甲氨蝶呤治疗前后银屑病皮损中ICAM-3、Ki-67、PCNA及CD31表达的变化

Although the effectiveness of methotrexate (MTX) in the treatment of psoriasis is very well established, the mechanism of action is poorly understood. It was suggested that the therapeutic effect of MTX in psoriasis might be mediated by inhibition of adhesion molecule expression. The aim of our study was to investigate the different effects of MTX treatment on cell proliferation, inflammatory infiltrate, adhesion molecules, and angiogenesis in psoriasis, and to clarify the mechanism by which MTX exerts its therapeutic effects. Clinical response, the morpho- phenot- ypic changes, epidermal thickness, and mitosis count were analyzed and the expression of CD31 and ICAM- 3, proliferative markers such as Ki- 67, PCNA, were evaluated by immunohistochemical techniques in lesional psoriatic epidermis, before and after the treatment with MTX in ten patients. In posttreatment biopsies a decrease in the degree of epidermal hyperplasia and a significant reduction in the severity of the inflammatory infiltrate (P< 0.05) were observed. In addition,CD31 and ICAM- 3 expression was significantly decreased ondermal cellular infiltrate, (respectively; P< 0.05,P< 0.01). Ki67 and PCNA expression were suppressed concurrently in about 90% of cases (P< 0.01). We suggest that MTX may have an inhibitory effect on an initial integral component of the pathways that lead to psoriasis. Immunopharmacologic intervention in adhesion event has the potential to improve psoriasis. Inhibition of revascularization may be another mechanism of actionof MTX.

白塞病患者载脂蛋白E多态性和脂蛋白成分

Background. Behc.et’s disease (BD) is a multisystemic disease of unknown etio logy characterized by chronic relapsing oral-genital ulcers and uveitis. Some a bnormalities in lipoprotein metabolism have been described in patients with BD. Methods. In this study, apolipoprotein E (apo E) polymorphism and lipoprotein ch olesterol concentrations in 30 patients with BD were compared with those of 27 c ontrol subjects. Results. Both patients and controls were found to be normolipid emic. Patients with BD had significantly higher concentrations of high-density lipoprotein (HDL) cholesterol than those of controls (P < .0.05); however, there was no difference in serum triglyceride, low-densitylipoprotein(LDL)and very l ow-density lipoprotein (VLDL) cholesterol concentrations. The distribution of a po E genotypes and alleles was the same in both groups. There were slight differ ences in allele frequency between the groups, but this was not statistically sig nificant. Conclusions. The high HDL cholesterol levels observed in our patients were not related to abnormalities in apo E alleles.

Behcet病患者的N乙酰基转移酶2多态性

It is possible that dietary, environmental factors and/or genetic polymorphism s in xenobiotic-metabolizing enzymes may contribute to the development of Behce t’s disease. As N-acetyltransferase (NAT) 2 is an important xenobiotic-metabo lizing enzyme and theoretically the nonacetylated xenobiotics may induce an auto immune mechanism, the aim of the present study was to investigate whether the ge netic polymorphism of NAT2 plays a role in susceptibility to Behcet’s disease. Forty Behcet’s disease patients and 82 control subjects were enrolled in the st udy. NAT2.5A, NAT2.6A, NAT27.A/B and NAT2.14A polymorphisms were detected by usi ng real time PCR with LightCycler (Roche Diagnostics GmbH, Mannheim, Germany). T he NAT2.5A and NAT2.6A mutant genotypes carried an increased risk of developing Behcet’s disease [odds ratio(OR) =66.29,95%confidenceinterval(CI) =8.21-535. 3 3; and OR = 24; 95%CI = 2.04-304.98, respectively]. The NAT2.7A/B and NAT2.14 A gene polymorphisms were not an increased risk for developing Behcet’s disease. As a result of this study we conclude the NAT2 slow acetylator status may be a determinant in susceptibility to Behcet’s disease. This finding may have implic ations for the theories of the pathogenesis of the disease as well as for therap eutic aspects.

圆形切除面部良性小丘疹圆顶形黑色素细胞痣

Background. Patients frequently request the removal of benign, papular and dome-shaped nevi for cosmetic or functional reasons. Total excision is probably the most widely used method of removal. Aim. To introduce the round excision technique for the treatment of benign, papular and dome-shaped nevi on the face. Methods. In a prospective study, 36 benign, papular or dome-shaped nevi of all types were removed by the round excision technique. The lesions were circumscribed with a number 15 scalpel blade, 2 mm beyond the limits, with incision to the full depth of the dermis, and removed by cutting horizontally at the maximum depth of the circular incision. Histologic examinations were performed for all specimens. Results. Complete removal of nevi was achieved in all patients with excellent or good cosmetic results. Of the 36 nevi, 24 were intradermal and 12 were compound nevi. Dog-ear formation was observed in only one patient. Conclusion. Round excision may be a better alternative to conventional fusiformor shaveexcision of benign, dome-shaped or papular nevi of the face.