Hungarian Immunology

[Alpha calcidol treatment in patients with psoriatic arthropathy: clinical and immunological effects]

GAÁL János, LAKOS Gabriella, ALEKSZA Magdolna, KISS Judit, HORVÁTH Irén, HORKAY Edit, NAGY Georgina, SZEGEDI Andrea

OCTOBER 20, 2007

Hungarian Immunology - 2007;6(05)

[OBJECTIVE - Our objective was to describe the functional changes of the immune system also to evaluate the clinical parameters during systemic alphacalcidol (1αOH vitamin D3) treatment in patients with psoriatic arthropathy. PATIENTS AND METHOD - Nineteen patients with peripheral polyarticular form of psoriatic arthropathy were investigated. Ten patients were treated with daily 2×25 mcg alphacalcidol per os for 6 months and the other 9 patients served as controls. Three visits (at start, 3 and 6 months later) were carried out during the study, changes in the laboratory and clinical parameters were examined and analysed statistically in the treated and control groups. RESULTS - In the peripheral blood of the treated group a statistically significant decrease in the percentage of CD3/CD69 positive activated and CD8 positive IFNγ producing T cells was observed and the serum level of IFNγ also showed a significant decrease during the first 3 months. Another three months later no change in the above mentioned variables could be detected. Additionally, there was a significant decrease in the clinical activity of the disease using DAS28 score during the whole 6 months follow up period. In the control group no significant changes were observed. CONCLUSION - Our results show that systemic alphacalcidol treatment has a notable immune modulatory effect on patients with psoriatic arthropathy. This effect is manifested in short-term temporary decrease of type 1 immune responses and continuous decrease in the disease activity.]

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ANTAL-SZALMÁS Péter, ALEKSZA Magdolna, GONDA Andrea, HERÉDI Emese, SIPKA Sándor, HUNYADI János, SZEGEDI Andrea

[BACKGROUND - Psoriasis is a chronic inflammatory skin disorder characterised by an altered rate of interferon (IFN)-γ and interleukin (IL)-4 producing lesional and peripheral blood CD4+ and CD8+ T cells. To further characterise the imbalance of these cells and cytokines the rate and as a novel approach the absolute cell count (ACC) of IFN-γ+, IL-4+ and IL-10+ Thelper and Tcytotoxic cells was determined in the peripheral blood of psoriatic individuals. MATERIALS AND METHODS - Cell-associated cytokine expression was determined using intracellular cytokine staining and flow cytometry, serum cytokine levels were measured by enzyme linked immunosorbent assays (ELISAs) in the samples of 35 psoriatic patients and 15 controls. RESULTS - Significantly elevated rate (p<0.008) and ACC (p<0.009) of CD4+/IFN-γ+ cells was observed in the patients (28.3±8.8% and 237,216±134,154 cells/ml) compared to the healthy controls (21.0+ 6.8% and 135,772±50,212 cells/ml). In contrast the rate and the ACC of CD4+/IL-4+ cells decreased significantly in psoriasis (0.45±0.67% vs. 1.01± 0.48%, p<0.0001; 3,229±3,724 vs. 5,117±4,171 cells/ml, p<0.05). In the case of CD8+ T cells only the rate and the ACC of CD8+/IL-10+ cells increased significantly in patients compared to controls (5.49±5.42% vs. 1.59±0.78%, p<0.003 and 19,799±17,412 vs. 5,564±2,794 cells/ml, p<0.03). Though higher IFN-γ and lower IL-4 and IL-10 serum concentrations were detected in psoriasis these differences between patients and controls were not significant. Comparing the different cytokine parameters the serum cytokine levels showed some correlation only with the ACC and not with the rate of cytokine positive cells. CONCLUSIONS - These results further prove the presence of an altered balance in cytokine regulation towards the Thelper 1 cytokines in psoriasis, besides indicate that application of the ACC of cytokine positive helper and cytotoxic T cells as a novel parameter can help in the characterisation of these changes in different disorders.]

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