Clinical and immunohistochemical assessment of the effect of cyclosporin in keratinocytes and dermal dendrocytes in psoriasis.
BACKGROUND
Cyclosporine is a potent immunosupressor, which induces cytokeratin expression pattern changes and dermal dendrocytes number increase.


OBJECTIVE
To evaluate its clinical effect in psoriasis, on keratinocytic proliferation and differentiation, and on dermal dendrocytes proliferation.


METHODS
Thirty patients with psoriasis were treated and evaluated for 8 weeks. Clinical improvement was evaluated by Psoriasis Area and Severity Index (PASI). Biopsies were performed initially and after 8 weeks. Immunohistochemistry [CK markers 10, 14, and 16, and factor XIIIa+ (FXIIIa+)] was performed.


RESULTS
Mean PASI before treatment was 26.32 and 3.71 after. Mean initial and final PASI difference was 22.61 (p < 0.001). Two patients had serum creatinine and six uric acid increase. Before and after treatment, mean numbers per field of dermal dendrocytes were 7.07 and 3.68, respectively. Mean difference was 3.39, with p < 0.001. CK10 immunohistochemical pattern demonstrated recovery of normal expression pattern in 26 patients, while CK14 pattern demonstrated improvement in 21 patients.


CONCLUSIONS
Cyclosporine was effective and safe for psoriasis in low doses, with significant decrease of PASI and dermal dendrocytes number after 8 weeks of therapy. CK10 and 14 pattern changed and, less prominently, CK16 expression. These modifications occur later than the PASI and dermal dendrocytes variation.
Lago
Eduardo
E
Sector of Dermatology and Post Graduation Course in Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. eduarudolago@eduardolago.med.br
Carneiro
Sueli
S
Cuzzi
Tullia
T
Magalhães
Geraldo
G
Cássia
Flavia
F
Pessanha
Fátima
F
Ramos-e-Silva
Marcia
M
D000328:Adult; D000368:Aged; D002454:Cell Differentiation / Q000187:drug effects; D049109:Cell Proliferation / Q000187:drug effects; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D003713:Dendritic Cells / Q000473:pathology*; D020405:Dermis / Q000473:pathology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D053550:Keratin-10 / Q000378:metabolism; D053547:Keratin-14 / Q000378:metabolism; D053536:Keratin-16 / Q000378:metabolism; D015603:Keratinocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D053547:Keratin-14; D053536:Keratin-16; D053550:Keratin-10; D016572:Cyclosporine