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Interleukin-18 is a cytokine with a possible role in the pathogenesis of psoriasis. We examined subpopulations of peripheral blood lymphocytes and their expression of activation markers and correlated this with plasma levels of IL-18 and clinical disease severity in patients with psoriasis. We included 12 patients with psoriasis who had a PASI score from 15 to 48 and compared them to controls. IL-18 plasma concentrations were determined with an enzyme-linked immunosorbent assay. We observed a significant correlation between the IL-18 levels and the area of skin affected with psoriasis and the PASI score. We also observed an increase in NK cells and memory helper CD45RO + /CD4+cells.

Objective: To determine the increase in healing rate of venous ulcer in patients receiving a micronised purified flavonoid fraction (MPFF) as supplementation to standard local care., Design: A randomised, open, controlled, multicentre study., Setting: Departments of Dermatology and University Outpatients Clinics., Patients: One hundred and forty patients with chronic venous insufficiency and venous ulcers., Intervention: PATIENTS received standard compressive therapy plus external treatment alone or 2 tablets of MPFF daily in addition to the above treatment for 24 weeks., Main Outcome Measure: Healing of ulcers and their reduction in size after 24 weeks of treatment., Results: The percentage of patients whose ulcers healed completely was found to be markedly higher in those receiving MPFF in addition to standard external and compressive treatment than in those treated with conventional therapy alone (46.5% vs 27.5%; p<0.05. OR=2.3, 95% CI 1.1-4.6). Ulcers with diameters <3 cm were cured in 71% of patients in the MPFF group and in 50% of patients in the control group, whereas ulcers between 3 and 6 cm in diameter were cured in 60% and 32% of patients (p<0.05), respectively. The mean reduction in ulcer size was also found to be greater in patients treated with MPFF (80%) than in the control group (65%) (p<0.05). The cost-effectiveness ratio (cost per healed ulcer) in the MPFF group was 1026.2 compared with 1871.8 in the control group., Conclusions: These results indicate that MPFF significantly improves the cure rate in patients with chronic venous insufficiency.

Background: Endothelial leucocyte adhesion molecule-1 (ELAM-1) acts as an adhesion ligand for neutrophils and monocytes and the expression of this molecule on the vascular endothelium may reflect its ability to recruit neutrophils from circulation. The next step is the transendothelial migration of neutrophils into lesional psoriatic skin. ELAM-1 may also exist in a soluble form., Methods: We determined the serum levels of ELAM-1 by ELISA in 41 patients with psoriasis and 20 controls., Results: Patients with acute psoriasis displayed higher levels of ELAM-1 (85.45 +/- 47.72 ng/ml) than controls (36.02 +/- 15.60 ng/ml) and patients with chronic disease (61.24 +/- 27.91 ng/ml). In 25 patients we measured the serum level of ELAM-1 twice: at the beginning and after treatment of the disease and we did not find any significant changes. We also found a correlation between serum ELAM-1 and PASI score., Conclusions: These data suggest that there is a high serum level of E-selectin in psoriatic subjects even after clearing of the disease. Serum E-selectin may reflect the general activation of endothelial cells in the disease and may be a new sensitive marker of disease activity.