Background: Psoriasis is associated with abnormal plasma lipid metabolism and a high frequency of cardiovascular events. Increased lipid levels are also seen in patients with psoriasis treated with acitretin. Apolipop...Background: Psoriasis is associated with abnormal plasma lipid metabolism and a high frequency of cardiovascular events. Increased lipid levels are also seen in patients with psoriasis treated with acitretin. Apolipoprotein E (ApoE) variants have been linked to hypertriglyceridaemia and hypercholesterolaemia in normal individuals. Two coding single nucleotide polymorphisms at +3937 and +4075 define the three common ApoE alleles e2, e3 and e4. Objectives: To test the hypothesis that particular ApoE polymorphism(s) are associated with psoriasis and that specific ApoE allelic variant(s) may be a marker for predicting disease response to acitretin. Methods: DNA was genotyped for ApoE polymorphisms using a radioactive hybridization technique in cohorts of patients with psoriasis, including patients with chronic plaque psoriasis (CPP, n = 212), guttate psoriasis (GP, n = 94), palmoplantar pustulosis (PPP, n = 101), controls (n = 137), acitretin responders (n =106) and acitretin nonresponders (n = 84). Results: The frequency of the e4 allele (+3937C/+4075C) was significantly higher in patients with CPP and GP than in controls (P = 0.008 and P = 0.02, respectively). There was no significant difference in allele frequencies between patients with PPP and controls. Allelic distribution was similar in acitretin responders and nonresponders. Conclusions: These data demonstrate an association between the Apo e4 allele and CPP and GP, suggesting a possible pathogenic role for ApoE in psoriasis. Our results do not support a link between disease response to acitretin and the e2, e3 or e4 allelic variants of ApoE.展开更多
Background: The severity of polymorphic light eruption (PLE)-is highly vari able. The results of studies of the prevalence, pathogenesis, provocation and tr eatment of PLE may be highly dependent on the severity of di...Background: The severity of polymorphic light eruption (PLE)-is highly vari able. The results of studies of the prevalence, pathogenesis, provocation and tr eatment of PLE may be highly dependent on the severity of disease in the patient s studied. Objectives: To produce a simple, valid and reproducible method to ass ess the severity of PLE, Patients and methods: Eighty patientswere asked about t he PLE they had experienced during the preceding 12 months, using a standardized interview comprising 16 questions. The answer to each question received a score . A PLE Severity Index (PLESI) was formulated, consisting of 10 questions, with a possible total score of 2- 100. The internal consistency of the PLESI (the ex tent to which the responses to different questions correlated with each other) w as assessed by reliability analysis, using Cronbach’s method. Twenty patients were re-interviewed 7- 27 days later to assess the repeatability of the PLESI . The ease of provocation of PLE by exposure at 24- h intervals to solar-simu lated radiation was assessed on a five-point scale in nine of the 80 subjects (the EOPSSR score). Results The value of Cronbach’s α for the PLESI was 0.77 . The distribution of the PLESI was consistent with a normal distribution, with a mean value of 52.7 and standard deviation of 19.4. It had a coefficient of rep eatability of 20.1. The PLESI was positively correlated with EOPSSR (rs = 0.69, P=0.039) and the number of years since onset of PLE (rs=0.25, P=0.03). There was no association between the PLESI and the duration of persistence of the eruptio n after ceasing sun exposure (rs=0.12, P= 0.30), the development of tolerance as summer progressed (rs=- 0.14, P=0.39), gender (P=0.50) or skin type (P=0.87). Conclusions: This study has (i) validated the concept that a single score can re flect disease severity in PLE by showing that the principal characteristics of t he condition, including, for example, the extent of anatomical distribution and the ease of provocation of the eruption, correlate with each other; (ii) formula ted the PLESI, which is a simple, valid and reproducible way of assessing diseas e severity; we suggest it could be used worldwide to determine the severity of P LE among patients enrolled in future PLE research; (iii) shown that the ease wit h which the eruption is provoked by solar-simulated radiation correlates with the severity of the condition; and (iv) shown that the duration of persistence o f the eruption after sun exposure does not correlate with the severity of the co ndition.展开更多
文摘Background: Psoriasis is associated with abnormal plasma lipid metabolism and a high frequency of cardiovascular events. Increased lipid levels are also seen in patients with psoriasis treated with acitretin. Apolipoprotein E (ApoE) variants have been linked to hypertriglyceridaemia and hypercholesterolaemia in normal individuals. Two coding single nucleotide polymorphisms at +3937 and +4075 define the three common ApoE alleles e2, e3 and e4. Objectives: To test the hypothesis that particular ApoE polymorphism(s) are associated with psoriasis and that specific ApoE allelic variant(s) may be a marker for predicting disease response to acitretin. Methods: DNA was genotyped for ApoE polymorphisms using a radioactive hybridization technique in cohorts of patients with psoriasis, including patients with chronic plaque psoriasis (CPP, n = 212), guttate psoriasis (GP, n = 94), palmoplantar pustulosis (PPP, n = 101), controls (n = 137), acitretin responders (n =106) and acitretin nonresponders (n = 84). Results: The frequency of the e4 allele (+3937C/+4075C) was significantly higher in patients with CPP and GP than in controls (P = 0.008 and P = 0.02, respectively). There was no significant difference in allele frequencies between patients with PPP and controls. Allelic distribution was similar in acitretin responders and nonresponders. Conclusions: These data demonstrate an association between the Apo e4 allele and CPP and GP, suggesting a possible pathogenic role for ApoE in psoriasis. Our results do not support a link between disease response to acitretin and the e2, e3 or e4 allelic variants of ApoE.
文摘Background: The severity of polymorphic light eruption (PLE)-is highly vari able. The results of studies of the prevalence, pathogenesis, provocation and tr eatment of PLE may be highly dependent on the severity of disease in the patient s studied. Objectives: To produce a simple, valid and reproducible method to ass ess the severity of PLE, Patients and methods: Eighty patientswere asked about t he PLE they had experienced during the preceding 12 months, using a standardized interview comprising 16 questions. The answer to each question received a score . A PLE Severity Index (PLESI) was formulated, consisting of 10 questions, with a possible total score of 2- 100. The internal consistency of the PLESI (the ex tent to which the responses to different questions correlated with each other) w as assessed by reliability analysis, using Cronbach’s method. Twenty patients were re-interviewed 7- 27 days later to assess the repeatability of the PLESI . The ease of provocation of PLE by exposure at 24- h intervals to solar-simu lated radiation was assessed on a five-point scale in nine of the 80 subjects (the EOPSSR score). Results The value of Cronbach’s α for the PLESI was 0.77 . The distribution of the PLESI was consistent with a normal distribution, with a mean value of 52.7 and standard deviation of 19.4. It had a coefficient of rep eatability of 20.1. The PLESI was positively correlated with EOPSSR (rs = 0.69, P=0.039) and the number of years since onset of PLE (rs=0.25, P=0.03). There was no association between the PLESI and the duration of persistence of the eruptio n after ceasing sun exposure (rs=0.12, P= 0.30), the development of tolerance as summer progressed (rs=- 0.14, P=0.39), gender (P=0.50) or skin type (P=0.87). Conclusions: This study has (i) validated the concept that a single score can re flect disease severity in PLE by showing that the principal characteristics of t he condition, including, for example, the extent of anatomical distribution and the ease of provocation of the eruption, correlate with each other; (ii) formula ted the PLESI, which is a simple, valid and reproducible way of assessing diseas e severity; we suggest it could be used worldwide to determine the severity of P LE among patients enrolled in future PLE research; (iii) shown that the ease wit h which the eruption is provoked by solar-simulated radiation correlates with the severity of the condition; and (iv) shown that the duration of persistence o f the eruption after sun exposure does not correlate with the severity of the co ndition.
