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Michael Sticherling

Publications and source records attributed to Michael Sticherling.

23 records · Page 2Linked to original sources
PubMed2002

Risk factors for lethal outcome in patients with bullous pemphigoid: low serum albumin level, high dosage of glucocorticosteroids, and old age.

BACKGROUND: Although bullous pemphigoid (BP) is the most frequent autoimmune bullous disease and is associated with a considerable case-fatality rate, little is known about factors that influence its prognosis. OBJECTIVE: To identify prognostic factors for lethal outcome in the first year after the initial hospitalization in patients with BP. DESIGN: A multicenter retrospective cohort study. SETTING: Seven dermatologic university hospitals in Germany. PARTICIPANTS: A total of 369 patients diagnosed as having BP between January 1, 1987, and December 31, 1997. STATISTICS: Univariate (Kaplan-Meier) and multivariate (Cox regression) analysis. RESULTS: Of the 369 patients with BP, 209 (57%) died, 106 (29%) within the first year after hospitalization. Fifty-four percent were women. The mean +/- SD age at entry was 77.3 +/- 11.1 years. The patients with BP were followed up to 10.5 years, with a median time of 1.8 years to death or interview (25th and 75th quartiles, 0.5 and 4.0 years). The major risk factors for lethal outcome in the first year after hospitalization were an increased age, with a multivariate risk estimate of 3.2 (95% confidence interval [CI], 1.9-5.2) for age greater than 80.4 years (median); a daily glucocorticosteroid dosage of more than 37 mg (75th quartile) at discharge, with a multivariate risk estimate of 2.5 (95% CI, 1.5-4.3); serum albumin levels of 3.6 g/dL or less (25th quartile), with a multivariate risk estimate of 2.6 (95% CI, 1.5-4.4); and an erythrocyte sedimentation rate greater than 30 mm/h (75th quartile), with a multivariate risk estimate of 1.7 (95% CI, 1.1-2.8). CONCLUSIONS: There is a considerable case-fatality rate in patients with BP. Older patients who require a higher dosage of oral glucocorticosteroids at hospital discharge and who have low serum albumin levels are at greater risk of death within the first year after hospitalization. These prognostic factors should be considered in the care of patients with BP as well as in the design of future clinical trials.

Aged↗
PubMed2002

How specific is the TUNEL reaction? An account of a histochemical study on human skin.

The TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling) technique has been described as sensitive method of labeling apoptotic nuclei in tissues, which preferentially stains apoptotic strand breaks. In the current study, three commercially available TUNEL kits for paraffin-embedded and cryostat tissues were tested to optimize this method for the studies on human skin. The investigation included normal skin (n = 10), atopic eczema (n = 4), basal cell carcinoma (n = 5), and lupus erythematosus (LE) (n = 31) sections. Additionally, the expression of certain apoptotic markers (Fas antigen and Bcl-2 protein) was studied immunohistologically on normal and LE skin. During TUNEL labeling according to the manufacturers' protocols, abnormally high background and nonspecific staining were found in all skin sections. The manipulation with the pretreatment time and, in particular, the introduction of an additional step (terminating the labeling reaction by inhibiting the terminal deoxynucleotidyl transferase activity) in two kits led to a remarkable improvement in their performance. The conclusions are that it is generally difficult to establish a functionally specific TUNEL technique for skin sections and that the choice of a kit is absolutely crucial for obtaining reliable results. Considering the extent to which the apoptosis research has been carried out recently, it is advisable to remain critical in evaluating the results. Further, it is necessary to combine the TUNEL technique with the investigation of other apoptotic markers.

Apoptosis↗
PubMedDate not supplied

The role of RANTES in nasal polyposis.

BACKGROUND: Characteristic infiltrates of eosinophils are a hallmark of nasal polyps (NPs). Several studies suggest that members of the CC chemokine family may be involved in this process. RANTES (regulated on activation, normal t-cell-expressed and secreted) is a member of the CC chemokine family with chemotactic activity on mainly eosinophils and T lymphocytes. Thus, RANTES is an interesting target for the recruitment of eosinophils and T lymphocytes into the nose. The degree of the tissue eosinophilia has been reported to correlate with the severeness of the symptomatology of the disease and the extension on the lower respiratory tract, as well as with the probability of the recurrence of NPs. Therefore, we hypothesized that high numbers of eosinophils correlate with high levels of RANTES and that associated atopic diseases modify this correlation. METHODS: Total RNA was extracted from NP homogenates, reverse transcribed and RANTES mRNA expression analyzed using semiquantitative reverse transcription polymerase chain reaction and Northern blot analysis. Histological studies divided NPs in an eosinophilic and low eosinophilic group. Additionally, RANTES protein concentration was measured in homogenates by a RANTES-specific enzyme-linked immunosorbent assay. RESULTS: This study has clearly shown that RANTES is expressed and secreted in NPs. The group with a high tissue eosinophilia had a significant higher RANTES gene expression and protein production than NPs without tissue eosinophilia. The isolated coincidence of acetylsalicyl acid intolerance with chronic hyperplastic sinusitis/NP additionally increased significantly the RANTES amounts in NPs. CONCLUSION: Increased RANTES leads to increased tissue eosinophilia. Associated acetylsalicylic acid intolerance seems to enhance the amount of RANTES in NPs and might explain in part the more severe clinical course in those patients. Thus, RANTES appears to play an important role in mobilization of eosinophils into the local inflamed tissue.

Biomarkers↗
PubMedDate not supplied

Cutaneous photosynthesis of vitamin D: an evolutionary highly-conserved endocrine system that protects against environmental hazards including UV-radiation and microbial infections.

Phytoplankton and zooplankton have been producing vitamin D for more than 500 million years. While the function of vitamin D in the physiology of lower non-vertebrate organisms is not well understood, it is known that most vertebrates need vitamin D to develop and maintain a healthy mineralized skeleton. However, recent findings have demonstrated that 1,25(OH)2D, the biologically-active vitamin D metabolite, exerts a multitude of important physiological effects independently of the regulation of calcium and bone metabolism. These new functions of vitamin D include protection against cancer and other diseases in various tissues. In this review, current knowledge of an additional new function of the cutaneous photosynthesis of vitamin D, that has recently emerged, is summarized: the role of vitamin D as an evolutionary highly-conserved endocrine system that protects the skin and other tissues against environmental hazards, including ionizing and UV-radiation, microbial infections and oxidative stress, is discussed.

Endocrine System↗