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Treatment of Severe Psoriasis with Low Dose Cyclosporin A and the Effect on the Helper‐suppressor T Cell Ratio in Peripheral Blood
Author(s) -
Sasaki Tetsuo,
Ikezawa Zenro,
Nakajima Hiroshi
Publication year - 1988
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.1988.tb01195.x
Subject(s) - psoriasis , cd8 , medicine , t lymphocyte , cytotoxic t cell , immunology , lymphocyte , endocrinology , pharmacology , immune system , in vitro , chemistry , biochemistry
Oral administration of cyclosporin A (CsA) 14 mg/kg/day has been reported to improve psoriasis in a double‐blind study. The purpose of this study was to evaluate the efficacy of a lower dose of CsA in severe psoriasis and to monitor lymphocyte subpopulations in peripheral blood in order to detect its mechanism of action. Eleven patients with severe, active psoriasis were treated only with oral administration of 5 mg/kg/day CsA twice a day for 3 months, during which they were closely examined, including single‐ and two‐color analysis of lymphocyte surface markers by flow cytometry using monoclonal antibodies. Seven patients showed improvement within a week, and the others within 2‐3 weeks. Five patients had total remission, 2 showed marked improvement, and 4 showed moderate improvement; no clinically important side effects, except hypertrichosis in 2 females were seen. In the peripheral blood of patients treated with CsA there was a decrease in the percentages of helper inducer (CD4 + 4B4 + )T(Thi) cells, while no significant decrease was found in those of suppressor inducer (CD4 + 2H4 + )T(Tsi), suppressor effector (CD8 + CD11 + )T(Tse), or cytotoxic (CD8 + CD11 ‐ )T(Tc) cells, resulting in a decrease in the ratio of Thi to Tsi, Tse and Tc. The activated helper (CD4 + HLA‐DR + )—suppressor (CD8 + HLA‐DR + )T cell ratio was also decreased. These immunological findings obtained from the patients were consistent with in vitro studies of CsA reported earlier and may well explain the effectiveness of CsA in psoriasis as observed in this study.