anti-interleukin-1 therapy in the management of gout.

    Science.gov (United States)

    Schlesinger, Naomi

    2014-02-01

    Gout is the most common inflammatory arthritis in humans. Current treatment options to control the pain and inflammation of acute and chronic gout include nonsteroidal anti-inflammatory drugs, colchicine, and corticosteroids. However, patients are commonly unresponsive to, intolerant of, or have contraindications to current treatments. Interleukin-1 (IL-1), a proinflammatory cytokine, plays a major role in mediating gouty inflammation. This role of IL-1 has led investigators to explore a new class of anti-inflammatory drugs that inhibit IL-1 signal transduction. IL-1 inhibitors currently in trials for gout include anakinra, rilonacept, and canakinumab. Anakinra is an IL‑1 receptor antagonist that inhibits the activity of both IL‑1α and IL‑1β, rilonacept is a soluble decoy receptor and canakinumab is an anti‑IL‑1β monoclonal antibody. In case cohorts, anakinra was found to be efficacious in combating acute gout pain and inflammation, whereas rilonacept has been found to be efficacious for reducing the risk of recurrent attacks. Canakinumab has been shown to be efficacious in both reducing pain and inflammation in acute attacks, and for reducing the risk of recurrent attacks. All three IL-1 inhibitors are generally well tolerated. This article reviews the current IL-1 inhibitors and the results of trials in which they have been tested for the management of acute and chronic gouty inflammation.

  15. Genetics of Psoriasis and Pharmacogenetics of Biological Drugs

    Directory of Open Access Journals (Sweden)

    Rocío Prieto-Pérez

    2013-01-01

    Full Text Available Psoriasis is a chronic inflammatory disease of the skin. The causes of psoriasis are unknown, although family and twin studies have shown genetic factors to play a key role in its development. The many genes associated with psoriasis and the immune response include TNFα, IL23, and IL12. Advances in knowledge of the pathogenesis of psoriasis have enabled the development of new drugs that target cytokines (e.g., etanercept, adalimumab, and infliximab, which target TNFα, and ustekinumab, which targets the p40 subunit of IL23 and IL12. These drugs have improved the safety and efficacy of treatment in comparison with previous therapies. However, not all patients respond equally to treatment, possibly owing to interindividual genetic variability. In this review, we describe the genes associated with psoriasis and the immune response, the biological drugs used to treat chronic severe plaque psoriasis, new drugs in phase II and III trials, and current knowledge on the implications of pharmacogenomics in predicting response to these treatments.

  16. Successful treatment of psoriasis with ustekinumab in patients with multiple sclerosis.

    Science.gov (United States)

    Chang, Shurong; Chambers, Cindy J; Liu, Fu-Tong; Armstrong, April W

    2015-07-01

    Psoriasis is a chronic inflammatory disease, evolving from a complex interplay of genetic and environmental factors. In the recent years, we have seen much progress in understanding the immunopathogenesis of psoriasis, paving the way for new therapies with biologics. Currently, the most commonly used biologics in psoriasis are TNF inhibitors etanercept, infliximab and adalimumab, and the IL-12/23 inhibitor ustekinumab. As TNF inhibitors are contraindicated in patients with multiple sclerosis, ustekinumab remained the only biologic available for these patient before the recent approval of Secukinumab, an IL-17A inhibitor. Herein we report two patients with multiple sclerosis and comorbid psoriasis successfully treated with ustekinumab without progression of their multiple sclerosis. Our cases demonstrate that ustekinumab is a reasonably safe choice in this patient population. We also briefly reviewed new therapies currently under investigation, which will undoubtedly further expand our armamentarium for the treatment of psoriasis in patients with neuromuscular diseases.

  17. DIFFERENTIAL DIAGNOSIS OF ARTICULAR SYNDROME IN PSORIASIS

    OpenAIRE

    VAISOV ADKHAM SHAVKATOVICH; ALLAEVA MUASSAR JALALADINOVNA

    2015-01-01

    Articular syndrome in psoriasis is an urgent problem to date. By the way, not always articular syndrome in psoriasis is a manifestation of the disease. And so, below is a case osteochondropathy patient with psoriasis.

  18. Itchy, Scaly Skin? Living with Psoriasis

    Science.gov (United States)

    ... exit disclaimer . Subscribe Itchy, Scaly Skin? Living With Psoriasis The thick, red, scaly skin of psoriasis can ... Diet Itchy, Scaly Skin? Wise Choices Links Treating Psoriasis Doctors often use a trial-and-error approach ...

  19. A short history of anti-rheumatic therapy - V. Analgesics

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available The pharmacological treatment of pain has very ancient origins, when plant-derived products were used, including mandrake extracts and opium, a dried latex obtained from Papaver somniferum. In the XVI and XVII centuries opium came into the preparation of two compounds widely used for pain relief: laudanum and Dover’s powder. The analgesic properties of extracts of willow bark were then recognized and later, in the second half of the XIX century, experimental studies on chemically synthesized analgesics were planned, thus promoting the marketing of some derivatives of para-amino-phenol and pyrazole, the predecessors of paracetamol and metamizol. In the XX century, nonsteroidal anti-inflammatory drugs were synthesized, such as phenylbutazone, which was initially considered primarily a pain medication. The introduction on the market of centrally acting analgesics, such as tramadol, sometimes used in the treatment of rheumatic pain. is quite recent.

  20. Withdrawal of anti-tumour necrosis factor α therapy in inflammatory bowel disease.

    Science.gov (United States)

    Papamichael, Konstantinos; Vermeire, Severine

    2015-04-28

    Anti-tumour necrosis factor α (anti-TNFα) therapy is an established treatment in inflammatory bowel disease. However, this treatment is associated with high costs and the possibility of severe adverse events representing a true challenge for patients, clinicians and health care systems. Consequently, a crucial question is raised namely if therapy can be stopped once remission is achieved and if so, how and in whom. Additionally, in a real-life clinical setting, discontinuation may also be considered for other reasons such as the patient's preference, pregnancy, social reasons as moving to countries or continents with less access, or different local policy or reimbursement. In contrast to initiation of anti-TNFα therapy guidelines regarding stopping of this treatment are missing. As a result, the decision of discontinuation is still a challenging aspect in the use of anti-TNFα therapy. Currently this is typically based on an estimated, case-by-case, benefit-risk ratio. This editorial is intended to provide an overview of recent data on this topic and shed light on the proposed drug withdrawal strategies. PMID:25944990

  1. Dual-targeting anti-angiogenic cyclic peptides as potential drug leads for cancer therapy

    Science.gov (United States)

    Chan, Lai Yue; Craik, David J.; Daly, Norelle L.

    2016-01-01

    Peptide analogues derived from bioactive hormones such as somatostatin or certain growth factors have great potential as angiogenesis inhibitors for cancer applications. In an attempt to combat emerging drug resistance many FDA-approved anti-angiogenesis therapies are co-administered with cytotoxic drugs as a combination therapy to target multiple signaling pathways of cancers. However, cancer therapies often encounter limiting factors such as high toxicities and side effects. Here, we combined two anti-angiogenic epitopes that act on different pathways of angiogenesis into a single non-toxic cyclic peptide framework, namely MCoTI-II (Momordica cochinchinensis trypsin inhibitor-II), and subsequently assessed the anti-angiogenic activity of the novel compound. We hypothesized that the combination of these two epitopes would elicit a synergistic effect by targeting different angiogenesis pathways and result in improved potency, compared to that of a single epitope. This novel approach has resulted in the development of a potent, non-toxic, stable and cyclic analogue with nanomolar potency inhibition in in vitro endothelial cell migration and in vivo chorioallantoic membrane angiogenesis assays. This is the first report to use the MCoTI-II framework to develop a 2-in-1 anti-angiogenic peptide, which has the potential to be used as a form of combination therapy for targeting a wide range of cancers. PMID:27734947

  2. Tumor-associated fibroblasts as "Trojan Horse" mediators of resistance to anti-VEGF therapy.

    Science.gov (United States)

    Francia, Giulio; Emmenegger, Urban; Kerbel, Robert S

    2009-01-01

    While targeting VEGF has shown success against a number of human cancers, drug resistance has resulted in compromised clinical benefits. In this issue of Cancer Cell, Crawford et al. (2009) report that tumors resistant to anti-VEGF therapy stimulate tumor-associated fibroblasts to express proangiogenic PDGF-C, implicating it as a potential therapeutic target.

  3. Integrative biology approach identifies cytokine targeting strategies for psoriasis.

    Science.gov (United States)

    Perera, Gayathri K; Ainali, Chrysanthi; Semenova, Ekaterina; Hundhausen, Christian; Barinaga, Guillermo; Kassen, Deepika; Williams, Andrew E; Mirza, Muddassar M; Balazs, Mercedesz; Wang, Xiaoting; Rodriguez, Robert Sanchez; Alendar, Andrej; Barker, Jonathan; Tsoka, Sophia; Ouyang, Wenjun; Nestle, Frank O

    2014-02-12

    Cytokines are critical checkpoints of inflammation. The treatment of human autoimmune disease has been revolutionized by targeting inflammatory cytokines as key drivers of disease pathogenesis. Despite this, there exist numerous pitfalls when translating preclinical data into the clinic. We developed an integrative biology approach combining human disease transcriptome data sets with clinically relevant in vivo models in an attempt to bridge this translational gap. We chose interleukin-22 (IL-22) as a model cytokine because of its potentially important proinflammatory role in epithelial tissues. Injection of IL-22 into normal human skin grafts produced marked inflammatory skin changes resembling human psoriasis. Injection of anti-IL-22 monoclonal antibody in a human xenotransplant model of psoriasis, developed specifically to test potential therapeutic candidates, efficiently blocked skin inflammation. Bioinformatic analysis integrating both the IL-22 and anti-IL-22 cytokine transcriptomes and mapping them onto a psoriasis disease gene coexpression network identified key cytokine-dependent hub genes. Using knockout mice and small-molecule blockade, we show that one of these hub genes, the so far unexplored serine/threonine kinase PIM1, is a critical checkpoint for human skin inflammation and potential future therapeutic target in psoriasis. Using in silico integration of human data sets and biological models, we were able to identify a new target in the treatment of psoriasis.

  4. Is anti-platelet therapy interruption a real clinical issue? Its implications in dentistry and particularly in periodontics

    Directory of Open Access Journals (Sweden)

    Kumar A

    2009-01-01

    Full Text Available The use of anti-platelet therapy has reduced the mortality and morbidity of cardiovascular disease remarkably. A considerable number of patients presenting before a dentist or periodontist give a history of anti-platelet therapy. A clinical dilemma whether to discontinue the anti-platelet therapy or continue the same always confronts the practitioner. Diverse opinions exist regarding the management of such patients. While one group of researchers advise continuation of anti-platelet therapy rather than invite remote, but possible, thromboembolic events, another group encourages discontinuation for variable periods. This study aims at reviewing the current rationale of anti-platelet therapy and the various options available to a clinician, with regard to the management of a patient under anti-platelet therapy. Current recommendations and consensus favour no discontinuation of anti-platelet therapy. This recommendation, however, comes with a rider to use caution and consider other mitigating factors as well. With a large number of patients giving a history of anti-platelet therapy, the topic is of interest and helps a clinician to arrive at a decision.

  5. Anti-miR delivery strategies to bypass the blood-brain barrier in glioblastoma therapy

    Science.gov (United States)

    Kim, Dong Geon; Kim, Kang Ho; Seo, Yun Jee; Yang, Heekyoung; Marcusson, Eric G.; Son, Eunju; Lee, Kyoungmin; Sa, Jason K.; Lee, Hye Won; Nam, Do-Hyun

    2016-01-01

    Small non-coding RNAs called miRNAs are key regulators in various biological processes, including tumor initiation, propagation, and metastasis in glioblastoma as well as other cancers. Recent studies have shown the potential for oncogenic miRNAs as therapeutic targets in glioblastoma. However, the application of antisense oligomers, or anti-miRs, to the brain is limited due to the blood-brain barrier (BBB), when administered in the traditional systemic manner. To induce a therapeutic effect in glioblastoma, anti-miR therapy requires a robust and effective delivery system to overcome this obstacle. To bypass the BBB, different delivery administration methods for anti-miRs were evaluated. Stereotaxic surgery was performed to administer anti-Let-7 through intratumoral (ITu), intrathecal (ITh), and intraventricular (ICV) routes, and each method's efficacy was determined by changes in the expression of anti-Let-7 target genes as well as by immunohistochemical analysis. ITu administration of anti-miRs led to a high rate of anti-miR delivery to tumors in the brain by both bolus and continuous administration. In addition, ICV administration, compared with ITu administration, showed a greater distribution of the miR across entire brain tissues. This study suggests that local administration methods are a promising strategy for anti-miR treatment and may overcome current limitations in the treatment of glioblastoma in preclinical animal models. PMID:27102443

  6. Role of anti-thrombotic therapy for recurrent pregnancy loss due to anti-phospholipid syndrome

    International Nuclear Information System (INIS)

    Background: Recurrent pregnancy loss is a major health problem effecting 1 to 2% of women of reproductive age. Its causes range from chromosomal abnormalities to endocrinological factors and thrombophilia related factors. Treating thrombophilia s especially anti phospholipid syndrome with low dose aspirin and low molecular weight heparin improves foetal outcome. This study will add local data to already existing knowledge. Method: Sixty selected patients from gynaecology OPD of Aero Hospital with clinical and/or serological findings of anti phospholipid syndrome from February 2009 to January 2011 were given aspirin 75 mg once daily and enoxaparine 40 mg subcutaneously once daily from 6 - 8 weeks to 35 and 37 weeks respectively. Results : Ninety-three percent of patients achieved live birth. Out of these 75% patients delivered at term and 18% had preterm delivered. Four (7%) had early pregnancy loss and only one had early neonatal death due to extreme prematurity. None of patients experienced any major hemorrhagic complications . Conclusion: Use of low dose aspirin and low molecular weight heparin is safe in pregnancy and improve foetal outcome in patients with recurrent pregnancy loss due to anti phospholipids syndrome. (author)

  7. Use of fumaric acid esters in psoriasis

    Directory of Open Access Journals (Sweden)

    Roll Antonie

    2007-01-01

    Full Text Available Fumaric acid esters (FAE are chemical compounds derived from the unsaturated dicarbonic acid fumaric acid. The usage of FAEs in treatment of psoriasis was introduced in the late 1950′s. In the 1980s more standardized oral preparations of FAEs were developed containing dimethylfumarate(DMF and salts of monoethylfumarate(MEF as main compounds. In 1994, Fumaderm ® an enteric-coated tablet containing DMF and calcium, magnesium, and zinc salts of MEF was approved for the treatment of psoriasis in Germany and since then has become the most commonly used systemic therapy in this country. Fumaric acids have been proven to be an effective therapy in patients with psoriasis even though the mechanisms of action are not completely understood. About 50-70% of the patients achieve PASI 75 improvement within four months of treatment and without any long-term toxicity, immunosuppressive effects, or increased risk of infection or malignancy. Tolerance is limited by gastrointestinal side effects and flushing of the skin. This article reviews pharmacokinetics, uses, contraindications, dosages, and side effects of treatment with FAEs.

  8. Opportunities for improvement in anti-thrombotic therapy and other strategies for the management of acute coronary syndromes

    DEFF Research Database (Denmark)

    Bueno, Héctor; Sinnaeve, Peter; Annemans, Lieven;

    2016-01-01

    . Globally, 4738 (44.8%) were attended before hospitalization, 4241 (40.1%) had an ECG, 2119 (20%) received anti-platelet therapy and 101 STEMI patients (2%) fibrinolysis. In-hospital, 7944 patients (75.2%) received dual anti-platelet therapy, most often with clopidogrel (69.7%), and less with prasugrel (5....... CONCLUSION: This large international study shows room for improvement in use of anti-thrombotic drugs and other strategies for optimal management of ACS, including pre-hospital ECG and anti-thrombotic therapy. Regional practice differences not based on evidence or conditioned by economic constraints should...

  9. Predictive Biomarkers for Bevacizumab in Anti-tumor Therapy

    Directory of Open Access Journals (Sweden)

    Qingqing PAN

    2011-07-01

    Full Text Available Bevacizumab, the monoclonal antibody of vascular endothelial growth factor (VEGF has been applied to the therapy of several neoplasms, but an appropriate biomarker to predict the efficacy has not been found. Those markers can originate from peripheral circulation, tumor tissue and genes. Some researches have found that low level of vascular cell adhesion molecule-1 (VCAM-1, E-selectin, angiopoietin 2 (Ang-2 in circulation or carbonic anhydrase 9 (CA9, CD31-microvessel density (CD31-MVD in tumor tissue can predict better activity of bevacizumab. Moreover, high level of soluble VEGFR2 (sVEGFR2 in circulation or the ratio of phosphorylated-VEGFR2 (p-VEGFR2 and VEGFR2 in tumor tissue increasing has the same predictive function. As to the gene, VEGF-634 CC, VEGF-1498 TT and VEGFR2 H472Q are only related to the side effct. Thus more clinical tirals and basic researches should be performed to find out effective biomarkers in bevacizumab’s therapy.

  10. Dry powder inhalable formulations for anti-tubercular therapy.

    Science.gov (United States)

    Parumasivam, Thaigarajan; Chang, Rachel Yoon Kyung; Abdelghany, Sharif; Ye, Tian Tian; Britton, Warwick John; Chan, Hak-Kim

    2016-07-01

    Tuberculosis (TB) is an intracellular infectious disease caused by the airborne bacterium, Mycobacterium tuberculosis. Despite considerable research efforts, the treatment of TB continues to be a great challenge in part due to the requirement of prolonged therapy with multiple high-dose drugs and associated side effects. The delivery of pharmacological agents directly to the respiratory system, following the natural route of infection, represents a logical therapeutic approach for treatment or vaccination against TB. Pulmonary delivery is non-invasive, avoids first-pass metabolism in the liver and enables targeting of therapeutic agents to the infection site. Inhaled delivery also potentially reduces the dose requirement and the accompanying side effects. Dry powder is a stable formulation of drug that can be stored without refrigeration compared to liquids and suspensions. The dry powder inhalers are easy to use and suitable for high-dose formulations. This review focuses on the current innovations of inhalable dry powder formulations of drug and vaccine delivery for TB, including the powder production method, preclinical and clinical evaluations of inhaled dry powder over the last decade. Finally, the risks associated with pulmonary therapy are addressed. A novel dry powder formulation with high percentages of respirable particles coupled with a cost effective inhaler device is an appealing platform for TB drug delivery. PMID:27212477

  11. Anti-EGFR Therapy: Mechanism and Advances in Clinical Efficacy in Breast Cancer

    Directory of Open Access Journals (Sweden)

    John F. Flynn

    2009-01-01

    Full Text Available This review will focus on recent advances in the application of antiepidermal growth factor receptor (anti-EGFR for the treatment of breast cancer. The choice of EGFR, a member of the ErbB tyrosine kinase receptor family, stems from evidence pinpointing its role in various anti-EGFR therapies. Therefore, an increase in our understanding of EGFR mechanism and signaling might reveal novel targets amenable to intervention in the clinic. This knowledge base might also improve existing medical treatment options and identify research gaps in the design of new therapeutic agents. While the approved use of drugs like the dual kinase inhibitor Lapatinib represents significant advances in the clinical management of breast cancer, confirmatory studies must be considered to foster the use of anti-EGFR therapies including safety, pharmacokinetics, and clinical efficacy.

  12. Climatotherapy in Psoriasis

    Directory of Open Access Journals (Sweden)

    Sedat Özçelik

    2008-12-01

    Full Text Available Hydroclimatology is used successfully as a treatment modality for psoriasis, either solely or as an adjunct to more specific treatments. Climatotherapy is a type of treatment utilizing the atmosphere, temperature, humidity, sun light, sea water, thermo-mineral water and mud. Therapeutic effect is achieved through the combined action of sun light, sea water, and fresh air and, of combinations with spa water. Some elements such as selenium, magnesium, potassium, slica, calcium, sulfates, and sodium, found in water, are believed to be absorbed through the skin, and are also beneficial for the good therapeutic response to climatotherapy. Important climatotherapy centers for psoriasis in the world are Dead Sea, Kangal Hot Spring with Fish, Blue Lagoon, Black Sea-Bulgaria, and La Roche- Possay. Climatotherapy of psoriasis are alternative therapeutic options for the management of psoriasis. The promising results together with the combination of treatment and complete physical/mental recreation result in the growing popularity of these therapeutic options amongst the patients. However, further research and larger controlled studies are needed to evaluate the mechanism of action as well as to compare the efficacy of climatherapy to conventional therapeutic modalities.

  13. Cyclosporin A in psoriasis

    NARCIS (Netherlands)

    F. Heule (Freerk)

    1991-01-01

    textabstractAlthough a large therapeutic arsenal of conventional drugs is available to treat patients with psoriasis, a group of patients still exists that fulfill the inherent exclusion criteria or present with subjective or objective side-effects. This necessitates the need for controlled studies

  14. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2011-06-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  15. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2012-02-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  16. Anti-TNF-alpha therapy enhances the effects of enzyme replacement therapy in rats with mucopolysaccharidosis type VI.

    Directory of Open Access Journals (Sweden)

    Efrat Eliyahu

    Full Text Available BACKGROUND: Although enzyme replacement therapy (ERT is available for several lysosomal storage disorders, the benefit of this treatment to the skeletal system is very limited. Our previous work has shown the importance of the Toll-like receptor 4/TNF-alpha inflammatory pathway in the skeletal pathology of the mucopolysaccharidoses (MPS, and we therefore undertook a study to examine the additive benefit of combining anti-TNF-alpha therapy with ERT in a rat model of MPS type VI. METHODOLOGY/PRINCIPAL FINDINGS: MPS VI rats were treated for 8 months with Naglazyme® (recombinant human N-acetyl-galactosamine-4-sulfatase, or by a combined protocol using Naglazyme® and the rat-specific anti-TNF-alpha drug, CNTO1081. Both protocols led to markedly reduced serum levels of TNF-alpha and RANKL, although only the combined treatment reduced TNF-alpha in the articular cartilage. Analysis of cultured articular chondrocytes showed that the combination therapy also restored collagen IIA1 expression, and reduced expression of the apoptotic marker, PARP. Motor activity and mobility were improved by ERT, and these were significantly enhanced by combination treatment. Tracheal deformities in the MPS VI animals were only improved by combination therapy, and there was a modest improvement in bone length. Ceramide levels in the trachea also were markedly reduced. MicroCT analysis did not demonstrate any significant positive effects on bone microarchitecture from either treatment, nor was there histological improvement in the bone growth plates. CONCLUSIONS/SIGNIFICANCE: The results demonstrate that combining ERT with anti-TNF-alpha therapy improved the treatment outcome and led to significant clinical benefit. They also further validate the usefulness of TNF-alpha, RANKL and other inflammatory molecules as biomarkers for the MPS disorders. Further evaluation of this combination approach in other MPS animal models and patients is warranted.

  17. Randomised controlled trial examining the effect of exercise in people with rheumatoid arthritis taking anti-TNFα therapy medication.

    LENUS (Irish Health Repository)

    Reid, Angela

    2011-01-01

    Substantial progress has been made in the medical management of rheumatoid arthritis (RA) over the past decade with the introduction of biologic therapies, including anti-tumour necrosis factor alpha (anti-TNFα) therapy medications. However, individuals with RA taking anti-TNFα medication continue to experience physical, psychological and functional consequences, which could potentially benefit from rehabilitation. There is evidence that therapeutic exercise should be included as an intervention for people with RA, but to date there is little evidence of the benefits of therapeutic exercise for people with RA on anti-TNFα therapy medication. A protocol for a multicentre randomised controlled three-armed study which aims to examine the effect of dynamic group exercise therapy on land or in water for people with RA taking anti-TNFα therapy medication is described.

  18. Modulation of epidermal transcription circuits in psoriasis: new links between inflammation and hyperproliferation.

    Directory of Open Access Journals (Sweden)

    William R Swindell

    Full Text Available BACKGROUND: Whole-genome expression profiling has been used to characterize molecular-level differences between psoriasis lesions and normal skin. Pathway analysis, however, is complicated by the fact that expression profiles have been derived from bulk skin biopsies with RNA derived from multiple cell types. RESULTS: We analyzed gene expression across a large sample of psoriatic (PP and uninvolved/normal (PN skin biopsies (n = 215 patients. We identified 1975 differentially expressed genes, including 8 associated with psoriasis susceptibility loci. To facilitate pathway analysis, PP versus PN differences in gene expression were analyzed with respect to 235 gene modules, each containing genes with a similar expression pattern in keratinocytes and epidermis. We identified 30 differentially expressed modules (DEMs biased towards PP-increased or PP-decreased expression. These DEMs were associated with regulatory axes involving cytokines (e.g., IFN-γ, IL-17A, TNF-α, transcription factors (e.g., STAT1, NF-κB, E2F, RUNX1 and chromatin modifiers (SETDB1. We identified an interferon-induced DEM with genes encoding anti-viral proteins (designated "STAT1-57", which was activated in psoriatic epidermis but repressed following biologic therapy. Genes within this DEM shared a motif near the transcription start site resembling the interferon-stimulated response element (ISRE. CONCLUSIONS: We analyzed a large patient cohort and developed a new approach for delineating epidermis-specific pathways and regulatory mechanisms that underlie altered gene expression in psoriasis. Our findings highlight previously unrecognized "transcription circuits" that can provide targets for development of non-systemic therapies.

  19. Anti-oxidative therapy with oral dapsone improved HCV antibody positive annular elastolytic giant cell granuloma.

    Science.gov (United States)

    Igawa, K; Maruyama, R; Katayama, I; Nishioka, K

    1997-05-01

    A 72-year-old fisherman who was positive for the HCV antibody developed an annular, erythematous, infiltrated lesions on sun-exposed areas. The lesions were diagnosed as annular elastolytic giant cell granuloma both clinically and histologically. Topical corticosteroid and cryotherapy with liquid nitrogen for several months failed to improve the lesions. We then started dapsone, a known anti-oxidant, at 50 mg/day. A month later, the margins of the erythematous lesions faded, and the infiltration gradually decreased. No recurrence has been observed for one year after the start of the therapy. Anti-oxidative therapy appears to be effective for annular elastolytic giant cell granuloma and could be an alternate therapy for refractory granulomatous disease. PMID:9198323

  20. Psoriasis and Contact Sensitivitiy

    Directory of Open Access Journals (Sweden)

    Deniz Arlı

    2013-03-01

    Full Text Available Objective: The aim of this study was to investigate the frequency of contact sensitivity in patients with psoriasis, whether there was an association between clinical types and contact sensitivity, whether patch test is a factor that causes Koebner reaction and frequency of contact sensitivity against commonly used topical corticosteroids. Methods: Fifty patients with psoriasis and 50 healthy volunteers were included in this study and ‘European standard series' and test units of active ingredients of some corticosteroids were performed on their upper back. The patches were read on hours 24, 48 and on day 7 in order to detect delayed allergic reactions and also Koebner reaction. The results of both groups were compared by using chi-square test. Results: At the end of the patch test allergic reaction was observed in 7 of 50 (14% patients with psoriasis and 12 of 50 (24% healthy volunteers. There was no statistically significant difference between allergic reaction of study group and healthy volunteers. There was no statistically significant difference between the clinical types of psoriasis and allergic contact sensitivity. The frequency of reaction increased in individuals having a positive sensitivity history to any substance in both patient and control groups. Reaction to topical steroids was not seen in any patients. Koebner phenomenon due to patch test was also not seen in any patients. Conclusion: We did not show any association between psoriasis and contact sensitivity in this study. We believe that contact allergens should be determined by using patch test in psoriatic patients with a positive history to any substance.

  1. Targeting ryanodine receptors for anti-arrhythmic therapy

    Institute of Scientific and Technical Information of China (English)

    Mark D McCAULEY; Xander H T WEHRENS

    2011-01-01

    Antiarrhythmic drugs are a group of pharmaceuticals that suppress or prevent abnormal heart rhythms, which are often associated with substantial morbidity and mortality. Current antiarrhythmic drugs that typically target plasma membrane ion channels have limited clinical success and in some cases have been described as being pro-arrhythmic. However, recent studies suggest that pathological release of calcium (Ca2+) from the sarcoplasmic reticulum via cardiac ryanodine receptors (RyR2) could represent a promising target for antiarrhythmic therapy. Diastolic SR Ca2+ release has been linked to arrhythmogenesis in both the inherited arrhythmia synSeveral classes of pharmaceuticals have been shown to reduce abnormal RyR2 activity and may confer protection against triggered arrhythmias through reduction of SR Ca2+ leak. In this review, we will evaluate the current pharmacological methods for stabilizing RyR2 and suggest treatment modalities based on current evidence of molecular mechanisms.

  2. Magnetite Nanostructures as Novel Strategies for Anti-Infectious Therapy

    Directory of Open Access Journals (Sweden)

    Ioannis Liakos

    2014-08-01

    Full Text Available This review highlights the current situation of antimicrobial resistance and the use of magnetic nanoparticles (MNPs in developing novel routes for fighting infectious diseases. The most important two directions developed recently are: (i improved delivery of antimicrobial compounds based on a drastic decrease of the minimal inhibition concentration (MIC of the drug used independently; and (ii inhibition of microbial attachment and biofilm development on coated medical surfaces. These new directions represent promising alternatives in the development of new strategies to eradicate and prevent microbial infections that involve resistant and biofilm-embedded bacteria. Recent promising applications of MNPs, as the development of delivery nanocarriers and improved nanovehicles for the therapy of different diseases are discussed, together with the mechanisms of microbial inhibition.

  3. Human anti-nucleolin recombinant immunoagent for cancer therapy.

    Science.gov (United States)

    Palmieri, Dario; Richmond, Timothy; Piovan, Claudia; Sheetz, Tyler; Zanesi, Nicola; Troise, Fulvia; James, Cindy; Wernicke, Dorothee; Nyei, Fata; Gordon, Timothy J; Consiglio, Jessica; Salvatore, Francesco; Coppola, Vincenzo; Pichiorri, Flavia; De Lorenzo, Claudia; Croce, Carlo M

    2015-07-28

    Nucleolin (NCL) is a nucleocytoplasmic protein involved in many biological processes, such as ribosomal assembly, rRNA processing, and mRNA stabilization. NCL also regulates the biogenesis of specific microRNAs (miRNAs) involved in tumor development and aggressiveness. Interestingly, NCL is expressed on the surface of actively proliferating cancer cells, but not on their normal counterparts. Therefore, NCL is an attractive target for antineoplastic treatments. Taking advantage of phage-display technology, we engineered a fully human single-chain fragment variable, named 4LB5. This immunoagent binds NCL on the cell surface, it is translocated into the cytoplasm of target cells, and it abrogates the biogenesis of NCL-dependent miRNAs. Binding of 4LB5 to NCL on the cell surface of a variety of breast cancer and hepatocellular carcinoma cell lines, but not to normal-like MCF-10a breast cells, dramatically reduces cancer cell viability and proliferation. Finally, in orthotopic breast cancer mouse models, 4LB5 administration results in a significant reduction of the tumor volume without evident side effects. In summary, here we describe, to our knowledge, the first anti-NCL single-chain fragment variable displaying antineoplastic activity against established solid tumors, which could represent the prototype of novel immune-based NCL-targeting drugs with clinical potential as diagnostic and therapeutic tools in a wide variety of human cancers. PMID:26170308

  4. Human anti-nucleolin recombinant immunoagent for cancer therapy

    Science.gov (United States)

    Palmieri, Dario; Richmond, Timothy; Piovan, Claudia; Sheetz, Tyler; Zanesi, Nicola; Troise, Fulvia; James, Cindy; Wernicke, Dorothee; Nyei, Fata; Gordon, Timothy J.; Consiglio, Jessica; Salvatore, Francesco; Coppola, Vincenzo; Pichiorri, Flavia; De Lorenzo, Claudia; Croce, Carlo M.

    2015-01-01

    Nucleolin (NCL) is a nucleocytoplasmic protein involved in many biological processes, such as ribosomal assembly, rRNA processing, and mRNA stabilization. NCL also regulates the biogenesis of specific microRNAs (miRNAs) involved in tumor development and aggressiveness. Interestingly, NCL is expressed on the surface of actively proliferating cancer cells, but not on their normal counterparts. Therefore, NCL is an attractive target for antineoplastic treatments. Taking advantage of phage-display technology, we engineered a fully human single-chain fragment variable, named 4LB5. This immunoagent binds NCL on the cell surface, it is translocated into the cytoplasm of target cells, and it abrogates the biogenesis of NCL-dependent miRNAs. Binding of 4LB5 to NCL on the cell surface of a variety of breast cancer and hepatocellular carcinoma cell lines, but not to normal-like MCF-10a breast cells, dramatically reduces cancer cell viability and proliferation. Finally, in orthotopic breast cancer mouse models, 4LB5 administration results in a significant reduction of the tumor volume without evident side effects. In summary, here we describe, to our knowledge, the first anti-NCL single-chain fragment variable displaying antineoplastic activity against established solid tumors, which could represent the prototype of novel immune-based NCL-targeting drugs with clinical potential as diagnostic and therapeutic tools in a wide variety of human cancers. PMID:26170308

  5. Erythrodermic psoriasis: pathophysiology and current treatment perspectives

    Directory of Open Access Journals (Sweden)

    Singh RK

    2016-07-01

    Full Text Available Rasnik K Singh,1 Kristina M Lee,2 Derya Ucmak,2 Merrick Brodsky,3 Zaza Atanelov,4 Benjamin Farahnik,5 Michael Abrouk,3 Mio Nakamura,2 Tian Hao Zhu,6 Wilson Liao2 1Department of Medicine, University of California – Los Angeles, David Geffen School of Medicine, Los Angeles, 2Department of Dermatology, University of California – San Francisco, San Francisco, 3Department of Medicine, University of California – Irvine, School of Medicine, Irvine, CA, 4Department of Medicine, New York Medical College, Valhalla, NY, 5Department of Medicine, University of Vermont College of Medicine, Burlington, VT, 6Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA Abstract: Erythrodermic psoriasis (EP is a rare and severe variant of psoriasis vulgaris, with an estimated prevalence of 1%–2.25% among psoriatic patients. The condition presents with distinct histopathologic and clinical findings, which include a generalized inflammatory erythema involving at least 75% of the body surface area. The pathogenesis of EP is not well understood; however, several studies suggest that the disease is associated with a predominantly T helper 2 (Th2 phenotype. Given the morbidity and potential mortality associated with the condition, there is a need for a better understanding of its pathophysiology. The management of EP begins with a comprehensive assessment of the patient’s presentation and often requires multidisciplinary supportive measures. In 2010, the medical board of the US National Psoriasis Foundation published consensus guidelines advocating the use of cyclosporine or infliximab as first-line therapy in unstable cases, with acitretin and methotrexate reserved for more stable cases. Since the time of that publication, additional information regarding the efficacy of newer agents has emerged. We review the latest data with regard to the treatment of EP, which includes biologic therapies such as ustekinumab and

  6. Discontinuation of anti-VEGF cancer therapy promotes metastasis through a liver revascularization mechanism

    DEFF Research Database (Denmark)

    Yang, Yunlong; Zhang, Yin; Iwamoto, Hideki;

    2016-01-01

    The impact of discontinuation of anti-VEGF cancer therapy in promoting cancer metastasis is unknown. Here we show discontinuation of anti-VEGF treatment creates a time-window of profound structural changes of liver sinusoidal vasculatures, exhibiting hyper-permeability and enlarged open-pore sizes...... of the fenestrated endothelium and loss of VE-cadherin. The drug cessation caused highly leaky hepatic vasculatures permit tumour cell intravasation and extravasation. Discontinuation of an anti-VEGF antibody-based drug and sunitinib markedly promotes liver metastasis. Mechanistically, host hepatocyte......, but not tumour cell-derived vascular endothelial growth factor (VEGF), is responsible for cancer metastasis. Deletion of hepatocyte VEGF markedly ablates the 'off-drug'-induced metastasis. These findings provide mechanistic insights on anti-VEGF cessation-induced metastasis and raise a new challenge...

  7. The value of histopathological diagnosis in rupoid psoriasis accompanied by fever. A case report and a review of the literature

    Directory of Open Access Journals (Sweden)

    Morariu S.H.

    2014-12-01

    Full Text Available Psoriasis is a common dermatosis, however the rupoid type is considered as an exceptional form of this disease. Rupoid scabs are very rare in dermatological daily practice, usually being seen as secondary to syphilis in immunosuppressed patients. Rupoid psoriasis is characterized by thick and multilayered crusts that are resistant to local therapy and present a sudden onset. Severe arthropathy is a common manifestation. We did not found in literature any association of rupoid psoriasis with intermittent fever.

  8. Exacerbation of Skin Lesions in a 50 year old Man with Psoriasis during Treatment by Pegylated Interferon.

    Science.gov (United States)

    Sharifi, Amir Houshang; Fakharzadeh, Elham; Zamini, Hedyeh; Haj-Sheykholeslami, Arghavan; Jabbari, Hossain

    2012-01-01

    Chronic hepatitis C might lead to several immunological dysfunctions. Studies have shown a positive association between hepatitis C virus (HCV) infection and psoriasis. These results suggest that the infection may be one of the triggering factors for the development or exacerbation of psoriasis. Here, we present a case of chronic HCV infection with psoriasis who developed exacerbation of skin lesions during therapy with peginterferon alpha-2a plus ribavirin. We discuss the management, course and results of HCV treatment in this patient.

  9. A short history of anti-rheumatic therapy. III. Non steroidal anti-inflammatory drugs

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available The chemical advances of the 20th century led to the synthesis of non steroidal anti-inflammatory drugs (NSAIDs, beginning from phenylbutazone and indomethacin and continuing with other new drugs, including ibuprofen, diclofenac, naproxen, piroxicam and, more recently, the highly selective COX-2 inhibitors (coxibs. This progress derived from the discovery of the mechanism of action of these drugs: the inhibition of synthesis of prostaglandins due to the cycloxigenase enzyme system, according to the experimental contributions of John R. Vane.

  10. Evaluation of life quality in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Stojković Tatjana S.

    2015-01-01

    Full Text Available Psoriasis is a disease that has a profound impact on all aspects of life quality because over years patients are faced not only with poor health, but also with a number of restrictions imposed by the disease in their professional, social and emotional life. The aim of the study was to assess the level of impairment to the life quality in patients with chronic plaque psoriasis in relation to the clinical status of the disease, disease duration, and age and gender of the examinees. The cross-sectional study was conducted at the Clinic for Skin and Venereal Diseases of the Clinical Center of Niš. The total sample consisted of 142 examinees, 82 in the primary group (patients with psoriasis, and 60 in the control group (healthy volunteers. In order to assess the impact of psoriasis on life quality and compare it to the life quality of healthy population, the DLQI questionnaire (Dermatology Life Quality Indexwas used and the disease severity was estimated based on the value of the PASI score (Psoriasis Area and Severity Index. The results showed that the groups of examinees differ appreciably in self-assessment in all five dimensions of life quality. In patients with psoriasis, there was statistically significantly lower life quality as a reflection of the disease severity and subjective perceptions of the disease impact and treatment impact, but also as a result of a number of restrictions in daily functioning caused by the disease. Patients with a severer clinical status gave low ratings to their ability to function in all areas covered by the DLQI questionnaire, especially in the symptoms and feelings subscale. The results of our study indicate the importance of a multidisciplinary approach in the treatment of patients with psoriasis and the possibility of introducing a supportive therapy, which would, along with a regular dermatological therapy, notably improve the life quality of these patients.

  11. Designing anti-cancer drugs and directing anti-cancer therapy

    OpenAIRE

    Velasquez, Elinor; Soto-Andrade, Jorge; Bongalon, Ben

    2014-01-01

    A prototype for a web application was designed and implemented as a guide to be used by clinicians when designing the best drug therapy for a specific cancer patient, given biological data derived from the patients tumor tissue biopsy. A representation of the patients metabolic pathways is displayed as a graph in the application, with nodes as substrates and products and edges as enzymes. The top metabolically active sub- paths in the pathway, ranked using an algorithm based on both the patie...

  12. Antioxidative potential of a combined therapy of anti TNFα and Zn acetate in experimental colitis

    Institute of Scientific and Technical Information of China (English)

    Michela Barollo; Giacomo Carlo Sturniolo; Valentina Medici; Renata D'Incà; Antara Banerjee; Giuseppe Ingravallo; Marco Scarpa; Surajit Patak; Cesare Ruffolo; Romilda Cardin

    2011-01-01

    AIM: To evaluate whether combination therapy with anti-tumour necrosis factor α (TNFα). Zantibody and Zn acetate is beneficial in dextran sodium sulphate(DSS) colitis. METHODS: Colitis was induced in CD1-Swiss mice with 5% DS for 7 d. The exp erimental mice were th en randomised into the following subgroups: standard diet + DSS treated (induced colitis group); standard diet + DSS + subcutaneous 25. Μg anti-TNFα treated group; Zn acetate treated group + DSS + subcutaneous 25 μg anti-TNFα; standard diet + DS + subcut aneou s 6.25 μg anti-TNFα treated group and Zn acetate treated group + DS + subcut aneou s 6.25 μg anti-TNFα. Each group of mice was matched with a similar group of sham contro l animals. Macro scop ic and histo logical featur es were scor ed blindly. Homo genates of th e colonic mu cosa were assessed for myeloperoxidase activity as a biochemical marker of inflamm ation and DNA addu cts (8OHdG) as a measur e of ox idative damage. RESULTS: DSS produced submucosal erosions, ulcers, inflammatory cell infiltration and cryptic abscesses which were reduced in both groups of mice receiving either anti-TNFα alone or com bined with zinc. The effect was more pronounced in the latter group. .(vs Zn diet, P < 0.02).Myeloperoxidase activity (vs controls, P < 0.02) and DNA addu cts, greatly elevated in th e DSS fed colitis group (vs controls,. P < 0.05), were significantly redu ced in th e tr eated group s, with a mor e remarkable effect in the group receiving combined therapy (vs standard diet,. P < 0.04). CONCLUSION: DSS induces colonic inflammation which is modulated by the administration of anti-TNFα. Combining anti-TNFα Zwith Zn acetate offers marginal benefit in colitis severity.

  13. Antioxidative potential of a combined therapy of anti TNFα and Zn acetate in experimental colitis

    Science.gov (United States)

    Barollo, Michela; Medici, Valentina; D’Incà, Renata; Banerjee, Antara; Ingravallo, Giuseppe; Scarpa, Marco; Patak, Surajit; Ruffolo, Cesare; Cardin, Romilda; Sturniolo, Giacomo Carlo

    2011-01-01

    AIM: To evaluate whether combination therapy with anti-tumour necrosis factor α (TNFα) antibody and Zn acetate is beneficial in dextran sodium sulphate (DSS) colitis. METHODS: Colitis was induced in CD1-Swiss mice with 5% DSS for 7 d. The experimental mice were then randomised into the following subgroups: standard diet + DSS treated (induced colitis group); standard diet + DSS + subcutaneous 25 μg anti-TNFα treated group; Zn acetate treated group + DSS + subcutaneous 25 μg anti-TNFα; standard diet + DSS + subcutaneous 6.25 μg anti-TNFα treated group and Zn acetate treated group + DSS + subcutaneous 6.25 μg anti-TNFα. Each group of mice was matched with a similar group of sham control animals. Macroscopic and histological features were scored blindly. Homogenates of the colonic mucosa were assessed for myeloperoxidase activity as a biochemical marker of inflammation and DNA adducts (8OH-dG) as a measure of oxidative damage. RESULTS: DSS produced submucosal erosions, ulcers, inflammatory cell infiltration and cryptic abscesses which were reduced in both groups of mice receiving either anti-TNFα alone or combined with zinc. The effect was more pronounced in the latter group (vs Zn diet, P < 0.02). Myeloperoxidase activity (vs controls, P < 0.02) and DNA adducts, greatly elevated in the DSS fed colitis group (vs controls, P < 0.05), were significantly reduced in the treated groups, with a more remarkable effect in the group receiving combined therapy (vs standard diet, P < 0.04). CONCLUSION: DSS induces colonic inflammation which is modulated by the administration of anti-TNFα. Combining anti-TNFα with Zn acetate offers marginal benefit in colitis severity. PMID:22039323

  14. JAK Inhibitors: Treatment Efficacy and Safety Profile in Patients with Psoriasis

    Directory of Open Access Journals (Sweden)

    Leeyen Hsu

    2014-01-01

    Full Text Available Janus kinase (JAK pathways are key mediators in the immunopathogenesis of psoriasis. Psoriasis treatment has evolved with the advent of targeted therapies, which inhibit specific components of the psoriasis proinflammatory cascade. JAK inhibitors have been studied in early phase trials for psoriasis patients, and the data are promising for these agents as potential treatment options. Tofacitinib, an oral or topically administered JAK1 and JAK3 inhibitor, and ruxolitinib, a topical JAK1 and JAK2 inhibitor, have been most extensively studied in psoriasis, and both improved clinical symptoms of psoriasis. Additional JAK1 or JAK3 inhibitors are being studied in clinical trials. In phase III trials for rheumatoid arthritis, tofacitinib was efficacious in patients with inadequate responses to tumor necrosis factor inhibitors, methotrexate monotherapy, or disease-modifying antirheumatic drugs. The results of phase III trials are pending for these therapies in psoriasis, and these agents may represent important alternatives for patients with inadequate responses to currently available agents. Further investigations with long-term clinical trials are necessary to verify their utility in psoriasis treatment and assess their safety in this patient population.

  15. Psoriasis in the US Medicare Population: Prevalence, Treatment, and Factors Associated with Biologic Use.

    Science.gov (United States)

    Takeshita, Junko; Gelfand, Joel M; Li, Penxiang; Pinto, Lionel; Yu, Xinyan; Rao, Preethi; Viswanathan, Hema N; Doshi, Jalpa A

    2015-12-01

    Psoriasis is a common chronic inflammatory disorder, primarily of the skin. Despite an aging population, knowledge of the epidemiology of psoriasis and its treatments among the elderly is limited. We examined the prevalence of psoriasis and its treatments, with a focus on biologics and identification of factors associated with biologic use, using a nationally representative sample of Medicare beneficiaries in 2011. On the basis of several psoriasis identification algorithms, the claims-based prevalence for psoriasis in the United States ranged from 0.51 to 1.23%. Treatments used for moderate-to-severe psoriasis (phototherapy, oral systemic, or biologic therapies) were received by 27.3% of the total psoriasis sample, of whom 37.2% used biologics. Patients without a Medicare Part D low-income subsidy (LIS) had 70% lower odds of having received biologics than those with LIS (odds ratio 0.30; 95% confidence interval, 0.19-0.46). Similarly, the odds of having received biologics were 69% lower among black patients compared with white patients (0.31; 0.16-0.60). This analysis identified potential financial and racial barriers to receipt of biologic therapies and underscores the need for additional studies to further define the epidemiology and treatment of psoriasis among the elderly.

  16. Psoriasis in the U.S. Medicare population: prevalence, treatment, and factors associated with biologic use

    Science.gov (United States)

    Takeshita, Junko; Gelfand, Joel M.; Li, Penxiang; Pinto, Lionel; Yu, Xinyan; Rao, Preethi; Viswanathan, Hema N.; Doshi, Jalpa A.

    2015-01-01

    Psoriasis is a common chronic inflammatory disorder, primarily of the skin. Despite an aging population, knowledge of the epidemiology of psoriasis and its treatments among the elderly is limited. We examined the prevalence of psoriasis and its treatments, with a focus on biologics and identification of factors associated with biologic use, using a nationally representative sample of Medicare beneficiaries in 2011. Based on several psoriasis identification algorithms, the claims-based prevalence for psoriasis in the United States ranged from 0.51% to 1.23%. Treatments employed for moderate to severe psoriasis (phototherapy, oral systemic, or biologic therapies) were received by 27.3% of the total psoriasis sample, of whom 37.2% used biologics. Patients without Medicare Part D low-income subsidies had 70% lower odds of having received biologics than those with low-income subsidies (odds ratio 0.30; 95% confidence interval, 0.19– 0.46). Similarly, the odds of having received biologics was 69% lower among black patients than white patients (0.31; 0.16–0.60). This analysis identified potential financial and racial barriers to receipt of biologic therapies and underscores the need for additional studies to further define the epidemiology and treatment of psoriasis among the elderly. PMID:26214380

  17. Psoriasis and Associated Psychiatric Disorders

    Science.gov (United States)

    Abreu, José Luís Pio Da Costa; Reis, José Pedro Gaspar Dos; Figueiredo, Américo Manuel Da Costa

    2016-01-01

    Introduction and objective: Psoriasis is a chronic skin disease with a high impact on self-esteem and patients’ health-related quality of life. In the last decades some studies have pointed out mental disorders associated with psoriasis and the etiopathogenic mechanisms behind that co-existence. This work compiles psychopathology associated with psoriasis and further analyzes the etiopathogenesis of psoriasis and mental disorders. Methods: A systematic review of the literature was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and using the “5S” levels of organization of evidence from healthcare research, as previously described. Results: Psoriasis is linked with many mental disorders, both in the psychotic and neurotic sprectrum. Chronic stress diminishes hypothalamic-pituitary-adrenal axis and upregulates sympathetic-adrenal-medullary responses, stimulating pro-inflammatory cytokines. Then, it maintains and exacerbates psoriasis and some of its mental disorders. High levels of pro-inflammatory cytokines connect psoriasis, psychiatric conditions, and other comorbidities of psoriasis (such as atherosclerosis) within a vicious cycle. Furthermore, the etiopathogenesis of the link between each psychiatric comorbidity and psoriasis has its own subtleties, including the cooccurrence of other comorbidities, the parts of the body affected by psoriasis, treatments, and biological and psychosocial factors. Conclusion: The study of psychopathology can amplify our understanding about the etiopathogenesis of psoriasis and associated mental disorders. Patients would benefit from a psychodermatologic approach. The adequate treatment should take into account the mental disorders associated with psoriasis as well as the circumstances under which they occur.

  18. Mode of inheritance in psoriasis

    OpenAIRE

    Kumar Arvind; Mohan Lalit; Singh K.; Pandey O; Mukhija R

    1992-01-01

    One hundred and eighty patients of psoriasis and 100 controls were analysed to find out the genetic nature of psoriasis and if so, then to determine the possible mode of inheritance. The prevalence of psoriasis in relatives, percentage of positive family history and percentage of total affected relatives in the patient group was significantly higher than the controls, and clustering of affected relatives in patient group suggested genetic involvement. Ratio of affected and unaffected in the s...

  19. Anti-angiogenesis therapies: their potential in cancer management

    Directory of Open Access Journals (Sweden)

    Andrew Eichholz

    2010-05-01

    Full Text Available Andrew Eichholz, Shairoz Merchant, Andrew M GayaDepartment of Clinical Oncology, Guy’s and St. Thomas’ NHS Foundation Trust, London, United KingdomAbstract: Angiogenesis plays an important role in normal animal growth and development. This process is also vital for the growth of tumors. Angiogenesis inhibitors have a different mechanism of action to traditional chemotherapy agents and radiation therapy. The angiogenesis inhibitors can act synergistically with conventional treatments and tend to have non-overlapping toxicities. There are four drugs which have a proven role in treating cancer patients. Bevacizumab is a humanized monoclonal antibody that binds to and neutralizes vascular endothelial growth factor (VEGF. Sunitinib and sorafenib inhibit multiple tyrosine kinase receptors that are important for angiogenesis. Thalidomide inhibits the activity of basic fibroblast growth factor-2 (bFGF. The licensed indications and the supporting evidence are discussed. Other drugs are currently being tested in clinical trials and the most promising of these drugs are discussed. Aflibercept, also known as VEGF-trap, is a recombinant fusion protein that binds to circulating VEGF. The vascular disrupting agents act by targeting established blood vessels. These exciting new treatments have the potential to transform the management of cancer.Keywords: angiogenesis, bevacizumab, tyrosine kinase inhibitors, thalidomide, aflibercept, vascular disrupting agents

  20. Pityriasis versicolor during anti-TNF-α monoclonal antibody therapy: therapeutic considerations.

    Science.gov (United States)

    Balestri, Riccardo; Rech, Giulia; Piraccini, Bianca Maria; Antonucci, Angela; Ismaili, Alma; Patrizi, Annalisa; Bardazzi, Federico

    2012-09-01

    Anecdotal reports have shown that tumour necrosis factor (TNF)-α inhibition may cause unchecked superficial infection with the microorganisms responsible for pityriasis versicolor (PV). We observed several cases of PV, which is frequently resistant to topical therapies, in psoriatic patients undergoing anti-TNF-α monoclonal antibody therapy. To evaluate the incidence and the therapeutic management of PV in this group of individuals, between 1 January and 27 December 2010, we examined 153 psoriatic patients for the hypopigmented/hyperpigmented macular and scaling lesions associated with PV. All patients positive for PV were given topical therapy with miconazole nitrate cream twice daily for 28 days, after which they were re-evaluated. In patients non-responsive to topical therapy, we started systemic therapy with fluconazole, 300 mg week(-1) for 3 weeks. We diagnosed seven cases of PV. At the end of topical treatment, complete healing of lesions was observed in only one patient. In the other six patients, systemic treatment led to complete resolution of the infection. Although the onset of PV during anti-TNF-α therapy is seldom reported, it is not likely to be rare, but rather under-reported because of its limited pathological significance. In our opinion, the therapeutic management of this condition deserves greater consideration, as the use of topical treatments alone is largely ineffective compared with systemic treatment.

  1. Introducing Stereology as a Tool to Assess the Severity of Psoriasis

    DEFF Research Database (Denmark)

    Kamp, Søren; Stenderup, Karin; Rosada, Cecilia;

    2008-01-01

      The purpose of this study was to introduce stereology as a novel tool in assessing the severity of psoriasis. Psoriasis is a well described chronic inflammatory skin disease affecting approximately 2% of the Caucasian population.   The severity of psoriasis has been assessed by a multitude...... of clinical and histological tools in recent medical history. However, studies of the efficacy of potential anti-psoriatic drugs have been hampered by the lack of methods that are both objective and quantitative in nature. Stereology is a microscopy tool based on mathematical statistics applied...... to histological specimens in order to obtain three-dimensional properties from two-dimensional tissue samples. The psoriasis xenograft model used in this trial is accepted as a leading animal model for psoriasis. Psoriatic skin from psoriatic patients was grafted onto severe combined immunodeficient (SCID) mice...

  2. Comparative evaluation of NBUVB phototherapy and PUVA photochemotherapy in chronic plaque psoriasis

    OpenAIRE

    Dayal Surabhi; Mayanka; Jain V

    2010-01-01

    Background: Psoralen UV-A (PUVA) is an established therapy for psoriasis, but there is a well-documenated risk of melanoma and nonmelanoma skin cancer. Narrow-band Ultraviolet-B (NBUVB) therapy has a lower carcinogenic risk, has equal therapeutic potential and is considerably safe in the long term than PUVA. Aim: The aim of present study was to compare the efficacy and side-effects of PUVA and NBUVB in chronic plaque psoriasis. Methods: Sixty patients of chronic plaque psoriasis were taken up...

  3. Changing trends in anti-coagulant therapies. Are heparins and oral anti-coagulants challenged?

    Science.gov (United States)

    Fareed, J; Iqbal, O; Cunanan, J; Demir, M; Wahi, R; Clarke, M; Adiguzel, C; Bick, R

    2008-06-01

    The conventional management of thrombotic and cardiovascular disorders is based on the use of heparin, oral anticoagulants and aspirin. Despite progress in the sciences, these drugs still remain a challenge and mystery. The development of low molecular weight heparins (LMWHS) and the synthesis of heparinomimetics represent a refined use of heparin. Additional drugs will continue to develop. However, none of these drugs will ever match the polypharmacology of heparin. Aspirin still remains the leading drug in the management of thrombotic and cardiovascular disorders. The newer antiplatelet drugs such as adenosine diphosphate receptor inhibitors, GPIIb/IIIa inhibitors and other specific inhibitors have limited effects and have been tested in patients who have already been treated with aspirin. Warfarin provides a convenient and affordable approach in the long-term outpatient management of thrombotic disorders. The optimized use of these drugs still remains the approach of choice to manage thrombotic disorders. The new anticoagulant targets, such as tissue factor, individual clotting factors, recombinant forms of serpins (antithrombin, heparin co-factor II and tissue factor pathway inhibitors), recombinant activated protein C, thrombomodulin and site specific serine proteases inhibitors complexes have also been developed. There is a major thrust on the development of orally bioavailable anti-Xa and IIa agents, which are slated to replace oral anticoagulants. Both the anti-factor Xa and anti-IIa agents have been developed for oral use and have provided impressive clinical results. However, safety concerns related to liver enzyme elevations and thrombosis rebound have been reported with their use. For these reasons, the US Food and Drug Administration did not approve the orally active antithrombin agent Ximelagatran for several indications. The synthetic pentasaccharide (Fondaparinux) has undergone clinical development. Unexpectedly, Fondaparinux also produced major

  4. Triggering psoriasis: the role of infections and medications.

    Science.gov (United States)

    Fry, Lionel; Baker, Barbara S

    2007-01-01

    Psoriasis can be provoked or exacerbated by a variety of different environmental factors, particularly infections and drugs. Strong evidence exists for the induction of guttate psoriasis by a preceding tonsillar Streptococcus pyogenes infection, whereas disease exacerbation has been linked with skin and/or gut colonization by Staphylococcus aureus, Malassezia, and Candida albicans. The role, if any, of viruses (papillomaviruses, HIV, and endogenous retroviruses) present in lesional skin is at present unknown. The use of various drugs, such as lithium, beta-blockers, antimalarial agents, nonsteroidal anti-inflammatory drugs, and angiotensin-converting enzyme inhibitors, has also been associated with induction or worsening of disease in psoriatic patients.

  5. The effect of phototherapy on systemic inflammatory process in patients with plaque psoriasis.

    Science.gov (United States)

    Batycka-Baran, Aleksandra; Besgen, Petra; Wolf, Ronald; Szepietowski, Jacek C; Prinz, Joerg C

    2016-08-01

    Psoriasis is a common, chronic immune-mediated inflammatory disease. The inflammatory process in psoriasis has systemic effects and may influence the development of psoriatic comorbidities. The systemic action of phototherapy in patients with psoriasis has been so far poorly elucidated. We aimed to investigate the expression of genes encoding selected psoriasis-related cytokines in peripheral blood mononuclear cells (PBMCs) isolated from patients with psoriasis before and after treatment with phototherapy. 17 patients with mild to moderate plaque psoriasis were treated with narrow band-UVB (NB-UVB), 8 patients with moderate to severe plaque psoriasis with bath-psoralen-ultraviolet A therapy (PUVA). PBMCs were isolated by Ficoll gradient density centrifugation. Expression of genes encoding TNF-α, IL-17A, IL-6, IL-1 β, INF-γ, and IL-10 in PBMCs of patients with psoriasis before and after phototherapy was analyzed with quantitative RT-PCR. Treatment with NB-UVB therapy led to a significant decrease in IL-17A, TNF-α, and IL-6 mRNA levels in PBMCs (p=0.003; p=0.042; p=0.019, respectively). Following treatment with bath-PUVA therapy, we observed a significant decrease in TNF-α and IL-6 mRNA levels in PBMCs (p=0.031, p=0.035, respectively). Treatment with phototherapy in patients with psoriasis may affect systemic inflammation by downregulation of the expression of genes encoding proinflammatory cytokines in PBMCs, implicated in the development of psoriasis and psoriatic comorbidities. PMID:27314537

  6. The higher proportion of men with psoriasis treated with biologics may be explained by more severe disease in men.

    Directory of Open Access Journals (Sweden)

    David Hägg

    Full Text Available OBJECTIVES: Moderate to severe psoriasis, once regarded as merely a skin disease, is today seen as an inflammatory systemic disease. The sex ratio of the prevalence of psoriasis is balanced. In recent years several reports have documented that men receive more systemic or UV treatment than women, and different hypotheses were made. In PsoReg, the national registry for systemic treatment of psoriasis in Sweden, we have, like other European registries, observed a predominance of men (59%, especially of men treated with biologics (63%. Biologics are a relatively new group of very effective but high-priced drugs. The objective of this study was to analyse if women are discriminated by not having the same access to the high-priced biologics. DESIGN: Population based cohort study using data from a nationwide quality register of psoriasis patients. POPULATION: 2294 patients with moderate to severe psoriasis receiving systemic treatment from a specialist in dermatology. MAIN OUTCOME MEASURES: Time to initiation of biologic treatment. A multiple Cox proportional hazard's regression was performed, with time to initiating a biologic treatment as the outcome in order to assess the independent role of the patient's sex in initiating such therapy. The psoriasis severity was defined as a time-varying variable. RESULTS: Men had more severe psoriasis than women according to the Psoriasis Area and Severity Index (PASI, regardless of age at enrolment, and throughout the study period. The analysis in the multiple Cox regression show that age, psoriasis severity and psoriasis arthropathy were relevant factors for initiating biologic therapy, whereas sex is not. CONCLUSIONS: Although as many women as men are believed to suffer from psoriasis, men seem to be more severely affected by psoriasis. The asymmetry in allocation of biologic therapy thereby probably reflects the differing disease activity between the sexes, and is not a discrimination against women per se.

  7. Evidence that a neutrophil-keratinocyte crosstalk is an early target of IL-17A inhibition in psoriasis.

    Science.gov (United States)

    Reich, Kristian; Papp, Kim A; Matheson, Robert T; Tu, John H; Bissonnette, Robert; Bourcier, Marc; Gratton, David; Kunynetz, Rodion A; Poulin, Yves; Rosoph, Les A; Stingl, Georg; Bauer, Wolfgang M; Salter, Janeen M; Falk, Thomas M; Blödorn-Schlicht, Norbert A; Hueber, Wolfgang; Sommer, Ulrike; Schumacher, Martin M; Peters, Thomas; Kriehuber, Ernst; Lee, David M; Wieczorek, Grazyna A; Kolbinger, Frank; Bleul, Conrad C

    2015-07-01

    The response of psoriasis to antibodies targeting the interleukin (IL)-23/IL-17A pathway suggests a prominent role of T-helper type-17 (Th17) cells in this disease. We examined the clinical and immunological response patterns of 100 subjects with moderate-to-severe psoriasis receiving 3 different intravenous dosing regimens of the anti-IL-17A antibody secukinumab (1 × 3 mg/kg or 1 × 10 mg/kg on Day 1, or 3 × 10 mg/kg on Days 1, 15 and 29) or placebo in a phase 2 trial. Baseline biopsies revealed typical features of active psoriasis, including epidermal accumulation of neutrophils and formation of microabscesses in >60% of cases. Neutrophils were the numerically largest fraction of infiltrating cells containing IL-17 and may store the cytokine preformed, as IL-17A mRNA was not detectable in neutrophils isolated from active plaques. Significant clinical responses to secukinumab were observed 2 weeks after a single infusion, associated with extensive clearance of cutaneous neutrophils parallel to the normalization of keratinocyte abnormalities and reduction of IL-17-inducible neutrophil chemoattractants (e.g. CXCL1, CXCL8); effects on numbers of T cells and CD11c-positive dendritic cells were more delayed. Histological and immunological improvements were generally dose dependent and not observed in the placebo group. In the lowest-dose group, a recurrence of neutrophils was seen in some subjects at Week 12; these subjects relapsed faster than those without microabscesses. Our findings are indicative of a neutrophil-keratinocyte axis in psoriasis that may involve neutrophil-derived IL-17 and is an early target of IL-17A-directed therapies such as secukinumab.

  8. 理性情绪疗法对银屑病患者自尊状况的影响%Effect of rational emotive therapy in patients with psoriasis condition of self-esteem

    Institute of Scientific and Technical Information of China (English)

    农美英; 蒋维连; 戴玉琴

    2015-01-01

    Objective To study the effects of rational emotive therapy in patients with psoriasis condition of self-esteem. Methods From May 2012 to May 2014,100 cases of psoriasis patients in our hospital were randomly divided into the control group and the observation group. 50 patients in the control group were given the conventional nursing intervention. The rational emotive therapy including psychological diagnosis, understanding,working through,re-education and so on was used in the observation group. The State Self-Esteem Scale(SSES)was used to evaluate the level of self-esteem. Results In the observation group,the total score of self-esteem,behavioral self-esteem,social self-esteem and appearance self-esteem scores were(63. 48 ± 3. 86), (21. 78 ± 2. 62),(21. 81 ± 2. 86)and(19. 89 ± 2. 26),respectively. Those scores of the control group were (54. 40 ±3. 75),(19. 04 ± 2. 35),(19. 02 ± 2. 08)and(16. 36 ± 2. 03),respectively. There were statistical significances between two groups(t = - 9. 635,- 7. 265,- 7. 287,- 7. 435;P < 0. 05). Conclusions The rational emotive therapy can improve the level of self-esteem,life quality and the mental health of patients with psoriasis.%目的:探讨理性情绪疗法对银屑病患者自尊状况的影响。方法2012年5月—2014年5月选择100例银屑病患者,随机分为对照组和观察组,各50例,对照组按照常规护理模式进行干预,观察组在此基础上给予理性情绪疗法,包括心理诊断、领悟、修通、再教育等,干预前后采用状态自尊量表(SSES)对两组患者进行自尊状况评定。结果观察组干预后自尊总分为(63.48±3.86)分,行为自尊为(21.78±2.62)分,社会自尊为(21.81±2.86)分,外表自尊为(19.89±2.26)分,对照组分别为(54.40±3.75),(19.04±2.35),(19.02±2.08),(16.36±2.03)分,两组比较差异有统计学意义( t 值分别为-9.635,-7.265,-7.287,-7.435;P <0.05)。结

  9. Prevalence of interdigital psoriasis of the feet ("psoriasis alba") in mild, moderate, and severe psoriasis.

    Science.gov (United States)

    Leibovici, Vera; Lemster, Natalya; Ramot, Yuval; Siam, Rula; Siam, Ihab; Maly, Alex; Strauss-Liviatan, N; Hochberg, Malka

    2015-09-01

    Interdigital psoriasis of the feet ("psoriasis alba") is a rare form of inverse psoriasis. We conducted a cross-sectional study of the prevalence of interdigital psoriasis in mild, moderate, and severe psoriasis, compared to atopic dermatitis and normal controls. Data were collected during 2010-2013 from 232 psoriatic patients, 190 patients with atopic dermatitis, and 202 normal controls. The psoriatic and atopic dermatitis patients were from the dermatology department and outpatient clinic of the Hadassah-Hebrew University Medical Center in Jerusalem, Israel. The normal controls were healthy workers and volunteers from Hadassah Hospital who were not aware of any dermatological disease and had never consulted a general practitioner or dermatologist for skin problems of the feet. Our study revealed a prevalence of 2.6% of interdigital psoriasis of the feet in psoriatic patients, especially in men, and none in atopic dermatitis and normal controls. Three of the six affected patients with interdigital psoriasis of the feet complained of itching, both feet were involved in four patients, while two presented with additional palmoplantar psoriasis. The hematoxylin and eosin histopathological findings were in line with those found in inverse psoriasis. Dermatologists should be aware of this entity and treat it correctly. The diagnosis should be considered in psoriatic patients presenting with whitish plaque or patches in the toe-webs, in whom the fungal test is negative and are not responding to antimycotic treatment.

  10. Psoriasis and metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Aslı Günaydın

    2014-06-01

    Full Text Available Background and Design: Psoriasis is a chronic, inflammatory disease that occurs with poligenic and other triggering factors. Psoriasis which is accepted as a systemic disease has been verified to be associated with other diseases. Cardiovascular diseases, hepatosteatosis, obesity, diabetes mellitus, hypertension and hyperlipidemia are the ones that are the most significant. Material and Method: In thıs study fasting blood glucose, serum lipid levels (total cholesterol, HDL cholesterol, triglyceride, basal insulin levels, insulin resistances and body mass indexes, cigarette and alcohol habits of 50 adult patients are compared with the age and gender matched 50 nonpsoriatic controls. Conclusion: In our study, methabolic syndrome and its components diabetes mellitus, obesity, hypertension, dyslipidemia are found to be in higher rates in psoriatic group compared to nonpsoriatics.

  11. Sleep loss and cytokines levels in an experimental model of psoriasis.

    Directory of Open Access Journals (Sweden)

    Camila Hirotsu

    Full Text Available Up to 80% of people develop a cutaneous condition closely connected to their exposure to stressful life events. Psoriasis is a chronic recurrent inflammatory skin disorder with multifactorial etiology, including genetic background, environmental factors, and immune system disturbances with a strong cytokine component. Moreover, psoriasis is variably associated with sleep disturbance and sleep deprivation. This study evaluated the influence of sleep loss in the context of an animal model of psoriasis by measuring cytokine and stress-related hormone levels. Male adult Balb/C mice with or without psoriasis were subjected to 48 h of selective paradoxical sleep deprivation (PSD. Sleep deprivation potentiated the activities of kallikrein-5 and kallikrein-7 in the skin of psoriatic groups. Also, mice with psoriasis had significant increases in specific pro-inflammatory cytokines (IL-1β, IL-6 and IL-12 and decreases in the anti-inflammatory cytokine (IL-10 after PSD, which were normalized after 48 h of sleep rebound. Linear regression showed that IL-2, IL-6 and IL-12 levels predicted 66% of corticosterone levels, which were selectively increased in psoriasis mice subject to PSD. Kallikrein-5 was also correlated with pro-inflammatory cytokines, explaining 58% of IL-6 and IL-12 variability. These data suggest that sleep deprivation plays an important role in the exacerbation of psoriasis through modulation of the immune system in the epidermal barrier. Thus, sleep loss should be considered a risk factor for the development of psoriasis.

  12. Comparison of combination therapies in the treatment of rheumatoid arthritis: leflunomide-anti-TNF-alpha versus methotrexate-anti-TNF-alpha.

    Science.gov (United States)

    De Stefano, Renato; Frati, Elena; Nargi, Fernando; Baldi, Caterina; Menza, Luana; Hammoud, Mohammed; Galeazzi, Mauro

    2010-05-01

    To compare the efficacy and safety of leflunomide (LEF)-anti-TNF-alpha combination therapy to methotrexate (MTX)-anti-TNF-alpha combination therapy in a group of patients with active rheumatoid arthritis (RA). We have recruited 120 patients with RA with a high disease activity despite being treated with MTX (15 mg/week) or LEF (20 mg/die) for 3 months, without side effects. In each of these patients, therapy with either MTX or LEF was continued and randomly combined with an anti-TNF-alpha drug: etanercept, infliximab, or adalimumab. Patients were assessed at study entry and at 4, 12, and at 24 weeks. The efficacy endpoints included variations in the DAS28-ESR and the ACR20, ACR50, and ACR70 responses. At each visit, any side-effect was recorded. There were no statistically significant differences in the DAS28 variations and in the ACR responses between the two groups or among the six subgroups. The number of discontinuation due to the appearance of serious side effects was higher, but not statistically significant, in the LEF-anti-TNF-alpha group than in the MTX-anti-TNF-alpha group. Other adverse events that did not necessitate the discontinuation of therapy occurred much more frequently in patients treated with MTX than in those treated with LEF. Anti-TNF-alpha drugs can be used in combination not only with MTX, but also with LEF, with the same probability of achieving significant clinical improvement in RA patients and without a significantly greater risk of serious adverse events. In contrast, it seems that combination therapy with LEF-anti-TNF-alpha is more readily tolerated than combination therapy with MTX-anti-TNF-alpha.

  13. Ustekinumab for the treatment of psoriasis.

    Science.gov (United States)

    Laws, Philip M; Warren, Richard B

    2011-03-01

    Management of psoriasis over the last decade has changed significantly with the introduction of biological therapies. Ustekinumab is a first-in-class biological agent, inhibiting the action of IL-12 and IL-23, and has provided further evidence for the role of Th1 and Th17 lymphocytes in the pathogenesis of psoriasis. Efficacy has been clearly demonstrated in three Phase III clinical trials. Week 12 Psoriasis Area and Severity Index (PASI) 75 was observed in 66.4-75.7% of patients with PASI 90 achieved in 36.7-50.9%. This marked clinical response is also reflected in a significant improvement in quality of life. The most recent Phase III clinical trial has demonstrated the superior efficacy of ustekinumab (regardless of dosing regimen) compared with high-dose etanercept at week 12. Long-term efficacy has been demonstrated over 148 weeks with 64-76% of patients maintaining PASI 75. The role of ustekinumab in the treatment of psoriatic arthritis has shown some benefit in Phase II clinical trials. Phase III clinical trials are pending and will provide further guidance on management of concurrent disease. The currently available safety data are on the whole reassuring, although ongoing vigilance remains central to the detection of rare or late sequelae. PMID:21426253

  14. Evaluation of efalizumab using safe psoriasis control

    Directory of Open Access Journals (Sweden)

    Henninger Eric

    2006-09-01

    Full Text Available Abstract Background Safe Psoriasis Control (SPC is an important comprehensive measure that is validated for the assessment of benefit:risk of psoriasis treatments, combining efficacy, quality of life, and safety measures. The objective of this analysis was to assess the benefit:risk of efalizumab, a novel biologic agent indicated for the treatment of moderate-to-severe plaque psoriasis, by applying the SPC to data from randomized, placebo-controlled clinical studies of efalizumab. Methods SPC was applied to week 12 data from four placebo-controlled, Phase III studies: three retrospective and one prospective, the latter including a cohort of "high-need" patients for whom existing therapies were inadequate or unsuitable. Results In the retrospective analysis, 39.4% of patients achieved SPC after 12 weeks of treatment with efalizumab, compared with 10.4% for placebo. In the prospective analysis, 34.3% of patients achieved SPC after 12 weeks of treatment with efalizumab, compared with 7.3% on placebo. Among high-need patients, 33.0% achieved SPC, compared with 3.4% on placebo. Conclusion Efalizumab has a favorable benefit:risk profile using the comprehensive outcome measure SPC.

  15. Von zumbusch psoriasis

    OpenAIRE

    Von zumbusch psoriasis; Tamayo-Escobar Sebastián

    2012-01-01

    Psoriasis is a disease of the skin that is characterized by the presence of papular andscaly lesions. It is a clinical history of a woman of 38 years old who consulted forclinical manifestations of three days of evolution, consisting of sudden appearance oflesions such as erythematous, desquamative, confluents and widespread plaques thatreached to compromise more than 90% of the total body surface. These lesions wereof pruriginous and painful character. The patient had signs of systemic infla...

  16. PSYCHOLOGICAL FACTORS IN PSORIASIS

    OpenAIRE

    Chaudhury, S.; Das, A.L.; John, Ranjan T.; Ramadasan, P.

    1998-01-01

    This study compares the levels of anxiety, depression, alexithymia and stressful life events in 30 consecutive patients of psoriasis with equal number of age and sex matched normal controls, patients with fungal infections and patients with neurosis, Sinha′s anxiety scale, Hamilton′s depression rating scale, Toronto alexithymia scale and the presumptive stressful life events scale were used to measure anxiety, depression, alexithymia and stressful life events respectively Analysis revealed th...

  17. An Infantile Pustular Psoriasis Case Successfully Treated with Acitretin

    Directory of Open Access Journals (Sweden)

    Fatma Şule Afşar

    2010-03-01

    Full Text Available Generalized pustular psoriasis (GPP, which is characterized by fever, chills, rigors, and tiny sterile pustule formation on skin, is a rarely seen dermatose in childhood. Herein, we present a 20-months-old boy diagnosed with GPP based on the typical clinical and histopathological findings. The patient completely recovered after 2.5 months of oral acitretin therapy.

  18. Efficacy And Safety Of Methotrexate In Psoriasis A Reappraisal

    OpenAIRE

    Kanwar Amrinder J; Jaswal Ritu; Thami Gurvinder P

    2000-01-01

    Fifty five patients of extensive psoriasis were treated with oral weekly methotrexate. All patients responded promptly to methotrexate therapy. Relapse was observed after variable periods following stoppage of methotrexate. Safety, efficacy, maintenance dose, relapse and long term effects of methotrexate in psorasis are discussed.

  19. Recent advances in phototherapy for psoriasis [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Mio Nakamura

    2016-07-01

    Full Text Available Phototherapy involves repeated exposure of the skin to ultraviolet light to treat various inflammatory skin conditions such as psoriasis. Recent studies have identified specific immunologic effects of phototherapy that may underlie phototherapy efficacy. Furthermore, recent advancements have been made in developing safe and effective targeted phototherapy modalities for difficult-to-treat areas such as scalp psoriasis. Targeted phototherapy in the form of the excimer laser holds potential for more aggressive, effective treatment and long-lasting remission of psoriasis. Phototherapy is now also used successfully with biologic agents as combination therapy to treat recalcitrant psoriasis. Therefore, though one of the oldest therapeutic modalities for psoriasis, phototherapy remains a mainstay treatment with promise for further advancement.

  20. Exploring the Physiological Link between Psoriasis and Mood Disorders

    Directory of Open Access Journals (Sweden)

    Cody J. Connor

    2015-01-01

    Full Text Available Psoriasis is a chronic, immune-mediated skin condition with a high rate of psychiatric comorbidity, which often goes unrecognized. Beyond the negative consequences of mood disorders like depression and anxiety on patient quality of life, evidence suggests that these conditions can worsen the severity of psoriatic disease. The mechanisms behind this relationship are not entirely understood, but inflammation seems to be a key feature linking psoriasis with mood disorders, and physiologic modulators of this inflammation, including the hypothalamic-pituitary-adrenal axis and sympathetic nervous system, demonstrate changes with psychopathology that may be contributory. Cyclical disruptions in the secretion of the sleep hormone, melatonin, are also observed in both depression and psoriasis, and with well-recognized anti-inflammatory and antioxidant activity, this aberration may represent a shared contributor to both conditions as well as common comorbidities like diabetes and cardiovascular disease. While understanding the complexities of the biological mechanisms at play will be key in optimizing the management of patients with comorbid psoriasis and depression/anxiety, one thing is certain: recognition of psychiatric comorbidity is an imperative first step in effectively treating these patients as a whole. Evidence that improvement in mood decreases psoriasis severity underscores how psychological awareness can be critical to clinicians in their practice.

  1. Treatment of Psoriasis Vulgaris by Oral Administration of Yin Xie Ping Granules——A Clinical Report of 60 Cases

    Institute of Scientific and Technical Information of China (English)

    Chang Shan; Liu Yuan; Bo Xiuzhen; Qi Aiju

    2006-01-01

    @@ Psoriasis is a chronic and an easily recurrent dermatosis, with the characteristic red papules and patches covered with silvery scales especially on the outer aspects of the limbs, scalp, and back.1 The cause of the disease is not clear yet, and no satisfactory therapies are available for the treatment so far. We treated 60 cases of psoriasis vulgaris by oral administration of Yin Xie Ping Granules (银屑平颗粒 Granulae for Treating Psoriasis) from August 2004 to March 2005 with quite good results, with another 60 cases treated by taking Xiao Yin Pian (消银片 Tablets for Relieving Psoriasis) as the controls.A report follows.

  2. eIF4F is a nexus of resistance to anti-BRAF and anti-MEK cancer therapies.

    Science.gov (United States)

    Boussemart, Lise; Malka-Mahieu, Hélène; Girault, Isabelle; Allard, Delphine; Hemmingsson, Oskar; Tomasic, Gorana; Thomas, Marina; Basmadjian, Christine; Ribeiro, Nigel; Thuaud, Frédéric; Mateus, Christina; Routier, Emilie; Kamsu-Kom, Nyam; Agoussi, Sandrine; Eggermont, Alexander M; Désaubry, Laurent; Robert, Caroline; Vagner, Stéphan

    2014-09-01

    In BRAF(V600)-mutant tumours, most mechanisms of resistance to drugs that target the BRAF and/or MEK kinases rely on reactivation of the RAS-RAF-MEK-ERK mitogen-activated protein kinase (MAPK) signal transduction pathway, on activation of the alternative, PI(3)K-AKT-mTOR, pathway (which is ERK independent) or on modulation of the caspase-dependent apoptotic cascade. All three pathways converge to regulate the formation of the eIF4F eukaryotic translation initiation complex, which binds to the 7-methylguanylate cap (m(7)G) at the 5' end of messenger RNA, thereby modulating the translation of specific mRNAs. Here we show that the persistent formation of the eIF4F complex, comprising the eIF4E cap-binding protein, the eIF4G scaffolding protein and the eIF4A RNA helicase, is associated with resistance to anti-BRAF, anti-MEK and anti-BRAF plus anti-MEK drug combinations in BRAF(V600)-mutant melanoma, colon and thyroid cancer cell lines. Resistance to treatment and maintenance of eIF4F complex formation is associated with one of three mechanisms: reactivation of MAPK signalling, persistent ERK-independent phosphorylation of the inhibitory eIF4E-binding protein 4EBP1 or increased pro-apoptotic BCL-2-modifying factor (BMF)-dependent degradation of eIF4G. The development of an in situ method to detect the eIF4E-eIF4G interactions shows that eIF4F complex formation is decreased in tumours that respond to anti-BRAF therapy and increased in resistant metastases compared to tumours before treatment. Strikingly, inhibiting the eIF4F complex, either by blocking the eIF4E-eIF4G interaction or by targeting eIF4A, synergizes with inhibiting BRAF(V600) to kill the cancer cells. eIF4F not only appears to be an indicator of both innate and acquired resistance but also is a promising therapeutic target. Combinations of drugs targeting BRAF (and/or MEK) and eIF4F may overcome most of the resistance mechanisms arising in BRAF(V600)-mutant cancers.

  3. Use of nonsteroidal anti-inflammatory drugs prior to chronic renal replacement therapy initiation

    DEFF Research Database (Denmark)

    Fosbøl, Emil L; Kamper, Anne-Lise; Køber, Lars;

    2012-01-01

    PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be associated with severe renal complications, including acute renal failure, reduced glomerular filtration rate and interstitial nephritis. Caution against NSAIDs is therefore recommended in advanced chronic kidney disease. In this study......, we examined NSAID use, aetiology and comorbidity among a national cohort of patients before the initiation of chronic renal replacement therapy (RRT). METHODS: Patients initiated on chronic RRT in the period 1997-2006 were identified in the Danish National Registry on Regular Dialysis...

  4. Giving voice to service user choice: music therapy as an anti-oppressive practice

    OpenAIRE

    Baines, Susan

    2014-01-01

    peer-reviewed Societal structures create and maintain disparities between persons of dominant and non-dominant status affecting all aspects of the community including healthcare service delivery. Music therapists as healthcare providers have a responsibility to explore ways that social justice approaches can address and mitigate discrimination in music therapy education, research, and practice. Anti-oppressive practice (AOP) offers a systematic way to disassemble inequity in...

  5. CD8+ Cell Anti-HIV Activity Rapidly Increases Upon Discontinuation of Early Antiretroviral Therapy

    OpenAIRE

    Killian, M. Scott; Roop, Jeremy; Ng, Sharon; Frederick M Hecht; Levy, Jay A.

    2009-01-01

    CD8+ lymphocytes can suppress HIV replication without killing the infected cells. This CD8+ cell noncytotoxic anti-HIV response (CNAR) is associated with a beneficial clinical course. In this longitudinal study of 16 participants in the Options Project at UCSF, we measured the ability of CD8+ lymphocytes to suppress HIV replication in CD4+ cells during primary HIV infection, early antiretroviral therapy, and after treatment. CD8+ lymphocytes from subjects with untreated primary HIV-1 in...

  6. Translational approaches targeting the p53 pathway for anti-cancer therapy

    OpenAIRE

    Essmann, Frank; Schulze-Osthoff, Klaus

    2012-01-01

    The p53 tumour suppressor blocks cancer development by triggering apoptosis or cellular senescence in response to oncogenic stress or DNA damage. Consequently, the p53 signalling pathway is virtually always inactivated in human cancer cells. This unifying feature has commenced tremendous efforts to develop p53-based anti-cancer therapies. Different strategies exist that are adapted to the mechanisms of p53 inactivation. In p53-mutated tumours, delivery of wild-type p53 by adenovirus-based gen...

  7. Clients’ Satisfaction with Anti Retroviral Therapy Services at Hamidia Hospital Bhopal

    OpenAIRE

    Bhagat Vimal Kishor, Pal D K, Lodha Rama S, Bankwar Vishal

    2011-01-01

    Background: The HIV/AIDS pandemic is a major public health problem with an estimated 33.33 million people living with the virus globally. Free antiretroviral treatment was initiated in India 2004. Patients’ satisfaction is one of the commonly used outcome measures of patient care. Objective: To assess the satisfaction of people living with HIV/AIDS with services provided at anti retroviral therapy Centre Hamidia Hospital Bhopal. Material and Methods: A hospital based cross-sectional study was...

  8. Mathematical and numerical analysis of a model for anti-angiogenic therapy in metastatic cancers

    CERN Document Server

    Benzekry, Sebastien

    2010-01-01

    We introduce and analyze a phenomenological model for anti-angiogenic therapy in the treatment of metastatic cancers. It is a structured transport equation with a nonlocal boundary condition describing the evolution of the density of metastasis that we analyze first at the continuous level. We present the numerical analysis of a lagrangian scheme based on the characteristics whose convergence establishes existence of solutions. Then we prove an error estimate and use the model to perform interesting simulations in view of clinical applications.

  9. Is the Ratio of Antibodies Against Oxidized LDL to Oxidized LDL an Indicator of Cardiovascular Risk in Psoriasis?

    Directory of Open Access Journals (Sweden)

    Medha Rajappa

    2016-09-01

    Full Text Available Objectives: Psoriasis is a chronic inflammatory skin disease. Chronic inflammation results in increased oxidative stress and oxidizes lipoproteins, increasing their atherogenicity. This study sought to estimate the levels of oxidized low-density lipoprotein (ox-LDL and antibodies against oxidized LDL (anti-ox-LDL and compute the ratio of anti-ox-LDL/ox-LDL as a single composite parameter to assess the oxidative lipoprotein burden as an indicator of cardiovascular risk in patients with psoriasis. Methods: This cross-sectional study included 45 patients with psoriasis. All patients were given a psoriasis severity index score and their ox-LDL and anti-ox-LDL estimated using ELISA. Results: The results of this study show an elevation in the ratio of anti-ox-LDL to ox-LDL in patients with psoriasis, which initiate and perpetuate the pathogenesis of psoriasis and its comorbidity, atherosclerotic cardiovascular disease. Conclusions: Our results suggest that an elevated ratio of anti-ox-LDL/ox-LDL can serve as a composite parameter reflecting the total oxidative lipoprotein burden and cardiovascular risk in psoriasis patients.

  10. Moving Past Anti-VEGF: Novel Therapies for Treating Diabetic Retinopathy

    Science.gov (United States)

    Bolinger, Mark T.; Antonetti, David A.

    2016-01-01

    Diabetic retinopathy is the leading cause of blindness in working age adults, and is projected to be a significant future health concern due to the rising incidence of diabetes. The recent advent of anti-vascular endothelial growth factor (VEGF) antibodies has revolutionized the treatment of diabetic retinopathy but a significant subset of patients fail to respond to treatment. Accumulating evidence indicates that inflammatory cytokines and chemokines other than VEGF may contribute to the disease process. The current review examines the presence of non-VEGF cytokines in the eyes of patients with diabetic retinopathy and highlights mechanistic pathways in relevant animal models. Finally, novel drug targets including components of the kinin–kallikrein system and emerging treatments such as anti-HPTP (human protein tyrosine phosphatase) β antibodies are discussed. Recognition of non-VEGF contributions to disease pathogenesis may lead to novel therapeutics to enhance existing treatments for patients who do not respond to anti-VEGF therapies. PMID:27618014

  11. Moving Past Anti-VEGF: Novel Therapies for Treating Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Mark T. Bolinger

    2016-09-01

    Full Text Available Diabetic retinopathy is the leading cause of blindness in working age adults, and is projected to be a significant future health concern due to the rising incidence of diabetes. The recent advent of anti-vascular endothelial growth factor (VEGF antibodies has revolutionized the treatment of diabetic retinopathy but a significant subset of patients fail to respond to treatment. Accumulating evidence indicates that inflammatory cytokines and chemokines other than VEGF may contribute to the disease process. The current review examines the presence of non-VEGF cytokines in the eyes of patients with diabetic retinopathy and highlights mechanistic pathways in relevant animal models. Finally, novel drug targets including components of the kinin–kallikrein system and emerging treatments such as anti-HPTP (human protein tyrosine phosphatase β antibodies are discussed. Recognition of non-VEGF contributions to disease pathogenesis may lead to novel therapeutics to enhance existing treatments for patients who do not respond to anti-VEGF therapies.

  12. Adjuvant effect of anti-4-1BB mAb administration in adoptive T cell therapy of cancer

    Directory of Open Access Journals (Sweden)

    Qiao Li, Takekazu Iuchi, Maria N. Jure-Kunkel, Alfred E. Chang

    2007-01-01

    Full Text Available Administration of anti-4-1BB mAb has been found to be a potent adjuvant when combined with other therapeutic approaches, e.g. chemotherapy, cytokine therapies, anti-OX40 therapy, and peptide or DC vaccines. However, the adjuvant effect of anti-4-1BB mAb administration in adoptive T cell therapy of cancer has not been fully evaluated. In this report, effector T cells were generated in vitro by anti-CD3/anti-CD28 activation of tumor-draining lymph node (TDLN cells and used in an adoptive immunotherapy model. While T cells or anti-4-1BB alone showed no therapeutic efficacy in mice bearing macroscopic 10-day pulmonary metastases, T cells plus anti-4-1BB mediated significant tumor regression in an anti-4-1BB dose dependent manner. Mice bearing microscopic 3-day lung metastases treated with T cells alone demonstrated tumor regression which was significantly enhanced by anti-4-1BB administration. NK cell depletion abrogated the augmented therapeutic efficacy rendered by anti-4-1BB. Cell transfer between congenic hosts demonstrated that anti-4-1BB administration increased the survival of adoptively transferred TDLN cells. Using STAT4-/- mice, we found that modulated IFNγ secretion in wt TDLN cells after anti-CD3/CD28/4-1BB activation in vitro was lost in similarly stimulated STAT4-/- TDLN cells. Additionally, anti-4-1BB administration failed to augment the therapeutic efficacy of T cell therapy in STAT4-/- mice. Together, these results indicate that administered anti-4-1BB mAb can serve as an effective adjuvant to augment the antitumor reactivity of adoptively transferred T cells by recruiting the host NK cells; increasing the persistence of infused effector T cells, and modulating the STAT4 molecular signaling pathway.

  13. Asthma in patients with psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, A S; Skov, Lone; Skytthe, A;

    2015-01-01

    We read with interest the report by Fang and colleagues of the relationship between psoriasis and asthma in a large retrospective case-control study from Taiwan [1]. The study found a 1.38-fold increased risk of asthma among patients with psoriasis, and with an increasing risk according to higher...

  14. Interventions for nail psoriasis (Review)

    NARCIS (Netherlands)

    Vries, A.C. de; Bogaards, N.A.; Hooft, L.; Velema, M.; Pasch, M.C.; Lebwohl, M.; Spuls, P.I.

    2013-01-01

    BACKGROUND: Psoriasis is a common skin disease that can also involve the nails. All parts of the nail and surrounding structures can become affected. The incidence of nail involvement increases with duration of psoriasis. Although it is difficult to treat psoriatic nails, the condition may respond t

  15. The carboxyl terminus of VEGF-A is a potential target for anti-angiogenic therapy.

    Science.gov (United States)

    Carter, James G; Gammons, Melissa V R; Damodaran, Gopinath; Churchill, Amanda J; Harper, Steven J; Bates, David O

    2015-01-01

    Anti-VEGF-A therapy has become a mainstay of treatment for ocular neovascularisation and in cancer; however, their effectiveness is not universal, in some cases only benefiting a minority of patients. Anti-VEGF-A therapies bind and block both pro-angiogenic VEGF-Axxx and the partial agonist VEGF-Axxxb isoforms, but their anti-angiogenic benefit only comes about from targeting the pro-angiogenic isoforms. Therefore, antibodies that exclusively target the pro-angiogenic isoforms may be more effective. To determine whether C-terminal-targeted antibodies could inhibit angiogenesis, we generated a polyclonal antibody to the last nine amino acids of VEGF-A165 and tested it in vitro and in vivo. The exon8a polyclonal antibody (Exon8apab) did not bind VEGF-A165b even at greater than 100-fold excess concentration, and dose dependently inhibited VEGF-A165 induced endothelial migration in vitro at concentrations similar to the VEGF-A antibody fragment ranibizumab. Exon8apab can inhibit tumour growth of LS174t cells implanted in vivo and blood vessel growth in the eye in models of age-related macular degeneration, with equal efficacy to non-selective anti-VEGF-A antibodies. It also showed that it was the VEGF-Axxx levels specifically that were upregulated in plasma from patients with proliferative diabetic retinopathy. These results suggest that VEGF-A165-specific antibodies can be therapeutically useful. PMID:25274272

  16. Advances in individual markers of interferon in anti-cancer therapy

    Institute of Scientific and Technical Information of China (English)

    Chi Pan; Chenjing Zhang; Jianjin Huang

    2013-01-01

    Interferon (IFN) is a cytokine with various biological functions, including antivirus, immunoregulation and anti-tumor. It has been wildly used in many anti-cancer therapies, including malignant melanoma, hepatocellular carcinoma, ad-vanced renal-cell carcinoma, non-Hodgkin's lymphoma, chronic myelogenous leukemia and AIDS-related Kaposi's sarcoma. However, its effective dose is always very high, which may bring some serious side effects, nevertheless, not all patients can benefit from the IFN therapy. So a problem we have faced is that how to improve the efficiency and sensitivity of IFN? To solve this problem, many studies have been launched to find the effective prognostic factors and individual biomarkers for guiding the treatment better. In addition, further clarifying the anti-tumor mechanisms of IFN is benefit for explaining how the biomark-ers predict prognosis of patients. In recent studies, many IFN associated genes and proteins predicting sensitivity of IFN therapy have been found, which may associate with the progression of cancer, such as IFN regulatory factor (IRF), IFNAR2 mRNA, microRNA, IFITM-1. Some factors in peripheral blood are easier to detect and have the potential to been popularized in clinical practice, such as CD8high CD57+ lymphocyte levels in malignant melanoma, serum IFNAR2 mRNA in mCRC. This review briefly summarized the advances of antitumorally individual markers of IFN.

  17. Anti-interleukin-6 therapy through application of a monogenic protein inhibitor via gene delivery.

    Science.gov (United States)

    Görtz, Dieter; Braun, Gerald S; Maruta, Yuichi; Djudjaj, Sonja; van Roeyen, Claudia R; Martin, Ina V; Küster, Andrea; Schmitz-Van de Leur, Hildegard; Scheller, Jürgen; Ostendorf, Tammo; Floege, Jürgen; Müller-Newen, Gerhard

    2015-01-01

    Anti-cytokine therapies have substantially improved the treatment of inflammatory and autoimmune diseases. Cytokine-targeting drugs are usually biologics such as antibodies or other engineered proteins. Production of biologics, however, is complex and intricate and therefore expensive which might limit therapeutic application. To overcome this limitation we developed a strategy that involves the design of an optimized, monogenic cytokine inhibitor and the protein producing capacity of the host. Here, we engineered and characterized a receptor fusion protein, mIL-6-RFP-Fc, for the inhibition of interleukin-6 (IL-6), a well-established target in anti-cytokine therapy. Upon application in mice mIL-6-RFP-Fc inhibited IL-6-induced activation of the transcription factor STAT3 and ERK1/2 kinases in liver and kidney. mIL-6-RFP-Fc is encoded by a single gene and therefore most relevant for gene transfer approaches. Gene transfer through hydrodynamic plasmid delivery in mice resulted in hepatic production and secretion of mIL-6-RFP-Fc into the blood in considerable amounts, blocked hepatic acute phase protein synthesis and improved kidney function in an ischemia and reperfusion injury model. Our study establishes receptor fusion proteins as promising agents in anti-cytokine therapies through gene therapeutic approaches for future targeted and cost-effective treatments. The strategy described here is applicable for many cytokines involved in inflammatory and other diseases. PMID:26423228

  18. The concept of psoriasis as a systemic inflammation: implications for disease management.

    Science.gov (United States)

    Reich, K

    2012-03-01

    psoriasis. Tumour necrosis factor-α (TNF-α) inhibitors are known to counteract insulin resistance and emerging studies demonstrate an even higher protective effect of TNF-α antagonist therapy against the development of diabetes or CV co-morbidities in patients. The recent data reviewed here indicate a role for earlier and more appropriate treatment of psoriasis with drugs such as TNF-α antagonists. Such an approach has the potential to significantly improve patient outcomes through the treatment of psoriasis itself and possibly also in protection against co-morbidities. PMID:22356630

  19. [Influence of exogenous and endogenous factors on the course of psoriasis].

    Science.gov (United States)

    Trojacka, Ewelina; Zaleska, Martyna; Galus, Ryszard

    2015-03-01

    Psoriasis is a chronic, inflammatory disease, which symptoms appear mainly within the skin. Genetic and environmental factors are known to play a key role in etiopathogenesis of psoriasis. Therapy directed against psoriasis includes the topical and the systemic treatment. The immunotherapy (biologicals) is known to be relatively less harmful, due to action strictly against proinflammatory molecules, responsible in part for the progression of psoriasis. Because of substantial role of environmental factors in the etiopathogenesis of psoriasis, it is possible to get a clinical improvement of psoriatic lesions by modification of patients dietary habits and their lifestyle. Reduction of the calorific value of meals, the bodyweight reduction, the diet rich in unsaturated fats and antioxidants, likewise, abstinence and the reduction of stress level in everyday life, are known to have a positive effect on the course of psoriasis. It is stated that psoriatic patients are suffering from many other diseases e.g. cardiovascular, respiratory and hormonal diseases, whose treatment might exacerbate psoriasis. Thus, patients with psoriasis following the appropriate recommendations can greatly reduce disease progression.

  20. Smoking and risk for psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, Ann Sophie; Skov, Lone; Skytthe, Axel;

    2016-01-01

    BACKGROUND: Smoking is a potential risk factor for psoriasis. Both psoriasis and smoking habits are partly explained by genetic factors. However, twin studies investigating the association between these traits are limited. METHODS: Questionnaire-based data on smoking habits and psoriasis were...... collected for 34,781 twins, aged 20-71 years, from the Danish Twin Registry. A co-twin control analysis was performed on 1700 twin pairs discordant for lifetime history of smoking. Genetic and environmental correlations between smoking and psoriasis were estimated using classical twin modeling. RESULTS......: After multivariable adjustment, age group (50-71 vs. 20-49 years) and childhood exposure to environmental tobacco smoke (ETS) were significantly associated with psoriasis in the whole population (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.02-1.29 [P = 0.021] and OR 1.28, 95% CI 1.10-1.49 [P...

  1. Epidemiology of psoriasis: clinical issues.

    Science.gov (United States)

    Krueger, G G; Duvic, M

    1994-06-01

    Psoriasis is a genetically inherited spectrum of skin diseases characterized by epidermal proliferation and inflammation, which are reversible. Although many have reported that psoriasis is triggered by trauma, infections, stress, drugs, etc., the epidemiology of psoriasis remains poorly understood. Linkage to human leukocyte antigen-(HLA)-Cw6 and DR7 is strong in people with early onset disease, but concordance in monozygotic twins is only 67%, emphasizing the importance of a triggering event. Other factors that have been reported to affect the course of psoriasis include upper respiratory infections, smoking, obesity, alcohol ingestion, regional enteritis, and human immunodeficiency virus infection. This manuscript reviews the clinical epidemiology of psoriasis and highlights some of the needs for further investigation into specific areas of the disease.

  2. Therapies aimed at the gut microbiota and inflammation: antibiotics, prebiotics, probiotics, synbiotics, anti-inflammatory therapies.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2011-03-01

    Several recent observations have raised the possibility that disturbances in the gut microbiota and\\/or a low-grade inflammatory state may contribute to symptomatology and the etiology of irritable bowel syndrome (IBS). Consequent on these hypotheses, several therapeutic categories have found their way into the armamentarium of those who care for IBS sufferers. These agents include probiotics, prebiotics, antibiotics, and anti-inflammatory agents.

  3. Concordance of KRAS/BRAF Mutation Status in Metastatic Colorectal Cancer before and after Anti-EGFR Therapy

    Directory of Open Access Journals (Sweden)

    S. Gattenlöhner

    2009-01-01

    Full Text Available Anti-EGFR targeted therapy is a potent strategy in the treatment of metastatic colorectal cancer (mCRC but activating mutations in the KRAS gene are associated with poor response to this treatment. Therefore, KRAS mutation analysis is employed in the selection of patients for EGFR-targeted therapy and various studies have shown a high concordance between the mutation status in primary CRC and corresponding metastases. However, although development of therapy related resistance occurs also in the context of novel drugs such as tyrosine kinase-inhibitors the effect of the anti-EGFR treatment on the KRAS/BRAF mutation status itself in recurrent mCRC has not yet been clarified. Therefore, we analyzed 21 mCRCs before/after anti-EGFR therapy and found a pre-/posttherapeutic concordance of the KRAS/BRAF mutation status in 20 of the 21 cases examined. In the one discordant case, further analyses revealed that a tumor mosaicism or multiple primary tumors were present, indicating that anti-EGFR therapy has no influence on KRAS/BRAF mutation status in mCRC. Moreover, as the preselection of patients with a KRASwt genotype for anti-EGFR therapy has become a standard procedure, sample sets such ours might be the basis for future studies addressing the identification of potential anti-EGFR therapy induced genetic alterations apart from KRAS/BRAF mutations.

  4. Current trends in highly active anti-retroviral therapy in an anti-retroviral therapy centre attached to a remote government medical college of Maharashtra, India: a retrospective study

    OpenAIRE

    Pravin S. Rathod; Praveenkumar T Patil; Rekha P. Lohar; A.W. Patil

    2016-01-01

    Background: Highly active anti-retroviral therapy (HAART) became the keystone of national AIDS program. There is lack of awareness and inadequate training about drug safety monitoring among health care professionals in India. Hence, the present study was carried out to study current trends in HAART and pattern of associated adverse drug reactions. Methods: A retrospective observational study was conducted at an anti-retroviral therapy (ART) Centre. A total of 151 HIV/AIDS Patients (old and...

  5. Anti-CD20 as the B cells targeting agent in the combined therapy to modulate anti-factor VIII immune responses in hemophilia A inhibitor mice

    Directory of Open Access Journals (Sweden)

    Chao Lien eLiu

    2014-01-01

    Full Text Available Neutralizing antibody formation against transgene products can represent a major complication following gene therapy with treatment of genetic diseases, such as hemophilia A. Although successful approaches have been developed to prevent the formation of anti-factor VIII (FVIII antibodies, innovative strategies to overcome pre-existing anti-FVIII immune responses in FVIII-primed subjects are still lacking. Anti-FVIII neutralizing antibodies circulate for long periods in part due to persistence of memory B cells. Anti-CD20 targets a variety of B cells (pre-B cells to mature/memory cells; therefore, we investigated the impact of B cell depletion on anti-FVIII immune responses in hemophilia A mice using anti-CD20 combined with regulatory T (Treg cell expansion using IL-2/IL-2mAb complexes plus rapamycin. We found that anti-CD20 alone can partially modulate anti-FVIII immune responses in both unprimed and FVIII-primed hemophilia A mice. Moreover, in mice treated with anti-CD20 + IL-2/IL-2mAb complexes + rapamycin + FVIII, anti-FVIII antibody titers were significantly reduced in comparison to mice treated with regimens targeting only B or T cells. In addition, titers remained low after a second challenge with FVIII plasmid . Treg cells and activation markers were transiently and significantly increased in the groups treated with IL-2/IL-2mAb complexes ; however,significant B cell depletion was obtained in anti-CD20-treated groups. Importantly, both FVIII-specific antibody-secreting cells and memory B cells were significantly reduced in mice treated with combination therapy. This study demonstrates that a combination regimen is highly promising as a treatment option for modulating anti-FVIII antibodies and facilitating induction of long-term tolerance to FVIII in hemophilia A mice.

  6. HOSPITAL BASED STUDY ON CHILDHOOD PSORIASIS

    OpenAIRE

    Murugan; Adi Krishanan; Trishna; Krishnakanth; Anandan; Sudha,; Mahalakshni

    2015-01-01

    Childhood psoriasis is a distressing condition with significant social and psychological consequences. Childhood psoriasis being less reported entity, this study was undertaken to study the incidence, pattern and prevalence of childhood psoriasis. MATERIALS & METHODS: In this retrospective epidemiologic study, a complete analysis of OP Records of patients with psoriasis who attended the Psoriasis Clinic of dermatology OPD, during the period of 1 year from June 2014- June 2...

  7. Identification and Quantitative Characterization of PSORI-CM01, a Chinese Medicine Formula for Psoriasis Therapy, by Liquid Chromatography Coupled with an LTQ Orbitrap Mass Spectrometer

    Directory of Open Access Journals (Sweden)

    Shao-Dan Chen

    2015-01-01

    Full Text Available PSORI-CM01 is a Chinese medicine formula prepared from medicinal herbs and used in China for the treatment of psoriasis. However, the chemical constituents in PSORI-CM01 have not been clarified yet. In order to quickly define the chemical profiles and control the quality of PSORI-CM01 preparations, ultra-high liquid chromatography coupled with electrospray ionization hybrid linear trap quadrupole Orbitrap mass spectrometry (UHPLC-ESI-LTQ/Orbitrap-MS was applied for simultaneous identification and quantification of multiple constituents. A total of 108 compounds, including organic acids, phenolic acids, flavonoids, and terpenoids, were identified or tentatively deduced on the base of their retention behaviors, MS and MSn data, or by comparing with reference substances and literature data. In addition, an optimized UHPLC-ESI-MS method was established for the quantitative determination of 14 marker compounds in different dosage forms of PSORI-CM01 preparations. The validation of the method, including spike recoveries, linearity, sensitivity (LOQ, precision, and repeatability, was carried out and demonstrated to be satisfied the requirements of quantitative analysis. This is the first report on the comprehensive determination of chemical constituents in PSORI-CM01 preparations by UHPLC-ESI-LTQ/Orbitrap mass spectrometry. The results suggested that the established methods would be a powerful and reliable analytical tool for the characterization of multi-constituents in complex chemical system and quality control of TCM preparations.

  8. The Role of 39 Psoriasis Risk Variants on Age of Psoriasis Onset

    OpenAIRE

    Yingchang Lu; Sinae Kane; Haoyan Chen; Argentina Leon; Ethan Levin; Tien Nguyen, Van; Maya Debbaneh; Millsop, Jillian W.; Rishu Gupta* ,; Monica Huynh; Daniel Butler; Kelly Cordoro; Wilson Liao

    2013-01-01

    Recent genome-wide association studies (GWAS) have identified multiple genetic risk factors for psoriasis, but data on their association with age of onset have been marginally explored. The goal of this study was to evaluate known risk alleles of psoriasis for association with age of psoriasis onset in three well-defined case-only cohorts totaling 1,498 psoriasis patients. We selected 39 genetic variants from psoriasis GWAS and tested these variants for association with age of psoriasis onset...

  9. Persistent release of IL-1s from skin is associated with systemic cardio-vascular disease, emaciation and systemic amyloidosis: the potential of anti-IL-1 therapy for systemic inflammatory diseases.

    Directory of Open Access Journals (Sweden)

    Keiichi Yamanaka

    Full Text Available The skin is an immune organ that contains innate and acquired immune systems and thus is able to respond to exogenous stimuli producing large amount of proinflammatory cytokines including IL-1 and IL-1 family members. The role of the epidermal IL-1 is not limited to initiation of local inflammatory responses, but also to induction of systemic inflammation. However, association of persistent release of IL-1 family members from severe skin inflammatory diseases such as psoriasis, epidermolysis bullosa, atopic dermatitis, blistering diseases and desmoglein-1 deficiency syndrome with diseases in systemic organs have not been so far assessed. Here, we showed the occurrence of severe systemic cardiovascular diseases and metabolic abnormalities including aberrant vascular wall remodeling with aortic stenosis, cardiomegaly, impaired limb and tail circulation, fatty tissue loss and systemic amyloid deposition in multiple organs with liver and kidney dysfunction in mouse models with severe dermatitis caused by persistent release of IL-1s from the skin. These morbid conditions were ameliorated by simultaneous administration of anti-IL-1α and IL-1β antibodies. These findings may explain the morbid association of arteriosclerosis, heart involvement, amyloidosis and cachexia in severe systemic skin diseases and systemic autoinflammatory diseases, and support the value of anti-IL-1 therapy for systemic inflammatory diseases.

  10. Liver gene therapy by lentiviral vectors reverses anti-factor IX pre-existing immunity in haemophilic mice

    OpenAIRE

    Annoni, Andrea; Cantore, Alessio; Della Valle, Patrizia; Goudy, Kevin; Akbarpour, Mahzad; Russo, Fabio; Bartolaccini, Sara; D'Angelo, Armando; Roncarolo, Maria Grazia; Naldini, Luigi

    2013-01-01

    A major complication of factor replacement therapy for haemophilia is the development of anti-factor neutralizing antibodies (inhibitors). Here we show that liver gene therapy by lentiviral vectors (LVs) expressing factor IX (FIX) strongly reduces pre-existing anti-FIX antibodies and eradicates FIX inhibitors in haemophilia B mice. Concomitantly, plasma FIX levels and clotting activity rose to 50–100% of normal. The treatment was effective in 75% of treated mice. FIX-specific plasma cells (PC...

  11. Does prolonged anti-inflammatory therapy reduce number of unnecessary repeat saturation prostate biopsy?

    Directory of Open Access Journals (Sweden)

    Giuseppe Candiano

    2013-06-01

    Full Text Available Introduction. The effect of a prolonged oral anti-inflammatory therapy on PSA values in patients with persistent abnormal PSA values after negative prostate biopsy (PBx was evaluated. Material and methods. From September 2011 to September 2012, 70 patients (medi- an age 62 years, with persistent abnormal PSA values after negative extended PBx, were given an herbal extract with anti-inflammatory activity for 3 months (Lenidase®; 1 tablet daily constituted of baicalina, bromelina and escina. All patients were submitted to prostate biopsy for: abnormal DRE; PSA > 10 ng/mL, PSA values between 4.1-10 or 2.6-4 ng/mL with free/total PSA < 25% and < 20%, respectively. Three months after the end of anti-inflammato- ry therapy all patients were revaluated; indication for repeat saturation biopsy (SPBx and detection rate for PCa were compared with those previously recorded in our Department using the same inclusions criteria for biopsy. Results. Oral administration of Lenidase® was well tolerated and no side effects were observed; PSA values decreased in 54 (77.8% out 70 patients with a median PSA reduction of 20.5% (from 8.8 to 7 ng/mL and remained unchanged in 16 patients (22.2%; the repeat SPBx rate resulted significantly lower (22.8% vs 35.5%; p < 0.05 showing a superimposable detection rate for PCa (3 cases in comparison with our previous data (18.7% vs 22%. Conclusions. In our preliminary data a prolonged oral anti-inflammatory therapy reduced PSA levels in patients with negative PBx and persistent suspicious for PCa decreasing the indication to perform repeat SPBx (about 30% of the cases.

  12. I Live with Psoriasis | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Living with Psoriasis I Live with Psoriasis Past Issues / Fall 2013 Table of Contents Kristin ... equally. "Know as much as you can about psoriasis..." —Kristin Donahue Psoriasis first flared into Kristin Donahue's ...

  13. What is Psoriasis? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Living with Psoriasis What is Psoriasis? Past Issues / Fall 2013 Table of Contents What Is Psoriasis? There are several forms of psoriasis. The typical ...

  14. Predictors of response to anti-tumor necrosis factor therapy in ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Evanthia; Zampeli; Michalis; Gizis; Spyros; I; Siakavellas; Giorgos; Bamias

    2014-01-01

    Ulcerative colitis(UC) is an immune-mediated, chronic inflammatory disease of the large intestine. Its course is characterized by flares of acute inflammation and periods of low-grade chronic inflammatory activity or remission. Monoclonal antibodies against tumor necrosis factor(anti-TNF) are part of the therapeutic armamentarium and are used in cases of moderate to severe UC that is refractory to conventional treatment with corticosteroids and/or immunosuppressants. Therapeutic response to these agents is not uniform and a large percentage of patients either fail to improve(primary non-response) or lose response after a period of improvement(secondary non-response/loss of response). In addition, the use of anti-TNF agents has been related to uncommon but potentially serious adverse effects that preclude their administration or lead to their discontinuation. Finally, use of these medications is associated with a considerable cost for the health system. The identification of parameters thatmay predict response to anti-TNF drugs in UC would help to better select for patients with a high probability to respond and minimize risk and costs for those who will not respond. Analysis of the major clinical trials and the accumulated experience with the use of anti-TNF drugs in UC has resulted to the report of such prognostic factors. Included are clinical and epidemiological characteristics, laboratory markers, endoscopic indicators and molecular(immunological/genetic) signatures. Such predictive parameters of long-term outcomes may either be present at the commencement of treatment or determined during the early period of therapy. Validation of these prognostic markers in large cohorts of patients with variable characteristics will facilitate their introduction into clinical practice and the best selection of UC patients who will benefit from anti-TNF therapy.

  15. Quality of life in psoriasis patients

    Directory of Open Access Journals (Sweden)

    Fatma M Abd Al Salam.,** Seham F Mohamed, **Taghreed M El-Shafie.

    2009-12-01

    Full Text Available Skin and psyche share embryonic origins, various psychological factors, including emotional trauma and stressful life events, may affect both onset and progression of some skin conditions, Psoriasis is a chronic skin disease with substantial impact on patient's social and relational ways of living and subsequently on their quality of life. This chronic condition has a significant negative impact on patients' quality of life. Psoriasis has been linked to patients depression and suicidal tendencies Patients and Methods The study group consisted of 50 consenting consecutive cases of psoriasis vulgaris, of both sexes, aged 18-62 years (41.44 ± 0.101, and with duration of the disease 6-10 years, attending the dermatology outpatient clinic of Al Zahraa university hospital. The extent of clinical severity of the disease was assessed by the psoriatic area and severity index (PASI Score, Assessment of quality of life of patients by Lehman Quality of Life Interview (LQLI .According toPASI score they were devided into 3groups :mild cases were treated by topical steroid and salyslic acid while moderate cases were treated by NB-UVB and severe cases were treated by systemic methotrexate. Results showed that 57.4% of patients were unsatisfied with their family relations and 43.5% are satisfied. However, about their social relations they were 55.3% satisfied while 44.6% were unsatisfied. In the other hand, they were 52.3% satisfied with their finance while the other 48.2% were unsatisfied with it. As regard, work or school they were 66.4% satisfied and 33.5% unsatisfied. While they were 85.1% satisfied with low, safety, and 14.8% unsatisfied. The same for health 94.4% satisfied and 6.5% unsatisfied .The third group treated by systemic methotrexate show marked increase in LQLI. Conclusions: Psoriasis is a disease with profound impact on the psychological and social aspect of the patient, particularly because of its visibility. Systemic therapy of psoriasis

  16. Sigma receptor-mediated targeted delivery of anti-angiogenic multifunctional nanodrugs for combination tumor therapy.

    Science.gov (United States)

    Li, Yuanke; Wu, Yuanyuan; Huang, Leaf; Miao, Lei; Zhou, Jianping; Satterlee, Andrew Benson; Yao, Jing

    2016-04-28

    The potential of low molecular weight heparin (LMWH) in anti-angiogenic therapy has been tempered by poor in vivo delivery to the tumor cell and potentially harmful side effects, such as the risk of bleeding due to heparin's anticoagulant activity. In order to overcome these limitations and further improve the therapeutic effect of LMWH, we designed a novel combination nanosystem of LMWH and ursolic acid (UA), which is also an angiogenesis inhibitor for tumor therapy. In this system, an amphiphilic LMWH-UA (LHU) conjugate was synthesized and self-assembled into core/shell nanodrugs with combined anti-angiogenic activity and significantly reduced anticoagulant activity. Furthermore, DSPE-PEG-AA-modified LHU nanodrugs (A-LHU) were developed to facilitate the delivery of nanodrugs to the tumor. The anti-angiogenic activity of A-LHU was investigated both in vitro and in vivo. It was found that A-LHU significantly inhibited the tubular formation of human umbilical vein endothelial cells (HUVECs) (pnanodrugs are a promising multifunctional antitumor drug delivery system. PMID:26941036

  17. Salicylic Acid 6% in an ammonium lactate emollient foam vehicle in the treatment of mild-to-moderate scalp psoriasis.

    Science.gov (United States)

    Kircik, Leon

    2011-03-01

    Scalp psoriasis is a common life-altering skin condition causing a great deal of distress. It significantly affects quality of life and is difficult to manage. Treatment can provide variable results, often impacting patient compliance with therapy. Salicylic acid is used as adjunctive therapy to other topical treatments because of its marked keratolytic effect. Its effectiveness as a monotherapy is not fully understood. An emollient foam formulation of 6% salicylic acid (Salkera) in an ammonium lactate vehicle has recently become available. Efficacy, tolerability and patient acceptability of salicylic acid 6% emollient foam were assessed in an open-label pilot study of 10 subjects with scalp psoriasis. All psoriasis severity parameters were reduced with a significant decrease in Psoriasis Scalp Severity Index (PSSI) score from 15.3 to 3.0 after four weeks of monotherapy (PSalicylic acid 6% emollient foam provides a useful option in the treatment of psoriasis that is highly effective, well tolerated and acceptable to patients.

  18. Anti-PD-1/PD-L1 antibody therapy for pretreated advanced nonsmall-cell lung cancer

    Science.gov (United States)

    Zhou, Guo-Wu; Xiong, Ye; Chen, Si; Xia, Fan; Li, Qiang; Hu, Jia

    2016-01-01

    Abstract Background: Anti-PD-1/PD-L1 antibody therapy is a promising clinical treatment for nonsmall-cell lung cancer (NSCLC). However, whether anti-PD-1/PD-L1 antibody therapy can provide added benefits for heavily pretreated patients with advanced NSCLC and whether the efficacy of anti-PD-1/PD-L1 antibody therapy relates to the tumor PD-L1 expression level remain controversial. Thus, this meta-analysis evaluated the efficacy and safety of anti-PD-1/PD-L1 antibody therapy for pretreated patients with advanced NSCLC. Methods: Randomized clinical trials were retrieved by searching the PubMed, EMBASE, ASCO meeting abstract, clinicaltrial.gov, and Cochrane library databases. The pooled hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), and odds ratios for the overall response rate and adverse events (AEs) were calculated by STATA software. Results: Three randomized clinical trials involving 1141 pretreated patients with advanced NSCLC were included. These trials all compared the efficacy and safety of anti-PD-1/PD-L1 antibodies (nivolumab and MPDL3280A) with docetaxel. The results suggested that, for all patients, anti-PD-1/PD-L1 therapy could acquire a greater overall response (odds ratio = 1.50, 95% CI: 1.08–2.07, P = 0.015, P for heterogeneity [Ph] = 0.620) and longer OS (HR = 0.71, 95% CI: 0.61–0.81, P AEs of anti-PD-1/PD-L1 therapy were significantly lower than that of docetaxel. However, the risks of pneumonitis and hypothyroidism were significantly higher. Conclusion: Anti-PD-1/PD-L1 antibody therapy may significantly improve the outcomes for pretreated advanced NSCLC patients, with a better safety profile than docetaxel. PMID:27583876

  19. Implementing Best Practice in Psoriasis

    DEFF Research Database (Denmark)

    Kragballe, Knud; Gniadecki, Robert; Mørk, Nils-Jørgen;

    2014-01-01

    In the absence of Nordic-wide guidelines on the best practice management of psoriasis, this paper aims to provide Nordic recommendations for treatment goals, evaluation of quality of life impact and assessment/management of co-morbidities. This Delphi approach consisted of telephone interviews...... of psoriasis patients with cardio-metabolic risk factors to their general practitioner. In order to achieve the best practice management of psoriasis, Nordic dermatologists should be trained and adhere to these recommendations in conjunction with available treatment guidelines....

  20. Natural killer cells in psoriasis.

    LENUS (Irish Health Repository)

    Tobin, A M

    2012-02-01

    Psoriasis is one of the most common immune-mediated disorders. There is evidence that it is mediated by Th1 and, more recently, Th17 cells. The cytokine pattern, particularly the dominance of TNF-alpha, implicates the innate immune system in psoriasis pathogenesis. Of the many components of the innate immune system known to be involved in psoriatic lesions, natural killer and natural killer T cells appear to have a unique role. We review the evidence supporting a role for natural killer cells in psoriasis.

  1. Psoriasis, Introduction, General Information, Epidemiology

    Directory of Open Access Journals (Sweden)

    Esra Adışen

    2008-12-01

    Full Text Available Psoriasis is a chronic inflammatory skin disorder affecting 1-3% of the population and psoriatic patients constitute 6-8% of the attendants of outpatient dermatology polyclinics. Though it is a common disease with well known clinical features, current studies have focused on the pathogenesis and the treatment of the disease while little research has focused on epidemiologic characteristics of the disease. The etiopathogenesis of psoriasis is related with immunologic, autoimmune, and genetic factors. Currently psoriasis has been considered as a disease spectrum or a systemic disease and there is a growing body of research on the pathogenesis, associating disorders and treatment of the disease.

  2. Psoriasis--a dermatological enigma.

    Science.gov (United States)

    Zivković, D

    1998-01-01

    At the beginning, the interdisciplinary character of psoriasis encroaching into numerous fields of medicine as well as non-medical sciences is emphasized. The disease has been found an interesting field for genetic studies, also entering the fields of endocrinology and pathophysiology, and as a psychosomatic phenomenon arising many questions in the domain of psychiatry and psychology. With the associated joint and bone alterations, psoriasis is an intriguing problem for an array of medical disciplines, e.g., rheumatology, orthopedics, physical medicine and balneology. Pediatrics is involved through psoriasis in children, and ophthalmology through ocular symptoms of the disease. The therapeutic use of ultraviolet rays introduces psoriasis in the field of photobiology, and the impact of diet into the domain of dietetics. Also, alternative medicine is involved to a greater extent in psoriasis than in any other disease. This survey is followed by a historical account of psoriasis, revealing that the disease was known in all periods of the development of mankind that have left written documents behind. However, it was only toward the end of the 18th century and at the beginning of the 19th century that psoriasis was recognized and described as a unique and independent disease. The prevalence of psoriasis in Europe und USA ranges between 1.5%-2% and 0.5%-1.5%, respectively. The disease is rare in blacks, Indians and yellow race, whereas in Eskimos it is not found at all. Then, psoriasis is presented as a hereditary disease, the onset of which requires the action of so-called provocative factors triggering the hereditary elements. Psoriasis most commonly develops at the age of 20-50 years, i.e. during the most active period of man's life. Then, the morphological classification of psoriasis according to clinical picture is presented, with a historical account of pathophysiologic and etiologic concepts over the past hundred years. And finally, the basic trends and concepts

  3. Mode of inheritance in psoriasis

    Directory of Open Access Journals (Sweden)

    Kumar Arvind

    1992-01-01

    Full Text Available One hundred and eighty patients of psoriasis and 100 controls were analysed to find out the genetic nature of psoriasis and if so, then to determine the possible mode of inheritance. The prevalence of psoriasis in relatives, percentage of positive family history and percentage of total affected relatives in the patient group was significantly higher than the controls, and clustering of affected relatives in patient group suggested genetic involvement. Ratio of affected and unaffected in the sibships with unaffected parents and one parent affected and ratio in the children of patients suggested polygenic mode of inheritance.

  4. Photo(chemotherapy in Psoriasis

    Directory of Open Access Journals (Sweden)

    Hatice Şanlı

    2010-12-01

    Full Text Available Phototherapy remains an essential treatment option for patients with moderate to severe psoriasis. Various spectra of the UV-B and UV-A wavelenghts are used for the treatment of psoriasis vulgaris. Photochemotherapy combines initial topical or systemic administration of a photosensitizer with the subsequent exposure to light of the corresponding wavelength, generally UVA light (320-400 nm. Photochemotherapy and narrow band UVB can be used as treatments either as monotherapy or combination with other agents,to effectively treat moderate or severe psoriasis.

  5. HOSPITAL BASED STUDY ON CHILDHOOD PSORIASIS

    Directory of Open Access Journals (Sweden)

    Murugan

    2015-10-01

    Full Text Available Childhood psoriasis is a distressing condition with significant social and psychological consequences. Childhood psoriasis being less reported entity, this study was undertaken to study the incidence, pattern and prevalence of childhood psoriasis. MATERIALS & METHODS: In this retrospective epidemiologic study, a complete analysis of OP Records of patients with psoriasis who attended the Psoriasis Clinic of dermatology OPD, during the period of 1 year from June 2014- June 2015 were taken. The age at presentation, duration of psoriasis, pattern of involvement, h/o treatment, h/o preceeding infections were all recorded. RESULTS: The incidence of childhood psoriasis was observed to be (1.16%. The incidence of psoriasis in male (43% children and female (57% children was-. The mean age of onset of childhood psoriasis was -, positive family history seen in 5% of patients. Psoriasis vulgaris is the most common type of psoriasis followed by palmoplantar psoriasis. Nail involvement was seen in 30% of cases. Arthropathy was seen in 1% of patients. Preceeding infection was seen in 155 of patients. CONCLUSION: The rising trends in incidence of childhood psoriasis in recent times may mirror the evolving lifestyle and psychosocial environment in society. The evolving patterns of childhood psoriasis has significant avenues for research & further follow-up. Larger, coordinated multicentric long term studies to determine their course in adulthood may be required in future.

  6. Progress of anti-vascular endothelial growth factor therapy for ocular neovascular disease: benefits and challenges

    Institute of Scientific and Technical Information of China (English)

    Xu Jianjiang; Li Yimin; Hong Jiaxu

    2014-01-01

    Objective This review aims to summarize the progress of current clinical studies in ocular angiogenesis treated with antivascular endothelial growth factor (VEGF) therapy and to discuss the benefits and challenges of the treatment.Data sources Pubmed,Embase and the Cochrane Library were searched with no limitations of language and year of publication.Study selection Clinical trials and case studies presented at medical conferences and published in peer-reviewed literature in the past decade were reviewed.Results Anti-VEGF agents have manifested great potential and promising outcomes in treating ocular neovascularization,though some of them are still used as off-label drugs.Intravitreal injection of anti-VEGF agents could be accompanied by devastating ocular or systemic complications,and intimate monitoring in both adult and pediatric population are warranted.Future directions should be focused on carrying out more well-designed large-scale controlled trials,promoting sustained duration of action,developing safer and more efficient generation of anti-VEGF agents.Conclusions Anti-VEGF treatment has proved to be beneficial in treating both anterior and posterior neovascular ocular diseases.However,more safer and affordable antiangiogenic agencies and regimens are warranted to be explored.

  7. Drug exposure and psoriasis vulgaris: case-control and case-crossover studies.

    Science.gov (United States)

    Cohen, Arnon D; Bonneh, Dan Y; Reuveni, Haim; Vardy, Daniel A; Naggan, Lechaim; Halevy, Sima

    2005-01-01

    Intake of drugs is considered a risk factor for psoriasis. The aim of this study was to investigate the association between drugs and psoriasis. A case-control study including 110 patients who were hospitalized for extensive psoriasis was performed. A control group (n = 515) was defined as patients who had undergone elective surgery. A case-crossover study included 98 patients with psoriasis. Exposure to drugs was assessed during a hazard period (3 months before hospitalization) and compared to a control period in the patient's past. Data on drug sales were extracted by data mining techniques. Multivariate analyses were performed by logistic regression and conditional logistic regression. In the case-control study, psoriasis was associated with benzodiazepines (OR 6.9), organic nitrates (OR 5.0), angiotensin-converting enzyme (ACE) inhibitors (OR 4.0) and non-steroidal anti-inflammatory drugs (NSAIDs) (OR 3.7). In the case-crossover study, psoriasis was associated with ACE inhibitors (OR 9.9), beta-blockers (OR 9.9), dipyrone (OR 4.9) and NSAIDs (OR 2.1). Extensive psoriasis may be associated with intake of ACE inhibitors, NSAIDs or beta-blockers. PMID:16191849

  8. Side effects of anti-TNFa therapy in juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Elisabetta Valcamonica

    2011-09-01

    Full Text Available Aim of the study: To report adverse events registered in our population affected by JIA and treated with anti-TNFa blockers. Methods: Ninety-five patients were enrolled to be treated with Etanercept, median age 14 years (range 4-34; median duration of therapy 12 months (range1-40. 19 patients were als treated with MTX (median dose 12.5 mg/week. Fifty-six patients were enrolled to be treated with Infliximab associated with MTX (median dose of MTX 8.8mg/week, median age 23.2 years (range 7.8-34.9; median duration of therapy 20.1 months (range 1.4-60.4. All adverse events were divided in definitely, probably and possibly related to the biologic agent. Results: Side effects definitely related to Infliximab were the reactions to infusions and the Anti-dsDNA positivity. Side effects definitely related to Etanercept were severe headache and thrombocytopenia. Side effects probably correlated to both the biological agents were behavioural modifications and pain amplification syndrome. Probably correlated to the treatment with Etanercept was the onset of Crohn’s disease in 3 patients. Possibly correlated to the biological agents were the new onset or flare-up of Chronic Iridocyclitis and single cases of thyroideal cancer, hypoglossal nerve paralysis and a severe Cytomegalovirus pulmonary infection. No case of tuberculosis infection was registered during this study. Conclusions: Treatment with a TNFa antagonist seems to be associated with various adverse events. Some of them, like onset of Crohn’s disease, behavioural modifications are unusual and others, like pain amplification syndrome were never described before. Children and young adults affected by JIA should be monitored very carefully so as to limit as much as possible the risk of serious side effects on anti-TNFa therapy.

  9. Pathogenesis and treatment of psoriasis: exploiting pathophysiological pathways for precision medicine.

    Science.gov (United States)

    Alwan, Wisam; Nestle, Frank O

    2015-01-01

    Psoriasis is a common, chronic inflammatory skin disease associated with multi-system manifestations including arthritis and obesity. Our knowledge of the aetiology of the condition, including the key genomic, immune and environmental factors, has led to the development of targeted, precision therapies that alleviate patient morbidity. This article reviews the key pathophysiological pathways and therapeutic targets and highlights future areas of interest in psoriasis research.

  10. Psoriasis complicated with venous thromboembolism: report of two cases and a literature review

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yun-xia; CHEN Gang; ZHAO Rui-zhen; ZHANG Xiao-guang

    2011-01-01

    Cases of psoriasis complicated with venous thromboembolism are rarely reported. Here, we report two cases and review the current literature on the subject. Two patients with long-standing severe psoriasis presented with chest pain,shortness of breath and breathing difficulties. The patients were diagnosed using lung ventilation-perfusion scans or computed tomographic pulmonary angiography. Anticoagulation or thrombolytic therapy was initiated, and long-term continuous anticoagulation with warfarin prevented any recurrences.

  11. Fulminant ulcerative colitis associated with steroid-resistant minimal change disease and psoriasis: A case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    A 43-year-old Chinese patient with a history of psoriasis developed fulminant ulcerative colitis after immunosuppressive therapy for steroid-resistant minimal change disease was stopped. Minimal change disease in association with inflammatory bowel disease is a rare condition. We here report a case showing an association between ulcerative colitis, minimal change disease,and psoriasis. The possible pathological link between 3 diseases is discussed.

  12. Telomere and telomerase as targets for anti-cancer and regeneration therapies

    Institute of Scientific and Technical Information of China (English)

    Yi-hsin HSU; Jing-jer LIN

    2005-01-01

    Telomerase is a ribonucleoprotein that directs the synthesis of telomeric sequence.It is detected in majority of malignant tumors, but not in most normal somatic cells.Because telomerase plays a critical role in cell immortality and tumor formation, it has been one of the targets for anti-cancer and regeneration drug development. In this review, we will discuss therapeutic approaches based mainly on small molecules that have been developed to inhibit telomerase activity, modulate telomerase expression, and telomerase directed gene therapy.

  13. Use of acid-suppressive therapy before anti-reflux surgery in 2922 patients

    DEFF Research Database (Denmark)

    Lødrup, A; Pottegård, A; Hallas, J;

    2015-01-01

    , the Danish National Prescription Register, and the Danish Person Register. RESULTS: The study population thus included 2922 patients (median age: 48 years, 55.7% male). The annual proportion of patients redeeming ≥180 DDD of acid-suppressive therapy increased from 17.0% 5 years before anti-reflux surgery...... to 64.9% 1 year before. The probability for inadequate dosing 1 year before surgery (DDD) was significantly increased for younger patients, patients operated in the period 2000-2003, patients who had not undergone pre-surgical manometry, pH- or impedance monitoring, and patients who had...

  14. Urinary biopyrrins: A new marker of oxidative stress in psoriasis

    Directory of Open Access Journals (Sweden)

    Ola Ahmed Bakry

    2016-01-01

    Full Text Available Background: Psoriasis is a common chronic, relapsing, immune-mediated disease involving skin and joints of genetically predisposed individuals. Oxidative stress has been found to play many important roles in cellular damage and loss of function in a number of tissues and organs and is believed to contribute to the pathogenesis of a variety of diseases. Urinary biopyrrin levels have gained attention as an indicator of oxidative stress. Aim and Objective: To measure urinary biopyrrins excretion as a marker of oxidative stress in psoriasis. Patients and Methods: This case–control study was carried out on 85 subjects; 55 cases with chronic plaque psoriasis and 30 age, gender and body mass index-matched normal subjects as a control group. Urinary biopyrrin levels were measured using enzyme immunoassay. Results: There was a highly significant difference between cases and controls regarding urinary biopyrrins level (P < 0.001. There was significant positive correlation between biopyrrins level and both the age of cases (r = 0.28, P = 0.01 and psoriasis area and severity index score (r = 0.99, P < 0.001. Conclusion: Urinary biopyrrins are increased in patients with psoriasis, and the level is correlated with disease severity. Further large-scale studies involving different ages and different clinical varieties of the disease are needed to expand and validate current findings. The clinical usefulness of antioxidants in psoriasis treatment needs to be evaluated in future research. Furthermore, the value of biopyrrins as biomarkers for monitoring response to therapy needs to be evaluated.

  15. Experimental cancer gene therapy by multiple anti-survivin hammerhead ribozymes

    Institute of Scientific and Technical Information of China (English)

    Qi Fei; Yuwen Ke; Xuebiao Yao; Jingde Zhu; Hongyu Zhang; Lili Fu; Xinlan Dai; Baomei Gao; Min Ni; Chao Ge; Jinjun Li; Xia Ding

    2008-01-01

    To improve the efficacy of gene therapy for cancer, we designed four hammerhead ribozyme adenoviruses (R1 to R4) targeting the exposed regions of survivin mRNA. In addition to the in vitro characterization, which included a determination of the sequence specificity of cleavage by primer extension, assays for cell proliferation and for in vivo tumor growth were used to score for ribozyme efficiency.The resulting suppression of survivin expression induced mitotic catastrophe and cell death via the caspase-3-dependent pathway. Importantly, administration of the ribozyme adenoviruses inhibited tumor growth in a hepato-cellular carcinoma xenograft mouse model. Co-expression of R1, R3 and R4 ribozymes synergistically suppressed survivin and, as this combination targets all major forms of the survivin transcripts, produced the most potent anti-cancer effects. The adenoviruses carrying the multiple hammerhead ribozymes described in this report offered a robust gene therapy strategy against cancer.

  16. Vessel Architectural Imaging Identifies Cancer Patient Responders to Anti-angiogenic Therapy

    Science.gov (United States)

    Emblem, Kyrre E.; Mouridsen, Kim; Bjornerud, Atle; Farrar, Christian T.; Jennings, Dominique; Borra, Ronald J. H.; Wen, Patrick Y.; Ivy, Percy; Batchelor, Tracy T.; Rosen, Bruce R.; Jain, Rakesh K.; Sorensen, A. Gregory

    2013-01-01

    Measurement of vessel caliber by Magnetic Resonance Imaging (MRI) is a valuable technique for in vivo monitoring of hemodynamic status and vascular development, especially in the brain. Here, we introduce a new paradigm in MRI coined as Vessel Architectural Imaging (VAI) that exploits an intriguing and overlooked temporal shift in the MR signal forming the basis for vessel caliber estimation and show how this phenomenon can reveal new information on vessel type and function not assessed by any other non-invasive imaging technique. We also show how this biomarker can provide novel biological insights into the treatment of cancer patients. As an example, we demonstrate using VAI that anti-angiogenic therapy can improve microcirculation and oxygen saturation levels and reduce vessel calibers in patients with recurrent glioblastomas, and more crucially, that patients with these responses have prolonged survival. Thus, VAI has the potential to identify patients who would benefit from therapies. PMID:23955713

  17. Large Vessel Vasculitis Occurring in Rheumatoid Arthritis Patient under Anti-TNF Therapy

    Directory of Open Access Journals (Sweden)

    Valentina Cestelli

    2014-01-01

    Full Text Available Vasculitis is a heterogeneous group of disorders characterized by the presence of necrotic inflammatory phenomena and destruction of blood vessels. Vasculitis is classified as primary (idiopathic or secondary to infections, connective tissue diseases and drugs but can also be considered as a paraneoplastic phenomenon. Evidence shows that the increasing use of biological agents results in a growing number of reports of autoimmune diseases induced by these therapies. An inflammatory articular chronic disease such as rheumatoid arthritis may be complicated by extra-articular manifestations, such as cutaneous or systemic vasculitis. Herewith, we describe the case of a great vessels arteritis in a patient affected by rheumatoid arthritis in therapy with an anti-TNF agent (etanercept.

  18. Progress in anti-endothelin therapy in the treatment of pulmonary arterial hypertension and heart failure

    Institute of Scientific and Technical Information of China (English)

    MAYANJA Patrick; MA Gen-shan

    2014-01-01

    Endothelin-1 ( ET-1 ) is not only a potent vasoconstrictor , but causes proliferation of many of the vascular cells involved in vascular remodelling .ETA receptors mediate vasoconstriction and cell proliferation , whereas ETB receptors are important for the clearance of ET-1, endothelial cell survival , the release of nitric oxide and prostacyclin , and the inhibition of endothelin-converting enzyme ( ECE )-1.ET is activated in pulmonary arterial hypertension ( PAH) , heart failure ( HF) and many other cardiovascular diseases .The most efficient way to antagonize the ET-1 system is the use of ET-1 receptor antagonists that can block either ETA-or ETA-and ETB-receptors, or ECE inhibition which blocks the conversion of big ET-1 to ET-1.In this brief review , we will try to summarize the progress of anti-endothelin therapy in the treatment of PAH and HF treatment therapies .

  19. New developments in small molecular compounds for anti-hepatitis C virus (HCV) therapy

    Institute of Scientific and Technical Information of China (English)

    Jing TONG; You-wei WANG; Yuan-an LU

    2012-01-01

    Infection with hepatitis C virus (HCV) affects approximately 170 million people worldwide.However,no vaccine or immunoglobulin is currently available for the prevention of HCV infection.The standard of care (SOC)involving pegylated intenrferon-α (PEG-IFN α) plus ribavirin (RBV) for 48 weeks results in a sustained virologic response in less than 50% of patients with chronic hepatitis C genotype 1,the most prevalent type of HCV in North America and Europe.Recently,reliable in vitro culture systems have been developed for accelerating antiviral therapy research,and many new specifically targeted antiviral therapies for hepatitis C (STAT-C) and treatment strategies are being evaluated in clinical trials.These new antiviral agents are expected to improve present treatment significantly and may potentially shorten treatment duration.The aim of this review is to summarize the current developments in new anti-HCV drugs.

  20. An audit on virological efficacy of anti-retroviral therapy in a specialist infectious disease clinic.

    LENUS (Irish Health Repository)

    Reyad, A

    2009-06-01

    We have assessed the efficacy of anti retroviral therapy (ART) using undetectable viral load (VL) (<50 RNA copies\\/ml) as a marker of virological success, in patients who have Human Immunodeficiency Virus (HIV) attending the Department of Infectious Disease. A cross-sectional review of patients\\' case notes was used to obtain their demographics and treatment details. 79% (253) of the hospital case notes of clinic population was available for analysis, which represents 90% of those receiving ART in the clinic. 166\\/253 of the cohort were receiving treatment at the time of this study and 95% (157\\/166) of these were on treatment for greater than 6 months. The total virological success rate is 93%, which is comparable to other centres and are as good as those from published clinical trials. 56% of those on therapy who have virological failure were Intravenous Drug Users (IVDUs). Case by case investigation for those with treatment failure is warranted.

  1. Sarcoidosis in Patients with Psoriasis

    DEFF Research Database (Denmark)

    Khalid, Usman; Gislason, Gunnar Hilmar; Hansen, Peter Riis

    2014-01-01

    PURPOSE: Psoriasis is a chronic inflammatory disease characterized by a systemic immunological response which is mainly driven by activated T helper (Th) 1 and Th17 lymphocytes. Like psoriasis, sarcoidosis is a chronic inflammatory disorder with Th1/Th17-driven inflammation. Therefore, we...... investigated the risk of sarcoidosis in patients with psoriasis compared to the background population in a nationwide cohort. METHODS: The study included the entire Danish population aged ≥10 years followed from 1st January 1997 until diagnosis of sarcoidosis, death or 31st December 2011. Patients...... with a history of psoriasis and/or sarcoidosis at baseline were excluded. Information on comorbidity and concomitant medication was identified by individual-level linkage of administrative registers. Incidence rates of sarcoidosis were calculated and adjusted hazard ratios (HRs) were estimated by multivariable...

  2. Anti-TNFα-therapy as an evidence-based treatment option for different clinical manifestations of psoriatic arthritis.

    Science.gov (United States)

    Köhm, Michaela; Burkhardt, Harald; Behrens, Frank

    2015-01-01

    The development programmes of different TNF-blocking agents in psoriatic arthritis (PsA) not only provided substantial evidence for the therapeutic benefits of the specific treatment options, but also enabled new insights into the differential treatment effects on distinct disease manifestations. For the first time, specific robust evidence for distinctive effects on different manifestations of PsA, as a distinct entity separate from rheumatoid arthritis (RA), has been generated in a standardized way. The clearest evidence was shown for an effect on peripheral arthritis (polyarticular) with ACR20 response rates from 45 up to 58% (vs. 9-24% for placebo), and an inhibition of radiographic progression demonstrated for the first time for a treatment principle in PsA. However, as PsA does not remain confined to the peripheral joints, it was necessary to address diverse patterns of PsA-subtypes in the outcome measurements of the anti-TNF trials. Accordingly, the results of the clinical studies on anti-TNF treatment also have demonstrated efficacy on enthesitis, dactylitis and skin psoriasis, either in sub analysis of results from phase III RCTs, or in additional prospective studies.

  3. Steroids block the anti-inflammatory effects of low level laser therapy

    Science.gov (United States)

    Lopes-Martins, Rodrigo Alvaro B.; Albertini, Regiane; Lopes-Martins, Patricia Sardinha L.; Iversen, Vegard V.; Bjordal, Jan M.

    2006-02-01

    Objective: Concomitant use of multiple therapies is common in musculoskeletal and airway disorders. Low level laser therapy (LLLT) is considered a promising therapy in arthritis, tendinopathies and rhinitis. We designed two animal studies to assess if the expected anti-inflammatory effect LLLT could be affected by resection of the adrenal gland or concomitant use of the cortisol antagonist mifepristone. Methods: Two studies were performed, with 40 male Wistar rats and with 40 Balb C male mice respectively.. In both studies, four groups received carrageenan and one control group received saline. At 1, 2, and 3 hours after injections, LLLT irradiation was performed with a dose of 7.5 J/cm2. In the rat study, two of the carrageenan groups had the adrenal gland dissected. In the mice study, two of the carrageenan-injected groups were in addition pre-treated with orally administered mifepristone. Results: In the rat paw study, LLLT reduced edema significantly compared to the carrageenan only group (1.5 vs 0.9 ml, p< 0.05), but LLLT failed to inhibit edema formation in the group which had the adrenal gland resected. In carrageenan-induced pleurisy, LLLT significantly reduced the number of leukocyte cells ( p<0.0001, Mean 34.5 [95%CI: 32.8 - 36.2] versus 87.7 [95%CI: 81.0 - 94.4]), and that the effect of LLLT could be totally blocked by adding the cortisol antagonist mifepristone ( p<0.0001, Mean 34.5 [95%CI: 32.1 - 36.9] versus 82.9 [95%CI: 70.5 - 95.3]). Conclusion: Steroid therapy should not be used concomitantly with LLLT, as the anti-inflammatory effect of LLLT is lost if cortisol receptors are downregulated.

  4. The clinical efficacy of extracorporeal and intravascular hemocorrection methods in psoriasis

    Directory of Open Access Journals (Sweden)

    Baityakov V.V.

    2012-03-01

    Full Text Available Purpose. The study of the influence of extracorporeal and intravascular hemocorrection methods (plasmapheresis, ultraviolet blood radiation, ozonetherapy and its combination on skin process and life quality in patients with extensive psoriasis. Methods. 253 patients with extensive psoriasis from the age of 18 to 72 have been investigated. PASI (Psoriasis Area and Severity Index and dermatological index of life quality (DILQ have been used for treatment assessment. Results. The inclusion of efferent quantum and ozone therapy methods in the complex treatment of psoriasis has promoted to the more rapid and complete positive dynamics of skin process and the improvement of life quality. The use of plasmapheresis and its variations with photomodification or the ozone treatment of returning erythrocyte suspension has been the most effective. Plasmapheresis and its modifications are appropriateto be used in the complex treatment of the patients with severe forms of psoriasis. Conclusion: Further study of efferent quantum and ozone therapy methods and their wider use in psoriasis therapy and other chronic dermatosis seem to be promising.

  5. Some psychosomatic aspects of psoriasis.

    Science.gov (United States)

    Gupta, M A; Gupta, A K; Ellis, C N; Voorhees, J J

    1990-01-01

    The contribution of psychosomatic factors toward the morbidity associated with psoriasis should be evaluated in the context of the patient's developmental stage and life situation. The skin, as a sensory organ, plays a critical role in an individual's physical and emotional growth in early life. The skin also plays an integral role as an organ of communication throughout life and greatly affects an individual's body image and self-esteem. If these factors are not taken into consideration, the morbidity associated with psoriasis may increase, or the patient may remain dissatisfied with treatment even in the face of clinically satisfactory treatment outcome. Some recent studies indicate that the adverse impace of psoriasis upon the quality of life can result in significant chronic stress, which may in turn exacerbate the psoriasis in a subgroup of patients. As disease-related stress is present in every patient to some degree, the dermatologist should regularly assess the psychosocial impact of the disease. Certain personality factors, such as a tendency to want the approval of others and difficulty with assertion of angry feelings, may make the patient with psoriasis more vulnerable to stress and contribute toward the stress reactivity of the disease. The presence of depression in psoriasis may modulate itch perception, exacerbate pruritus, and lead to difficulties with initiating and maintaining sleep. Helping the patient to develop assertiveness skills in addition to supportive psychotherapy may facilitate the patient's capacity to cope with the daily stresses associated with psoriasis. Treatment of depressive symptoms may prove to be a helpful adjunct in the management of pruritus and sleep difficulties in psoriasis. PMID:2204373

  6. Anti-calmodulins and tricyclic adjuvants in pain therapy block the TRPV1 channel.

    Directory of Open Access Journals (Sweden)

    Zoltán Oláh

    Full Text Available Ca(2+-loaded calmodulin normally inhibits multiple Ca(2+-channels upon dangerous elevation of intracellular Ca(2+ and protects cells from Ca(2+-cytotoxicity, so blocking of calmodulin should theoretically lead to uncontrolled elevation of intracellular Ca(2+. Paradoxically, classical anti-psychotic, anti-calmodulin drugs were noted here to inhibit Ca(2+-uptake via the vanilloid inducible Ca(2+-channel/inflamatory pain receptor 1 (TRPV1, which suggests that calmodulin inhibitors may block pore formation and Ca(2+ entry. Functional assays on TRPV1 expressing cells support direct, dose-dependent inhibition of vanilloid-induced (45Ca(2+-uptake at microM concentrations: calmidazolium (broad range > or = trifluoperazine (narrow range chlorpromazine/amitriptyline>fluphenazine>>W-7 and W-13 (only partially. Most likely a short acidic domain at the pore loop of the channel orifice functions as binding site either for Ca(2+ or anti-calmodulin drugs. Camstatin, a selective peptide blocker of calmodulin, inhibits vanilloid-induced Ca(2+-uptake in intact TRPV1(+ cells, and suggests an extracellular site of inhibition. TRPV1(+, inflammatory pain-conferring nociceptive neurons from sensory ganglia, were blocked by various anti-psychotic and anti-calmodulin drugs. Among them, calmidazolium, the most effective calmodulin agonist, blocked Ca(2+-entry by a non-competitive kinetics, affecting the TRPV1 at a different site than the vanilloid binding pocket. Data suggest that various calmodulin antagonists dock to an extracellular site, not found in other Ca(2+-channels. Calmodulin antagonist-evoked inhibition of TRPV1 and NMDA receptors/Ca(2+-channels was validated by microiontophoresis of calmidazolium to laminectomised rat monitored with extracellular single unit recordings in vivo. These unexpected findings may explain empirically noted efficacy of clinical pain adjuvant therapy that justify efforts to develop hits into painkillers, selective to sensory Ca(2

  7. Anti-calmodulins and tricyclic adjuvants in pain therapy block the TRPV1 channel.

    Science.gov (United States)

    Oláh, Zoltán; Jósvay, Katalin; Pecze, László; Letoha, Tamás; Babai, Norbert; Budai, Dénes; Otvös, Ferenc; Szalma, Sándor; Vizler, Csaba

    2007-06-20

    Ca(2+)-loaded calmodulin normally inhibits multiple Ca(2+)-channels upon dangerous elevation of intracellular Ca(2+) and protects cells from Ca(2+)-cytotoxicity, so blocking of calmodulin should theoretically lead to uncontrolled elevation of intracellular Ca(2+). Paradoxically, classical anti-psychotic, anti-calmodulin drugs were noted here to inhibit Ca(2+)-uptake via the vanilloid inducible Ca(2+)-channel/inflamatory pain receptor 1 (TRPV1), which suggests that calmodulin inhibitors may block pore formation and Ca(2+) entry. Functional assays on TRPV1 expressing cells support direct, dose-dependent inhibition of vanilloid-induced (45)Ca(2+)-uptake at microM concentrations: calmidazolium (broad range) > or = trifluoperazine (narrow range) chlorpromazine/amitriptyline>fluphenazine>W-7 and W-13 (only partially). Most likely a short acidic domain at the pore loop of the channel orifice functions as binding site either for Ca(2+) or anti-calmodulin drugs. Camstatin, a selective peptide blocker of calmodulin, inhibits vanilloid-induced Ca(2+)-uptake in intact TRPV1(+) cells, and suggests an extracellular site of inhibition. TRPV1(+), inflammatory pain-conferring nociceptive neurons from sensory ganglia, were blocked by various anti-psychotic and anti-calmodulin drugs. Among them, calmidazolium, the most effective calmodulin agonist, blocked Ca(2+)-entry by a non-competitive kinetics, affecting the TRPV1 at a different site than the vanilloid binding pocket. Data suggest that various calmodulin antagonists dock to an extracellular site, not found in other Ca(2+)-channels. Calmodulin antagonist-evoked inhibition of TRPV1 and NMDA receptors/Ca(2+)-channels was validated by microiontophoresis of calmidazolium to laminectomised rat monitored with extracellular single unit recordings in vivo. These unexpected findings may explain empirically noted efficacy of clinical pain adjuvant therapy that justify efforts to develop hits into painkillers, selective to sensory Ca(2

  8. Anti-rotavirus effects by combination therapy of stevioside and Sophora flavescens extract.

    Science.gov (United States)

    Alfajaro, Mia Madel; Rho, Mun-Chual; Kim, Hyun-Jeong; Park, Jun-Gyu; Kim, Deok-Song; Hosmillo, Myra; Son, Kyu-Yeol; Lee, Ju-Hwan; Park, Sang-Ik; Kang, Mun-Il; Ryu, Young Bae; Park, Ki Hun; Oh, Hyun-Mee; Lee, Seung Woong; Park, Su-Jin; Lee, Woo Song; Cho, Kyoung-Oh

    2014-06-01

    Anti-rotaviral activities of Sophora flavescens extract (SFE) and stevioside (SV) from Stevia rebaudiana Bertoni either singly or in various combinations were examined in vitro and in vivo using a porcine rotavirus G5[P7] strain. Combination of SFE and SV inhibited in vitro virus replication more efficiently than each single treatment. In the piglet model, SV had no effect on rotavirus enteritis, whereas SFE improved but did not completely cure rotaviral enteritis. Interestingly, combination therapy of SFE and SV alleviated diarrhea, and markedly improved small intestinal lesion score and fecal virus shedding. Acute toxicity tests including the piglet lethal dose 50, and body weight, organ weight and pathological changes for the combination therapy did not show any adverse effect on the piglets. These preliminary data suggest that the combination therapy of SV and SFE is a potential curative medication for rotaviral diarrhea in pigs. Determination of the efficacy of this combination therapy in other species including humans needs to be addressed in the future. PMID:24704033

  9. RELATIONSHIP BETWEEN TYPES OF FACIAL PSORIASIS WITH DLQI AND SEVERITY OF PSORIASIS : A STUDY

    Directory of Open Access Journals (Sweden)

    Murugan

    2015-08-01

    Full Text Available Psoriasis is a chronic papulosquamous disorder involving any skin site. Involvement of exposed areas is associated with significant stigma. Facial involvement in psoriasis causes considerable cosmetic imbalance and psychosocial stress to the affected individual. Facial psoriasis has been described as severe psoriasis. KEYWORDS: D IQL facial psoria sis centro facial periorofacial.

  10. RELATIONSHIP BETWEEN TYPES OF FACIAL PSORIASIS WITH DLQI AND SEVERITY OF PSORIASIS : A STUDY

    OpenAIRE

    Murugan; Adikrishnan; De Rahul; Trishna Vaishali; Krishnakanth; Sudha; Anandan; Mahalakshmi

    2015-01-01

    Psoriasis is a chronic papulosquamous disorder involving any skin site. Involvement of exposed areas is associated with significant stigma. Facial involvement in psoriasis causes considerable cosmetic imbalance and psychosocial stress to the affected individual. Facial psoriasis has been described as severe psoriasis. KEYWORDS: D IQL facial psoria sis centro facial periorofacial.

  11. Long-term use of adalimumab in the treatment of moderate to severe plaque psoriasis: a review of the literature

    Directory of Open Access Journals (Sweden)

    Angela Y Moore

    2010-04-01

    Full Text Available Angela Y Moore, Blakely S RichardsonArlington Center for Dermatology, Arlington, Texas, USAAbstract: Psoriasis is a chronic T-cell-mediated inflammatory disease that primarily affects the skin and joints. Patients with moderate to severe psoriasis constitute about 30% of the psoriasis population. Treatment of this group is challenging due to the long-term side effects, toxicities and inconvenience of conventional treatments such as phototherapy, methotrexate and cyclosporine. However, recent advances in our understanding of the pathogenesis of psoriasis have led to the popular use of biologics, which offer a safer, more convenient and effective targeted therapy. Adalimumab was originally approved for treating rheumatoid arthritis. Currently, adalimumab is also approved for treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy or when other systemic therapies are medically less appropriate. Since the onset of the use of biologics, there have been concerns over safety and efficacy when used as long-term therapy. This paper reviews all publications, posters and abstracts reporting original data on the efficacy and/or safety of adalimumab in patients treated for chronic plaque psoriasis for more than 1 year.Keywords: psoriasis, adalimumab, biologics

  12. Tuberculosis screening in patients with psoriasis before antitumour necrosis factor therapy : comparison of an interferon-gamma release assay vs. tuberculin skin test

    NARCIS (Netherlands)

    Laffitte, E.; Janssens, J. P.; Roux-Lombard, P.; Thielen, A. M.; Barde, C.; Marazza, G.; Panizzon, R. G.; Saurat, J-H.

    2009-01-01

    Background Antitumour necrosis factor (anti-TNF) treatments may reactivate latent tuberculosis infection (LTBI). For detecting LTBI, the tuberculin skin test (TST) has low sensitivity and specificity. Interferon-gamma release assays (IGRA) have been shown to be more sensitive and specific than TST.

  13. Psoriasis in Children: A Review.

    Science.gov (United States)

    Balato, Anna; Scalvenzi, Massimiliano; Cirillo, Teresa; Gallo, Lucia; Ayala, Fabio; Balato, Nicola

    2015-01-01

    Psoriasis is a chronic, immune-mediated, inflammatory systemic disease which targets primarily the skin. It presents a genetic basis, affecting 1 to 3% of the white population. Nevertheless, the existence of two psoriasis incidence peaks has been suggested (one in adolescence before 20 years of age and another in adulthood) onset may occur at any age, including childhood and adolescence, in which its prevalence ranges between 0.7% and 1.2%. As for adult psoriasis, pediatric psoriasis has recently been associated with obesity, metabolic syndrome, increased waist circumference percentiles, and metabolic laboratory abnormalities, warranting early monitoring and lifestyle modifications. In addition, due to psoriasis chronic nature and frequently occurring relapses, psoriatic patients tend to have an impaired quality of life, often requiring long-term treatment. Therefore, education of both pediatric patients and their parents is essential to successful and safe disease management. However, systemic treatment of children is challenging as the absence of standardized guidelines and the fact that evidence-based data form randomized controlled trials are very limited. This review shows an overview of the current understanding of the pathogenesis, comorbidities, differential diagnosis, treatment and prevention of pediatric psoriasis, also presenting with an emphasis on the necessity of an integrated treatment approach involving different specialists such as dermatologist, pediatricians, rheumatologists, etc. PMID:25938378

  14. Hepcidin expression in psoriasis patients

    Directory of Open Access Journals (Sweden)

    Nursel Dilek

    2014-01-01

    Full Text Available Background: Iron is an essential nutrient for mammals. Accelerated loss of nutrients through hyperproliferation and desquamation from the skin in psoriasis is known. Hepcidin is an important and recently discovered regulator of iron homeostasis. Aims and Objectives: The present study was undertaken to investigate the hepcidin expression in psoriasis patients. Materials and Methods: We examined peripheral blood cell counts, serum Fe, ferritin, interleukin-6 (IL-6 and hepcidin levels using respectively automated hematology analyzer, Iron assay on the AEROSET system, chemiluminescent microparticle immunoassay with automated analyzer, and enzyme-linked immunosorbent assay. Results: The independent comparison of Fe, ferritin, IL-6 and hepcidin levels in psoriasis patients and control group (healthy volunteers revealed lower Fe and higher IL-6, hepcidin levels in psoriasis patients. No significant difference was seen in the ferritin level between the psoriasis and the control group. Conclusions: We think that studies on hepcidin expression in psoriatic plaques will contribute to our understanding the role of iron and hepcidin in the pathogenesis of psoriasis.

  15. Targeted Therapy of Cancer Using Photodynamic Therapy in Combination with Multi-faceted Anti-Tumor Modalities

    Directory of Open Access Journals (Sweden)

    Malini Olivo

    2010-05-01

    Full Text Available Photodynamic therapy (PDT has emerged as one of the important therapeutic options in the management of cancer and other diseases. PDT involves a tumor-localized photosensitizer (PS, which when appropriately illuminated by visible light converts oxygen into cytotoxic reactive oxygen species (ROS, that attack key structural entities within the targeted cells, ultimately resulting in necrosis or apoptosis. Though PDT is a selective modality, it can be further enhanced by combining other targeted therapeutic strategies that include the use of synthetic peptides and nanoparticles for selective delivery of photosensitizers. Another potentially promising strategy is the application of targeted therapeutics that exploit a myriad of critical pathways involved in tumorigenesis and metastasis. Vascular disrupting agents that eradicate tumor vasculature during PDT and anti-angiogenic agents that targets specific molecular pathways and prevent the formation of new blood vessels are novel therapeutic approaches that have been shown to improve treatment outcome. In addition to the well-documented mechanisms of direct cell killing and damage to the tumor vasculature, PDT can also activate the body’s immune response against tumors. Numerous pre-clinical studies and clinical observations have demonstrated the immuno-stimulatory capability of PDT. Herein, we aim to integrate the most important findings with regard to the combination of PDT and other novel targeted therapy approaches, detailing its potential in cancer photomedicine.

  16. Secretion, blood levels and cutaneous expression of TL1A in psoriasis patients

    DEFF Research Database (Denmark)

    Pedersen, Anders Elm; Schmidt, Esben Gjerløff Wedebye; Sørensen, Jesper Freddie;

    2015-01-01

    and induction in psoriasis. Indeed, the pathogenesis in psoriasis is still not fully understood and it is speculated that cytokines other than TNF-α are important in subsets of patients. Also, for patients with severe disease that are treated with systemic anti-TNF-α blockade, novel candidates to be used...... as disease and response biomarkers are of high interest. Here, we demonstrate TL1A expression in biopsies from psoriatic lesions. Also, we investigated spontaneous and induced TL1A secretion from PBMCs and blood levels from a cohort of psoriasis patients. Here, increased spontaneous secretion from PBMCs...... was observed as compared to healthy controls and a small subset of patients had highly elevated TL1A in the blood. Interestingly, activation of PBMCs with various cytokines showed a decreased sensitivity for TL1A activation in psoriasis patients compared to healthy controls.TL1A levels in blood and biopsies...

  17. Pro- and Anti-Inflammatory Cytokine Balance in Major Depression: Effect of Sertraline Therapy

    Directory of Open Access Journals (Sweden)

    Ali Sengul

    2008-01-01

    Full Text Available The specific associations between antidepressant treatment and alterations in the levels of cytokines remain to be elucidated. In this study, we aimed to explore the role of IL-2, IL-4, IL-12, TNF-α, TGF-β1, and MCP-1 in major depression and to investigate the effects of sertraline therapy. Cytokine and chemokine levels were measured at the time of admission and 8 weeks after sertraline treatment. Our results suggest that the proinflammatory cytokines (IL-2, IL-12, and TNF-α and MCP-1 were significantly higher, whereas anti-inflammatory cytokines IL-4 and TGF-β1 were significantly lower in patients with major depression than those of healthy controls. It seems likely that the sertraline therapy might have exerted immunomodulatory effects through a decrease in the proinflammatory cytokine IL-12 and an increase in the anti-inflammatory cytokines IL-4 and TGF-β1. In conclusion, our results indicate that Th1-, Th2-, and Th3-type cytokines are altered in the depressed patients and some of them might have been corrected by sertraline treatment.

  18. Toward Repurposing Metformin as a Precision Anti-Cancer Therapy Using Structural Systems Pharmacology.

    Science.gov (United States)

    Hart, Thomas; Dider, Shihab; Han, Weiwei; Xu, Hua; Zhao, Zhongming; Xie, Lei

    2016-01-01

    Metformin, a drug prescribed to treat type-2 diabetes, exhibits anti-cancer effects in a portion of patients, but the direct molecular and genetic interactions leading to this pleiotropic effect have not yet been fully explored. To repurpose metformin as a precision anti-cancer therapy, we have developed a novel structural systems pharmacology approach to elucidate metformin's molecular basis and genetic biomarkers of action. We integrated structural proteome-scale drug target identification with network biology analysis by combining structural genomic, functional genomic, and interactomic data. Through searching the human structural proteome, we identified twenty putative metformin binding targets and their interaction models. We experimentally verified the interactions between metformin and our top-ranked kinase targets. Notably, kinases, particularly SGK1 and EGFR were identified as key molecular targets of metformin. Subsequently, we linked these putative binding targets to genes that do not directly bind to metformin but whose expressions are altered by metformin through protein-protein interactions, and identified network biomarkers of phenotypic response of metformin. The molecular targets and the key nodes in genetic networks are largely consistent with the existing experimental evidence. Their interactions can be affected by the observed cancer mutations. This study will shed new light into repurposing metformin for safe, effective, personalized therapies. PMID:26841718

  19. Toward Repurposing Metformin as a Precision Anti-Cancer Therapy Using Structural Systems Pharmacology

    Science.gov (United States)

    Hart, Thomas; Dider, Shihab; Han, Weiwei; Xu, Hua; Zhao, Zhongming; Xie, Lei

    2016-01-01

    Metformin, a drug prescribed to treat type-2 diabetes, exhibits anti-cancer effects in a portion of patients, but the direct molecular and genetic interactions leading to this pleiotropic effect have not yet been fully explored. To repurpose metformin as a precision anti-cancer therapy, we have developed a novel structural systems pharmacology approach to elucidate metformin’s molecular basis and genetic biomarkers of action. We integrated structural proteome-scale drug target identification with network biology analysis by combining structural genomic, functional genomic, and interactomic data. Through searching the human structural proteome, we identified twenty putative metformin binding targets and their interaction models. We experimentally verified the interactions between metformin and our top-ranked kinase targets. Notably, kinases, particularly SGK1 and EGFR were identified as key molecular targets of metformin. Subsequently, we linked these putative binding targets to genes that do not directly bind to metformin but whose expressions are altered by metformin through protein-protein interactions, and identified network biomarkers of phenotypic response of metformin. The molecular targets and the key nodes in genetic networks are largely consistent with the existing experimental evidence. Their interactions can be affected by the observed cancer mutations. This study will shed new light into repurposing metformin for safe, effective, personalized therapies. PMID:26841718

  20. Gellan gum nanohydrogel containing anti-inflammatory and anti-cancer drugs: a multi-drug delivery system for a combination therapy in cancer treatment.

    Science.gov (United States)

    D'Arrigo, Giorgia; Navarro, Gemma; Di Meo, Chiara; Matricardi, Pietro; Torchilin, Vladimir

    2014-05-01

    During the last decades, it has become evident that inflammation plays a critical role in tumorigenesis: tumor microenvironment is largely orchestrated by inflammatory cells. In the present work, a novel gellan gum nanohydrogel system (NH) able to carry and deliver simultaneously anti-cancer and anti-inflammatory drugs was developed. Prednisolone was chemically linked to the carboxylic groups of gellan gum to serve as a hydrophobic moiety promoting nanohydrogel formation, whereas paclitaxel was then physically entrapped in it. NH improved drug performances, acting as paclitaxel and prednisolone solubility enhancer and favoring the drug uptake in the cells. Moreover, NH allowed an increased cytotoxic effect in vitro on several types of cancer cells due to the synergistic effect of the combination of anti-inflammatory and anti-cancer drugs. Thus, NH can be useful in a combination therapy that attacks both, malignant cells and tumor inflammatory components. PMID:24215783

  1. Secukinumab - a stupendous option in psoriasis management

    Directory of Open Access Journals (Sweden)

    Damal Kandadai Sriram

    2016-09-01

    Full Text Available Psoriasis is a chronic inflammatory skin disease with increased epidermal proliferation related to dysregulation of the immune system. In spite of several therapeutic strategies available for the treatment of this condition, the disease causes untold suffering particularly in the severe variant of the disease. Secukinumab is a human IgG1 monoclonal antibody that binds to the cytokine interleukin-17A (IL-17A inhibiting the pro-inflammatory effects that are involved in the development of plaque psoriasis. Secukinumab 300mg is to be given via subcutaneous injection at weeks 0, 1, 2, 3 and 4 and once monthly thereafter. The efficacy of secukinumab has been evaluated in three phase 3 clinical trials. The drug showed an overwhelming improvement in the primary end points as assessed by PASI 75 and modified IGA scores. The only major concern with secukinumab is the increased risk of nasopharyngitis and mucocutaneous candidiasis due to the interference with host defence mechanisms by targeting IL-17. Secukinumab has also shown favorable response in the treatment of psoriatic arthritis, ankylosing spondylitis from clinical trials. The drug has been approved by the US FDA in January 2015 for the treatment of moderate to severe psoriasis in patients who require systemic therapy. Nevertheless long term safety data are still awaited. While the results of these trials have been extremely gratifying, it remains to be seen if the stupendous performance displayed in clinical trials could be translated in real world practice. [Int J Res Med Sci 2016; 4(9.000: 3661-3665

  2. Photo-thermal therapy of bladder cancer with Anti-EGFR antibody conjugated gold nanoparticles.

    Science.gov (United States)

    Chen, Chieh Hsiao; Wu, Yi-Jhen; Chen, Jia-Jin

    2016-01-01

    The aim of this study was to enhance the effectiveness of photo thermal therapy (PTT) in the targeting of superficial bladder cancers using a green light laser in conjunction with gold nanoparticles (GNPs) conjugated to antibody fragments (anti-EGFR). GNPs conjugated with anti-EGFR-antibody fragments were used as probes in the targeting of tumor cells and then exposed to a green laser (532nm), resulting in the production of sufficient thermal energy to kill urothelial carcinomas both in vitro and in vivo. Nanoparticles conjugated with antibody fragments are capable of damaging cancer cells even at relatively very low energy levels, while non-conjugated nanoparticles would require an energy level of 3 times under the same conditions. The lower energy required by the nanoparticles allows this method to destroy cancerous cells while preserving normal cells when applied in vivo. Nanoparticles conjugated with antibody fragments (anti-EGFR) require less than half the energy of non-conjugated nanoparticles to kill cancer cells. In an orthotopic bladder cancer model, the group treated using PTT presented significant differences in tumor development. PMID:27100501

  3. Exercise as an anti-inflammatory therapy for rheumatic diseases-myokine regulation.

    Science.gov (United States)

    Benatti, Fabiana B; Pedersen, Bente K

    2015-02-01

    Persistent systemic inflammation, a typical feature of inflammatory rheumatic diseases, is associated with a high cardiovascular risk and predisposes to metabolic disorders and muscle wasting. These disorders can lead to disability and decreased physical activity, exacerbating inflammation and the development of a network of chronic diseases, thus establishing a 'vicious cycle' of chronic inflammation. During the past two decades, advances in research have shed light on the role of exercise as a therapy for rheumatic diseases. One of the most important of these advances is the discovery that skeletal muscle communicates with other organs by secreting proteins called myokines. Some myokines are thought to induce anti-inflammatory responses with each bout of exercise and mediate long-term exercise-induced improvements in cardiovascular risk factors, having an indirect anti-inflammatory effect. Therefore, contrary to fears that physical activity might aggravate inflammatory pathways, exercise is now believed to be a potential treatment for patients with rheumatic diseases. In this Review, we discuss how exercise disrupts the vicious cycle of chronic inflammation directly, after each bout of exercise, and indirectly, by improving comorbidities and cardiovascular risk factors. We also discuss the mechanisms by which some myokines have anti-inflammatory functions in inflammatory rheumatic diseases.

  4. Psoriasis and New-Onset Diabetes

    DEFF Research Database (Denmark)

    Khalid, Usman; Hansen, Peter Riis; Gislason, Gunnar Hilmar;

    2013-01-01

    OBJECTIVE Psoriasis is associated with increased risk of cardiovascular events and increased prevalence of cardiovascular risk factors. Diabetes mellitus (DM) is a major contributor to cardiovascular morbidity and mortality that may be associated with psoriasis, but conflicting results have been...

  5. Clearance of recalcitrant psoriasis after tonsillectomy.

    Science.gov (United States)

    Hone, S W; Donnelly, M J; Powell, F; Blayney, A W

    1996-12-01

    Infection is a well-recognized triggering factor for both guttate and chronic plaque psoriasis. We investigated prospectively 13 patients with recalcitrant psoriasis exacerbated by recurrent tonsillitis, who underwent tonsillectomy between 1990 and 1993. There were 12 female patients and one male, with a mean age of 17 yr (range 6-28). Six patients had guttate psoriasis resistant to standard treatments and seven patients had chronic plaque psoriasis exacerbated by tonsillitis that was severe enough to warrant at least one admission to hospital. Patients were followed by chart review and postal questionnaire. Psoriasis was cleared completely after tonsillectomy in five out of the six patients (83%) with guttate psoriasis and was improved in one patient. Two out of seven patients with plaque psoriasis (29%) were cleared, two (29%) were improved and three (42%) were unchanged. We conclude that tonsillectomy may be a successful treatment modality in selected patients with recalcitrant guttate or chronic plaque psoriasis.

  6. Corticosteroid and Fragrance Allergy Exacerbating Scalp Psoriasis

    OpenAIRE

    Jacob, Sharon E.; Butler, Dan; Herro, Elise

    2014-01-01

    Increasing evidence indicates that allergic contact dermatitis can worsen pre-existing psoriasis. The authors highlight a delayed-hypersensitivity reaction to a common psoriasis medication and discuss therapeutic interventions.

  7. New Psoriasis Drug Works Longer Term, Too

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_159264.html New Psoriasis Drug Works Longer Term, Too Moderate-to-severe ... has shown "unprecedented" effects on the skin condition psoriasis seems to work well in the longer term, ...

  8. Emerging treatments in the management of psoriasis: biological targeting with ustekinumab

    Directory of Open Access Journals (Sweden)

    Marina Papoutsaki

    2009-05-01

    Full Text Available Marina Papoutsaki, Antonio Costanzo, Sergio ChimentiDepartment of Dermatology, University of Rome, “Tor vergata”, Rome, ItalyAbstract: Psoriasis is a chronic, genetically determined, immune-mediated, inflammatory skin disease affecting approximately 2% to 3% of Caucasian population. Given the well-established role of the immuno-mediated inflammation in the pathogenesis of psoriasis, in the past few years several key steps in the pathogenesis of this disease have been elucidated and the increased knowledge led to the development of specific drugs, commonly defined as “biologics” targeting one or more of these steps. At present an anti-CD11a antibody (efalizumab, an anti-LFA3/CD2 receptor (alefacept and 3 antitumor necrosis factor alpha agents (adalimumab, etanercept, infliximab are now commercially available for the treatment of both psoriasis and psoriatic arthritis. Recent studies have demonstrated that interleukins (IL 12 and 23 play an important role in the pathophysiology of psoriasis. In fact members of the IL-12 family of cytokines have the potential to act as the next major cytokine(s in pathogenesis and the treatment of psoriasis. Ustekinumab (CNTO 1275, Centocor Inc, Malvern, PA, USA is a human monoclonal antibody that binds to the shared p40 protein subunit of human interleukins 12 and 23 with high affinity and specificity, thereby preventing interaction with their surface IL-12Rβ1 receptor. Different clinical studies have been conducted to date. In particular a phase II study and two phase III studies, PHOENIX 1 together with PHOENIX 2, show very encouraging results. This review reports on the latest progress made in the clinical use of biologic drugs for psoriasis focusing on the new human IL-12/23 monoclonal antibody, ustekinumab, for psoriasis.Keywords: psoriasis, ustekinumab, interleukin-12/23 monoclonal antibody

  9. How much of the productivity losses among psoriasis patients are due to psoriasis

    OpenAIRE

    Mustonen, Anssi; Mattila, Kalle; Leino, Mauri; Koulu, Leena; Tuominen, Risto

    2015-01-01

    Background In previous studies, productivity losses have been measured specifically due to psoriasis or generally due to health problems in psoriasis patients. There is no information on the proportion of health related productivity losses that are due to psoriasis. The aim of this study was to estimate the proportion of productivity losses due to psoriasis and due to other medical problems among employed psoriasis patients. Methods Patients visiting a tertiary level dermatological clinic dur...

  10. Adalimumab treatment for severe recalcitrant chronic plaque psoriasis.

    LENUS (Irish Health Repository)

    Ryan, C

    2012-02-01

    AIM: To assess the efficacy and safety profile of adalimumab in patients with severe, recalcitrant chronic plaque psoriasis, and to assess short-term overlapping of other systemic treatment with adalimumab to prevent flaring of disease. METHODS: This was a retrospective study comprising 39 patients with chronic plaque psoriasis treated with adalimumab between October 2005 and January 2008. All had failed treatment with other systemic agents, including biological therapies in 59% of patients. Patients were started on adalimumab 40 mg weekly or fortnightly, as clinically indicated. Severity of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI). Therapeutic response was assessed by 75% improvement on PASI (PASI 75). All adverse events were recorded. RESULTS: Results were analysed separately for those treated with adalimumab only and those on combination treatment. PASI 75 was achieved in 38% (8 of 21 patients at week 16), 62% (13 of 21 patients) at week 24, 69% (9 of 13 patients) at week 48% and 71% (5 of 7 patients) at week 72 in the adalimumab-only group, compared with 56% (5 of 9 patients) at week 16, 50% (4 of 8 patients) at week 24, 80% (4 of 5 patients) at week 48% and 67% (2 of 3 patients) at week 72 in the combined group. Of the 39 patients, 15 (38%) achieved a PASI of 0 at some point in their treatment. Adalimumab was well tolerated; 38% of patients experienced side-effects, which were generally mild. CONCLUSION: Adalimumab was effective in a group of patients with psoriasis refractory to other systemic therapies, including biological treatments, and was well tolerated.

  11. COST-EFFECTIVENESS ANALYSIS OF ANTI-DIABETIC THERAPY IN A UNIVERSITY TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Giwa Abdulganiyu

    2014-03-01

    Full Text Available Purpose: To conduct cost-effectiveness analysis of anti-diabetic therapy in a University Teaching Hospital in 2010. Methods: A retrospective review of selected case-notes was conducted. World Health Organization Defined Daily Dose Method of evaluating drug use and probability method for potential effectiveness of antidiabetic therapeutic options from literature analysis was employed in determining cost-effectiveness of each anti-diabetic therapeutic option identified from anti-diabetic drug utilization studies. Sample Size, n=1200. Subjects’ case-notes were selected by systematic random sampling (Sampling Interval = 1. Results: Glibenclamide (N1.76/unit of effectiveness which was more cost-effective than chlopropamide (N2.97/unit of effectiveness in the management of moderate hyperglycemia in non-obese Type II Diabetes Mellitus was more frequently prescribed (81.5%. Glibenclamide + Metformin (N7.63/unit of effectiveness which was more frequently prescribed (92.5% was not necessarily more cost-effective than Chlopropamide + Metformin (N9.76/unit of effectiveness in the management of moderate hyperglycemia in obese Type II Diabetes- Mellitus. Biphasic Isophane Insulin (N12.65/unit of effectiveness which was more cost-effective than soluble insulin + insulin zinc (N30.37/unit of effectiveness in the management of serve hyperglycemia in non-obese Type II Diabetes Mellitus was less frequently prescribed (42.3%. Biphasic Isophane Insulin + Metformin (N15.91/unit of effectiveness which was more cost-effective than soluble insulin + insulin zinc + metformin (N34.45/ unit of effectiveness in the management of severe hyperglycemia in obese Type II Diabetes Mellitus patients was less frequently prescribed (25%. Conclusions: Prescription of lees cost-effective anti-diabetic drugs was rampant in Hospitals.

  12. Epidermal Th22 and Tc17 cells form a localized disease memory in clinically healed psoriasis.

    Science.gov (United States)

    Cheuk, Stanley; Wikén, Maria; Blomqvist, Lennart; Nylén, Susanne; Talme, Toomas; Ståhle, Mona; Eidsmo, Liv

    2014-04-01

    Psoriasis is a common and chronic inflammatory skin disease in which T cells play a key role. Effective treatment heals the skin without scarring, but typically psoriasis recurs in previously affected areas. A pathogenic memory within the skin has been proposed, but the nature of such site-specific disease memory is unknown. Tissue-resident memory T (TRM) cells have been ascribed a role in immunity after resolved viral skin infections. Because of their localization in the epidermal compartment of the skin, TRM may contribute to tissue pathology during psoriasis. In this study, we investigated whether resolved psoriasis lesions contain TRM cells with the ability to maintain and potentially drive recurrent disease. Three common and effective therapies, narrowband-UVB treatment and long-term biologic treatment systemically inhibiting TNF-α or IL-12/23 signaling were studied. Epidermal T cells were highly activated in psoriasis and a high proportion of CD8 T cells expressed TRM markers. In resolved psoriasis, a population of cutaneous lymphocyte-associated Ag, CCR6, CD103, and IL-23R expressing epidermal CD8 T cells was highly enriched. Epidermal CD8 T cells expressing the TRM marker CD103 responded to ex vivo stimulation with IL-17A production and epidermal CD4 T cells responded with IL-22 production after as long as 6 y of TNF-α inhibition. Our data suggest that epidermal TRM cells are retained in resolved psoriasis and that these cells are capable of producing cytokines with a critical role in psoriasis pathogenesis. We provide a potential mechanism for a site-specific T cell-driven disease memory in psoriasis. PMID:24610014

  13. Moderate-to-Severe Plaque Psoriasis

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    Rocío Prieto-Pérez

    2015-01-01

    Full Text Available Psoriasis is a chronic skin disease in which genetics play a major role. Although many genome-wide association studies have been performed in psoriasis, knowledge of the age at onset remains limited. Therefore, we analyzed 173 single-nucleotide polymorphisms in genes associated with psoriasis and other autoimmune diseases in patients with moderate-to-severe plaque psoriasis type I (early-onset, <40 years or type II (late-onset, ≥40 years and healthy controls. Moreover, we performed a comparison between patients with type I psoriasis and patients with type II psoriasis. Our comparison of a stratified population with type I psoriasis n=155 and healthy controls N=197 is the first to reveal a relationship between the CLMN, FBXL19, CCL4L, C17orf51, TYK2, IL13, SLC22A4, CDKAL1, and HLA-B/MICA genes. When we compared type I psoriasis with type II psoriasis N=36, we found a significant association between age at onset and the genes PSORS6, TNF-α, FCGR2A, TNFR1, CD226, HLA-C, TNFAIP3, and CCHCR1. Moreover, we replicated the association between rs12191877 (HLA-C and type I psoriasis and between type I and type II psoriasis. Our findings highlight the role of genetics in age of onset of psoriasis.

  14. Et liv med psoriasis - et litteratur review

    DEFF Research Database (Denmark)

    Kjær, Lone; Glasdam, Stinne

    2011-01-01

    Psoriasis is a non-contagious skin disease affecting the patient’s physical, mental and social well-being. But what do we know about living with psoriasis? The aim of this article is to review published research literature dealing with the impact psoriasis has on a patient’s life in general, qual...

  15. ANALGESIC AND ANTI INFLAMMATORY EFFECT OF LEECH THERAPY (JALAUKAVCHARAN IN THE PATIENTS OF OSTEOARTHRITIS (SANDHIGATA VATA

    Directory of Open Access Journals (Sweden)

    Singh Akhilesh Kumar

    2012-02-01

    Full Text Available Osteoarthritis (degenerative joint disease is the most common joint disorder. It mostly affects cartilage. The top layer of cartilage breaks down and wears away. Osteoarthritis is of two types, primary (idiopathic and secondary. In idiopathic osteoarthritis, the most common form of the disease, no predisposing factor is apparent. Secondary OA is pathologically indistinguishable from idiopathic OA but is attributable to an underlying cause. The NSAID’S are main drug of choice in modern medicine which have lots of side effect therefore are not safe for long term therapy. Raktamokshan viz bloodletting is one of the ancient and important parasurgical procedure described in Ayurveda for treatment of various diseases. Of them, Jalaukavacharana or Leech Therapy has gained greater attention globally, because of its medicinal values. The saliva of leech contains numerous biologically active substances, which has anti-inflammatory, analgesic as well as anesthetic property. Keeping this view in mind we have started leech therapy in the patients of osteoarthritis and found encouraging results.

  16. Itch in psoriasis: epidemiology, clinical aspects and treatment options

    Directory of Open Access Journals (Sweden)

    F Prignano

    2009-02-01

    Full Text Available F Prignano, F Ricceri, L Pescitelli, T LottiDepartment of Dermatological Sciences, University of Florence,Florence, ItalyBackground: Pruritus is an important symptom in psoriasis vulgaris, may be severe and seriously affect the quality of life of patients, but published data on its frequency and characteristics are limited.Objective: The study objective was to characterize the prevalence of itch in psoriatic patients and the effect of treatment modalities by using a comprehensive itch questionnaire of our own design.Methods: A structured itch questionnaire was given to 90 patients with moderate to severe chronic-plaque psoriasis selected consecutively from the patients visiting the Department of Dermatology of the University of Florence. The questionnaire concerned the areas involved in psoriasis and pruritus, the pruritus characteristics, the worsening and relieving factors and treatment modalities. Itch intensity was reflected by a 10 point visual analog scale (VAS and the degree of symptoms discriminated between mild (1–3, moderate (4–7 and severe (8–10.Results: Almost 85% of psoriatic patients suffered from itching; the frequency of pruritus was daily and mean intensity by VAS scale was moderate. Presence and intensity of pruritus and body mass index (BMI were correlated. 40% of patients with pruritus were overweight (BMI > 25 < 30 and 10% obese (BMI > 30. Almost all patients appeared unsatisfied with the available treatment modalities for pruritus in psoriasis. Emollients, topical steroids and calcipotriol cream could relieve pruritus but their effect was temporary. Among the antipsoriatic therapies, phototherapy with narrow band ultraviolet B (nb-UVB was the most effective treatment in reducing pruritus. Biological therapies, mainly etanercept and efalizumab, proved useful in its control.Conclusions: The questionnaire was a useful tool to characterize itch, and the results might help us to better understand pruritus in psoriasis

  17. New treatments for psoriasis: which biologic is best?

    Science.gov (United States)

    Nelson, Andrew A; Pearce, Daniel J; Fleischer, Alan B; Balkrishnan, Rajesh; Feldman, Steven R

    2006-01-01

    Psoriasis is a chronic, debilitating disease affecting not only the skin, but also having a significant impact on a patient's quality of life. The treatment of severe psoriasis is quite challenging due to the chronic, relapsing nature of the disease and the difficulties inherent in treatment planning. Though the biologics are perhaps the most promising of available psoriasis treatments, the decision to institute a given therapy may be fraught with complexity for the clinician. Patients now hear of these promising new treatments for psoriasis via print, television and radio advertising; they frequently come to their physician asking if they are eligible for any of these agents and, if so, 'which biologic is best?'. This paper attempts to determine the ideal biologic agent based upon several parameters: FDA- and EU-approved indications, therapeutic efficacy, impact on quality of life, cost-effectiveness, and safety profile. Certainly the physician is central to medical decision-making, though ultimately patient preference may play the largest role in determining the 'best' biologic agent. There is no single ideal biologic for all patients and a physician's job is to educate patients on the relative advantages and disadvantages of each agent. Through informed discussion, the clinician can help each individual patient decide which biologic agent is ideal for them. PMID:16766334

  18. Differential expression of the angiogenesis growth factors in psoriasis vulgaris

    Directory of Open Access Journals (Sweden)

    Liew Siaw-Cheok

    2012-07-01

    Full Text Available Abstract Background Angiogenesis has been reported to be one of the contributory factors to the pathogenesis of psoriasis vulgaris. This study aims to compare the expression of different angiogenesis growth factors namely (1 the vascular endothelial growth factor (VEGF subfamily: A, B, C, D and placenta growth factor (PlGF; (2 nerve growth factor (NGF and (3 von Willebrand factor (vWFr in the skins of patients with psoriasis vulgaris and non-psoriatic volunteers. Results Comparative immunohistochemistry study was performed on the paraffin-sectioned psoriatic and healthy skins with the abovementioned markers. VEGF-C (p = 0.016 and NGF (p = 0.027 were expressed intensely in the cases when compared with the controls. The NGF was the only marker that was solely expressed in the cases and absent in all the controls. Conclusion The NGF (angiogenesis and VEGF-C (lymphangiogenesis might play a crucial role in the pathogenesis of psoriasis vulgaris and could be researched further as potential new targeted therapies for psoriasis vulgaris.

  19. Psoriasis vulgaris and digestive system disorders: is there a linkage?

    Directory of Open Access Journals (Sweden)

    Maria Juszkiewicz-Borowiec

    2010-02-01

    Full Text Available Psoriasis is well-known immune-mediated skin disease often associated with co-morbidities, including dyslipidaemia and obesity. Few reports imply that the disease might be also related to pathology of mucosal surfaces, especially that of the digestive system. The authors present a case of psoriasis and concurrent digestive system abnormalities, and review the literature regarding the topic. A 40-year-old man suffered from an exacerbation of exudative psoriasis for about 6 months. Topical antipsoriatics proved ineffective and the disease gradually progressed to a severe disseminated form. Subsequent detailed examinations revealed persistent gastroduodenitis due to H. pylori infection, pancreatic dysfunction and fatty change of the liver, although the patient denied any gastrointestinal symptoms. As a result appropriate treatment of the diagnosed digestive system disorders was added to topical antipsoriatic therapy. Within 2 weeks of treatment clinical symptoms and laboratory signs showed a marked trend to normalisation. The presented medical history seems to suggest that there may be some kind of interplay between psoriasis and digestive system disorders.

  20. Therapeutic Effect and Safety of Ustekinumab for Plaque Psoriasis:A Meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Yi Liu; Jian-ping Gong; Wen-fang Li

    2014-01-01

    Objective To evaluate the efficacy and safety of ustekinumab in the therapy of plaque psoriasis. Methods Literatures published up to November 2013 were collected from Cochrane library, MEDLINE, and PubMed which were related with ustekinumab for plaque psoriasis. The efficacy was estimated using relative risk of Psoriasis Area and Severity Index (PASI) 75 response rate at the week 12 endpoint in clinical trials, and adverse effects were also analyzed. Meta-analysis was carried out by using Review Manager 5.1. Results Six randomized control trials consistent with the inclusion criteria were selected and reviewed. Ustekinumab 45 mg group and 90 mg group could get better therapeutic effect compared with the placebo group (all P0.05), except that infection rate in ustekinumab 45 mg group was higher than the placebo group (P=0.02). Conclusions Ustekinumab is an effective and safe therapeutic method for plaque psoriasis. However, further longer time analysis of safety is needed.

  1. Comparative evaluation of NBUVB phototherapy and PUVA photochemotherapy in chronic plaque psoriasis

    Directory of Open Access Journals (Sweden)

    Dayal Surabhi

    2010-01-01

    Full Text Available Background: Psoralen UV-A (PUVA is an established therapy for psoriasis, but there is a well-documenated risk of melanoma and nonmelanoma skin cancer. Narrow-band Ultraviolet-B (NBUVB therapy has a lower carcinogenic risk, has equal therapeutic potential and is considerably safe in the long term than PUVA. Aim: The aim of present study was to compare the efficacy and side-effects of PUVA and NBUVB in chronic plaque psoriasis. Methods: Sixty patients of chronic plaque psoriasis were taken up for the study and were randomly divided into two groups of 30 each. They were well matched in terms of age, sex, psoriasis extent and pretreatment psoriasis area severity index (PASI scoring. One group was treated with twice-weekly narrow-band UV-B (TL-01 phototherapy and the other group received twice-weekly oral 8-Methoxsalen PUVA for a period of 3 months. Results: Both the groups achieved >75% reduction in the PASI score or complete clearance at the end of 3 months, but PUVA group patients required significantly fewer number of treatment sessions and fewer number of days to clear the psoriasis as compared to the NBUVB group, while the mean cumulative clearance dose and adverse effects were significantly lower in the NBUVB group. Conclusion: We concluded that PUVA group patients achieved a faster clearance, but the adverse effects were significantly lower in the NBUVB group.

  2. Changes in colorectal carcinoma genomes under anti-EGFR therapy identified by whole-genome plasma DNA sequencing.

    Directory of Open Access Journals (Sweden)

    Sumitra Mohan

    2014-03-01

    Full Text Available Monoclonal antibodies targeting the Epidermal Growth Factor Receptor (EGFR, such as cetuximab and panitumumab, have evolved to important therapeutic options in metastatic colorectal cancer (CRC. However, almost all patients with clinical response to anti-EGFR therapies show disease progression within a few months and little is known about mechanism and timing of resistance evolution. Here we analyzed plasma DNA from ten patients treated with anti-EGFR therapy by whole genome sequencing (plasma-Seq and ultra-sensitive deep sequencing of genes associated with resistance to anti-EGFR treatment such as KRAS, BRAF, PIK3CA, and EGFR. Surprisingly, we observed that the development of resistance to anti-EGFR therapies was associated with acquired gains of KRAS in four patients (40%, which occurred either as novel focal amplifications (n = 3 or as high level polysomy of 12p (n = 1. In addition, we observed focal amplifications of other genes recently shown to be involved in acquired resistance to anti-EGFR therapies, such as MET (n = 2 and ERBB2 (n = 1. Overrepresentation of the EGFR gene was associated with a good initial anti-EGFR efficacy. Overall, we identified predictive biomarkers associated with anti-EGFR efficacy in seven patients (70%, which correlated well with treatment response. In contrast, ultra-sensitive deep sequencing of KRAS, BRAF, PIK3CA, and EGFR did not reveal the occurrence of novel, acquired mutations. Thus, plasma-Seq enables the identification of novel mutant clones and may therefore facilitate early adjustments of therapies that may delay or prevent disease progression.

  3. Pathophysiological basis of systemic treatments in psoriasis.

    Science.gov (United States)

    Volc, Sebastian; Ghoreschi, Kamran

    2016-06-01

    Over the past 15 years, the spectrum of systemic antipsoriatic treatments has dramatically expanded. Until the end of the last millennium, systemic therapy had been restricted to four oral agents: methotrexate, cyclosporine, acitretin, and fumaric acid esters. Today, there are additionally seven biologics and one new oral antipsoriatic drug, as well as the first available biosimilars. Six more biologics with novel target structures and at least four biosimilars are currently being developed (phase III). This progress has been based on new insights into the pathogenesis of psoriasis, in which tumor necrosis factor and especially Th17 immune responses with their associated cytokines interleukin 23 and 17 play a key role. The development of new-generation biologics as well as immunomodulatory small molecules can be attributed to these pathophysiological findings. Phosphodiesterase 4 inhibitors, dimethyl fumarate, and Janus kinase inhibitors all interact with Th17 immune responses. Some of these drugs are in advanced clinical development and are also beneficial in psoriatic arthritis. Today, psoriasis and psoriatic arthritis therefore rank among the most readily treatable inflammatory autoimmune disorders. Dermatology is increasingly becoming a specialty of modern targeted immunotherapies. PMID:27240060

  4. AZ17: a new bispecific drug targeting IL-6 and IL-23 with potential clinical use-improves psoriasis in a human xenograft transplantation model

    DEFF Research Database (Denmark)

    Stenderup, Karin; Kjeldsen, Cecilia Rosada; Shanebeck, K;

    2015-01-01

    ; widely accepted to be associated with psoriasis. To meet the need for new therapeutics, we aimed to create a clinically relevant bispecific drug, by combining the inhibitory properties of anti-IL-6 and anti-IL-23 antibodies, exhibiting high affinity, high stability and the ability to be produced in high...... variables that were synthesized separately in Escherichia coli. To improve stability and extend pharmacokinetics, a flexible poly-ethylene glycol molecule was used as linker. In preclinical psoriasis models, AZ17 reduced IL-23-induced ear inflammation and improved psoriasis in a xenograft transplantation...... model where psoriasis skin is transplanted onto immune-deficient mice. The data presented here suggest AZ17 to be a promising drug candidate in psoriasis and other inflammatory diseases associated with Th17 cell development....

  5. Napkin psoriasis--case report.

    Science.gov (United States)

    Creţu, Anca; Crihan, Elena; Oanţă, A; Sălăvăstru, Carmen; Brănişteanu, D; Brănişteanu, Daciana Elena

    2014-01-01

    Psoriasis is a chronic inflammatory disease that can affect up to 1% of children. Genetic (family history of psoriasis) and environmental factors (bacterial or viral infections, stress, and trauma) are frequently involved in its occurrence. Napkin psoriasis is a particular form of psoriasis affecting mainly children younger than 2 years of age and can be classified together with other diseases under diaper rash. We present the case of a 4-month-old infant, born at term, naturally, weight and height within the normal range, who was brought to the Dermatology Clinic for the occurrence of erythematosquamous lesions in the anogenital area, buttocks and upper third of the thighs, with subsequent dissemination of lesions. The onset of symptoms began a few days after a respiratory tract infection. Initially he received treatment with systemic antibiotic and topical corticosteroid and antibiotic with unfavorable outcome. Laboratory tests revealed iron-deficiency anemia, leukocytosis, thrombocytosis, accelerated ESR, marked hepatic cytolysis, hyperphosphatemia and nasal carriage of Staphylococcus aureus. A systemic antihistamine and nonspecific desensitization treatment was administered. Topical treatment consisted in the removal of predisposing factors and irritants (diaper, urine) by rigorous hygiene, application of topical non-fluorinated cortico-steroid and use of emollients, with favorable course of the lesions. The peculiarity of the case is that the diagnosis of psoriasis was based on history, physical examination and laboratory tests, in the absence of a pathology examination to confirm the diagnosis. Pathology examination could not be performed due to patient's age as biopsy required general anesthesia.

  6. Psoriasis and autoimmune skin diseases

    Directory of Open Access Journals (Sweden)

    Poljački Mirjana N.

    2002-01-01

    Full Text Available Introduction Presuming that psoriasis is an autoimmune skin disease, the aim of this study was to establish its association with other autoimmune skin diseases. The material was obtained at the Dermatovenereological Clinic Clinical Center Novi Sad. Material and methods This 10-year retrospective study (1990-1999 included 1743 psoriasis patients. The control group consisted of 7492 nonpsoriatic dermatological patients. Results Association of psoriasis with other dermatological diseases of autoimmune nature has been established in 13 (0.74 % patients. The most frequent association was with lichen ruber planus in five patients, with alopecia areata and vitiligo in three patients, and in one with bullous pemphigoid and herpetiform dermatitis. Using Fisher's test no significant association was established. Discussion and conclusion According to literature data association of psoriasis with other autoimmune diseases is well known, but rare, which is in accordance with our results. The question arises whether this association is the matter of poor coexistence or the matter of genetic mutations. However, once established, these associations can further highlight the autoimmune nature of psoriasis. The research of autoimmunity would lead us to epithelial cells in thymus, and their badly learnt cognitive function about what is own, and what is not.

  7. Interleukin-20 plays a critical role in maintenance and development of psoriasis in the human xenograft transplantation model

    DEFF Research Database (Denmark)

    Stenderup, K; Rosada, C; Worsaae, A;

    2009-01-01

    Background Interleukin (IL)-20 is a recently discovered cytokine displaying increased levels in psoriatic lesions. Interestingly, IL-20 levels decrease with antipsoriatic treatment, correlating with clinical improvement. However, the role of IL-20 in the aetiology of psoriasis is unknown. Objecti......Background Interleukin (IL)-20 is a recently discovered cytokine displaying increased levels in psoriatic lesions. Interestingly, IL-20 levels decrease with antipsoriatic treatment, correlating with clinical improvement. However, the role of IL-20 in the aetiology of psoriasis is unknown...... donors with moderate to severe plaque psoriasis were transplanted on to immuno-deficient mice. The transplanted mice were treated with anti-IL-20 antibodies or recombinant human IL-20. Results We demonstrate that blocking IL-20 signalling with anti-IL-20 antibodies induces psoriasis resolution and...

  8. Prevalence of hepatotrophic viruses b&c in psoriasis -A study from kashmir

    Directory of Open Access Journals (Sweden)

    Ahmad Qazi

    2005-01-01

    Full Text Available The association of psoriasis with hepatotrophic viruses B and C (HBV&HCV infection has been reported with conflicting results in literature .This association has never been investigated in Kashmir where the prevalence of psoriasis in the general population varies from 2.4 to 3.4 % and the epidemiology of chronic liver disease reveals infection with HBV and HCV to be causative in 25% and 45% of the cases respectively. The aim of this study was to determine the prevalence of HbsAg and anti- HCV antibody amongst Kashmiri patients with psoriasis. Fifty Kashmiris with psoriasis (study group and fifty apparently healthy persons coming forward for voluntary blood donation to the hospital (control group were screened for the presence of HbsAg by Monolisa Ag HbsAg one step enzyme immunoassay technique .The serological estimation of HCV was done by HCD 3.0 in vitro enzyme immunoassay for detection of anti HCV antibody in the serum. Two (4% of the 50 patients in the study group were sero-positive for HbsAg and one (2% for anti HCV. Seven (14% of the control group were sero-positive for HbsAg and none (0% for anti HCV. The prevalence of HbsAg in the study group comprising Kashmiri patients of psoriasis was lower than in the control group of voluntary blood donors whereas the prevalence of anti HCV was 2% in the study group against nil in the control group.Using the Chi-square test for analysis of data, the null hypothesis applies.It would appear that the prevalence of HbsAg and HCV infections in psoriasis is not statistically significant.

  9. Boron labeled rabbit anti-rat fibrin and goat anti-rabbit gamma globulin antibodies and their potential for slow neutron capture therapy of tumors

    International Nuclear Information System (INIS)

    The therapeutic effectiveness of slow neutron capture therapy is currently dependent upon achieving a high concentration gradient of boron between tumor and normal tissue. Labeling of anti-tumor or anti-tumor site antibodies with boron containing compounds could provide this high therapeutic value. Anti-rat fibrin antibodies, which show considerable localization at the site of several transplantable rat tumors, were labeled with 4-boronophenylalanine (4-BPA) using the N-carboxy anhydride procedure. Activity of these labeled antibodies was studied by modifying the test for fibrinogen concentration of hemophiliac blood. The number of 4-BPAs bound to each active antibody was determined indirectly using the fluorimetric test for phenylalanine concentration in serum. These tests showed that labeled antibodies retained their activity, and it was possible to add up to fifty 4-BPAs per active antibody. The indirect approach to achieving a high therapeutic value of boron was also investigated. This procedure involves labeling anti-immunoglobulin antibodies that bind to anti-tumor antibodies which are already bound to their respective antigens. Indirect labeling has the potential of increasing the therapeutic value by a factor of ten over the direct approach. Activity of labeled goat anti-rabbit gamma globulin (RGG) antibodies was studied by radial immunodiffusion and passive hemagglutination. The number of 4-BPAs bound to each active antibody was determined indirectly by fluorimetry. These labeled antibodies also retained their activity, and it was possible to add upwards of forty 4-BPAs per active antibody

  10. Our Clinic Experience with Infliximab in Cases with Moderate-Severe Psoriasis: A Retrospective Study

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    Emel Bülbül Başkan

    2009-09-01

    Full Text Available Background and Design: In this study, we aimed to evaluate the efficacy, safety and side effects of infliximab therapy in patients followed up in our clinic with moderate-severe psoriatic patients unresponsive to conventional therapies.Material and Method: Twenty-six psoriasis patients who were given infliximab therapy in our clinic between years 2006-2008, were retrospectively analyzed for their demographical clinical features, changes in PASI score, duration, efficacy and adverse effects of the therapy. Results: There were 15 female and 11 male psoriasis patients; ages ranging from 18 to 70 years (45.2±12.9. 17 of them were diagnosed as generalize plaque type psoriasis, 2 as eritrodermic psoriasis, 5 as generalize pustular, two of them as palmoplantar pustular psoriasis. Thirteen have associated psoriatic arthritis. All patients received 5 mg/kg intravenous infliximab infusion at weeks 0, 2, and 6, followed by every 8 weeks. Number of infliximab therapy sections was ranging from 2 to 16 and duration of treatment from 1 month to 28 months. Improvement in PASI between pretreatment and after induction therapy was statistically significant (p<0.05. Additional systemic treatment for disease activation was applied to patients receiving infliximab monotherapy at 14.-38. weeks. We observed allergic infusion reactions in 15.4% of the patients. Conclusion: In compatible with data in literature, we found that infliximab therapy provides a rapid clinical response in patients (generalized, eritrodermic and/or pustular psoriasis who are unresponsive to immunosupressive agents or in cases which these treatment modalities cannot be used because of side effects.

  11. Complementary and alternative medicine for psoriasis: what the dermatologist needs to know.

    Science.gov (United States)

    Talbott, Whitney; Duffy, Nana

    2015-06-01

    Complementary and alternative medicine (CAM) use is common among patients with psoriasis. CAM modalities include traditional Chinese medicine (TCM), herbal therapies, dietary supplements, climatotherapy, and mind/body interventions. In this review, evidence from clinical trials investigating the efficacy of CAM for psoriasis is reviewed. There is a large amount of evidence from controlled trials that have shown that the combination of TCM with traditional therapies for psoriasis is more efficacious than traditional therapies alone. Herbal therapies that have the most evidence for efficacy are Mahonia aquifolium and indigo naturalis, while there is a smaller amount of evidence for aloe vera, neem, and extracts of sweet whey. Dietary supplementation in patients with psoriasis demonstrates consistent evidence supporting the efficacy of fish oil supplements. Zinc supplementation has not been shown to be effective; however, some evidence is available (albeit conflicting) for vitamin D, vitamin B12, and selenium supplementation. Overwhelming evidence supports the effectiveness of Dead Sea climatotherapy. Finally, mindfulness-based stress reduction can be helpful as adjuvant treatment of psoriasis. There are potential benefits to these modalities, but also potential side issues. Concerns with CAM include, but are not limited to, contamination of TCM products with heavy metals or corticosteroids, systemic toxicity or contact dermatitis from herbal supplements, and ultraviolet light-induced carcinomas from climatotherapy. Dermatologists should be aware of these benefits and side effects to allow for informed discussions with their patients. PMID:25904522

  12. Manifestation of psoriasis in the oral cavity.

    Science.gov (United States)

    Fatahzadeh, Mahnaz

    2016-03-01

    Despite the common prevalence of cutaneous psoriasis, the existence of manifestations in the oral cavity is subject to controversy. In this article, dermatologic psoriasis is reviewed, and a patient with generalized, symptomatic oral mucosal erythema resembling atrophic candidiasis synchronous with flare of chronic skin psoriasis is described. Diagnostic work up and therapeutic response supported that these mucosal findings were the oral counterpart of cutaneous disease. Dental providers should be familiar with the signs and symptoms of oral psoriasis, institute appropriate preventive measures, and provide palliation directed at symptomatic oral changes of psoriasis. PMID:26665263

  13. Therapeutic effect of dexamethasone implant in retinal vein occlusions resistant to anti-VEGF therapy

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    Wallsh J

    2016-05-01

    Full Text Available Josh Wallsh, Behnam Sharareh, Ron GallemoreRetina Macula Institute, Torrance, CA, USAPurpose: To test the efficacy of the intravitreal dexamethasone (DEX implant in patients with retinal vein occlusions (RVOs who have failed multiple anti-vascular endothelial growth factor (anti-VEGF treatments.Methods: A randomized exploratory study of ten patients with branch RVO or central RVO who received at least two previous anti-VEGF treatments and had persistent or unresponsive cystoid macular edema. Treatment with the DEX implant was either every 4 months or pro re nata (PRN depending on their group assignment for 1 year. Multifocal electroretinography and microperimetry were the primary end points, with high-resolution optical coherence tomography and best-corrected visual acuity as the secondary end points.Results: All patients in both the every 4 month and PRN cohorts who completed the study received the three maximal injections of DEX; therefore, the data from both cohorts were combined and reported as a case series. On average, the multifocal electroretinography amplitude increased significantly from 5.11±0.66 to 24.19±5.30 nV/deg2 at 12 months (P<0.005, mean macular sensitivity increased from 7.67±2.10 to 8.01±1.98 dB at 4 months (P=0.32, best-corrected visual acuity increased significantly from 51.0±5.1 to 55.4±5.1 early treatment of diabetic retinopathy study letters at 2 months (P<0.05, and central retinal thickness decreased from 427.6±39.5 to 367.1±37.8 µm at 4 months (P<0.05. Intraocular pressure increased significantly in one patient, with that patient requiring an additional glaucoma medication for management. Additionally, cataract progression increased significantly (P<0.05 in this patient population and partially limited analysis of other end points.Conclusion: DEX should be considered as a treatment option in patients with RVOs who have failed anti-VEGF therapy, as the results of this study demonstrated an improvement in

  14. Durable Cancer Regression Off-treatment and Effective Re-induction Therapy with an Anti-PD-1 Antibody

    Science.gov (United States)

    Lipson, Evan J.; Sharfman, William H.; Drake, Charles G.; Wollner, Ira; Taube, Janis M.; Anders, Robert A.; Xu, Haiying; Yao, Sheng; Pons, Alice; Chen, Lieping; Pardoll, Drew M.; Brahmer, Julie R.; Topalian, Suzanne L.

    2012-01-01

    Purpose Results from the first-in-human phase I trial of the anti-programmed death-1 (PD-1) antibody BMS-936558 in patients with treatment-refractory solid tumors, including safety, tolerability, pharmacodynamics, and immunologic correlates, have been previously reported. Here, we provide long-term follow-up on three patients from that trial who sustained objective tumor regressions off therapy, and test the hypothesis that re-induction therapy for late tumor recurrence can be effective. Patients and methods Three patients with colorectal cancer, renal cell cancer, and melanoma achieved objective responses on an intermittent dosing regimen of BMS-936558. Following cessation of therapy, patients were followed for over 3 years. A patient with melanoma who experienced a prolonged partial regression followed by tumor recurrence received re-induction therapy. Results A patient with colorectal cancer experienced a complete response which is ongoing after 3 years. A patient with renal cell cancer experienced a partial response lasting 3 years off therapy, which converted to a complete response which is ongoing at 12 months. A patient with melanoma achieved a partial response that was stable for 16 months off therapy; recurrent disease was successfully treated with re-induction anti-PD-1 therapy. Conclusion These data represent the most prolonged observation to date of patients with solid tumors responding to anti-PD-1 immunotherapy and the first report of successful re-induction therapy following delayed tumor progression. They underscore the potential for immune checkpoint blockade with anti-PD-1 to reset the equilibrium between tumor and the host immune system. PMID:23169436

  15. Viruses, anti-viral therapy, and viral vaccines in children with immune thrombocytopenia.

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    Elalfy, Mohsen S; Nugent, Diane

    2016-04-01

    Immune thrombocytopenia (ITP) might be preceded by silent or overt viral infections. Similarly, anti-viral drugs and viral vaccines could also trigger ITP and might play a central role in its pathogenesis. The seasonal nature of childhood ITP suggests that viral infections might initiate immune responses that increase the predisposition and occurrence of ITP. Active cytomegalovirus or Epstein-Barr virus should be considered in differential diagnosis when thrombocytopenia is associated with lymphadenopathy, especially with splenomegaly. This review will focus on the specific association of ITP in association with viral disease and vaccinations, and will discuss the effectiveness of current therapies in light of our current understanding of viral-associated ITP. PMID:27312173

  16. Immunomodulating and Anti-Relapse Effects of Ozone Therapy in Atopic Dermatitis in Preschool and Primary School Children

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    Illek Y.Y.

    2013-06-01

    Full Text Available The aim of the investigation was to study the state of immunologic responsiveness, immunomodulating and anti-relapse effects of ozone therapy in children with severe extended atopic dermatitis. Materials and Methods. We examined 64 children (38 boys and 26 girls aged 5–10 years with severe extended atopic dermatitis. Group 1 patients (n=33 received complex standard treatment, Group 2 (n=31 — complex therapy in combination with ozone therapy. Results. Complex standard therapy resulted in complete, though short, clinical remission; and in remission the patients preserved the changed parameters of cellular and humoral components of immune system, nonspecific resistance and the levels of pro-inflammatory cytokines in blood serum; while the patients receiving complex therapy combined with ozone therapy were found to have more rapid improvement of clinical indices, normalization of the most parameters of immunologic responsiveness and a long clinical remission.

  17. INTERACTION BETWEEN ANTI-HYPERTENSIVE AND NON-STEROIDAL ANTI INFLAMMATORY DRUGS: IMPLICATIONS IN MANAGEMENT OF OSTEOARTHRITIS AND OPINION ON A COMPROMISE THERAPY

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    Mr. Adeolu O. Ajala

    2010-01-01

    Full Text Available The premise for this article is that a significant proportion of patients presenting in the clinic with osteoarthritis have hypertension as co-morbidity. A common drug of choice in managing symptoms of osteoarthritis including those affecting the knee joint is the Non-Steroidal Anti-Inflammatory Drugs (NSAIDS groups. It has been reported however that NSAIDs diminish the effects of anti-hypertensive drugs and may lead to an ineffective hypertension therapy. In order to avoid complications in the health of the patient with concomitant hypertension and osteoarthritis and who are on both antihypertensive and NSAIDs, it becomes imperative to consider using non-pharmacologic approaches such as physiotherapy in managing the symptoms of osteoarthritis in this group of patients and thereby maximizing the effects of their antihypertensive therapy. This is more so that information exists on efficacy of physiotherapy in form of therapeutic exercises and electrotherapeutic modalities in management of clinical features of osteoarthritis.

  18. Conditional Cytotoxic Anti-HIV Gene Therapy for Selectable Cell Modification.

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    Garg, Himanshu; Joshi, Anjali

    2016-05-01

    Gene therapy remains one of the potential strategies to achieve a cure for HIV infection. One of the major limitations of anti-HIV gene therapy concerns recovering an adequate number of modified cells to generate an HIV-proof immune system. Our study addresses this issue by developing a methodology that can mark conditional vector-transformed cells for selection and subsequently target HIV-infected cells for elimination by treatment with ganciclovir (GCV). We used the herpes simplex virus thymidine kinase (TK) mutant SR39, which is highly potent at killing cells at low GCV concentrations. This gene was cloned into a conditional HIV vector, pNL-GFPRRESA, which expresses the gene of interest as well as green fluorescent protein (GFP) in the presence of HIV Tat protein. We show here that TK-SR39 was more potent that wild-type TK (TK-WT) at eliminating infected cells at lower concentrations of GCV. As the vector expresses GFP in the presence of Tat, transient expression of Tat either by Tat RNA transfection or transduction by a nonintegrating lentiviral (NIL) vector marked the cells with GFP for selection. In cells selected by this strategy, TK-SR39 was more potent at limiting virus replication than TK-WT. Finally, in Jurkat cells modified and selected by this approach, infection with CXCR4-tropic Lai virus could be suppressed by treatment with GCV. GCV treatment limited the number of HIV-infected cells, virus production, as well as virus-induced cytopathic effects in this model. We provide proof of principle that TK-SR39 in a conditional HIV vector can provide a safe and effective anti-HIV strategy. PMID:26800572

  19. Natural products as starting points for future anti-malarial therapies: going back to our roots?

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    Wells Timothy NC

    2011-03-01

    Full Text Available Abstract Background The discovery and development of new anti-malarials are at a crossroads. Fixed dose artemisinin combination therapy is now being used to treat a hundred million children each year, with a cost as low as 30 cents per child, with cure rates of over 95%. However, as with all anti-infective strategies, this triumph brings with it the seeds of its own downfall, the emergence of resistance. It takes ten years to develop a new medicine. New classes of medicines to combat malaria, as a result of infection by Plasmodium falciparum and Plasmodium vivax are urgently needed. Results Natural product scaffolds have been the basis of the majority of current anti-malarial medicines. Molecules such as quinine, lapachol and artemisinin were originally isolated from herbal medicinal products. After improvement with medicinal chemistry and formulation technologies, and combination with other active ingredients, they now make up the current armamentarium of medicines. In recent years advances in screening technologies have allowed testing of millions of compounds from pharmaceutical diversity for anti-malarial activity in cellular assays. These initiatives have resulted in thousands of new sub-micromolar active compounds – starting points for new drug discovery programmes. Against this backdrop, the paucity of potent natural products identified has been disappointing. Now is a good time to reflect on the current approach to screening herbal medicinal products and suggest revisions. Nearly sixty years ago, the Chinese doctor Chen Guofu, suggested natural products should be approached by dao-xing-ni-shi or ‘acting in the reversed order’, starting with observational clinical studies. Natural products based on herbal remedies are in use in the community, and have the potential unique advantage that clinical observational data exist, or can be generated. The first step should be the confirmation and definition of the clinical activity of herbal

  20. Off-Label Uses of Anti-TNF Therapy in Three Frequent Disorders: Behçet’s Disease, Sarcoidosis, and Noninfectious Uveitis

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    Daniel Sánchez-Cano

    2013-01-01

    Full Text Available Tumoral necrosis factor α plays a central role in both the inflammatory response and that of the immune system. Thus, its blockade with the so-called anti-TNF agents (infliximab, etanercept, adalimumab, certolizumab pegol, and golimumab has turned into the most important tool in the management of a variety of disorders, such as rheumatoid arthritis, spondyloarthropatties, inflammatory bowel disease, and psoriasis. Nonetheless, theoretically, some other autoimmune disorders may benefit from these agents. Our aim is to review these off-label uses of anti-TNF blockers in three common conditions: Behçet’s disease, sarcoidosis, and noninfectious uveitis. Due to the insufficient number of adequate clinical trials and consequently to their lower prevalence compared to other immune disorders, this review is mainly based on case reports and case series.