engleski

Effect of Naphthalene Therapy on Proliferation Activity, Immunoreactivity and Angiogenesis in the Skin of Psoriasis Patients

Naphthalene has been used for 15 years in the treatment of psoriasis at Special Hospital for Medical Rehabilitation in Ivanic Grad near Zagreb, Croatia. Naphthalene is obtained from naphtha, a complex mixture of various compounds, mostly hydrocarbons. A new naphthalene preparation, Ivalan, is enriched with sterans, constituents believed to represent active naphthalene components, and has a reduced content of polyaromatics. Experimental model studies revealed no genotoxicity. The preparation is available in the form of oil for local treatment. Aim: To assess the effects of the new naphthalene preparation on proliferative activity, immunoreactivity, angiogenesis and apoptosis in the epidermis of psoriasis patients.The study included 26 (eight female and 18 male) vulgar psoriasis patients, mean age 50 (range 32-65) years. On therapy initiation, the mean PASI score was 22.4. Naphthalene was applied over involved skin areas once daily. After 30 minutes, the patients removed residual preparation from the skin and took a shower. Biopsy specimens were obtained from target lesions before and after three-week treatment. The number of proliferating keratinocytes was determined by immunohistochemistry using Ki-67 antibodies as positive cell count/mm epidermis length, CD4+ and CD8+ cell count/mm epidermis length and /mm2 dermis. The number of neovascular formations/mm2 dermis was measured by use of CD31 antibodies. Cell count expressing apoptotic activity was determined by use of anti bcl-2 antibodies. Statistically, all data were expressed as mean &#61617; SD. Statistical data analysis was performed using paired t-test, and significance was re-checked by Student's t-test or Mann Whitney U test when the normality of data failed. The level of significance was set at p<0.001.Treatment with naphthalene resulted in a significant (p<0.001) decrease of proliferative activity in the epidermis, as shown by the reduced Ki-67+ cell count ; decreased CD4+ and CD8+ cell count in the epidermis and dermis ; decreased CD31+ count ; and increased Bcl-2 positive cell count. At the end of therapy, the mean PASI score was 7.73. Out data showed a significant favorable effect of naphthalene treatment in vulgar psoriasis. This effect manifested as the significant reduction of proliferative activity in the epidermis and of immunocompetent cell (CD4 and CD8) counts in the epidermis and dermis, antiangiogenic action (decreased CD31+ cell count), and enhanced apoptotic effect as demonstrated by the increased Bcl-2 positive cell count. Study results suggested that naphthalene might prove useful as local therapy for mild and moderate psoriasis.

psoriasis; proliferation activity; immunoreactivity; angiogenesis

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