Majoie I M Leonie, Oldhoff J Marja, van Weelden Huib, Laaper-Ertmann Marloes, Bousema Mente T, Sigurdsson Vigfus, Knol Edward F, Bruijnzeel-Koomen Carla A F, de Bruin-Weller Marjolein S
Department of Dermatology and Allergology, University Medical Center Utrecht, The Netherlands.
J Am Acad Dermatol. 2009 Jan;60(1):77-84. doi: 10.1016/j.jaad.2008.08.048.
Phototherapy may be effective in atopic dermatitis (AD). Medium-dose (MD) ultraviolet (UV) A1 was introduced for the treatment of AD. Few immunohistochemical data are available pertaining to phototherapy in AD. Regulatory T cells may play a role in clearing AD.
We sought to compare the clinical and immunohistochemical effects of narrowband (NB) UVB and MD UVA1 treatment in patients with AD.
Thirteen adult patients with AD were included in this randomized investigator-blinded half-sided comparison study between NB UVB and MD UVA1. Disease activity was measured using the Leicester sign score. Skin biopsy specimens were taken before and after phototherapy. Regulatory T cells were stained with the forkhead box protein P3 (FoxP3).
NB UVB and MD UVA1 both significantly decreased AD severity (P < .01) and the dermal cellular infiltrate. The percentage of FoxP3(+)CD3(+) T cells did not change after NB UVB or MD UVA1 treatment.
MD UVA1 therapy was given 3 times per week instead of the preferred regimen of 5 times per week. This was necessary to achieve good blinding of the study.
NB UVB and MD UVA1 seem equally effective in the treatment of patients with moderate to severe AD. Neither MD UVA1 nor NB UVB had an effect on the percentage of FoxP3(+)CD3(+) T cells.
光疗可能对特应性皮炎(AD)有效。中剂量(MD)紫外线A1(UVA1)已被用于治疗AD。关于AD光疗的免疫组化数据较少。调节性T细胞可能在清除AD中发挥作用。
我们试图比较窄谱中波紫外线(NB-UVB)和MD UVA1治疗AD患者的临床和免疫组化效果。
13例成年AD患者纳入了这项NB-UVB与MD UVA1之间的随机、研究者盲法、半侧对照研究。使用莱斯特体征评分来测量疾病活动度。在光疗前后取皮肤活检标本。用叉头框蛋白P3(FoxP3)对调节性T细胞进行染色。
NB-UVB和MD UVA1均显著降低了AD的严重程度(P <.01)和真皮细胞浸润。NB-UVB或MD UVA1治疗后,FoxP3(+)CD3(+) T细胞的百分比没有变化。
MD UVA1治疗为每周3次,而非首选的每周5次方案。这对于实现研究的良好设盲是必要的。
NB-UVB和MD UVA1在治疗中度至重度AD患者方面似乎同样有效。MD UVA1和NB-UVB对FoxP3(+)CD3(+) T细胞的百分比均无影响。