RESUMEN
Tocilizumab (TCZ) is a recombinant-humanized anti-human interleukin 6 receptor monoclonal antibody of the immunoglobulin (Ig) IgG1 subclass with a H2L2 polypeptide structure. Even if it was approved by the US Food and Drug Administration for the treatment of rheumatoid arthritis, systemic juvenile idiopathic arthritis and polyarticular juvenile idiopathic arthritis, satisfying results have also been reported with TCZ in various refractory dermatological diseases such as psoriasis, psoriatic arthritis, Behçet's disease, systemic lupus erythematosus, systemic sclerosis, relapsing polychondritis, vasculitis and atopic dermatitis. TCZ treatment in dermatology and adverse effects of the drug were reviewed here after the pharmacological properties, mechanism of action, dosage and administration of the drug were summarized. We estimate that by the help of newly well-designed studies with wider spectrum of subjects to comprehensively investigate the efficacy and safety will be able to contribute to the clinical management of the diseases especially refractory to the other treatments. Therefore, during the next decade, TCZ will be promising drugs in the treatment of refractory dermatological diseases.
Asunto(s)
Anticuerpos Monoclonales Humanizados , Antiinflamatorios/farmacología , Anticuerpos Monoclonales Humanizados/efectos adversos , Anticuerpos Monoclonales Humanizados/farmacología , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antirreumáticos/efectos adversos , Antirreumáticos/farmacología , Antirreumáticos/uso terapéutico , Artritis Psoriásica/tratamiento farmacológico , Síndrome de Behçet/tratamiento farmacológico , Terapias Complementarias , Enfermedad Injerto contra Huésped/tratamiento farmacológico , Humanos , Interleucina-6/antagonistas & inhibidores , Lupus Eritematoso Sistémico/tratamiento farmacológico , Policondritis Recurrente/tratamiento farmacológico , Esclerodermia Sistémica/tratamiento farmacológico , Enfermedad de Still del Adulto/tratamiento farmacológico , Vasculitis/tratamiento farmacológicoRESUMEN
BACKGROUND: Endocan is a novel human endothelial cell-specific molecule. The central role of leukocytes and endothelial dysfunction in the development of Behçet disease (BD) led us to hypothesize that endocan might be a marker of this disease. OBJECTIVE: We investigated the relationship between serum levels of endocan and disease activity in patients with BD. METHODS: In all, 33 patients (16 active, 17 inactive) with BD and 35 healthy persons were included in the study. Endocan and C-reactive protein were measured in all subjects. RESULTS: Patients with BD had significantly higher serum endocan levels. Mean serum levels of endocan were 1.29 ± 0.60 ng/mL (range: 0.58-2.99) in patients with BD and 0.75 ± 0.16 ng/mL (range: 0.48-1.21) in control subjects (P < .001). In patients with BD, serum endocan levels correlated moderately but significantly with C-reactive protein, erythrocyte sedimentation rate, and disease activity. Receiver operating characteristic curve analysis suggested that the optimum endocan level cut-off point for patients with BD was 0.87 ng/mL, with a sensitivity and specificity of 75.8% and 80%, respectively (area under curve 0.835, 95% confidence interval 0.738-0.932). LIMITATIONS: The main limitation of our study is the relatively small sample size. CONCLUSIONS: Circulating endocan may be a marker of BD activity.
Asunto(s)
Síndrome de Behçet/sangre , Proteína C-Reactiva/análisis , Proteínas de Neoplasias/sangre , Proteoglicanos/sangre , Adulto , Síndrome de Behçet/fisiopatología , Biomarcadores/sangre , Sedimentación Sanguínea , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Progresión de la Enfermedad , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proteínas de Neoplasias/análisis , Proteoglicanos/análisis , Curva ROC , Valores de Referencia , Índice de Severidad de la EnfermedadRESUMEN
We report a case of Demodex infestation in a 35 year old coal miner presenting with a 5 year history of scally papulopustular eruption on his face. He had been working inunderground coal tunnels in a humid- hot- dusty environment and he had been used to bath twice a day with hot water and multiple cleaners. The patient was treated successfully with oral metronidazol, topical permethrin, topical steroids and avoidance of undergraund mining . We believe his occupational environment made him prone to infestation by changes in sebum composition and/or viscosity, his bath habituation facilitated infestation, damaging the epidermal barrier function and his previous treatments exaggerated his infestation. During evaluation of the patient, specific occupational factors and habituations will be related with higher succession rates of treatment. We need to conduct further studies in order to draw a definite conclusion about the effect of the occupational environment on Demodex infestation.