miercuri, 15 decembrie 2010

Cercetari noi in terapia psoriazisului

Cercetari noi in terapia psoriazisului facute de Department of Dermatology at the Kochi Medical School Hospital for help with the clinical study.

Articol omplet la :http://www.nature.com/jid/journal/v131/n1/full/jid2010255a.html

Effect of topical application of STA-21 ointment on psoriasis lesions

Eight patients with psoriasis, who had not been treated with systemic therapies in the previous 2 months, with UV therapy in the previous 3 weeks, or with topical therapy in the previous 2 weeks, were allocated to intervention in this study for 2 weeks. To perform the study with intrapatient comparison of the effect of STA-21 versus vehicle alone, we selected two discrete macular lesions with almost the same clinical severity on each patient: one being treated with 0.2% STA-21 in petrolatum, the other with petrolatum alone. Generally, treatment with STA-21 ointment was well tolerated in all study subjects. No patient was removed from the study because of any apparent adverse effects, including life-threatening toxicity, local irritation, and contact dermatitis, during the trial.

We assessed the objective clinical scores of erythema, induration, and scaling (Figure 6b). Score improvements by STA-21 over vehicle alone were obtained in five patients (patients 1–5), who showed >30% difference in the score decline after 2 weeks treatment with STA-21 compared with vehicle control. Representative photographs of responder patients 1, 2 (Figure 6a), 3, and 5 (Supplementary Figure S1 online) are shown. Some improvement by petrolatum alone was presumably due to the effect of the occlusive dressing (patients 1, 2, 3, 4, 6, and 7), but such an effect was not observed in patients 5 and 8, who did not apply occlusive dressing. However, any application of occlusive might not greatly affect the outcome because the drug treatment was performed under the same conditions as vehicle alone. Although patient 6 showed no score improvement by STA-21 (Figure 6b), the lesion spreading was apparently inhibited by STA-21 compared with vehicle control (Supplementary Figure S2 online). Two of the eight patients (7 and 8 in Supplementary Figure S1 online) did not show appreciable response to the STA-21 ointment by the end of the 2-week study, but vehicle alone did not outperform STA-21. Despite the limited number of patients allocated and the short period of the study, six of eight patients tested showed an improvement (75%) when treated with STA-21 ointment compared with control. Summary data for the mean clinical score across all eight patients are shown in Figure 6c. Compared with vehicle controls, STA-21-treated lesions showed clinical improvement (P=0.026 and 0.056 at days 7 and 14, respectively, by Mann–Whitney U-test). Taken collectively, we expect that blocking Stat3 signaling by STA-21 is a promising new modality for the treatment of psoriasis and urge further randomized controlled research.

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