Glade C P, Van Erp P E, Van De Kerkhof P C
Department of Dermatology, University Hospital Nijmegen, Netherlands.
Br J Dermatol. 1996 Sep;135(3):379-84.
Calcipotriol and corticosteroids, two therapy modalities frequently prescribed in the treatment of psoriasis, are often used in combination. The aim of the present study was to determine whether the cell biological response pattern of concurrent use of calcipotriol and corticosteroids is different from calcipotriol monotherapy. Forty patients with chronic plaque psoriasis were divided at random in four parallel groups and treated for 8 weeks with: (1) calcipotriol cream (50 micrograms/g once daily); (2) calcipotriol cream twice daily; (3) calcipotriol and clobetasone 17-butyrate (0.5 mg/g) creams; and (4) calcipotriol and betamethasone 17-valerate (1 mg/g) creams. Before and after treatment keratotome biopsies were taken and single cell suspensions prepared for flow cytometric analysis. Flow cytometric multiparameter quantification of markers for proliferation (TO-PRO-3), differentiation (antikeratin 10) and inflammation (antivimentin) was used to evaluate all four therapy modalities. A statistically significant decrease of the percentage of basal cells in S- and G2M-phase (proliferation) was obtained with all therapy modalities, except for calcipotriol monotherapy applied once daily. A significant reduction of the number of vimentin-positive cells (non-keratinocytes) was observed following combined treatment with calcipotriol and clobetasone butyrate. In contrast, monotherapy with calcipotriol had virtually no effect on the number of vimentin-positive cells. It can be concluded that: (i) calcipotriol monotherapy, applied once daily was less antiproliferative compared with twice daily applications of calcipotriol or the combined treatment with corticosteroids and that (ii) the combination of calcipotriol and corticosteroids proved to have a marked effect on the percentage of non-keratinocytes, in contrast to the modest effect of calcipotriol.
钙泊三醇和皮质类固醇是治疗银屑病时常用的两种治疗方式，常联合使用。本研究的目的是确定钙泊三醇和皮质类固醇联合使用的细胞生物学反应模式是否与钙泊三醇单药治疗不同。40例慢性斑块状银屑病患者被随机分为4个平行组，接受8周的治疗：（1）钙泊三醇乳膏（50微克/克，每日一次）；（2）钙泊三醇乳膏每日两次；（3）钙泊三醇和丁酸氯倍他索（0.5毫克/克）乳膏；（4）钙泊三醇和戊酸倍他米松（1毫克/克）乳膏。治疗前后进行角膜刀活检，并制备单细胞悬液用于流式细胞术分析。使用流式细胞术对增殖标志物（TO-PRO-3）、分化标志物（抗角蛋白10）和炎症标志物（抗波形蛋白）进行多参数定量，以评估所有四种治疗方式。除每日一次应用钙泊三醇单药治疗外，所有治疗方式均使S期和G2M期（增殖）基底细胞百分比有统计学意义的下降。钙泊三醇与丁酸氯倍他索联合治疗后，波形蛋白阳性细胞（非角质形成细胞）数量显著减少。相比之下，钙泊三醇单药治疗对波形蛋白阳性细胞数量几乎没有影响。可以得出结论：（i）与每日两次应用钙泊三醇或与皮质类固醇联合治疗相比，每日一次应用钙泊三醇单药治疗的抗增殖作用较小；（ii）与钙泊三醇的适度作用相比，钙泊三醇与皮质类固醇联合使用对非角质形成细胞百分比有显著影响。
