Lago Eduardo, Carneiro Sueli, Cuzzi Tullia, Magalhães Geraldo, Cássia Flavia, Pessanha Fátima, Ramos-e-Silva Marcia
Sector of Dermatology and Post Graduation Course in Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
J Cutan Pathol. 2007 Jan;34(1):15-21. doi: 10.1111/j.1600-0560.2006.00571.x.
Cyclosporine is a potent immunosupressor, which induces cytokeratin expression pattern changes and dermal dendrocytes number increase.
To evaluate its clinical effect in psoriasis, on keratinocytic proliferation and differentiation, and on dermal dendrocytes proliferation.
Thirty patients with psoriasis were treated and evaluated for 8 weeks. Clinical improvement was evaluated by Psoriasis Area and Severity Index (PASI). Biopsies were performed initially and after 8 weeks. Immunohistochemistry [CK markers 10, 14, and 16, and factor XIIIa+ (FXIIIa+)] was performed.
Mean PASI before treatment was 26.32 and 3.71 after. Mean initial and final PASI difference was 22.61 (p < 0.001). Two patients had serum creatinine and six uric acid increase. Before and after treatment, mean numbers per field of dermal dendrocytes were 7.07 and 3.68, respectively. Mean difference was 3.39, with p < 0.001. CK10 immunohistochemical pattern demonstrated recovery of normal expression pattern in 26 patients, while CK14 pattern demonstrated improvement in 21 patients.
Cyclosporine was effective and safe for psoriasis in low doses, with significant decrease of PASI and dermal dendrocytes number after 8 weeks of therapy. CK10 and 14 pattern changed and, less prominently, CK16 expression. These modifications occur later than the PASI and dermal dendrocytes variation.
环孢素是一种强效免疫抑制剂，可诱导细胞角蛋白表达模式改变及真皮树突状细胞数量增加。
评估其对银屑病的临床疗效、对角质形成细胞增殖和分化以及对真皮树突状细胞增殖的影响。
对30例银屑病患者进行8周的治疗和评估。通过银屑病面积和严重程度指数（PASI）评估临床改善情况。在治疗开始时及8周后进行活检。进行免疫组织化学检测（细胞角蛋白标记物10、14和16，以及因子ⅩⅢa+）。
治疗前平均PASI为26.32，治疗后为3.71。治疗前后PASI的平均差值为22.61（p<0.001）。2例患者血清肌酐升高，6例患者尿酸升高。治疗前后，每视野真皮树突状细胞的平均数量分别为7.07和3.68。平均差值为3.39，p<0.001。CK10免疫组织化学模式显示26例患者恢复正常表达模式，而CK14模式显示21例患者有所改善。
低剂量环孢素对银屑病有效且安全，治疗8周后PASI和真皮树突状细胞数量显著减少。CK10和CK14模式发生改变，CK16表达改变不太明显。这些改变比PASI和真皮树突状细胞变化出现得晚。
