engleski

Action mechanism of photochemotherapy (PUVA) in psoriatic patients

According to current concepts, psoriasis is an autoimmune, T-lymphocyte induced, cytokine and chemokine mediated disease. The exact cause of psoriasis remains unknown, therefore the treatment is symptomatic. PUVA photochemotherapy has for years been very successfully used in the treatment of psoriasis vulgaris involving more than 30% of the skin area but the mechanism of its action has not yet been fully elucidated. The aim of the study was to investigate the antiproliferative, antiangiogenic and apoptotic action of photochemotherapy (PUVA), and to compare it with the clinical picture of the disease.Proliferating keratinocyte count was immunohistochemically determined by use of anti Ki-67 antibodies, the number of blood vessels in the dermis by use of F-8 anti¬ ; bodies, and cell count expressing apoptotic oncogenes by use of anti bcl-2 antibodies, all these before and after photochemotherapy (PUVA). PASI score was determined before and after treatment. The study included 30 patients with psoriasis vulgaris with indications for photochemotherapy (PUVA). Study results demonstrated the antiproliferative, antiangiogenic and apoptotic action of photochemotherapy. Photochemotherapy (PUVA) was found to efficiently act on the main pathogenetic mechanisms of psoriasis, and to significantly improve the clin¬ ; ical picture of psoriasis patients. In spite of the ever growing fear from UV exposure, even for therapeutic pur¬ ; pose, we believe that because of its efficacy demonstrated in the present study, pho¬ ; tochemotherapy (PUVA) will for quite a while remain the first choice therapy in the man¬ ; agement of psoriasis vulgaris involving more than 30% of the skin area in patients free from contraindications for this therapy.

photochemotherapy (PUVA); psoriasis; T-lymphocyte

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