Background. Macrophages are of great importance in the development of obesity and psoriasis. Signaling via PPAR-γ in certain macrophage populations is associated with M2-like features and anti-inflammatory profile. In this research, we evaluated the anti-inflammatory action of pioglitazone by the immunohistochemical study of M1 and M2 macrophages in psoriasis-affected skin in obese patients. Methods. We used immunohistochemistry to characterize CD68+ and CD163+ macrophages and pathomorphological description of skin biopsy, obtained from 6 obese psoriatic patients before and after treatment with 15, 30, and 45 mg pioglitazone, once a day during 6 months. Two patients with conventional therapy and without pioglitazone served as control. Results. Generally, CD163+ cell quantities in psoriasis-affected skin significantly dominated over CD68+ before and after all treatment regiments. Among patients who received pioglitazone, some of them clearly responded to treatment from lowest to highest doses by decreasing CD68+ cells. In the group with 30 mg pioglitazone regiment, we detected a significant reduction of CD68+ cells in dermal infiltrates: CI 95% (16–32) before versus CI 95% (2–7) after treatment. Pioglitazone dose escalation led to certain normalization of skin morphology. Conclusion. The immunohistochemical study allows us to show the anti-inflammatory effect of pioglitazone in psoriatic obese patients, which can be mediated by reducing the number of СD68+ macrophages, but not СD163+ macrophages, in the affected dermis.

The aim of the study is to increase the effectiveness of the treatment of exacerbation of COPD group B GOLD II with the use of combined therapy of the combined drug PulmoBRIZ containing two components – ambroxol and acetylcysteine and the course of halotherapy. Materials and methods: We observed 60 patients with COPD B, GOLD II. They were divided into two groups: the first – the main (n=30) – patients receiving basic therapy, mucolytic therapy – a combination of Ambroxol and acetylcysteine – 200/30 to 1 tabl. 2 times a day, number 7 days and, from the 3rd day – sessions of halotherapy 1 time per day № 10. The second group, the control group (n=30), followed only basic therapy, did not take mucolytics and halotherapy sessions. Results: Patients receiving therapy with the combination of ambroxol and acetylcysteine and halotherapy sessions experienced a significant increase in FEV1 by 8.3% (p <0.05); the Tiffon index was 7.2% (p<0.05), reactive anxiety levels (RA) and manifestations of autonomic dysfunction decreased, whereas in patients in the control group these indicators did not improve significantly. Conclusions: The proposed complex therapy of COPD patients with the inclusion of the combined drug ambroxol and acetylcysteine and halotherapy sessions contributes to the improvement of the quality of life of patients.

Psoriasis is one of the most common dermatoses, affecting from 2% to 4% of the world's population, according to the statistics from WHO. The recent increase in the incidence of comorbid psoriasis and obesity leads to severe, atypical, disabling, and treatment-resistant forms of dermatosis, which significantly impair the quality of life of patients, reduce the efficiency and social activity of patients, thus acquiring not only a medical but also a social significance. There is a theoretical justification for a possible role of circadian rhythm disorders, manifested by changes in eating behavior, reduced sleep duration, and individual chronotype of patients in the development of obesity, chronic low-intensity inflammation, and some chronic autoimmune diseases such as psoriasis. However, this issue remains understudied and insufficiently substantiated. Therefore, the aim of our research was to identify the correlation between the circadian rhythm in terms of changes in the chronotype of human working capacity and indicators of systemic inflammation in patients with extensive psoriasis and concomitant alimentary obesity. The results of correlation analysis showed a high negative correlation between the working capacity chronotype in patients and the level of IL-33, as well as a medium negative correlation between the working capacity chronotype in patients and the level of IL-6 and CRP. Therefore, changes in the circadian rhythm to the evening type of human working capacity chronotype may increase the level of systemic inflammation in patients with extensive vulgar psoriasis and concomitant alimentary obesity. Thus, further in-depth study of the relationship between systemic inflammation and circadian rhythm changes in patients with extensive vulgar psoriasis and concomitant alimentary obesity is promising and essential for the development of scientifically substantiated principles for early prevention and timely correction of these comorbidities.

Psoriasis is one of the most common chronic recurrent systemic autoimmune multifactorial diseases, affected the skin, joints, internal organs and systems of the body. Despite the significant prevalence of psoriasis and a large number of studies devoted this problem there is still no single view on the pathogenesis of this dermatosis. To clear up the pathogenesis of psoriasis, it seems to be reasonable to focus on the common comorbidities or multimorbidities, which may occur in the course of psoriasis, as this issue is still insufficiently studied. Recent reports have proven the evidences of indisputable link between psoriasis and obesity. The scientific literature extensively covers the issues of identical pathogenetic mechanisms of inflammatory processes in psoriasis and obesity. Given the current data on the role of systemic inflammation underlying the development of both psoriasis and obesity, the study of molecular mechanisms of its development and in particularly the role of proinflammatory nuclear transcription factors, thiazolidinediones have been found out as pathogenetically justified medicine of choice for the therapy of these diseases. In this study, we determined the effectiveness of using 30 mg of pioglitazone daily for 6 months in the course of treatment for patients with extensive psoriasis vulgaris of moderate severity, who were also diagnosed as having concomitant grade І-ІІ alimentary obesity that was supported by clinical and immunological findings evidenced of systemic inflammation. Analyzing the results obtained, we have found out the prolonged therapy with pioglitazone leads to a decrease in systemic inflammation and contributes to a milder recurrent course of psoriasis.

Мета. Вивчити вплив плазмаферезу (ПФ) на лабораторні показники інтоксикації та запального процесу у пацієнтів з гострим некротичним панкреатитом (ГНП). Матеріали і методи. До дослідження залучено 73 пацієнти з ГНП. Контрольну групу склали 27 пацієнтів, які отримували інтенсивну медикаментозну терапію. До основної групи включили 46 пацієнтів, яким стандартну інтенсивну терапію доповнили ПФ. Крім рутинних, вивчали показники інтоксикації та маркери запалення. Результати. У пацієнтів основної групи показники інтоксикації та запалення вже після першого сеансу ПФ були достовірно нижчими за аналогічні показники у пацієнтів контрольної групи. Щодо частини пацієнтів, у яких зазначені показники наближалися до аналогічних показників у здорових людей, було прийнято рішення обмежитися лише одним сеансом ПФ. Решті пацієнтів провели два, а окремим - навіть три сеанси ПФ. Після повторних сеансів ПФ показники інтоксикації та запалення у пацієнтів основної групи достовірно відрізнялися не лише від аналогічних показників у пацієнтів контрольної групи, а й від показників у пацієнтів, яким було проведено лише один сеанс екстракорпоральної детоксикації. Висновки. ПФ зменшує клінічні прояви панкреатиту, а також знижує лабораторні показники інтоксикації та запального процесу.