A pilot study of the effect of oral 8-methoxypsoralen and intraarticular ultraviolet light on rheumatoid synovitis.
OBJECTIVE
To determine the feasibility and safety of combining oral 8-methoxypsoralen (8-MOP) and intraarticular ultraviolet A band light (UVA) to treat rheumatoid synovitis, and to demonstrate a favorable biological effect.


METHODS
Six patients with rheumatoid arthritis (RA) and clinically evident knee synovitis were given a single oral dose of 8-MOP (0.6 mg/kg) followed by arthroscopy with a UVA laser equipped small arthroscope. Nine tissue samples treated with UVA doses ranging from 4 to 52 J/cm2 were examined by light microscopy and by immunohistochemistry for vascular cell adhesion molecule 1 (VACM-1), intracellular adhesion molecule 1 (ICAM-1), E-selectin and HLA-DR expression.


RESULTS
No reduction in inflammation was evident on light microscopy, nor was there any evidence of tissue injury on gross inspection or light microscopy. At 28 and 52 J/cm2, VCAM-1, ICAM-1 and E-selectin staining were reduced in the posttreatment synovial biopsies. No local or systemic complications were observed by Day 30 in any patient.


CONCLUSIONS
This treatment modality appears to be feasible and safe and may potentially be useful in the treatment of the synovitis associated with RA.
Laing
T J
TJ
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
Ike
R W
RW
Griffiths
C E
CE
Richardson
B C
BC
Grober
J S
JS
Keroack
B J
BJ
Toth
M B
MB
Railan
D
D
Cooper
K D
KD
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000473:pathology; D001706:Biopsy; D015815:Cell Adhesion Molecules / Q000032:analysis; D019040:E-Selectin; D005240:Feasibility Studies; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000032:analysis; D007719:Knee Joint / Q000473:pathology; D008297:Male; D008730:Methoxsalen / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D010865:Pilot Projects; D013583:Synovial Membrane / Q000098:blood supply / Q000737:chemistry; D013585:Synovitis / Q000188:drug therapy* / Q000473:pathology; D014467:Ultraviolet Therapy; D019010:Vascular Cell Adhesion Molecule-1
D015815:Cell Adhesion Molecules; D019040:E-Selectin; D006684:HLA-DR Antigens; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D008730:Methoxsalen