Mozzanica N, Pigatto P D, Finzi A F
Dermatology Institute, University of Milan, Italy.
Dermatology. 1993;187 Suppl 1:3-7. doi: 10.1159/000247285.
Cyclosporin has been used efficaciously in recent years for the management of severe psoriasis. The remarkable efficacy of this drug and its known immunosuppressive properties have indicated even more strongly the involvement of the immune system in the induction and maintenance of psoriasis. The present review summarizes the role of cellular immunity in the pathogenesis of psoriasis and possible mechanisms of action of cyclosporin in psoriasis, and describes the laboratory studies performed in our Department under two headings, changes in lesional immune infiltrate (evaluated immunohistologically) and changes in neutrophil chemotaxis during cyclosporin treatment. Our immunohistological study showed that the psoriatic plaques contained an infiltrate composed mainly of activated CD4+ T cells. Cyclosporin treatment significantly decreased T cells and normalized the distribution and antigen expression of intraepidermal Langerhans cells, increasing the number of CD1+ dendritic cells. Our studies on neutrophil chemotaxis showed that cyclosporin reduced the chemotactic activity of neutrophilic polymorphonuclear leukocytes (in vivo but not in vitro), seemingly as a consequence of blocking the production of chemoattracting cytokines by psoriatic monocytes.
近年来，环孢素已被有效地用于重度银屑病的治疗。这种药物的显著疗效及其已知的免疫抑制特性，更有力地表明了免疫系统在银屑病的诱发和维持过程中所起的作用。本综述总结了细胞免疫在银屑病发病机制中的作用以及环孢素在银屑病中的可能作用机制，并在两个标题下描述了我们科室进行的实验室研究，即皮损免疫浸润的变化（通过免疫组织学评估）和环孢素治疗期间中性粒细胞趋化性的变化。我们的免疫组织学研究表明，银屑病斑块中主要由活化的CD4 + T细胞组成浸润。环孢素治疗显著减少了T细胞，并使表皮内朗格汉斯细胞的分布和抗原表达正常化，增加了CD1 + 树突状细胞的数量。我们对中性粒细胞趋化性的研究表明，环孢素降低了嗜中性多形核白细胞的趋化活性（在体内而非体外），这似乎是由于阻断了银屑病单核细胞产生趋化细胞因子所致。
