Cold urticaria (CU) is an allergic reaction that manifests itself as hives-like rashes or red spots in response to general or local cooling of the body. Th e disease can be acquired or hereditary, ...and in the cold season it can affect all segments of the population. Th is pathological condition, at first glance, does not seem to be a very dangerous variant of a local cold injury, but in persons who are prone to exposure to low temperatures, especially with a burdened cold history, it may be accompanied by chronicity of the process and complicated by neurovasculitis, obliterating endarteritis and secondary Raynaud’s syndrome, may decrease the quality of life of the victims and become a cause of disability. The pathophysiology of CU is largely unknown, but it is likely to be related to immunoglobulin E (IgE) and mast cell activation. Cooling has been reported to induce the release of neutrophilic and eosinophilic chemotactic factors, prostaglandin D2, and tumor necrosis factor (TNF-α). Less common immunologic fi ndings in patients with CU include cryoglobulinemia consisting of monoclonal IgG and mixed IgG/IgM and IgG/IgA cryoglobulin types. The mechanisms of development of CU are mainly determined by the formation of cryoglobulins (cold hemolysins) and subsequent degranulation of mast cells. Th e diagnosis of CU depends on the patient’s history and the results of cold provocation tests. Patients with CU are recommended first of all not to overcool, to take warm showers, to wear warm clothes and a hat, and not to consume cold food and drinks. Treatment options include second-generation H1 antihistamines and glucocorticosteroids. New promising option is omalizumab, a humanized monoclonal antibody derived from a recombinant DNA molecule that targets and selectively binds to circulating IgE and affects mast cells function. In patients with CU undergoing general anesthesia, premedication including antihistamines and corticosteroids is recommended, along with strict maintenance of perioperative normotermia.
Холодова кропивниця (ХК) є алергічною реакцією, яка проявляється висипаннями за типом кропив’янки або червоних плям у відповідь на загальне або локальне охолодження тіла. Захворювання буває набутим або спадковим і в холодну пору року може уражувати всі верстви населення. Цей патологічний стан на перший погляд видається не дуже небезпечним варіантом локальної холодової травми, але в осіб, які схильні до впливу низьких температур, особливо з обтяженим холодовим анамнезом, може супроводжуватися хронізацією процесу й ускладнюватись нейроваскулітом, облітеруючим ендартеріїтом і вторинним синдромом Рейно, може знизити якість життя постраждалих і стати причиною інвалідності. Патофізіологія ХК мало вивчена, але ймовірно пов’язана з імуноглобуліном Е (IgE) та активацією тучних клітин. Охолодження тканин індукує викид хемотактичних факторів нейтрофілів та еозинофілів, простагландину D2 та фактора некрозу пухлин альфа (TNF-α). Менш частою імунологічною знахідкою у пацієнтів з ХК є кріоглобулінемія з моноклональними IgG та змішаними IgG/ IgM або IgG/IgA типами кріоглобулінів. Механізм розвитку ХК здебільшого визначається формуванням кріоглобулінів (холодних гемолізинів) та наступною дегрануляцією тучних клітин. Діагностика ХК залежить від анамнезу пацієнта та результатів холодових тестів. Пацієнтам з ХК рекомендують насамперед не переохолоджуватися, приймати теплий душ, носити теплий одяг та головний убір, не вживати холодну їжу та напої. Варіанти терапії включають H1-гістаміноблокатори другого покоління та глюкокортикоїди. Новою перспективною опцією є омалізумаб — моноклональне антитіло, яке отримують з рекомбінантної молекули ДНК і яке селективно зв’язує циркулюючий IgE і впливає на функцію тучних клітин. У пацієнтів з ХК, які підлягають загальній анестезії, в премедикацію рекомендовано включати антигістамінні та кортикостероїди, разом із суворим дотриманням періопераційної нормотермії.
Objective – before and after the treatment to determine the functional state of the liver, serum levels of enzymes and biochemical indices in syphilis patients with viral hepatites B and C. The ...results of the study are based on the data from a comprehensive examination of 35 patients with syphilis alone and 127 patients with syphilis co-infected with viral hepatites B and C before and after treatment. Test methods: hepatology, rheogeopathography, enzyme content and biochemical parameters determined in the serum. According to the results of radionuclide hepatology it has been established that disorders of the functional capacity of the liver already occur in the early stages of the disease. The most significant disorders have been in the patients with the prescription of infection for more than 12 months and in the patients co-infected with viral hepatites B and C. A disorder of pigment metabolism and increased activity of transaminases have been revealed in early latent syphilis. In co-infection with viral hepatites B and C an increase in total bilirubin, Lactate dehydrogenase, Alanine transaminase, Aspartate aminotransferase and albumin has been revealed. Dysproteinemia has been revealed in patients with early latent syphilis co-infected with hepatitis C. Patients with early latent syphilis treated with immunomodulators tend to normalize these indices. In patients with syphilis a disorder of the functional state of the liver have been revealed already at an early stage of the disease. The most pronounced disorder of biochemical parameters and activity of liver enzymes are observed in syphilis patients with viral hepatites B and C, as well as in patients with early latent syphilis only with the prescription of the infection for more than 12 months; in such a case it is advisable to use drugs affecting the immune system.
Objective – to study the concentration of pro- and anti-inflammatory cytokines in patients with early latent syphilis before and after treatment. The study was conducted in 112 patients with early ...latent syphilis (52 men and 60 women) and 15 healthy persons of the control group – all aged 18-43. Serological tests were used: the classical complex of serological reactions (CSR), ELISA, the reaction of passive hemagglutination (RPGA), immunofluorescence reaction with absorption (RIF-abs) and RIF-200. Using ELISA, the levels of cytokines IL-2, IL-6, IL-10, TNFα, and INFγ were determined in serum (in patients with latent syphilis, before and after treatment). The analysis of the received data was carried out with application of the program package Statistics 6.0. To identify the relationships between the indices, Friedman's nonparametric variance analysis with the definition of χ2 was used. The concentration of IL-10 before treatment in patients with early latent syphilis was significantly increased by 3.7 (14.9±0.9 pg/ml compared to the control group 4.11±0.5 pg/ml). The dependence of the content of this cytokine on the period of infection was established. It was found that one year after treatment concentration of IL-10 remained 1.8 times higher. The concentration of IL-6 was increased by 6.5 times in patients with latent early syphilis and was also dependent on the period of the infection, and also even 1.5-2 years after treatment the IL-6 content remained elevated. It was also found that in patients with latent early syphilis the concentration of IL-2 was increased by 2.3 times and it did not normalize in 24.5% of patients even two years after treatment. In patients with latent early syphilis, the concentration of TNFα was increased by 3.6 times. After treatment, the concentration of TNFα decreased, but exceeded the control values by 1.55 times. Further analysis of the concentration of TNFα revealed that, with a disease period of up to one year, the concentration of this cytokine was normal during ten months after treatment, and in patients with the disease period of more than one year, after treatment normalization of the TNFα level was absent in 64.5% even after 18 months. It was found that the concentration of INFγ in patients with early latent syphilis before treatment was increased by 3.8 times in comparison with the control group. After treatment, almost 25 % of patients with the duration of the infection more than one year revealed no normalization of INFγ and it was increased by 1.5 times. In patients with latent early syphilis there was a significant increase in the concentration of cytokines TNFα and INFγ, an imbalance of IL-2, IL-6, IL-10 as well as. The dependence of the cytokine concentration on the period of infection is noted. Based on the study of the cytokine status in patients with early latent syphilis with periods of infection of more than one year, the use of immunomodulatory therapy may be recommended. Increasing the concentration of such cytokines as TNFα, IL-6, IL-10 after treatment can be used as prognostic tests of serological resistance.
The objective of the work was to study the effectiveness of the use of purified bacterial lysates of the most therapy-resistant strains of microorganisms, the causative agents of pustular skin ...infections, by comparing clinical data and the skin microbiome in patients with acne. The results of the study are based on the data of a comprehensive examination of 35 patients with acne of 2-3 degrees before and after treatment, as well as data of the examination of 15 patients of the control group. Examination methods: clinical examination of the skin, determination of the quantitative composition and microbiological identification of the skin microbiome (bacteria of the genera Staphylococcus, Streptococcus, Propionibacterium Corynebacterium, Micrococcus, Sarcina, Aerococcus, Acinetobacter, Brevibacterium, Citrobacter, Serratia, Lactobacillus; yeast-like fungi of the genera Malassesia and Candida, mold fungi ). In the studied patients with acne, the representative microorganisms of the skin microbiome were Propionibacterium acnes, S. epidermidis, and C. lipophilicum. In patients with acne, the stability of the skin microbiome was carried out due to the redistribution between S. epidermidis and C. lipophilicum. In patients receiving "Acnevac"® (Bioveta, a. s.), a component of a complex treatment, along with earlier periods of clinical improvement, there was noted an earlier normalization of the skin microbiome in comparison with patients receiving standard therapy. Approaches to the treatment of acne with antibiotics and chemotherapy require a revision. The state of the skin microbiome broadens knowledge on the pathogenesis of acne and the search for other means for the individual treatment of patients. Positive changes in the skin microbiome under the influence of treatment with purified bacterial lysates of the most therapy-resistant strains of microorganisms, the causative agents of pustular skin infections, make it possible to recommend its use for a longer term – up to 6 months.
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