Abstract
Psoriasis is a multifactorial disease with a dysregulation in immune system. The aim of this study was to survey the clinical efficacy and safety of muramyl peptide—the ligand of the receptors of innate immunity (drug Licopid, AO Peptek, Moscow, Russia) in patients with psoriasis. The effect of muramyl peptide on 86 patients with different severity of plaque psoriasis was tested. The Psoriasis Area and Severity Index (PASI), cytokine status and production of nitric oxide in blood serum, and the subsequent course of psoriasis have been evaluated. Evaluation of significance of observed differences was presented by the Student's t-test. As a result of the treatment, clinical cure or improvement was detected in 98.2% of patients (p < 0.05), while 24.4% had a complete cure. Subsequent observations during 4 years showed that patients who received muramyl peptide statistically significantly increased relapse-free period. Moreover, subsequent relapses of the disease after treatment with muramyl peptide were in much more milder form in the cases of mild psoriasis. The conducted studies showed that monotherapy with muramyl peptide stopped the clinical manifestations of psoriasis, normalized the processes of cytokine-dependent [interleukin (IL)−4, IL-10, IL-12, tumor necrosis factor alpha (TNF-α)] regulation of the immune response and nonspecific resistance, expressed in a decreasing amount of serum antigens sCD54 [soluble intercellular adhesion molecule-1 (sICAM-1)] to reference values (p ≤ 0.01). Taken together, our research demonstrated the effectiveness of therapy with muramyl peptide and moreover, that elevated levels of sCD54 and MIF (p ≤ 0.01) in the serum of patients with psoriasis considered as potential biomarkers of the severityof psoriasis and control over their dynamics have prognostic significance in determining the effectiveness of the therapy.
Highlights
Psoriasis is a chronic, noncommunicable, painful, disfiguring, and disabling disease for which there is no cure with negatively impact clinical outcomes and quality of life [1]
In the treatment of all patients with psoriasis, a medicine based on N-acetylglucosaminyl-N-acetylmuramyldipeptide (GMDP, drug Licopid R, AO Peptek, Moscow, Russia) was used for 1 tablet (10 mg) for half an hour before meals 2 times a day during 20 days
The carried out investigation have shown high therapeutic efficiency and safety of application of muramyl peptide at psoriasis
Summary
Noncommunicable, painful, disfiguring, and disabling disease for which there is no cure with negatively impact clinical outcomes and quality of life [1]. It should be noted that the psoriatic process is most sensitive to immunosuppressive effects (methotrexate, cyclosporine, psoralen and ultraviolet A (PUVA) therapy, biologically active drugs). Such therapies are often accompanied by unwanted side effects, often leading to more severe clinical relapses, which significantly limit the range of their use [18,19,20]. The emergence of a persistent imbalance in the immune system underlying the cellularmolecular mechanism of the development of pathological processes in psoriasis has created the prerequisites for the development of treatment methods that can effectively affect the pathogenesis of the disease and thereby lead to healing. The use of drugs that can target specific receptors of innate immunity, such as muramyl peptide (MP), is pathogenetically substantiated in the treatment of psoriasis
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