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

Fulltext:
51451.pdf
Embargo:
until further notice
Size:
493.6Kb
Format:
PDF
Description:
publisher's version
Publication year
2007Source
Journal of Dermatological Treatment, 18, 5, (2007), pp. 279-85ISSN
Publication type
Article / Letter to editor

Display more detailsDisplay less details
Organization
Dermatology
Journal title
Journal of Dermatological Treatment
Volume
vol. 18
Issue
iss. 5
Page start
p. 279
Page end
p. 85
Subject
CTR 2: Clinical Pharmacology and physiology; N4i 1: Pathogenesis and modulation of inflammation; N4i 4: Auto-immunity, transplantation and immunotherapy; UMCN 4.2: Chronic inflammation and autoimmunityAbstract
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.
This item appears in the following Collection(s)
- Academic publications [227900]
- Electronic publications [107393]
- Faculty of Medical Sciences [86236]
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.