Method for evaluating inflammatory process activity at psoriasis

FIELD: medicine.

SUBSTANCE: the present innovation deals with laboratory methods for studying skin diseases by detecting the content of inflammatory process markers in blood serum at the moment of disease exacerbation and in the end of therapy. As markers of inflammatory process one should apply alpha-1 acid glycoprotein and nitrogen oxide. At decreased content of acid glycoprotein in blood serum ranged 1.19-1.21 g/l up to 0.78-0.82, and as for nitrogen oxide ranged 44.5-54.4 mcM/l up to 24-29.2 mcM/l one should evaluate psoriasis activity to be high. At decreased content of alpha-1 acid glycoprotein ranged 1-1.04 g/l - up to 0.76-0.8 g/l, and nitrogen oxide ranged 37.9-43.5 mcM/l up to 20.6-27.4 mcM/l the psoriasis activity should be evaluated as low. The innovation provides higher significance of diagnostics, decreases labor intensity and period for carrying out the experiments mentioned that enables to develop a number of individual curative procedures for every patient.

EFFECT: higher accuracy of evaluation.

2 ex

 

The invention relates to medicine, namely to laboratory methods of research of diseases of the skin, and can be used to evaluate the activity of a common progressive psoriasis and psoriatic arthropathy.

There is a method of assessing the activity of the inflammatory process in the various forms of psoriasis (Hava "the Role of acute phase proteins in the characteristic of non-specific reactivity of patients with psoriasis and development of pathogenetic therapy." Abstract. Dissert., M., 2003, p.4-15). In this method for clinical assessment of skin condition used the international index PASI. To calculate the index PASI consider the number and characteristics of pathological elements on the skin of the patient.

The disadvantages of this method are the complexity, due to the long process of counting the number of lesions on the entire surface of the body before, during and after treatment, and lack of accurate research because of the subjective visual assessment of the nature of the lesions and their number.

There is a method of assessing the activity of the inflammatory process in psoriasis, including the determination of markers of the inflammatory process, at the time of exacerbation and after treatment of the patient (U.S. Pat. Of the Russian Federation No. 2243560, CL G 01 N 33/48, 2003).

In this way as the evaluation criterion is Opletalova process selected fractions of serum proteins - alpha-2 and gamma-globulins, as the most informative from the point of view of assessing the severity of the inflammatory process and immune status. This method allows to estimate the form of the disease that it is necessary to select the appropriate treatment.

This method has insufficient diagnostic accuracy, due to the fact that the markers alpha-2 and gamma-globulins give a General characterization of the protein composition of the blood, which reduces the sensitivity of diagnosis.

In contrast to the known marker alpha-1 acid glycoprotein is one of the individual characteristics of the protein in the blood, making it more sensitive indicator of inflammation. Nitric oxide is also highly sensitive criterion of inflammation, in addition, in contrast to the known, it is more mobile in the course of inflammation, quickly and sharply reacts to the beginning of inflammation and quickly and sharply reduced during treatment.

The use of these markers will allow you to give a personal assessment of the activity of the process that will help to develop an individual approach to treatment of patients. In addition, the definition of these markers is less laborious and long.

In accordance with this task, aimed at improving the accuracy of differential diagnosis of psoriasis by individual assessment of the current process, and is also reducing the time and labour studies.

To solve this problem in the method of assessing the activity of the inflammatory process in psoriasis, including the determination of markers of the inflammatory process, at the time of exacerbation and at the end of treatment, proposed as markers to use alpha-1 acid glycoprotein and nitric oxide and decreasing the acid content of the glycoprotein from 1.19-1,21 g/l to 0.78-0,82 g/l, and nitrogen oxide from 44,5 is 54.5 μmol/l to 24-29,2 mmol/l high activity of psoriasis, with a decrease in alpha-1 acid glycoprotein from 1-1,04 g/l to 0.76-0.8 g/l, and nitrogen oxide from 37,9-43,5 µmol/l to 20.6-27,4 µmol/l to evaluate the low activity of psoriasis.

The method is as follows.

On admission the patient in the hospital during the acute period of the disease immunoturbidimetric method determines the content of alpha-1 acid glycoprotein and nitric oxide in the blood serum. Usually the content of these markers in the period of exacerbation of the disease in patients with advanced progressive psoriasis and psoriatic arthropathy are: alpha-1 acid glycoprotein 1,19-1,21 g/l, and nitric oxide 37,9 is 54.5 (at a rate of alpha-1 acid glycoprotein 0,75-0,81 g/l and nitrous oxide, 18,6-25 µmol/l, respectively). After the treatment, at discharge, determine the content of alpha-1 acid glycoprotein and oxide is zhota in serum immunoturbidimetric method. When the decrease in the content of alpha-1 acid glycoprotein from 1.19-1,21 g/l to 0.78-0,82 g/l, and nitrogen oxide from 44,5 is 54.5 μmol/l to 24-29,2 µmol/l appreciate the high activity of psoriasis, with a decrease in alpha-1 acid glycoprotein from 1-1,04 g/l to 0.76-0.8 g/l, and nitrogen oxide from 37,9-43,5 µmol/l to 20.6-27,4 µmol/l to evaluate the low activity of psoriasis.

Example 1.

Patient Gerasimov A.I., and/b 741, at entry: skin have multiple specific lesions, the diagnosis - a common psoriasis, at a rate of alpha-1 acid glycoprotein 0,75-0,81 g/l and nitrous oxide, 18,6-25 µmol/l, respectively.

Upon admission to the hospital, in the acute period of the disease, alpha-1 acid glycoprotein and nitric oxide in the blood serum was 1.19 g/l and 51.6 mmol/l, respectively, which is significantly above the norm (the norm of alpha-1 acid glycoprotein 0,75-0,81 g/l and nitrous oxide, 18,6-25 µmol/l, respectively). After the treatment at discharge, patient alpha-1 acid glycoprotein and nitric oxide in the blood serum was 0,79 g/l and 29.2 μmol/l, which is close to the norm. The result of these studies clarified the diagnosis of common psoriasis with high activity.

In accordance with this assigned therapeutic treatment, which consisted in taking protivovospalitel the x, immunomodulatory drugs that enhance the resistance of the organism, antihistamines, gemodez, methotrexate, and ointments and shampoos affecting local process.

Example 2.

Patient kites BV, and/b 896, skin have multiple specific lesions, the diagnosis - a common psoriasis.

Upon admission to the hospital, in the acute period of the disease, alpha-1 acid glycoprotein and nitric oxide in the blood serum was 1.04 g/l and 38,8 µmol/l, respectively, which is above the norm (the norm of alpha-1 acid glycoprotein 0,75-0,81 g/l and nitrous oxide, 18,6-25 µmol/l, respectively). After the course of treatment to discharge the contents of alpha-1 acid glycoprotein and nitric oxide in the blood serum was 0.8 g/l and 24.4 µmol/l, respectively, which corresponds to the norm. The result of these studies clarified the diagnosis of common psoriasis with low activity. In accordance with this prescribed treatment, which consisted in taking a fortifying preparations, providing increased nonspecific resistance of the organism, vitamins B6, B12, PUVA with Ocarina, retinoids, as well as ointments and shampoos.

Using this method will also increase the accuracy of diagnostics, reduce the complexity and time of the research, which will in short the e time to develop a number of individual therapeutic measures, depending on the individual nature of the disease, and thereby accelerate the recovery of the sick.

A method of evaluating the activity of the inflammatory process in psoriasis, including the determination of markers of inflammation in the serum at the time of exacerbation and after treatment of the patient, characterized in that as markers use alpha-1 acid glycoprotein and nitric oxide and decreasing the acid content of the glycoprotein from 1.19-1,21 g/l to 0.78-0,82 g/l, and nitrogen oxide from 44,5 is 54.5 μmol/l to 24-29,2 µmol/l appreciate the high activity of psoriasis, with a decrease in alpha-1 acid glycoprotein from 1-1,04 g/l to 0.76-0.8 g/l, and nitrogen oxide from 37,9-43,5 to 20.6-27,4 µmol/l appreciate the low activity of psoriasis.



 

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