| The effect of the combination of calcipotriol and betamethasone dipropionate versus both monotherapies on epidermal proliferation, keratinization and T-cell subsets in chronic plaque psoriasis. | |
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MedLine Citation:
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PMID: 15009104 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Several reports have indicated that the combination of calcipotriol ointment and potent or ultrapotent corticosteroids are more effective and better tolerated, as compared to the monotherapies. The aim of the present study was to find out the effect of combination of calcipotriol ointment once daily and betamethasone dipropionate ointment once daily vs. the effect of twice-daily applications of each of the two treatments as monotherapy during a four-week treatment period. Seven patients with chronic plaque psoriasis were included for treatment with the three treatment schedules. Biopsies were taken before treatment and after four weeks of treatment, and markers for epidermal proliferation (Ki-67) and epidermal differentiation (keratin-10) were studied using a quantitative image analysis, and T-cell subsets in epidermis and dermis (CD4, CD8, CD25, CD45RO, CD45RA, CD94, CD161, and CD2) were studied using immunohistochemical scoring. The most impressive clinical result was reached with the combination. Calcipotriol proved to have a major effect on the proliferation marker Ki-67 and differentiation marker keratin-10, whereas the effect on T-cell subsets was more selective with major reductions of CD45RO(+) and CD8(+) T cells. In contrast, the effect of betamethasone dipropionate on the epidermis was restricted to a normalization of differentiation with a highly significant increase of keratin-10 positive epidermal surface without a significant effect on Ki-67 positive nuclei, and the effect on T-cell subsets was restricted to a reduction of natural killer T-cell receptors designated by CD94 and CD161 in the epidermis. The combination of the two treatments did not affect the proliferation marker Ki-67 and keratinization marker keratin-10, beyond the effect of calcipotriol monotherapy. However, the combination had a profound effect on, virtually, all T-cell subsets, beyond the effect of the monotherapies. It is concluded that the action spectra of calcipotriol and betamethasone on the psoriatic plaque are different and that the combination has effects on T-cell subsets, beyond the addition of the effects of monotherapies. |
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Authors:
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W H P M Vissers; M Berends; L Muys; P E J van Erp; E M G J de Jong; P C M van de Kerkhof |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article |
Journal Detail:
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Title: Experimental dermatology Volume: 13 ISSN: 0906-6705 ISO Abbreviation: Exp. Dermatol. Publication Date: 2004 Feb |
Date Detail:
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Created Date: 2004-03-10 Completed Date: 2004-04-09 Revised Date: 2010-04-12 |
Medline Journal Info:
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Nlm Unique ID: 9301549 Medline TA: Exp Dermatol Country: Denmark |
Other Details:
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Languages: eng Pagination: 106-12 Citation Subset: IM |
Affiliation:
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Department of Dermatology, University Medical Centre St Radboud, Nijmegen, The Netherlands. w.vissers@derma.umcn.nl |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Inflammatory Agents
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administration & dosage,
therapeutic use Antigens, CD / analysis Betamethasone / administration & dosage, therapeutic use* Calcitriol / administration & dosage, analogs & derivatives*, therapeutic use* Cell Division / drug effects Dermis / drug effects, immunology Drug Therapy, Combination Epidermis / drug effects, immunology Humans Keratins / metabolism Ointments Psoriasis / drug therapy* Skin / drug effects, pathology* T-Lymphocyte Subsets / drug effects, immunology* T-Lymphocytes / drug effects, immunology |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents; 0/Antigens, CD; 0/Ointments; 112965-21-6/calcipotriene; 32222-06-3/Calcitriol; 378-44-9/Betamethasone; 68238-35-7/Keratins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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