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Cyclosporin A in the treatment of cutaneous vasculitis. Clinical and cellular effects
Author(s) -
Tosca A.D.,
Ioannidou D.J.,
Katsantonis J.C.,
Kyriakis K.P.
Publication year - 1996
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/j.1468-3083.1996.tb00156.x
Subject(s) - medicine , dermis , vasculitis , cell adhesion molecule , immune system , immunology , immunohistochemistry , integrin , systemic vasculitis , pathology , disease , receptor
Background Treatment of cutaneous vasculitis(CV) is an unsettled issue. Cyclosporin A (Cy‐A) has been successfully used in dermatoses with immunologic background. some systemic vasculitides and Behcet's disease. Objective To check the therapeutic potential of Cy‐A in severe or recalcitrant cases of CV was considered of interest. The effects on the in situ cell populations involved in the inflammatory‐immune events were further investigated. Methods An open clinical trial (12 cases) was carried out. An immunohistochemical study was also performed, evaluating skin specimens from established lesions, before and 48 h after Cy‐A first administration. The effect on endothelial adhesion molecules, integrin bearing leukocytes, T‐cells, lymphomononuclear cells and dendrocytes in the dermis as well as on epidermal antiyenic determinants focused our interest. Results Reduced endothelial ICAM‐1 expression was shown. Cy‐A was proved to adversely affect b2 integrin expression and therefore adhesion pathways. T‐cells, epidermal dendritic cells and dendrocytes were found decreased. On clinical grounds, a very early therapeutic response was noted. Tolerance was good in the dose of 5mg/kg/day. Relapses, however, have not been avoided. Conclusion Cy‐A seems to be very effective on both the clinical and cellular level where inflammatory‐immunologic events seem to be temporarily inhibited.