The effects of short term acitretin and ciclosporin treatments on IL?2 and TNF-? levels in moderate to severe plaque type psoriasis

Psoriasis is a commonly observed, chronic and characterized by reccurency disorder which affects the skin and joints. Pathogenesis of prosiasis is not absolutely known, and it is thought to be an autoimmune and inflamatuar disease, which is characterized by increase in keratinocyte through T cells. Different observations prove the patogenic roles of T cells in psoriasis.This study presents comparison of efficiency of short term ciclosporin and acitretin treatments in moderate to severe plaque type psoriasis patients, determination of the correlation between the treatment and the levels of IL?2 and TNF-?, which are the cytokins of Th1 influencive in pathogenesis.This study was performed as a prospective, randomized and 8 weeks clinical research. The research covered 46 moderate-severe plaque type psoriasis patients who are18 year and older, whose PASI scores are equal or higher than 10 and with no systemic disease. The study was grouped into two treatments as ciclosporin (n=21) and acitretin (n=25). In order to determine the disease activity in psoriasis patients, PASI scores were computed before and after treatment. The PASI scores of the patients were evaluated 8 weeks later. Blood specimens were taken from the patients, two times as before and after the treatment, in order to determine the IL?2 and TNF-? levels.Significant decrease in PASI scores was observed in both treatment groups during the 8 week treatment, however, no statistically significant difference was observed between the two treatment groups. At the end of this study, both treatment methods were observed to decrease the IL?2 and TNF-? levels in similar rates, in 8-week time period. As the variaitons of IL?2 and PASI values in the treatment groups were analyzed, no significant correlation was observed between variations of IL?2 and PASI values in the two treatment groups. On the other hand, as the variation of TNF-? and PASI values in both the treatment groups were observed, significant correlation was determined only in variations of TNF-? and PASI values in ciclosporin treatment group.As parallel to results of our study, we believe that knowing the levels of IL-2 and TNF-? can be helpful while evaluating the activity of the disease and respond to the treatment, and also that both the treatments are affective in short term.Key words: Psoriasis, Ciclosporin, Acitretin, IL?2, TNF-?