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  • Author: Ilona Hartmane x
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Change of TGF-β1 concentration in blood serum of patients during systemic treatment of severe psoriasis

TGF-β1 is a growth factor with multiple actions, responsible for many pathological and physiological processes. Radiation of the skin with a narrowband 311 nm UVB light source is the most often used method of therapy in psoriasis treatment. The aim of the study was to compare different therapy methods on the change of TGF-β1 serum concentration during two weeks of treatment. The TGF-β1 concentration in blood serum of patients with psoriasis was statistically significantly lower than in the control group. For psoriasis treatment, narrow band 311 nm UVB phototherapy was applied to 37 patients and systemic pharmacological treatment with metothrexate, to a group of 18 patients. After two weeks, there was a significant reduction of Psoriasis Area and Severity Index (PASI) and increase of TGF-β1 serum concentration. Narrowband UVB caused a lower PASI, and higher TGF-β1 serum concentration than did pharmacological systemically treatment. Growth factor TGF-β1 had an effect on both of these processes. Lack of TGF-β1 in psoriatic skin is responsible for TH1-induced immune reactions and intensive proliferation of keratinocytes, which are typical of psoriasis. UVB radiation results in a higher TGF-β1 tissue concentration. Elevation of TGF-β1 concentration in blood serum and skin after UVB may present a possible mechanism for the positive effect of UVB in psoriasis treatment.

Abstract

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.

Optimised Routines for Monitoring of Treated Late Latent Syphilis Patients

Highly sensitive and specific tests are needed in monitoring of the serological activity and efficacy of treatment of late latent syphilis. In a retrospective study, the data of 52 patients who had received treatment for late latent syphilis were analysed in the Clinical Centre of Skin and Sexually Transmitted Diseases, Latvia. The diagnostic sensitivity and specificity was calculated by Syphilis Immunoblot IgG, Treponema Pallidum Immobilisation Reaction (TPIR) and Syphilis Express Diagnosis (SED). The correlation between Treponema Pallidum Immobilisation Reaction (TPIR) and Syphilis Immunoblot IgG, SED and TPIR results were estimated. Syphilis Immunoblot IgG is useful for latent syphilis diagnostics. The values of the synthetic peptide TmpA, TmpN15 and TmpN47 on the Syphilis Immunoblot IgG strip are useful for monitoring of the treatment of late latent syphilis patients.