光动力疗法治疗硬化性苔藓——聚焦抗核抗体评估的临床及免疫学结果

ALA-Photodynamic treatment in Lichen sclerosus-clinical and immunological outcome focusing on the assesment of antinuclear antibodies.

作者信息

Olejek Anita, Gabriel Iwona, Bilska-Janosik Anna, Kozak-Darmas Iwona, Kawczyk-Krupka Aleksandra

机构信息

School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Department of Gynecology, Obstetrics and Oncological Gynecology, Batorego 15, 41-902, Bytom, Poland.

出版信息

Photodiagnosis Photodyn Ther. 2017 Jun;18:128-132. doi: 10.1016/j.pdpdt.2017.02.006. Epub 2017 Feb 17.

DOI:10.1016/j.pdpdt.2017.02.006

PMID:28219801

Abstract

BACKGROUND

Lichen sclerosus (LS) is a difficult to treat, often relapsing disease with unknown background. Autoimmune diseases also coexist with LS. Over recent years photodynamic therapy (PDT) has been shown to be a noninvasive and successful therapeutic approach for the effective treatment of many conditions. However, the change of immune status of the patients based on ANA antibodies has not been yet reported. Our aim was to observe the clinical response followed by possible changes in autoimmune antibodies levels before and after PDT for LS.

MATERIAL AND METHODS

We enrolled 100 women with Lichen sclerosus with or without a concomitant autoimmune disease. All patients received 10 cycles of PDT (65 treated with DIOMED Light, 35 with PhotoDYN Light). We assessed autoimmune antibodies before and after PDT in addition to the clinical response evaluation.Two-year prospective controlled before-and-after study.

RESULTS

Following PDT, patients showed a significant attenuation in symptoms' intensity (itching, pruritus, vulvar discomfort). After therapy 41% of patients had partial response, 51% of patients had no symptoms and 8% had persistent or worsened symptoms. The most frequent autoimmune disease were thyroid disorders, followed by vitiligo and arthritis. 57% patients with an additional autoimmune disease before PDT had ANA antibodies. The mean level of ANA in this group diminished significantly after PDT treatment (261.74 IU/ml before vs. 123.20 IU/ml after treatment).

CONCLUSION

Based on our results, we assume that PDT may influence the immune status of patients with Lichen sclerosus.

摘要

背景

硬化性苔藓（LS）是一种难以治疗且常复发的疾病，病因不明。自身免疫性疾病也与LS共存。近年来，光动力疗法（PDT）已被证明是一种有效治疗多种疾病的非侵入性成功治疗方法。然而，基于抗核抗体（ANA）抗体的患者免疫状态变化尚未见报道。我们的目的是观察LS患者接受PDT治疗前后的临床反应以及自身免疫抗体水平的可能变化。

材料与方法

我们纳入了100例患有或不伴有自身免疫性疾病的硬化性苔藓女性患者。所有患者均接受10个周期的PDT治疗（65例使用DIOMED光，35例使用PhotoDYN光）。除了临床反应评估外，我们还评估了PDT治疗前后的自身免疫抗体。这是一项为期两年的前瞻性对照前后研究。

结果

PDT治疗后，患者症状强度（瘙痒、外阴不适）显著减轻。治疗后，41%的患者有部分反应，51%的患者无症状，8%的患者症状持续或加重。最常见的自身免疫性疾病是甲状腺疾病，其次是白癜风和关节炎。57%在PDT治疗前患有其他自身免疫性疾病的患者有ANA抗体。该组患者ANA的平均水平在PDT治疗后显著降低（治疗前为261.74 IU/ml，治疗后为123.20 IU/ml）。