title: Bath-PUVA therapy improves impaired resting regulatory T cells and increases activated regulatory T cells in psoriasis.
abstract: BACKGROUND
  Bath-psoralen plus ultraviolet light A (PUVA) therapy is an effective, safe, and inexpensive treatment for psoriasis. Psoriasis might be due to an unbalanced ratio of Th17 cells and regulatory T cells (Treg). The Treg functional ratio is significantly lower in patients with psoriasis compared with controls and is inversely correlated with the Psoriasis Area and Severity Index score. We previously reported that bath-PUVA therapy significantly increases the number of Treg and restores Treg function to almost normal in most patients with psoriasis.
  
  
  OBJECTIVE
  We examined the effects of bath-PUVA therapy on three distinct Foxp3+subsets: activated Treg (aTreg), resting Treg (rTreg), and cytokine-secreting non-suppressive T cells.
  
  
  METHODS
  We enrolled 15 patients with psoriasis and 11 healthy controls. We examined aTreg, rTreg, and cytokine-secreting non-suppressive T cells in peripheral blood obtained from the psoriasis patients before and after every fifth bath-PUVA therapy session.
  
  
  RESULTS
  Levels of aTreg, which are considered to have the strongest suppressive activity in patients with psoriasis, were significantly increased in the early bath-PUVA therapy sessions, and then diminished. Levels of rTreg were lower in psoriasis patients than in healthy controls, and increased during bath-PUVA therapy.
  
  
  CONCLUSIONS
  Bath-PUVA therapy induced aTreg and rTreg concomitantly with an improvement in the psoriatic lesions, suggesting a mechanism for the effectiveness of bath-PUVA therapy for psoriasis patients.
authors.affiliation: Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kubo
authors.affiliation: Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Muramatsu
authors.affiliation: Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Sagawa
authors.affiliation: Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Chiyo
authors.initials: C
authors.lastname: Saito
authors.affiliation: Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Kasuya
authors.affiliation: Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nishioka
authors.affiliation: Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Nishida
authors.affiliation: Department of Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Sayuri
authors.initials: S
authors.lastname: Yamazaki
authors.affiliation: Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. Electronic address: amorita@med.nagoya-cu.ac.jp.
authors.forename: Akimichi
authors.initials: A
authors.lastname: Morita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001494:Baths; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism; D006801:Humans; D008297:Male; D008730:Methoxsalen / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011701:PUVA Therapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011565:Psoriasis / Q000097:blood / Q000188:drug therapy*; D012720:Severity of Illness Index; D050378:T-Lymphocytes, Regulatory / Q000187:drug effects* / Q000378:metabolism; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D017319:Photosensitizing Agents; D008730:Methoxsalen
keywords: Bath-PUVA therapy; Cytokines; Psoriasis; Regulatory; T-Lymphocytes; Ultraviolet therapy