Department of Dermatology, Faculty of Medicine, Cairo University, Egypt.
J Dermatolog Treat. 2011 Feb;22(1):2-10. doi: 10.3109/09546630903410182. Epub 2010 Jun 5.
To evaluate the efficacy of two topically applied immunomodulative agents through the detection of lymphocyte subsets using monoclonal antibodies against CD4, CD8 and MHC II.
Fifty patients from the Departments of Medical Biochemistry, Dermatology and Pathology at Cairo University with different degrees of alopecia areata (AA) were included in this study. They were classified into two groups each of 25 patients. Each patient was treated with the immunomodulative agent on one side of the scalp and the other side was left as a control. Biopsies were taken from all patients at the beginning of treatment and at the end of the study. Tissue specimens were prepared for histologic and immunophenotypic analysis. The main outcome measures were the uses of diphencyprone (DPCP) and topical tacrolimus as two topical immunotherapeutic modalities in the treatment of AA.
A clinical response of 68% was achieved in group A (treated with DPCP) while group B (treated with 0.1% tacrolimus) showed an insignificant clinical response. Decreased expression of CD4 and increased expression of CD8 and MHC II was detected in the post-treated areas compared with pretreated areas in cases treated with DCPC. In tacrolimus-treated cases, there was a decrease in CD4 and MHC II, with no change in CD8 between the pre- and post-treated areas.
DCPC is one of the most accepted therapeutic modalities in the treatment of AA, with a favourable prognosis among patchy hair loss. MHC II expression was the one correlating with clinical response. Tacrolimus, though beneficial in other dermatoses, could not be considered effective in the treatment of AA.
通过使用针对 CD4、CD8 和 MHC II 的单克隆抗体检测淋巴细胞亚群，评估两种局部应用的免疫调节药物的疗效。
本研究纳入了开罗大学医学生化系、皮肤科和病理学系 50 名不同程度斑秃（AA）的患者。他们被分为两组，每组 25 名患者。每位患者在头皮一侧使用免疫调节药物治疗，另一侧作为对照。所有患者在治疗开始时和研究结束时均进行活检。组织标本进行组织学和免疫表型分析。主要观察指标是二苯甲酮（DPCP）和局部他克莫司作为两种局部免疫治疗 AA 的方法的应用。
A 组（用 DPCP 治疗）的临床缓解率为 68%，而 B 组（用 0.1%他克莫司治疗）的临床缓解率无显著差异。与 DPCP 治疗后的区域相比，DPCP 治疗后的区域 CD4 的表达减少，CD8 和 MHC II 的表达增加。在他克莫司治疗的病例中，CD4 和 MHC II 减少，而 CD8 在预处理和后处理区域之间没有变化。
DPCP 是治疗 AA 的最可接受的治疗方法之一，在斑片状脱发中具有良好的预后。MHC II 的表达与临床反应相关。尽管他克莫司在其他皮肤病中有益，但不能认为它在治疗 AA 中有效。
