Abstract
Goal. To study the dynamics of expression rates of growth factor proteins in psoriatic patients receiving the PUVA therapy. Materials and methods. The authors conducted a study of 30 patients with psoriasis vulgaris treated with the PUVA therapy. The psoriasis severity and extent of itching were assessed prior to and after the treatment by the PASI index and visual analogue scale, respectively. The expression of semaphorin 3A, amphiregulin, nerve growth factor and PGP 9.5 protein (a nerve fiber marker) in the skin was assessed by the indirect immunofluorescence method. The expression of PGP 9.5 protein was used to assess the quantity and mean length as well as average and total fluorescence intensity of nerve fibers. Results. An increased expression of amphiregulin and nerve growth factor as well as increase in the quantity, mean length and average and total fluorescence intensity of nerve fibers were revealed in the epidermis of psoriatic patients. Following a course of the PUVA therapy, a decrease in the PASI index and extent of itching, reduced expression of amphiregulin and nerve growth factor as well as reduced quantity, mean length and average and total fluorescence intensity of nerve fibers in the epidermis were observed. Direct correlation dependence between the extent of itching, amphiregulin and nerve growth factor expression level and quantity and length of nerve fibers in the epidermis was discovered. Direct correlation dependence between the amphiregulin and nerve growth factor expression level, and average length of nerve fibers in the epidermis was discovered. Conclusion. The itching intensity in psoriatic patients receiving the PUVA therapy is reduced due to the decreased skin expression of the nerve growth factor and amphiregulin.
Highlights
The authors conducted a study of 30 patients with psoriasis vulgaris treated with the PUVA therapy
The expression of semaphorin 3A, amphiregulin, nerve growth factor and PGP 9.5 protein in the skin was assessed by the indirect immunofluorescence method
An increased expression of amphiregulin and nerve growth factor as well as increase in the quantity, mean length and average and total fluorescence intensity of nerve fibers were revealed in the epidermis of psoriatic patients
Summary
Для терапии зуда используются блокаторы H1гистаминовых рецепторов, однако при хронических воспалительных заболеваниях кожи их эффективность недостаточна [11]. Уменьшение зуда при использовании УФА1фототерапии, узкополосной фототерапии 311 нм и ПУВА-терапии было отмечено у больных узловатым пруриго [41—43]. Применение фототерапии при атопическом дерматите приводит к снижению у больных интенсивности зуда и уменьшению числа нервных волокон в коже, особенно в эпидермисе [50]. В связи с этим противозудный эффект фототерапии связывается с уменьшением количества пруритоцептивных чувствительных нервных волокон в коже [51]. Sundler (2004), обследовав 4 больных псориазом после курса фототерапии, обнаружили у них исчезновение зуда и уменьшение числа нервных волокон в эпидермисе [51]. В то же время согласно имеющимся данным, у больных псориазом при проведении ПУВА-терапии и узкополосной средневолновой фототерапии отмечается развитие зуда как нежелательного явления [52, 53]. Цель исследования — изучить влияние ПУВА-терапии на интенсивность зуда у больных псориазом, выраженность иннервации кожи и экспрессию в коже белков факторов роста
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