Person: ÖZGEN, ZÜLEYHA
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Demographic, clinical and treatment characteristics of patients with Kaposi's sarcoma: A single-center study
Objective: The clinical, demographic and treatment characheristics of patients with Kaposi's sarcoma (KS) are not well-detined. There is lack of consensus on treatment modalities. Thus, we aimed to define demographic, clinical characteristics and treatment outcomes in our cohort of patients with KS. Patients and Methods: A retrospective cohort study was done and all patients who were followed up in our specialized cutaneous tumors outpatient clinic with a diagnosis of KS between 2006 and 2018 were included in the study. Results: A total of 25 patients were included in the study. The mean age of the patients was 66 and 80% were male. The most common form of KS was classic type (80%). During a mean follow-up of 43 months, the most frequently administered treatments were cryotherapy, interferons, radiotherapy, topical imiquimod and topical timolol. Overall a complete response was observed in 9 (36%) patients. Conclusion: The clinical and demographic characteristics of our cohort match those observed in existing literature. We think that the use of local treatments such as cryotherapy, topical imiquimod should be used more frequently in patients with limited disease. Considering the efficacy of timolol in other vascular tumors, future prospective studies investigating the effects of timolol in KS are highly warranted.
COVID-19 severity and SARS-Cov-2 vaccine safety in pemphigus patients
There are safety concerns in the treatment of pemphigus patients with immunosuppressants, particularly rituximab (RTX), in times of the COVID-19 pandemic. In the beginning, the reports were more pessimistic. However, few reports have recently pointed to manageable courses in this patient group. Therefore, we investigated the disease characteristics and demographic features of pemphigus patients in the period of the COVID-19 pandemic. We aimed to investigate the impact of immunosuppressants on the course of COVID-19 in pemphigus patients. Also, we tried to find out the rate of flares due to COVID-19 and SARS-Cov-2 vaccines. This multicenter study included 247 patients with pemphigus from three tertiary dermatology clinics with the specialized outpatient clinic for autoimmune blistering diseases. Patients were asked standardized questions in person or via telephone calls. Also, demographic data were collected from patients\" files. Two hundred forty-four of 247 patients took the survey between August and September 2021. The data of three patients were obtained from the National Health System. We collected the data of all pemphigus patients who visited the clinics at least once in the past 3 years. Among 51 patients having COVID-19, 40 had a non-serious disease, whereas 11 required hospitalization. One patient died because of COVID-19 infection. The number of patients is limited, and data depends mainly on patients\" statements. RTX treatment does not require additional safety cautions than other immunosuppressives.
Growth Arrest-Specific 6 and Cardiometabolic Risk Factors in Patients with Psoriasis
ObjectivesAn increased risk for cardiovascular disease with psoriasis has been reported. Growth Arrest-Specific 6 (GAS6) amplifies pro-inflammatory endothelial cell activation via TAM receptors. However, it also inhibits inflammation by multiple mechanisms including phagocytosis. The objective of this study was to investigate whether plasma GAS6 levels are associated with conventional cardiometabolic (CM) risk factors in patients with psoriasis. MethodsForty patients diagnosed with psoriasis (22 male, mean age: 43.313.8years) and 40 age-/sex-matched healthy controls (22 male, mean age: 39.38.9years) were included in the study. CM risk factors (hypertension, hyperlipidemia, diabetes mellitus, and cigarette smoking) were identified. GAS6 levels were measured by ELISA. ResultsThere were no significant differences between the plasma GAS6 levels of patients with psoriasis compared to the control group (6.6 +/- 2.0ng/mL, 7.6 +/- 2.8ng/mL, respectively, P>0.05). However, GAS6 levels of patients with psoriasis having a smoking history (n=11) were significantly lower than both patients with psoriasis who had no smoking history (n=29) and controls (5.5 +/- 1.7ng/mL, 6.9 +/- 1.9ng/mL, 7.6 +/- 2.8ng/mL, respectively, P<0.05). Similarly, psoriasis patients with at least one CM risk factor showed lower GAS6 levels compared to subjects without any CM risk factor (5.7 +/- 1.7ng/mL, 7.3 +/- 2.0ng/mL, P<0.01). There was no correlation between the GAS6 level, disease duration or PASI score (r=0.150, -0.150, and P=0.310, 0.398, respectively). ConclusionsThis pilot study provides the first evidence in humans for an association between low plasma GAS6 levels and conventional risk factors in psoriasis. Further large scale, prospective studies are needed to confirm these results.
Immunmodulation in the treatment of dermatological diseases
Immunological effects have an important role in the action mechanisms of the majority of topical and systemic agents, and even some physical treatment modalities in dermatology. Depending on the disease being treated, these effects may be suppression or stimulation of the immune system as well as modulation of the existing functions. Agents that show their effects mainly by immunmodulation in the treatment of dermatological diseases are discussed in the present article. Treatment alternatives included in the article, azathioprine, mycophenolate mofetil, cyclosporine, glucocorticosteroids, topical calcineurin inhibitors, photo(chemo)therapy, intravenous immunoglobuline, interferon, rituximab, omalizumab, imiquimod and extracorporeal photopheresis are discussed focusing especially on their immunomodulatory effects without any mention on their prescribing details, treatment protocols and monitorization aspects.
Effect of Dental Follicle Mesenchymal Stem Cells on Th1 and Th2 Derived Naive T Cells in Atopic Dermatitis Patients
Objective: The purpose of our study is to investigate the immunomodulatory effects of Dental Follicle Mesenchymal Stem Cells (DF-MSCs) on lymphocytes isolated from peripheral blood of Atopic Dermatitis (AD) patients, a Th2 disease and psoriasis, a Th1 / Th17 disease and compare them with healthy individuals in vitro. Methods: Patients with the AD (n = 9) and psoriasis (n = 6) who are followed up in Marmara University Pediatric Allergy and Immunology and Dermatology outpatient clinics and healthy subjects (n = 6) were included. Peripheral Blood Mononuclear Cells (PBMCs) were isolated from 20 ml of venous blood of all participants. Cells were cultured for 72 hours in the absence and presence of DF-MSCs with anti-CD3/anti-CD28 stimulation or without stimulation. At the end of this period, CD4+ and CD8+ T lymphocyte proliferation and cytokine levels from the culture supernatants were analyzed by flow cytometry. Results: In the presence of DF-MSCs, proliferation ratio was suppressed in both CD4+ and CD8+ cells in AD and psoriasis patients (p<0,05). IFN-gamma levels significantly increased in AD patients in the presence of DF-MSCs (p<0,05) whereas decreased significantly in psoriasis patients in the presence of DF-MSCs (p<0,05). IL-4 levels significantly decreased in AD patients in the presence of DF-MSCs (p<0,05) but remained unchanged in psoriasis patients (p>0,05). IL-10 increased significantly in both groups in the presence of DF-MSCs (p<0,05). Conclusion: Our results support immunoregulatory effects of DF-MSCs on both AD and psoriasis which are Th2 and Th1 / Th17 dominant diseases respectively. Our evidence-based results demonstrated that DF-MSCs could have a beneficial therapeutic implication for inflammatory skin diseases.