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Biomedical subjects

S Shuster

Publications and source records attributed to S Shuster.

At least 73 records · Page 4Linked to original sources

Oral cyclosporin inhibits the expression of contact hypersensitivity in man.

The expression of delayed contact hypersensitivity was studied in 6 patients with chronic contact dermatitis treated with cyclosporin A (CsA) 5 mg/Kg/day. Quantitative patch test challenge was used to establish individual dose-response curves and threshold concentration to certain allergens in the European Standard Battery. In all 6 patients, responses were reduced over the whole range of allergen concentrations, and in the 5 in whom the threshold for expression of contact hypersensitivity could be determined, the threshold was raised by CsA therapy. In addition, the clinical manifestations of allergic contact dermatitis underwent complete resolution within 2-3 weeks of CsA therapy. It was concluded that CsA inhibits expression of delayed contact hypersensitivity reactions in human skin.

Administration, Oral↗

Cyclosporin A in atopic dermatitis: therapeutic response is dissociated from effects on allergic reactions.

Fourteen patients with severe chronic atopic dermatitis were treated with cyclosporin A (CyA, Sandimmun; 5 mg/kg/day) for 7-16 weeks. All showed a marked clinical improvement and half could omit topical corticosteroid treatment during therapy. Adverse effects were minor, but two patients relapsed despite continued treatment. In the others, the disease recurred soon after stopping CyA. Serum IgE levels and prick-test responses were unchanged by CyA. Immediate and late-phase cutaneous responses to intradermal house dust mite antigen (HDM) were significantly increased during treatment; but a delayed response, present at 24 and 48 h, was unaffected. Four of six patients challenged with HDM patch tests to tape-stripped skin during treatment showed eczematous reactions at 48 h. Thus, cyclosporin A has a powerful therapeutic effect in atopic dermatitis but does not reduce allergic responses to inhalant antigens.

Adolescent↗

Nail is produced by the normal nail bed: a controversy resolved.

Nail thickness and mass (dry weight/unit surface area) of 21 toenails, removed from 19 patients after accidental injury, were measured over the mid point of the lunula, at the nail plate immediately distal to the lunula and at the distal end of the nail bed. Nail thickness increased from 43% of the final thickness over the mid-point of the lunula to 81% at its distal margin, the remaining increase in thickness being formed by the nail bed. The changes in nail mass were comparable. We conclude that ventral nail produced by the nail bed comprises about one-fifth of the terminal nail thickness and mass.

Adolescent↗

[Cyclosporin A in atopic dermatitis: therapeutic effect and effect on allergic reactions are dissociated from each other].

Fourteen patients with severe chronic atopic dermatitis were treated with cyclosporin A (CyA, Sandimmun; 5 mg/kg/day) for 7-16 weeks. All showed a marked clinical improvement and half could omit topical corticosteroid treatment during therapy. Adverse effects were minor, but two patients relapsed despite continued treatment. In the others, the disease recurred soon after stopping CyA. Serum IgE levels and prick-test responses were unchanged by CyA. Immediate and late-phase cutaneous responses to intradermal house dust mite antigen (HDM) were significantly increased during treatment; but a delayed response, present at 24 and 48 h, was unaffected. Four of six patients challenged with HDM patch tests to tape-stripped skin during treatment showed eczematous reactions at 48 h. Thus, cyclosporin A has a powerful therapeutic effect in atopic dermatitis but does not reduce allergic responses to inhalant antigens.

Adolescent↗

'Irritants' increase the response to an allergen in allergic contact dermatitis.

We studied the effect of "irritants" on the response to an allergen in 15 patients. Dilutions of allergens were applied in duplicate, and 24 hours later they were removed and sodium lauryl sulfate (11 subjects) or anthralin (dithranol) (four subjects) was applied for a further 24 hours to one set of patches. Control dilutions of irritants alone were applied. Responses were measured objectively at 72 hours. The response to both allergen and irritant was greater than to either alone. Doses of allergen, which did not produce a response when applied alone, produced a response when an irritant was added. Irritants therefore increase the allergic contact dermatitis response and may explain the presence of contact dermatitis in patients with negative patch tests.

Allergens↗

Reduction of anthralin-induced inflammation by application of amines.

Twenty-two primary, secondary, and tertiary amines were studied to determine whether they could reduce anthralin-induced inflammation. Amine solutions of 0.18 mol/L were applied after anthralin application to normal forearm skin. Inflammation was measured with the use of Harpenden calipers by the increase in skin thickness at 48 hours. Inflammation was reduced by 66% to 95% with the use of nine different amines. There was no overall correlation between the inhibiting effect and either amine basicity or octanol/water partition coefficient. However, within each of the series of primary, secondary, and tertiary alkylamines there appeared to be some correlation between inhibitory effect and alkyl chain size, which may reflect differences in transdermal flux. Some of these amines are used in cosmetics and skin cleansers and could help reduce the inflammation that accompanies anthralin therapy for psoriasis.

Administration, Cutaneous↗

The effect of triethanolamine application on anthralin-induced inflammation and therapeutic effect in psoriasis.

Twenty patients with chronic plaque psoriasis were treated with short-contact anthralin followed by 10% triethanolamine application to one side of the body and aqueous cream to the other. Anthralin-induced inflammation was inhibited on the triethanolamine-treated side whereas anthralin therapy had to be temporarily stopped in 18 patients on the aqueous cream side because of anthralin-induced inflammation. Therapeutic response was not different in the two sides. This study shows that anthralin-induced inflammation and its therapeutic effect can be dissociated.

Adolescent↗

The effect of indomethacin on the kinetics of histamine, 48/80 and antigen wealing.

1. The kinetics of weal formation and disappearance following intradermal injection of histamine, compound 48/80 and antigen were measured in indomethacin and inert geltreated human forearm skin. 2. Rates of formation went in descending order for histamine, 48/80 and antigen; rate constants of disappearance for equal sized weals were the same for histamine and 48/80 but were much less for antigen. The corresponding half-lives were 77, 73 and 160 min for histamine, 48/80 and antigen weal disappearance respectively. 3. Cyclo-oxygenase inhibition by topical indomethacin had no effect either on the immediate weal and flare responses or on the rates of formation and disappearance of the weals. 4. These findings together with previous studies using H1-receptor antagonists indicate that 48/80 acts by histamine release but that antigen releases both histamine and an additional material or materials which are not related to cyclo-oxygenase activity. 5. Exacerbation of chronic idiopathic urticaria by cyclo-oxygenase inhibitors is therefore likely to be part of the urticarial disease process.

Adult↗

Contact dermatitis with negative patch tests: the additive effect of allergens in combination.

We deduced on theoretical grounds that conventional patch testing would be inadequate for the detection of sensitivity to multiple allergens. Fourteen patients with positive patch tests to two unrelated allergens were studied and the response to those two allergens was measured when tested singly or in combination, using 10 different pair combinations from 15 common allergens. With serial dilutions in chloroform (14 patients) and paraffin (four patients), the response was related to the log-dose of the allergen, and change in skin-fold thickness corresponded well with clinical grading. Single allergens diluted below the threshold for a patch-test response gave a response when given in combination, the threshold for a response to one allergen being lowered by the presence of another. On the linear part of the dose-response curves the response to the mixture of allergens was additive, the combined response being the sum of the individual components. Approaching the plateau region the response to the combination was greater than to the individual allergens but less than the sum of the single responses. The same results were obtained with allergens in paraffin. We conclude that conventional single allergen patch testing by itself is inadequate for the diagnosis of contact dermatitis.

Allergens↗

The permissive effect of sebum in seborrhoeic dermatitis: an explanation of the rash in neurological disorders.

The hypothesis that sebum permits the growth of Pityrosporum ovale, and hence the development of seborrhoeic dermatitis, was tested by observing whether a reduction of sebum production by isotretinoin would improve the disorder. In 10 male patients with seborrhoeic dermatitis, treatment with isotretinoin for 6 weeks reduced the mean sebum excretion rate by 70% and improved the severity of the rash, but with a site difference in magnitude of response. It is concluded that the residual pool of sebum is important for the growth of P. ovale and that, within the physiological range, sebum has a permissive effect on the growth of this yeast. Variation in the pools of residual sebum explains a number of features of the disease such as site of involvement and greater prevalence in males than females. The pathological increase in the residual pool of sebum due to immobility explains the frequent occurrence of seborrhoeic dermatitis in patients with a variety of neurological disorders.

Adult↗

Relapse rates in moderately severe chronic psoriasis treated with cyclosporin A.

Seventeen patients with chronic psoriasis were given cyclosporin A (CsA) 5 mg/kg per day. Twelve patients cleared within 3 months and their relapse rate, 41% at 6 months, was not significantly different from that previously reported with dithranol or PUVA. This pilot study also suggests that continuing CsA for up to 4 weeks after clinical clearance confers no advantage with regard to relapse. Significant adverse effects on renal function and blood pressure did not occur.

Adult↗

Control and function of sebaceous glands.

This review describes the various types of sebaceous glands, their locations, and where possible their different functions. All sebaceous glands are similar in structure and secrete sebum by a holocrine process. However, the nature of this secretion and the regulation of the secretory process seem to differ among the various types of glands. Methods for measuring sebum secretion and assessing sebaceous gland activity are also described. The area of major interest during the last 20 years has undoubtedly been the mechanisms that control sebaceous gland function. Most studies have focused on the endocrine control and in particular on the role of androgens and pituitary hormones, although evidence suggests that nonendocrine factors may also be important. However, many questions remain and during the next few years attention will certainly be given to the role of retinoids and their mode of action in the treatment of acne.

Animals↗