Retinol-binding protein in serum and epidermis of patients with ichthyosis vulgaris.
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Biomedical subjects
Publications and source records attributed to G Michaëlsson.
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A decreased capacity of the leucocytes to phagocyte yeast particles was found in patients with Crohn's disease of the ileum. Patients with lesions only in the colon showed normal phagocytic activity as did patients with ulcerative colitis (U.C.). Intradermal injection of killed Strep. pyogenes produced an increased erythrmatous reaction after 48 hours in patients with U.C., and the reaction was pustular in half of them. None of the controls or the patients with Crohn's disease of the ileum had such a reaction. An increased erythematous reaction to streptokinase-streptodornase was also more common in patients with U.C. than in those with Crohn's disease and a control group. No such difference was seen to other bacterial antigens. The reactivity to kallikrein, prostaglandin E1, histamine or bradykinin did not differ from that of normal subjects.
The serum levels of zinc, vitamin A and retinol binding protein (RBP) were studied in 75 acne patients before and during oral treatment with zinc, vitamin A or placebo. In the zinc-treated patients an increase in the mean serum zinc level was seen after 2 weeks, when also the first clinical improvement occurred. After 4 weeks the zinc level had increased by about 30% and no further significant increase was observed during 3 months of treatment. In 33 healthy subjects there was an increase of 14% after 4 weeks of zinc therapy. Vitamin A and placebo induced no significant changes in the serum zinc status. Prior to therapy the serum levels of vitamin A and RBP were lower in the acne patients than in the controls. Zinc + vitamin A treatment raised the serum RBP value to normal after 4 weeks. In patients given vitamin A alone, a probable increase in RBP was achieved. Zinc and placebo treatment did not change the serum level of RBP.
The clinical and laboratory findings in a patient constantly lacking eosinophil and basophil leucocytes in bone-marrow, blood, expectorates, and skin exudate are reported. He had repeated infections, asthma, haemolytic anaemia, vasomotor rhinitis, alopecia totalis, widespread scabies, and an extensive growth of warts. His IgA and IgE are low and this may account for some of the clinical features. When his plasma and serum were added in vitro the buffy coat of blood from other subjects, degranulation of eosinophils was seen within two hours. An immunological destruction of eosinophils and basophils is the most plausible explanation for their absence.
The effects of oral zinc sulfate (corresponding to 135 mg of zinc daily) alone and in combination with vitamin A (300,000 international units) daily on acne lesions have been compared with those of vitamin A alone and of a placebo. The number of comedones, papules, pustules, and infiltrates were counted at each visit. After four weeks, there was a significant decrease in the number of papules, pustules, and infiltrates in the zinc-treated groups. The effect of zinc plus vitamin A was not better than zinc alone. After 12 weeks of treatment, the mean acne score had decreased from 100% to 15%. The mechanism for the effect of zinc therapy in acne, to our knowledge, is not presently known.¿
The serum levels of zinc and retinol-binding protein (RBP) have been determined in 173 patients with acne and compared with those of a control group. The RBP is a specific transport protein and its level in plasma reflects the amount of vitamin A available to the tissues. Patients with severe acne were found to have lower levels of RBP than either patients with mild acne or healthy subjects of the same age. In the case of males with severe acne, the mean serum zinc level was significantly lower than that of the control group. No such difference was observed for girls. The observed condition of low levels of zinc and vitamin A in the serum of patients with severe acne may provide a rationale for the clinically good effect of oral zinc treatment.
With a double-blind technique, the effects of oral zinc and tetracyclines were compared in 37 patients with moderate and severe acne. No difference in effect between the treatments was seen and no side-effects were noted in any group. After 12 weeks of treatment, the average decrease in the acne score was about 70% in both groups.
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In 94% of the patients with dermatitis herpetiformis, a locally applied ointment with an ester of nicotinic acid (Trafuril) induced an abnormal reaction with erythema, edema, papules, and often vesicles. The appearance of the reaction to Trafuril is similar to DH lesions. It differs markedly from the reactions to iodide where, as a rule, only one large blister results. The reaction is most pronounced 12-24 hours after application of Trafuril. The reactivity is strongest in the predilection areas for dermatitis herpetiformis. Strongly increased reactivity to Trafuril in DH is induced by pretreatment with streptokinase, streptokinase-streptodornase, or urokinase. Diminished reactivity to Trafuril is seen after pretreatment with injections of Compound 48/80, tranexamic acid, cromoglycate, or application of fluocinolone-acetonide, as well as after stroking the skin.