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Cannabinoids, loratadine and allopurinol as novel additions to the antipsoriatic ammunition
Author(s) -
Namazi MR
Publication year - 2005
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.1468-3083.2004.01184.x
Subject(s) - medicine , pharmacology , nitric oxide , tumor necrosis factor alpha , immunology , cytokine , cyclic guanosine monophosphate , cyclic adenosine monophosphate , histamine , psoriasis , receptor , endocrinology
ABSTRACT As the current antipsoriatic medications are commonly associated with deleterious side‐effects, a determined search for safer agents, which could be used alone or in combination with current antipsoriatic drugs, would be very imperative. Psoriasis is believed to be characterized by a type 1 cytokine pattern; interferon‐γ, interleukin (IL)‐2 and tumour necrosis factor (TNF)‐α are predominantly expressed in this disorder. Nitric oxide, reactive oxygen species, histamine, leukotriene B 4 , and increased keratinocyte cyclic adenosine monophosphate/cyclic guanosine monophosphate (cAMP/cGMP) ratio are supposed to play roles in the pathogenesis of this disorder. Based on the immunopathogenesis of psoriasis, this paper introduces three novel, potential treatments for this clinical conundrum: (i) cannabinoids, which exert inhibitory effects on antigen processing and macrophage/T‐cell interaction and also on the release of IL‐2, TNF‐α and nitric oxide from immune cells; (ii) loratadine, which is an antihistamine capable of decreasing the cAMP/cGMP ratio and the production of leukotriene B 4 ; and (iii) allopurinol, which scavenges free radicals, inhibits the production of TNF‐α, and downregulates the expression of intercellular adhesion molecule‐1 and P2X 7 receptors on monocytes/macrophages, which are involved in antigen presentation and production of the inflammatory response, respectively. Importantly, allopurinol, especially in combination with cyclosporin, has been shown to be effective against experimental autoimmune uveitis, which, like psoriasis, is a cell‐mediated autoimmune disorder.