Nicolle Gollo Mazzotti

Improvement of pruritus and quality of life of children with atopic dermatitis and their families after joining support groups

Introduction  Atopic dermatitis places a large burden on patients and their families, with greater risk of emotional disorders and behavioural problems. Preliminary evidence suggests that support groups and educational programs are helpful in reducing stress, disease and pruritus severity and improves quality of life (QoL).

Peripheral markers of oxidative stress in chronic mercuric chloride intoxication

The present study was designed to evaluate the time course changes in peripheral markers of oxidative stress in a chronic HgCl2 intoxication model. Twenty male adult Wistar rats were treated subcutaneously daily for 30 days and divided into two groups of 10 animals each: Hg, which received HgCl2 (0.16 mg kg(-1) day(-1)), and control, receiving the same volume of saline solution. Blood was collected at the first, second and fourth weeks of Hg administration to evaluate lipid peroxidation (LPO), total radical trapping antioxidant potential (TRAP), and superoxide dismutase (Cu,Zn-SOD), glutathione peroxidase (GPx), glutathione-S-transferase (GST), and catalase (CAT). HgCl2 administration induced a rise (by 26%) in LPO compared to control (143 +/- 10 cps/mg hemoglobin) in the second week and no difference was found at the end of the treatment. At that time, GST and GPx were higher (14 and 24%, respectively) in the Hg group, and Cu,Zn-SOD was lower (54%) compared to control. At the end of the treatment, Cu,Zn-SOD and CAT were higher (43 and 10%, respectively) in the Hg group compared to control (4.6 +/- 0.3 U/mg protein; 37 +/- 0.9 pmol/mg protein, respectively). TRAP was lower (69%) in the first week compared to control (43.8 +/- 1.9 mM Trolox). These data provide evidence that HgCl2 administration is accompanied by systemic oxidative damage in the initial phase of the process, which leads to adaptive changes in the antioxidant reserve, thus decreasing the oxidative injury at the end of 30 days of HgCl2 administration. These results suggest that a preventive treatment with antioxidants would help to avoid oxidative damage in subjects with chronic intoxication.

The CDKN2A p.A148T variant is associated with cutaneous melanoma in Southern Brazil

Abstract:  Several germline mutations and sequence variants in cancer predisposition genes have been described. Among these, the CDKN2A p.A148T variant appears to be frequent in patients with melanoma, at least in certain ethnic groups. In this case–control study, we evaluated 127 patients with cutaneous melanoma and 128 controls from Southern Brazil, the region with the highest melanoma incidence rates in the country. Using PCR–RFLP, we demonstrate that CDKN2A p.A148T variant was significantly more frequent in patients with melanoma than in controls (12.6% vs 3.9%; P = 0.009). There was no association between presence of the polymorphism and tumor thickness, site of the primary tumor, melanoma subtype, age at diagnosis, quantitative and qualitative number of nevi. Patients with a positive family of history for other cancers were particularly prone to carry the CDKN2A p.A148T allele. All patients with p.A148T‐positive melanoma reported European ancestry, especially German, and this was confirmed using a panel of ancestry‐informative INDELs. Our data suggest that CDKN2A p.A148T is a melanoma susceptibility allele in Southern Brazil and is particularly common in patients with melanoma of predominantly European ancestry.

The role of adrenergic receptor polymorphisms in heart failure

The main function of the cardiac adrenergic system is to regulate cardiac work both in physiologic and pathologic states. A better understanding of this system has permitted the elucidation of its role in the development and progression of heart failure. Regardless of the initial insult, depressed cardiac output results in sympathetic activation. Adrenergic receptors provide a limiting step to this activation and their sustained recruitment in chronic heart failure has proven to be deleterious to the failing heart. This concept has been confirmed by examining the effect of beta-blockers on the progression of heart failure. Studies of adrenergic receptor polymorphisms have recently focused on their impact on the adrenergic system regarding its adaptive mechanisms, susceptibilities and pharmacological responses. In this article, we review the function of the adrenergic system and its maladaptive responses in heart failure. Next, we discuss major adrenergic receptor polymorphisms and their consequences for heart failure risk, progression and prognosis. Finally, we discuss possible therapeutic implications resulting from the understanding of polymorphisms and the identification of individual genetic characteristics.

Avaliação da relação do prurido e níveis sangüíneos de IgE com a gravidade do quadro clínico em pacientes com dermatite atópica

FUNDAMENTOS: Pacientes portadores de dermatite atopica apresentam frequentemente niveis sericos elevados de IgE, e o prurido e uma das manifestacoes cardinais da doenca. OBJETIVOS: Descrever as caracteristicas do prurido nos pacientes com dermatite atopica (DA) e correlacionar a gravidade do eczema com os niveis plasmaticos de imunoglobulina E (IgE). METODOS: Os pacientes com dermatite atopica atendidos no Servico de Dermatologia do Hospital de Clinicas de Porto Alegre e nos Servicos de Pediatria e Dermatologia da Universidade Luterana do Brasil responderam a um questionario sobre sintomas da dermatite atopica e deles foi coletado sangue para dosagem da IgE serica. A gravidade da dermatose foi calculada conforme criterios sugeridos por Rajka et al. Os dados foram analisados no programa SPSS. RESULTADOS: Oitenta e nove pacientes completaram o estudo. A media de idade foi de 9,6 ± 9 anos, e 51% dos pacientes eram do sexo feminino. Quando analisada a frequencia de prurido de acordo com a gravidade do quadro clinico, foi encontrada uma relacao significativa (p = 0,003). Os pacientes com quadro leve de dermatite atopica tinham coceira diaria em 45% dos casos; aqueles com quadro grave tinham 90,9% de sintomas diarios; e apenas 4,5% tinham mais de sete dias de intervalo entre os episodios de coceira. A mediana dos niveis de IgE serica foi de 347UI\ml. As medianas da IgE serica nos pacientes com eczema leve, moderado e grave foram 279UI\ml, 347UI/ml e 952UI/ml, respectivamente (p = 0,699). Pacientes do sexo feminino apresentaram niveis de IgE menores do que os do sexo masculino (212UI/ml and 2067UI/ml, p= 0,004). CONCLUSAO: Pacientes com quadros graves de dermatite atopica apresentam prurido mais frequente do que aqueles com manifestacoes mais leves. Na avaliacao dos niveis sericos de IgE em relacao a gravidade da DA, apesar de os valores serem mais altos nos pacientes mais graves, nao se encontrou relacao estatistica significativa. Pacientes do sexo masculino tem niveis sericos de IgE significativamente mais altos do que os do sexo feminino. A frequencia do prurido esta relacionada com a gravidade da dermatite atopica.

Infarto do miocárdio experimental e aumento do estresse oxidativo em diafragma de ratos

OBJETIVO: Este e um estudo experimental que visa a avaliar o efeito da insuficiencia cardiaca no estresse oxidativo em diafragma de ratos. METODOS: O modelo de infarto do miocardio por ligadura da arteria coronaria esquerda foi utilizado para desenvolvimento de insuficiencia cardiaca. No 42o dia apos a ligadura coronaria, os animais foram mortos e tiveram o diafragma retirado e homogeneizado. O estresse oxidativo foi avaliado em homogeneizados de diafragma atraves de medidas de lipoperoxidacao e de ensaios de atividade enzimatica antioxidante: catalase, glutationa peroxidase (enzimas que reduzem o peroxido de hidrogenio a agua) e superoxido dismutase (enzima antioxidante que reduz o superoxido a peroxido de hidrogenio). RESULTADOS: Os resultados encontrados foram os seguintes: o modelo de ligadura de arteria coronaria esquerda foi efetivo em gerar insuficiencia cardiaca, com area media de infarto de 39% da area do ventriculo esquerdo; a lipoperoxidacao estava 217% aumentada no diafragma dos animais infartados em relacao aos controles; a atividade antioxidante da catalase estava reduzida em 77% e a da glutationa peroxidase em 20%, em comparacao com o grupo controle; o infarto nao alterou a atividade enzimatica da superoxido dismutase. CONCLUSAO: Os resultados sugerem a presenca de estresse oxidativo no musculo diafragmatico em animais submetidos a ligadura da arteria coronaria esquerda.

Photodynamic therapy: a useful adjunct therapy for recalcitrant ulceration in pemphigus vulgaris

© 2008 The Authors JEADV 2009, 23, 570–620 Journal compilation

Density of mast cells and intensity of pruritus in psoriasis vulgaris: a cross sectional study

BACKGROUND Psoriasis is a chronic and prevalent disease, and the associated pruritus is a common, difficult-to-control symptom. The mediators involved in psoriatic pruritus have not been fully established. OBJECTIVE To evaluate associations between the number of mast cells in psoriatic lesions and the intensity of pruritus. METHODS 29 patients with plaque psoriasis were recruited. In all participants, Psoriasis Area and Severity Index and Body Surface Area were assessed. A questionnaire was administered to obtain clinical information and the Dermatology Life Quality Index. Pruritus was assessed using a visual analog scale and skin biopsies were performed for staining with Giemsa and Immunohistochemistry with C-Kit. RESULTS Pruritus was observed in 91.3% of our patients. Median VAS was 6 (p25-75: 2-8). The immunohistochemical method revealed a mean of 11.32 mast cells/field and Giemsa staining revealed a mean of 6.72 mast cells/field. There was no correlation between the intensity of pruritus and mast cell count, neither in Immunohistochemistry (p = 0.15; rho = -0.27) nor in Giemsa (p = 0.16; rho = -0.27). Pruritus did not impact on the Dermatology Life Quality Index (p = 0.51; rho = -0.13). STUDY LIMITATIONS The small sample size may be considered the main limitation of our study. CONCLUSIONS Although mast cells are mediators of pruritus in many cutaneous diseases, our findings support that psoriatic pruritus is a complex disorder with multifactorial, complex pathophysiology, involving pruritogenic mediators others than mast cells.BACKGROUND Psoriasis is a chronic and prevalent disease, and the associated pruritus is a common, difficult-to-control symptom. The mediators involved in psoriatic pruritus have not been fully established. OBJECTIVE To evaluate associations between the number of mast cells in psoriatic lesions and the intensity of pruritus. METHODS 29 patients with plaque psoriasis were recruited. In all participants, Psoriasis Area and Severity Index and Body Surface Area were assessed. A questionnaire was administered to obtain clinical information and the Dermatology Life Quality Index. Pruritus was assessed using a visual analog scale and skin biopsies were performed for staining with Giemsa and Immunohistochemistry with C-Kit. RESULTS Pruritus was observed in 91.3% of our patients. Median VAS was 6 (p25-75: 2-8). The immunohistochemical method revealed a mean of 11.32 mast cells/field and Giemsa staining revealed a mean of 6.72 mast cells/field. There was no correlation between the intensity of pruritus and mast cell count, neither in Immunohistochemistry (p = 0.15; rho = -0.27) nor in Giemsa (p = 0.16; rho = -0.27). Pruritus did not impact on the Dermatology Life Quality Index (p = 0.51; rho = -0.13). STUDY LIMITATIONS The small sample size may be considered the main limitation of our study. CONCLUSIONS Although mast cells are mediators of pruritus in many cutaneous diseases, our findings support that psoriatic pruritus is a complex disorder with multifactorial, complex pathophysiology, involving pruritogenic mediators others than mast cells.