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Epidemiology, comorbidities and quality of life in patients with psoriasis
Hugo, Jan ; Gkalpakiotis, Spyridon (advisor) ; Kodet, Ondřej (referee) ; Slonková, Veronika (referee)
Psoriasis is a complex systemic disease included among the Immune-Mediated Inflammatory Diseases (IMID). Although not life-threatening in itself, it has a dramatic impact on patients' quality of life and is associated with a risk of developing a number of comorbidities. Therefore, considering that it is one of the most common chronic dermatoses, affecting more than 100 million people worldwide, the WHO has designated psoriasis as a major global health problem. The goal of the treatment is to get the disease under long-term control, to achieve the fewest visible manifestations and minimal activity of new ones, while in patients with severe psoriasis, systemic therapy is necessary. However, this has been very difficult for a long time, because conventional systemic therapies were often not sufficiently effective, and due to side effects and the need for frequent laboratory tests, they were also not appropriate for long-term administration. Nevertheless, intensive research and a better understanding of the aetiopathogenesis of psoriasis have led to the development of targeted biological therapy, which represents a significant advance in both efficacy and safety. But it is a new therapy, so many questions are not yet answered, especially with newer generations of biological therapy. Therefore, our work...
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Chronic Inflammation and Metabolic Syndrom in Patients with Psoriasis
Vachatová, Simona ; Ettler, Karel (advisor) ; Vašků, Vladimír (referee) ; Tichý, Martin (referee)
Psoriasis is a chronic recurrent inflammatory disease. Genetic and immunological factors are involved in development of psoriasis. Psoriasis is associated with numerous comorbidities including metabolic syndrome (MetS). Adipocytokines produced by white adipose tissue may be involved in the pathogenesis of psoriasis. Adipocytokines could serve as a missing link in the association between psoriasis and obesity/MetS. The most important adipokines include adiponectin, leptin and resistin. Adiponectin is expressed by adipocytes and has a high anti- inflammatory potential. Leptin is a protein produced in adipose tissue and is an important part in regulating energy metabolism. It has a pro-inflammatory effect. Polypeptide resistin is produced by macrophages and monocytes of the visceral adipose tissue. It was named for its ability to induce insulin resistence. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is also product of macrophages, that can be served as a marker for cardiovascular risk. Increased smoking rates in patients with psoriasis is associated with their reduced quality of life. In addition, smoking of tobacco cigarettes is closely associated with MetS: smokers have an increased risk of MetS. Between psoriasis and smoking has also been demonstrated a direct link. Smoking is a well-recognized cause...
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The Role of Microbiota in the Pathogenesis of Psoriasis
Stehlíková, Zuzana ; Jirásková Zákostelská, Zuzana (advisor) ; Demnerová, Kateřina (referee) ; Hrdý, Jiří (referee)
Psoriasis is a chronic, immune-mediated inflammatory skin disease. Its pathogenesis is associated with dysregulated cooperation among keratinocytes, innate and adaptive immune cells, coupled with environmental triggers, including microbiota. The aim of our study was to describe the microbiota composition in psoriasis and explore the role of bacteria and fungi in the pathogenesis of this disease. We used a mouse model of psoriasis induced by topical application of imiquimod (IISI) in both germ-free (GF) mice and conventional (CV) mice with microbiota manipulated by administration of a mixture of broad-spectrum antibiotics (ATB). ATB treatment markedly changed the intestinal but not the skin bacterial diversity and led to higher resistance to IISI in CV mice. Metronidazole was the most effective antibiotic, alleviating IISI symptoms in CV, but not in GF mice. This confirms that the effect of metronidazole on IISI was microbiota- dependent. Additionally, we characterized the microbiota composition of psoriatic lesions and unaffected skin in psoriatic patients compared to healthy controls, as well as the impact of different sampling approaches on uncovering cutaneous microbiota composition. We observed significant differences in α- and β-diversities when comparing identical samples sequenced on V1V2...
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Potential role of skin microbiota in the pathogenesis of dermatological diseases
Mihula, Martin ; Jirásková Zákostelská, Zuzana (advisor) ; Grobárová, Valéria (referee)
The surface of the human body is colonized by a large number of microorganisms whose composition depends not only on external and internal factors, but is also significantly influenced by the topography of human skin. The complex skin microbiota is an essential part of physiological and protective mechanisms of the skin. The change in the dynamics of microbial communities on the skin or in the gastrointestinal tract is currently considered to be part of triggering mechanisms of many skin diseases. Some of the skin inflammatory diseases are directly associated with a shift of skin microbiota composition - for instance atopic dermatitis, acne vulgaris or psoriasis. Gaining and perceiving knowledge about interspecies interactions and their effect on a host could lead to the development of new diagnostic and therapeutic approaches which could make the prevention or treatment of some skin disorders more effective. Key words: skin, skin diseases, skin microbiota, immunity, psoriasis, atopic dermatitis, vitiligo
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Biological treatment and its influence on the course of latent viral infections in patients with psoriasis
Laurin, Josef ; Šmahelová, Jana (advisor) ; Janovec, Václav (referee)
There are more than 80 identified autoimmune diseases. One of the most prevalent ones is psoriasis. Its prevalence is around 2-5 % worldwide. The treatment of this inflammatory skin disease can be divided as follows: in cases of low severity, topical therapies are used for local treatment and in the cases of insufficient effect, stronger therapies are used. Phototherapy is used for moderate severity, and systemic therapy is used in moderate to severe disease. Systemic agents include cytostatic methotrexate, immunosuppressant cyclosporin, or retinoids (vitamin A analogues). However, even systemic therapies may not yield the desired effects or may have adverse effects on the overall condition of the patient. In those cases, biological therapy comes to use. Biological therapy is usually conducted using antibodies and fusion proteins, which are made using recombinant technologies. Tumour necrosis factor α (TNF-α) and interleukin 12, 17 and 23 (IL-12, IL-17 and IL-23) inhibitors are the most commonly used in the treatment of psoriasis. During the inhibition of the immune system, it has been confirmed that a reactivation of viral infections can occur. These reactivations may subsequently lead to the development of various diseases caused by latent viral infections.
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The possibilities of using ointments containing industrial hemp to treat skin diseases
KALISTOVÁ, Romana
Medicinal hemp can influence symptoms of many diseases. It seldom causes total recovery; however the refilling of a healing effect of hemp can reduce occurring of some diseases and prevent many others. The key to successful hemp usage as a medicine is in systematic using and also in frequency of administration. The following diseases were chosen because hemp was already used there and also was proved its effectiveness towards symptomatic relief. In the first part of my baccalaureate thesis is introduced a historical and scientific survey of hemp and its usability for medical purposes. In the practical part of my work is mentioned a qualitative research dealing with its potential influence. The aim of my work is to propose already mentioned facts in a form which is available to the general public as well as contributing other interested persons to further exploring.
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Possibilities of physiotherapy methods of psoriatic arthritis
DROBNÁ, Martina
This bachelor thesis deals with the problems of psoriatic arthritis, which has chronic evolution among most cases and can lead to articular deformities in patients. This disease has an unclear pathogenesis conditioned by genetic, external and immunologic factors. It affects above all patients with type I psoriasis with emerging symptoms such as swellings with articular pains, morning stiffness and overall fatigue. PsA often shows positive antigen HLA B27, without presence of rheumatoid nodules and negative rheumatoid factor (Štolfa, 2012). PsA causes both physical handicap in patients and substantial disturbance of their social and psychical life. The thesis is divided into theoretical and practical part. The theoretical part briefly outlines the anatomy of skin as well as structure and function of joints. Onward it describes psoriasis, its forms and methods of treatment. The next chapter explains the term arthritis and presents RA as an example. It is followed by detailed description of PsA, definition of the disease, its causes and occurrence, clinical picture and some therapy possibilities. In the practical part, the method of qualitative research was used, with participation of three female patients suffering from PsA. Therapy was initiated by input kinesiologic analysis, including specific examinations such as goniometric examinations of joints, grasp examinations, muscle palpation examinations and others. Patient appointments were held regularly each week for a period of eight-week therapy. On each appointment, previously applied therapy was consulted, exercises were repeated, possibly uncertainties were clarified. Each therapy lasted about 45 minutes, during which hypertonic muscles along with trigger points were relaxed according to specific patient issues. In the last session, output kinesiologic analysis was done and patients were informed about the importance of adhering to regimen measures. The results of the research clearly show overall posture improvement in all patients. A very substantial indicator of therapy success is noticeable reduction of swellings and pain, and hand function improvement. The therapy also focused on adjustment of faulty breathing stereotype manifesting itself with upper type, thereby causing overexertion of cervical spine muscles and frequent headaches. Strong emphasis was also put on activation of the transverse arch, which was collapsed in all patients. This bachelor thesis can be used in clinical practice of physiotherapists or as an educational material for patients.
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