Caproni M, Palleschi G M, Falcos D, Papi C, Lotti T
Department of Dermatology, University of Florence, Italy.
Int J Dermatol. 1995 Jul;34(7):510-3. doi: 10.1111/j.1365-4362.1995.tb00630.x.
Adhesion molecules play a major role in the pathogenesis of inflammatory skin diseases by regulating lymphocyte trafficking and homing in an inflamed area.
The expression of the lymphocyte function-associated antigen-1 (LFA-1) and of its ligand, the intercellular adhesion molecule-1 (ICAM-1) has been studied in psoriatic skin lesions of 10 patients with guttate, nummular, and palmoplantar psoriasis. In addition, the peculiar immunophenotype of infiltrating cells (CD3, CD4, CD8, CD25) and their correlation with HLA-DR expression before and after treatment with oral cetirizine, a highly selective, third generation H1-receptor antagonist has been examined using the labeled avidin biotin (LAB) system.
Cetirizine treatment modulated in vivo the expression of adhesion molecules LFA-1/CAM-1 as shown in all cases by decreased levels of their expression on keratinocytes and on dermal endothelial cells (P < 0.001). The expression of HLA-DR on keratinocytes and endothelial cells was also inhibited after treatment. The numbers of infiltrating CD3-, CD4-, CD8-positive cells were reduced, whereas there was no significant modification of CD25-positive cells within the epidermis and the dermis.
This open clinical trial suggests that cetirizine could be effective in treating psoriasis: (1) for its symptomatic control on itching; (2) for its immunopharmacologic modulation of leukocyte integrins and on the immunophenotype pattern of infiltrating and resident cells, and (3) for contributing to the clearing of the lesions clinically.
黏附分子通过调节淋巴细胞在炎症区域的迁移和归巢，在炎症性皮肤病的发病机制中起主要作用。
研究了10例点滴状、钱币状和掌跖部银屑病患者银屑病皮损中淋巴细胞功能相关抗原-1（LFA-1）及其配体细胞间黏附分子-1（ICAM-1）的表达。此外，使用标记抗生物素蛋白生物素（LAB）系统检测了口服西替利嗪（一种高选择性第三代H1受体拮抗剂）治疗前后浸润细胞的特殊免疫表型（CD3、CD4、CD8、CD25）及其与HLA-DR表达的相关性。
西替利嗪治疗在体内调节了黏附分子LFA-1/ICAM-1的表达，所有病例均显示角质形成细胞和真皮内皮细胞上它们的表达水平降低（P<0.001）。治疗后角质形成细胞和内皮细胞上HLA-DR的表达也受到抑制。浸润的CD3、CD4、CD8阳性细胞数量减少，而表皮和真皮内CD25阳性细胞无明显改变。
这项开放性临床试验表明，西替利嗪可能对治疗银屑病有效：（1）因其对瘙痒的症状控制；（2）因其对白细胞整合素的免疫药理调节以及对浸润细胞和驻留细胞免疫表型模式的调节；（3）因其有助于临床上皮损的消退。
