Clinical Study Selected Inflammatory and Metabolic Markers in Psoriatic Patients Treated with Goeckerman Therapy

Psoriasis is associated with metabolic activity of adipose tissue which produces pro-and anti-inflammatory adipokines. Goeckerman therapy (GT) represents an effective treatment of psoriasis. This study evaluated variation of selected inflammatory and metabolic markers during GT and the relationships between the markers, severity of the disease (PASI score), body mass, and the basic characteristics of the therapy. The study was conducted on a group of patients ( = 32) and on a control group ( = 24). Before GT, we found significantly elevated levels of proinflammatory CRP ( < 0.001) and leptin ( < 0.05) in psoriatic patients (compared to the controls). The therapy significantly decreased the levels of CRP and adiponectin. We found positive correlations between CRP and total duration of GT ( < 0.05) and CRP and the time of UV exposure ( < 0.01) and negative correlations between adiponectin and the total duration of GT ( < 0.05) and adiponectin and the application of CCT ointment ( < 0.001). From our results, we can conclude that GT causes partial reduction of both proinflammatory and anti-inflammatory markers. However, the levels of proinflammatory CRP and leptin remained significantly higher in the patients than in the control group

Abstract 324: Effect of Prehospital Use of Plasma and Erythrocytes on Crystalloid and Blood Product Requirements in Trauma

Introduction: Recent studies demonstrated positive effects of blood products (BP) administration by helicopter emergency medical services (HEMS) to trauma patients but most of them were limited to specific cohorts (e.g. mixture of primary and secondary transports, long prehospital times, high prevalence of penetrating injuries, military use). This study aimed to assess implementation of prehospital use of BP into a regional trauma system treating predominantly blunt injuries (&gt;95 %) and achieving short prehospital times (first emergency call to handover at trauma center ~60 min). Methods: A prospective observational study in patients treated with prehospital plasma (1 unit) followed by erythrocytes (1 unit) during the initial 7 months of the RABBIT trial (Rapid Administration of Blood by HEMS in Trauma, ClinicalTrials NCT03522636). The treatment group was compared to a historical cohort treated with massive transfusion protocol but no BP available prehospitally. It was hypothesized that early transfusion was associated with lower severity of coagulopathy and lower requirements for crystalloids and BP within 24 hours. Data analysis was performed using Prism 6.0 (GraphPad, La Jolla, USA). Results: Twenty patients treated with prehospital BP (Jun-Dec 2018) were compared to 24 patients in a control group (Jun-Dec 2017). There were no secondary transports. No differences were found between groups in age (47.0 ± 4.1 vs. 46.1 ± 3.7 years, p=0.87), ISS (33.5 ± 3.7 vs. 35.8 ± 3.4, p=0.65), prehospital time (60.9 ± 3.8 vs. 63.8 ± 3.6 min, p=0.59), fibrinogen (2.6 ± 0.2 vs. 2.5 ± 0.2 g/L, p=0.74) and lactate on admission to trauma center (4.5 ± 0.7 vs. 4.4 ± 0.7 mmol/L, p=0.94). The treated patients had better INR (1.1 ± 0.1 vs. 1.4 ± 0.1, p=0.028), and required 14.5 ± 1.7 units of BP in 24 hours compared to 21.42 ± 4.0 units in a control group (p=0,15). Prehospital and emergency department (ED) dose of crystalloids was reduced from 1696 ± 161 mL to 1088 ± 137 mL (p=0.006). No colloids were given at any time. There were no transfusion related complications. Conclusion: Prehospital use of plasma and erythrocytes in a setting with short prehospital times was associated with lower need for crystalloids, better INR at admission, and a trend towards lower consumption of BP in a trauma center. </jats:p

Selected Inflammatory and Metabolic Markers in Psoriatic Patients Treated with Goeckerman Therapy

Psoriasis is associated with metabolic activity of adipose tissue which produces pro- and anti-inflammatory adipokines. Goeckerman therapy (GT) represents an effective treatment of psoriasis. This study evaluated variation of selected inflammatory and metabolic markers during GT and the relationships between the markers, severity of the disease (PASI score), body mass, and the basic characteristics of the therapy. The study was conducted on a group of patients (n=32) and on a control group (n=24). Before GT, we found significantly elevated levels of proinflammatory CRP (p<0.001) and leptin (p<0.05) in psoriatic patients (compared to the controls). The therapy significantly decreased the levels of CRP and adiponectin. We found positive correlations between CRP and total duration of GT (p<0.05) and CRP and the time of UV exposure (p<0.01) and negative correlations between adiponectin and the total duration of GT (p<0.05) and adiponectin and the application of CCT ointment (p<0.001). From our results, we can conclude that GT causes partial reduction of both proinflammatory and anti-inflammatory markers. However, the levels of proinflammatory CRP and leptin remained significantly higher in the patients than in the control group

Mitochondrial Respiration of Platelets: Comparison of Isolation Methods

Multiple non-aggregatory functions of human platelets (PLT) are widely acknowledged, yet their functional examination is limited mainly due to a lack of standardized isolation and analytic methods. Platelet apheresis (PA) is an established clinical method for PLT isolation aiming at the treatment of bleeding diathesis in severe thrombocytopenia. On the other hand, density gradient centrifugation (DC) is an isolation method applied in research for the analysis of the mitochondrial metabolic profile of oxidative phosphorylation (OXPHOS) in PLT obtained from small samples of human blood. We studied PLT obtained from 29 healthy donors by high-resolution respirometry for comparison of PA and DC isolates. ROUTINE respiration and electron transfer capacity of living PLT isolated by PA were significantly higher than in the DC group, whereas plasma membrane permeabilization resulted in a 57% decrease of succinate oxidation in PA compared to DC. These differences were eliminated after washing the PA platelets with phosphate buffer containing 10 mmol&middot;L&minus;1 ethylene glycol-bis (2-aminoethyl ether)-N,N,N&prime;,N&prime;-tetra-acetic acid, suggesting that several components, particularly Ca2+ and fuel substrates, were carried over into the respiratory assay from the serum in PA. A simple washing step was sufficient to enable functional mitochondrial analysis in subsamples obtained from PA. The combination of the standard clinical PA isolation procedure with PLT quality control and routine mitochondrial OXPHOS diagnostics meets an acute clinical demand in biomedical research of patients suffering from thrombocytopenia and metabolic diseases

Metabolic Syndrome and Selective Inflammatory Markers in Psoriatic Patients

The presented article studies the role of selected inflammatory and anti-inflammatory serum markers of psoriatic patients in the pathogenesis of metabolic syndrome (MS) and psoriasis. The study is based on the comparison between the group of psoriatic patients (74) and the control group (65). We found significantly higher BMI (p<0.05) and diastolic blood pressure (p<0.05) in the psoriatic patients. The values of waist circumference and BMI were significantly higher (p<0.05) in the male patients compared to the men in the control group. The analysis revealed significantly higher CRP (p<0.001), Lp-PLA2 (p<0.001), leptin (p<0.01), and resistin (p<0.01) levels in the psoriatic patients. Significantly higher levels of CRP (p<0.01), Lp-PLA2 (p<0.001), leptin (p<0.01), and resistin (p<0.05) were found in the patients with MS compared to the controls with MS. The level of adiponectin was significantly lower (p<0.01) in the patients with MS. Finally, we found significantly higher level of Lp-PLA2 (p<0.001) in the group of patients without MS compared to the controls without MS. In conclusion, observed inflammatory and anti-inflammatory markers (CRP, adiponectin, leptin, resistin, and Lp-PLA2) are involved in both pathogenesis of MS and pathogenesis of psoriasis. The level of Lp-PLA2 indicates the presence of subclinical atherosclerosis (cardiovascular risk) in psoriatic patients

Mitochondrial Respiration of Platelets: Comparison of Isolation Methods

Multiple non-aggregatory functions of human platelets (PLT) are widely acknowledged, yet their functional examination is limited mainly due to a lack of standardized isolation and analytic methods. Platelet apheresis (PA) is an established clinical method for PLT isolation aiming at the treatment of bleeding diathesis in severe thrombocytopenia. On the other hand, density gradient centrifugation (DC) is an isolation method applied in research for the analysis of the mitochondrial metabolic profile of oxidative phosphorylation (OXPHOS) in PLT obtained from small samples of human blood. We studied PLT obtained from 29 healthy donors by high-resolution respirometry for comparison of PA and DC isolates. ROUTINE respiration and electron transfer capacity of living PLT isolated by PA were significantly higher than in the DC group, whereas plasma membrane permeabilization resulted in a 57% decrease of succinate oxidation in PA compared to DC. These differences were eliminated after washing the PA platelets with phosphate buffer containing 10 mmol·L−1 ethylene glycol-bis (2-aminoethyl ether)-N,N,N′,N′-tetra-acetic acid, suggesting that several components, particularly Ca2+ and fuel substrates, were carried over into the respiratory assay from the serum in PA. A simple washing step was sufficient to enable functional mitochondrial analysis in subsamples obtained from PA. The combination of the standard clinical PA isolation procedure with PLT quality control and routine mitochondrial OXPHOS diagnostics meets an acute clinical demand in biomedical research of patients suffering from thrombocytopenia and metabolic diseases.</jats:p

Systemic Inflammation, Oxidative Damage to Nucleic Acids, and Metabolic Syndrome in the Pathogenesis of Psoriasis

In the pathogenesis of psoriasis, systemic inflammation and oxidative stress play mutual roles interrelated with metabolic syndrome (MetS). This study aims to map the selected markers of inflammation (C-reactive protein (CRP)), oxidative damage to nucleic acids (DNA/RNA damage; 8-hydroxy-2′-deoxyguanosine, 8-hydroxyguanosine, and 8-hydroxyguanine), and the parameters of MetS (waist circumference, fasting glucose, triglycerides, high-density lipoprotein (HDL) cholesterol, diastolic and systolic blood pressure) in a group of 37 patients with psoriasis (62% of MetS) and in 43 healthy controls (42% of MetS). Levels of CRP, DNA/RNA damage, fasting glucose, and triglycerides were significantly elevated in patients. MetS in conjunction with psoriasis was associated with high levels of CRP, significantly higher than in control subjects without MetS. Patients with MetS exhibited further DNA/RNA damage, which was significantly higher in comparison with the control group. Our study supports the independent role of psoriasis and MetS in the increase of CRP and DNA/RNA damage. The psoriasis contributes to an increase in the levels of both effects more significantly than MetS. The psoriasis also diminished the relationship between CRP and oxidative damage to nucleic acids existent in controls