[Phototherapy of skin diseases].
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Biomedical subjects
Publications and source records attributed to H Meffert.
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The paper reports on the effects of multiple whole-body infra-red-A irradiational (IRA) on 13 male patients known to have stage I or stage II essential arterial hypertension (WHO definition). The peripheral blood pressure was decreased significantly by IRA exposures. The lowered diastolic blood pressure lasted into posttreatment time. This effect is regarded as a consequence of an improvement in peripheral haemodynamics. A measure of this improvement is the different shape of the blood pressure pulse waves. Calculation and comparison of the spectral components of the recorded pulse signals show that these components are useful for a prediction of the blood pressure lowering effect.
The hydroxyl radical scavenging and antipsoriatic activity of a number of lipophilic and hydrophilic benzoic acid derivatives was investigated. To quantify antioxidative effects, a newly introduced test system based on the diminution of the ESR signal of DMPO-OH (generated by Fenton's reagent) by the tested compounds was applied. It was found that the in vitro antioxidative (toward hydroxyl radical) activity of benzoic acid esters decreases with increasing chain length whereas the antipsoriatic activity increases. This effect is discussed in terms of a larger lipophilicity of long-chain esters. Propyl gallate was found to be the most active OH scavenger since it is some orders of magnitude more efficient than "model" antioxidants like alpha-tocopherol or mannitol. The highest antipsoriatic activity was exhibited by hydroxy benzoic acid decyl ester.
Seven female systemic sclerosis patients (all from acrosclerosis type, with intestinal involvement, and marked Raynaud phenomenon) were treated with infrared A whole body irradiations (wavelengths between 800 and 1,400 nm, 12 W/dm2 maximally). The single exposure lasted for 30 minutes and resulted in an 0.9 degrees C rise of central body temperature. Acral skin rewarming became regular immediately after irradiation and kept improved, as compared with pre-treatment values, for at least 18 weeks. All the patients told about a comfortable feeling of warmth after each treatment lasting for one two days. Three out of the seven reported lower frequency and severity of Raynaud attacks.
It is supposed that anti-Ro(SS-A) antibodies play an important role in the development of photosensitive skin disease in subacute cutaneous lupus erythematosus and neonatal lupus erythematosus. The aim of the experiments was to demonstrate that anti-Ro(SS-A) antibodies and UVA-light cause a cytotoxic effect on human keratinocytes in vitro. Keratinocytes are irradiated with UVA-light in presence of serum containing anti-Ro(SS-A) antibodies (62 E, ELISA). After application of 20 J/cm2 UVA-light only 48.5% of the irradiated cells are still vital (standard trypan blue exclusions test). Examination by scanning electron microscopy shows plain depressions on the surface of the keratinocytes, which were irradiated in presence of anti-Ro(SS-A) antibodies.
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Using surviving human skin, percutaneous absorption following topical application of hematoporphyrin derivative was investigated. Hematoporphyrin derivative gave strong red fluorescence, which was dependent from it's actual concentration, from the used kind of vehicle, from preparation time, and from time between preparation and application of hematoporphyrin derivative solution. Ultrastructural investigation verified cytoplasmatic membranes and mitochondria as the principal targets also after topical application followed by irradiation with visible light.
Lipophilic propionibacterium acnes stores large amounts of porphyrins. This peculiarity can be used for photodynamic destruction of propionibacteria. After repeated irradiations with a blue light-type high pressure lamp (Narva NC 1000-64) both acne and seborrhoea was improved markedly (10 irradiations, each for 10 minutes, cumulative light dose 325 J/cm2). Also porphyrin content inside acne follicles dropped. Serial irradiations with short range visible light (400 to 420 nm) are recommended for acne treatment during the light-poor season of the year.
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Before and after skin treatment by ultraviolet radiation, infrared radiation or visible light the ability of polymorphonuclear leukocytes (PMN) to form oxygen intermediates was investigated in 31 healthy volunteers. Superoxide production was evaluated photometrically as the reduction of Iodonitrotetrazoliumchloride (INT). After whole body treatment by 4 UV exposures all persons exhibited significantly enhanced rates of INT-reduction for 26-62 days. The in vivo half-time of PMN is 5-7 hours. Therefore a direct effect of irradiation over that long period is rather unlikely, suggesting that mediators should play a crucial role in signal transduction from the skin to the peripheral blood cells. Most likely candidates for connective links are interferon-gamma (IFN-gamma), granulocyte-monocyte colony stimulating factor (GM-CSF) and tumor necrosis factor (TNF).
The treatment of transplants by a combination of 8-methoxypsoralen and longwave ultraviolet radiation (PUVA) leads to prolongation of the transplants in allogeneic receivers without immunosuppression. The rejection of skin grafts in the mice could be delayed significantly. The rejection of kidney and heart allografts could be prevented completely. A significant diminution of the acute rejection crises and a raising of the one-year survival rate showed a first clinical study by means of PUVA treatment in human kidney grafts.
There is in photosensitive lupus erythematosus a strong association of high titers of anti-Ro(SS-A) antibodies in the serum of the patient with the development of special skin reactions depending on UV-light. The aim of our experiments was to detect a cytotoxic effect of anti-Ro(SS-A) antibodies and UVA-light on human endothelial cells in vitro (standard trypan blue exclusion test, SEM). After UVA-doses of 1 to 100 J/cm2, which were tested, and influence of serum containing anti-Ro(SS-A) antibodies (62 E, ELISA) membrane destructions of endothelial cells depending on the UVA-dose can be seen, irrespective of the fact whether the antibodies are present throughout the irradiation or added afterwards. This cytotoxic reaction depends on complement. A UVA-dose of 100 J/cm2 causes lethal damage of 40% of the cells. These results were confirmed by scanning electron microscopy.
The advancement of growth of albino guinea pig hair has been induced by sodium thiocyanate through oral application (32 mg/kg) and more distinctly through balneological use (0.3, 5 resp. 10 g/l). The density of the hair has been increased at 6-38%, the longitudinal growth advanced at 2-14% and the phases of follicle cycle have been changed on behalf of anagenic hair at 11-39%.
Data of birth from 4040 atopic dermatitis patients born in the Berlin area were analyzed in view of their distribution over the 12 months of the year. For comparison the data of birth of all people being born during two years were treated the same way. There was a marked increase of atopic dermatitis with the persons born during the months August to October. On the other hand, the prevalence of atopic dermatitis was diminished with that persons who were born from February till July (with exception of May). Obviously, during the first months of life seasonally differing external factors influence directly o indirectly the decision, whether atopic dermatitis later on will manifest or not. These results should been taken into consideration for family planning in high-risk families.
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In 21 patients suffering from obstructive peripheral arterial disease stage II according to Fontaine, therapeutic efficacy of serial whole body irradiations (infrared or ultraviolet radiation) and pretended or real ultraviolet light blood irradiations was evaluated. Before, during and after treatment the following parameters were monitored: walking distance, oxygen partial pressure (quasi-arterial/venous), flow properties of blood (appearant blood viscosity, hemodynamics (peak flow, ultrasonics). There were no significant changes following both modalities of whole body irradiations either by sunshine-like ultraviolet light nor by infrared radiation, nor by pretended blood irradiation. In the same patients mean walking distance was prolonged threefold after ultraviolet irradiation of the patient's own venous blood and subsequent retransfusion. Simultaneously, oxygen utilisation was improved (enlarged arterial/venous difference), lactate concentration was decreased and apparent blood viscosity was diminished, whereas blood flow remained unchanged or only slightly improved. In this way the circulus vitiosus of obstructive peripheral arterial disease can be overcome. As a consequence of blood irradiation walking distance enlarges, providing better chances for physical training, which helps to extend walking distance furthermore.
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