Článek podává přehled o etiologii a možných opatřeních k prevenci a léčbě sekundární osteoporózy asociované s deficiencí estrogenů a s chronickým zánětem při revmatoidní artritidě. V obou situacích je aktivace T helper‑17 buněk spojena se zvýšením tvorby prozánětlivých cytokinů (zejména RANKL, TNFα a IL‑17) a se zrychlením úbytku kostní hmoty. Kauzální terapie základního onemocnění (biologická léčba revmatoidní artritidy, hormonální léčba při deficienci estrogenů) zastavuje úbytek a zhoršování kvality kostní hmoty a snižuje riziko vzniku zlomenin. V indikovaných situacích může být metodou volby antiresorpční nebo osteoanabolická léčba. Novým směrem v prevenci osteoporózy asociované s chronickým zánětem je úprava dysbiózy střevní mikrobioty.
This review examines the etiology and preventive and therapeutic options for secondary osteoporosis associated with estrogen deficiency and chronic inflammation in rheumatoid arthritis. In both situations, an enhanced reactivity of T helper‑17 cells causes an elevation of inflammatory cytokines, especially RANKL, TNFα, and IL‑17, and acceleration of net bone loss. Treating the underlying disease (biological therapy of rheumatoid arthritis, hormonal therapy of estrogen deficiency) prevents the bone loss and deterioration of bone tissue quality and reduces fracture risk. In indicated situations, antiresorptive or bone anabolic therapies may represent an option. New target for prevention of osteoporosis associated with chronic inflammation may be care of dysbiosis of gut microbiota.
- MeSH
- Biological Therapy methods utilization MeSH
- Diphosphonates administration & dosage adverse effects therapeutic use MeSH
- Chronic Disease MeSH
- Estrogen Replacement Therapy methods trends utilization MeSH
- Fractures, Bone diagnosis complications therapy MeSH
- Glucocorticoids administration & dosage adverse effects therapeutic use MeSH
- Inflammatory Bowel Diseases * diagnosis etiology complications MeSH
- Bone Density physiology immunology drug effects MeSH
- Humans MeSH
- Menopause physiology immunology drug effects MeSH
- Osteoporosis * diagnosis etiology therapy MeSH
- Probiotics therapeutic use MeSH
- Arthritis, Rheumatoid * diagnosis etiology therapy MeSH
- Statistics as Topic MeSH
- Gastrointestinal Microbiome physiology immunology drug effects MeSH
- Teriparatide administration & dosage adverse effects therapeutic use MeSH
- Age Factors MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- MeSH
- Atrophic Vaginitis * etiology drug therapy physiopathology therapy MeSH
- Dehydroepiandrosterone therapeutic use MeSH
- Estrogen Replacement Therapy utilization MeSH
- Phytotherapy utilization MeSH
- Homeopathy utilization MeSH
- Laser Therapy methods utilization MeSH
- Humans MeSH
- Lubricants therapeutic use MeSH
- Menopause MeSH
- Oxytocin therapeutic use MeSH
- Sexual Behavior MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- MeSH
- Atrophic Vaginitis drug therapy MeSH
- Estrogen Replacement Therapy * utilization MeSH
- Hormone Replacement Therapy * MeSH
- Myocardial Ischemia prevention & control MeSH
- Climacteric * drug effects MeSH
- Clinical Studies as Topic MeSH
- Humans MeSH
- Osteoporosis, Postmenopausal prevention & control MeSH
- Practice Guidelines as Topic MeSH
- Check Tag
- Humans MeSH
- Female MeSH
Článek se zabývá patogenezí, klinickým obrazem a možnostmi lokální a systémové terapie acne vulgaris. Zmíněny jsou i metody korektivní dermatologie.
This article reviews the pathogenesis, clinical picture, and options of topical and systemic treatment of acne vulgaris. Also presented are the methods of corrective dermatology.
- MeSH
- Acne Vulgaris * diagnosis etiology therapy MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Benzoyl Peroxide therapeutic use MeSH
- Estrogen Replacement Therapy utilization MeSH
- Immunologic Factors therapeutic use MeSH
- Isotretinoin therapeutic use MeSH
- Clindamycin therapeutic use MeSH
- Disease Attributes * MeSH
- Cosmetic Techniques * utilization MeSH
- Cryotherapy methods utilization MeSH
- Dicarboxylic Acids therapeutic use MeSH
- Laser Therapy methods utilization MeSH
- Humans MeSH
- Macrolides therapeutic use MeSH
- Propionibacterium acnes immunology isolation & purification MeSH
- Retinoids therapeutic use MeSH
- Dermatitis, Seborrheic diagnosis MeSH
- Tetracyclines therapeutic use MeSH
- Life Style MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Ablation Techniques utilization MeSH
- Acne Vulgaris MeSH
- Dermatitis, Atopic MeSH
- Pulmonary Disease, Chronic Obstructive diagnosis therapy MeSH
- Crohn Disease MeSH
- Diabetes Mellitus MeSH
- Estrogen Replacement Therapy adverse effects utilization MeSH
- Atrial Fibrillation diagnosis etiology drug therapy classification complications prevention & control MeSH
- Gastrointestinal Tract MeSH
- Hormone Replacement Therapy MeSH
- Inflammatory Bowel Diseases diagnosis prevention & control therapy MeSH
- Cardiac Care Facilities organization & administration manpower MeSH
- Congresses as Topic * MeSH
- Evidence-Based Medicine MeSH
- Carcinoma, Non-Small-Cell Lung therapy MeSH
- Otolaryngology methods MeSH
- Motor Activity MeSH
- Aging physiology metabolism pathology psychology drug effects MeSH
- Testosterone administration & dosage pharmacology deficiency standards therapeutic use MeSH
- Thrombophilia MeSH
- Varicose Veins economics therapy MeSH
- Patient Education as Topic MeSH
- Inflammation MeSH
- Health Services Misuse MeSH
