Saratov JOURNAL of Medical and Scientific Research

Central State Medical Academy of the ADP of the Russian Federation

Assessment of the efficiency of cyclosporine use in psoriasis

Year: 2017, volume 13 Issue: №3 Pages: 673-678
Heading: Dermatovenerology Article type: Review
Authors: Kruglova L.S., Ponich E.S., Osina A.V., Gryazeva N.V.
Organization: Central State Medical Academy of the ADP of the Russian Federation
Summary:

The article presents a review of randomized studies involving patients with severe psoriasis, which showed that after 10-12 weeks of monotherapy with cyclosporine there was a decline of the Index of prevalence and severity of psoriasis (PASI). After achieving clinical remission must be decided on a gradual reduction of the dose of cyclosporine to the lowest effective dose, or the complete abolition of the medication. Simultaneous use of cyclosporine and UVB at the moment is not widely studied. Combined use of methotrexate and cyclosporine has been used successfully in the treatment of rheumatoid and psoriatic arthritis. The combined intake of cyclosporine and systemic biological agents should be used in exceptional cases of severe forms of psoriasis, not amenable to other treatments, and only for a limited period of time.

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Analysis of the various schemes efficiency of methotrexate use in psoriasis treatment

Summary:

Currently, there has been a steady increase in the incidence of psoriasis, including severe forms. It is extremely important for psoriasis to administrate medicines in time. Methotrexate inhibits the increased proliferation of keratinocytes, inhibits the production of such inflammatory mediators as leukotrienes, TNF-a, collagenase, IL-1, IL-6, but at the same time it increases production of anti-inflammatory IL-10. Objective: to analyze the efficacy of methotrexate in various forms of psoriasis. Material and Methods. Under observation in the period from 2011 to 2016 were 516 patients, including those treated with methotrexate. Methotrexate was assigned according to the scheme: 1st injection 10mg/week, with no adverse effects 20-25 mg/week. All patients received folic acid at a dose of 20-40 mg/day for 5 days starting 3 days after the injection of methotrexate. Evaluation of efficiency was carried out using indices of dermatological status and quality of life. Results. Achievement of clinical remission was observed in 257 (49.7%) in patients; achieving a significant improvement was noted in 32 (6.2%) patients; achieving improvements in 126 (24.4%) patients; no effect 33 (6.4%) patients, and deterioration (further progression of skin lesions) were observed in 68 (13.2%) patients. Conclusion. Methotrexate has a high efficacy in such clinical forms of psoriasis as vulgar (64.9%), inverse (63.9%), exudative (44.7%), and pustular palmar-plantar psoriasis 12.9%.

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Immunopathogenetic mechanisms of skin toxic response of antitumor therapy with mul-tikinase of angiogenesis inhibitors

Year: 2017, volume 13 Issue: №3 Pages: 605-611
Heading: Dermatovenerology Article type: Review
Authors: Shatokhina Е.А., Kruglova L.S.
Organization: Central State Medical Academy of the ADP of the Russian Federation
Summary:

The violation of the angiogenesis is associated with pathogenesis of many diseases, but especially pronounced pathological angiogenesis underlies the growth of tumors and metastasis. The physiological control of the angiogenesis is carried out by many growth factors, one main factor — the vascular endothelial growth factor (VEGF), realizing their effects by receptors — proteinkinases. The target therapy of various neoplastic diseases, based on the suppression of angiogenesis, aimed at blockade of receptors for VEGF and other pro-angiogenic growth factors. However, the medicine blockade of receptors for growth factors and suppression of tumor angiogenesis leads to inappropriate exposure are the main cells of the dermis — fibroblasts. As a result of changing the regulatory mechanisms of inhibition of the physiological renewal of epidermis, suppression of angiogenesis and repair when damaged skin there are various skin toxic reactions that are dependent on receptor targets of angiogenesis inhibitors. The study of the mechanisms of adverse events of targeted therapy is an important way of oncoimmunology and dermatology, which will further help to determine the optimal scheme of correction of dermal toxicity and maximize the effectiveness of the antitumor therapy.

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Analysis of the genes polymorphisms distribution of the MMP1, XRCC1, HFE (2), GSTT in patients with non-neoplastic melanin hyperpigmentation

Year: 2017, volume 13 Issue: №3 Pages: 590-594
Heading: Dermatovenerology Article type: Original article
Authors: Ikonnikova EV, Kruglova LS, Shatokhina EA, Talybova AM.
Organization: Central State Medical Academy of the ADP of the Russian Federation
Summary:

Objective: to study the factors of increased risk of hyperpigmentation, with the polymorphism of MMP1, XRCC1, HFE (2), GSTT genes and analysis of their association in patients with various clinical forms of non-neoplastic melanin hyperpigmentation. Material and methods. The study included 38 patients with hyperpigmentation (melasma / chlo-asma, post-traumatic/ post-inflammatory hyperpigmentation, solar lentigo). All patients were underwent buccal swabs with sterile cotton buds to take the material for the study. All patients were underwent genetic analysis of polymorphism of HFE (2), XRCC1, MMP1, and GSTT genes by genotyping single-nucleotide substitutions. Results. In patients with melasma / chloasma, the high value of the alleles cipher of MMP1, XRCC1, and GSTT genes was noted, while the cipher of HFE (rs1799945) and HFE (rs1800562) allele index showed average values. In patients with post-traumatic / post-inflammatory pigmentation, the high value ofthe alleles cipher of MMP1, HFE (rs1799945) and HFE (rs1800562), GSTT genes was noted, while XRCC1 allele cipher showed average values. In patients with solar lentigo, the high value ofthe alleles cipher of MMP1, XRCC1, and GSTT genes was noted, while the cipher of HFE (rs1799945) and HFE (rs1800562) allele index showed average values. Conclusion. Was revealed the similarity ofthe results of genetic research in patients with melasma / chloasma and in patients with solar lentigo.

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