Antioxidant for Scleroderma

Heal scleroderma naturally

2012-01-11T01:00:00.000-08:00

(NaturalNews) One of the fastest growing epidemics in our society is a group of ailments called autoimmune diseases: including Lupus, Rheumatoid Arthritis, HIV, Multiple Sclerosis, Celiac disease and Scleroderma. Although the prevailing view has been that genetics is the primary cause of these ills, recent studies have focused on the role of diet and nutrition as contributing factors. Diets high in processed, caloric and acidic foods create an environment so toxic that the immune system cannot fend against everyday invaders that it would normally conquer with ease. With an autoimmune disease, the body attacks its own organs and tissues, turning against the very systems that sustain its survival.

Scleroderma is a chronic connective tissue disorder and is classified as a rheumatic autoimmune disease. Scleroderma means "hardening of the skin", which results in the overproduction of collagen within the body. The devastating symptoms include stiff, painful fingers; necrosis, or tissue death, in the fingertips due to Raynaud's Phenomenon (causes a lack of oxygenated blood from getting to the fingertips due to blood vessel constriction); difficulty in breathing; digestive disorders; chronic fatigue; depression; Candida; loss of menstrual cycle; tightening of the facial skin, especially cheeks and lips; recession of gums; and tightness in the jaw.

Although these symptoms seem insurmountable, Sales Director Laura Sands was able to reverse this degenerating disease.

Laura Sands was diagnosed in 2007. The disease quickly destroyed her life and her dreams of becoming a Certified Chiropractic Sports Physician. She was forced to leave Chiropractic College because she was too exhausted and in too much pain to continue with the intense curriculum.

"I felt sabotaged by my own body, and I struggled for 7 months, with little to no success, to stop this disease from taking me down like a sinking ship," Laura recalls.

Having always been against medication and drug therapies as a means to healing, Laura decided to take a holistic route and experimented with several holistic therapies to try to get the disease under control: colonics, hyperbaric oxygen treatments, and acupuncture.

After crossing paths with several key proponents of supergreens and superfoods, Laura was introduced to the idea of healing her body at the cellular level through nutrition. She began to take supergreen supplements twice a day, feeding her nutrient-deprived body and cells with an array of super foods, vitamins, minerals, live enzymes, antioxidants, phytonutrients, and probiotics. She also changed her diet to vegan, which meant eliminating all animal products and the hormones and antibiotics usually found in meat and dairy.

"I felt a difference in my energy within the first 3 days, and over the next 12 months, my health continued to improve. My depression and chronic fatigue began to dissipate, my digestion and elimination returned to normal, my menstrual cycles were normal, my lungs finally cleared out and I could take a deep breathe with ease. Also, the inflammation and pain in my fingers had decreased!" Laura explains.

Because the body always tries to reach homeostasis, or perfect balance, once Laura began to provide her cells with the right combination of nutrients derived from whole food ingredients, her immune system started to do its job once again, now free from the terrible burden of acidic foods, chemicals and synthetics. Her cells were able to completely absorb the minerals and whole food nutrients, and in conjunction with Laura's vegan diet and her positive attitude, she won her drug-free battle against Scleroderma. "I have never felt better in my life," says Laura.

Learn more: http://www.naturalnews.com/033309_scleroderma_remedies.html#ixzz1j8eBGNIq

Brief Summary from Chinese Medicine Hospital

2011-07-07T19:57:00.000-07:00

Brief Summary: Miss B, from USA, suffered from scleroderma. After 20-day treatment in our hospital, her condition has been improved greatly.
　
Record of Hospitalization

Name: Miss B. Sex: Female

Age: 32 Marital Status: Single

Profession: Staff of Ford Car Company in USA

Date of hospitalization: February 16, 2006.

Major complaint: Multiple atrophy and sclerosis on the skin of her both hands as well as stiff finger joints for 8 years.

Disease history: The skin of her both hands became tight without obvious reasons 8 years ago. The wrinkle vanished and her facial wrinkle also disappeared. There is waxen gloss on the surface of skin and the skin can not be pinched by hand. Fixed expression. It’s difficult for her to open and close the mouth. Tight feeling of her chest. She once took treatment in her local hospital, and took hormone medicine orally, but without obvious effects.

Now we find her skin is atrophic and becoming thinner, it looks like parchment. Muscular dystrophy. Breath difficulty. Stiffness and deformation of the finger joints. Restricted activities. Distention and fullness of the stomach duct. She is aversion to coldness. Cold limbs. Her both hands are stiff and deformed. Frequent cough. Phlegm is whitish and yellow. The sleep is OK. Appetite is not very good. The bowel movement and urination are normal. The tongue body is shortened and slightly reddish. Thin and whitish tongue coating. Deep and fine pulse.

Last August she got first aid in the local hospital because of lung function failure. She also suffers from the lung fibrosis and pulmonary emphysema.

Malnutrition. Normal growth of her body. The state of mind is clear. Chronic disease with sick looking. Fixed facial expression. The skin is cold and lack of elasticity. No bleeding spots or spider angioma, and no skin rash. We could not touch the lymph node under the two jaws and the surface of her whole body. The head is not deformed. No pressing pains and. The hair does not have gloss. No eyelid droop and no edema. No hyperemia and bleeding of the conjunctiva. The sclera is not yellow. The cornea is transparent. Normal size of the pupillae and well response to the reflection of light. The hearing ability is normal. No pressing pains of the nipples. The nasal cavity is smooth and no abnormal secretion. The oral cavity does not have the unusual odor. No cyanosis of lips. The movement of the tongue body is not flexible. Atrophic tongue. The tongue coating is thin and whitish. No hyperemia of the throat. No swallowing difficulty. The neck is soft. The trachea is located in the middle. We can see the neck vein pulsates obviously. The chest is symmetrical. No pressing pains and no varicosity of the chest wall. The chest does not have sclerosis. The breath is shallow and quick. The rhythm is regular. The sound respouse is symmetrical. The pleura does not have the frictional feeling. The heart rate is 65 times per minute. The heart rhythm is uneven. There is no additional sound and the pericardium fricative. The abdomen is soft. No pressing pains and no rebound tenderness. No check-up of the liver, the spleen, the kidney.

Individual history：

No addiction of smoking and drinking. Menstrual period lasts 4-5 days per month and it is slightly reddish. She does not have history of tuberculosis and hepatitis or other infectious diseases. She has no experience of blood transfusion or allergy to medicine.

No similar disease case in the family. Her parents are in good health.

Phsical examination：

Body temperature: 36 Celsius degree

Pulse: 20 times per minute

Heart rate: 60 times per minute

Blood pressure: 110/70 mmHg

Diagnosis:

· TCM : Numbness of the skin (The kidney Yang is insufficient, disharmony between yin and wei )

· Western Medicine: scleroderma

February 17, 2006.

Both hands with belt-shaped atrophy and sclerosis as well as stiff finger joints for 8 years.

Take one dosage of herbal tea to warm and invigorate the kidney Yang, harmonize yin and wei and invigorate the lung qi. And use the herbal medicine to promote blood circulation and remove blood stasis and warm vessel.

Last night the condition is stable and sleep is OK. Her appetite is unsatisfactory. The bowel movement and urination are normal. Tongue body is slightly reddish, the tongue coating is thin and whitish. Deep and fine pulse. Other doctors take part in the treatment are physician-in-charge Dr. Ming and Dr. Qiu. They approve my treatment plan with acupuncture and massage treatment.

Dr. Ming / Dr. Yang

February 18, 2006.

Today the spirit is not very good. The stomach is uncomfortable. A little bit diarrhea. Therefore we adjust the formula to recuperate the spleen and the stomach.

Formula:

agastache 6g, tangkuei 6g, amomum fruit 6g, etc.

Dr. Yang

February 19, 2006.

Today the spirit and sleep are good. Poor appetite and no desire for food. The tongue body is slightly whitish. Thin and whitish tongue coating. The pulse is fine.

Formula:

cinnamom twig 10g carthamus flower 10g millettia root and stem 30g etc.

Dr. Yang

February 20, 2006.

Today the spirit is unsatisfactory. Distending pains of the stomach. She desires to vomit after eating. Tongue body is slightly reddish. The tongue coating is thin and white. Fine and rapid pulse. Headache and running nose.

Formula:

bupleurum root 6g, ovate atractylodes root 10g, Poria 10g, etc.

Dr. Yang

February 21, 2006.

Today she feels good. Stomach distention disappeared. The appetite is better than before. Facial skin is not so tight. Tongue body is slightly reddish. The tongue coating is thin and whitish. The pulse is fine and rapid and deep. The bowel movement and urination are normal.

Formula:

Poria 10g, codonopsis root 10g, salvia root 10g, etc.

Dr. Yang

February 22, 2006.

Today she feels good. After several days acupuncture and massage treatment together with the help of the external use medicine treatment, the facial skin is softer than before. The spirit is good. She went to sleep at 3 o'clock in the early morning. Stomach distention disappeared. No diarrhea. Tongue body is slightly reddish. The tongue coating is thin and whitish. The pulse is deep, fine and rapid. The bowel movement and urination are normal.

Dr. Yang

February 23, 2006.

The facial expression gets obvious improvement. The muscles of the limbs relax. The spirit is good. The distention of the stomach vanished. The tongue can elongate longer than before. The tongue coating is thin and white. Saliva is few. The pulse is deep, thin and rapid. The feces and urination are normal.

Formula:

Poria 10g, codonopsis root 10g, salvia root 10g, etc.

Dr. Yang

February 25, 2006.

Today she feels good. The facial skin is more relaxed than before. The wrinkle appears while smiling. No stomach distention. The finger joints can move more flexibly. The damaged skin is not as sunken as before. The mouth can open for approximately one and a half finger wide. Tongue body is slightly reddish. The tongue coating is thin and white with spots. The pulse is fine, rapid and powerful. The appetite is good. The bowel movement and urination are normal. The sleep is good.

Formula:

Poria 10g, codonopsis root 10g, salvia root 10g, etc.

Dr. Yang

March 1, 2006.

The facial skin is more softer than before. The wrinkle appeared when she smiles. The finger joints can move more flexibly and not so stiff. Lower limb is a little bit swollen. Tongue body is slightly reddish. The tongue coating is thin and whitish with spots. The pulse is fine, rapid and powerful. Good appetite and sleep. Bowel movement and urination are normal.

Formula:

Poria 10g, codonopsis root 10g, salvia root 10g, etc.

Dr. Yang

March 4, 2006.

She feels discomfort of the stomach. Stomach distention. Burp. Stiffness of the neck. The stiffness of the hand skin is obviously relaxed and softer. We can see the wrinkle after pressing her skin. When she smiles the face has the wrinkle as well. The bowel movement and urination are normal. The sleep is good. Tongue is slightly whitish. The tongue coating is thin and whitish with spots. The pulse is fine and string-like.

Formula:

Poria 10g, tangkuei 10g, peach kernel 10g, etc.

Dr. Yang

March 7, 2006.

She doesn’t feel neck stiffness today. After pressing her skin, we can see the wrinkle. We can also see the dimple when she smiles. The bowel movement and urination are normal. The sleep is good. Tongue is slightly whitish. The tongue coating is thin and white. Fine and string-like pulse.

Formula:

Poria 10g, tangkuei 10g, peach kernel 10g, etc.

Dr. Yang

　

Based upon our very successful help to many scleroderma patients, scleroderma is now one of the significant focuses of our hospital.

　

　

　

Healing Immune Disorders: Natural Defense-Building Solutions by Andrew Gaeddert

2011-06-20T23:44:00.000-07:00

Clastogenic inosine nucleotide as components of the chromosome breakage factor in scleroderma patients

2011-06-20T23:32:00.000-07:00

In the present study, we attempted to identify the chemical nature of the clastogenic factor (CF) from patients with progressive systemic sclerosis (scleroderma). Computerized mass spectrometry of clastogenic fractions obtained by HPLC of plasma ultrafiltrates detected molecular peaks compatible with inosine triphosphate and inosine diphosphate (ITP and IDP). The concomitant detection of IDP, together with ITP, and the absence of these peaks in nonclastogenic fractions and corresponding control fractions are arguments in favor of a biological relevance of these observations. The most important confirmation came from the clastogenic effect of commercial ITP and IDP added to the culture medium of the test cultures. The induction of chromatid type damage by these substances in lymphocytes exposed in the G0 phase of their cell cycle and the prevention of this damage by superoxide dismutase are analogous to the observations with CF.

Scleroderma Coping Strategies by B. Bianca Podesta,Lee S. Shapiro, M.D. (FRW)

2011-06-20T23:27:00.000-07:00

The autoimmune diseases by Noel R. Rose,Ian R. Mackay

2011-06-20T23:23:00.000-07:00

Read More about Systemic Sclerosis, Scleroderma...Unit 29, p. 369-377

The Best Alternative Medicine by Kenneth R. Pelletier,Andrew Weil

2011-06-20T21:53:00.000-07:00

Read More about Superoxide Dismutase (SOD) and Scleroderma ....Page 105

Oxford textbook of clinical nephrology Book 1

2011-06-20T21:49:00.000-07:00

Read More about oxidant stress in scleroderma pathogenesis, treatment of systemic sclerosis and renal manifestations of systemic sclerosis....Page 848-851

Combination treatment in autoimmune diseases by Dr. W. B. Harrison,B. A. C. Dijkmans

2011-06-20T21:42:00.000-07:00

Read More about Combination Therapies for Systemic Sclerosis (using antioxidant agents) ....Page 109-119

Natural Product To Help Our Heart Muscle

2011-06-01T19:10:00.000-07:00

The main function of our heart is to pump blood throughout our entire body.

Congestive heart failure and cardiomyopathy are diseases of the heart muscle and can have several causes, like: hypertension, repeated or severe heart attacks, viral infections and infiltrative heart diseases like lupus or scleroderma.

In each case the disease weakens the heart muscle and disable it to handle the amount of blood it receives from the body. To compensate for the heart's weakened state, it starts to dilate and to beat faster. Ultimately, blood backs up into the lungs, filling them with fluid.

This is called congestive heart failure. The patient starts to drawn on his or her own fluid. Weakening of the heart is called cardiomyopathy and is a very severe case of congestive heart failure, characterised by a large dilated heart.

When the heart muscle is weakened, it places an increased demand on the nutrients the heart cell need, in order to create energy. Because of excessive use of these nutrients, the heart muscle becomes depleted of CoQ10, which is the most important nutrient for energy creation.

Patients who take this supplement are be able to replenish their weakened heart muscle's stores of CoQ10, generating more energy and compensate for it's weakened state. Patients should continue to supplement their traditional medical treatment over a long period of time.

Clinical studies on CoQ10, which involved 2,660 patients with heart failure, resulted in nearly 80% improvement in three major symptom categories. CoQ10 can be a significant helpful supplement for the treatment of the heart muscle.

Coenzyme Q10 (CoQ10) is a fat - soluble vitamin and a strong antioxidant. Coenzymes are cofactors, essential for a large number of enzymatic reactions within the body. CoQ10 is the cofactor for at least three very important enzymes, used within the mitochondria, which is the furnace of the cell, where its energy is produced.

Mitochondria enzymes are needed for the production of the high - energy phosphate and adenosine triphosphate, upon which all cellular functions depends. It is in the mitochondria where the energy starts, but where also dangerous by-products, free radicals, are created.

CoQ10 is very important to help neutrolizing free radicals and most importantly, to create energy. CoQ10 is produced by the body, but this is a complicated process. It is also found in a variety of foods, like organic meats, beef, sardines, mackerel and peanuts.

Doctors need to learn and understand how natural products can help their patients. By supporting the natural function of the body and trying to enhance its ability to perform at optimal level ; only then everything possible is done to benefit the healing process of the body.

Connective Tissue Diseases: Holistic Therapy Options

2011-06-01T18:50:00.000-07:00

Connective Tissue Diseases: Holistic Therapy Options–Sjoegren¿s Syndrome; Systemic Sclerosis – Scleroderma; Systemic Lupus Erythematosus; Discoid Lupus Erythematosus; Secondary and Primary Raynaud's phenomenon; Raynaud's Disease; Polymyositis, Dermatomyositis.

Hannelore Helbing-Sheafe’s constant struggle with her health was a powerful motivator to investigate possible ways to help herself and others. The focus of her practice was always on finding the cause of the problem and instructing patients in using correct nutrients and/or natural medicine and therapy to correct and reverse existing health problems. Her main focus has been to seek balance in all body systems. Connective Tissue Diseases – Holistic Therapy Options provides valuable informa

Frequency And Impact Of Symptoms Experienced By Patients With Systemic Sclerosis: Results From A Canadian National Survey

2011-06-01T18:39:00.000-07:00

Background:

Patients with systemic sclerosis (SSc) report a number of problems that have been linked to disability and reduced quality of life. Due to the rarity and heterogeneity of SSc, not enough is known about the range of problems faced by individuals living with SSc. Several studies have assessed problems faced by patients with SSc, however, knowledge about the relative importance of these different problems is limited by the small number of studies that have been conducted, the relatively narrow scope of potential problems assessed in existing studies, and the small sample sizes in these studies. The objective of the present study was to identify, in a large SSc sample, symptoms of SSc that patients rated as frequent and that highly impacted their ability to carry out daily activities.

Methods:

Patients with SSc were recruited to complete the anonymous Canadian Scleroderma Patient Survey of Health Concerns and Research Priorities through patient advocacy group websites, Canadian magazines, scleroderma-related newsletters, and support groups across Canada. The survey included questions regarding the frequency and impact of 69 SSc symptoms, which were generated from a panel of Canadian Scleroderma Research Group and Scleroderma Society of Canada members using existing questionnaires, symptom checklists and research articles. Descriptive analyses were performed dichotomizing symptom frequencies into never or rarely versus sometimes, most of the time or always and symptom impact on daily activities into no or minimal impact versus moderate to severe impact. In addition, for each item, among patients with symptom frequency of at least sometimes, the percentage of patients with at least moderate impact on daily activities was calculated.

Results:

Our study included 464 Canadian persons with SSc. The 5 highest-rated symptoms in terms of frequency were fatigue (89%), Raynaud's phenomenon (86%), hand stiffness (81%), joint pain (81%) and difficulty sleeping (76%). The same 5 symptoms were the highest-rated in terms of having a moderate to severe impact on daily activities, in the order of fatigue (72%), Raynaud's phenomenon (67%), joint pain (64%), hand stiffness (59%), and difficulty sleeping (59%). In addition to these symptoms, items related to decreased hand function (difficulty making a fist; difficulty holding objects; difficulty opening hand; difficulty faucet) were frequently endorsed by more than 400 patients and of these patients, at least 67% endorsed a moderate to severe impact on daily activities.

Conclusion:

The results of this study confirmed the importance of core symptoms of SSc with respect to quality of life, such as fatigue. Limitations in hand function, another area identified by patients as being significant, is common and contributes to overall disability levels. However, little literature exists testing the effectiveness of rehabilitation techniques to improve hand function among patients with SSc. Other areas with very little research that appear to play important roles in daily functioning include sleeping problems and male sexual functioning. A patient- researcher consensus is suggested in order to focus future SSc research.

Scoring of reflux symptoms associated with scleroderma and the usefulness of rabeprazole

2011-06-01T18:34:00.000-07:00

OBJECTIVE:

The high frequency of gastroesophageal reflux disease (GERD) as a complication of scleroderma (systemic sclerosis, SSc) calls for treatment with powerful acid suppressants such as proton pump inhibitors (PPI). The present study used a GERD-specific questionnaire to assess the symptoms of GERD in SSc patients, and examine the effectiveness of rabeprazole (RPZ) for treating the symptoms of GERD.

METHODS:

The Frequency Scale for the Symptoms of GERD (FSSG), a medical questionnaire developed in Japan for evaluating GERD, and the Visual Analogue Scale (VAS) were used to evaluate GERD symptoms and the degree of pain, respectively, in 151 SSc subjects. These tools were also used to assess the effect of 8 weeks' treatment with the PPI RPZ (10 mg/day).

RESULTS:

Data on age and gender, and FSSG and VAS scores before treatment and after 4 and 8 weeks' RPZ treatment, were available for 84 subjects. The mean FSSG score was 13.9+/-9.7 before treatment, 8.3+/-8.1 after 4 weeks of treatment, and 7.0+/-7.0 after 8 weeks of treatment; the score reduction was significant (p<0.001) indicating the effectiveness of RPZ in improving subjective GERD symptoms. The VAS scores revealed a significant improvement in pain after both 4 and 8 weeks compared with baseline scores. Six subjects experienced adverse effects and five discontinued the analysis during the period.

CONCLUSION:

Administration of RPZ 10 mg/day is effective for the control of the symptoms of GERD associated with SSc. In addition to assessing the symptoms of GERD, the FSSG questionnaire can be used to evaluate the therapeutic effect of drugs.

Adjustable Beds For Acid Reflux Disease

2011-06-01T18:25:00.000-07:00

All of us are quite aware of the adjustable beds. Adjustable beds are ones which provide utmost relaxation to everyone. Resting on an adjustable bed after a tiresome day will definitely wipe off your tiredness.

Different people have different sleeping preferences. Some may make use of pillows to raise the heads for better breathing while some may place pillows under their knees to keep the spine straight. Poor sleeping habits often lead to various ailments.

One such ailment is Acid Reflux disease. This is caused when the flap between stomach and esophagus is not closed properly. When, a person suffering from Acid Reflux sleeps on a flat bed, acid in stomach moves to esophagus and throat, thus causing a burning sensation and a very unpleasant feeling. Esophagus has less protection and is very sensitive towards such acids.

People suffering from Acid Reflux are advised not to sleep straight. Elevating the head at least to six inches and sleeping at a sloping position helps avoid the acids from stomach entering the esophagus. This will eliminate the cause of burning sensation and unpleasantness.

Using several pillows to raise you head will cause more uncomfortable than relaxation. Instead the desired position can be achieved by use of adjustable beds. You can set your adjustable bed to keep your head raised while sleeping and so acid never leaks into esophagus.

So you are now free from all those unpleasant feelings which have been troubling you from quite a long time. Moreover you can avoid your sleep being disrupted by Acid reflux disease.

There are various manufacturers of adjustable beds. Some good brands provide you with as many as 1000 comfort positions. So there's hardly any chance that you may not find the position right for you. You no more have to worry about sleeplessness due to your medical condition.

Some adjustable beds have manual controls while some can be electrically controlled. Sitting on your bed you can adjust the position and relax. Some top brands of adjustable beds offer heat and massage options.

Adjustable beds are known for the comfort they provide and better sleep. With adjustable beds you'll never have to work so much to make yourself comfortable. You just have to use a few controls to adjust your bed as per your needs. That's it.

If any of you are suffering from Acid Reflux Disease then you really need not think twice about buying an adjustable bed. Help yourself by getting one.

Jason Uvios writes about "Adjustable Beds For Acid Reflux Disease" to visit : mattresses, adjustable air beds and tempurpedic adjustable beds.

Systemic sclerosis with pencil‐in‐cup deformity

2011-05-31T05:19:00.000-07:00

SIR, We report a 16‐yr‐old female suffering from systemic sclerosis (SSc) who presented with deforming symmetrical polyarthritis which she had had for the past 1 yr, associated with a history of Raynaud's phenomenon and thickening of the skin, initially involving the hand and then becoming generalized to involve the feet, face and trunk. The patient had scleroderma facies, thickened skin over the face, extremities and trunk, healed fingertip infarcts, resorption of the pulp of the terminal pad of the fingers, flexion contractures of the fingers, and swelling and tenderness of the metacarpophalangeal (MCP) and proximal (PIP) and distal (DIP) interphalangeal joints of both hands. There was no telangiectasia, calcinosis or friction rub over the involved joints on movement. Raised erythrocyte sedimentation rate (ESR, Westergren; 40 mm/h), negativity for rheumatoid factor (20 IU/ml), positivity for anti‐Scl‐70 (41.390 EU/ml; cut‐off >25 EU/ml) by double‐sandwich bichromatic solid‐phase enzyme‐linked immune assay, and negativity for antinuclear antibodies (ANA) and anticentromere antibodies were the important investigatory findings. X‐ray of the hands showed acro‐osteolysis, flexion deformity of the fingers, erosive and destructive changes in the carpometacarpal (CMC), MCP, PIP and DIP joints with relative sparing of the CMC of the thumb, soft tissue atrophy, and whittling of the head of the proximal phalanx with broadening of the base of the middle phalanx, resulting in the characteristic pencil‐in‐cup deformity of the left 5th PIP joint (Fig. 1⇔). There was no radiological evidence of calcinosis. X‐ray of the chest was within normal limits. Pulmonary function tests showed a FVC of 1.62 (76% predicted), FEV1/FVC of 100 and FEF25–75 of 3.9 (143% of predicted value). On questioning, the patient denied a history of psoriasis in family members, and examination of available family members failed to reveal psoriasis.

The patient was classified as having diffuse SSc according to the 1980 ACR classification criteria [1]. Erosive arthritis in systemic sclerosis can occur with associated rheumatoid arthritis (RA). Horiki et al. [2] reviewed the literature and found 15 patients in whom SSc overlapped with RA. They compared the clinical and laboratory features of these patients, and suggested that SSc–RA overlap may be a distinct entity based on the characteristic features observed in these patients, which include generalized skin sclerosis (12 out of 14 patients), severe seropositive erosive polyarthritis (15 out of 15), pulmonary fibrosis (14 out of 15), anti‐topoisomerase I antibodies (eight out of 10 examined) and HLA haplotypes DR4, 53; DQA1*0301; DBQ1*04 (in five cases examined). None of the reported patients of SSc–RA overlap had destructive DIP involvement [2]. Unlike the earlier reported cases, our patient was negative for rheumatoid factor, and had prominent destructive changes also involving DIP and an almost simultaneous onset of arthritis, skin thickening and Raynaud's phenomenon. Thickened skin of the trunk, destructive arthropathy, prominent DIP involvement, seronegativity and the absence of systemic features suggest that the patient did not have mixed connective tissue disease either.

Non‐rheumatoid arthritis in SSc usually presents as rheumatoid‐like symmetrical polyarthritis with predominant hand involvement, and may be erosive in as many as 40% of patients, but is less destructive [3]. Unlike RA, DIP and the first CMC joints may be involved [3, 4]. The radiological features are usually limited to mild joint‐space narrowing, osteoporosis and small discrete erosions at periarticular margins [3]. Patients who have SSc with arthritis are reported to have predominantly limited skin involvement [5] and calcinosis [3]. They are also more likely to be positive for rheumatoid factor (80%) [5] and anticentromere [5], antinuclear and anti‐double‐stranded DNA antibodies [6]. However, the above‐mentioned features were not observed in this patient.

Even though DIP involvement is reported frequently in SSc with arthritis [3], the pencil‐in‐cup deformity is considered to be relatively specific for psoriatic arthropathy. To the best of our knowledge it has not been reported in SSc or in SSc–RA overlap. Although psoriasis has been reported previously in association with SSc [7], there was no evidence initially of the skin or nail changes of psoriasis in our patient, and none had appeared at the 3‐month follow‐up. A family history of psoriasis was also lacking. Significant DIP involvement and the pencil‐in‐cup deformity in this patient suggest that arthritis in SSc can mimic the hand‐joint involvement of psoriatic arthropathy. Fischer [8] also pointed out that erosions in SSc occur at the entheses of the hand. It has been suggested that soft‐tissue calcification occurring at the insertions of ligaments into the phalanges could lead to erosions of the neighbouring bone during absorption of the calcifications [9]. The involvement of the DIP and a pencil‐in‐cup deformity (psoriatic arthropathy‐like illness) in SSc suggests the role of enthesitis in the causation of erosions.

References

Unlocking Mysteries of Immune System Key in Curing Inflammatory Disease

2011-05-31T05:11:00.000-07:00

(ARA) - A 10-year-old student, instructed by the school nurse to not come back to school, because of his psoriasis. A young mother, disabled by multiple sclerosis, forced to use a cane where she once strolled freely. An esteemed university chemistry professor, unable to grasp the tools so vital to teaching his craft because of rheumatoid arthritis.

For all three, each day is a struggle against bodies that have turned against them. The natural process of inflammation, normally enacted to repair tissue and fight infection, has gone awry, attacking the skin, central nervous and musculoskeletal systems, respectively. As a result, the boy lives with scaly, red patches of skin which, though not contagious, make adults shy away and prompt his classmates to tease him mercilessly. The mother battles relapses of fatigue and loss of balance which appear without warning and outstay their welcome. And the professor, who teaches through the painful swelling in his hands, lives from bottle to bottle of nonsteroidal anti-inflammatory agents.

“For years, a group of chronic, inflammatory diseases has frustrated physicians and patients seeking effective treatment,” says Cecil B. Wilson, M.D., an internist in Winter Park, Fla. and an American Medical Association (AMA) trustee. “The growing body of knowledge about the immune system’s role in diseases such as psoriasis, rheumatoid arthritis, myasthenia gravis, scleroderma and multiple sclerosis (MS) means that there is hope for long-term treatments and perhaps even cures.”

In light of such recent discoveries, the AMA held an inflammatory diseases media briefing in New York City, where experts gathered to discuss the evolving body of thought surrounding the treatment of these chronic autoimmune diseases which, as of now, have no cure.

“All of these disorders are chronic progressive diseases,” says Anthony Gaspari, M.D., a dermatology expert from the University of Maryland in Baltimore and a speaker at the AMA media briefing. “Unlocking the secrets of some might lead to therapies for others.” For example, he said, while the immune system has long been implicated in MS, “it has only been in the last five years or so that we’ve believed that the immune system plays a role in psoriasis.”

New Biologic Treatments Offer Hope
Although many inflammatory diseases seem to have a genetic component, some are triggered by other processes. Cytokines, for instance, are naturally-produced proteins that trigger inflammatory and disease-fighting responses to toxins, injury, viruses and bacteria. These proteins are of particular interest when studying inflammatory disorders, Gaspari says, as their malfunction may be responsible for everything from the over-production of skin in psoriasis to the destruction of nerve insulating material in MS to the abnormal growth of connective tissue in scleroderma.

Psoriasis, which affects up to 7 million men and women, serves as a particularly good bench-to-bedside example of how scientific discoveries are making their way from the lab into clinical practice. While the exact cause of psoriasis is not known, experts do know that symptoms are a result of cells in the outer layer of the skin reproducing quickly and piling up on the skin’s surface. Although certain cases are limited to areas such as the elbows, knees and scalp, others can involve anywhere from 10 to 100 percent of the body.

For those patients who suffer from more aggressive cases, new biologic agents offer an alternative in treating psoriasis, said Kenneth B. Gordon, M.D., associate professor of medicine in the division of dermatology at Loyola University Medical Center in Maywood, Ill. Designed through genetic engineering to affect only the target organ system -- in this case the immune system and the skin -- biologic therapies avoid the multiorgan toxicity often seen with traditional treatments such as methotrexate and cyclosporine. Biologics are delivered via injection rather than orally, because the proteins would be broken down in the stomach, and improvements are typically seen after a couple of months of twice-a-week to every-other-week treatment.

The first biologic for the treatment of psoriasis was approved by the Food and Drug Administration in February 2003; others are being looked at for potential use. These agents, Gordon says, may help more patients in returning to normal lives.

“Many patients no longer seek healthcare for this condition because they believe their options are exhausted and they must live with the disease,” Gordon explains. “They are frustrated with therapy because their physician doesn’t think their condition merits aggressive therapy or doesn’t understand the therapies that are available. People who have given up hope need to know that there are new treatments available.” And while therapies such as specific alteration in gene expression are on the distant horizon, for now, Gordon believes, “biological agents are the future for the next decade or beyond.”

Optimistic Future for Patients
In MS, a life-long chronic disease affecting 250,000 to 300,000 Americans, the disease attacks random patches of the central nervous system’s white matter, causing partial destruction of myelin, the substance which insulates the nerve fibers of the brain and spinal cord. Initial symptoms are often vision-related, such as blurred or double vision, distortion of red and green, or blindness in one eye. Muscular weakness, loss of coordination or balance, numbness or pain, fatigue and slurred speech typically follow. Studies show that the aforementioned cytokines may cause this abnormal autoimmune response and influence myelin damage.

Standard therapy has included corticosteroids to suppress the immune system. But now, for the first time, people with MS have a choice of several biologically-based anti-inflammatory treatments to effectively modify the course of their disease. New biologic agents such as beta-interferons are immunomodulatory -- not immunosuppressive -- in nature, halting MS inflammation by repairing the blood-brain barrier and reducing the inflammatory process. Depending on the beta-interferon prescribed, patients may experience decreased relapse rates, increased time between relapses, decreased attack severity and a reduced number of MS lesions.

“Patients should be very optimistic about the long-term outlook for multiple sclerosis,” says AMA media briefing speaker Brian R. Apatoff, M.D., director of Multiple Sclerosis Clinical Care and Research Center at New York-Weill Cornell Medical Center in New York City. “Twenty years ago there weren’t really any treatments for MS, we were fumbling around with corticosteroids as the mainstay in immune intervention. Now we have become more sophisticated and developed new therapies which have fewer side effects than steroids but still control the inflammation.”

Multiple sclerosis patients aren’t the only ones who should be feeling optimistic about their diagnosis. For although there is currently no cure for any of these diseases, the future looks promising. “As we unravel the mysteries of the immune system and identify the genes that are passed on in families,” Gaspari says, “we may be able to develop therapies that can be used long-term or that actually cure these disorders.”

Valuation of scleroderma and psoriatic arthritis health states by the general public

2011-05-31T05:04:00.000-07:00

Objective

Psoriatic arthritis (PsA) and scleroderma (SSc) are chronic rheumatic disorders with detrimental effects on health-related quality of life. Our objective was to assess health values (utilities) from the general public for health states common to people with PsA and SSc for economic evaluations.

Methods

Adult subjects from the general population in a Midwestern city (N = 218) completed the SF-12 Health Survey and computer-assisted 0-100 rating scale (RS), time trade-off (TTO, range: 0.0-1.0) and standard gamble (SG, range: 0.0-1.0) utility assessments for several hypothetical PsA and SSc health states.

Results

Subjects included 135 (62%) females, 143 (66%) Caucasians, and 62 (28%) African-Americans. The mean (SD) scores for the SF-12 Physical Component Summary scale were 52.9 (8.3) and for the SF-12 Mental Component Summary scale were 49.0 (9.1), close to population norms. The mean RS, TTO, and SG scores for PsA health states varied with severity, ranging from 20.2 to 63.7 (14.4-20.3) for the RS 0.29 to 0.78 (0.24-0.31) for the TTO, and 0.48 to 0.82 (0.24-0.34) for the SG. The mean RS, TTO, and SG scores for SSc health states were 25.3-69.7 (15.2-16.3) for the RS, 0.36-0.80 (0.25-0.31) for the TTO, and 0.50-0.81 (0.26-0.32) for the SG, depending on disease severity.

Conclusion

Health utilities for PsA and SSc health states as assessed from the general public reflect the severity of the diseases. These descriptive findings could have implications regarding comparative effectiveness research for tests and treatments for PsA and SSc.

Hair And Scalp Diseases – Early Symptoms Of Scleroderma

2011-05-31T05:01:00.000-07:00

There bottle be present a number of muddle around skin diseases human being hair and scalp diseases, before a bit with the intention of bottle ensue treated topically comparable Psoriasis, before eczema, representing example. However, sometimes, in attendance are valid skin diseases with the intention of want bigger mind and occasionally bigger awareness proviso they are headed for be present identified correctly. Scleroderma is individual of these diseases.

Scleroderma comes commencing two Greek words, skleros, import hard, derma, import skin. It is straightforward headed for complicate a bit comparable Psoriasis by Scleroderma popular its beforehand stages for the reason that in attendance is a hardening of the skin, except Scleroderma is a great deal different. in attendance are two types of Scleroderma, and they, all the rage attack boast several subtypes. The two types of Scleroderma are confined to a small area and systemic, all in the midst of its identifiable variations.

Localized Scleroderma deals solitary together with the skin and the bandanna and muscles beneath it, except complete Scleroderma has headed for achieve by a extra pronounced create with the intention of includes the skin and the underlying tissues with the intention of hint headed for the key organs. Of the confined to a small area Scleroderma in attendance are two types, Morphea, (From the Greek import makeup before form), and Linear.

With confined to a small area Morphea typography Scleroderma, the first symptoms initiate together with flushed patches with the intention of move forward headed for patches with the intention of are ended of thick skin with the intention of takes taking place an elliptical shape, which becomes an off-white go red together with lavender stitching with the intention of wires insufficiently hair growth. These patches bottle look taking place the face, arms before legs, by the side of first, all the rage the first stages as a procession taking place the armrest before leg. representing some, this form of Scleroderma bottle be present disabling, except frequently these symptoms desire chance gone send-off enduring skin wound headed for the confined to a small area area.

In complete Scleroderma, the symptoms are called CREST, disturbing the skin and the underlying tissues with the intention of head start headed for the blood vessels and key organs. coat of arms in brief stands representing a digit of several symptoms with the intention of come to mind together with complete Scleroderma. They comprise headed for perform by calcium deposits popular the connective tissues with the intention of bottle fall foul of by means of the skin clothed in ulcers occasionally taking place the fingers, hands and face, and what’s more the knees and elbows.

Another is Raynaud’s miracle with the intention of affects the tiny blood vessels popular the hands and feet, which respond headed for chill before via spiraling pasty before equal blue, spiraling headed for cherry as the blood current returns, chief headed for harms in the midst of the fingers with the intention of may possibly vacation ulcers before scarring.

The additional ingredient of coat of arms popular complete Scleroderma is the Esophageal dysfunction everyplace the tube with the intention of connects the throat headed for the stomach has a dysfunction all the rage the muscles with the intention of disturb the better gullet together with harms swallowing, and the worse gullet in the midst of heartburn.

Other symptoms of complete Scleroderma are strict skin taking place the fingers the impairs regular function, and tiny cherry a skin condition commencing engorgement of tiny blood vessels.

If you consider you boast at all individual of these symptoms, before whichever of these symptoms all the rage recipe by all other, it may possibly ensue individual create of Scleroderma. You must without delay think about it you medical doctor as these symptoms insist on certified attention.

Scleroderma has devastating things taking place the hair and scalp as fine clothed in unstable degrees.

Psoriasis and diffuse systemic sclerosis: a report of three patients

2011-05-31T04:54:00.000-07:00

Sir, We report three patients who presented to the Rheumatic Diseases Centre, Hope Hospital, UK with the rare combination of diffuse systemic sclerosis (SSc) and psoriasis, one of whom also had psoriatic arthritis (PsA). In two of the patients there was a temporal relationship between the development of the two conditions, and in both these patients the SSc followed a very aggressive course with rapidly progressive skin involvement. The possible explanations for the co‐existence of these two diseases are discussed.

Patient 1. A 54‐yr‐old female who initially presented to the Dermatology Service in 1993 with an acute onset of pustular psoriasis on the palms and soles. She was treated with the systemic retinoid acitretin. In March 1995 she was referred to the rheumatologists with an 8‐month history of Raynaud's phenomenon and diffuse skin thickening over the upper limbs and trunk. On initial investigation, full blood count (FBC) was normal, erythrocyte sedimentation rate (ESR) was 14 mm/h, full biochemical profile was normal and she was negative for antinuclear antibodies (ANA), rheumatoid factor (RF), antibodies to extractable nuclear antigens (ENA) including Scl‐70 (topoisomerase) and anti‐centromere antibodies. Oesophageal dysmotility and reflux were demonstrated on barium swallow examination and skin biopsy showed dense hyaline sclerosis of the dermis consistent with scleroderma. Nailfold microscopy showed drop‐out and dilatation of the capillaries. A diagnosis of diffuse SSc was made. Within 3 months she had developed a renal crisis associated with accelerated hypertension and pulmonary oedema, which responded to aggressive treatment with diuretics and angiotensin converting enzyme (ACE) inhibitors. Since then, renal function has remained stable. Subsequent treatment has included low‐dose prednisolone on the assumption that there was a significant inflammatory component to her severe, debilitating skin involvement and regular intravenous prostacyclin infusions. She has continued to have severe psoriasis of the hands and feet requiring in‐patient management and topical steroids.

Patient 2. A 43‐yr‐old male who presented in 1990 with an acute inflammatory polyarthritis involving proximal interphalangeal joints, knees and ankles, with a dactylitis of the right second toe. He had a 2‐yr history of psoriasis involving scalp and elbows. Initial investigations, including FBC, ESR (7 mm/h) and full biochemical profile, were normal. He was negative for RF but had positive ANA in a titre of 1/100 with a homogeneous staining pattern. X‐rays of the hands, feet and sacroiliac joints were normal. Aspiration of synovial fluid from the left knee revealed a white cell count (WCC) of 2880/mm3 with 73% lymphocytes. A diagnosis of PsA was made, and he was treated with intra‐articular steroid injections, followed by sulphasalazine (which was ineffective) and later, D‐penicillamine. By 1992, his clinical condition had clearly changed, when he presented with symptoms of Raynaud's phenomenon associated with tightening of the skin, and dysphagia. On examination he had diffuse scleroderma affecting the face, upper and lower limbs. Antibodies to Scl‐70 were positive. Nailfold microscopy was normal. Oesophageal reflux was demonstrated on barium swallow. Due to his rapidly progressive skin disease, in January 1995 his penicillamine was stopped and he was entered into the UK randomized controlled trial of alpha‐interferon, where he remained on placebo for 12 months. Since then his skin thickening has remained stable. However, he has required non‐steroidal anti‐inflammatory drugs (NSAIDs) and occasional intra‐articular steroids for the PsA.

Following these initial observations, we searched the records of all patients with diffuse SSc, to determine whether any had co‐existent psoriasis. The diagnoses of all patients seen at the Rheumatic Diseases Centre, Hope Hospital are recorded on a standardized database, and we found one additional patient listed as having both conditions.

Patient 3. A 63‐yr‐old female who was referred from another rheumatological unit in 1994 with a 10‐yr history of scleroderma involving the face, trunk and limbs. She gave a history of scalp psoriasis since childhood for which she had seen a dermatologist. Investigations, including FBC, ESR, full biochemical profile, RF, ANA, antibodies to ENA, anti‐centromere antibodies and nailfold microscopy were all normal. She had a restrictive defect on pulmonary function tests. She has remained well with no deterioration in skin thickening.

We have reported three patients who had the unusual combination of diffuse SSc and psoriasis, one of whom also had PsA. There are only two reported cases of the co‐existence of psoriasis and SSc in the English literature [1, 2], one of whom had PsA [1]. A further three cases have been described in Russian [3, 4]. However, psoriasis has been occasionally reported in conjunction with Raynaud's phenomenon [5] and connective tissue disorders including systemic lupus erythematosus (SLE) [6], morphoea and a sclerodermoid variant of mixed connective tissue disease (MCTD) which was interestingly found in a pair of identical twins [7]. There are three possible explanations for this observation. First, it may have occurred by chance. Second, both diseases may share a common aetiology, and third, the presence of psoriasis may have triggered the development of SSc.

With respect to the association being due to chance, 57 patients with SSc who have diffuse skin involvement are currently attending the Rheumatic Diseases Centre. However, it is rare for patients to present with early, aggressive diffuse SSc and it was therefore unusual for two such patients presenting within a short time period to have concomitant psoriasis, a fact which drew a possible association to our attention. Of the 57 patients attending with diffuse SSc, three (5.3%) are listed as having psoriasis. This figure is higher than the reported UK prevalence of 1–3%. Further, it is likely that the actual frequency of psoriasis in our patients will be higher than this, since we did not specifically set out to look for it. However, we realize that we cannot exclude the possibility that these conditions occurred together by chance.

The second possible explanation is that the two conditions may share a common aetiology. A link between psoriasis and autoimmunity is suggested by the higher than expected prevalence of ANA in patients with psoriasis, particularly after exposure to ultraviolet light [8]. It has been suggested that both psoriasis and autoimmune diseases including SSc may result from a common underlying defect in the immune system [5]. It is therefore interesting to note that both conditions share certain pathological features, such as dermal inflammation, abnormalities of vascularization, acro‐osteolysis and possibly abnormalities of the nailfold capillaries.

Previous studies have noted the presence of specific autoantibodies directed against core proteins of heterogeneous nuclear ribonucleoproteins (RNP) in a patient with SSc and PsA [1], and against U1 and U2 small RNPs in two patients with psoriasis and Raynaud's phenomenon [5]. These autoantibodies were not found in sera of patients with psoriasis, Raynaud's or SSc alone, and it was suggested that they may be associated with the development of a distinct form of connective tissue disease [5]. Although we were not able to test specifically for these autoantibodies, none of our three patients had antibodies to U1 RNP, nor had a speckled pattern of ANA staining.

A common genetic background may explain the association, as suggested by the presence of both psoriasis and a sclerodermoid variant of MCTD in two identical female twins [7]. Molta et al. [9] performed full HLA typing on two extended pedigrees which included family members with a wide variety of connective tissue and immunological disorders, including SSc, psoriasis and PsA. However, they were unable to find any common underlying HLA phenotype. The results of HLA typing in our patients was also unhelpful (patient 1: A2, B44 B62, DRB1*0404 0701; patient 2: A2 A3, B7 B18, DRB1*11). It is perhaps more likely that any underlying genetic association is explained by non‐HLA genes, for example those involved in cytokine production.

Finally, it is possible that the psoriasis, or its treatment, may have triggered the development of SSc, presumably in a susceptible host. A variety of immunological changes have been well described in patients with psoriasis. Both psoriasis and SSc are predominantly characterized by skin involvement, and it could be hypothesized that the skin abnormalities in psoriasis may have altered the passage and processing of foreign antigen through the skin, thus triggering the development of scleroderma. In patient 1 (and to a lesser extent, patient 2), the development of psoriasis was followed closely by the development of an aggressive form of SSc, which suggests that the psoriasis may have had some role in triggering the SSc. These hypotheses remain speculative, and we would value any further suggestions as to how these conditions may be linked, and whether others have seen similar patients.

Ref.

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DIET IN DERMATOLOGY: PRESENT PERSPECTIVES

2011-05-31T04:49:00.000-07:00

Many nutrients are essential for life, and an adequate amount of nutrients in the diet is necessary for providing energy, building and maintaining body organs, and for various metabolic processes. The role of food in the induction of various skin disorders and skin diseases leading to nutritional deficiencies is well known. The photo-protective potential of antioxidants, the effects of micronutrient supplementation on the skin immune system, and the modulating effects of fatty acids on skin disorders are well documented. Skin diseases due to nutritional deficiencies, the dietary role in skin immunity and various skin diseases, and the role of antioxidants and other supplements in skin health have been reviewed.

The association between skin disorders and nutritional deficiencies is well established. Relation between health and food has gained interest in recent years. Dermatologic conditions linked with nutrition can range from nutritional deficiencies, excess nutrients or metabolic disorders. Dietary modifications, although based on anecdotal reports or theoretical grounds, might help prevent recurrences of many skin diseases. In vitro studies and animal models have given us some insight in understanding the role of nutrients in skin diseases. However, there is a gap in the understanding on how combinations of nutrients, as they appear in the diet and when they are taken as multiple supplements, work in vivo. Further studies are required to fulfill this gap. The effective dosage and toxicity of nutritional supplements need to be defined.

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How To Know If Your Body Is Acidic? – What Signs To Look Out For

2011-05-31T04:21:00.000-07:00

It can be really crucial to remember that the symptoms of acidity are normally based on the quantity of acids we have in our body. These signs and symptoms are grouped according to it order of severity. Much less severe symptoms may well indicate that you simply are just slightly acidic. For anyone who is in the middle you may just be very acidic but severe and life-threatening symptoms can indicate that you are extremely acidic. An excessive amount of acid inside the body will demand alkalizing diet instantly.

Read on to know a few of the symptoms which will pin point that your body is acidic. This is extremely vital simply because each and every of these signs may be disorder, illness or illness that will caused on account of excess acidity and lifestyle. In addition, these signs and symptoms will help us figure out the quantity of acidity your body.

Included within the early acidic signs are dizziness, sensitive to particular chemicals, heartburn, metallic tasting, strong smell of urine, hyperactivity, muscular pains, fatigue, premenstrual tension, acne, unexplained tiredness, panic attacks, diarrhea, constipation, headaches, coated tongue and bloating. In this case the individual may expertise only 1 or two symptoms at a time, which depends on the level of acidity he has.

The symptoms of middle acidity are eczema, psoriasis, foggy brain, endometriosis, depression, viral infections, depression, loss of memory, headaches, migraine, insomnia, cold sores, bronchitis, impotence, yeast infection, hives, sinusitis, inflammation, asthma, swelling and environmental allergies. This may call for the individual to avoid acidic foods than men and women with symptoms that are much less severe.

In case of severe acidic the signs and symptoms are tuberculosis, hodgkin’s illness, lupus erthemotosis, rheumatoid arthritis, scleroderma, chron’s disease, certain cancers and numerous sclerosis. Severe symptoms of acidity may well indicate that the person has an extensive amount of acidity in his body. This only indicates that the person wants to follow a strict alkalizing diet and necessary medical attention appropriate away. Ignoring these symptoms might worsen the condition and could be life-threatening.

As a matter of reality, even should you be just slightly acidic, it truly is very vital to live a healthy and uncomplicated lifestyle like eating additional on vegetables and fruits. Obtaining a standard physical exercise also assists your method to be healthy and fight disease effectively. Being too acidic is actually a risk factor for developing disease like diabetes, heart difficulties, cancer along with other complications that may perhaps cause your life.

Have you ever wondered what are alkaline foods, you can visit alkaline diet to discover the secrets to alkalizing your body and be healthy.

Apolipoprotein A-I mimetic peptides

2011-05-29T23:36:00.000-07:00

Recent publications reveal the mechanism of action of apolipoprotein A-I (apoA-I) mimetic peptides to be the remarkable binding affinity that oxidized lipids have for these peptides compared with apoA-I. There was no difference in the binding affinity of oxidized lipids or in peptide efficacy in reducing inflammation and atherosclerosis in rabbits injected with peptides synthesized from all D- or all L-amino acids. The apoA-I mimetic peptide 4F increased the formation of pre-β high-density lipoprotein, increased cholesterol efflux, and reduced lipoprotein oxidation in vitro; it increased antioxidants and vascular repair in type 1 diabetic rats; it improved vasodilation, oxidative stress, myocardial inflammation, and angiogenic potential in a mouse model of scleroderma; it reduced renal inflammation in low-density lipoprotein receptor-null mice fed a Western diet; it reduced arthritis in a rat model; it reduced adiposity, increased adiponectin levels, and improved insulin sensitivity in obese mice; and it improved high-density lipoprotein inflammatory properties in humans with coronary heart disease.

Current treatment options in Raynaud’s phenomenon

2011-05-29T23:31:00.001-07:00

The treatment of Raynaud’s phenomenon (RP) strictly depends on the severity of symptoms and on the presence of an underlying systemic disease. For this reason, any patient with RP should be carefully assessed for signs and symptoms that may herald an underlying disease. Primary RP can usually be managed with conservative nonpharmacologic lifestyle modifications (eg, avoidance of cold temperatures, tobacco, caffeine, and any drug interfering with vascular tone) and pharmacologic treatment added only if attacks are poorly controlled. Vasodilating drugs (eg, calcium channel blockers, angiotensin II receptor antagonists, topical nitrates, and prostanoids) are still the mainstay of medical therapy for RP. Anecdotal reports with different kinds of therapies appear regularly but always need evidence-based confirmation. In particular, antioxidant agents may be useful in limiting the progressive endothelial damage. Novel therapeutic tools interfering either with primary or secondary pathogenetic processes (ie, endothelial and peripheral nervous system dysfunction and smooth muscle cell hypertrophy) are awaited.

Significance of serum uric acid in pulmonary hypertension due to systemic sclerosis: a pilot study

2011-05-29T23:29:00.000-07:00

Systemic sclerosis is a connective tissue disease, which may lead to elevated pulmonary arterial pressure due to pulmonary arterial hypertension and/or left ventricular diastolic dysfunction. Uric acid (UA) has been shown to be elevated in patients with pulmonary hypertension (PH) and heart failure. We aimed to investigate the potent relationship between serum UA and pulmonary pressure as well as functional capacity in patients with SSc. We studied 66 patients (mean age 57.7 ± 12.1 years, 63 women), presenting with SSc. Systolic pulmonary artery pressure assessed by echocardiography, lung function tests, six-minute walk test (6MWT) and serum UA levels were recorded in all patients. In 24 (36%) patients, the diagnosis of PH was established by echocardiography (systolic pulmonary artery pressure ≥40 mmHg). Patients with PH had higher UA serum levels compared to patients without PH (5.1 ± 2.1 mg/dl vs. 4.2 ± 0.9 mg/dl, p = 0.04). Among patients with PH, UA values were inversely correlated with the SMWT distance (r = −0.51, p = 0.01). Serum UA values increased in proportion to the functional capacity in PH patients with scleroderma. Further investigations in prospective studies will unfold in detail the pathophysiological significance of UA in SSc patients with PH and determine its role as a prognostic marker in the assessment and monitoring of the disease.

Oxidative stress in patients with COPD and pulmonary hypertension

2011-05-29T23:24:00.000-07:00

OBJECTIVE:

Oxidative stress plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Oxidant/antioxidant imbalance has also been reported in various forms of pulmonary hypertension. The present study aimed to assess systemic oxidative stress, as reflected by serum malondialdehyde (MDA) concentrations and activities of antioxidant enzymes in erythrocytes [glutathione peroxidase (GPX), superoxide dismutase (SOD) and catalase (CAT)] in patients with and without pulmonary hypertension secondary to COPD.

PATIENTS AND METHODS:

Seventy-five patients (58 male) with COPD (mean age 65.1 ± 1.2 years; mean smoking history 35.6 ± 3.8 pack-years) were studied. Twenty-one healthy non-smokers served as a control group. Pulmonary function was evaluated with body plethysmography; mean and systolic pulmonary artery pressures (Ppa) were assessed with Doppler echocardiography. Serum concentrations of MDA and activities of GPX, SOD and CAT in washed red blood cells were measured using spectrophotometry.

RESULTS:

Pulmonary hypertension was present in 28 patients with COPD (systolic Ppa: 46.4 ± 2.3 mmHg; mean Ppa: 26.0 ± 1.9 mmHg) and absent in 47 (systolic Ppa: 22.9 ± 0.8 mmHg; mean Ppa: 13.4 ± 0.6 mmHg). Compared with the healthy control group, all the patients (with or without pulmonary hypertension) had higher serum MDA concentrations (1.5 ± 0.1 versus 2.3 ± 0.1 versus 2.3 ± 0.1 nmol/mL, ANOVA, P < 0.001) and lower erythrocyte GPX activity (51.3 ± 3.2 versus 42.2 ± 2.0 versus 41.3 ± 2.5 U/g Hb, P = 0.029), whereas SOD (1121.1 ± 29.0 versus 1032.6 ± 21.8 versus 1032.7 ± 36.2 U/g Hb, P = 0.063) and CAT activities (4.9 ± 0.2 versus 4.6 ± 0.1 versus 4.7 ± 0.2 U/g Hb; P= 0.454) were similar. No differences were observed in serum MDA concentrations or activities of GPX, SOD and CAT in erythrocytes between COPD patients with and without pulmonary hypertension. CONCLUSION: The study demonstrates the presence of oxidative/antioxidative imbalance in the systemic circulation in patients with COPD: compared with healthy subjects, COPD patients had higher serum MDA concentrations and lower GPX activity in erythrocytes. The magnitudes of the increase in MDA and reduction in GPX activity were similar in COPD patients with pulmonary hypertension and in those with normal pulmonary artery pressures.