Extracorporeal Photochemotherapy in the Treatment of Typical and Atypical Lichen Planus Rubrum

Молочков, А. В.; Кильдюшевский, А. В.; Молочкова, Ю. В.

doi:10.18786/2072-0505-2016-44-2-213-220

Cited by 3 publications

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“…и соавт. (2016) отметили положительную динамику кожного процесса и длительную ремиссию, а также положительные иммунопатологические сдвиги после 4 сеансов [55].…”

Section: обзор наружных лп предлагаемых для лечения кплunclassified

Lichen Planus: Treatment Capabilities (Review)

Шикалов,

Панкратов,

Панкратов

et al. 2024

Дерматовенерология Косметология

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В статье приведен обзор методов лечения красного плоского лишая с поражением кожи, слизистых оболочек, волосистой части головы и ногтей, регламентируемых Национальными руководствами Республики Беларусь, Российской Федерации, а также рекомендуемых в литературе в качестве возможных или перспективных направлений. Представлена краткая характеристика предлагаемых лекарственных препаратов и информация о результатах их применения (глюкокортикоиды, ингибиторы кальциневрина, антималярийные, противогрибковые, ретиноиды, цитостатики, дапсон, сульфасалазин, микофенолата мофетил, антибиотики, средства для местного применения и физиотерапевтические методы). При всем разнообразии доступных терапевтических вариантов не существует общепризнанных международных руководств по лечению, основанных на данных крупных исследований. Новые данные изучения патогенеза КПЛ и применения генно-инженерных биологических препаратов, вероятно, смогут предоставить в ближайшей перспективе многообещающие возможности в лечении. The article provides an overview of treatment methods of lichen planus with lesions of the skin, mucous membranes, scalp and nails, regulated by the National Guidelines of the Republic of Belarus, the Russian Federation, as well as recommended in the literature as possible or promising directions. A brief description of the proposed drugs and information on the results of their use are presented (glucocorticoids, calcineurin inhibitors, antimalarial, antifungal, retinoids, cytostatics, dapsone, sulfasalazine, mycophenolate mofetil, antibiotics, topical agents and physiotherapeutic methods). Despite the variety of therapeutic options available, there are no generally accepted international treatment guidelines based on data from large studies. New data on the pathogenesis of LP and the use of genetically engineered biological drugs will likely provide promising treatment opportunities in the near future.

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Section: обзор наружных лп предлагаемых для лечения кплunclassified

Lichen Planus: Treatment Capabilities (Review)

Шикалов,

Панкратов,

Панкратов

et al. 2024

Дерматовенерология Косметология

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“…Ранее проведенные нами исследования по изучению клинической эффективности ЭКФ у больных распространенным, в том числе резистентным к кортикостероидной терапии типичным красным плоским лишаем показали высокую клиническую эффективность этого метода лечения [39][40][41]. Красный плоский лишай представляет собой клеточно-опосредованное аутоиммунное заболевание, в патогенезе которого активно участвуют Th1-клетки.…”

Section: экстракорпоральный фотоферез при аутоиммунных заболеванияхunclassified

Extracorporeal photopheresis as a non-specific immune therapy of autoimmune diseases and skin T-cell lymphoma (a review of the literature and own studies)

et al. 2019

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Aim: To present well-known and disputable mechanisms of the effects of extracorporeal photopheresis (ECP) in heterogeneous clinical conditions, as well as to demonstrate its advantages over conventional hormonal, immunosuppressive and cytostatic treatments, with a recommendation to widely implement it into practical management of autoimmune disease and cutaneous T-cell lymphomas (CTCLs).Key points: Despite convincing evidence of the ECP efficacy in the treatment of T-cell mediated disorders, a unifying concept of its mechanism has not been established so far. In this review, we attempted to determine the value of multiple, sometimes contradictory and equivocal points of view to immunobiochemical processes underlying the restoration of mechanism of immune tolerance in some autoimmune diseases and CTCLs. We focused our attention on our own clinical and immunological data obtained during a 20-years' experience with the use of ECP in clinical departments of MONIKI (Russia). Based on this, we have shown that ECP is more effective in autoimmune diseases than conventional treatment approaches with hormones, immunosuppressants and cytostatics. Unlike them, ECP is selectively targeted to auto-aggressive T-cells without induction of systemic immunosuppression. The leading role is played by the transformation of activated (immunogenic) myeloid dendrite cells (DC) into tolerogenic cell associated with their synthesis of inhibitor cytokines. The interplay of the cytokines with an antigen results in polarization of CD4+ Т lymphocytes via the Th2 pathway with restoration of the Th1/Th2 balance and their cytokine production. ECP triggers regulatory anti-clonotypic effector memory cells at the end stage of CD3+/CD8+/CD27-/CD28-/CD62L+ differentiation, that provide and maintain the peripheral immune tolerance, by deletion of the clone of auto-reactive cytotoxic lymphocytes and inducing their apoptosis. In autoimmune disorders, ECP results in reduction of the expression of integrin adhesion molecules on auto-reactive cell membranes with subsequent loss of their ability to migrate through the endothelium to their target cells. In its turn, it leads to decreasing immunoinflammatory response in the lesion. Both clinical and experimental data indicate that the mechanism of ECP action against CTCLs is characterized by activation of tumor cell apoptosis, unblocking of co-activation receptors on the antigen-presenting DC providing the functioning of the second signaling pathway for T lymphocyte activation. This results in proliferation of anti-tumor effector cells pool, production of DC activating cytokines that participate in the CD4+ polarization via Th1 pathway. In addition, this review considers the mechanism of the immunomodulating effect of ECP in the context of its influence at the levels of transcription and translation of proteins contributing to the pathophysiology of the disorders, based on molecular immunogenetic studies. Thus, ECP is able to induce antigen-specific immunological tolerance through the transformation of antigen-presenting cells, modulation of cytokine profile, adhesion and activation molecules, as well as through formatting of the regulatory T cells (Tregs).Conclusion: Undoubtedly, the immunobiological ECP technique has significant advantages over well-known conventional hormonal, immunosuppressive, and cytostatic therapies of autoimmune diseases and CTCLs.

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Lichen planus ruber, current therapy: a systematic review

Тлиш

Осмоловская

2021

Kuban. nauсh. med. vestnik

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Background. Lichen planus ruber is a common inflammatory disease of skin and mucous membranes with a chronic relapsing course, resistance to conventional therapy, diverse clinical manifestations and capacity of tumourisation. Dermatosis is often comorbid with various underlying gastrointestinal, cardiovascular illnesses and endocrinopathies. Women are more impacted than men (ratio 1.4:1), the disease lasts from 5 to 40 years.Objectives. Assessment of the efficacy and safety of current therapies for lichen planus ruber.Methods. The PubMed, Web of Science, Medline, eLibrary and Scopus databases were mined for randomised controlled studies on treatment of this dermatosis in the period of 2014–2020, and selected impactive publications within 1991–2012 were also included in the review. The following keywords were used: lichen planus [красный плоский лишай], systemic and local drugs [системные и местные препараты], phototherapy [фототерапия], physiotherapeutic methods of treatment [физиотерапевтические методы лечения]. Publications in peer-reviewed journals had priority. Content and descriptive analyses were used as research tools.Results. Therapy for lichen planus ruber is multicomponent including a wide range of techniques, mostly immune-stimulating but often unproved for efficacy and safety. Selected studies are small-sample. The review presents feasible drug-based and physiotherapeutic methods to tackle lichen planus ruber, their application by the disease clinical presentation and prevalence, patient’s personal discomfort, psycho-emotional status and comorbidity. We describe the mechanisms of action, clinical efficacy, application types and noxious side effects in practiced albeit sometimes contentious therapies.Conclusion. Further well-designed research is warranted to aim at enhanced efficacy, safety and long-term remission in therapy for lichen planus ruber.

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Extracorporeal Photochemotherapy in the Treatment of Typical and Atypical Lichen Planus Rubrum

Cited by 3 publications

References 0 publications

Lichen Planus: Treatment Capabilities (Review)

Lichen Planus: Treatment Capabilities (Review)

Extracorporeal photopheresis as a non-specific immune therapy of autoimmune diseases and skin T-cell lymphoma (a review of the literature and own studies)

Lichen planus ruber, current therapy: a systematic review

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