Decreased serum paraoxonase and arylesterase activities in patients with rosacea.

BACKGROUND: Recent evidence suggests that oxidative stress may be an important phenomenon in the pathophysiology of rosacea. Paraoxonase-1 (PON1) is an antioxidant enzyme with three activities: paraoxonase, arylesterase and dyazoxonase. In this study, we evaluated serum paraoxonase and arylesterase activities, and serum lipid hydroperoxide (LOOH) levels in patients with rosacea in comparison to healthy controls. MATERIAL AND METHOD: The study included 39 rosacea patients and healthy controls, consisting of 40 age- and sex-matched healthy volunteers. Serum paraoxonase and arylesterase activities were measured using paraoxon and phenylacetate substrates. Serum LOOH levels were measured with the ferrous ion oxidation-xylenol orange assay. RESULTS: In rosacea group mean serum paraoxonase and arylesterase activities were 74.54 ± 38.30 U L(-1) and 141.29 ± 22.27 kU L(-1) respectively, which were significantly lower than controls (P = 0.010, 0.005; respectively). Mean serum LOOH level of rosacea group was 8.17 ± 1.91 µmol L(-1) which was significantly higher than controls (P = 0.009). There were no statistically significant differences between the clinical subtypes of the disease, menopause situation or ocular involvement with the respect to the serum paraoxonase and arylesterase activities and LOOH levels (all; P > 0.05). CONCLUSIONS: Serum PON1 enzyme activities have decreased significantly in rosacea. These findings support that decreased PON1 activity and increased oxidative stress may play a role in the pathogenesis of rosacea. Further studies are needed to elucidate the role of PON1 activity in the pathophysiology of rosacea.

Elevated insulin resistance in patients with recurrent aphthous stomatitis.

OBJECTIVES: The role of glucose metabolism disorders in periodontal diseases including recurrent aphthous stomatitis (RAS) is currently attracting attention. The aim of this study is to investigate insulin resistance (IR) in patients with RAS in otherwise healthy individuals. MATERIALS AND METHODS: The study enrolled 81 patients with RAS and 61 healthy control subjects. Blood glucose, insulin, C-peptide, hemoglobin A1c, total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and HOMA-IR were measured in each individual. RESULTS: Forty-two of the RAS group were in the active, and 39 of the RAS group were in the passive stage. The levels of c-peptide, insulin, and HOMA-IR were remarkably higher in the RAS group (p = 0.015; p < 0.0001; p < 0.0001, respectively) than the control group. The levels of HbA1c, glucose (p = 0,045), TC (p = 0,008), HDL cholesterol (p = 0,002), and HOMA-IR (p = 0.022) were significantly higher in patients with RAS in the active stage. CONCLUSION: The study revealed an elevated IR in patients with RAS that was not previously shown. IR was more prominent when the patients were in the active stage that elevated inflammatory cytokines may induce IR by interfering with insulin signaling. Further studies, investigating the interplay between RAS, inflammation, and IR are needed. CLINICAL RELEVANCE: Patients who admitted the hospital with RAS might be screened for prediabetes.

Behcet disease and pregnancy.

PURPOSE: Behcet disease (BD) is a multisystemic vaculitis commonly diagnosed in reproductive years. The authors aimed to investigate the relationship between BD and pregnancy outcomes. MATERIALS AND METHODS: In this multicenter retrospective survey study, the authors compared the pregnancy outcomes of BD patients with the healthy controls. RESULTS: A total of 298 pregnancies of 94 patients with BD and 219 pregnancies of 95 healthy controls were evaluated. The mean birth weight of all babies of women with BD and the control group were 3,214 grams and 3,351 grams, respectively (p = 0.028). The miscarriage rates were also higher in the BD group. The com- plication rates of pregnancy with hypertension, preeclampsia, preterm labour in the study group and the control group were 12.8% and 11.6%, respectively (p = 0.489). CONCLUSION: The current study demonstrated that BD patients delivered smaller babies and they have higher miscarriage rates when compared to the healthy controls which might be due to the vasculitis of the placenta.

Epidemiological patterns of perniosis, and its association with systemic disorder.

BACKGROUND: There are few studies exploring the epidemiological properties of perniosis (chilblains) and its association with systemic disorders. AIM: To collect epidemiological data for perniosis, to investigate any association with systemic disorders, and to identify markers for the differential diagnosis of idiopathic and secondary perniosis. METHODS: This was a prospective study of 51 patients with perniosis [female : male ratio 2.64 : 1, mean ± SD age 24.6 ± 14.7 years, with 25 patients (49%) aged 0-18 years]. Each patient was interviewed, and signs suggestive of connective-tissue disorders were recorded. Detailed laboratory investigations including autoimmune parameters were performed. RESULTS: Significant proportions of the patients had both chronic and idiopathic perniosis (P < 0.001 for both). The mean age of the group with secondary perniosis was significantly higher than that of the idiopathic group (P < 0.01). There was no significant gender difference in the secondary perniosis group (P = 0.71). Clerking work was the most common occupation (37%, P = 0.01). Persistence beyond the cold seasons, and presence of photosensitivity, hypergammaglobulinaemia and rheumatoid factor were significant findings in the secondary group (P = 0.02, P = 0.02, P < 0.01, P < 0.05, respectively). CONCLUSIONS: Perniosis is not rare in children, but patients with secondary perniosis are more likely to be older. In terms of underlying systemic disorder, advanced age and male gender may be important demographic features. Measurement of cryoglobulin levels in the initial laboratory investigations of patients with perniosis is not necessary. Persistence beyond the cold seasons, and presence of photosensitivity, hypergammaglobulinaemia and rheumatoid factor may be useful in differentiating between idiopathic and secondary perniosis.

Immunoregulatory effects of isotretinoin in patients with acne.

BACKGROUND: In vitro studies have shown that retinoids influence T-cell differentiation. OBJECTIVES: To study the effect of isotretinoin on T-cell differentiation markers in patients with acne. METHODS: A total of 37 patients with acne vulgaris (25 female, 12 male, age 19.6 ± 3.7 years) and 30 age- and sex-matched healthy controls (19 female, 11 male, age 20.5 ± 4.4 years) were included in the study. Screening for biochemical parameters in serum samples were done just before initiation (pretreatment) and after 3 months of isotretinoin treatment (post-treatment) in the acne group. RESULTS: Baseline levels of tumour necrosis factor (TNF)-α (P<0.0001), interleukin (IL)-4 (P<0.0001), IL-17 (P<0.0001) and interferon (IFN)-γ (P=0.002) were significantly higher in the acne group compared with the control group. TNF-α (P<0.0001), IL-4 (P<0.0001), IL-17 (P<0.0001) and IFN-γ (P<0.0001) levels decreased after isotretinoin treatment. TNF-α and IL-4 values after isotretinoin treatment were similar to those of the control group. However, levels of IL-17 (P<0.0001) after isotretinoin treatment were higher than those of the control group, despite a significant decline after treatment. Levels of IFN-γ (P<0.0001) after isotretinoin treatment were lower than those of the control group. CONCLUSIONS: This study shows that isotretinoin treatment significantly decreases TNF, IL-4, IL-17 and IFN-γ levels in patients with acne. We failed to show that isotretinoin redirects naive T helper (Th) differentiation preferentially towards the Th2 cell lineage.