van Rossum M M, van Erp P E, van de Kerkhof P C
Department of Dermatology, University Medical Centre St. Radboud, Nijmegen, The Netherlands.
Dermatology. 2001;203(2):148-52. doi: 10.1159/000051730.
Calcipotriol and corticosteroids are established topical antipsoriatics. Previous studies have shown that combined therapy with calcipotriol and betamethasone dipropionate was more effective than monotherapy. In the present study, a recently developed combination product of calcipotriol and betamethasone dipropionate was compared with both monotherapies and the vehicle.
Twenty-five psoriatic patients were treated twice daily with the combination product, monotherapy or vehicle during 4 weeks. Skin biopsies, taken before and after treatment, were analysed using a multi-parameter flow cytometric method. Parameters of inflammation (vimentin-positive cells), normal differentiation (keratin-10-positive cells) and proliferation (cells in SG(2)M-phase) were assessed.
Flow cytometric analysis showed that the combination product turned out to be more effective in reducing inflammation compared with the other treatments. Restoration of normal differentiation was more advanced in patients treated with the combination product or betamethasone dipropionate compared to the vehicle. The highest number of normally differentiated cells was seen after use of the combination product. All treatments, except for the vehicle, decreased hyperproliferation. CONCLUSIONS This study shows that the combination product is a valuable new approach to the treatment of psoriasis.
卡泊三醇和皮质类固醇是公认的外用抗银屑病药物。既往研究表明,卡泊三醇与二丙酸倍他米松联合治疗比单一疗法更有效。在本研究中,将一种新开发的卡泊三醇与二丙酸倍他米松的复方制剂与两种单一疗法及赋形剂进行比较。
25例银屑病患者在4周内每日接受两次复方制剂、单一疗法或赋形剂治疗。治疗前后采集皮肤活检标本,采用多参数流式细胞术进行分析。评估炎症参数(波形蛋白阳性细胞)、正常分化参数(角蛋白-10阳性细胞)和增殖参数(处于S/G2M期的细胞)。
流式细胞术分析显示,与其他治疗方法相比,复方制剂在减轻炎症方面更有效。与赋形剂相比,接受复方制剂或二丙酸倍他米松治疗的患者正常分化的恢复更明显。使用复方制剂后可见正常分化细胞数量最多。除赋形剂外,所有治疗均减少了过度增殖。结论:本研究表明,复方制剂是治疗银屑病的一种有价值的新方法。