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INVENTION
Russian Federation Patent RU2242001
METHOD assess the severity of psoriasis
Name of the inventor: GY Kurnikov (RU); Novikov VV (RU); Savkina YS (RU); Kryzhanova MA
The name of the patentee: State Institution "Nizhny Novgorod Research Institute for Skin and Venereal Diseases"
Address for correspondence: 603950, Nizhny Novgorod, ul. Kovalikhinskaya, 49G, GU NNIKVI
Starting date of the patent: 2003.04.30
The invention relates to medicine, namely to dermatology, and can be used to assess the severity of psoriasis flow. Summary of the invention consists in determining the content of blood serum soluble form of HLA I antigens and Class raising HLA I class over 2000 U / ml for severe psoriasis set, and a value less than 2000 U / ml - for easy. The technical result is to increase the accuracy of assessing the severity of psoriasis flow.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, in particular dermatology, and can be used to assess the severity of psoriasis flow.
Psoriasis is a chronic skin disease with various clinical manifestations. The causes of psoriasis are still unclear.
Currently, psoriasis is regarded as a systemic disease in which the important role played by the immune system (Mordovtsev VP, Mushet GV Albanova VI Psoriasis (pathogenesis, treatment, clinic) - Kishinev:. Shtiintsa 1991 ).
In recent years, there is evidence that the implementation of the immune response are involved soluble forms of membrane antigens of immune cells (VV Novikov Soluble forms of differentiation antigens of hematopoietic cells // Hematology and Blood Transfusion. 1996, №6, S.40-43). It has been found that human lymphocytes upon activation secrete significant amounts of soluble HLA I molecules form a class (sHLA-I). Physiological concentration of sHLA-I significantly increased during inflammation. This indicates that sHLA-I may serve as a marker of pathological changes in the body (Golenkov AK, Mitin TA, Novikov VV, etc. The clinical significance of soluble adhesion molecules (sCD50 -. ICAM-3) apoptosis (sCD95) and sHLA class I in lymphoproliferative diseases // Russian journal of biotherapeutic 2002, №1, S.60-64).
An attempt to allocate specific psoriasis disorders of the immune system has not yet come to fruition, and the changes are identified in the framework of the immune response during inflammatory response to injury (V.N.Shilov Psoriasis -. Solution -. M., 2001).
Currently, assessment of severity of psoriasis are clinically performed by calculating the index of prevalence and severity of the process (index PASI), based on the definition of peeling, the affected area of the skin, the degree of infiltration and erythema (Frederiksson, T.Pettersson, V.Dermatologika, 1978, 157; Mordovtsev VN, etc. Psoriasis (pathogenesis, clinical features, treatment) - Chisinau:.. Shtiintsa 1991, s.16-128).
However, the definition of current psoriasis severity in this way is difficult because of the subjectivity of evaluation.
The objective of the present invention - increase the accuracy of assessing the severity of psoriasis flow.
The problem is solved in that in a patient by drawing blood from peripheral veins serum was prepared, measured for its content antigen HLA I class soluble form and raising HLA I class over 2000 U / ml establish heavy psoriasis, and a value of at least 2000 IU / ml - easy for.
The method is as follows
The patient by sampling 1 ml of blood from a peripheral vein to obtain serum. As first antibodies, sorbed on a solid phase (wells of ELISA) using monoclonal antibody 53-ppi. The antibodies purified beforehand rivanolnym method by the conventional method. Used as PPI-216 mAb second antibody conjugated to horseradish peroxidase method periyodatnym (ES Vyazmina, 2002). We used polystyrene plates collapsible production "MEDPOLIMER" modified ultraviolet radiation.
Monoclonal antibodies diluted PPI-53 0.85% solution of NaCl was added to wells and plates 100 L each. Plates were incubated for 24 hours at room temperature, then washed 5-6 times with phosphate buffered saline pH 7.4 (T-DCF).
The serum of the patient, pre-diluted 1:10 in a solution of DCF-T was added to wells of the plates in the volume of 100 ul and incubated for 24 hours at room temperature. Plates were then washed as described above and the wells were added 100 ul of monoclonal antibody conjugate PPI-216 with horseradish peroxidase in the working dilution. Plates were incubated for 45 min at 37 ° C and after washing the wells were added 100 microliters of a solution of substrate mixture containing 0.01% orthophenylenediamine and 0.05% H 2 O 2 in citrate buffer. Plates were incubated for 10 min at room temperature, then added to the wells at 50 ul of 0.1 M H 2 SO 4 solution. Interpretation of results was performed at a wavelength of 492 nm using a photometer AMF-M / 340.
Soluble HLA I molecules, class evaluated in arbitrary units (U / ml) and with increasing levels of HLA I class more than 2000 units / mL was adjusted severe psoriasis, and a value less than 2000 U / ml - for easy.
The study involved 90 patients with psoriasis. In the course of studying this option, it found that patients with psoriasis was significantly increased the content of soluble molecules HLA I class to 2072 ± 285 U / ml. In healthy donor soluble HLA I molecules, class equal to 1012 ± 36 U / ml.
In the stationary stage in serum HLA I molecules form a class increase was observed until 1816 ± 268 U / ml compared to the control group (1,012 ± 36 units / ml). In the advanced stage of the disease the level of HLA I molecules class increased to a greater extent and reaches a concentration of 2764 ± 354 U / ml.
The data indicate that the serum level of soluble HLA molecules 
2 class I associated with the severity of psoriasis flow.
Patients at the value of the index above 2000 IU / ml was stated severe psoriasis.
Examples of specific performance.
Example 1. Patient G., entered the clinic Nizhny Novgorod Research Institute STI 16.04.02, with the preliminary diagnosis of psoriasis. Case Report №892. Age - 30 years. On the skin of the trunk, extensor surfaces of the upper and lower extremities were observed in the form of a rash characteristic of psoriatic plaques. Before treatment, a study of soluble molecules HLA I class. It turned out that this figure is equal to 835 IU / mL.
Conclusion: In patients determined easy for psoriasis. Clinical diagnosis - a common psoriasis, stationary phase. Follow-up confirmed the above conclusion (the standard treatment, discharge from the hospital on day 20).
Example 2. Patient Ch, entered the clinic Nizhny Novgorod Research Institute STI 21.01.02, with the preliminary diagnosis of psoriasis. Case Report №153. Age - 59 years. On the skin of the trunk, extensor surfaces of the upper and lower extremities were observed in the form of a rash characteristic of psoriatic plaques. Before treatment, a study of soluble molecules HLA I class. It turned out that this figure is 4590 IU / ml.
Conclusion: the patient is determined by severity of the psoriasis. Clinical diagnosis - a common psoriasis, progressive stage. Follow-up confirmed the above conclusion (methotrexate combination therapy, duration of treatment is 34 days).
Example 3. Patient S., was admitted to the clinic Nizhny Novgorod Research Institute STI 17.04.02, with the preliminary diagnosis of psoriasis. Case History # 908. Age - 48 years. On the skin of the trunk, extensor surfaces of the upper and lower extremities were observed in the form of a rash characteristic of psoriatic plaques. Before treatment, a study of soluble molecules HLA I class. It turned out that this figure is 6020 IU / ml.
Conclusion: the patient is determined by severity of the psoriasis. Clinical diagnosis - a common psoriasis, progressive stage. Follow-up confirmed the above conclusion (methotrexate combination therapy, duration of treatment is 38 days).
Thus, the proposed method has the advantage over the prior art identified, resulting in improving the accuracy and objectivity of determining the severity of the psoriatic process.
CLAIM
A method of evaluating the severity of psoriasis, comprising the examination of the patient, characterized in that by drawing blood from peripheral veins serum was prepared, measured for its content of soluble antigen HLA I class and raising HLA I class over 2000 U / ml establish heavy psoriasis , and a value less than 2000 U / ml - for easy.
print version
Publication date 06.01.2007gg
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