Cyclosporine improves psoriasis in a double-blind study.
Cyclosporine improves psoriasis in a double-blind study.
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在一项双盲研究中，环孢素可改善牛皮癣。
DOI：
10.1001/jama.1986.03380220076026
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
J. Voorhees
中科院分区：
文献类型：
--
作者：
C. Ellis;D. C. Gorsulowsky;T. Hamilton;J. Billings;Marc D. Brown;J. Headington;K. Cooper;O. Baadsgaard;E. Duell;T. Annesley;J. Turcotte;J. Voorhees
在一项双盲试验中，21例重度斑块状银屑病患者被随机分配接受口服环孢素，14 mg/kg/d，或其载体。治疗4周后，11名环孢素接受者对治疗有以下反应：2名完全清除，6名明显改善，2名中度改善，1名轻微改善;而10名接受溶媒治疗的患者无变化或改善极小。在改用环孢霉素四周后，接受载体治疗的患者表现出与最初仅接受环孢霉素的患者相似的令人印象深刻的改善。治疗1周和4周后，分别有17/21（81%）和20/21（95%）例患者出现中度或显著改善或完全清除。环孢素治疗7天后，病变中的有丝分裂像和白三烯B4水平分别下降了86%和64%。环孢素治疗7天后，所有患者皮损中单核细胞（包括活化T细胞）和多形核白细胞浸润均明显减少。这些结果表明，银屑病可能有一个由活化的T细胞和/或其他免疫细胞介导的免疫学基础，如果一个长期的方案，具有良好的疗效副作用比可以确定，环孢素将是一个显着的进步，在银屑病的治疗。
In a double-blind trial, 21 patients with severe plaque psoriasis were randomly assigned to receive oral cyclosporine, 14 mg/kg/d, or its vehicle. After four weeks of therapy the 11 cyclosporine recipients had the following response to treatment: two had total clearing and six improved markedly, two moderately, and one minimally; whereas ten vehicle-treated patients showed no change or minimal improvement. Vehicle-treated patients, after a switch to cyclosporine for four weeks, demonstrated impressive improvement similar to that seen in patients who initially received only cyclosporine. Moderate or marked improvement or total clearing was noted in 17 (81%) of 21 and 20 (95%) of 21 after one and four weeks of therapy, respectively. Mitotic figures and leukotriene B4 levels in lesions decreased 86% and 64%, respectively, after seven days of cyclosporine therapy. Mononuclear (including activated T cells) and polymorphonuclear leukocyte infiltrates were markedly reduced in lesions of all patients after seven days of cyclosporine therapy. These results suggest that psoriasis may have an immunologic basis mediated by activated T cells and/or other immune cells; if a long-term regimen with a favorable efficacy-side effect ratio can be determined, cyclosporine would be a significant advance in the treatment of psoriasis.