Karel Ettler

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

Background  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.

Sensitization to aeroallergens in atopic dermatitis patients: association with concomitant allergic diseases

A few reports demonstrate the relationship between IgE sensitization to aeroallergens in atopic dermatitis (AD) patients and other allergic diseases and parameters.

Egg allergy in patients over 14 years old suffering from atopic eczema.

Objective  The aim of this study was to evaluate the occurrence of egg allergy in patients over 14 years old suffering from atopic eczema and especially to evaluate if egg allergy can deteriorate the course of atopic eczema in this group of patients.

Immunologic Changes in TNF-alpha, sE-selectin, sP-selectin, sICAM-1, and IL-8 in Pediatric Patients Treated for Psoriasis with the Goeckerman Regimen

Abstract:  Psoriasis is a chronic inflammatory skin disease which is often manifested during childhood. The present study investigated changes in the serum levels of proinflammatory cytokines and soluble forms of adhesion molecules in children with psoriasis. The observed patient group of 26 children was treated with the Goeckerman regimen. This therapy combines dermal application of crude coal tar with ultraviolet radiation. The Psoriasis Area Severity Index decreased significantly after treatment by with the Goeckerman regimen (p < 0.001). Serum levels of the proinflammatory cytokine TNF‐alpha and adhesion molecules sICAM‐1, sP‐selectin and sE‐selectin decreased after the Goeckerman regimen. The TNF‐alpha and sICAM‐1 decreased significantly (p < 0.05). Our findings support the complex role of these immune parameters in the immunopathogenesis of psoriasis in children. The serum level of IL‐8 increased after the Goeckerman regimen. This fact indicates that the chemokine pathway of IL‐8 activity could be modulated by this treatment, most likely by polycyclic aromatic hydrocarbons.

Evaluation of allergy to soy in patients with atopic dermatitis older than 14 years of age

Atopic dermatitis is associated with food allergies. The aim of this study is to evaluate soy allergy in patients suffering from atopic dermatitis. Altogether 228 persons were included; specific IgE, skin prick tests, atopy patch tests, challenge tests with soy and history of soy allergy were evaluated. Soy allergy was confirmed in eight patients (3.5%, in four patients with worsening of atopic dermatitis, in four patients with oral allergy syndrome), sensitisation to soy was found in another 47 patients (20%) with no clinical manifestation after soy ingestion. Dependence was confirmed statistically between soy allergy and pollen allergy and soy sensitivity and pollen allergy. About 20% of patients suffering from atopic dermatitis are sensitised to soy. Clinical symptoms of soy allergy occur only in 3.5% of patients suffering from atopic dermatitis.

Food hypersensitivity reactions in atopic dermatitis patients and analysis of contomitant diseases

Only few population-based data exist on the association of food hypersensitivity reactions and atopic diseases. The objective of this study was to evaluate the dependence between the occurrence of food hypersensitivity reactions and other atopic diseases and parameters. Complete dermatological and allergological examination was performed. Statistical evaluation of the relations between the occurrence of food hypersensitivity reactions and the occurrence of asthma bronchiale, rhinitis, duration of atopic dermatitis, family history and onset of atopic dermatitis was performed. Two hundred and thirty-five patients were examined – 75 men and 160 women, average age 26.2 years (SD = 9.5). Patients suffering from food hypersensitivity reactions, in general, suffer significantly more often from rhinitis and from persistent eczematic lesions; the dependence was confirmed in patients with hypersensitivity reactions to nuts, kiwi, fishes and apple. Atopic march was confirmed in patients suffering from atopic dermatitis and from food hypersensitivity reactions.

Genotoxic Hazard and Cellular Stress in Pediatric Patients Treated for Psoriasis with the Goeckerman Regimen

Abstract:  The Goeckerman regimen (GR) represents a local treatment of psoriasis and includes topical dermal application of crude coal tar (containing polycyclic aromatic hydrocarbons) and exposure to UV‐irradiation. The aim of the study was to evaluate contribution of GR to genotoxic risk and cellular stress in pediatric patients who represent a sensitive population subgroup. Genotoxic risk (42 patients) was evaluated by using chromosomal aberrations (CA) in peripheral lymphocytes. Cellular stress (26 patients) was assessed by using heat shock proteins (Hsp70). All indicators were determined in blood samples collected before GR and immediately after GR. Decreasing of psoriasis area and severity index (PASI) score indicated higher likelihood of GR (p < 0.001). Significantly increased CA (p < 0.001) and Hsp70 (p < 0.05) indicated higher genotoxic risk and cellular stress in sensitive pediatric patients, immediately after GR.

CC and CXC chemokines patterns in psoriasis determined by protein array method were influenced by Goeckerman's therapy.

Goeckermans therapy (GT) of psoriasis is based on daily application of pharmacy grade coal tar on affected skin with subsequent exposure to UV light. The aim of this study was to evaluate the influence of Goeckermans therapy of psoriasis on the levels of proangiogenic chemokines ENA-78 (CXCL5, Epithelial Cell Derived Neutrophil Attractant-78), GRO alpha (CXCL1, Growth-Related Oncogene), IL-8 (CXCL8, Interleukin-8), MCP-1 (CCL2, Monocyte Chemotactic (Chemoattractant) Protein 1) and RANTES (CCL5, Regulated on Activation of Normal T Cell Expressed and Secreted) in peripheral blood of 22 childrens patients with psoriasis. 22 otherwise healthy children serve as a control group. The serum levels of chemokines were determined by commercial membrane protein array technique (RayBiotech, USA). Efficacy of Goeckermans therapy was delineated by PASI score. Disease activity was significantly diminished by Goeckermans therapy (p < 0.001). Serum levels of GRO alpha and MCP-1 in patients before GT were significantly higher than those measured in healthy blood donors (GRO alpha: p = 0.0128 and MCP-1: p = 0.0003). Serum levels of GRO alpha, MCP-1 and RANTES were significantly diminished by GT (GRO alpha: p = 0.002, MCP-1: p = 0.048 and RANTES: p = 0.0131). Compared to the healthy controls, serum level of MCP-1 remained significantly increased in psoriasis patients after GT (p < 0.0001). In conclusion, we found that the GT of psoriasis influenced the serum levels of proinflammatory and proangiogenic chemokines, especially GRO alpha, MCP-1 and RANTES. It could be the cause for decreased proangiogenic activity which is described after GT of psoriasis.

Evaluation of food allergy to wheat, cow milk, egg, soy and peanuts in patients suffering from atopic dermatitis

Few large studies concerning the importance of food allergy in adolescents and adult patients with atopic dermatitis exist. The evaluation of food allergy to egg white and yolk, peanuts, soy, cow milk and wheat in patients suffering from atopic dermatitis. Two hundred forty patients (70 men, 170 women) were examined. Complete dermatological and allergological examination was performed in all patients, including specific IgE, skin prick test and atopy patch test. The challenge test was performed according to the results of examinations with suspected foods. The food allergy to peanuts was confirmed in 20% of patients, to egg in 6%, to soy in 3.3%, to wheat in 2.5% and to milk in 0.8% – altogether in 65 patients (27.5%). The positive results in examinations without clinical symptoms of food allergy were recorded in another 78 patients (32.5%). The diagnostic work-up should comprise not only the laboratory methods, but also the diagnostic hypoallergenic diet and the challenge test.

Metabolic Syndrome and Selective Inflammatory Markers in Psoriatic Patients

The presented article studies the role of selected inflammatory and anti-inflammatory serum markers of psoriatic patients in the pathogenesis of metabolic syndrome (MS) and psoriasis. The study is based on the comparison between the group of psoriatic patients (74) and the control group (65). We found significantly higher BMI (p < 0.05) and diastolic blood pressure (p < 0.05) in the psoriatic patients. The values of waist circumference and BMI were significantly higher (p < 0.05) in the male patients compared to the men in the control group. The analysis revealed significantly higher CRP (p < 0.001), Lp-PLA2 (p < 0.001), leptin (p < 0.01), and resistin (p < 0.01) levels in the psoriatic patients. Significantly higher levels of CRP (p < 0.01), Lp-PLA2 (p < 0.001), leptin (p < 0.01), and resistin (p < 0.05) were found in the patients with MS compared to the controls with MS. The level of adiponectin was significantly lower (p < 0.01) in the patients with MS. Finally, we found significantly higher level of Lp-PLA2 (p < 0.001) in the group of patients without MS compared to the controls without MS. In conclusion, observed inflammatory and anti-inflammatory markers (CRP, adiponectin, leptin, resistin, and Lp-PLA2) are involved in both pathogenesis of MS and pathogenesis of psoriasis. The level of Lp-PLA2 indicates the presence of subclinical atherosclerosis (cardiovascular risk) in psoriatic patients.