Agnieszka Beata Serwin

Selenium status in psoriasis and its relations to the duration and severity of the disease

OBJECTIVE We examined the role of selenium (Se) status in psoriasis and its relation to the severity and duration of the disease. METHODS The study was conducted among 30 patients with psoriasis of less than 10 mo duration (study group 1, sg 1) and 30 with psoriasis of more than 3 y duration (study group 2, sg 2). Control groups (cg) consisted of 30 patients with short periods of skin disorders other than psoriasis and 24 healthy volunteers (cg 1 and cg 2, respectively). Plasma Se concentration and glutathione peroxidase (GSH-Px) activity in plasma and erythrocytes were measured to determine Se status. RESULTS Plasma Se (microg/L) levels were 47.11 +/- 11.61 in sg 1, 38.69 +/- 13.22 in sg 2, 43.53 +/- 11.73 in cg 1, and 48.71 +/- 9.39 in cg 2; plasma GSH-Px (U/mL) levels, were 0.15 +/- 0.04, 0.14 +/- 0.04, 0.16 +/- 0.04, and 0.18 +/- 0.03, respectively; and erythrocyte GSH-Px (U/g of hemoglobin) levels were 13.97 +/- 4.27, 13.16 +/- 3.85, 14.25 +/- 3.84, and 14.35 +/- 3.35, respectively. Erythrocyte GSH-Px correlated inversely to severity of psoriasis in sg 2 (r = -0.37, P < 0.05). CONCLUSION Se status is depressed and related to the severity of the disease only in patients with psoriasis lasting more than 3 y.

Tumour necrosis factor α (TNF-α)-converting enzyme (TACE) and soluble TNF-α receptor type 1 in psoriasis patients treated with narrowband ultraviolet B

Purpose: The aim of the study was to examine the tumour necrosis factor α (TNF‐α)‐converting enzyme (TACE) concentration in peripheral blood mononuclear cells (PBMC) and its relationship with plasma concentration of soluble TNF‐α receptor type 1 (sTNF‐R1) and with the disease severity in psoriasis patients treated with narrowband ultraviolet B (NB‐UVB).

Selenium status in psoriasis and its relationship with alcohol consumption.

The aim of the study was to examine the influence of alcohol consumption on the severity of psoriasis and selenium (Se) concentration and Se-dependent gluathione peroxidase activity in plasma (pl-GSH-Px) and in erythrocytes (RBC-GSH-Px) in psoriatic patients. Thirty-five in-patients with psoriasis lasting <10 mo and 42 with psoriasis lasting >3 yr constituted groups 1 and 2, respectively. The severity of psoriasis was assessed using the PASI scoring system and the consumption of alcohol, using a structured questionnaire. The Se concentration was 47.11±11.61 µg/L in group 1 and 38.69±13.22 µg/L in group 2 (p<0.05), the pl-GSH-Px was 0.15±0.04 U/mL and 0.14±0.04 U/mL (p>0.05), and the RBC-GSH-Px was 13.97±4.27 U/g Hb and 13.16±3.85 U/g Hb (p>0.05), respectively. In excessive drinkers (<10% of patients, all males), the Se concentration was 32.84±10.88 µg/L, the pl-GSH-Px was 0.15±0.03 U/mL, and the RBC-GSH-Px was 11.64±3.32 U/g Hb. A low RBC-GSH-Px correlated to the consumption of high-grade alcoholic beverages (R=−0.45, p<0.05) and to the PASI value (R=−0.37, p<0.05) in group 2. Depressed Se concentration and Se-dependent GSH-Px can be related to the severity and a duration of psoriasis. The excessive consumption of alcohol is associated with severity of the disease and with low activity of GSH-Px in erythrocytes in patients with long-lasting psoriasis.

Incidence and mortality of bullous pemphigoid in north‐east Poland (Podlaskie Province), 1999–2012: a retrospective bicentric cohort study

Bullous pemphigoid (BP) is the most frequently encountered autoimmune blistering disorder, affecting mainly elderly population. The aim of the study was to assess the incidence of BP in Podlaskie Province (north‐east Poland) in 1999–2012, socio‐demographic characteristics and mortality of patients with BP.

Tumour necrosis factor (TNF-α) alpha converting enzyme and soluble TNF-α receptor type 1 in psoriasis patients in relation to the chronic alcohol consumption

Background  Tumour necrosis factor alpha converting enzyme (TACE) is a major sheddase of TNF‐α and its receptors, essential for the generation of soluble, mature molecules. The regulation of the TACE activity by ethanol in vitro has been suggested recently. The alcohol abuse is a frequent problem among psoriasis patients. The aim of the study was to analyse the relationship between long‐term alcohol consumption and the concentration of TACE in peripheral blood mononuclear cells (PBMC) and its substrate – soluble TNF‐α receptor type 1 (sTNF‐R1) in plasma in psoriasis patients.

Soluble tumor necrosis factor-α receptor type 1 during selenium supplementation in psoriasis patients

OBJECTIVE Tumor necrosis factor-alpha (TNF-alpha) and its receptors play important roles in the induction and maintenance of psoriatic lesions. Selenium (Se), a trace element with immunomodulatory properties, is usually decreased in psoriasis patients. We examined the influence of Se supplementation on soluble TNF-alpha receptor type 1 (sTNF-R1) and topical treatment in psoriasis patients. METHODS The study was conducted in between January and June 2002. Twenty-two inpatients with active plaque psoriasis received topical treatment with 5% salicylic acid ointment, 0.1% to 0.3% dithranol ointment, and 200 microg daily of Se as selenomethionine (SeMet; n = 11, group 1) or placebo (n = 11, group 2) for 4 wk. Psoriasis Area and Severity Index (PASI) score and Se and sTNF-R1 concentrations were assessed at baseline and every 2 wk. Control sera were obtained from 10 healthy subjects. For statistical analysis, parametric tests were used, and the level of significance was set at P = 0.05. RESULTS The baseline sTNF-R1 levels were 1.87 +/- 0.58 ng/mL (1.98 +/- 0.44 ng/mL in group 1 and 1.75 +/- 0.69 ng/mL in group 2, P = 0.34) in psoriasis patients and 1.65 +/- 0.25 ng/mL in control subjects (P = 0.17); baseline Se concentrations were 48.31 +/- 13.20 microg/L (48.31 +/- 13.20 microg/L in group 1 and 50.35 +/- 13.49 microg/L in group 2, P = 0.41) in psoriasis patients and 58.30 +/- 17.21 microg/L in control subjects (P = 0.05). A positive correlation between PASI and sTNF-R1 was noticed (r = 0.36, P = 0.04; r = 0.51 in group 1 and r = 0.18 in group 2). After 4 wk, almost complete remission of skin lesions was achieved in both groups, but the PASI score was higher in group 1 than in group 2 (4.30 +/- 3.92 and 1.67 +/- 1.17, respectively; P < 0.05). TNF-R1 levels were 1.81 +/- 0.42 ng/mL in group 1 and 1.33 +/- 0.40 ng/mL in group 2 (P = 0.01), and the correlation between PASI score and TNF-R1 level became inverse (r = -0.24 in group 1 and r = -0.59 in group 2). Se concentrations were 107.51 +/- 18.08 microg/L in group 1 and 56.83 +/- 15.32 microg/L in group 2 (P < 0.01). CONCLUSIONS Increased level of sTNF-R1 may be an indicator of active psoriasis. Supplementation with selenomethionine was ineffective as adjuvant treatment in plaque psoriasis and may contribute to the maintenance of elevated TNF-R1 concentration in psoriasis patients despite the remission of skin lesions.

Soluble tumor necrosis factor α receptor type 1 in psoriasis patients treated with narrowband ultraviolet B

Purpose: The purpose of this study was to examine the influence of narrowband ultraviolet (NB‐UVB) therapy on the serum concentration of soluble tumor necrosis factor receptor type 1 (sTNF‐R1) in psoriasis patients.

SOLUBLE TUMOUR NECROSIS FACTOR-ALPHA RECEPTOR TYPE 1 AS A BIOMARKER OF RESPONSE TO PHOTOTHERAPY IN PATIENTSWITH PSORIASIS

Abstract The purpose of the study was to analyze the relationship between the serum concentration of soluble tumour necrosis factor-α type 1 (sTNF-R1), the severity of plaque-type psoriasis and therapeutic response. We compared sTNF-R1 in 25 patients treated with narrowband ultraviolet B (NB-UVB) radiation and 25 patients treated with systemic photochemotherapy (psoralen plus UVA – PUVA). The pretreatment Psoriasis Area and Severity Index (PASI) score and sTNF-R1 concentration were 16.32±5.26 and 1.99±0.40 ng ml−1, respectively, in the group treated with NB-UVB, and 17.22±3.48 and 2.07±0.31 ng ml−1, respectively, in the group treated with PUVA. The concentration of sTNF-R1 in healthy controls was 1.49±0.34 ng ml−1 (p<0.05 compared with patients with psoriasis). The pretreatment PASI score correlated with sTNF-R1 in both treatment groups (r=0.46 and r=0.44, p<0.05). NB-UVB and PUVA gave similar therapeutic effects (the PASI score after 20 treatments was 4.42±1.67 in the NB-UVB-treated group and 5.55±2.10 in PUVA-treated patients); however, the sTNF-R1 concentration at the same time differed significantly: 1.52±0.37 ng ml−1 and 1.98±0.39 ng ml−1 (p<0.001), respectively. Moreover, the decline in sTNF-R1 in both treatment groups was significant only in patients in whom the duration of skin lesions was less than 3 months. The results suggest that the value of serum sTNF-R1 concentration as a marker of response to phototherapy may depend on duration of skin lesions and the treatment method.

Three cases of classic Kaposi's sarcoma with different subtypes of Kaposi's sarcoma‐associated herpesvirus

Case 1 A 71-year-old man, seen for the first time in June 1997, had a 4-year history of bluish-red macules, progressively forming plaques and nodules, localized at first on distal parts of the feet and then the lower legs. Involvement of the penis, hands and forearms was noticed in 1997, the upper legs and lower part of the trunk in 1998, and the mucous membrane of the hard palate in 1999 (Fig. 1). The patient had a history of five episodes of localized herpes zoster (1980–91), diabetes mellitus since 1990 (treated with insulin since 1993) with diabetic polyneuropathy, and arterial hypertension diagnosed in 1996. The diagnosis of Kaposi’s sarcoma (KS) was confirmed histopathologically in May 1998 (Fig. 2). The virological examination (DNA amplification) of skin-biopsy specimens (2000)

Linear IgA bullous dermatosis in a diabetic patient with chronic renal failure

A 60‐year‐old woman was admitted in October 2000 for disseminated polymorphic papular and vesiculobullous skin lesions with a herpetiform pattern ( Fig. 1 ). The eruption occurred 1 month prior to admission and was accompanied by intense itching and burning. A few vesicles in the oral mucosa appeared 6 months after the onset of the skin lesions. The patients history was notable for noninsulin‐dependent diabetes mellitus since the age of 32 years, complicated by arterial hypertension, neuropathy, and nephropathy with subsequent renal failure. The patient started hemodialysis 20 years after the onset of diabetes and was hemodialyzed three times a week for 4 h (index of dialysis adequacy (Kt/v) ≈ 1.3). She had received insulin since the age of 55 years. Furosemide, started in 1998, was withdrawn in October 2000, a few days after admission.