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DERMATOVENEREOLOGY
INVENTION
Patent of the Russian Federation RU2233160

METHOD OF TREATMENT OF PSORIASIS

METHOD OF TREATMENT OF PSORIASIS

The name of the inventor: Kungurov N.V. (RU); Mataev SI (RU); Suhovei Yu.G. (RU); Matusevich S.L. (RU); Goltsov S.V.
The name of the patent owner: Matusevich Sergey Lvovich
Address for correspondence: 625000, Tyumen, st. Nemtsova, 72, apt.7, S.L. Matusevich
The effective date of the patent: 2002.09.24

The invention relates to medicine, in particular to immunology and dermatology, and concerns the metabolic immunocorrection of patients with psoriasis. The method includes traditional basic therapy of psoriasis patients and the use of a complex of amino acids, which is used as the drug "AMINO-1900", taking it 1 tablet 3 times a day, regardless of food intake for 30 days. The method increases the effectiveness of treatment, prolongs remission due to saturation of the environment of keratinocyte environment with amino acids necessary for the proper functioning of the immune system.

DESCRIPTION OF THE INVENTION

The invention relates to medicine, in particular to immunology and dermatology.

Psoriasis is one of the most common skin diseases. Psoriasis is defined as an immunoproliferative dermatosis of a multifactorial nature with a genetic fraction of 64-72% and a media component of 28-36% characterized by hyperproliferation of the epidermal cells, a violation of keratinization, an inflammatory reaction in the dermis, changes in various organs and systems (1,2,3). Psoriasis is not life-threatening pathological condition and in rare cases leads to death. However, frequent relapses of the disease, which may be accompanied by widespread skin lesions, cause the patient physical discomfort and are the cause of complex psychological problems. Severe and persistent forms of psoriasis (arthropathic, erythrodermic forms, pustular psoriasis, psoriasis of the palms and soles) are often the cause of disability of the patient in childhood and working age. In addition, due to a steady increase in the incidence rate, an increase in the incidence of disabling forms, further study of the pathogenesis of this disease has an undoubted socio-economic significance and seems necessary for the improvement of diagnostic, prevention and treatment (4, 5).

In connection with the fact that the functions of nutrition and immunity are evolutionarily unified, it becomes necessary to take into account the influence of certain types of malnutrition on the mechanisms of immune defense, determining the principles of dietary immunocorrection and forming immunological criteria for the status of nutrition. In this connection, it is extremely important to study the effect of the forms of poly-nutrient deficiency that are prevalent in the nutrition of patients on the indicators of interest, including the state of immunobiological reactivity. In addition, in adjusting the diet of individual groups of patients, it is necessary to rely on both the necessary nutrient composition and genetically determined, food habits of the population that are formed taking into account the climatic conditions of the habitat.

Moreover, directed modification of the metabolism of immunocompetent cells by means of alimentary effects is one of the ways of functional regulation of the immune system in psoriasis (6).

A method of immunocorrection in psoriasis with immunoactive drugs is known, for example, T-activin (7)

However, the appointment of such is not entirely justified, since the latest literature data determine psoriasis as an immunoactive process.

The problem solved by the invention is the elimination of the exogenous amino acid deficiency revealed in psoriasis necessary for the adequate functioning of the immune system under conditions of increased function.

In carrying out the invention, the technical result is to increase the efficiency and shorten the treatment time, and prolong the remission - is solved as follows.

This technical result is achieved by the addition of a complex of amino acids in the method of treatment of psoriasis by metabolic immunocorrection to complex traditional therapy in order to saturate the environment of keratinocyte encirclement with amino acids. In this case, a complex of amino acids is taken 1 tablet 3 times a day, regardless of food intake for 30 days.

The use of a complex of amino acids, which are active metabolites, allow after absorption from the gastrointestinal tract to be immediately integrated into the mechanisms of the metabolic conveyor.

As a complex of amino acids for therapy use a complex of amino acids produced by the company "Universal" (USA) - "AMINO-1900" (No.ROSS US.Àa55.С00215 from 22.06.99). Table 1 shows the dynamics of the PASI index in patients with advanced psoriasis before and after traditional therapy (8) and therapy with a complex of amino acids, in Table 2 - the indices of immune status in patients with advanced psoriasis before and after traditional therapy and therapy with a complex of amino acids.

Experimental study showed that after carrying out metabolic immunocorrection, the complex of amino acids in the volume of psoriasis therapy established a decrease in the frequency of relapses of the disease. Thus, in this group of patients (with a continuously-recurrent psoriasis course) from 23.1 ± 8.2% (6 patients, at n = 26) after therapy only in 7.7 ± 5.2% (2 patients) exacerbation was observed Once a half a year, and the rest 15.4 ± 7.1% of treated (4 patients) within 7 months were not registered exacerbation of psoriasis. This indicates a favorable effect of this method of therapy on the clinical course of psoriasis. Moreover, the appointment of a complex of amino acids in the volume of therapy of psoriasis contributes to the prolongation of remissions, the reduction of the time spent in hospital (Table), which is confirmed by significant differences in the time of stay in the hospital of these patients 18,6 ± 1,7 bed-days in comparison with those receiving Traditional therapy is 23.9 ± 1.9 (p <0.05).

Diagnosis: common psoriasis, progressive stage. He complained of common rashes on the skin and scalp, joint pain, change of nail plates. From an anamnesis: for the first time I fell ill at the age of 15 after a psychotrauma. On the extensor surface of the forearm there were individual rashes. The process was seasonal. The exacerbations were in the spring-winter period. Soon the rash spread over the entire surface of the skin. Repeatedly received inpatient treatment: antihistamine and hyposensitizing drugs, multivitamin complex and ointment, hormone therapy.

Upon admission, the patient had the following clinical picture. The general condition is satisfactory, the visible mucous membranes are clean, of ordinary color. In the lungs, the breath is vesicular, there is no wheezing. Heart sounds are clear, the rhythm is correct. Pulse 76 beats per minute. At palpation the stomach is soft, painless, there are no symptoms of irritation of the peritoneum. The intestine is palpated in the form of an elastic strand, painless. The symptom of "effleurage" is negative on both sides. Sexual organs according to the male type, without features.

From the side of the skin: rashes of a widespread nature, localized on the scalp, trunk, upper and lower extremities, mainly on the extensor surface, where there were papules the size of a drop-shaped to a coin-like, bright red color. Papular elements merged into plaques on the chest, interblade, lumbosacral region and lower leg, the size of plaques up to 8-10 cm in diameter. On the surface of silvery-white scales, around the inflammatory corolla, when scraping psoriasis phenomena are obtained. Nail plates changed by the type of thimble.

An objective indicator of the course of the psoriatic process in dynamics is the PASI index of the severity of the lesion, which is calculated taking into account the size of the affected area, the severity of hyperemia, infiltration and flaking.

The formula for calculating the severity of the psoriatic process is the PASI index

PASI = 0.3 ґ [Pt + It + Et] ґ Pt + 0.2 ґ [вw + Iv + Ev] ґ Pv + 0,4 ґ [Wn + In + En] ґ Mon +0.1 ґ [ + Ng + Ey] N, where W is the peeling, I is infiltration, E is erythema, P is the area of ​​the lesion, m is the trunk, in the upper limbs, n is the lower limb, r is the scalp.

The PASI index before treatment was 29.2 ± 3.2.

Upon admission, the following assays were obtained.

General blood analysis. Hg 108 g / l, er. - 3,0 g / l, ESR 14 mm / h, L - 4,2 g / l, p - 2%, with -59%, l - 33%, b - 0%, e - 3%, m - 3%.

The immune status of the blood: CD38 (21,8 ± 2,2), CD8 (31,4 ± 1,2), CDDR (16,0 ± 2,3), CD71 (1,8 ± 0,1), CD25 ( 4.7 ± 0.4), CD95 (5.3 ± 0.6), IgA (2.8 ± 0.3); CEC 3.5 (18.7 ± 3.1). The patient was treated in accordance with the claimed method.

When comparing the index of PASI patients with advanced psoriasis before and after therapy with a complex of amino acids, a significant decrease in the latter (29,2 ± 3,2-7,8 ± 2,6; р <0,05) was revealed.

The immune status of the blood: CD38 (16.3 ± 1.0), CD8 (23.7 ± 0.7), CDDR (8.4 ± 1.2), CD71 (0.9 ± 0.1), CD25 2.1 ± 0.2), CD95 (1.9 ± 0.4), IgA (2.0 ± 0.1), CEC 3.5 (27.4 ± 2.7).

Example 2. Patient S., aged 40, was treated in a dermatological hospital in the Tyumen City Department of Internal Affairs (case history No. 547) in March 2000.

Diagnosis: common psoriasis, progressive stage. He complained about common skin rashes and changes in nail plates. From an anamnesis: it was ill from a birth, it is sharp, rashes have appeared on all surface of a skin. Repeatedly received inpatient treatment for erythroderma: antihistamine, hyposensitizing drugs, multivitamin complex and ointment, hormonal therapy, physiotherapy.

Upon admission, the patient had the following clinical picture. The general condition is satisfactory, the visible mucous membranes are clean, of ordinary color. In the lungs, the breath is vesicular, there is no wheezing. Heart sounds are clear, the rhythm is correct. Pulse 80 beats per minute. At palpation the stomach is soft, painless, there are no symptoms of irritation of the peritoneum. The intestine is palpated in the form of an elastic strand, painless. The symptom of "effleurage" is negative on both sides. Sexual organs according to the male type, without features. From the side of the skin: rashes on the entire surface of the skin and scalp, are represented by papules the size of a teardrop-shaped to a coin-like, bright red color, merging into large plaques on the chest, interblade, lumbosacral region and shin. On the surface of silvery-white scales, around the inflammatory corolla, when scraping psoriasis phenomena are obtained. The nail plates have been altered by the type of subungual hyperkeratosis. The PASI index before treatment was 32.2 ± 4.1.

Upon admission, the following assays were obtained.

General blood analysis. Hg 120 g / l, er. - 3.5 g / l, ESR 26 mm / h, L - 5.2 g / l, p - 2%, c - 61%, l - 32%, b - 0%, e - 1%, m - 6%.

The immune status of the blood: CD38 (21,9 ± 2,1), CD8 (30,4 ± 1,1), CDDR (18,0 ± 2,7), CD71 (1,9 ± 0,2), CD25 ( 4.9 ± 0.6), CD95 (6.2 ± 0.8), IgA (2.9 ± 0.2); CEC 3.5 (22.8 ± 4.1).

The patient was treated in accordance with the claimed method.

The PASI index after therapy with a complex of amino acids was (8.2 ± 3.2, p <0.05).

The immune status of the blood: CD38 (15.2 ± 1.0), CD8 (21.7 ± 0.6), CDDR (6.4 ± 1.1), CD71 (0.8 ± 0.1), CD25 1,1 ± 0,1), CD95 (1,2 ± 0,3), IgA (1,9 ± 0,1), CEC 3,5 (16,3 ± 2,3).

A total of 26 patients with psoriasis aged 16 to 45 years were treated.

It is established that the use of a complex of amino acids in the volume of therapy of patients with psoriasis:

- has a positive effect of our combined therapy on the clinical course of advanced psoriasis, expressed by a decrease in the PASI index compared with that before treatment;

- allows to reduce the time spent in hospital (bed-day) by 22.2% compared with patients receiving basic therapy, thereby determining the economic effect of this therapeutic strategy;

- positively affects the number of circulating populations of lymphocytes, expressed by the normalization of CD38, CD8, CDDR, CD71, CD25, CD95, IgA and large-molecule CEC.

Thus, the approximation of laboratory characteristics to the characteristics of the healthy group as a result of the treatment is associated with a positive clinical dynamics with respect to the symptoms of psoriasis. The obtained data indicate the expediency of using a complex of amino acids as a metabolic immunocorrection of psoriasis.

INFORMATION SOURCES

1. Vladimirov VV, Menshikova L.V. Modern ideas about psoriasis and methods of its treatment // Rus. honey. Journal. - 1998. - № 20. Pp. 1318-1323.

2. Glukhenky B.T. Psoriasis. // Likuvannya ta Diagnostics. - 1998. - №1. C.47.

3. Dovzhansky SI, Utts S.R. Psoriasis or psoriatic disease. At 2 o'clock Saratov: Sarat Publishing House. University, 1992. - Part 1. - P.176.

4. Krinitsyna Yu.M., Krivosheev BN Modern methods of treatment of patients with psoriasis. Methodical recommendations for doctors. // Novosibirsk, 1998. - P.35.

5. Mashkileyson A.L., Rubins A.Ya., Wexler H.M. Immunological aspects of the pathogenesis of psoriasis // Vestn. Dermatology. - 1987. №2. - P.17-22.

6. Baadsgaard O. Immunological cells in psoriasis pathogenesis // JEADV. Vol. 9 (Suppl. 1) - Sept. 1997. Abstracts VI Congress of the European Academy of Dermatol. And Vener., Sept. 14-15, 1997, Dublin, Ireland, 1997. P.1.

7. Skripkin Yu.K., Kubanova AA, Mordovtsev V.N. Modern methods of therapy of psoriasis: Method. Recommendations. M., 1995. - P.16.

8. Federal guidance for doctors on the use of medicines (formular system). - M, 2001. - 298 p.

CLAIM

A method for the treatment of psoriasis, which includes traditional basic therapy for psoriasis patients and metabolic immunocorrection by taking a complex of amino acids, characterized in that AMINO-1900 is used as a complex of amino acids, which is taken 1 tablet 3 times a day regardless of food intake for 30 Days.

print version
Date of publication 01.04.2007гг