Treatment of rheumatoid arthritis by extracorporeal photochemotherapy. A pilot study.
Treatment of rheumatoid arthritis by extracorporeal photochemotherapy. A pilot study.
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体外光化疗治疗类风湿性关节炎。
DOI：
10.1002/art.1780340604
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发表时间：
1991
影响因子：
--
通讯作者：
Edelson,RL
中科院分区：
文献类型：
--
作者：
Malawista,SE;Trock,DH;Edelson,RL
在一项针对 7 名类风湿性关节炎患者的为期 6 个月的初步研究中，我们测试了一种治疗方法，该治疗方法涉及通过紫外线 A 能量将生物惰性的甲氧沙林 (8-甲氧基补骨脂素) 体外光活化为共价交联淋巴细胞 DNA 的形式；受伤的细胞被重新注入患者体内。先前的实验研究表明，该方案可针对治疗后的 T 细胞上的抗原产生免疫反应，并且在皮肤 T 细胞淋巴瘤患者中进行的临床试验已取得成功。当前研究的患者每月接受治疗，连续两天（或以后每两周一次）。在治疗 12 至 16 周之间，似乎出现了一个断点，此后 4 名患者的关节计数和关节评分开始改善。在 4 名患者中，有 3 名患者的这些指标最终分别平均减少了基线值的 71% 和 80%，并且不太直接的临床反应指标也出现了不同程度的改善。第四名患者的关节计数和评分略有改善（分别比基线提高了 33% 和 59%），但他需要替代疗法，而其余 3 名研究患者的关节计数和评分没有改善。无论是检查 4 名明显反应者 (P = 0.01) 还是整组 7 名患者 (P = 0.01)，关节计数的平均斜率在明显断点之后（但之前）与零显着不同。治疗完成后，改善的患者的临床恶化也延迟了 2-3 个月。仅出现 1 种机械不良反应（102 次治疗中出现单次短暂性低血压），并且没有毒性作用。这项初步研究表明，体外光化疗至少在短期内可能对某些类风湿性关节炎患者有效，而且其毒性比目前用于治疗这种疾病的任何药物都要小。值得进一步评价。
In a 6‐month pilot study of 7 patients with rheumatoid arthritis, we tested a treatment involving the extracorporeal photoactivation of biologically inert methoxsalen (8‐methoxypsoralen) by ultraviolet A energy to a form that covalently cross‐links lymphocyte DNA; the injured cells are reinfused into the patient. Prior experimental studies had indicated that this regimen produces an immune reaction against antigens on treated T cells, and a clinical trial in patients with cutaneous T cell lymphoma had been successful. The current study patients were treated monthly, on 2 successive days (or biweekly, later on). Between 12 and 16 weeks of therapy, there appeared to be a breakpoint, after which the joint counts and joint scores of 4 of the patients began to improve. In 3 of the 4 patients, these measures eventually diminished by a mean of 71% and 80% of baseline values, respectively, and there was variable improvement in less direct indicators of clinical response. The joint counts and scores of the fourth patient improved modestly (by 33% and 59% of baselines, respectively) but he required alternative therapy, and those of the remaining 3 study patients did not improve. Mean slopes for the joint counts were significantly different from zero after the apparent breakpoint (but not before), whether one examined the 4 apparent responders (P= 0.01) or the entire group of 7 patients (P= 0.01). After completion of therapy, there was also a delay, of 2–3 months, in the clinical deterioration of those patients who had improved. There was only 1 mechanical adverse effect—a single episode of transient hypotension in 102 treatment sessions–‐and no toxic effects. This preliminary study suggests that extracorporeal photochemotherapy may be effective, at least in the short term, in certain patients with rheumatoid arthritis, with less apparent toxicity than that of any of the drugs currently used for this disorder. It deserves further evaluation.
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通过输注同基因光灭活效应淋巴细胞抑制抗皮肤同种异体移植免疫。
DOI：
10.1111/1523-1747.ep12696853
发表时间：
1989
期刊：
The Journal of investigative dermatology
影响因子：
--
作者：
Perez,M;Edelson,R;Laroche,L;Berger,C
通讯作者：
Berger,C
影响因子：
10.3
作者：
H. Wilfert;H. Hönigsmann;G. Steiner;J. Smolen;K. Wolff
通讯作者：
K. Wolff
影响因子：
158.5
作者：
EDELSON, R;BERGER, C;LAROCHE, L
通讯作者：
LAROCHE, L
影响因子：
39.2
作者：
Rook,AH;Jegasothy,BV;Heald,P;Nahass,GT;Ditre,C;Witmer,WK;Lazarus,GS;Edelson,RL
通讯作者：
Edelson,RL
评估类风湿关节炎时关节计数指数减少。
影响因子：
--
作者：
M. Egger;D. Huth;J. Ward;J. Reading;H. Williams
通讯作者：
H. Williams