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1.
Immunopharmacol Immunotoxicol ; 46(1): 67-72, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37676055

RESUMEN

BACKGROUND: Atopic dermatitis (AD) is a chronic, inflammatory, often severely itching skin disorder. It may worsen due to stress, depression, or anxiety. Calcitonin gene-related peptide (CGRP) may be involved in inflammation signaling. CGRP has also been suggested in relation to stress, depression, and anxiety. This study aimed to investigate the expression of CGRP in the skin of patients with AD. METHODS: Twenty-seven adult patients with AD, characterized with clinical and psychodemographic parameters, were investigated regarding CGRP expression in skin biopsies, using an immunohistochemical technique. RESULTS: The total number of CGRP-positive nerve-like fibers was found to be higher in lesional skin than in non-lesional skin. Moreover, more inflammatory cells of dendritic shape intruded into the epidermis in lesional skin compared to non-lesional skin. Keratinocytes showing expression of CGRP were also found in lesional skin. Interestingly, the number of CGRP-positive nerve-like fibers in lesional skin correlated with depressive and anxiety scores. Correlation with depressive score was also found for round CGRP-positive inflammatory cells in the epidermis. CONCLUSIONS: CGRP may have a role in both the inflammatory process and distress, in AD.


Asunto(s)
Péptido Relacionado con Gen de Calcitonina , Dermatitis Atópica , Adulto , Humanos , Péptido Relacionado con Gen de Calcitonina/metabolismo , Dermatitis Atópica/patología , Piel/patología , Epidermis/patología , Inflamación/patología
2.
Immunopharmacol Immunotoxicol ; 41(1): 117-122, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30773959

RESUMEN

Context: Atopic dermatitis (AD) is a chronic, inflammatory, itching skin disorder, which may worsen due to stress, depression and anxiety. Tachykinins may be involved in inflammation signaling as well as they may have a role in stress, depression and anxiety. Objective: This study aimed to measure the expression of tachykinin markers, in the skin of patients with AD, and the correlation of these tachykinins with clinical and psychodemographic parameters. Materials and methods: Twenty-eight adult patients with AD were investigated regarding tachykinin expression in skin biopsies, using an immunohistochemical technique. The patients were characterized with clinical and psychodemographic parameters. Results: The number of substance P and neurokinin (NK)A positive nerve fibers, as well as NKA positive mononuclear dermal cells, was increased in lesional compared to non-lesional skin. Interestingly, the depression score and the number of dermal NK-1 receptor (R) positive cells in lesional as well as in non-lesional skin showed a correlation. Conclusion: These findings indicate an upregulation of the tachykinergic system in the inflamed skin of AD.


Asunto(s)
Dermatitis Atópica/metabolismo , Neuroquinina A/metabolismo , Receptores de Neuroquinina-1/metabolismo , Piel/metabolismo , Sustancia P/metabolismo , Adulto , Biopsia , Estudios Transversales , Dermatitis Atópica/inmunología , Dermatitis Atópica/patología , Dermatitis Atópica/psicología , Femenino , Humanos , Inflamación , Masculino , Persona de Mediana Edad , Fibras Nerviosas/inmunología , Fibras Nerviosas/metabolismo , Fibras Nerviosas/patología , Neuroquinina A/genética , Receptores de Neuroquinina-1/genética , Piel/inmunología , Piel/patología , Sustancia P/genética , Encuestas y Cuestionarios , Regulación hacia Arriba , Adulto Joven
3.
Acta Derm Venereol ; 98(3): 324-328, 2018 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-29182791

RESUMEN

Atopic dermatitis (AD) is a chronic, itchy, inflammatory skin disorder that may worsen due to stress and anxiety. Tachykinins have been suggested to be involved in the inflammation in AD, as well as pruritus. Aprepitant is a NK-1 receptor antagonist. This open randomized trial evaluated the effect of aprepitant added to topical treatment in adult patients with moderate-severe AD. The treatment group (n = 19) received 80 mg/day aprepitant for 7 days as a supplement to standardized topical treatment with a moderately strong steroid and a moisturizer. The control group (n = 20) received topical treatment alone. Patients were monitored for the extent of the disease (using SCORing of Atopic Dermatitis; SCORAD), pruritus, and scratching movements. In both the aprepitant-treated and the control groups there was a decrease in SCORAD, pruritus and scratching movements. However, there was no significant additional improvement in any of these parameters in the aprepitant-treated group compared with the control group.


Asunto(s)
Antipruriginosos/administración & dosificación , Dermatitis Atópica/tratamiento farmacológico , Morfolinas/administración & dosificación , Antagonistas del Receptor de Neuroquinina-1/administración & dosificación , Prurito/tratamiento farmacológico , Piel/efectos de los fármacos , Sustancia P/antagonistas & inhibidores , Administración Cutánea , Adulto , Antipruriginosos/efectos adversos , Aprepitant , Dermatitis Atópica/diagnóstico , Dermatitis Atópica/metabolismo , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Morfolinas/efectos adversos , Antagonistas del Receptor de Neuroquinina-1/efectos adversos , Prurito/diagnóstico , Prurito/metabolismo , Índice de Severidad de la Enfermedad , Piel/metabolismo , Piel/patología , Sustancia P/metabolismo , Suecia , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
4.
Acta Derm Venereol ; 96(6): 732-6, 2016 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-26831833

RESUMEN

Stress and anxiety may worsen atopic dermatitis (AD) through the serotonin system. Serotonergic expression was measured in 28 patients with AD in relation to extent of the disease (SCORing of Atopic Dermatitis; SCORAD), pruritus intensity (visual analogue scale; VAS), anxiety traits (Swedish Universities Scales of Personality; SSP) and depression (Montgomery-Åsberg Depression Rating Scale-Self assessment; MADRS-S). Biopsies were taken from lesional and non-lesional AD skin, and investigated for expression of serotonin, its receptors 5-HT1A and 5-HT2, and serotonin transporter protein (SERT), using immunohistochemistry. 5-HT1AR-immunoreactivity (ir) was higher in lesional skin in apical epidermis and in mast cell-like cells in dermis, and 5-HT2AR-ir in apical epidermis and on blood vessels. In contrast, a basement membrane 5-HT2AR-ir signal was higher in non-lesional skin. The distribution of SERT-ir in the basal epidermal layer was higher in lesional skin. Positive and negative correlations were found between serotonergic markers and SCORAD, inflammation, pruritus intensity, anxiety traits, and depression score, indicating that serotonergic mechanisms are involved in AD.


Asunto(s)
Dermatitis Atópica/inmunología , Prurito/inmunología , Receptor de Serotonina 5-HT1A/metabolismo , Receptor de Serotonina 5-HT2A/metabolismo , Proteínas de Transporte de Serotonina en la Membrana Plasmática/metabolismo , Serotonina/metabolismo , Adulto , Ansiedad/psicología , Biopsia , Depresión/psicología , Dermatitis Atópica/fisiopatología , Dermatitis Atópica/psicología , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Prurito/fisiopatología , Prurito/psicología , Autoevaluación (Psicología) , Índice de Severidad de la Enfermedad
5.
Mycoses ; 59(7): 436-41, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26931645

RESUMEN

Direct microscopy of keratinised specimens is a standard screening procedure that assists clinicians to differentiate true superficial mycoses from non-fungal disorders of the skin, nail and hair. Most clinical dermatologists use bright-field microscopy when searching for dermatophyte fungi in clinical samples while laboratory-based mycologists increasingly favour fluorescence microscopy in order to optimise visualisation of fungal elements. This study compared the validity and speediness of fluorescence microscopy vs. conventional light microscopy when screening for fungi in 206 dermatological samples from dermatology outpatients. Both senior dermatologist and a less experienced investigator (medical student) attained high and comparable levels of specificity (91.7-93.8%), positive predictive value (77.1-81.4%) and negative predictive value (83.7-89.9%) using either method. Fluorostaining with Blankophor prior to fluorescence microscopy increased the sensitivity by 22 ± 1% as compared to light microscopy of unstained samples. For both investigators, the time required to identify fungal elements by the fluorescence-based technique was reduced by at least 50%, thus improving the performance of direct microscopy in the clinical setting.


Asunto(s)
Arthrodermataceae/aislamiento & purificación , Cabello/microbiología , Microscopía Fluorescente/métodos , Micología/métodos , Uñas/microbiología , Piel/microbiología , Tiña/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Arthrodermataceae/genética , Arthrodermataceae/ultraestructura , Niño , Preescolar , ADN de Hongos/análisis , Femenino , Humanos , Masculino , Microscopía de Polarización , Persona de Mediana Edad , Onicomicosis/diagnóstico , Onicomicosis/microbiología , Pacientes Ambulatorios , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Coloración y Etiquetado , Tiña/microbiología , Tiña del Cuero Cabelludo/diagnóstico , Tiña del Cuero Cabelludo/microbiología , Adulto Joven
6.
Bipolar Disord ; 17(3): 340-4, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25213221

RESUMEN

OBJECTIVES: Darier disease is an autosomal dominant skin disorder caused by mutations in the ATPase, Ca++ transporting, cardiac muscle, slow twitch 2 (ATP2A2) gene and previously reported to cosegregate with bipolar disorder and schizophrenia in occasional pedigrees. It is, however, unknown whether these associations exist also in the general population, and the objective of this study was to examine this question. METHODS: We compared a national sample of individuals with Darier disease and their first-degree relatives with matched unexposed individuals from the general population and their first-degree relatives, respectively. To examine risks for bipolar disorder and schizophrenia, risk ratios and 95% confidence intervals (CIs) were estimated using conditional logistic regressions. RESULTS: Individuals with Darier disease had a 4.3 times higher risk of being diagnosed with bipolar disorder (95% CI: 2.6-7.3) and a 2.3 times higher risk of being diagnosed with schizophrenia (95% CI: 1.1-5.2) than matched individuals from the general population. Relatives of individuals with Darier disease had a 1.6 times higher risk of having bipolar disorder (95% CI: 1.1-2.5) than relatives of matched individuals from the general population, but no increased risk of schizophrenia (risk ratio = 0.8, 95% CI: 0.4-1.8). CONCLUSIONS: The association between Darier disease and bipolar disorder is manifest also in the population, and our data suggest that genetic variability within the ATP2A2 gene that causes Darier disease also confers susceptibility for bipolar disorder. The Darier-causing mutations merit additional attention in molecular genetic research on bipolar disorder.


Asunto(s)
Trastorno Bipolar/genética , Enfermedad de Darier/genética , Sistema de Registros , ATPasas Transportadoras de Calcio del Retículo Sarcoplásmico/genética , Esquizofrenia/genética , Trastorno Bipolar/epidemiología , Estudios de Cohortes , Enfermedad de Darier/epidemiología , Predisposición Genética a la Enfermedad , Humanos , Oportunidad Relativa , Linaje , Riesgo , Esquizofrenia/epidemiología , Suecia/epidemiología
7.
Dermatology ; 230(4): 375-80, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25823412

RESUMEN

BACKGROUND: Psoriasis has been reported to be associated with alcohol consumption. OBJECTIVE: To investigate the level of alcohol intake in individuals with psoriasis and correlate intake with the extent of disease and pruritus. METHODS: Twenty-nine outpatients (15 females and 14 males) with stable chronic plaque psoriasis of moderate severity were recruited. The Psoriasis Area and Severity Index (PASI) and the degree of pruritus (visual analogue scale) were compared with measures of drinking habits as determined by the Lifetime Drinking History (LDH), the Alcohol Use Disorders Identification Test and whole-blood phosphatidylethanol (PEth), an alcohol-specific biomarker. RESULTS: The majority of patients were social drinkers with moderate alcohol consumption as determined by PEth and LDH. Alcohol consumption correlated significantly with the PASI score. There was no correlation between alcohol use and pruritus. CONCLUSION: The level of alcohol consumption is correlated with the extent of psoriasis.


Asunto(s)
Consumo de Bebidas Alcohólicas/sangre , Glicerofosfolípidos/sangre , Prurito/etiología , Psoriasis/patología , Adolescente , Adulto , Edad de Inicio , Anciano , Biomarcadores/sangre , Niño , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Psoriasis/etiología , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Adulto Joven
8.
Acta Derm Venereol ; 94(2): 185-7, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23994911

RESUMEN

Physical activity promotes health and prevents disease. When patients with atopic dermatitis (AD) undertake exercise, the itch often gets worse due to sweating, and this may reduce their engagement in physical exercise. The aim of this study was to determine the level of physical exercise in patients with AD compared with a control group from a normal population. Our hypothesis was that patients with AD have a lower level of physical exercise due to their skin disease. A total of 110 patients with AD and 196 subjects from a normal population, age range 20-34 years, answered a questionnaire. Eleven patients with AD underwent an in-depth interview. The patients with AD had the same level of physical exercise and attitude to physical exercise as the normal population. Therefore, our hypothesis could not be confirmed. In conclusion, the skin symptoms of AD do not appear to be an obstacle to moderate physical exercise.


Asunto(s)
Dermatitis Atópica/epidemiología , Ejercicio Físico/fisiología , Conductas Relacionadas con la Salud , Adulto , Estudios de Casos y Controles , Dermatitis Atópica/fisiopatología , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Sudoración/fisiología , Suecia/epidemiología , Adulto Joven
9.
Acta Derm Venereol ; 93(3): 277-80, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23165739

RESUMEN

Atopic dermatitis (AD) is a chronic inflammatory skin disease with often severe itch. The aim of this study was to determine the pruritogenic and vascular effect of serotonin (5-hydroxytryptamine; 5-HT) in patients with AD and in healthy controls. A 50 µg dose of 5-HT was injected intradermally into non-lesional skin of 25 patients with AD and 25 healthy control individuals, and the effect compared with 0.2 µg histamine as a positive control, and buffer as a negative control. Pruritus was recorded by the subjects, using a computerized visual analogue scale, while flare and wheal were recorded by the investigator. There was no qualitative or quantitative difference in 5-HT-induced itch between patients and control subjects, or between males and females. However, reduced flare and wheal were found in the patient group for 5-HT. There were no correlations between clinical findings (i.e. eczema severity, clinical pruritus) and recorded experimental itch, or flare or wheal responses for 5-HT, in the patients with AD. In both groups a shorter itch latency was found for 5-HT compared with histamine. Through the use of intradermal injections, making it possible to calculate the dose of substance delivered, a lower vascular response to 5-HT was shown in patients with AD compared with healthy controls. In addition to confirming a pruritogenic role of 5-HT in both patients with AD and healthy controls, we found a shorter itch latency for 5-HT compared with histamine in both groups. The short itch latency time may indicate a direct effect of 5-HT on itch receptors.


Asunto(s)
Dermatitis Atópica/complicaciones , Prurito/etiología , Serotonina/administración & dosificación , Piel/irrigación sanguínea , Piel/efectos de los fármacos , Adulto , Estudios de Casos y Controles , Dermatitis Atópica/patología , Dermatitis Atópica/fisiopatología , Femenino , Histamina/administración & dosificación , Humanos , Inyecciones Intradérmicas , Masculino , Persona de Mediana Edad , Prurito/patología , Prurito/fisiopatología , Tiempo de Reacción , Sensación , Piel/inervación , Piel/patología , Factores de Tiempo , Adulto Joven
10.
Ann Dermatol ; 35(5): 342-347, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37830415

RESUMEN

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disorder. It is often reported to be worsened by psychological stress. OBJECTIVE: To explore the role of psychological stress and related triggers in AD, and its connection to worsening of this disease, focusing on patients' perspectives. METHODS: In total, 28 patients with AD were included in focus groups. Topics regarding psychological stress and psychological triggers were discussed. RESULTS: The hypothesis that psychological stress may have impact on eczema and its pruritus was supported by all of the patients. Distinguishing the worsening effect of psychological stress from effects of physiological triggers, such as infection, climate and allergic factors, was claimed to be difficult by many patients. Most of the patients thought that chronic stress affected the AD more when compared to acute stress. Family problems, financial problems, work overload, school exam periods, lack of structure at work, and unforeseen events were identified as important psychological triggers. Conventional treatment/therapy with topical corticosteroids and emollients, UV light treatment, were suggested as possible treatments, as well as psychological intervention and physical exercise. CONCLUSION: Psychological stress is an important factor to consider in the management of patients with AD. In particular, chronic stress tends to worsen AD. The type of stress can possibly also affect the quality of the pruritus experienced by the patients. Unforeseen events and decision making were frequently mentioned as important triggers. Furthermore, physical exercise was reported to provide beneficial effects.

11.
Immunopharmacol Immunotoxicol ; 34(3): 534-8, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22124413

RESUMEN

CONTEXT: The symptoms of atopic dermatitis (AD) are often aggravated by anxiety, and the serotonin transporter (5-HTT) has been shown to be of importance in this context. Three polymorphisms affecting transcription of this gene are known: a repetitive element, in the promoter region (5HTTLPR), a variable number tandem repeats (VNTR) within intron 2 referred to as STin2, and a single-nucleotide (A/G) polymorphism (SNP) located within the 5-HTTLPR. OBJECTIVE: To examine for possible relationships between these polymorphisms and aggravation of AD by stress. MATERIALS AND METHODS: Thirty-three patients with a history of such aggravation, together with 33 age- and gendermatched healthy control subjects, were recruited. The Karolinska Scales of Personality questionnaire was employed to evaluate anxiety-related personality traits and genomic DNA was extracted from blood samples and analyzed using the polymerase chain reaction. RESULTS: Although the prevalence of the short and long alleles of 5-HTTLPR did not differ between the patients and healthy controls, there was a tendency towards high prevalence of the short (10-copy) variant of STin2 among the patients. When the study population was further analysed by subdivision into subgroups all AD patients with high- anxiety traits carried the short variant of STin2. In the corresponding healthy control group, the prevalences of the 10-and 12-copy variants were 62% and 38%, respectively (P < 0.01). CONCLUSION: These findings indicate a possible association between the 10-copy variant of STin2 and aggravation of AD by anxiety.


Asunto(s)
Ansiedad/genética , Dermatitis Atópica/genética , Polimorfismo de Nucleótido Simple , Regiones Promotoras Genéticas , Carácter Cuantitativo Heredable , Proteínas de Transporte de Serotonina en la Membrana Plasmática/genética , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad
12.
Immunopharmacol Immunotoxicol ; 34(4): 679-85, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22268664

RESUMEN

CONTEXT: Human mastocytosis is a rare disease, in which the serotonergic system may be involved. OBJECTIVE: The objective of the present study was to examine the possible presence of serotonin (5-HT) and its 5-HT1A receptor (R) in the skin of patients with mastocytosis. In addition, the effect of the 5-HT1AR was tested on human mastocytosis cells, cultured in vitro. MATERIALS AND METHODS: The expression of 5-HT and 5-HT1AR in patients with urticaria pigmentosa and mastocytoma was studied using immunohistochemistry. The effects of 8-OH-DPAT, an agonist of 5-HT1AR, on the proliferation (cell number), viability, apoptosis, spontaneous release of histamine, as well as a possible 5-HT metabolism, in the human HMC-1 mast cell line, were investigated. RESULTS: Both 5-HT and 5-HT1AR were expressed in the mast cells in biopsies of mastocytoma and urticaria pigmentosa, as well as in HMC-1 cells. However, no metabolism of 5-HT by the cell line could be detected by the methodology used. The 5-HT1AR agonist had no significant effect on the viability and number of HMC-1 cells, and was without effect on the apoptosis. At concentrations of 10⁻6 mol/L and 10⁻8-10⁻¹° mol/L (i.e. also at physiological concentrations), the agonist inhibited histamine release by these cells by as much as 30%. CONCLUSION: These findings indicate that 5-HT and its 5-HT1AR are expressed in human mastocytosis and that an agonist of the 5-HT1AR might be of value in the treatment of these patients.


Asunto(s)
Regulación Neoplásica de la Expresión Génica/inmunología , Proteínas de Neoplasias/inmunología , Receptor de Serotonina 5-HT1A/inmunología , Serotonina/inmunología , Neoplasias Cutáneas/inmunología , Piel/inmunología , 8-Hidroxi-2-(di-n-propilamino)tetralin/farmacología , Adulto , Línea Celular , Femenino , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Humanos , Masculino , Mastocitos/inmunología , Mastocitos/metabolismo , Mastocitos/patología , Mastocitosis Cutánea , Persona de Mediana Edad , Proteínas de Neoplasias/biosíntesis , Receptor de Serotonina 5-HT1A/biosíntesis , Serotonina/metabolismo , Agonistas de Receptores de Serotonina/farmacología , Piel/metabolismo , Piel/patología , Neoplasias Cutáneas/metabolismo , Neoplasias Cutáneas/patología , Células Tumorales Cultivadas
13.
Immunopharmacol Immunotoxicol ; 32(1): 147-52, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20109036

RESUMEN

BACKGROUND AND AIM: A connection between chronic mild stress and altered innervation in the skin of an atopic mouse strain, NC/Nga, was studied. MATERIAL AND METHODS: We used three groups of mice, stressed control (SC, stressed but not immunized with a mite antigen), non-stressed eczematous (NSE, not stressed but immunized) and stressed eczematous (SE, stressed and immunized). RESULTS: There was a decrease of protein gene product (PGP) 9.5 positive nerve fibers in SE compared to SC mice, in both epidermis and dermis, also in SE compared to NSE mice. Also a decrease in growth associated protein (GAP)-43 positive nerve fibers was seen in SE compared to SC, in both epidermis and dermis. CONCLUSION: Chronic mild stress in atopic mice leads to decreased innervation in eczematous lesions.


Asunto(s)
Eccema/fisiopatología , Piel/inervación , Estrés Psicológico/fisiopatología , Animales , Enfermedad Crónica , Corticosterona/sangre , Femenino , Proteína GAP-43/análisis , Ratones , Regeneración Nerviosa , Ubiquitina Tiolesterasa/análisis
14.
Psoriasis (Auckl) ; 9: 75-79, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31687362

RESUMEN

Psoriasis is a chronic inflammatory skin disease that may be triggered or worsened by several factors, including alcohol. A higher than average alcohol consumption is common among individuals with psoriasis. Neurobiological signaling affected by alcohol intake includes a range of neurotransmitters, such as the dopaminergic, serotonergic, and tachykinergic systems, involved in reward and drug-seeking. These neurotransmitters may also have an impact on the inflammatory processes per se in psoriasis. Future therapy may, therefore, be targeted at neurotransmitter networks involved with both alcohol intake and the inflammatory processes.

15.
Exp Dermatol ; 17(4): 301-11, 2008 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-18177349

RESUMEN

Serotonin (5-hydroxytryptamine; 5-HT) is an important mediator of bidirectional interactions between the neuroendocrine system and the skin. The rate of synthesis of 5-HT from l-tryptophan can be enhanced by brain-derived neuronal growth factor, cytokines, exposure to ultraviolet light and steroids. The major source of 5-HT in the skin are platelets, which, upon aggregation, release this biogenic amine. Moreover, the epidermal and dermal skin express the enzymes required for the transformation of tryptophan to 5-HT, and certain skin cells, such as melanocytes, have been demonstrated to produce 5-HT. In addition, rodent mast cells produce 5-HT, but human mast cells have not yet been fully examined in this respect. Skin cells express functionally active, membrane-bound receptors for 5-HT, as well as proteins that transport 5-HT. The interactions of 5-HT with these various proteins determines the nature, magnitude and duration of serotonergic responses. The immune and vasculature systems in the skin are traditional targets for bioregulation by 5-HT. Moreover, recent findings indicate that keratinocytes, melanocytes and dermal fibroblasts also respond to this amine in various ways. Thus, mammalian skin is both a site for the production of and a target for bioregulation by 5-HT. This indicates that agonists and antagonists directed towards specific 5-HT receptors could be useful in connection with treatment of skin diseases. Based on our increasing knowledge concerning these receptors and their plasticity, future research will focus on the development of serotonergic drugs that exert metabotrophic effects on the cells of the skin without affecting the central nervous system.


Asunto(s)
Sistemas Neurosecretores/fisiología , Serotonina/fisiología , Fenómenos Fisiológicos de la Piel , Piel/metabolismo , Animales , Plaquetas/metabolismo , Citocinas/fisiología , Humanos , Terminales Presinápticos/metabolismo , Receptores de Serotonina/fisiología , Serotonina/química , Serotoninérgicos/farmacología , Piel/citología , Piel/efectos de los fármacos , Enfermedades de la Piel/fisiopatología , Triptófano/química , Triptófano/metabolismo
16.
J Dermatol ; 35(1): 1-5, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18181768

RESUMEN

Pruritus is a common complaint among patients of psoriasis vulgaris of the chronic plaque type. Despite a high prevalence of pruritus in psoriasis, limited information is available on this subject. The aim was to assess patients' perspective of pruritus in psoriasis vulgaris of plaque type, by using focus groups. A total of 20 patients with chronic plaque psoriasis participated in focus group discussions and were divided into five groups, on different occasions. Themes for the discussion were introduced and moderated by the investigators. The focus groups created a proper atmosphere for discussion on different aspects of pruritus in psoriasis. The patients regarded themselves able to discriminate between pruritus and pain. Pruritus was most common on the lower back and legs. Stress, cold weather and skin dryness were seen as the most common worsening factors for pruritus. Sunbathing and application of emollients with or without steroids and calcipotriol cream were suggested as factors that relieved pruritus. Quality of life was affected in some patients, for instance they were reluctant to participate in social activities. Patients' perspectives on pruritus in psoriasis were important for a better understanding of this sensation. The information collected from the focus group discussions might be useful for further study in this area.


Asunto(s)
Grupos Focales , Prurito/etiología , Psoriasis/complicaciones , Administración Tópica , Adolescente , Adulto , Vestuario/efectos adversos , Fármacos Dermatológicos/uso terapéutico , Femenino , Alimentos/efectos adversos , Helioterapia , Humanos , Masculino , Persona de Mediana Edad , Prurito/epidemiología , Prurito/terapia , Psoriasis/terapia , Calidad de Vida , Estrés Psicológico/complicaciones , Tiempo (Meteorología)
17.
Drug News Perspect ; 20(8): 521-5, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-18080039

RESUMEN

Psoriasis is a chronic inflammatory skin disease, where specific immunity and/or innate immunity may be of importance in the disease pathogenesis. Psoriasis may be worsened by stress, which suggests that a neuroimmune interaction is contributing to the disease. Serotonin (5-HT) is a monoamine which besides general effects also has an impact on cell proliferation, migration and apoptosis. 5-HT exerts its effects via several receptors. 5-HT has a role in inflammation, and 5-HT receptors as well as its transporter protein have been found in psoriatic skin. 5-HT 1A receptor-positive mast cells, and 5-HT 2A receptor and serotonin reuptake transporter (SERT)-positive T lymphocytes may be targets for therapy with serotonergic drugs in psoriasis.


Asunto(s)
Psoriasis/tratamiento farmacológico , Serotoninérgicos/uso terapéutico , Animales , Humanos , Modelos Biológicos , Psoriasis/metabolismo , Psoriasis/fisiopatología , Receptores de Serotonina/metabolismo , Serotonina/fisiología , Serotoninérgicos/farmacología
18.
Arch Dermatol Res ; 299(2): 85-91, 2007 May.
Artículo en Inglés | MEDLINE | ID: mdl-17370082

RESUMEN

Substance P and its receptor(R) neurokinin (NK)-1 may have a role in the pathogenesis of psoriasis. Stress has been reported to play a role in the onset and exacerbation of psoriasis, which might include the substance P-NK-1 receptor(R) pathway. A feature of psoriasis, that has been correlated to the severity of stress and secretion of substance P, is pruritus. The objective of this study was to investigate the expression of substance P and the NK-1R in involved and noninvolved psoriatic skin, using a biotinylated streptavidin technique. Moreover, a possible correlation between the patient s level of chronic stress, measured by salivary cortisol samples, degree of lesional pruritus, measured by means of a visual analogue scale, and the expression of substance P- and the NK-1R, was investigated. There was a low number of substance P positive nerve fibres in noninvolved and involved skin, the major immunoreactivity for substance P being found in inflammatory cells. The number of substance P- and NK-1R positive inflammatory cells was increased in involved compared to noninvolved psoriatic skin. The substance P positive cells were mostly lymphocytes, while most of the NK-1R positive cells were mast cells. NK-1R immunoreactivity was also seen as a reticular pattern in the upper part of the epidermis of involved skin in the majority of the patients. Low cortisol ratios in the patients, being an indicator of chronic stress, were correlated to an increased number of substance P- and NK-1R positive inflammatory cells in noninvolved psoriatic skin, and higher cortisol ratios to the presence of keratinocyte NK-1R immunoreactivity in involved skin. The degree of pruritus could not be correlated to the number of substance P positive fibers nor cells. Nonneuronal substance P and its receptor NK-1 might have a role in psoriasis, also during chronic stress.


Asunto(s)
Prurito/metabolismo , Psoriasis/metabolismo , Receptores de Neuroquinina-1/metabolismo , Estrés Psicológico/fisiopatología , Sustancia P/metabolismo , Adulto , Anciano , Enfermedad Crónica , Femenino , Regulación de la Expresión Génica , Humanos , Hidrocortisona/metabolismo , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Psoriasis/patología , Psoriasis/psicología , Saliva/metabolismo , Piel/patología , Piel/fisiopatología , Estrés Psicológico/etiología
19.
Lakartidningen ; 1142017 11 07.
Artículo en Sueco | MEDLINE | ID: mdl-29292916

RESUMEN

In case of pruritus, always consider scabies! Scabies is an itching skin disease caused by the mite Sarcoptes scabiei which affects more than 100 million people worldwide. Regarded as a neglected tropical disease by the WHO, it is a major public health burden in endemic areas. As direct skin-to-skin contact is the main route of transmission family members and sexual partners are often affected. Typical presentation includes a severely pruritic rash with predilection for the extremities and the trunk. Definitive diagnosis relies on microscopic identification of the mites. Future, more efficient, diagnostic methods may include serological testing or PCR for S. scabiei DNA. A benzyl benzoate and disulfiram based lotion, Tenutex, is the treatment of choice in Sweden with topical permethrin or oral ivermectin being used in certain cases. Scabies is an important diagnosis to consider in all patients presenting with pruritus.


Asunto(s)
Escabiosis , Anciano , Animales , Antiparasitarios/administración & dosificación , Antiparasitarios/uso terapéutico , Niño , Humanos , Lactante , Prurito/parasitología , Sarcoptes scabiei , Escabiosis/diagnóstico , Escabiosis/tratamiento farmacológico , Escabiosis/epidemiología , Escabiosis/patología
20.
Arch Dermatol Res ; 298(3): 99-106, 2006 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16794822

RESUMEN

Psoriasis appears to be influenced by stress, which causes release of adrenal hormones. Serotonin, or hormonal actions on serotonin and serotonin receptors, may have a role in psoriasis. Distribution of serotonin receptors was studied in involved and noninvolved skin in patients with psoriasis and compared to normal skin, by using immunohistochemistry and antibodies to 5-HT1A, 5-HT2A and 5-HT3 receptors (R). There was a decreased (P<0.001) number of 5-HT1AR positive cells, the majority being tryptase positive, in involved and noninvolved psoriatic papillary dermis, compared to normal skin. 5-HTlAR expression was also found in the upper part of the epidermis, on vessel walls and on melanocytes. 5-HT2AR expressing papillary mononuclear cells, CD3 positive, were increased (P<0.001 and P<0.01, respectively) in involved and noninvolved psoriatic skin, compared to normal skin, an increase (P<0.01) also being found in the involved compared to noninvolved skin. Expression of 5-HT3R could be found in the basal epidermal layer of noninvolved but not in the involved skin of psoriasis, where it was only found in the acrosyringium. The present findings are compatible with the 5-HT1A and 5-HT2A receptors having antagonistic functions, and raise the possibility of using receptor specific drugs in the treatment of psoriasis.


Asunto(s)
Psoriasis/metabolismo , Receptor de Serotonina 5-HT1A/genética , Receptor de Serotonina 5-HT2A/genética , Adulto , Anciano , Anciano de 80 o más Años , Animales , Anticuerpos Monoclonales , Femenino , Humanos , Masculino , Ratones , Persona de Mediana Edad , Receptor de Serotonina 5-HT1A/biosíntesis , Receptor de Serotonina 5-HT1A/inmunología , Receptor de Serotonina 5-HT2A/biosíntesis , Receptor de Serotonina 5-HT2A/inmunología
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