The efficacy of narrow-band ultraviolet B phototherapy in the treatment of patients with active chronic plaque psoriasis and its effect on peripheral blood levels of various T-lymphocyte subpopulations: A clinical and flow cytometric immunophenotypical study

摘要

Psoriasis is a chronic inflammatory T-rymphocyte-mediated cutaneous disease. Ultraviolet B radiation can suppress the immune system and reduce inflammatory responses and narrow-band ultraviolet B radiation (NB-UVB; wavelength of 311 ±2 nm) is an effective therapy for psoriasis . The objectives of the present study were to evaluate the efficacy of NB-UVB phototherapy in the treatment of patients with active chronic plaque psoriasis, as clinically revealed by the area (extent) and severity of psoriatic lesions, as well as to examine the effect of NB-UVB phototherapy on peripheral blood levels of various T-lymphocyte subpopulations (CD3+, CD4+, CD8+ T lymphocytes, natural killer/T (NK/T) cells (CD3+CD16+, CD3+CD56+ or CD3+CD16+CD56+), natural killer (NK) cells (CD3-CD16+, CD3-CD56+ or CD3-CD16+CD56+), CD3+CLA+ [CLA = Cutaneous lymphocyte-associated antigen], CD3+CD8+CLA+, CD3+CD4+CD25+ and CD3+GD8+CD25+ T lymphocytes) in these patients. A third study objective was to examine whether the potential alterations in peripheral blood levels of the above-mentioned T-lymphocyte subpopulations after NB-UVB phototherapy in patients with active chronic plaque psoriasis could be used as therapeutic outcome measures and immunological parameters for assessing the efficacy of NB-UVB phototherapy. All study participants, Caucasian volunteers >18 years, signed an informed consent form, and ethical approval was obtained from the Ethics and Research Committee, Medical School, University of Athens, Greece. All experimental procedures were in accordance with the Helsinki Declaration of 1975, as amended in 1983. The test group included 20 untreated patients (12 males and eight females; age range 20-72 years; mean age 43.95 ± 15.46 years) with a clinical diagnosis of active chronic plaque psoriasis, while the control group comprised 10 individuals (one male and nine females; age range 33-65 years; mean age 43.80 ± 12.96 years) without active or past psoriasis. In both groups, participants exhibited no disease/condition that could potentially affect peripheral blood levels of T-lymphocyte subpopulations. Patients exhibiting absolute contraindications for NB-UVB phototherapy (e.g. lupus erythematosus) or subjected to systemic therapy for at least six months or topical therapy throughout the last two weeks of the four-week treatment period were excluded.