Berti E, Cerri A, Marzano A V, Richelda R, Bianchi B, Caputo R
Institute of Dermatological Science, University of Milan, IRCCS Ospedale Maggiore, Milan, Italy.
Eur J Dermatol. 1998 Sep;8(6):421-6.
The topical corticosteroids are widely used in the treatment of moderate psoriasis, because of their usefulness for reducing inflammation and controlling itching. The therapeutic effect of corticosteroids in different cutaneous inflammatory diseases may be partially explained by their varying ability to block in vitro the synthesis of different cytokines, which play a pivotal role in epidermal hyperproliferation and leukocyte recruitment into the skin. The purpose of the present investigation was to further elucidate the mode of action of mometasone furoate, a medium-high potency, topical corticosteroid, on adhesion molecules, cytokines and cytokine receptor expression in psoriatic skin. Using an immunohistochemical assessment, we examined lesional skin biopsies from ten psoriatic patients before treatment and after 1 and 3 weeks of therapy. The overexpression of alpha 2, alpha 3, alpha 6, and beta 1 integrins detected in the spinous layer of untreated psoriatic skin was significantly decreased after therapy in 8 out of 10 cases, characterized by only partial clinical remission. In the remaining patients, a disappearance of the above integrin reactivity paralleling the disappearance of psoriatic lesions was induced by the treatment. With the exception of GM-CSF, no or only marginal effects of mometasone furoate on the cytokine and cytokine receptor system were observed. A significant reduction of the positive immunostaining with anti-ICAM-1 and ICAM-2 monoclonal antibodies on dermal vascular endothelial cells was also seen. Thus, our findings indicate that the therapeutic effects of mometasone furoate in psoriasis are mediated principally by decreasing adhesion molecule expression and to a lesser degree by inhibiting cytokine synthesis.
外用糖皮质激素因其在减轻炎症和控制瘙痒方面的作用，被广泛用于中度银屑病的治疗。糖皮质激素在不同皮肤炎症性疾病中的治疗效果，可能部分归因于它们在体外阻断不同细胞因子合成的能力各异，而这些细胞因子在表皮过度增殖和白细胞向皮肤募集过程中起关键作用。本研究的目的是进一步阐明中高效外用糖皮质激素糠酸莫米松对银屑病皮肤中黏附分子、细胞因子及细胞因子受体表达的作用机制。我们采用免疫组织化学评估方法，检测了10例银屑病患者治疗前以及治疗1周和3周后皮损处的皮肤活检标本。10例患者中有8例在治疗后，其未治疗的银屑病皮肤棘层中检测到的α2、α3、α6和β1整合素的过表达显著降低，此时仅表现为部分临床缓解。在其余患者中，治疗诱导上述整合素反应性消失，同时银屑病皮损也消失。除粒细胞巨噬细胞集落刺激因子（GM-CSF）外，未观察到糠酸莫米松对细胞因子及细胞因子受体系统有作用或仅有轻微作用。真皮血管内皮细胞上抗细胞间黏附分子-1（ICAM-1）和ICAM-2单克隆抗体的阳性免疫染色也显著减少。因此，我们的研究结果表明，糠酸莫米松在银屑病中的治疗作用主要是通过降低黏附分子表达介导的，在较小程度上是通过抑制细胞因子合成介导的。
