Browsing by Author "Ćirković, Andja (56120460600)"

Background/Aim. Psoriasis is a chronic, immune-mediated, genetically determined disease, which is manifested by the appearance of erythematous scaly plaques. Treatment includes conventional therapies and biologics. The coronavirus disease 2019 (COVID-19) raised widespread concern for patients with psoriasis treated with immunosuppressive drugs, especially biologics. Even though there was no data at the beginning of the pandemic on the efficacy and safety of vaccines against COVID-19 in patients with psoriasis treated with biologics, the National Psoriasis Foundation (United States of America) recommended vaccination in these patients. The aim of this study was to evaluate the influence of COVID-19 on clinical characteristics and quality of life of psoriatic patients treated with biologics and evaluate the effectiveness of biologic therapy during the pandemic. Methods. A retrospective cross-sectional study was conducted at the Clinic of Dermatology and Venereology of the University Clinical Center of Serbia from March 2020 to January 2022. Data was collected from medical documentation during the consecutive hospitalization of patients with psoriasis who received biologics. Results. The study included a total of 181 patients with psoriasis divided into two groups. Patients from each group were treated with different biologics (ustekinumab in 63.0% and secukinumab in 37.0% of patients). They achieved significant improvement regarding their clinical characteristics after a two-year follow-up [Psoriasis Area and Severity Index (PASI) before treatment: 14.1 (0-50.5) and after treatment: 1.2 (0-49.7), p < 0.001] and quality of life [Dermatology Life Quality Index (DLQI) before treatment: 15.0 (0-34) and after treatment: 0 (0-28), p < 0.001]. Due to unsatisfactory therapeutic response in 4 (2.2%) patients, secukinumab was changed to ustekinumab. The vaccine against COVID-19 was given to 53.0% of patients, but only 20.4% received all three doses. Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed in 64 (35.4%) patients, and 68.0% of those infected contracted the disease before the first dose of the vaccine. Therapy with biologics was delayed due to SARS-CoV-2 infection in 52 (28.7%) patients, of which 11 (21.2%) had exacerbation of psoriasis. Conclusion. The vaccination rate in patients with psoriasis receiving biologics was hardly 50.0%, and about a third of the vaccinated patients had a milder form of COVID-19. The therapy with biologics was successful regardless of the short-term interruption of drug administration due to the beginning of the COVID-19 pandemic and the worsening of psoriasis in some patients during that time. © 2024 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background and Objectives: Ovarian cancer is the leading cause of death among gynecological tumors. PD-1/PD-L1 immunoregulatory mechanism is activated in ovarian cancers. Lymphocyte infiltration is a significant factor that affects its expression. We analyzed the correlation between localization of lymphocytic infiltrate and PD-L1 expression in epithelial ovarian tumors. Materials and Methods: PD-L1 expression was analyzed in 328 subjects, 122 with epithelial ovarian carcinoma, 42 with atypical proliferative tumor, and 164 with benign epithelial ovarian tumor. Expression in central and invasive tumor parts in epithelial ovarian carcinoma was combined with the most pronounced lymphocyte reaction. Immunohistochemical analysis was performed using the tissue microarray and correlated with a set of histopathology parameters. Results: PD-L1 expression was most prominent in epithelial ovarian carcinoma with different levels of expression observed between invasive and central tumor segments. A high level of PD-L1 expression on tumor cells was more frequently present in the invasive than in the central tumor parts (p < 0.001) only in high-grade serous ovarian carcinoma (HGSC). There was no significant correlation between peritumoral lymphocytic infiltrate and PD-L1 expression regardless of tumor segment. In the central tumor parts of HGSC, there was a correlation of intratumoral lymphocytic infiltrate with a higher level of PD-L1 expression (p = 0.003). Conclusions: The most prominent PD-L1 expression was observed in the invasive tumor parts of HGSC. Only the central parts of the HGSC exhibited significant PD-L1 expression in association with considerable intratumoral lymphocytic infiltrate. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Purpose: Programmed death-ligand 1 (PD-L1) was expressed in various gynecology tumors. High-grade ovarian cancers could be a potential target for immune anti-PD-L1 modulate therapy. Antibodies targeting PD-L1 molecules are emerging cancer therapeutics. This study was designed to evaluate the expression of PD-L1 marker in the high-grade ovarian cancer types and evaluate its prognostic potential. Methods: The study included 18 patients with ovarian high-grade serous cancer (HGSC) and 11 patients with clear cell cancer (CCC) histology type, both in the International Federation of Gynecology and Obstetrics (FIGO) stage I. The expression of the PD-L1 marker was measured by tissue microarray-based immunohistochemistry. Expression levels of PD-L1 were correlated with the presence of tumor-infiltrating lymphocyte (TIL) and other histopathology parameters. Results: HGSC ovarian cancers predominantly had low PD-L1 expression, while CCC ovarian cancers had high PD-L1 expression (p < 0.001). PD-L1 expression did not show significant differences considering analyzed parameters other than histology type (localization, size, FIGO stage, lymphovascular invasion, tumor necrosis, and presence of TIL) among all ovarian cancers. There was no statistically significant difference in any of the tumor characteristics within histologic types of ovarian cancers. Conclusion: PD-L1 expression was significantly higher in clear cell histology type than in high-grade serous ovarian cancers in FIGO I stage. © 2022, The Author(s) under exclusive licence to Association of Gynecologic Oncologists of India.

Background: Emerging epidemiological evidence suggests independent associations between psoriasis and metabolic syndrome. Objectives: The aim of the study was to examine the prevalence of metabolic syndrome and its components in patients with psoriasis, and to assess which factors may predict metabolic syndrome in these patients. Methods: A hospital-based, cross-sectional study with 244 psoriatic patients and 163 control subjects with skin diseases other than psoriasis was conducted at the Clinic of Dermatovenerology, Clinical Center of Serbia, Belgrade, from October 2011 to October 2012. Metabolic syndrome was defined using the revised National Cholesterol Education Program Adult Treatment Panel III. Severity of psoriasis was measured by Psoriasis Area and Severity Index and Body Surface Area. Results: The adjusted odds ratios (ORs) and 95% confidence intervals (CI) for psoriasis patients vs. non-psoriasis patients were 2.66 (95% CI, 1.58-4.42) for metabolic syndrome, 3.81 (95% CI, 2.30-6.31) for hypertension, 2.29 (95% CI, 1.39-3.78) for central obesity, 1.92 (95% CI, 1.08-3.41) for hyperglycemia, 1.87 (95% CI 1.18-2.96) for low high-density lipoprotein cholesterol level, and 1.42 (95% CI, 0.87-1.04) for hypertrigliceridemia. We failed to find any statistically significant association between the metabolic syndrome and clinical severity of psoriasis. Later onset and longer duration of psoriasis were predicting factors for metabolic syndrome in our patients. Study limitations: The cross-sectional design of the study does not allow us to draw directional causal inferences concerning the association between psoriasis and metabolic syndrome. Factors such as diet, alcohol consumption or mental health, which have not been evaluated in this study, may be confounders in this relation. Conclusion: A higher prevalence of metabolic syndrome and its components in patients with psoriasis than in controls, regardless of disease severity, emphasizes the need for early treatment and follow-up of all psoriatic patients with respect to metabolic diseases. © 2017 by Anais Brasileiros de Dermatologia.