The Expression of Activation Markers CD25 and CD69 Increases during Biologic Treatment of Psoriasis.

CD (cluster of differentiation) 69 and CD25 are considered early and late markers of the activation of lymphocytes, respectively. CD25 is a part of the IL-2 receptor and is present on the surface of immune and non-immune cells, with high amounts on activated lymphocytes and regulatory T cells. CD69 is expressed on various types of white blood cells, including newly activated lymphocytes, lymphocytes infiltrating tissues isolated from subjects with chronic auto-inflammatory diseases, several subtypes of memory T cells and regulatory T cells. Primarily, CD69 was considered to be an early marker of the activation of lymphocytes, but, right now, data derived from in vitro and in vivo studies have revealed the immunomodulatory role of this surface antigen. In 84 patients with psoriasis, of whom 28 were treated with different biologic drugs, as well as in 29 healthy control subjects, the expression of CD25 and CD69 on different subtypes of peripheral blood mononuclear cells (PBMCs) was studied with the use of flow cytometry. Significantly higher levels of CD3/CD69-, CD8/CD69- and CD19/CD69-positive PBMCs as well as within CD3+ cells were present in subjects suffering from psoriasis when compared to healthy controls. In patients with psoriasis who were treated with biologic drugs, the levels of CD3/CD69-, CD4/CD69- and CD19/CD69-positive PBMCs, and CD3/CD69 within CD3+ cells, CD4/CD69 within CD4+ cells, CD4/CD25 within CD4+ cells and CD19/CD69 within CD19+ cells were significantly higher than before therapy. Our results support a role for activation markers, especially CD69, in psoriasis. Further research is warranted to fully clarify their significance in this common dermatosis, especially during biologic treatment.

Selected miRNA and Psoriasis-Cardiovascular Disease (CVD)-Overweight/Obesity Network-A Pilot Study.

Psoriasis is nowadays recognized as a multifactorial systemic disease with complex and not fully understood pathogenesis. In psoriatic patients, the increased cardiovascular disease (CVD) risk and frequent comorbidities like obesity are observed. The aim of this study was to investigate differences in miRNA (miR-22-3p, miR-133a-3p, miR-146a-5p, miR-369-3p, and Let-7b-5p) involved in CVD risk among psoriatic patients with overweight/obesity and with normal weight. The study comprised 28 male psoriatic patients and 16 male healthy controls. miRNA isolated from peripheral blood mononuclear cells was reverse-transcribed and RT-qPCR was performed. We have found decreased levels of miR-22, miR-133a, miR-146a, and miR-369 among the psoriatic patients. There was a statistically significant difference in miR-22 and miR-146a levels between psoriatic patients with overweight/obesity and with normal weight. There were positive correlations between miR-22 and miR-146a levels and psoriatic arthritis (PsA) in psoriatic patients with normal weight and between the miR-133a level and PsA in the overweight/obese patients. The decreased levels of selected miRNA are consistent with the levels observed in CVD indicating their impact on the CVD risk in psoriatic patients. miR-22 and miR-146 may be recognized as one of the contributing factors in the obesity-CVD-psoriasis network.

The Impact of Biologic Treatment on PD-1/PD-L1 Pathway Disturbances in Psoriasis.

The programmed death-1 (PD-1) receptor plays a major physiological role in the maintenance of immune tolerance and, by interaction with its ligands (PD-L1 and PD-L2), prevents the development of multiple immune-mediated diseases. There is growing evidence of the PD-1/PD-L1 pathway playing an important role in the pathogenesis of psoriasis. In total, 84 subjects with psoriasis were included in this study, together with 29 healthy subjects as a control group. Twenty-eight of the psoriatic patients were treated with biologic therapy (TNF-alpha, interleukin (IL)-12/23, or IL-17 inhibitors). The amounts of PD-1- and PD-L1-positive T-cells in peripheral blood were evaluated using flow cytometry. Significantly lower levels of peripheral blood mononuclear cells (PBMCs) with the expression of PD-1 and PD-L1 were found in psoriatic patients compared to healthy individuals, i.e., CD3/PD-1-, CD3/PD-L1-, CD4/PD-1-, CD4/PD-L1-, CD8/PD-L1-, CD19/PD-1-, and CD19/PD-L1-positive cells. Biologic treatment resulted in the elevation of CD3/PD-L1- and CD8/PD-L1- and a decrease in CD8/PD-1-positive PBMCs. Our results confirm previous observations of the PD-1/PD-L1 pathway being disrupted in psoriasis, and that these disturbances may play an important role in development of the disease. Biologic drugs may reverse several abnormalities observed within this pathway, which may explain their excellent efficacy in the treatment of psoriasis. Further research should be conducted to fully explain the results obtained.

Risankizumab Therapy for Moderate-to-Severe Psoriasis-A Multi-Center, Long-Term, Real-Life Study from Poland.

The present multi-center, long-term, real-life study made an attempt to assess the efficacy of risankizumab in the treatment of moderate-to-severe plaque psoriasis. The study comprised 185 patients from 10 Polish dermatologic departments undergoing risankizumab treatment. The disease severity was measured using the Psoriasis Area and Severity Index (PASI) before the start of the risankizumab treatment and next at the defined timepoints, i.e., 4, 16, 28, 40, 52 and 96 weeks of treatment. The percentage of patients achieving PASI90 and PASI100 responses as well as the PASI percentage decrease at the defined timepoints were calculated, and correlations with clinical characteristics and therapeutic effect were analyzed. The number of patients evaluated at the defined timepoints was: 136, 145, 100, 93, 62, and 22 at 4, 16, 28, 40, 52 and 96 weeks of treatment, respectively. At 4, 16, 28, 40, 52 and 96 weeks, the PASI90 response was achieved in 13.2%, 81.4%, 87.0%, 86.0%, 88.7% and 81.8% of patients, whereas the PASI100 response was achieved in 2.9%, 53.1%, 67.0%, 68.8%, 71.0% and 68.2% of patients, respectively. Our study revealed a significant negative correlation between a decrease in the PASI and the presence of psoriatic arthritis as well as the patient's age and duration of psoriasis at several timepoints throughout the observation period.

Influence of Parameter Uncertainty to Stator Current Reconstruction Using Modified Luenberger Observer for Current Sensor Fault-Tolerant Induction Motor Drive.

In modern systems with induction motors (IM), in addition to precision, it is also very important to ensure the highest possible reliability and safety. To ensure the above, information about the stator current value is required. If the current sensor (CS) fails, a redundant sensor or an algorithmic solution can be used. The Luenberger observer (LO) can be used to estimate the lost stator current without increasing the cost of the drive system. However, this solution is based on the mathematical model of IM, which is sensitive to its parameters. Therefore, this paper presents a modified LO (MLO) and investigates the effect of a coefficient in the error gain matrix on improving robustness to changes in the IM parameters. As shown by extensive studies, the proposed solution has significantly reduced the influence of the IM parameters on the accuracy of the stator current estimation, which has not been previously reported in the known literature.

PD1/PD-L1 pathway in psoriasis and psoriatic arthritis: a review.

Programmed-death 1 (PD-1) is a co-receptor that inhibits the inflammatory response, and thus helps in maintenance of peripheral immunotolerance. Impairment in the PD-1/PD-L1 pathway is believed to play an important role in many immune-mediated diseases, including systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis and autoimmune hepatitis, and, as emphasized recently, in psoriasis and psoriatic arthritis. Biologic drugs targeting immune checkpoint regulators may be associated with new-onset psoriasis or exacerbations of pre-existing dermatosis. In this review we discuss the role of PD-1/PD-L1 pathway in psoriasis basing on data published to date.

Virtual Current Sensor in the Fault-Tolerant Field-Oriented Control Structure of an Induction Motor Drive.

Designing electrical drives resistant to the failures of chosen sensors has recently become increasingly popular due to the possibility of their use in fault-tolerant control (FTC) systems including drives for electric vehicles. In this article, a virtual current sensor (VCS) based on an algorithmic method for the reconstruction of the induction motor (IM) phase currents after current sensor faults was proposed. This stator current estimator is based only on the measurements of the DC-bus voltage in the intermediate circuit of the voltage-source inverter (VSI) and a rotor speed. This proposal is dedicated to fault-tolerant vector controlled IM drives, where it is necessary to switch to scalar control as a result of damage to the current sensors. The proposed VCS allows further uninterrupted operation of the direct rotor-field oriented control (DRFOC) of the induction motor drive. The stator current estimator has been presented in the form of equations, enabling its practical implementation in a microprocessor system. Simulation studies of the proposed algorithm in an open and closed-loop DRFOC structure are presented under different operation conditions of the drive system. The experimental verification of the proposed method is also presented and the accuracy of the stator current estimation algorithm is analyzed under various operating conditions of the drive system.

Anti-endothelial cell antibodies do not correlate with disease activity in systemic sclerosis.

INTRODUCTION: Anti-endothelial cell antibodies (AECA) recognize endothelial cell proteins and are thought to play an important role in vascular damage observed in systemic scleroderma (SSc) and many other autoimmune diseases. In SSc, AECA were found to be more common in patients with pulmonary hypertension, digital ulcers and nailfold capillaroscopic changes. Until now, there have been no studies examining the association between AECA positivity with the activity and duration of the disease. AIM: To evaluate associations between the presence of AECA in sera of patients with SSc and internal organs involvement as well as disease activity. MATERIAL AND METHODS: Sera of 58 patients with SSc (50 with localized subtype and 8 with diffuse subtype) were examined for AECA presence using an indirect immunofluorescence technique. Several clinical and laboratory features were also evaluated as well as disease activity and disease duration. RESULTS: A significant association between positive AECA and a subtype of SSc (p = 0.021) was found, as well as between presence of digital ulcers and digital scars (p = 0.001), calcinosis (p = 0.02), acroosteolysis (p = 0.028) and a nearly significant association between AECA and lung fibrosis (p = 0.47). No association between disease duration, disease activity and AECA (p = 1.000 and 0.191, respectively) was present. CONCLUSIONS: Anti-endothelial cell antibodies are not associated with the activity of SSc. Digital ulcers, calcinosis and acroosteolysis are more common among AECA-positive patients suggesting that the presence of AECA might be an indicator of vascular complications development in SSc. Positive AECA among patients with lung fibrosis indicate their possible role in the development of lung disease. Further prospective studies including a greater number of patients are required.

A 12-year-old Girl with Severe Plaque Psoriasis and Down Syndrome Treated Successfully with Etanercept.

The association between Down syndrome and psoriasis is unclear. Immunological abnormalities that present in individuals with Down syndrome result in mild immune debilitation, thus the risk of infectious complications during immunosuppressive therapy might be higher in this group of patients. We present a case of 12-year-old girl with severe plaque psoriasis and Down syndrome, who was initially treated with cyclosporine with good response. However, the drug was withdrawn due to massive viral warts development and loss of efficacy. Afterwards, the girl was treated with etanercept in short 10 week and long 24 week courses with excellent response. The presented case is the first report of a child with Down syndrome and concomitant severe plaque psoriasis treated successfully with etanercept.

CO2 Biofixation and Growth Kinetics of Chlorella vulgaris and Nannochloropsis gaditana.

CO2 biofixation was investigated using tubular bioreactors (15 and 1.5 l) either in the presence of green algae Chlorella vulgaris or Nannochloropsis gaditana. The cultivation was carried out in the following conditions: temperature of 25 °C, inlet-CO2 of 4 and 8 vol%, and artificial light enhancing photosynthesis. Higher biofixation were observed in 8 vol% CO2 concentration for both microalgae cultures than in 4 vol%. Characteristic process parameters such as productivity, CO2 fixation, and kinetic rate coefficient were determined and discussed. Simplified and advanced methods for determination of CO2 fixation were compared. In a simplified method, it is assumed that 1 kg of produced biomass equals 1.88 kg recycled CO2. Advance method is based on empirical results of the present study (formula with carbon content in biomass). It was observed that application of the simplified method can generate large errors, especially if the biomass contains a relatively low amount of carbon. N. gaditana is the recommended species for CO2 removal due to a high biofixation rate-more than 1.7 g/l/day. On day 10 of cultivation, the cell concentration was more than 1.7 × 10(7) cells/ml. In the case of C. vulgaris, the maximal biofixation rate and cell concentration did not exceed 1.4 g/l/day and 1.3 × 10(7) cells/ml, respectively.

High frequency ultrasonography of the skin and its role as an auxillary tool in diagnosis of benign and malignant cutaneous tumors--a comparison of two clinical cases.

The number of dermatologic entities that can be studied by ultrasound examination (US) of the skin is increasing. Conventional US and high frequency US (HFUS) are considered useful additional tools in improving the diagnosis and management of common benign and malignant skin tumors. US may help in positive and differential diagnosis of primary melanocytic neoplasms and of locoregional spread in melanoma patients. US preoperative evaluation of primary melanoma thickness correlates with histologically estimated melanoma thickness, and can help determine surgical margins and indications for sentinel lymph node biopsy. It is also useful during follow-up after surgical treatment for early detection of recurrence or metastases. In this case report, we present two cases of skin lesions clinically suspicious for malignancy. The first lesion was a round nodule 3 mm in diameter, resembling a blue nevus. In HFUS it was well delimited, hypoechoic, and well vascularized. The second lesion presented as an elevated, well-circumscribed nodule, 5-6 mm in diameter, inhomogeneous in color. HFUS depicted a poorly delimited, irregular, hypoechoic lesion crossing the dermoepidermal junction. At the first exam it was not vascularized, but 6 months later a number of vascular flow signals within the lesion were found. In histopathological examination the lesions were finally diagnosed as, respectively: benign cavernous hemangioma and melanoma. In both presented cases HFUS proved to be useful in a differential diagnosis of suspicious skin lesions. Noninvasive and easy to perform, HFUS is a valuable diagnostic method in dermatology.

Steatocystoma multiplex with hair shaft abnormalities.

Steatocystoma multiplex (SM) is an unusual benign disorder of the pilosebaceous duct characterized by multiple cysts with little or no nail and hair involvement. We report a 30-year-old woman with multiple cystic nodules located on the neck, axillae and forearms as well as patchy scalp alopecia. Histopathological examination of the lesions was diagnostic of SM. Trichoscopy revealed pili torti and pili canaliculi. This patient represents an unusual clinical presentation of SM because of the presence of hair abnormalities.

Usefulness of computed tomography virtual bronchoscopy in the evaluation of bronchi divisions.

BACKGROUND: Since introduction of multislice CT scanners into clinical practice, virtual brochoscopy has gained a lot of quality and diagnostic potential. Nevertheless it does not have established place in diagnostics of tracheal and bronchi disorders and its potential has not been examined enough. Nowadays a majority of bronchial tree variants and lesions are revealed by bronchofiberoscopy, which is an objective and a relatively safe method, but has side effects, especially in higher-risk subjects. Therefore noninvasive techniques enabling evaluation of airways should be consistently developed and updated. MATERIAL/METHODS: Material consisted of 100 adults (45 female, 55 male) aged between 18 and 65 years (mean 40 years, median 40.5 years, SD 14.02), who underwent chest CT examination by means of a 16-slice scanner. Every patient had normal appearance of chest organs, with the exception of minor abnormalities that did not alter airways route. Divisions of bronchial tree to segmental level were evaluated and assigned to particular types by means of virtual bronchoscopy projection. In case of difficulties MPR or MinIP projection was used. RESULTS: THE FREQUENCY OF LOBAR BRONCHI DIVISIONS OTHER THAN THE TYPICAL ONES WAS IN: right upper lobar bronchi 45%, left 55%; middle lobar bronchi 21%, lingula 26%; right lower lobar bronchi 28%, left 29%. Subsuperior bronchus or bronchi were found on the right side in 44% and on the left side in 37%. No dependency between types of bronchial divisions on different levels was found.

Trigeminal nerve - artery contact in people without trigeminal neuralgia - MR study.

BACKGROUND: Neurovascular conflict is regarded as the most common cause of idiopathic trigeminal neuralgia. It is suspected that a blood vessel in contact with the root entry zone of a trigeminal nerve causes its irritation. The aim of the study was to evaluate how signs of neurovascular conflict can be found in people without trigeminal neuralgia MATERIAL/METHODS: The study was conducted retrospectively. The authors analyzed MR examinations of 60 patients (120 nerves), aged 22-77 years, who did not have trigeminal neuralgia or related symptoms. Nerve-artery contact at the root entry zone of a trigeminal nerve, nerve deformation, and atrophy were searched for in angio-3D-TOF images (slice thickness: 1 mm). RESULTS: Contact between a trigeminal nerve and an artery was found in 30 cases (25% of nerves). The blood vessel was parallel to the nerve root in 14 cases (11.7%) and crossed it at a right or acute angle in 15 cases (12.5%). Contact between artery and atrophic nerve was found in one case. Modeling of the trigeminal nerve by an artery was not found. CONCLUSIONS: Contact between a trigeminal nerve root and an artery in the prepontine cistern is a frequently seen anatomical variant. Therefore, detection of such a variant is not equivalent to finding the cause of a patient's complaints.

[The value of neuroimaging (MRI and CT) in the diagnostics of headaches in children and adults--own experience]. / Wartosc badan neuroobrazowych (MR i TK) w diagnostyce bólów glowy u dzieci i doroslych--badania wlasne.

AIM: to evaluate MRI and CT findings in children and adults presenting with headaches and to define the value of these methods in the diagnostics of headaches. MATERIALS/METHODS: 164 children and 317 adults with headaches were included in the trial. In all cases either MRI or CT was performed depending on the specialist's referral or the patient's request in case of MRI. RESULTS: in the group of children 40.9% showed no abnormalities on neuroimaging. The results with abnormal features have been considered as 'positive' and divided in two groups: 'significant' lesions requiring further diagnostic procedures or urgent neurosurgery and 'benign' lesions, where patient management did not change. In 2.4% 'significant' lesions were found. The remaining 56.7% had 'benign' lesions diagnosed (16 abnormalities occurring alone or in combination). Among the adults 67.5% had normal MRI or CT scans. In 32.5% neuroimaging revealed abnormalities: 2.2% described as 'significant' lesions and 30.3% described as 'benign' lesions. CONCLUSIONS: 1. Neuroimaging methods (MRI and CT) should not be routinely ordered in the initial diagnostics of headaches. 2. Patients suspected of neoplastic disease, vascular malformations, posttraumatic lesions or focal brain lesions must have these examinations performed. 3. The percentage of patients with headaches who require such extended diagnostics with MRI or CT is low.