Narrow-band phototherapy and sodium salt of the synthetic diamide gamma-D-glutamyl-D-tryptophan as a combined method of psoriasis treatment: comprehensive and comparative evaluation

Abstract

The paper presents the results of a comparative study of various immunosuppressive treatment methods of medium severity vulgar psoriasis (PASI from 10 to 20). The parameters used were PASI indices, p53 apoptosis marker expression indices, and expression indices of T-regulatory cell marker Foxp3. The study involved 96 patients, from 18 to 60 years old, divided by randomization into three groups. Patients in the 1st group (n = 32) received narrow-band phototherapy according to a 4-day regimen. We used the Waldmann UV-7002K instrument and F79/120W-TL01 lamps generating radiation with a maximum emission at a wavelength of 311 nm. We started with a dose of 0.05–0.1 J/cm2, subsequently increased by 0.05–0.1 J/cm2 for each procedure, in the absence of erythema. In total, patients received 12–15 procedures, with a course dose of 4.7–7.65 J/cm2. In the 2nd group (n = 32), patients were treated with the sodium salt of the synthetic gamma-D-glutamyl-D tryptophan dipeptide. Patients of the 3rd group (n = 32) underwent combination therapy, which included both methods described above. As a result of treatment, the greatest decrease in the PASI index, as well as the level of expression of the marker of Foxp3 T-regulatory cells, was observed among patients who received the combined regimen. The data obtained indicate the high therapeutic efficacy of narrow-band phototherapy in combination with the sodium salt of the synthetic gamma-D glutamyl-D tryptophan synthetic dipeptide. It was also noted that the immunohistochemical marker p53, reflecting the cellular renewal of psoriatic papule keratinocytes, is an informative molecular-cellular indicator of the effectiveness of narrow-band phototherapy.