Does imiquimod pretreatment optimize 308‐nm excimer laser (UVB) therapy in psoriasis patients?

Abstract

Psoriasis continues to be a debilitating skin disease affecting 1-3% of the United States population. Although the effectiveness of several current biologic therapies have described this pathology as a IL-23, TNF-α and Th17-mediated disease, less invasive approaches are still in use and in need of refinement. One of these is the usage of narrow band-UVB (NB-UVB) therapy to deplete specifically intra-epidermal CD3+, CD4+ and CD8+ cells to clear psoriatic plaques. In order to improve NB-UVB therapy, we sought to determine whether skin pre-treatment with the TLR7 agonist imiquimod (IMQ) would help increase the efficiency of the former at resolving psoriatic plaques. Our results suggests that although IMQ seemed to activate the type I interferon pathway as previously described, its concomitant usage with NB-UVB for clearing psoriatic skin was ineffective. Although upregulation of genes M×A, GRAMD1A and DMXL2 suggested that IMQ treatment did induce skin changes in psoriasis patients, more optimal dosing of IMQ and NB-UVB might be necessary to achieve desired treatment responses. The observation that psoriasis involvement was not aggravated by usage of topical IMQ was encouraging. Additional observational studies might be necessary to further tailor the combination of IMQ with NB-UVB therapy to reliably improve the psoriatic pathology.

Effect of Different Wavelengths of Laser Irradiation on the Skin Cells

“…First, the Q-switched Nd:YAG laser in which ultraviolet 353 nm laser irradiation is changed from 1064 nm (infrared) wavelength using a special crystal. The second type is a gas (excimer) laser, commonly used in the treatment of psoriasis [ 22 , 23 ]. The third type is a metal vapor laser [ 24 ].…”

GRAMD1A Is a Biomarker of Kidney Renal Clear Cell Carcinoma and Is Associated with Immune Infiltration in the Tumour Microenvironment

“…In previous studies, GRAMD1A was found to accumulate at autophagosome initiation sites, influence cholesterol distribution during starvation, and participate in autophagosome biogenesis [ 24 ]. Besides, as one of the genes in the TLR7 regulatory pathway, GRAMD1A can be used to assess the response of psoriasis after treatment [ 25 ]. In human cancers, GRAMD1A is currently only found to promote proliferation, migration, and invasion of hepatocellular carcinoma as well as the expansion of hepatocellular carcinoma stem cells [ 10 , 11 ].…”