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PubMed1991

Comparison of topical PUVA with UVA for chronic vesicular hand eczema.

Topical PUVA was compared with UVA for the treatment of chronic vesicular hand eczema in a double-blind randomized within-patient trial. Twelve of 15 patients completed 8 weeks' treatment and were followed up for 8 weeks. Both sides improved over the 8-week treatment period (p less than 0.05) and both remained substantially better objectively and subjectively at 8 weeks' follow-up. There was no statistical difference between assessments of the treated hands at any stage. Nine of the patients who completed the study answered a questionnaire up to 18 months later. In 4, eczema was healed, 3 were better on the PUVA-treated hand and 1 on the UVA-treated hand. It is possible that UVA alone is beneficial for chronic hand eczema.

Adult↗
PubMed1990

The immunology of allergic contact dermatitis: the DNCB story.

The observations described here reveal several important aspects of the human immune system and its responses. The immune system is like most major physiologic systems in that it has tidy and predictable dose-response relationships. This applies both to the induction phase and also the elicitation or expression phase. There is thus a graded, dose-related increase in the magnitude of sensitization that applies throughout the range both of clinically detectable reactivity but also down to subclinical levels of response. It becomes possible to speculate about the kinetics of clonal expansion and the stage of the process at which specific T cells leave the lymph node to enter the circulation--the onset of clinical sensitivity. Additional stimulation to the system causes "boosting"--additional clonal expansion, already well known in the field of humoral immunology. Immune responsiveness appears to be normally distributed in the population, with one "tail" of the distribution containing "high responders" who are particularly susceptible to sensitization by environmental antigens. The high responder status reflects a propensity for increased activation of antigen-specific T cells during the induction of the response. Interestingly, the slope of the challenge dose-response curve and hence the expression phase is the same as that for normal subjects. An important factor in the activation or induction of an immune response is the concentration of antigen per unit area. Our studies on the influence of area of application of antigen indicate that at very small areas, between 3 mm and 1 cm across, changing area and hence number of antigen-bearing Langerhans cells may alter sensitization. Above a threshold or plateau level, changing the area makes very little difference, whereas change in the concentration per unit area, i.e., the number of antigen molecules per Langerhans cells, is a powerful determinant of sensitizing potency. We have not explored the upper limit of this phenomenon, i.e., maybe the relationship does not hold above a certain area or dose. The final series of observations showed that the application of antigen to skin pretreated with UVB or PUVA is followed by an absence of immunologic response. This state differs from that seen in mice in that it reflects a "failure" of activation of the immune system rather than a state of down-regulation or tolerance. Having established these ground rules, it will be possible to move on to a whole series of additional questions relating basic aspects of immunology to the applied areas of contact dermatitis.

Animals↗
PubMedDate not supplied

Engineering aspects of extracorporeal photochemotherapy.

Photopheresis is a new extracorporeal photochemotherapy in which the patient's blood or certain blood fraction is exposed to light in the presence of a light-activatable drug. The major engineering elements involved for better system design and patient treatment, such as system model, cell separation, irradiation, and energy measurement, are discussed.

Cell Separation↗
PubMed1989

[The best ways of the control of inflammatory diseases of the lung].

Three approaches to optimal control of inflammatory diseases of the lungs are described. The first approach includes improvement of the diagnostic procedure. The second approach is based on development of new complexes of drug therapy and organization of nondrug therapy. The third approach is prophylactic. The main goals of the approaches are formulated.

Anti-Bacterial Agents↗