The effect of topical corticosteroids in combination with alefacept on circulating T‐cell subsets in psoriasis

Autor: Jorn H. Bovenschen, Peter C.M. van de Kerkhof, Annechien M. G. Langewouters, Piet E.J. van Erp, Elke M G J de Jong
Rok vydání: 2007
Předmět:
Adult
Male
medicine.medical_specialty
medicine.drug_class
Administration
Topical
Recombinant Fusion Proteins
T cell
Population
Alefacept
Dermatology
Injections
Intramuscular
Severity of Illness Index
Auto-immunity
transplantation and immunotherapy [N4i 4]
Double-Blind Method
Antigens
CD
T-Lymphocyte Subsets
Psoriasis
medicine
Humans
Lymphocyte Count
Clinical efficacy
education
Glucocorticoids
Aged
Chronic inflammation and autoimmunity [UMCN 4.2]
Analysis of Variance
education.field_of_study
business.industry
Middle Aged
Flow Cytometry
medicine.disease
Peripheral blood
Pathogenesis and modulation of inflammation [N4i 1]
medicine.anatomical_structure
Toxicity
Corticosteroid
Drug Therapy
Combination
Female
Dermatologic Agents
Clinical Pharmacology and physiology [CTR 2]
business
Follow-Up Studies
medicine.drug
Zdroj: Journal of Dermatological Treatment, 18, 5, pp. 279-85
Journal of Dermatological Treatment, 18, 279-85
ISSN: 1471-1753
0954-6634
DOI: 10.1080/09546630701395044
Popis: Contains fulltext : 51451.pdf (Publisher’s version ) (Closed access) BACKGROUND: Novel therapies against psoriasis are emerging. Alefacept is such a treatment. It selectively targets the memory effector population of T cells and thereby diminishes the psoriatic plaques. In some cases, however, the use of alefacept as a monotherapy is not sufficient. OBJECTIVE: In the present study we investigate the safety and efficacy of adding topical steroids to alefacept treatment during the initial 4 weeks. METHODS: Peripheral blood was obtained from all patients and the presence of specific T-cell subsets was assessed by flow cytometry. Fourteen patients were included and treated with 15 mg alefacept intramuscularly for a period of 12 weeks. Each of them was randomized to use either betamethasone-dipropionate cream or a vehicle cream during the first 4 weeks of the alefacept course. RESULTS: Additional topical corticosteroid treatment during the first 4 weeks of alefacept treatment does not have a beneficial effect on the clinical efficacy. Marked changes were seen in the absolute cell counts of various of the analysed T-cell subsets in peripheral blood after 12 weeks of alefacept, either with or without additional local steroid application. The CD45RO+, CD8+CD45RO+, CD8+CD161+, CD4+CD25+, CD4+CLA+ and CD8+CLA+ populations showed a statistically significant decrease immediately after the treatment period. Further analysis revealed that the addition of local steroid therapy to alefacept results in marked decreases of all T-cell subsets analysed in this study, in contrast to the addition of the vehiculum only. CONCLUSION: Alefacept selectively targets the CD45RO+ lymphocyte population, as well as some other subpopulations of lymphocytes. This effect is independent of the use of additional topical therapy during the first 4 weeks. The extent of the decrease, on the contrary, is dependent on the use of corticosteroids.
Databáze: OpenAIRE
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