对于内源性原卟啉IX水平升高的患者,多次暴露于蓝光下不能改善牛皮癣

C. Maari, R. Bissonnette
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引用次数: 0

摘要

已知内源性原卟啉IX (PpIX)水平在银屑病斑块中升高。在局部应用氨基乙酰丙酸后,通过可见光激活PpIX已被证明可以改善牛皮癣。本研究旨在确定多次单独照射蓝光是否可以改善内源性PpIX水平升高患者的牛皮癣。患者和方法:17例至少有2个4 × 4 cm银屑病斑块,内源性PpIX水平升高(通过体内荧光光谱检测)的患者被纳入研究。患者被要求在治疗前停止所有局部治疗至少2周和全身治疗至少8周。将每个患者的两个斑块中的一个暴露在荧光板上的10 J/cm2的蓝光下,每周三次,连续4周。另一个斑块作为未暴露的对照组。在基线和4周治疗期间的每周以及最后一次暴露后的1周和3周进行盲法临床评估。银屑病的严重程度是通过评价0-4分红斑、硬结和脱屑的存在来评估的。在第1周和第4周用体内荧光光谱法测定光照前后PpIX水平。结果:所有患者均完成研究,未出现治疗相关副作用。体内荧光光谱显示,暴露斑块中的PpIX在光照射后几乎完全光漂白(P = 0.005)。暴露斑块和对照斑块在12次蓝光照射前后的平均银屑病严重程度评分无显著差异。结论:在当前条件下,多次蓝光照射对银屑病无改善作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
002 Multiple exposures to blue light does not improve psoriasis in patients with elevated endogenous levels of protoporphyrin IX
Endogenous levels of protoporphyrin IX (PpIX) are known to be elevated in psoriatic plaques. Activation of PpIX by visible light after topical application of aminolevulinic acid has been shown to improve psoriasis. This study was designed to determine whether multiple exposures to blue light alone could improve psoriasis in patients exhibiting elevated endogenous PpIX levels. Patients and methods: Seventeen patients with at least two psoriatic plaques of 4 × 4 cm exhibiting elevated endogenous PpIX levels (as detected by in vivo fluorescence spectroscopy) were included in the study. Patients were required to discontinue all topical therapies for at least 2 weeks and systemic therapy for at least 8 weeks before treatment. One of the two plaques on each patient was exposed to 10 J/cm2 Of blue light from a fluorescence panel three times per week for 4 consecutive weeks. The other plaque was used as a non-exposed control. Blinded clinical evaluations were performed at baseline and every week during the 4-week treatment period as well as at 1 and 3 weeks after the last exposure. Psoriasis severity was assessed by evaluating on a scale of 0–4 the presence of erythema, induration, and desquamation. PpIX levels were measured before and after light exposure by in vivo fluorescence spectroscopy at week 1 and 4. Results: All patients completed the study without presenting treatment related side-effects. In vivo fluorescence spectroscopy demonstrated an almost complete photobleaching of PpIX in exposed plaques immediately after light exposure (P = 0.005). There was no significant difference between the mean psoriasis severity score of the exposed or control plaques before and after 12 exposures to blue light. Conclusion: Under the current conditions multiple exposures to blue light did not improve psoriasis.
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