Effect of PUVA, narrow-band UVB and cyclosporin on inflammatory cells of the psoriatic plaque.
BACKGROUND
Because antigen presenting is necessary for T-cell activation, antigen-presenting cells should be involved in the pathogenesis of psoriasis. In this study, our purpose was to evaluate and compare effects of PUVA, cyclosporine A and narrow-band UVB on dendritic cells and activated lymphocytes in the psoriatic lesions.


METHODS
Forty-five volunteered patients (15 patients in each treatment group as PUVA, cyclosporin A and narrow-band UVB) were enrolled in this study. Lesional skin biopsies were taken from each patient before and after treatments. Fresh frozen biopsies were studied for the expressions of CD1a, CD68, CD86, CD4, CD8 and HLA-DR proteins by immunohistochemistry.


RESULTS
There was no correlation between severity of the lesions and expressions of the antigens. Only PUVA significantly decreased CD1a+ epidermal Langerhans cells' (LCs) counts. Treatment modalities decreased expression of costimulator CD86, and most of them decrease antigen-presenting capacity of skin by decreasing HLA class-II expression.


CONCLUSIONS
All treatment modalities equally reduce lymphocytes, macrophages and dendritic cells. PUVA is the only treatment that decreases epidermal LCs. All treatments effectively diminish expression of CD86 and inhibit this step of inflammation.
Erkin
Gul
G
Department of Dermatology, Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey. gulerkin@hacettepe.edu.tr
Uğur
Yeşim
Y
Gürer
Cansel Köse
CK
Aşan
Esin
E
Korkusuz
Petek
P
Sahin
Sedef
S
Kölemen
Fikret
F
D000938:Antigen-Presenting Cells / Q000187:drug effects / Q000276:immunology / Q000528:radiation effects; D015703:Antigens, CD / Q000378:metabolism; D002452:Cell Count; D016572:Cyclosporine / Q000627:therapeutic use*; D003713:Dendritic Cells / Q000187:drug effects / Q000276:immunology / Q000528:radiation effects; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015603:Keratinocytes / Q000187:drug effects / Q000276:immunology / Q000528:radiation effects; D016131:Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology / Q000528:radiation effects; D008264:Macrophages / Q000187:drug effects / Q000276:immunology / Q000528:radiation effects; D011701:PUVA Therapy; D011565:Psoriasis / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D012867:Skin / Q000187:drug effects / Q000276:immunology / Q000528:radiation effects; D014467:Ultraviolet Therapy
D015703:Antigens, CD; D007166:Immunosuppressive Agents; D016572:Cyclosporine