Induration

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  • 文章类型: Journal Article
    虽然纯化的蛋白衍生物(PPD)通常用作结核病(TB)感染的皮肤诊断试剂,它不能有效区分卡介苗(BCG)疫苗接种与结核分枝杆菌(MTB)复合体和非结核分枝杆菌感染。新型皮肤试剂ESAT6-CFP10(EC)具有良好的敏感性和特异性,这可以克服与PPD相关的限制。目前,EC皮试反应主要表现为红斑,而PPD主要引起硬结。我们使用豚鼠模型对EC诱导的红斑和PPD诱导的硬结之间的潜在差异进行了比较研究。EC依赖性红斑的大小与PPD诱导的硬结相似,和以单核细胞浸润为特征的炎症反应,巨噬细胞和淋巴细胞,以及组织损伤,出现在注射部位。淋巴细胞包括CD4+T细胞和CD8+T细胞,其释放IFN-γ作为主要细胞因子。EC红斑和PPD硬结均可导致急性期蛋白水平升高,差异途径相似,因此表明主要的诱导免疫途径是相似的。以上结果表明,EC产生的红斑可产生PPD硬结的主要迟发型超敏反应(DTH),提示红斑也可能具有一定的诊断意义,为其作为检测MTB感染的诊断指标提供可能的理论依据。
    While purified protein derivative (PPD) is commonly used as skin diagnostic reagent for tuberculosis (TB) infection, it cannot distinguish effectively Bacillus Calmette-Guérin (BCG) vaccination from Mycobacterium tuberculosis (MTB) complex and nontuberculous mycobacteria infection. The new skin reagent ESAT6-CFP10 (EC) has favorable sensitivity and specificity, which can overcome limitations associated with PPD. At present, EC skin test reactions are mainly characterized by erythema, while PPD mainly causes induration. We conducted a comparative study on the potential differences between EC-induced erythema and PPD-induced induration using a guinea pig model. The size of EC-dependent erythema was similar to that of PPD-induced induration, and an inflammatory response characterized by the infiltration of monocytes, macrophages and lymphocytes, as well as tissue damage, appeared at the injection site. The lymphocytes included CD4+ T and CD8+ T cells, which released IFN-γ as the main cytokine. Both EC erythema and PPD induration could lead to increased levels of acute-phase proteins, and the differential pathways were similar, thus indicating that the main induced immune pathways were similar. The above results indicated that erythema produced by EC could generate the main delayed-type hypersensitivity (DTH) response characteristic of PPD induration, thereby suggesting that erythema might also have a certain diagnostic significance and provide a possible theoretical basis for its use as a diagnostic indicator for detecting MTB infection.
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  • 文章类型: Journal Article
    BACKGROUND: Morphea is an uncommon disease that presents with skin induration and sclerosis. The disease is common in Caucasians and there are few studies describing the clinicoepidemiological profile of these patients from the Indian subcontinent.
    METHODS: This prospective study was conducted during a three year period from June 2014 to May 2017. All patients of morphea presenting to the dermatology outpatient department were evaluated for parameters like age, sex, duration, age of onset, clinical subtype and possible disease associations and triggering factors. The data was analysed, tabulated and mean, standard deviation and percentages calculated.
    RESULTS: 47 patients were incorporated into the study. These comprised of 10 (21.28%) males and 37 (78.72%) females. The average age of the patients was 23.92 ± 12.07 years with a mean age of onset being 22.13 ± 12.51 years. 22 (46.80%) patients presented within one year of onset of disease. Plaque morphea was the commonest type seen in 31 (65.96%) patients followed by linear morphea in 9 (19.15%) patients. We found preceding trauma in 3 patients and morphea developed following herpes zoster and intramuscular injection in one patient each.
    CONCLUSIONS: Morphea is an uncommon disease that is seen predominantly in females and young individuals. Circumscribed plaque morphea is the commonest variant. Certain predisposing factors like trauma can precede it.
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  • 文章类型: Journal Article
    推测血小板活化在免疫炎症反应中起重要作用。最近对多种炎性病症的若干研究已经使用平均血小板体积(MPV)作为血小板活化的标志物。
    确定银屑病患者的血液学参数与疾病严重程度指数之间的关系。
    对50名银屑病患者和50名健康对照受试者进行了病例对照研究。在患者和对照组之间比较了十个血液学参数。这些参数在PASI(牛皮癣面积和严重程度指数)评分的患者中也相关。使用IBMSPSS软件(版本21)对数据进行统计分析。使用Spearman等级相关性来发现PASI与血液学参数之间的相关性。
    当所有患者一起考虑时,MPV的平均值,两组(对照组和患者)之间的血小板计数(PLT)和红细胞分布宽度(RDW)显着差异。当MPV和RDW被提高时,与对照组相比,男女患者的PLT均降低。在男性患者中,MPV和RDW与银屑病面积和严重程度指数(PASI)具有统计学意义(MPV<0.01;RDW<0.05),而与对照组相比,男女PLT虽然降低,仅在女性患者中显示出显着意义(p<0.01)。
    患者的MPV和RDW平均值高于对照组,血小板平均值低于对照组。男性患者的MPV值和女性患者的血小板计数分别与PASI评分呈较强的正相关和负相关。可以得出结论,MPV升高和PLT降低可能是疾病严重程度和进展的良好指标。这些指标也可以帮助评估疾病的治疗过程。
    UNASSIGNED: Platelet activation is presumed to play an important role in the immunoinflammatory reactions. Several recent studies on a variety of inflammatory disorders have used Mean Platelet Volume (MPV) as a marker for platelet activation.
    UNASSIGNED: To determine the relationship between haematological parameters and disease severity index in psoriasis patients.
    UNASSIGNED: A Case control study was carried out on 50 psoriatic patients and 50 healthy control subjects. Ten haematologic parameters were compared between patients and control subjects. These parameters were also correlated in patients with PASI (Psoriasis Area and Severity Index) score. The data was statistically analysed using IBM SPSS software (Version 21). Spearman Rank Correlation was used to find the correlation between PASI and haematological parameters.
    UNASSIGNED: When all the patients were considered together, mean values for MPV, Platelet Count (PLT) and Red Cell Distribution Width (RDW) were significantly different between the two groups (Control and Patients). While MPV and RDW were raised, PLT was reduced in patients of both sexes when compared with controls. In Male patients the MPV and RDW showed statistically significant correlation with Psoriasis Area And Severity Index (PASI) (MPV <0.01; RDW<0.05), whereas PLT though reduced in both sexes when compared with controls, it showed significance in female patients alone (p <0.01).
    UNASSIGNED: The mean values for MPV and RDW were higher and mean platelet values were lower in patients than controls. The MPV values in male patients and Platelet counts in female patients showed strong positive and negative correlation respectively with the PASI score. It can be concluded that rising MPV and decreasing PLT could be good indicators of disease severity and progression. These indicators could also help in assessing the treatment course of the disease.
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