[Drug-induced hyper- and depigmentation].
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Biomedical subjects
Publications and source records attributed to A Krebs.
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The hepatocyte membrane asialoglycoprotein receptor (ASGP-R) was extracted from rabbit liver, purified, and then incubated with preformed vesicles of dimyristoyl phosphatidylcholine. The association of protein with lipid was dependent on vesicle size and the best results were achieved with small vesicles of about 20 nm diameter. The ligand binding capacity of ASGP-R-vesicle complexes was also measured and found to be approximately sevenfold greater than free receptor in aqueous buffer and twofold greater than receptor solubilized in Triton X-100. Most likely, the reconstitution procedure used in these experiments does not result in transmembrane insertion of the receptor. ASGP-R probably resides on the surface of the vesicle, held there primarily by weak hydrophobic forces.
The in vitro stability of 10-ethyldithranol (1,8-dihydroxy-10-ethyl-9(10H)-anthracenone) and its effects on healthy and psoriatic skin is investigated. 10-Ethyl-dithranol as a representative of the new class of 10-alkyldithranol derivatives neither stains nor irritates and has no antipsoriatic activity at all. This is due to the relatively stable substituent at carbon 10 which enables the fast oxidation processes necessary for the antipsoriatic effect. Therefore, antipsoriatically active dithranol derivatives require a free or easily liberated 10-position and hence the so-called 'minimum structure of antipsoriatic anthrones' keeps its validity.
In 11 of 15 patients suffering from chronic dermatoses of the palms and soles (psoriasis inversa, palmoplantar pustulosis, palmoplantar hyperkeratotic eczema and idiopathic pompholyx), an improvement was achieved with "aqua-SUP" therapy. Trials using this therapeutic modality, which is a combination of balneotherapy and selective UV phototherapy (SUP), have only rarely been reported so far. In addition, five patients received internal medication (mainly aromatic retinoid) that had previously not been effective enough, three of them in combination with local corticosteroids. Four more patients were administered local corticosteroids in addition to "aqua-SUP". Four patients experienced local pain in the treated area, especially in the initial phase of phototherapy, and a mild erythematobullous reaction occurred in three of them. No other side-effects were observed. The efficacy of "aqua-SUP" for the treatment of the above-mentioned dermatoses lies in the same range as that of local PUVA, which has been used up to now. However, as "aqua-SUP" is easily manageable, it is more convenient for the patient and does not involve the problems of photosensitization.
Oral treatment of psoriasis on an outpatient basis, using a preparation containing fumaric acid derivatives, was evaluated as initial monotherapy (3 months) and as long-term basic therapy (12-14 months) in 13 and 11 patients, respectively. The course of the disease was analysed in each individual case. After completion of both parts of the trial, half of the patients that had only responded poorly to conventional antipsoriatic therapy showed a significant improvement which occurred after several weeks of treatment. In 4 patients the medication had to be stopped because of abdominal pain. No severe side effects, particularly of a renal, hepatic or haematological nature, could be established. Studies in mice and rats disclosed only a low acute toxicity of the fumaric acid derivatives used. In additional analyses, hypotheses were dealt with concerning the mechanism of action of fumaric acid in psoriasis. To establish fumaric acid derivatives in the treatment of psoriasis, studies on chronic toxicity and pharmacokinetics will have to be conducted. Further clinical trials should evaluate a single fumaric acid derivative instead of mixtures.
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The flare-up of pompholyx-type nickel eczema induced by oral nickel challenge has been dealt with in several publications. To compare the reactivity of non-pompholyx and pompholyx-type nickel eczema, we challenged three groups of female volunteers (7 with non-pompholyx-type and 12 with pompholyx-type nickel eczema plus 10 control subjects without nickel allergy) with an oral dose of 2.5 mg nickel. By patch testing we additionally determined the degree of cutaneous nickel sensitivity using a series of nickel sulfate dilutions (5.0-0.00001%) and an possible cobalt allergy using 1% cobalt chloride. In 8 of the 19 patients with nickel allergy, the oral nickel challenge was positive (rash, flare-up at sites of healed eczema and former nickel patch tests, and worsening of preexisting eczema; acute pompholyx lesions only in patients with pompholyx-type eczema). The positive results showed the same frequency in non-pompholyx eczema (43%) as in the pompholyx type (42%). Moreover, no substantial difference was found in the degree of cutaneous nickel sensitivity between the two groups of eczema, and there was no correlation between these results and the outcome of the oral nickel challenge. An additional cobalt allergy was recorded significantly more often in pompholyx-type eczema (P = 0.048), yet there was no influence on the oral nickel challenge. The laboratory parameters examined (differential white cell count and total IgE) did not differ in either of the two eczema groups and did not change substantially during nickel challenge reactions.
Irradiation of 20 tattoos using the Q-switched Nd:YAG laser (energy density 3-5 J/cm2, asymmetrical pulse shape with 50% energy output in 18 ns, spot size 3 mm in diameter) gave the impression that black ink tattoos can be completely removed without scarring. Some patients needed several treatments. The results continued to improve even some months after the irradiation. In preliminary experiments on excised tattooed and untattooed skin the non-Q-switched Nd:YAG laser had distinct burning effects. It was therefore not tested in patients. The results of chemical, physical, and histological examinations are discussed with special reference to toxic side-effects that might be induced by laser irradiation.
The larvae of green lacewings (Chrysopidae) may occasionally attack man as temporary ectoparasites, causing papular reactions similar to those produced by gnat bites.
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We compared the DNA sequence of the Autographa californica nuclear polyhedrosis virus polyhedrin gene with that of the polyhedrin gene from a morphology mutant called M5. A single point mutation was found at the BamHI restriction site within the polyhedrin coding sequence. This point mutation caused a substitution of leucine for proline at amino acid 58 in the M5 polyhedrin. This point mutation was shown to be responsible for both the appearance of cubic polyhedra and the altered mobility of the polypeptide on sodium dodecyl sulfate-polyacrylamide gels by transferring the M5 polyhedrin gene to the wild-type virus by cotransfection. Recombinants were found which assembled cubic polyhedra in infected cells, had the BamHI restriction site missing, and had an altered mobility of their polyhedrin polypeptide. Computed-predicted secondary-structure analysis indicated that the amino acid at position 58 could be critical to the proper folding of polyhedrin.
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Following glomerulonephritis with subsequent anasarca and repeated penicillin treatments, generalized cutis laxa developed in a forty-year-old patient. Progressive signs of pulmonary emphysema appeared in the same period. Additionally, a monoclonal gammopathy was detected during extensive examination.
Seventy eight patients with chronic lung diseases were once or repeatedly vaccinated against influenza with a bivalent inactivated vaccine. The vaccination was well tolerated. Systemic reactions and transitory deterioration of the lung disease were exceptional. Fourfold rise of antibodies occurred in 1/3 (H1N1) and 1/2 (H3N2) of the patients. After one year, this increase was no more demonstrable. Annual revaccination is recommended.
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A patient suffering from severe pemphigus vulgaris was treated using large-volume plasma exchange in combination with an immunosuppressive regimen. As some recent reports have shown evidence that polyclonal, polyspecific human IgG in high doses through the i.v. route (IGIV) protect target platelets in idiopathic thrombocytopenic purpura from attack by antiplatelet autoantibodies and/or immune complexes, we also administered IGIV to this pemphigus-vulgaris patient. In order to test the hypothesis that IGIV might protect in vitro-cultured human skin from acantholysis induced by pemphigus antibodies, studies with skin organ cultures were carried out using plasma from another pemphigus-vulgaris patient who had undergone plasma exchange. The preincubation of either the skin explants or the pemphigus plasma with various concentrations of IGIV (ranging from 0.15 to 15 mg/ml in the culture medium) did not prevent acantholysis induced by the pemphigus plasma nor did it inhibit the binding of the specific antibodies visualized by direct immunofluorescence. Thus, the assumption that IGIV may coat the pemphigus antigens on epidermal cells making them inaccessible to pathogenic autoantibodies was not substantiated by our tests in vitro; likewise, the hypothesis of functionally blocking autoantibody activity by means of anti-idiotype effects of IGIV cannot be supported.