Effects of narrowband UV-B on pharmacodynamic markers of response to therapy: an immunohistochemical study over sequential samples.
BACKGROUND
To evaluate the effects of narrow-band UV-B (NBUVB) on the immunohistochemical markers of cellular and cytokine activation as well as of abnormal epidermal differentiation and proliferation--pharmacodynamic markers of response to therapy (PMT)--in psoriatic lesions.


METHODS
Clinical assessments and immunohistological staining of formalin-fixed paraffin sections of biopsies from psoriatic skin were done at baseline and at the end of the treatment period.


RESULTS
Ten patients with chronic plaque-type psoriasis were included. After treatment with NBUVB, the total number of CD3+, CD4+ and CD8+ T cells was reduced by an average of 86.6%, 86% and 85% in the epidermis and 70.3%, 70% and 62% in the dermis, respectively. Only the decrease in the number of epidermal CD4+ cells was statistically related with long-lasting remissions. The mean reduction in the expression of keratinocyte proliferation markers after NBUVB was 62%, 68% and 81% for Ki-67, cyclin A and cyclin B, respectively. Expression of suprabasal keratin 16 and filaggrin was almost normalized in most cases. All patients in whom expression of keratin16 remained after finishing UV-B therapy had an early relapse.


CONCLUSIONS
NBUVB is associated with changes in PMT close to those seen after remittive therapies. The normalization of immunohistochemical parameters of differentiation and the reduction/depletion in epidermal CD4+ cells was the most important markers of long-lasting remissions.
Carrascosa
Jose-Manuel
JM
Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. jmcarrascosac.germanstrias@gencat.net
Tapia
Gustavo
G
Bielsa
Isabel
I
Fuente
Maria-Jose
MJ
Ferrandiz
Carlos
C
D015703:Antigens, CD / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D019925:Cyclin A / Q000378:metabolism; D019926:Cyclin B / Q000378:metabolism; D020405:Dermis / Q000378:metabolism / Q000473:pathology / Q000528:radiation effects; D004817:Epidermis / Q000378:metabolism / Q000473:pathology / Q000528:radiation effects; D005260:Female; D000091344:Filaggrin Proteins; D006801:Humans; D007124:Immunoenzyme Techniques; D007381:Intermediate Filament Proteins / Q000378:metabolism; D053536:Keratin-16 / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000378:metabolism* / Q000473:pathology / Q000532:radiotherapy*; D012867:Skin / Q000378:metabolism* / Q000473:pathology / Q000528:radiation effects; D016176:T-Lymphocyte Subsets / Q000378:metabolism / Q000473:pathology; D016896:Treatment Outcome; D014467:Ultraviolet Therapy
D015703:Antigens, CD; D015415:Biomarkers; D019925:Cyclin A; D019926:Cyclin B; C000717249:FLG protein, human; D000091344:Filaggrin Proteins; D007381:Intermediate Filament Proteins; C507431:KRT16 protein, human; D053536:Keratin-16; D019394:Ki-67 Antigen