Publications by authors named "Matea Kuna"

4 Publications

  • Page 1 of 1

The Influence of Psychological Stress on HPV Infection Manifestations and Carcinogenesis.

Cell Physiol Biochem 2021 Jul;55(S2):71-88

Department of Gynaecology and Obstetrics, University Hospital Center Zagreb, Zagreb, Croatia.

Psychological stress is an important factor involved in disease manifestations of human papillomavirus (HPV) infection, and it can participate in HPV-associated carcinogenesis. The impact or effect which stress can have (exert) depends on a person's genetic pool, experiences and behaviors. Due to inconsistencies in some study results, this issue remains a subject of research. Concerning the course of HPV manifestations, it has been observed that a higher number of life stressors in at least the previous 6 months, the absence of social support and the types of personal coping mechanisms employed, all influence HPV progression. In women with cervical dysplasia, a connection between greater stress experiences and dysregulation of specific immune responses has been observed. Once HPV enters a cell via the α6 integrin there are three possible sequences: latent infection, subclinical infection, and clinically manifest disease. HPV proliferation in differentiated epithelial cells induces morphologically cytopathic changes (koilocytosis, epidermal thickening, hyperplasia, hyperkeratosis). Oncogenic transformation requires the integration of the virus genome into the host genome. In doing so, DNA in the E1 region of E2 breaks down, leading to transcription disorders of E6 and E7. For the formation of irreversible malignancy, the following sequence is necessary: initial expression of E6 and E7 genes followed by suppression of apoptosis and the stabile expression of E6 and E7 proteins that protect transformed cells from apoptosis. A successful immune response is characterized by a strong, local cell-mediated immune response. Several factors are important for the regression of HPV manifestation/infection, among which is psychological stress which can prolong the duration and severity of HPV disease. Stress hormones may reactivate latent tumor viruses, stimulate viral oncogene expression, and inhibit antiviral host responses. In the regression of HPV infection, increased activity of Th1 cells was observed. However, during psychosocial stress, a decrease in the Th1 type of immune response is seen, and there is a shift towards a Th2 response. Understanding perceived stress and biological changes in stress, as well as the evaluation of immune parameters, gives researchers a better picture of how stress influences HPV infections and how to improve disease management and outcomes.
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http://dx.doi.org/10.33594/000000395DOI Listing
July 2021

Chronic inducible urticaria: classification and prominent features of physical and non-physical types.

Acta Dermatovenerol Alp Pannonica Adriat 2020 Sep;29(3):141-148

Clinical Department of Dermatovenereology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.

Chronic inducible urticaria (CIndU) is a common inflammatory skin condition characterized by the recurrence of itchy wheals and/or angioedema that lasts more than 6 weeks and is induced by specific physical or environmental stimuli (cold, heat, exercise, pressure, sunlight, vibration, water, etc.). According to the current international classification, it includes physical urticarias (dermographism, delayed-pressure urticaria, exercise-induced urticaria, cold urticaria, heat urticaria, solar urticaria, and vibratory urticaria) and non-physical urticarias caused by exposure to specific stimuli (cholinergic urticaria, contact urticaria, and aquagenic urticaria). In terms of frequency, more common types of CIndU are dermographism, cholinergic urticaria, and delayed-pressure urticaria. In clinical practice, it is often difficult to define the exact type of CIndU; management thus begins with accurate identification of a possible trigger and its avoidance. The definite diagnosis for CIndU requires obtaining a detailed medical history of a patient with comprehensive information about predisposing factors, physical examination, and provocation testing (challenge tests). It is always necessary to recognize the prophylactic options for all the types and to have access to different therapies (primarily second-generation H1 antihistamines, but also H2 antihistamines, hydroxyzine, doxepin, oral glucocorticoids, omalizumab/anti-IgE therapy, phototherapy, physical desensitization, immunomodulatory agents, etc.) individualized for each patient.
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September 2020

Psychological Stress in Patients with Atopic Dermatitis.

Acta Dermatovenerol Croat 2018 Dec;26(4):297-303

Prof. Liborija Lugović-Mihić, MD, PhD, Department of Dermatovenereology Sestre milosrdnice University Hospital Center, Vinogradska c. 29, 10000 Zagreb, Croatia;

Atopic dermatitis (AD) is a frequent dermatosis with a growing incidence and multifactorial and complex pathogenic mechanisms that are still being investigated. Although the connection between AD and psychological stress has been known for a long time, there is a lack of reliable and objective indicators for the characterization of this association. Psychological stress triggers complex immune pathways. Therefore, acute stress quickly triggers a high release of cortisol and adrenalin or noradrenalin which then stimulates the immune system, primarily T-helper type 1 (Th1 cells) to produce pro-inflammatory cytokines, resulting in a cellular immune response and inflammation. On the other hand, chronic stress increases basal cortisol levels and decreases the capacity to mount an acute stress response, with the immune system shifting from a cellular response (which is active in acute stress) to a humoral response. Furthermore, skin keratinocytes contain receptors for neurotransmitters and hormones (muscarinic, adrenergic, glucocorticosteroid, androgenic, estrogenic), thus actively participating in psychoneuroimmunological pathways. The measurement of plasmatic cortisol has been used routinely, but in recent years, particularly in research, preference has been given to measurement of salivary cortisol. Reliable psychological tests are an important additional parameter for assessment of a patient's psychological state. We hope that future studies will supplement our current knowledge on the influence of psychological stress in AD.
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December 2018

Analysis of Dental Professionals' and Dental Students' Care for their Skin.

Acta Stomatol Croat 2018 Mar;52(1):46-52

Clinical Department of Dermatovenereology, University Hospital Centre "Sestre milosrdnice", Zagreb, Croatia.

Objectives: To determine prevalence of undesirable, work-related skin lesions and their localizations in dental professionals and students, and to collect data about diagnostic procedures they undergo and skin care they take when these lesions occur.

Subjects And Methods: Our research included 444 respondents (dentists, dental assistants, dental technicians, dental students) who filled out a questionnaire. They were asked to specify if they had observed any lesions on their skin and where; if they had undergone any treatments and in what way; if they had undergone any allergy tests; and if they had taken any protective measures.

Results: Of all the respondents that took part in the survey, 249 (56.1%) reported undesirable skin reactions commonly on their hands and fingers (96%). Before our survey, only 15% of them had seen a dermatologist, while 33% had undergone allergy tests (without a dermatologists' clinical examination). Also, 45% of them sometimes used soaps for sensitive skin and the majority (61%) of them used protective hand creams 1-2 times per day.

Conclusion: Although a large number of dental professionals and students have noticed work-related skin lesions, only some of them sought dermatologists' professional help and most of them did not take care of their skin adequately when those lesions occurred. According to the results of this study, it is necessary to take additional preventive measures to increase dental professionals' and students' awareness of occupational dermatoses and adequate skin care.
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http://dx.doi.org/10.15644/asc52/1/7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050747PMC
March 2018
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