BACKGROUND In recent years,immune checkpoint inhibitors(ICIs)have demonstrated remarkable efficacy across diverse malignancies.Notably,in patients with advanced gastric cancer,the use of programmed death 1(PD-1)blocka...BACKGROUND In recent years,immune checkpoint inhibitors(ICIs)have demonstrated remarkable efficacy across diverse malignancies.Notably,in patients with advanced gastric cancer,the use of programmed death 1(PD-1)blockade has significantly prolonged overall survival,marking a pivotal advancement comparable to the impact of Herceptin over the past two decades.While the therapeutic benefits of ICIs are evident,the increasing use of immunotherapy has led to an increase in immune-related adverse events.CASE SUMMARY This article presents the case of a patient with advanced gastric cancer and chronic plaque psoriasis.Following sintilimab therapy,the patient developed severe rashes accompanied by cytokine release syndrome(CRS).Fortunately,effective management was achieved through the administration of glucocorticoid,tocilizumab,and acitretin,which resulted in favorable outcomes.CONCLUSION Glucocorticoid and tocilizumab therapy was effective in managing CRS after PD-1 blockade therapy for gastric cancer in a patient with chronic plaque psoriasis.展开更多
In recent years,cancer immunotherapy has introduced novel treatments,such as monoclonal antibodies,which have facilitated targeted therapies against tumor cells.Programmed death-1(PD-1)is an immune checkpoint expresse...In recent years,cancer immunotherapy has introduced novel treatments,such as monoclonal antibodies,which have facilitated targeted therapies against tumor cells.Programmed death-1(PD-1)is an immune checkpoint expressed in T cells that regulates the immune system’s activity to prevent over-activation and tissue damage caused by inflammation.However,PD-1 is also expressed in tumor cells and functions as an immune evasion mechanism,making it a therapeutic target to enhance the immune response and eliminate tumor cells.Consequently,immune checkpoint inhibitors(ICIs)have emerged as an option for certain tumor types.Nevertheless,blocking immune checkpoints can lead to immune-related adverse events(irAEs),such as psoriasis and cytokine release syndrome(CRS),as exemp-lified in the clinical case presented by Zhou et al involving a patient with adva-nced gastric cancer who received sintilimab,a monoclonal antibody targeting PD-1.Subsequently,the patient experienced exacerbation of psoriasis and CRS.The objective of this editorial article is to elucidate potential immunologic mechanisms that may contribute to the development of CRS and psoriasis in patients receiving ICIs.It is crucial to acknowledge that while ICIs offer superior safety and efficacy compared to conventional therapies,they can also manifest irAEs affecting the skin,gastrointestinal tract,or respiratory system.In severe cases,these irAEs can lead to life-threatening complications such as circulatory shock or multiorgan failure.Consequently,it is recommended that patients receiving ICIs undergo regular monitoring to identify and manage these adverse events effectively.展开更多
Objective: To explore the effects of Tripterygium wilfordii combined with viaminate on psoriasis patients' immune indexes, endothelium, inflammatory reaction, sICAM-1 and NF-kB. Methods: A total of 112 patients wi...Objective: To explore the effects of Tripterygium wilfordii combined with viaminate on psoriasis patients' immune indexes, endothelium, inflammatory reaction, sICAM-1 and NF-kB. Methods: A total of 112 patients with psoriasis admitted in our hospital from September 2015 to November 2017 were randomly divided into control group (n=56) and observation group (n=56). The control group was treated only by Viaminate Capsules, and the observation group was treated with Tripterygium wilfordii tablet on the basis of the control group, the immune function, endothelial, inflammatory response, soluble intercellular adhesion molecules-1 (sICAM-1) and nuclear transcription factor-kB (NF-kB) expression levels were compared before and after treatment in the two groups. Results: Before treatment, CD4+, CD8+, CD4+/CD8+, vascular endothelial growth factor (VEGF), nitric oxide (NO), endothelin-1 (ET-1), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), NF-kB, and sICAM-1 in two groups were no significant difference. After treatment, CD4+and CD4+/CD8+in both groups were significantly increased, while CD8+was significantly lower than before treatment, the CD4+and CD4+/CD8+in the observation group were significantly higher than those in the control group, and CD8+was obviously lower than that of the control group;The VEGF, NO and ET-1 in both groups were dramatically lower than those before treatment, and the VEGF, NO and ET-1 in the observation group were significantly lower than those in the control group;The TNF-α and IFN-γ in two groups were significantly lower than before treatment, and TNF-α and IFN-γ in the observation group were remarkably lower than those in the control group;The NF-kB and sICAM-1 in two groups were obviously decreased than those before treatment, and the NF-kB and sICAM-1 in the observation group were significantly lower than those in the control group. Conclusion: Tripterygium wilfordii combined with viaminate capsules in the treatment of psoriasis patients, can effectively correct their immune dysfunction, improve endothelial function, reduce inflammatory response and inhibit the expression of NF-kB and sICAM-1 expression.展开更多
Objective:To detect the expression level of macrophage inflammatory protein-1(MIP-1)α,MIP-1βand monocyte chemoattractant protein-1(MCP-1)in with psoriasis vulgaris and explore the role in the pathogenesis of psorias...Objective:To detect the expression level of macrophage inflammatory protein-1(MIP-1)α,MIP-1βand monocyte chemoattractant protein-1(MCP-1)in with psoriasis vulgaris and explore the role in the pathogenesis of psoriasis vulgaris.Methods:The level of MIP-1α,MIP-1βand MCP-1 in peripheral blood from 50 patients with psoriasis vulgaris and 50 normal controls were measured by enzyme linked immunosorbent assay.The correlation with psoriasis area and severity index(PASI)was analyzed.The level of MIP-1α,MIP-1βand MCP-1 was compared between psoriasis vulgaris patients at active stage and resting stage.And the change in MIP-1α,MIP-1βand MCP-1 before and after therapy was also observed.Results:The content of MIP-1α,MIP-1βand MCP-1 in patients with psoriasis vulgaris was(1342.78±210.30),(175.28±28.18)and(266.86±32.75)ng/L,respectively,significantly higher than those in control group(P<0.05).The expression level of MIP-1α,MIP-1βand MCP-1 in peripheral blood of patients with psoriasis vulgaris was positively correlated wilh PASI(P<0.01).After acitretin therapy,expression level of MIP-1α,MIP-1βand MCP-1 in peripheral blood of patients with psoriasis vulgaris was significantly decreased.Conclusions:Chemokine factor MIP-1α,MIP-1βand MCP-1 may be involved in the pathogenesis of psoriasis vulgaris.展开更多
As one of the most serious types of psoriasis, pathogenesis of erythrodermic psoriasis（EP） is unclear so far. In this study, we aimed to detect the levels of Th1/Th2 cytokine-associated transcription factors and T-l...As one of the most serious types of psoriasis, pathogenesis of erythrodermic psoriasis（EP） is unclear so far. In this study, we aimed to detect the levels of Th1/Th2 cytokine-associated transcription factors and T-lymphocyte clone in peripheral blood mononuclear cells（PBMCs） derived from EP patients, and gene expression level of T-bet/GATA-3 in skin lesion. The potential role of Th1/Th2 reaction pattern played in the pathogenesis of EP was also discussed. Serum levels of IFN-γ, IL-2, IL-4 and IL-10 were quantified by ELISA among 16 EP patients, 20 psoriasis vulgaris（PV） patients and 15 healthy controls. The expression levels of T-bet/GATA-3 in the skin lesion and PBMCs were examined by real-time qPCR. The ratio of Th1/Th2 was measured by flow cytometry. The levels of IFN-γ, IL-2, IL-4 and IL-10 were higher in EP patients than in the healthy controls. The levels of IL-4 and IL-10 were 69.44±11.45 and 12.62±4.57 pg/mL, respectively, in EP patients, significantly higher than those in PV patients and healthy controls（P〈0.05）. Flow cytometry revealed the levels of both Th1 and Th2 in PBMCs from EP patients were higher than those in healthy controls, and the Th1/Th2 ratio was dramatically lower than in PV patients（P〈0.01）. The ratios of IFN-γ/IL-4 and T-bet/GATA-3 in EP patients were both less than 1.0, suggesting a reversal when compared with the other two groups. Our study indicated that the EP patients exerted a Th1/Th2 bidirectional response pattern, and the balance of Th cell subsets inclines to Th2, which might be one of the important mechanisms of EP pathogenesis.展开更多
基金Supported by Shaoxing Health Science and Technology Program,No.2022SY016,No.2022KY010.
文摘BACKGROUND In recent years,immune checkpoint inhibitors(ICIs)have demonstrated remarkable efficacy across diverse malignancies.Notably,in patients with advanced gastric cancer,the use of programmed death 1(PD-1)blockade has significantly prolonged overall survival,marking a pivotal advancement comparable to the impact of Herceptin over the past two decades.While the therapeutic benefits of ICIs are evident,the increasing use of immunotherapy has led to an increase in immune-related adverse events.CASE SUMMARY This article presents the case of a patient with advanced gastric cancer and chronic plaque psoriasis.Following sintilimab therapy,the patient developed severe rashes accompanied by cytokine release syndrome(CRS).Fortunately,effective management was achieved through the administration of glucocorticoid,tocilizumab,and acitretin,which resulted in favorable outcomes.CONCLUSION Glucocorticoid and tocilizumab therapy was effective in managing CRS after PD-1 blockade therapy for gastric cancer in a patient with chronic plaque psoriasis.
基金Supported by Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz,No.NC23189.0.
文摘In recent years,cancer immunotherapy has introduced novel treatments,such as monoclonal antibodies,which have facilitated targeted therapies against tumor cells.Programmed death-1(PD-1)is an immune checkpoint expressed in T cells that regulates the immune system’s activity to prevent over-activation and tissue damage caused by inflammation.However,PD-1 is also expressed in tumor cells and functions as an immune evasion mechanism,making it a therapeutic target to enhance the immune response and eliminate tumor cells.Consequently,immune checkpoint inhibitors(ICIs)have emerged as an option for certain tumor types.Nevertheless,blocking immune checkpoints can lead to immune-related adverse events(irAEs),such as psoriasis and cytokine release syndrome(CRS),as exemp-lified in the clinical case presented by Zhou et al involving a patient with adva-nced gastric cancer who received sintilimab,a monoclonal antibody targeting PD-1.Subsequently,the patient experienced exacerbation of psoriasis and CRS.The objective of this editorial article is to elucidate potential immunologic mechanisms that may contribute to the development of CRS and psoriasis in patients receiving ICIs.It is crucial to acknowledge that while ICIs offer superior safety and efficacy compared to conventional therapies,they can also manifest irAEs affecting the skin,gastrointestinal tract,or respiratory system.In severe cases,these irAEs can lead to life-threatening complications such as circulatory shock or multiorgan failure.Consequently,it is recommended that patients receiving ICIs undergo regular monitoring to identify and manage these adverse events effectively.
文摘Objective: To explore the effects of Tripterygium wilfordii combined with viaminate on psoriasis patients' immune indexes, endothelium, inflammatory reaction, sICAM-1 and NF-kB. Methods: A total of 112 patients with psoriasis admitted in our hospital from September 2015 to November 2017 were randomly divided into control group (n=56) and observation group (n=56). The control group was treated only by Viaminate Capsules, and the observation group was treated with Tripterygium wilfordii tablet on the basis of the control group, the immune function, endothelial, inflammatory response, soluble intercellular adhesion molecules-1 (sICAM-1) and nuclear transcription factor-kB (NF-kB) expression levels were compared before and after treatment in the two groups. Results: Before treatment, CD4+, CD8+, CD4+/CD8+, vascular endothelial growth factor (VEGF), nitric oxide (NO), endothelin-1 (ET-1), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), NF-kB, and sICAM-1 in two groups were no significant difference. After treatment, CD4+and CD4+/CD8+in both groups were significantly increased, while CD8+was significantly lower than before treatment, the CD4+and CD4+/CD8+in the observation group were significantly higher than those in the control group, and CD8+was obviously lower than that of the control group;The VEGF, NO and ET-1 in both groups were dramatically lower than those before treatment, and the VEGF, NO and ET-1 in the observation group were significantly lower than those in the control group;The TNF-α and IFN-γ in two groups were significantly lower than before treatment, and TNF-α and IFN-γ in the observation group were remarkably lower than those in the control group;The NF-kB and sICAM-1 in two groups were obviously decreased than those before treatment, and the NF-kB and sICAM-1 in the observation group were significantly lower than those in the control group. Conclusion: Tripterygium wilfordii combined with viaminate capsules in the treatment of psoriasis patients, can effectively correct their immune dysfunction, improve endothelial function, reduce inflammatory response and inhibit the expression of NF-kB and sICAM-1 expression.
基金supported by Technology Department of Hainan Province(811164)
文摘Objective:To detect the expression level of macrophage inflammatory protein-1(MIP-1)α,MIP-1βand monocyte chemoattractant protein-1(MCP-1)in with psoriasis vulgaris and explore the role in the pathogenesis of psoriasis vulgaris.Methods:The level of MIP-1α,MIP-1βand MCP-1 in peripheral blood from 50 patients with psoriasis vulgaris and 50 normal controls were measured by enzyme linked immunosorbent assay.The correlation with psoriasis area and severity index(PASI)was analyzed.The level of MIP-1α,MIP-1βand MCP-1 was compared between psoriasis vulgaris patients at active stage and resting stage.And the change in MIP-1α,MIP-1βand MCP-1 before and after therapy was also observed.Results:The content of MIP-1α,MIP-1βand MCP-1 in patients with psoriasis vulgaris was(1342.78±210.30),(175.28±28.18)and(266.86±32.75)ng/L,respectively,significantly higher than those in control group(P<0.05).The expression level of MIP-1α,MIP-1βand MCP-1 in peripheral blood of patients with psoriasis vulgaris was positively correlated wilh PASI(P<0.01).After acitretin therapy,expression level of MIP-1α,MIP-1βand MCP-1 in peripheral blood of patients with psoriasis vulgaris was significantly decreased.Conclusions:Chemokine factor MIP-1α,MIP-1βand MCP-1 may be involved in the pathogenesis of psoriasis vulgaris.
基金supported by grants from the National Natural Science Foundation of China(Nos.81171495 and 81271765)
文摘As one of the most serious types of psoriasis, pathogenesis of erythrodermic psoriasis（EP） is unclear so far. In this study, we aimed to detect the levels of Th1/Th2 cytokine-associated transcription factors and T-lymphocyte clone in peripheral blood mononuclear cells（PBMCs） derived from EP patients, and gene expression level of T-bet/GATA-3 in skin lesion. The potential role of Th1/Th2 reaction pattern played in the pathogenesis of EP was also discussed. Serum levels of IFN-γ, IL-2, IL-4 and IL-10 were quantified by ELISA among 16 EP patients, 20 psoriasis vulgaris（PV） patients and 15 healthy controls. The expression levels of T-bet/GATA-3 in the skin lesion and PBMCs were examined by real-time qPCR. The ratio of Th1/Th2 was measured by flow cytometry. The levels of IFN-γ, IL-2, IL-4 and IL-10 were higher in EP patients than in the healthy controls. The levels of IL-4 and IL-10 were 69.44±11.45 and 12.62±4.57 pg/mL, respectively, in EP patients, significantly higher than those in PV patients and healthy controls（P〈0.05）. Flow cytometry revealed the levels of both Th1 and Th2 in PBMCs from EP patients were higher than those in healthy controls, and the Th1/Th2 ratio was dramatically lower than in PV patients（P〈0.01）. The ratios of IFN-γ/IL-4 and T-bet/GATA-3 in EP patients were both less than 1.0, suggesting a reversal when compared with the other two groups. Our study indicated that the EP patients exerted a Th1/Th2 bidirectional response pattern, and the balance of Th cell subsets inclines to Th2, which might be one of the important mechanisms of EP pathogenesis.
