Utaş Serap, Köse Kader, Yazici Cevad, Akdaş Ahmet, Keleştimur Fahrettin
Erciyes University, School of Medicine, Department of Dermatology.
Clin Biochem. 2002 May;35(3):241-6. doi: 10.1016/s0009-9120(02)00294-1.
There is growing evidence supporting the reactive oxygen species (ROS) in the pathogenesis of psoriasis. Propylthiouracil(PTU), an antithyroid drug, has been shown to have beneficial effects on psoriasis. The aim of this study was to investigate both disturbances in oxidant/antioxidant system in psoriasis and whether PTU, shown to have immunomodulatory effects and antioxidant potential, has effects on oxidant/antioxidant system and clinical improvement in psoriatics.
Malondialdehyde (MDA), end product of lipid peroxidation, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and antioxidant enzymes were measured in plasma, erythrocytes and skin biopsies of psoriatics who were resistant to conventional therapy before and after 8 weeks of oral treatment with PTU (300 mg/day) or PTU/thyroxine (25 microg/day- to prevent possible hypothyroidism). The same parameters were also studied in healthy controls. Psoriasis Area and Severity Index (PASI) scores were used to evaluate the severity of the disease, and routine analyses and thyroid function tests were measured during the study.
Increased baseline MDA in all samples were found to be lower. In addition baseline SOD and GSH-Px in skin and erythrocytes were also lower. The increased plasma SOD levels in skin and erythrocytes of the study groups was found to be higher and lower,respectively in all patients after the treatment. No tissue parameters or erythrocyte GSH-Px were different from control levels at the end of the study. Significant clinical improvement and decreased PASI scores were observed in all patients. Post treatment TSH levels were higher in all patients, but these levels were within the reference range and none had clinical hypothyroidism.
These findings may provide some evidence for a potential role of increased lipid peroxidation and decreased antioxidant activity in psoriasis. PTU may be considered as treatment model in psoriasis, in particular for resistant cases, because of its antioxidant potential, and also antiproliferative and immunomodulatory effects.
越来越多的证据支持活性氧(ROS)在银屑病发病机制中的作用。丙硫氧嘧啶(PTU)是一种抗甲状腺药物,已被证明对银屑病有有益作用。本研究的目的是调查银屑病患者氧化/抗氧化系统的紊乱情况,以及已显示具有免疫调节作用和抗氧化潜力的PTU是否对银屑病患者的氧化/抗氧化系统及临床改善有影响。
在接受PTU(300mg/天)或PTU/甲状腺素(25μg/天,以预防可能的甲状腺功能减退)口服治疗8周前后,对常规治疗耐药的银屑病患者的血浆、红细胞和皮肤活检组织中脂质过氧化终产物丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)以及抗氧化酶进行检测。在健康对照者中也研究了相同参数。使用银屑病面积和严重程度指数(PASI)评分评估疾病严重程度,并在研究期间进行常规分析和甲状腺功能测试。
发现所有样本中升高的基线MDA降低。此外,皮肤和红细胞中的基线SOD和GSH-Px也降低。研究组皮肤和红细胞中血浆SOD水平升高,治疗后所有患者中分别发现升高和降低。研究结束时,组织参数或红细胞GSH-Px与对照水平无差异。所有患者均观察到显著的临床改善和PASI评分降低。所有患者治疗后促甲状腺激素(TSH)水平升高,但这些水平在参考范围内,且均无临床甲状腺功能减退。
这些发现可能为银屑病中脂质过氧化增加和抗氧化活性降低的潜在作用提供一些证据。PTU因其抗氧化潜力以及抗增殖和免疫调节作用,可被视为银屑病的治疗模式,特别是对于耐药病例。