Ohtsuka Tsutomu
Department of Dermatology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Mimami-Koshigaya, Koshigaya, Saitama 343-8555, Japan.
Arch Dermatol Res. 2008 Nov;300(10):545-50. doi: 10.1007/s00403-008-0887-5. Epub 2008 Sep 17.
Psoriasis is a disease presenting cutaneous, immunological and vascular abnormalities. Oral cyclosporin therapy has been shown to be effective for the disease. Clinical and laboratory findings affecting the response of oral cyclosporin therapy in patients with psoriasis were studied. Forty-seven patients with psoriasis (male:female = 27:20, age 56.7 + 12.6 years) were studied. The response to oral cyclosporin therapy was categorized as excellent, good, fair and poor according to decrease of PASI score and decrease of cyclosporin dose. Clinical and laboratory findings including cyclosporin trough level and high sensitivity-CRP were statistically analyzed. Nine patients showed excellent response, 17 good response, 19 fair response and 2 poor response. High sensitivity-CRP (0.11 +/- 0.02 mg/dl) in fair response patients to oral cyclosporin therapy was significantly lower than those in excellent response patients (0.42 +/- 0.21 mg/dl) (P < or = 0.05). Body mass index (23.4 +/- 0.6 kg/m(2)), HDL-cholesterol (57.1 +/- 3.6 mg/dl) and fasting plasma glucose (105 +/- 5 mg/dl) in fair response patients to oral cyclosporin therapy was significantly lower, higher and lower than those in excellent response patients (25.7 +/- 0.9 kg/m(2); 43.0 +/- 2.8, 140 +/- 20 mg/dl) (P < 0.05, P < 0.05, P < 0.05), respectively. No other clinical and laboratory findings showed statistical significance among excellent, good and fair response patients. These results showed the correlation between response of oral cyclosporin therapy and systemic inflammation, metabolic abnormality in patients with psoriasis.
银屑病是一种表现为皮肤、免疫和血管异常的疾病。口服环孢素治疗已被证明对该疾病有效。本研究探讨了影响银屑病患者口服环孢素治疗反应的临床和实验室指标。研究对象为47例银屑病患者(男:女 = 27:20,年龄56.7 ± 12.6岁)。根据银屑病面积和严重程度指数(PASI)评分的降低以及环孢素剂量的减少,将口服环孢素治疗的反应分为优、良、中、差四类。对包括环孢素谷浓度和高敏C反应蛋白(hs-CRP)在内的临床和实验室指标进行统计学分析。9例患者反应为优,17例为良,19例为中,2例为差。口服环孢素治疗反应为中的患者的高敏C反应蛋白水平(0.11 ± 0.02mg/dl)显著低于反应为优的患者(0.42 ± 0.21mg/dl)(P≤0.05)。口服环孢素治疗反应为中的患者的体重指数(23.4 ± 0.6kg/m²)、高密度脂蛋白胆固醇(57.1 ± 3.6mg/dl)和空腹血糖(105 ± 5mg/dl)分别显著低于、高于和低于反应为优的患者(25.7 ± 0.9kg/m²;43.0 ± 2.8,140 ± 20mg/dl)(P<0.05,P<0.05,P<0.05)。在反应为优、良和中的患者中,其他临床和实验室指标均无统计学差异。这些结果表明,银屑病患者口服环孢素治疗的反应与全身炎症和代谢异常之间存在相关性。