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DERMATOVENEREOLOGY
INVENTION
Patent of the Russian Federation RU2142830

METHOD OF TREATMENT OF PSORIASIS

METHOD OF TREATMENT OF PSORIASIS

The name of the inventor: Latyshev NA; Kasyanov SP; Akulin VN; Yutskovsky AD; Strelbitskaya OF; Li S.E.
The name of the patentee: Institute of Marine Biology, Far East Branch, Russian Academy of Sciences; Pacific Research Fisheries Center (TINRO-Center); Vladivostok State Medical University
Address for correspondence: 690041, Vladivostok, Palchevsky St., 17, Institute of Marine Biology, Far Eastern Branch of the Russian Academy of Sciences, Kravtsova Yu.Yu.
Date of commencement of the patent: 1997.09.24

The invention relates to dermatology and is intended for the treatment of psoriasis. The helium-neon laser lightguide, equipped with a magnetic nozzle, is applied to the area of ​​the elbow vein projection, on which a preparation containing a mixture of w- 3 polyene acids with a content of the sum of eicosapentaenoic and docosahexaenoic acid equal to 5-100% is previously applied. Irradiation is carried out with a power of 25-35 mW / cm 2 to 20-25 sessions, lasting 30-40 minutes. The method has anti-inflammatory, anti-edematous, regenerative, desensitizing, immunocorrecting, hypocholesterolemic action, and leads to an improvement in local blood flow.

DESCRIPTION OF THE INVENTION

The invention relates to medicine, namely, to dermatology, and can be used to treat psoriasis.

There are many methods of treating psoriasis, but there are no effective methods leading to the cure of the disease. Among the methods of treatment of psoriasis, one of the leading places is occupied by modern methods of phototherapy: SFT and PUVA. PUVA therapy is usually performed with the help of PUVA-30, UUD-1, PUVA-10, PUVA-5, PUVA-2 devices according to the following procedure. Pouvalene, a preparation containing 8-methoxypsoralen, and enhancing photosensitization, is prescribed for intake within 2 hours before irradiation in a dosage corresponding to the body weight. Procedures are conducted 4 times a week, the whole course - 20-25 (Rusak YE Development and improvement of pathogenetic methods of treatment of psoriasis on the basis of phototherapy: Author's abstract of the doctor of medical sciences: 14.00.11 - M., 1997. - 32 from. ). However, the wide spread of the methods of treatment of psoriasis with the help of phototherapy together with Pouvalene is prevented by side effects arising during the treatment: itching, dry skin, erythema, vesicular rashes, hypertrichosis, subungual ecchymosis, persistent hyperpigmentation of the skin, papillomatosis, etc.

There is a known method of treatment of psoriasis, which consists in appointing "Tigazon" (Tigason) 1 capsule (25 grams) per day simultaneously with photochemotherapy on a 4-day schedule using a photosensitizer Pouvalene. Clinical recovery is noted after 4 weeks (RF patent application 92007126/14, cl. A 61 K 31/595, published by BI N 4, 1996). However, "Tigazon" is a teratogenic drug, therefore its use is contraindicated not only during pregnancy, but also for all women of childbearing age. In addition, the use of this method leads to side effects, which are inherent in the above-mentioned PUVA-phototherapy method.

A method for the treatment of psoriasis by exposure to low-intensity laser radiation with a wavelength of 0.63 μm per formed blood elements is known. Blood irradiation was performed with an exposure of 30 minutes every other day to 6-7 sessions, against the backdrop of taking AEVIT preparation on the 1st capsule 2 times a day (Topical Medicine: Collection of scientific papers / Vladivostok State Medical Institute, Vladivostok, 1994 / - P. 30. / Arsen'ev MA Experience of helio-neon laser application "ALOK" intravenous effects in the treatment of psoriasis). However, this method did not pass, for several reasons, clinical trials and requires further study.

A method of treating psoriasis by means of medicamentous and intravascular laser irradiation of blood is known. Drug treatment was carried out using medicines: vitamin B 12 , ethacridine lactate in powders, pyrogenal in increasing dosages, antihistamines and desensitizing agents. Laser irradiation was carried out with a power of 1-2 mW, then with a daily successive increase of 1-3 mW for 10-12 days to 20 mW with a duration of sessions of 20 minutes (USSR author's certificate, No. 1813462, cl. A61 N 5/06, 1990.). The disadvantage of this method is the need to use a significant number of drugs.

There is a known method of external treatment of psoriasis with the use of an antipsoriatic agent (Dovzhansky SI, Utz SR Psoriasis or psoriatic disease., 2 hours Saratov: Sarat University Press, 1992. - 2 hours 47.), which is an ointment of the following composition, in grams:

  • Acid salicylic - 0,3 - 0,5
  • Tar birch - 30,0
  • Vaseline - 30,0

Treatment is carried out by lubricating the affected areas 2-3 times a day, until the inflammatory process is resolved, which is usually observed after 1-3 months or more. The shortcomings of this method include the duration of treatment.

The method closest to the claimed method for a set of essential features is the method of treating psoriasis by intravascular irradiation of circulating blood with a helium-neon laser. By puncturing the ulnar vein with a "normal needle for blood transfusion," irradiation of circulating blood was carried out through the light guide, while the power at the end of the light guide is 2-2.5 mW, the time of action is 30-35 min. Irradiation is carried out 2 times a week, the duration of the course is up to 6-8 procedures (Nedosekova NG Features of the course and therapy of burdened psoriasis: Author's abstract of Candidate of Medical Sciences: 14.00.11 .- M., 1991. - 16 sec. .).

The disadvantages of this method of treatment include morbidity of the procedure, repeated injury to the vein and the possibility of transmission of infection (AIDS, Botkin's disease, etc.).

The task to be solved by the invention is to reduce the side effects and harmful effects of drugs, expand the range of sparing treatments in outpatient settings.

The problem is solved by the fact that in a known method of treating psoriasis by laser irradiation of blood in the ulnar vein region, the light guide is additionally supplied with a magnetic attachment and applied directly to the area of ​​the elbow vein projection on which a preparation containing a mixture of ethyl esters of polyenic acids w -3 With the content of the sum of eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) acids equal to 5-100%, and irradiation is carried out at a wavelength of 0.60-0.63 μm, a power of 25-35 mW / cm 2 to 20-25 sessions, duration 30-40 minutes.

The irradiation is carried out with the aid of the CRIC-1 apparatus using a low-intensity red light guide with a constant pulse generation mode, a wavelength of 0.60-0.63 μm, which is additionally supplied with a magnetic packing.

The combination of the effect of laser radiation and the magnetic field provides an increase in the depth of penetration of laser radiation into tissues due to their polarization by the magnetic field, and increases the permeability of the skin for drug molecules. In addition, the total energy intensity of the action increases and the range of laser perception is broadened.

Carrying out irradiation with a laser flow of 25-35 mW / cm 2 facilitates the rapid penetration of the drug, namely a mixture of ethyl esters of polyethylene fatty acids w -3 series, into the body and their incorporation into the metabolic processes of leukotriene biosynthesis in the cells of the affected tissue, which ultimately Leads to anti-inflammatory, anti-edema, regenerative, desensitizing, immunocorrecting, hypocholesterolemic effects, and to improve local blood flow. All of the above, as a result, leads to the resolution of the disease.

The irradiation exposure of 30-40 minutes at a power of 25-35 mW / cm 2 was chosen taking into account the evolution of the development of psoriatic plaques, in which the proliferative and inflammatory reactions caused by disturbances in the regulation of the exchange of highly unsaturated fatty acids prevail.

It is established that the duration of the course of treatment of 20-25 sessions ensures the achievement of a stable effect and prolonged remissions, although the effect is manifested in 10-15 sessions.

Mixture of ethyl esters of polyenoic acids w -3 series is an oily liquid of yellow color with a weak specific fishy smell. The mixture does not lose liquid consistency even at -30 o C and does not contain any organic solvents in its composition.

The content in the preparation of the effective principle - ethyl esters of eicosapentaenoic and docosahexaenoic acids - can vary from 5 to 100%. The lower limit is determined on the basis that the decrease in the total content of these acids below 5% significantly reduces the effectiveness of the drug due to the high "ballast" content of esters of fatty acids that do not possess such action. The upper limit corresponds to the time when the preparation contains only ethyl esters of eicosapentaenoic and docosahexaenoic acids. This drug is most effective.

The proposed mixture of ethyl esters of polyethylene fatty acids w- 3 series is made according to RF patent No. 1581737, cl. C 11 C 1/00, C 11 C 7/00, 1993, as follows: the fish oil is hydrolyzed by mixing with a solution of potassium alkali in ethanol, the free fatty acids are isolated by acidifying the mixture with a solution of sulfuric acid, then the fatty acids are crystallized with urea in Solution of ethanol, after some exposure from the filtrate, polyene fatty acids are isolated, they are converted into ethyl esters in a solution of ethanol and sulfuric acid, and then the final product is obtained after purification.

The claimed method has been used for the treatment of psoriasis in a clinical setting. There were 59 patients under observation, 37 of them men, 22 women aged 19 to 60 years, with the duration of the disease from 1 to 30 years. In clinical examination, in all patients the skin process was widespread, represented by papules, pink-red plaques with silver-white scales on the surface. Psoriatic phenomena are positive, which indicates a progressive stage of the disease.

The control group consisted of 20 patients with psoriasis, who were treated with traditional methods of psoriasis therapy, in hospital (ointments, pastes containing tar, naphthalan, ichthyol, salicylic acid).

The second group consisted of 20 patients who received external plaque application with a mixture of ethyl esters of polyenoic acids w- 3 with a content of eicosapentaenoic and docosahexaenoic acid equal to 5-100% once a day.

In the groups of patients observed, the treatment of psoriasis was carried out by a new method claimed by the present invention. Treatment is carried out as follows.

Example 1

Patient K., 41 years old. The diagnosis is a common psoriasis, a progressive stage, a winter form. He is ill with this disease for 10 years. Previously he was treated by usual methods. Upon admission to treatment, the pathological process was represented by multiple psoriatic plaques located on the skin of the scalp, trunk, arms and legs. Plaques are covered with silvery scales. General clinical tests without abnormalities.

TREATMENT: 3-4 drops of a mixture of ethyl esters of polyenoic acids w -3 series with the content of the sum of eicosapentaenoic and docosahexaenoic acids 100% were applied daily to the area of ​​the elbow vein projection, then a lightguide additionally equipped with a magnetic packing was applied and the helium-neon laser irradiated for 40 min, the output power was 25 mW / cm 2 . Plaques began to clear by the end of the first week after the start of treatment, decreased erythema, infiltration in the lesions. After 15 sessions, the plaques were resolved completely.

Treatment lasted up to 25 sessions. At the time of the end of treatment - there was a pigmentation in place of the former plaques. At repeated inspections, in half a year and year, it is established, that pathological aggravation of process is not present.

Example 2

Patient S., 45 years old. The diagnosis is a common psoriasis, progressive, autumn-winter form. He has 5 years of illness. Previously, he was treated with traditional methods. Upon admission to treatment, the pathological process was represented by multiple psoriatic plaques located on the skin of the scalp, trunk, arms and legs. Plaques are covered with silvery scales. General clinical tests without abnormalities.

TREATMENT: 3-4 drops of a mixture of ethyl esters of polyene acids omega-3 series with the content of the sum of eicosapentaenoic and docosahexaenoic acid 5% were applied daily to the area of ​​the elbow vein projection, then a lightguide additionally equipped with a magnetic nozzle was applied and the helium-neon laser irradiated for 30 min, the output power was 35 mW / cm 2 . At the 7th session, the plaques markedly flattened and the inflammatory processes decreased. The patient noted a general improvement in the state of the body. Treatment lasted up to 25 sessions. At the time of the end of treatment, the process on the skin was resolved, there was a small infiltration "around the ring" on the skin in the region of the elbows by the type of on-duty plaques. It is discharged with recovery.

Control examination after six months showed no exacerbation of the process.

Example 3

Patient S., 60 years old. The diagnosis is a common psoriasis, a progressive stage, a mixed form. Duration of the disease is 30 years. Previously treated with conventional traditional methods. Upon admission to treatment, the pathological process was represented by multiple psoriatic plaques located on the skin of the trunk, arms and legs. Plaques are covered with silvery scales. He noted a strong itch. General clinical tests without abnormalities.

TREATMENT: 3-4 drops of a mixture of ethyl esters of polyenoic acids w -3 series with a content of the sum of eicosapentaenoic and docosahexaenoic acids 20% were applied daily to the area of ​​the elbow vein projection, then a lightguide additionally equipped with a magnetic packing was applied and the helium-neon laser irradiated for 30 min, the output power was 35 mW / cm 2 . Plaques began to clear by the end of the first week after the beginning of treatment, the itching decreased. He noted improvement in the general state of the body, sleep improved, became less irritable, after 15 sessions, plaques were completely resolved.

Treatment lasted up to 22 sessions. At the time of the end of treatment, the process on the skin was resolved completely, only pigmented spots remained on the place of the plaques. Control examination after six months showed no exacerbation of the process.

For clarity, other examples of the application of the claimed method are shown in the table. The treatment was carried out in the same way as in Examples 1 to 3, the treatment conditions are indicated in the fourth column, while the mixture of omega-3 polyene acid ethyl esters with a content of eicosapentaenoic and docosahexaenoic acid content of 5 to 100% is for the sake of brevity simply called a preparation and its concentration used For the treatment of a particular patient.

As the practice of using the claimed method has shown and it can be seen from the examples given , the effect of the treatment was already observed by the end of the first week after the start of treatment. So, erythema and flaking on the surface of the rashes decreased, itching and inflammation decreased significantly. First of all, the resolution of the elements was observed in cases of discharge foci, forming papular infiltration and on the scalp. Overall improvement of the whole organism was noted (good sleep, irritability decreases, gastrointestinal tract function improves). By the end of the second week the process was completely resolved, hyperpigmented spots were retained in place of the former rashes. Tolerance was good, only two patients had an increase in itching, which decreased after 7 days of treatment.

Practically in each of the 4 patients discharged after treatment with a positive clinical resolution of the inflammatory process, there was a persistent remission, there was no exacerbation of the skin process within one year.

Advantages of the proposed method of treatment in comparison with the control group is the following: a reduction in the course of treatment, eliminates the need for external use of expensive medications, treatment in outpatient conditions, an increase in the remission period.

In comparison with the group receiving local treatment with a mixture of ethyl esters of polyenoic acids w -3 series with a content of the sum of eicosapentaenoic and docosahexaenoic acid from 5 to 100%, in patients receiving treatment with the claimed method against the background of achieving a similar therapeutic effect, a general improvement in the state of the organism , Sleep improved, irritability decreased, bowel function was regulated. In addition, there was a significant saving of the medicinal preparation and there was no need to lubricate all affected skin areas. All of the above makes the claimed method of treatment more convenient and preferable for the treatment of patients on an outpatient basis.

So, the claimed method of treatment of psoriasis, in comparison with the known ones, is the most sparing method of treatment, allows to refuse expensive drugs, can be used for treatment in outpatient conditions, which will save considerable money for hospital stay.

CLAIM

A method of treating psoriasis by irradiating blood with a helium-neon laser in the ulnar vein region, characterized in that a lightguide provided with a magnetic attachment is applied to the elbow vein projection area, which is previously applied to a preparation containing a mixture of polyethylene acids of w -3 series with a content of eicosapentaenoic And docosahexaenoic acid, equal to 5-100%, and irradiation is carried out with a power of 25-35 mW / cm 2 to 20-25 sessions lasting 30-40 minutes.

print version
Date of publication 01.04.2007гг