Exoscope-based videocapillaroscopy system for in vivo skin microcirculation imaging of various body areas.

The capillary system immediately responds to many pathologies and environmental conditions. Accurate monitoring of its functioning often enables early detection of various diseases related to disorders in skin microcirculation. To expand the scope of capillaroscopy application, it is reasonable to visualize and assess blood microcirculation exactly in the areas of inflamed skin. Body vibrations, breathing, non-flat skin surface and other factors hamper the application of conventional capillaroscopes outside the nailfold area. In this paper, we propose an exoscope-based optical system for high-quality non-invasive computational imaging of capillary network in various areas of the body. Accurate image matching and tracking temporal intensity variations allow detecting the presence of blood pulsations, precise mapping of capillaries and photoplethysmogram acquisition. We have demonstrated the efficiency of the proposed approach experimentally by in vivo mapping and analysis of microvessels in wrist, forearm, upper-arm, breast and hip areas. We believe that the developed system will increase the diagnostic value of video capillaroscopy in clinical practice.

Autoimmune Chronic Spontaneous Urticaria Detection with IgG Anti-TPO and Total IgE.

BACKGROUND: Autoimmune chronic spontaneous urticaria (aiCSU) comes with high disease activity and poor response to treatment. Recently, elevated levels of IgG anti-thyroid peroxidase (aTPO) and low levels of total IgE were reported to be common in aiCSU. OBJECTIVE: To investigate how high aTPO and low IgE individually and combined are linked to features of aiCSU, including treatment responses. METHODS: We analyzed records of patients with CSU from 2 independent cohorts (n = 1120) for demographic, clinical, and laboratory parameters and treatment responses. Total IgE and aTPO were measured, and 4 markers of aiCSU were analyzed: autologous serum skin test, basophil activation test (BAT), and blood eosinophil and basophil counts. Cutoff values were greater than or equal to 34 kU/L (high aTPO) and less than 40 IU/mL (low total IgE). RESULTS: One of 10 patients with CSU had both high aTPO and low IgE (aTPO↑IgE↓, 11%, n = 123). aTPO↑IgE↓ was linked to higher age at CSU onset, being female, angioedema, and shorter CSU duration. aTPO↑IgE↓ was associated with markers of aiCSU, that is, BAT and autologous serum skin test positivity, basopenia, and eosinopenia (P < .01 for all). Almost half the patients with aTPO↑IgE↓ (44%, 19 of 43) had a positive BAT result, the best single marker for aiCSU, versus 12% (43 of 344) of patients without aTPO↑IgE↓ (P < .001). Relative risk of showing BAT positivity for a patient with aTPO↑IgE↓ is 3.636 (95% CI, 2.382-5.551). Patients with aTPO↑IgE↓ showed low response rates to antihistamine treatment as compared with patients without aTPO↑IgE↓ (30% vs 47%; P = .01). CONCLUSIONS: Our findings suggest that aTPO↑IgE↓ is a useful diagnostic marker for aiCSU in everyday clinical practice.

New polyprenyl phosphate based preparation Fortepren(®) as promising cytokine regulationg antiviral remedy.

Fortepren(®), a product of the phosphorylation of polyprenols from fir needles (with sodium polyprenyl phosphate being the main active ingredient), belongs to the class of antiviral drugs with immunomodulating activity. Fortepren(®) may be used as the drug of choice in the treatment of herpes diseases. It was shown that treatment with Fortepren(®) of patients with a chronic recurrent herpes infection after acute phase termination with acyclovir decreased the recurrence rate, as well as the severity of local symptoms. Fortepren(®) treatment of patients with a high incidence of recurrent herpes infection led to an increase in the interferon-producing ability of leucocytes stimulated with NDV, as well as in the production of key cytokines (IL-1ß, IL-15, MIP-1α, IFN-γ, IL-12 (p40), TNF-α, IFN-α2, IL-12 (p70), IL-6) taking part in the protection against viral infection. Data suggest that the action of the drug is directed, first of all, to the cells responsible for the natural resistance of the organism (macrophages, dendritic cells, etc.). The activation of natural immunity appears to be a leading mechanism of protection from herpesviral infection under the influence of polyprenyl phosphate.

Reduced degranulation of NK cells in patients with frequently recurring herpes.

NK cells lyse virus-infected cells by degranulation; however, alterations in NK cell degranulation in persistent viral infections have not been directly studied. Earlier reports have documented a decrease in NK activity in patients with frequently recurring herpes (FRH). We corroborate these findings by showing that the degranulation responses of blood NK cells from patients with FRH, both during relapse and during remission, are significantly lower than those in healthy donors. The impaired degranulation was probably not caused by defective target cell recognition, since it was observed upon stimulation both with K562 cells and with a receptor-independent stimulus (phorbol 12-myristate 13-acetate plus ionomycin). We also show that the intracellular expression of perforin and CD107a by NK cells from patients with FRH is not different from that in healthy donors, thus excluding that the low NK cell degranulation in FRH is caused by a smaller size of the lytic granule compartment. We confirm previous reports on lowered NK activity in FRH patients and show that NK activity is significantly impaired only during remission, but not relapse; the causes for the discrepancy between the low degranulation and "normal" NK cell activity during relapse are discussed. In all, these data point at the deficit of NK cell degranulation in FRH. Whether this is a predisposing factor or a consequence of herpes simplex virus infection requires further investigation.