Immunotherapy with Mycobacterium vaccae in the treatment of psoriasis.
A placebo-controlled study of immunotherapy with Mycobacterium vaccae for chronic plaque psoriasis showed improvement in the psoriasis area severity index in 19 of 21 immunotherapy recipients (P<0.005). Minor improvement, not reaching statistical significance for the group, occurred in nine of 14 placebo recipients. There were losses to follow-up and the placebo used, tetanus toxoid, was not ideal. Clinical improvement after immunotherapy persisted for 6 months and another injection of the immunotherapeutic given to a few volunteers from either group resulted in benefits lasting a year. Lymphoproliferative tests were carried out at each clinic visit, and on 50 matched controls. Starting with reduced responses to mycobacterial antigens and concanavalin A, both treatment groups showed a fall after 3 months, and diverged at 6 months with M. vaccae recipients rising to values similar to those of healthy controls, whereas placebo recipients continued to fall. Conclusions reached were that immunotherapy with M. vaccae gave long-lasting clinical benefit to most patients, with minimal side effects. This accompanied a return towards normal cellular immune responsiveness to mycobacterial antigens, which did not follow the use of the placebo.
Lehrer
A
A
Servicio de Dermatologia del Hospital Provincial de Rosario, Argentina.
Bressanelli
A
A
Wachsmann
V
V
Bottasso
O
O
Bay
M L
ML
Singh
M
M
Stanford
C
C
Stanford
J
J
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology*; D001426:Bacterial Proteins; D002478:Cells, Cultured; D018834:Chaperonin 60; D018833:Chaperonins / Q000276:immunology; D003208:Concanavalin A / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D016233:Immunotherapy, Active; D008213:Lymphocyte Activation / Q000276:immunology; D009161:Mycobacterium / Q000276:immunology*; D009162:Mycobacterium avium / Q000276:immunology; D009169:Mycobacterium tuberculosis / Q000276:immunology; D011565:Psoriasis / Q000276:immunology / Q000628:therapy*; D012720:Severity of Illness Index
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D018834:Chaperonin 60; C074119:heat-shock protein 65, Mycobacterium; D003208:Concanavalin A; D018833:Chaperonins