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Clinical and molecular evaluation of therapy with the use of cyclosporine A in patients with psoriasis vulgaris
Author(s) -
MichalskaBańkowska Anna,
WcisłoDziadecka Dominika,
Grabarek Beniamin,
Mazurek Urszula,
BrzezińskaWcisło Ligia,
Michalski Piotr
Publication year - 2019
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.14275
Subject(s) - psoriasis , medicine , psoriasis area and severity index , dermatology life quality index , diabetes mellitus , metabolic syndrome , body mass index , pharmacotherapy , gastroenterology , disease , dermatology , endocrinology
Background Psoriasis course involves increased secretion of pro‐inflammatory cytokines, among others, a beta transforming growth factor ( TGF βs) and its receptors. Cyclosporine A (CsA), an immunosuppressive medicine with the molecular mechanism of operation connected with the properties of cell cycle suppression, is often used in the treatment of severe forms of psoriasis. The efficacy of therapy is assessed based on the disease clinical progression indexes – Psoriasis Area and Severity Index ( PASI ), body surface area ( BSA ), and Dermatology Life Quality Index ( DLQI ). The aim of the study was the evaluation of the efficacy of the CsA treatment of patients with psoriasis vulgaris, based on the clinical parameters and an assessment of the expression profiles of TGF βs and TGF βRs, depending on the concurrent diabetes and metabolic syndrome. Methods The group under study composed of 32 patients (15 with the metabolic syndrome, seven with diabetes) treated with CsA for 84 days. The molecular analysis included extraction of RNA , assessment of TG β F1‐3, TGF β RI ‐ III gene expression with the use of the RT q PCR method. The clinical assessment of the effects of this pharmacotherapy involved evaluation of the parameters: PASI , BSA , DLQI before therapy commencement, on the 42nd and 84th days of therapy. Results A statistically significant change in the transcription activity of TGF β 1 in patients with and without diabetes ( P = 0.018) and patients with and without metabolic syndrome ( P = 0.023) was shown that on the 84th day of therapy. Conclusions TGF b1 may be claimed as the supplementary molecular marker to evaluate the efficacy of CsA therapy. It seems that systemic diseases have an effect on the efficacy of the applied pharmacotherapy and the course of psoriasis.