title: ALA-Photodynamic treatment in Lichen sclerosus-clinical and immunological outcome focusing on the assesment of antinuclear antibodies.
abstract: BACKGROUND
  Lichen sclerosus (LS) is a difficult to treat, often relapsing disease with unknown background. Autoimmune diseases also coexist with LS. Over recent years photodynamic therapy (PDT) has been shown to be a noninvasive and successful therapeutic approach for the effective treatment of many conditions. However, the change of immune status of the patients based on ANA antibodies has not been yet reported. Our aim was to observe the clinical response followed by possible changes in autoimmune antibodies levels before and after PDT for LS.
  
  
  METHODS
  We enrolled 100 women with Lichen sclerosus with or without a concomitant autoimmune disease. All patients received 10 cycles of PDT (65 treated with DIOMED Light, 35 with PhotoDYN Light). We assessed autoimmune antibodies before and after PDT in addition to the clinical response evaluation.Two-year prospective controlled before-and-after study.
  
  
  RESULTS
  Following PDT, patients showed a significant attenuation in symptoms' intensity (itching, pruritus, vulvar discomfort). After therapy 41% of patients had partial response, 51% of patients had no symptoms and 8% had persistent or worsened symptoms. The most frequent autoimmune disease were thyroid disorders, followed by vitiligo and arthritis. 57% patients with an additional autoimmune disease before PDT had ANA antibodies. The mean level of ANA in this group diminished significantly after PDT treatment (261.74 IU/ml before vs. 123.20 IU/ml after treatment).
  
  
  CONCLUSIONS
  Based on our results, we assume that PDT may influence the immune status of patients with Lichen sclerosus.
authors.affiliation: School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Department of Gynecology, Obstetrics and Oncological Gynecology, Batorego 15, 41-902, Bytom, Poland.
authors.forename: Anita
authors.initials: A
authors.lastname: Olejek
authors.affiliation: School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Department of Gynecology, Obstetrics and Oncological Gynecology, Batorego 15, 41-902, Bytom, Poland; Division of Urogynecology, Brigham and Women's Hospital, Boston, USA.
authors.forename: Iwona
authors.initials: I
authors.lastname: Gabriel
authors.affiliation: School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Department of Gynecology, Obstetrics and Oncological Gynecology, Batorego 15, 41-902, Bytom, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Bilska-Janosik
authors.affiliation: School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Department of Gynecology, Obstetrics and Oncological Gynecology, Batorego 15, 41-902, Bytom, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Kozak-Darmas
authors.affiliation: School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Batorego 15, 41-902, Bytom, Poland. Electronic address: akawczyk@gmail.com.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Kawczyk-Krupka
mesh_terms: D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D000974:Antibodies, Antinuclear / Q000276:immunology*; D016207:Cytokines / Q000276:immunology*; D004305:Dose-Response Relationship, Drug; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects / Q000276:immunology / Q000528:radiation effects; D007155:Immunologic Factors / Q000276:immunology; D018459:Lichen Sclerosus et Atrophicus / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000974:Antibodies, Antinuclear; D016207:Cytokines; D007155:Immunologic Factors; D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid
keywords: Autoimmune antibodies; Autoimmune disorders; Lichen sclerosus; Photodynamic therapy