Self-management-competency as a new target in Hidradenitis suppurativa care

Background: Hidradenitis suppurativa affects approximately 1% of the population.Objective: Highlighting the relevance of self-management-competency as a new therapeutic target.Method: 258 patients from the 'Epidemiology and Care in Acne inversa (EpiCAi)' project were included in the study. Disease burden was measured by patient-rated questionnaires in terms of disease activity, pain, quality of life, depression and insomnia and correlated with the domains of the health education impact questionnaire (heiQ) measuring self-management-competency.Results: 66 male (25.6%) and 192 female (74.4%) patients, with a mean age of 40.3 ± 10.24 years were included. Mean scores of pain on the numeric rating scale (NRS), Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HADS) were 5.11 ± 2.68, 11.35 ± 7.79 and 13.71 ± 7.57, respectively. The Insomnia severity index (ISI) showed a mean of 9.58 ± 5.76. The HADS has the highest increased total risk across all heiQ domains. With respect to the heiQ domains, the highest exposure can be attributed to improving constructive attitudes and approaches as well as decreasing emotional distress.Conclusion: There is a clear association of self-management-competency with overall disease burden, which underlines the need for psychoeducational support. This study provides ideas to develop new possible strategies of care.

18-beta-Glycyrrhetinic acid (BGA) as an electrical uncoupler for intracellular recordings in confluent monolayer cultures

In the study of epithelial cell biology, primary cell cultures or cell lines grown to confluency offer considerable advantages compared with isolated cells and cell clusters. This is due mainly to the development of appropriate cell-to-cell contacts that are a prerequisite for cell polarity and thus vectorial solute transport. On the other hand, electrical coupling via gap junctions in most instances significantly hinders the use of voltage-clamp techniques for electrophysiological analysis of transport processes in single cells. In the present study we employed the gap junctional blocker 18-beta-glycyrrhetinic acid (BGA) to reduce electrical cell-to-cell coupling in confluent primary cultures of rat hepatocytes. In current-clamp experiments, 40 micromol/l BGA reversibly increased apparent cell input resistance approximately tenfold. Due to this partial electrical isolation of cells, two-channel voltage-clamp experiments became feasible and, for the first time, the hypertonicity-induced Na+ conductance of rat hepatocytes could be analysed quantitatively. In ion substitution experiments, however, it became obvious that BGA, while leaving Na+ and K+ conductances virtually unchanged, completely blocked cell membrane Cl- conductance. This additional effect of BGA necessitates independent control experiments to ensure that the transport process under consideration is itself not changed by the compound. Nevertheless, BGA may serve as a powerful tool for the quantitative electrophysiological study of epithelial cells that are in quasi physiological contact with their neighbours.