Dréno B
Department of Dermatology, C.H.U., Nantes, France.
Stem Cells. 1993 Jul;11(4):269-75. doi: 10.1002/stem.5530110403.
Many treatments are used for epidermotropic cutaneous T cell lymphomas (CTCL) such as mycosis fungoides (MF) and Sézary syndrome (SS). All pretend to be effective, but none is really curative. As single drug therapy provides a response rate of about 55% with interferon alpha and about 45% with etretinate, we studied the effectiveness of combining these two drugs for immunomodulatory therapy in epidermotropic CTCL. A review of four reports, including a multicenter study performed in 45 patients, indicates a response rate of 56%, with better results for MF than SS. Side effects are generally moderate when low doses are used. The mechanism of action of this combined therapy on cutaneous lesions remains unclear. In vitro, a synergistic effect of retinoids on interferon alpha antiviral activity has been demonstrated, and in vivo an immunohistochemical study showed that the combined therapy modulates antigens expressed by keratinocytes and increases cytotoxic cells in dermis without modifying the number of Langerhans cells in epidermis.
许多治疗方法被用于亲表皮性皮肤T细胞淋巴瘤（CTCL），如蕈样肉芽肿（MF）和塞扎里综合征（SS）。所有这些治疗方法都声称有效，但没有一种能真正治愈。由于单药治疗使用干扰素α时缓解率约为55%，使用阿维A酯时约为45%，我们研究了将这两种药物联合用于亲表皮性CTCL免疫调节治疗的有效性。对包括一项在45例患者中进行的多中心研究在内的四份报告的综述表明，缓解率为56%，MF的效果优于SS。使用低剂量时副作用一般较轻。这种联合治疗对皮肤病变的作用机制尚不清楚。在体外，已证明维甲酸对角质形成细胞的作用机制尚不清楚。在体外，已证明维甲酸对干扰素α抗病毒活性有协同作用，在体内一项免疫组织化学研究表明，联合治疗可调节角质形成细胞表达的抗原，并增加真皮中的细胞毒性细胞，而不改变表皮中朗格汉斯细胞的数量。
