Esgleyes-Ribot T, Chandraratna R A, Lew-Kaya D A, Sefton J, Duvic M
Department of Dermatology, University of Texas Medical School at Houston 77030.
J Am Acad Dermatol. 1994 Apr;30(4):581-90. doi: 10.1016/s0190-9622(94)70066-4.
Oral retinoids have been widely used in psoriasis, but topical forms have been ineffective or irritating.
Our purpose was to determine the clinical and molecular effects of a new topical retinoid, AGN 190168, on psoriasis.
Seven patients with psoriasis were treated for 2 weeks with topical retinoid and 2 weeks with vehicle. Two control subjects with psoriasis were treated for 2 weeks with vehicle alone. Biopsy specimens from normal skin as well as from untreated and treated psoriatic lesions were compared by immunohistochemical analysis. Differentiation and inflammatory markers were studied.
Clinical improvement was seen in all seven patients after 2 weeks of treatment. Improvement was still present, but not significant, after 2 additional weeks of vehicle application. Histologic examination showed a return to a more normal morphology in four of seven biopsy specimens, which correlated with filaggrin expression. There was a diminution in the precocious expression of keratinocyte transglutaminase, keratin 16, and involucrin, as well as a decrease in epidermal growth factor receptor and in the number of cells expressing intercellular adhesion molecule type 1 and HLA-DR.
Clinical and histologic improvements were seen in psoriasis in association with the topical application of AGN 190168 at 2 weeks, including decreased inflammation and restoration of normal epidermal differentiation. Small patient numbers and the possibility that the changes were related to clinical improvement alone and not the topical agent preclude definitive conclusions.
口服维甲酸已广泛应用于银屑病治疗，但外用剂型效果不佳或有刺激性。
我们的目的是确定一种新型外用维甲酸AGN 190168对银屑病的临床和分子效应。
7例银屑病患者接受外用维甲酸治疗2周，然后接受赋形剂治疗2周。2例银屑病对照受试者仅接受赋形剂治疗2周。通过免疫组织化学分析比较正常皮肤以及未治疗和治疗后的银屑病皮损的活检标本。研究分化和炎症标志物。
治疗2周后，所有7例患者均有临床改善。再应用2周赋形剂后，改善仍然存在，但不显著。组织学检查显示，7例活检标本中有4例恢复到更正常的形态，这与丝聚合蛋白表达相关。角质形成细胞转谷氨酰胺酶、角蛋白16和内披蛋白的早熟表达减少，同时表皮生长因子受体以及表达细胞间黏附分子1和HLA-DR的细胞数量也减少。
外用AGN 190168 2周后，银屑病出现临床和组织学改善，包括炎症减轻和正常表皮分化恢复。由于患者数量少，且这些变化可能仅与临床改善有关，而非与外用药物有关，因此无法得出明确结论。
