Lymphocytapheresis in the treatment of psoriasis vulgaris.
Psoriasis is a common autoimmune chronic inflammatory skin disease that affects approximately 2% of the world's population; fundamental for its immunopathogenic mechanism is secretion of type 1 (Th1) cytokines by T cells and their activation. Since cytapheresis has been widely applied to autoimmune disorders, emphasizing the recently reported results of granulocyte and monocyte adsorption apheresis in psoriasis, a small series of psoriasis vulgaris (PV) patients underwent lymphocytapheresis (LCA) with the aim to remove lymphocytes. Five patients were submitted to weekly LCA. The severity of the disease had been evaluated through psoriasis area and severity index (PASI) score before LCA and one week after the last apheresis. PASI score before: patient A: 66; patient B: 33; patient C: 50; patient D: 56; patient E: 29. All the patients showed improvement of skin lesions. PASI score after LCA: patient A: 24; patient B: 8; patient C: 5; patient D: 36; patient E: 2.1. No side effects linked to apheresis were reported. LCA seems to produce interesting results in PV, and PASI improvement related to apheresis is clinically significant. Further studies to address its mechanism of action and potential long-term side effects are needed. It could become a valuable therapeutic alternative or a complementary tool, which might even be used to reduce the dosages of conventional pharmacological therapies adopted for this chronic disease.
Liumbruno
Giancarlo Maria
GM
Apheresis Unit of Blood Bank and Transfusion Service, Hospital of Livorno, Livorno, Italy. giancarlo@liumbruno.it
Centoni
Paolo Emilio
PE
Molfettini
Pietra
P
Ceretelli
Silvia
S
Ceccarini
Massimo
M
Bachini
Laura
L
Pomponi
Adriano
A
Bagnoni
Giovanni
G
Vitolo
Margherita
M
Eberle
Olimpia
O
Biondi
Alessandro
A
Sodini
Maria Laura
ML
D000327:Adsorption; D000328:Adult; D001327:Autoimmune Diseases / Q000378:metabolism; D001781:Blood Component Removal; D005260:Female; D006098:Granulocytes / Q000166:cytology; D006801:Humans; D007249:Inflammation; D007937:Leukapheresis / Q000379:methods*; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology; D011565:Psoriasis / Q000473:pathology* / Q000628:therapy*; D012867:Skin / Q000378:metabolism