Increased in situ expression of melanocortin-1 receptor in sebaceous glands of lesional skin of patients with acne vulgaris.

Central or peripheral stress may induce the development of clinical inflammation in the pilosebaceous unit, leading to the development of acne lesions or to exacerbation of pre-existing acne. Melanocortin peptides such as alpha-melanocyte-stimulating hormone and its receptors do not only regulate melanogenesis but can also affect non-pigmentary processes, such as inflammation, apoptosis and sebogenesis. The purpose of the study was to investigate by immunohistochemistry if changes of melanocortin-1 receptor expression exist in acne lesions versus normal skin. In all, 33 patients with acne vulgaris and seven age-matched volunteers without acne participated in the study. Skin biopsies were taken from acne-involved faces, the non-involved thigh skin of the same patients and from normal human skin. Melanocortin-1 receptor immunoreactivity was most prominently detectable in adnexal structures. Sebocytes and keratinocytes of the ductus seboglandularis of acne-involved and non-involved skin showed very intense melanocortin-1 receptor expression in contrast to less intense scattered immunoreactivity in normal skin samples. These data suggest that melanocortin-1 receptor is involved in the pathogenesis of acne.

Bilateral parotid enlargement due to malnutrition under the influence of the media in an adolescent in Lithuania.

The elimination of censorship for the media in post-communist countries in transition has contributed to increases in the prevalence of several medical problems. Children and adolescents are particularly vulnerable to the messages conveyed through the media, which influence their perceptions and behaviour. We describe a case of bilateral parotid enlargement due to malnutrition under the influence of self-prescribed diet in an adolescent. A 15-year-old girl reported to our institution under suspicion of Sjögren's syndrome for medical advice. Two months ago she developed persistent bilateral parotid enlargement and a dry mouth. Her medical history revealed a weight loss due to "self-prescribed" reduce diet. Social questioning clarified high use of the media and influence on the body concept and self image. On extra oral examination, a diffuse parotid enlargement was seen bilaterally. The examination of the mouth showed a low moisture level of the intraoral mucosa. The unstimulated whole salivary flow rate was 2 ml in 15 min. Laboratory findings evidenced anemia (107 g/l). The serum albumin concentration indicated a reduced level (28 g/l). Search for antinuclear antibodies, anti-SSA antibodies, anti-SSB, -Sm, -RNP and anti-double-stranded DNA antibodies was negative. Evaluation for antibodies against hepatitis C, cytomegalovirus and Epstein-Barr virus infection and HIV rendered negative results. A histopathologic examination of labial salivary gland biopsy revealed a picture of sialoadenosis. From the above investigations, a diagnosis of sialoadenosis due to malnutrition was made.

Spectroscopic study of ALA-induced endogenous porphyrins in arthritic knee tissues: targeting rheumatoid arthritis PDT.

The inflamed synovium of rheumatoid arthritis exhibits many features typical for neoplastic tissue implying that the photodynamic therapy might be an efficient modality for chronic poliarthritis. The accumulation of endogenously produced porphyrins after administration of exogenous 5-aminolevulinic acid (ALA) in a rabbit model of rheumatoid arthritis was evaluated by fluorescence spectroscopy. Independent of the way, intravenously or intra-articularly, in which ALA was administered to the experimental animals, the highest fluorescence intensity of endogenously produced porphyrins was detected in the tissues of the inflamed joints. Besides, the application of ALA had a systemic sensitising effect on the whole organism of rabbits. The highest amount of endogenously produced porphyrins in the inflamed joints measured from the surface of the skin above the synovium tissues was detected 1-3 h after the administration of ALA. Fluorescence measurements performed on the tissue specimens ex vivo showed the predominant accumulation of porphyrins in the synovium of the inflamed joints. The fluorescence of porphyrins was also observed in the cartilage tissues taken from knee joints. However, the fluorescence spectra features indicated that the composition of porphyrins detected in the cartilage tissues was different than that in the synovial tissues. The selective accumulation of porphyrins in the inflamed synovial tissues stands up for the application of photodynamic therapy in the treatment of rheumatoid arthritis and implies the possibility to use optical non-invasive methods based on fluorescence detection of endogenously produced porphyrins for diagnostics of inflamed tissues.

Carotid artery atherosclerotic plaque: clinical and morphological-immunohistochemical correlation.

BACKGROUND: The purpose of the study was to: 1) investigate carotid atherosclerotic plaque morphology and immunohistochemistry (IHC) with respect to the localization sites of Chlamydia pneumoniae, 2) find correlations between plaque morphology and clinical sonographical characteristics, and 3) determine the correlation between abundance of C. pneumoniae and complexity of the plaque. MATERIAL/METHODS: 200 patients with asymptomatic (A=59) and symptomatic (S=141) courses of carotid stenosis admitted to the Neurology and Neurosurgery Clinic for TIA or acute ischemic stroke were studied. For IHC the atherosclerotic plaques were incubated with primarily monoclonal anti-Chlamydia pneumoniae antibody clone RP402, code no. M6600, diluted 1:50 (DAKO). Statistical evaluation was performed. RESULTS: 34 (17%) homogeneous (HO), or stable, and 166 (83%) heterogeneous (HE), or unstable, plaques were divided into 3 HO and 5 HE subtypes according to the number of histopathological signs and prevalence of inflammatory cell types, having different sonographical characteristics and plaque thickness. Complex plaques of both A and S patients have activation signs for chronic inflammation, phagocytosis, and atheromatosis: all three of these in HE plaque subtypes, and only for atheromatosis in HO plaques. CONCLUSIONS: 1) C. pneumoniae IHC signals were found in every kind of phagocyte (histiocytes, macrophages, foreign body macrophages, foam cells, PMNs) located in the fibrous cap, atheroma (necrotic core), and especially at the boundary of fibrous cap/atheroma; 2) complexities were found, so plaque instability signs strongly correlate with abundance of C. pneumoniae (p<0.001); 3) sufficient correlation between plaque thickness and disease symptomaticity (p<0.01) was found.