Through 1980 and beyond psoriasis was thought be a primary hyperproliferation of the epidermal cells. Normal epidermis takes 28 days to grow; in psoriasis the epidermis grows in 4 days. Consequently the skin does not have time to properly mature; it takes on psoriasis's characteristic scaly, red, rough appearance.
In 1979 at the University of Pittsburgh School of Medicine, a patient with psoriasis unfortunately also had renal failure (unrelated to psoriasis), requiring a kidney transplant. Following transplantation the patient was prescribed cyclosporine, a potent anti-inflammatory agent, to prevent rejection. Unbelievably, the patient's psoriasis went away. This was the beginning of a new understanding of psoriasis. The understanding of the pathogenisis of psoriasis had changed from a primary hyperproliferative process of the epidermis to an immunologically-mediated disease.
In 1992, The Psoriasis Treatment Center of Central New Jersey was fortunate enough to offer its patients the opportunity to participate in a clinical trial with cyclosporine. Soon thereafter we participated in a clinical trial of a novel biologic agent, DAB-IL 2, which selectively destroyed activated T cells known to contribute to psoriasis. DAB-IL-2 completely cleared some patients with widespread psoriasis however some patients had side effects. Our findings were published in the Journal of the American Academy of Dermatology (Volume 38, Issue 6, p. 938, June 1998) in a paper titled "Administration of DAB IL-2 to patients with recalcitrant psoriasis."
Ultimately, the risk-benefit ratio of DAB-IL2 was not good enough. However, we were now on the way to try newer, better, and safer biologic agents.
No comments:
Post a Comment