Azithromycin pharmacokinetics in the serum and its distribution to the skin in healthy dogs and dogs with pyoderma.

Serum and skin tissue azithromycin (AZM) concentrations were analysed in healthy and pyoderma affected dogs to determine AZM pharmacokinetics and to establish the effect of disease on AZM skin disposition. AZM was administered orally to two groups of healthy dogs: (1) at 7.02 mg/kg (n=7) and (2) at 11.2mg/kg (n=9). A crossover design was used on five of them. Seven dogs with pyoderma were treated with AZM at 10.7 mg/kg. The two groups of healthy dogs received AZM once daily over three consecutive days and dogs with pyoderma received the same treatment repeated twice with an interval of 1 week. AZM concentrations were determined by liquid chromatography-tandem mass spectrometry. AZM was rapidly absorbed and slowly excreted. In healthy dogs, maximum serum concentrations appeared 2h after administration and were (mean ± standard deviation) 0.60 ± 0.25 µg/mL and 1.03 ± 0.43 µg/mL, and the half-lives were 49.9 ± 5.10 and 51.9 ± 6.69 h for doses of 7.02 and 11.2mg/kg, respectively. Clearance (CL0-24/F) was similar in both dosing groups (1.24 ± 0.24 and 1.29 ± 0.24 L/h/kg) and the respective mean residence time (MRT0-24) was 11.1 ± 0.8 and 8.4 ± 2.2h. The skin concentration in healthy dogs was 3.5-6.5 and 5.0-12.0 times higher than the corresponding serum concentration after the two doses and increased after the cessation of AZM administration. The ratio increased significantly in inflamed tissue (9.5-26.2).

Identification of a novel Staphylococcus pseudintermedius exfoliative toxin gene and its prevalence in isolates from canines with pyoderma and healthy dogs.

Staphylococcal exfoliative toxins are involved in some cutaneous infections in mammals by targeting desmoglein 1 (Dsg1), a desmosomal cell-cell adhesion molecule. Recently, an exfoliative toxin gene (exi) was identified in Staphylococcus pseudintermedius isolated from canine pyoderma. The aim of this study was to identify novel exfoliative toxin genes in S. pseudintermedius. Here, we describe a novel orf in the genome of S. pseudintermedius isolated from canine impetigo, whose deduced amino acid sequence was homologous to that of the SHETB exfoliative toxin from Staphylococcus hyicus (70.4%). The ORF recombinant protein caused skin exfoliation and abolished cell surface staining of Dsg1 in canine skin. Moreover, the ORF protein degraded the recombinant extracellular domains of canine Dsg1, but not Dsg3, in vitro. PCR analysis revealed that the orf was present in 23.2% (23/99) of S. pseudintermedius isolates from dogs with superficial pyoderma exhibiting various clinical phenotypes, while the occurrence in S. pseudintermedius isolates from healthy dogs was 6.1% (3/49). In summary, this newly found orf in S. pseudintermedius encodes a novel exfoliative toxin, which targets a cell-cell adhesion molecule in canine epidermis and might be involved in a broad spectrum of canine pyoderma.

Common ground?: Tetracyclines, matrix metalloproteinases, pustular dermatoses, and loxoscelism.

The fear of spiders is ancient and common throughout much of the world. Skin ulceration and necrosis due to Loxosceles spider envenomation ("bites") is among the best known sequelae of a usually accidental encounter. Therapies for Loxosceles envenomations either are not well documented or have adverse side effects that limit their use by generalists. Based on in vitro and in vivo studies in rabbits injected with purified or recombinant sphingomyelinase D2, Paixão-Cavalcante et al. (2007) propose in this issue that topical tetracyclines could become safe, efficacious therapy for cutaneous loxoscelism.

Exocytosis of Neutrophil Formyl peptide receptor-like 1 (fPRL1) results in downregulation of cytoplasmic fPRL1 in patients with purulent dermatitis.

N-Formyl peptide receptor-like 1 (fPRL1) is a member of the chemoattractant subfamily of G protein-coupled receptors and plays a key role in inflammation via chemotaxis and the regulation of mediator release from leukocytes. Activated fPRL1 has recently been shown to induce a complicated pattern of cellular signaling in vitro, but the details of the regulation and alteration of leukocyte cellular fPRL1 during inflammation in vivo remain unclear. To clarify the alteration of neutrophil fPRL1 during inflammation in vivo, the immunohistochemical staining of neutrophil fPRL1 in samples from patients with purulent dermatitis was performed. The in vitro morphological alteration of neutrophil fPRL1 on cellular membranes by stimulation with N-formylmethionyl-leucyl-phenylalanine (fMLP) was also examined. Both the cytoplasm and the cellular membranes of blood neutrophils stained strongly for fPRL1. On the other hand, the cellular membranes of neutrophils in dermatitis tissue stained strongly for fPRL1 but the cytoplasm stained weakly. The enhancement of neutrophil fPRL1 on cellular membranes by stimulation with fMLP indicates the exocytosis of neutrophil fPRL1-containing granules. In conclusion, we for the first time confirmed the alteration of neutrophil fPRL1 in clinical cases of purulent dermatitis. Cytoplasm that was weakly stained and cellular membranes that were well stained for fPRL1 were considered to be distinctive features of activated neutrophils in purulent dermatitis tissue.

Determination of plasma and skin concentrations of orbifloxacin in dogs with clinically normal skin and dogs with pyoderma.

Plasma and skin concentrations of orbifloxacin (Orbax tablets, Schering-Plough Animal Health) were assessed in 14 clinically normal dogs and 14 dogs with pyoderma following oral administration of the drug at 7.5 mg/kg once daily for 5 to 7 days. Skin biopsies and whole blood samples were obtained before dosing and at the time of the expected maximum concentration in skin (3 hours after dosing) on the first and on the fifth to seventh day of dosing. Skin biopsies and plasma were analyzed for orbifloxacin concentrations by high-performance liquid chromatography. Dogs with pyoderma had significantly higher mean skin concentrations of orbifloxacin within 3 hours of administration (Day 0: 7.80 +/- 3.40 mcg/g, Days 4 to 6: 9.47 +/- 6.23 mcg/g) than did dogs with normal skin (Day 0: 3.85 +/- 1.08 mcg/g, Days 4 to 6: 5.43 +/- 1.02 mcg/g). After dosing on Day 0 and after five to seven daily treatments, dogs with pyoderma had significantly higher mean orbifloxacin skin:plasma ratios (1.40 and 1.44, respectively) than did clinically normal dogs (0.81 and 0.96, respectively). The accumulation of orbifloxacin in diseased skin may contribute to the efficacy of this compound for the treatment of bacterial skin infections.

Determination of skin concentrations of enrofloxacin in dogs with pyoderma.

OBJECTIVE: To compare serum and skin concentrations of enrofloxacin in dogs with pyoderma with those of clinically normal dogs and to evaluate concentrations in dogs with superficial versus deep pyoderma. ANIMALS: 16 clinically normal dogs and 16 dogs with pyoderma. PROCEDURE: Enrofloxacin (approx 5 mg/kg of body weight, PO) was administered daily to all dogs. Serum samples and skin biopsy specimens were obtained on day 1 at 3 hours after drug administration and on day 3 immediately before and 3 hours after drug administration. Samples and specimens were assayed by high-performance liquid chromatography. Morphometric analysis was performed on skin biopsy specimens to determine correlation between inflammatory cells and peak tissue enrofloxacin concentration on day 1. RESULTS: Morphometric analysis revealed high correlation between dermal inflammatory cell count and drug concentration in dogs with pyoderma. CONCLUSIONS: At mean dosage of 5 mg/kg once daily, enrofloxacin tissue concentrations were significantly greater in dogs with pyoderma at 3 hours after pill administration. Enrofloxacin tissue concentration on day 3 at 3 hours after pill administration was 12.4 times the 90% minimum inhibitory concentration of enrofloxacin for Staphylococcus intermedius. CLINICAL RELEVANCE: In dogs with pyoderma, therapeutic tissue concentrations of enrofloxacin are reached as early as 3 hours after drug administration.

Fatal pyoderma gangrenosum in association with C7 deficiency.

Although pyoderma gangrenosum (PG) is often associated with systemic diseases, it has not been reported in association with congenital complement deficiencies. We describe an aggressive and ultimately fatal case of PG in a patient with a congenital C7 deficiency. Deficiencies of C7 can be associated with decreased neutrophil chemotaxis, phagocytosis, and opsonization, similar to the immunologic abnormalities described in patients with PG. Our patient's decreased complement level, if not directly related to the development of PG, may have contributed to the aggressive nature of her disease.

Association of aberrant F-actin formation with defective leukocyte chemotaxis and recurrent pyoderma.

A young boy with recurrent skin infections and slow wound healing was shown to have an isolated leukocyte chemotactic defect. The chemotactic abnormality was persistent throughout the observation period, could be demonstrated both in vivo and in vitro, and was not related to known causes of chemotactic defects. To investigate the underlying pathogenetic mechanism for this abnormality, the patient's polymorphonuclear (PMN) leukocytes were studied for their ability to respond to the chemotactic peptide N-formyl-methionylleucylphenylalanine (FMLP). The patient's leukocytes were able to bind FMLP normally and responded appropriately to the stimulus as shown by a rise in intracellular calcium after binding. However, his PMN leukocytes demonstrated abnormalities in the formation and disassembly of filamentous actin (F-actin), an important structural component in cell locomotion. Since the formation and disassembly of F-actin are important in the recycling of actin and crucial in the cell movement, the observed abnormalities may account for the disorder of chemotaxis seen in this patient. The findings in this case resemble the syndrome of neutrophil actin dysfunction. However, observed differences, including a much milder clinical disease, distinguish between these two clinical entities.

[Carbohydrate metabolism in patients with chronic pyoderma and its dynamics during therapy using sugar-decreasing preparations]. / Sostoianie uglevodnogo obmena u bol'nykh khronicheskoi piodermiei i ego dinamika v protsesse terapii s primeneniem sakharoponizhaiushchikh preparatov.

Carbohydrate metabolism has been examined in 301 patients with chronic pyoderma over the course of combined therapy including sugar-reducing drugs; biochemical methods (measurement of the blood sugar on an empty stomach, Staub-Traugott double carbohydrate load test, measurement of the blood serum seromucoid) and radioimmunoassay of the blood serum immunoreactive insulin have been employed. Diabetes mellitus has been first diagnosed in 2.9% of patients, latent diabetes in 18.8%, and in 4.7% of the examinees the parameters indicate the risk of this condition development. Combined therapy improves the examined parameters, providing good immediate and late results. These data favor the use of sugar-reducing agents in multiple-modality therapy of patients with chronic pyoderma.

[Fructosuria in pyodermitis]. / Fruktozuriia pri piodermitakh.

Oscillopolarographic studies of fructosuria in 112 patients with pyodermatitis have helped assess their carbohydrate metabolism and, specifically, the enzymic function of the liver. 89.3% of patients have developed increased fructose and fructose diphosphate excretion, vs. the reference group. High levels of both fructose and fructose diphosphate in the urine are not specific for pyoderma and may occur in other infections; concomitant diseases are conducive to an increase of fructosuria. Administration of hemodez as part of combined therapy for pyodermatitis reduces fructose and fructose diphosphate excretion.

Evidence for histamine-mediated inhibition of monocyte chemotaxis in atopic dermatitis.

Leukocyte chemotaxis was studied in 11 patients with severe childhood onset atopic dermatitis at a time when their disease was relatively quiescent. Pyoderma had been an important complication of the dermatitis in these patients. The chemotactic responsiveness of patient neutrophils and monocytes was on the average not significantly different from that of healthy control subjects, although three patients were identified who had significantly impaired responses. No correlation between IgE levels and leukocyte chemotaxis was observed. Because excessive amounts of histamine have been recovered from the skin of patients with atopic dermatitis, we evaluated the effects of histamine on the chemotactic responsiveness of leukocytes from these patients. Histamine caused a small dose-related increase in chemotaxis of neutrophils from both patients and control subjects (10(-7)M to 10(-5)M histamine). In contrast, histamine had no effect on the chemotaxis of monocytes from control subjects but inhibited the chemotactic responsiveness of monocytes from atopic dermatitis patients. These findings suggest that an abnormal sensitivity of monocytes to histamine is an intrinsic feature of atopic dermatitis that may be detectable when the disease is quiescent. Furthermore, this abnormality may contribute to the impairment of monocyte chemotaxis that has been previously observed in patients with active atopic dermatitis.