Kiehl R, Ionescu G
Research Department, Spezialklinik Neukirchen, Germany.
Acta Derm Venereol. 1992 Aug;72(4):253-5.
Purine nucleotide concentrations in skin- and blood-cells of psoriatic patients are abnormal: The increase in the steady state level of cGMP and the decrease in the cAMP concentrations are associated with an enhanced rate of cellular proliferation. Concomitantly we found in the present study decreased ADP and ATP concentrations in blood cells (p less than 0.0001). The change in nucleotide concentrations suggests a defective purine nucleotide synthesis pathway. Stimulation of the Krebs cycle with fumaric acid raises ATP (p less than 0.0001) and most probably cAMP levels and at the same time slows down the purine nucleotide synthesis through end-product inhibition. Both effects can inhibit DNA and protein synthesis activity, which results in inhibition of cellular proliferation. Fumaric acid seems therefore a useful treatment for psoriatic lesions if liver and kidney functions (purine nucleotide and urea cycle) are controlled during treatment.
cGMP稳态水平升高和cAMP浓度降低与细胞增殖速率加快有关。同时，我们在本研究中发现血细胞中的ADP和ATP浓度降低（p<0.0001）。核苷酸浓度的变化表明嘌呤核苷酸合成途径存在缺陷。用富马酸刺激三羧酸循环可提高ATP水平（p<0.0001），很可能还能提高cAMP水平，同时通过终产物抑制作用减缓嘌呤核苷酸合成。这两种作用均可抑制DNA和蛋白质合成活性，从而抑制细胞增殖。因此，如果在治疗过程中控制肝脏和肾脏功能（嘌呤核苷酸和尿素循环），富马酸似乎是治疗银屑病皮损的一种有效药物。
