OBJECTIVE:Plasma concentration of epoxyeicosatrienoic acids (EETs) derived from cytochrome P450 (CYP)-dependent metabolism of arachidonic acid is increased in women with preeclampsia (PE) as compared ...to normal pregnancy (N), and is even higher in fetal plasma (Herse et al. Circulation 2012, Jiang et al. Am J Hypertens 2013). We hypothesized that differences in EET synthesis or metabolism in the feto-placental unit underlie the observed differences in circulating EETs.
DESIGN AND METHOD:To evaluate EETs generation as well the expression of the relavant CYP isoforms and of the metabolizing enzyme soluble epoxide hydrolase (sEH), biopsies of placenta were collected from 19 N and 10 PE at the time of surgical delivery. EETs were extracted from tissue homogenates and analyzed by LCMS.
RESULTS:Both cis- and trans- EETs were detected in the placenta in PE and N, with similar mean ratios. Concentration of total EETs was higher in the placenta in PE compared to N (2.37 ± 1.42 ng/mg vs 1.20 ± 0.72 ng/mg, Mean ± SD, P < 0.01), especially the 5,6-, 8,9- and 11,12-EETs, measured in a subgroup of tissue samples (N = 10, PE = 5), were elevated. By immunohistochemistry, CYP2C8 was not detectable, CYP4A11 showed weak positivity in the mesenchimal axis of some villi (up to 50%) and scattered signal in the others. Also CYP2J2 was detectable in mesenchimal elements of placentas (scattered in 10–40% of villi, up to 50%). sEH showed weak signal in 1–3 cells for each villous, with a regular pattern distribution. CYP2C8, CYP4A11 and CYP2J2 were not detectable in umbilical cord. Western blotting analysis of placenta homogenates revealed a higher expression of sEH in N with respect to PE (3.9 ± 0.9 vs 0.8 ± 0.4 sEH relative expression, P < 0.05).
CONCLUSIONS:In conclusion, along with the enzymes implicated in their biosynthesis, significant amounts of EETs were found in the placenta and the umbilical cord. Reduced expression of sEH in PE may contribute to increased EET in the placenta. Altered synthesis of EETs occurs in the placenta, reinforcing the hypothesis of their pathogenetic role in PE.
OBJECTIVE:Sleep disordered breathing (SDB) and high blood pressure (BP) are more frequent among obese with respect to normal weight children and this may be due to endothelial dysfunction and a ...worsened arterial stiffness. The aim of this study was to evaluate the possible association between SDB and BP and the possible role of endothelial function and local and systemic arterial stiffness in a sample of obese children asymptomatic for sleep disturbances.
DESIGN AND METHOD:Thirty-nine obese children were included in the study. Children underwent overnight limited channel polysomnography; vascular measurements included(i) office and 24-hour ambulatory BP, (ii) brachial flow-mediated dilatation (FMD), carotid intima media thickness (cIMT), and distensibility (DC) by ultrasounds and (iii) systemic arterial stiffness (SI) by digital volume pulse analysis.
RESULTS:Significant correlations between different BP measurements (both office and ABPM estimated by z-score) and SDB were found, including respiratory disturbance index (RDI), apnea-hypopnea index (AHI), the number of desaturation/h, mean peripheral saturation (r ranging between 0.330 to 0.474). Carotid distensibility (DC) correlated with AHI (r = −0.367; p = 0.030) and with mean oxygen saturation (r = 0.401; p = 0.017). To the contrary, no relation between either FMD or SI or cIMT and all the tested respiratory markers was found. In multivariate analysis, supine z-SBP remained independently associated with the number of desaturation per hour or AHI also after correction for DC and BMI.(Figure is included in full-text article.)
CONCLUSIONS:ConclusionsOur data suggest that in obese children, even if asymptomatic for sleep respiratory problems, SDB might worsen BP, in part through an increase in arterial stiffness.
To test whether vascular function is altered in normal pregnancy and preeclampsia (hypertension and proteinuria after the 20
th
week of pregnancy), we performed a cross-sectional study comparing 15 ...preeclamptic women (PE) with 31 normotensive pregnant -11 pair matched for gestational age (MGA-NP) and 20 at term (T-NP)- and 20 non-pregnant women (HC). All subjects were matched for age and BMI (<27Kg/m
2
).Women with obesity, diabetes, pre-existing arterial hypertension were excluded. Women with PE received antihypertensive drugs. Stiffness index (SI) and Reflection Index (RI) were obtained by digital volume pulse analysis using photoplethy smography. Mean arterial pressure (MAP), plasma creatinine and uricacid were higher in PE (p<0.001 vs.NP and HC), where as heart rate (HR) was lower in PE (p<0.05 vs. NP). RI was higher in P Erespect to NP (median min-max 66.5%37-80) vs. 51.5% 31-80; p<0.001) whereas SI tended to increase in PE (7.6 m/sec 5.6 13.5; MGA_NP 6.5 m/sec 5.4-8.7; p=0.10). When normalized for MAP, both SI/MAP and RI/MAP were similar in PE and NP, whereas SI/HR and RI/HR normalized for HR were higher in PE (p<0.05 vs. NP and MGA_NP). SI (p<05) was higher in PE respect to HC. Correlation between SI and RI (r
s
=0.56 p<0.001), MAP and both SI and RI (r
s
=0.48 p=0.001; r
s
=0.50 p<0.001), HR and RI (r
s
=0.58 p<0.001), uric acid and RI (r
s
=0.41 p=0.007) was observed in PE+NP. The present results confirm that vascular function is altered in PE with higher RI suggesting peripheral vasoconstriction and a tendency toward higher SI, suggesting diminished compliance.
The aim of this study was to assess quality of life in patients with scalp dermatitis using the Italian version of the Scalpdex, and to validate the instrument in Italian. The survey was conducted in ...outpatients with psoriasis, seborrhoeic dermatitis, alopecia, or follicular lichen. Data were completed on 194 patients, 78% of whom had psoriasis. Scalpdex scores were always higher in women than in men, and in younger people compared to elderly people. The most frequent items were: being ashamed, embarrassed, bleeding scalp, feeling self-conscious, bothered that the condition is incurable, having the choice of colour of clothes affected, having a negative effect on daily life. The Italian Scalpdex showed good internal consistency, test-retest reliability, convergent validity, and responsiveness. In conclusion, the Italian version of the Scalpdex is a useful instrument to measure quality of life in patients with a scalp condition.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Abstract In this prospective, cross-sectional, multicenter study, we assessed clinical and laboratory characteristics from patients with cutaneous lupus erythematosus (CLE) using the Core Set ...Questionnaire of the European Society of Cutaneous Lupus Erythematosus (EUSCLE). 1002 (768 females, 234 males) patients with different subtypes of CLE, such as acute CLE (ACLE, 304 patients), subacute CLE (SCLE, 236 patients), chronic CLE (CCLE, 397 patients), and intermittent CLE (ICLE, 65 patients), from 13 European countries were collected and statistically analyzed by an SPSS database. The main outcome measures included gender, age at onset of disease, LE-specific and LE-nonspecific skin lesions, photosensitivity, laboratory features, and the criteria of the American College of Rheumatology (ACR) for the classification of systemic lupus erythematosus. The mean age at onset of disease was 43.0 ± 15.7 years and differed significantly between the CLE subtypes. In 347 (34.6%) of the 1002 patients, two or more CLE subtypes were diagnosed during the course of the disease and 453 (45.2%) presented with LE-nonspecific manifestations. Drug-induced CLE and Sjögren´s Syndrome had the highest prevalence in SCLE patients (13.1% and 14.0%, respectively). Photosensitivity was significantly more frequent in patients with ACLE, SCLE, and ICLE compared with those with CCLE. The detection of antinuclear antibodies such as anti-Ro/SSA and anti-La/SSB antibodies revealed further significant differences between the CLE subtypes. In summary, the EUSCLE Core Set Questionnaire and its database facilitate the analysis of clinical and laboratory features in a high number of patients with CLE and will contribute to standardized assessment and monitoring of the disease in Europe.
Summary
Background
In recent years it has been controversially discussed in the literature if smoking is associated with the activity of cutaneous lupus erythematosus (CLE) and the efficacy of ...antimalarial agents.
Objectives
To investigate the influence of smoking on disease severity and antimalarial treatment in patients with CLE using the Core Set Questionnaire of the European Society of Cutaneous Lupus Erythematosus (EUSCLE).
Methods
A total of 1002 patients (768 female, 234 male) with different CLE subtypes were included in this cross‐sectional study, which was performed in 14 different countries. Smoking behaviour was assessed by the EUSCLE Core Set Questionnaire in 838 patients and statistically analysed using an SPSS database. The results were correlated with the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) and the efficacy of antimalarial treatment.
Results
A high percentage (87·2%) of the 499 patients with CLE, who have ever smoked, had already smoked at the date of their first diagnosis. Patients with intermittent CLE have ever smoked significantly more often than patients with subacute CLE (P < 0·05) and chronic CLE (P < 0·05). The total CLASI activity and damage score of patients with CLE was 6·6 ± 7·1 and 2·6 ± 4·3, respectively, and was higher in patients who have ever smoked than in nonsmokers. Antimalarial treatment was successful in 84·3% of cases, with a significantly higher efficacy in nonsmokers than in patients with CLE who have ever smoked (P < 0·05).
Conclusions
This analysis of a multicentre study population of 838 patients with CLE assessed by the EUSCLE Core Set Questionnaire confirms that smoking negatively influences CLE disease severity and the efficacy of antimalarial treatment.
What's already known about this topic?
The influence of smoking on disease severity in patients with cutaneous lupus erythematosus (CLE) and the efficacy of antimalarial treatment is still being controversially discussed in literature.
What does this study add?
The present analysis of a study population of 838 patients with CLE suggests that smoking is a risk factor for the disease, in particular for intermittent CLE.
The results confirm that there is a negative influence of smoking on disease severity and that the efficacy of the antimalarials hydroxychloroquine and chloroquine is affected by smoking.
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