Skin Barrier Function in Patients with Primary and Secondary Sjögren's Syndrome

Sjögren's syndrome (SS) is a systemic autoimmune disease. A large percentage of patients with SS suffer from dry skin, the cause and pathogenesis of which in this group of patients remains obscure. The aim of the present study was to investigate skin barrier function in patients with SS. Measurements of transepidermal water loss (TEWL) and hydration of stratum corneum (corneometry, CM) were performed in 30 female patients with SS (17 with primary SS and 13 with secondary SS), 20 patients with atopic dermatitis (AD) and 14 healthy controls. There were no statistically significant differences in TEWL values between the three investigated groups, while CM values were significantly decreased in patients with AD when compared with patients with SS and the healthy controls. Based on the obtained results, skin barrier function and hydration in patients with SS showed no functional alterations.

Levels of EGF and VEGF in patients with primary and secondary Sjögren's syndrome

BACKGROUND

Aberrant angiogenesis plays a role in the pathogenesis of Sjögren's syndrome (SS).

OBJECTIVES

The aim of this study was to compare the levels of vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF) in stimulatory parotid saliva and in serum in healthy subjects (HS), patients with primary SS (pSS) and secondary SS (sSS) and to evaluate the expression of EGF, proangiogenic VEGF165 and antiangiogenic VEGF165 b mRNA isoforms. Additionally, we determined the salivary levels of serine/arginine splicing factor (SRSF1), which regulates VEGF165 and VEGF165 b expression.

MATERIAL AND METHODS

The study comprised 34 women (16 with pSS and 18 with sSS) and healthy subjects for blood and saliva sampling. EGF and VEGF levels in saliva and serum and salivary SRSF1 levels were determined by enzyme-linked immunosorbent assay (ELISA). The expression of VEGF165 , VEGF165 b and EGF in peripheral blood mononuclear cells (PBMC) was evaluated by quantitative polymerase chain reaction (qPCR).

RESULTS

There were no differences in the levels of EGF, VEGF, SRSF1 and in the expression of the EGF, VEGF165 and VEGF165 b between HS and SS patients, or between pSS and sSS patients. The salivary levels of VEGF165 and EGF were significantly higher in pSS, sSS and HS than serum levels. Levels of SRSF1 correlated positively with VEGF and EGF levels. Levels of EGF, VEGF and SRSF1 correlated with each other.

CONCLUSIONS

The balance of VEGF isoforms is not disturbed in SS. Saliva is more sensitive for the detection of EGF and VEGF than serum, but salivary levels of those proteins are not representative for SS.

Serum ICAM-1, VCAM-1 and E-selectin levels in patients with primary and secondary Sjögren's syndrome

BACKGROUND

Typical features of Sjögren's syndrome (SS) are severe xerostomia and xerophthalmia which are basic diagnostic criteria.

OBJECTIVES

The aim of this study was to compare the serum levels of soluble (s) intercellular adhesion molecule 1 (sICAM-1), vascular cell adhesion molecule 1 (sVCAM-1) and sE-selectin between primary (pSS), secondary (sSS) and healthy subjects (HS). We correlated these results with selected clinical parameters of disease activity and parameters of the severity of xerostomia and xerophthalmia.

MATERIAL AND METHODS

The serum levels of sICAM-1, sVCAM-1 and sE-selectin were determined by enzyme-linked immunosorbent assay (ELISA) in 16 patients with pSS, 18 with sSS and 15 HS. Eye dryness and xerostomia were assessed by the Schirmer's test, the Fox test and the visual analogue scale (VAS).

RESULTS

The levels of sICAM-1 in pSS and sVCAM-1 in sSS patients were significantly higher when compared to HS (p = 0.02 and p = 0.048, respectively). There were no differences between pSS and sSS. In pSS, sVCAM-1 correlated positively with VAS (rS = 0.52, p = 0.04) and the Fox test (rS = 0.66, p=0.01). In sSS, sE-selectin correlated positively with sICAM-1 (rS = 0.54, p = 0.01), the duration of the disease (rS = 0.51, p = 0.03) and negatively with the Schirmer's test (rS = 0.59, p = 0.04). sICAM-1 correlated positively with the erythrocyte sedimentation rate (ESR) value (rS = 0.59, p = 0.01).

CONCLUSIONS

sVCAM-1 reflects xerostomia in pSS. sICAM-1 and sE-selectin may be additional parameters of sSS activity.

Oral mucosal manifestations in primary and secondary Sjögren syndrome and dry mouth syndrome

INTRODUCTION

One of the most important symptoms of Sjögren syndrome is xerostomia. The oral cavity deprived of saliva and its natural lubricative, protective and antibacterial properties is prone to a number of unfavourable consequences.

AIM

To present the most important lesions on the oral mucosa in primary and secondary Sjögren syndrome and in dry mouth syndrome.

MATERIAL AND METHODS

The study group comprised 55 patients including 52 women and 3 men aged 20-72 years (average: 28.25 years).

RESULTS

Basing on the accepted criteria, primary Sjögren syndrome was diagnosed in 22 (40%) patients, secondary Sjögren syndrome in 18 (32.7%) patients, and dry mouth syndrome in 15 (27.27%) patients. The physical examination and the examination of the mouth were performed and history was elicited from every patient.

CONCLUSIONS

The most common pathologies appearing on the oral mucosa in primary and secondary Sjögren syndrome are angular cheilitis, cheilitis, increased lip dryness as well as non-specific ulcerations, aphthae and aphthoid conditions.

[Complete regression of eyeball metastasis secondary to non-small-cell lung cancer with Cisplatin and Vinorelbin therapy]

Lung cancer is the most common cause of cancer mortality in men and the fourth most common in women. The most frequent location of distant metastases are: the pleura, liver, suprarenal gland, brain, bones, pericardium and subcutaneous tissue. Others locations of distant metastases are very rare. This case report presents a 61-year-old female patient treated with Cisplatin and Vinorelbin therapy for posterior segment of eyeballs metastases secondary to NSCLS. Fluorescein angiography, computed tomography with contrast intensification and magnetic resonance were compared during the 3-month treatment period. After the 4-rd cycle of chemiotherapy (Cisplatin and Vinorelbin) one elevated choroidal mass on the posterior wall in the superiotemporal quadrant of the right eyeball and one mass in the lower-inside quadrant of the left eyeball had completely disappeared. The retina and a retinal pigment epithelial layer were flattened. Combining Cisplatin and Vinorelbin was optimal treatment for our patient with intraocular metastasis of NSCLC. The first clinical symptom of nonsmall cell lung cancer was blindness. The described case confirms, that distant metastases of non-small cell lung cancer also occur in atypical places at be a cause of great diagnostic problems and can delay start of anticancer treatment.