Bei Zhao’s research while affiliated with Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital and other places

Objectives: Psoriasis is a common chronic recurrent dermatitis. Accumulating observations show gut microbiota dysbiosis in psoriasis. We intend to further investigate the relationship between intestinal microbiota and psoriasis development. Design: We first performed an epidemiological investigation on differences of gastrointestinal discomfort symptoms between patients with psoriasis and general population. Then variation of gut microbiota in patients with psoriasis (un)treated with acitretin plus narrow-band ultraviolet B (NB-UVB) was analyzed by 16S rRNA sequencing. We last compared recovery status and vital cytokines (lesion and intestine) of mouse psoriasiform models, which were transplanted with fecal microbiota from patients with psoriasis or healthy controls. Results: (1) About 85.5% of patients with psoriasis vs. 58.1% of healthy controls presented with at least one gastrointestinal symptom. The prevalence of investigated symptoms (e.g., abdominal distension and constipation) were significantly higher in patients, compared with controls (p < 0.05). Passing flatus and constipation were significantly correlated with psoriasis (p < 0.05 in both cases). (2) The abundance of Ruminococcaceae family, Coprococcus_1 genus, and Blautia genus were decreased with psoriasis improvement (p < 0.05, respectively), which had been demonstrated significantly increased in psoriasis. (3) Mice receiving psoriatic microbes transplantation showed delayed recovery of psoriasiform dermatitis and less reduction of interleukin (IL)-17A than those receiving healthy microbiota or blank control (p < 0.05 and p < 0.01, respectively). Conclusion: Multiple evidence we provided here preliminarily demonstrates the involvement of gut microbiota in the different degree of psoriasis activity. The strategy based on overall microbial communities is expected to be a promising supplementary for long-term management of psoriasis.

Clown nose-like lesion refers to the manifestation of a reddish or skin-colored bulge on the tip of the nose or the manifestation of bulbous tip of the nose. More and more clinical cases show that clown nose-like lesion can also be the indication of some genetic syndromes, not just the manifestation of metastatic visceral tumor as it initially proposed. However, the clinical features of clown nose-like lesion indicated by metastatic malignancies, genetic cancer predisposition syndromes or primary diseases involving the nasal tip are lacking. In this study, patients with clown nose-like lesion in our clinical practices and from published literatures were collected and reviewed. We found that clown nose-like lesions caused by metastatic malignancies including lung cancer are often solitary and more common in male (24/31) older individuals (average age 62.3, ranging 40–78 years old). In addition, they usually appear for a short time, and are prone to be misdiagnosed as primary nasal diseases, leading to a poor prognosis (all patients with data available died within 4 months). Clown nose-like lesions associated with genetic cancer predisposition syndromes usually develop at a young age (mean age 15.3) with female preference (9/10). They are accompanied by multiple-systemic involvements, including low hair volume, developmental delay, cancer predisposition or neurological diseases. They show slow development and often positive family history (6/10). These two kinds of clown nose-like lesions are often asymptomatic, which delays the diagnosis and treatment of underlying malignancies or syndromes. In brief, the term of clown nose-like lesion is underrecognized, and should be updated. Clown nose-like lesions can serve as indicators to at least three categories of clinical issues: metastatic visceral tumors, genetic syndromes, and primary diseases involving the nasal tip. Increased awareness of clinical features of updated clown nose-like lesions can alert physicians to these underlying malignancies or syndromes, render earlier detection of associated medical issues, and allow for genetic counseling of family members.

Background Psoriasis is a common chronic recurrent dermatitis. Accumulating observations show gut microbiota dysbiosis in psoriasis. Objectives We intend to further investigate the relationship between intestinal microbiota and psoriasis development. Methods We first performed an epidemiological investigation on differences of gastrointestinal discomfort symptoms between psoriatic patients and general population. Then variation of gut microbiota in psoriatic patients (un)treated with Acitretin was analyzed by 16S rRNA sequencing. We last compared recovery status and vital cytokines of mouse psoriasiform models, which were transplanted with fecal microbiota from psoriatic patients or healthy controls. Results (1) 85.53% of psoriatic patients versus 58.08% of healthy controls presented with at least one gastrointestinal symptom. The prevalence of investigated symptoms (e.g. abdominal distension, constipation) were significantly higher in patients, compared with controls (p<0.05). Increased fart and constipation were significantly correlated with psoriasis (p<0.05, respectively). (2) The abundance of Ruminococcaceae family, Coprococcus_1 genus and Blautia genus were significantly decreased with psoriasis improvement, which had been demonstrated significantly increased in psoriasis. (3) Mice receiving psoriatic microflora transplantation showed significantly delayed recovery of psoriasiform dermatitis and less reduction of IL-17A, than those receiving healthy microflora or blank control (p<0.05 and p<0.01, respectively). Conclusions Multiple evidences we provided here demonstrate the involvement of gut microbiota in psoriasis development. The strategy based on gut microbiota is expected to be a promising supplementary for long-term management of psoriasis.