Impact of combination therapy on Ki-67 and Bcl-2 expression in psoriasis

BACKGROUND: Psoriasis is a chronic inflammatory immune-mediated disease characterized by an increased rate of keratinocyte division. Modern ideas about the immunopathogenesis of psoriasis, systemic inflammation and manifestations, comorbid conditions bring to the fore the question of the rational choice of therapy in patients with moderate and severe psoriasis. AIM: to study the effect of the combined use of PUVA therapy and methotrexate on the expression levels of receptors for the proliferation marker Ki-67 and the anti-apoptotic protein Bcl-2. MATERIALS AND METHODS: The study included 110 patients with moderate to sеvеrе psоriаsis,divided into 2 groups: the first group received PUVA therapy in combination with methotrexate (Mt); the second group received methotrexate (Mt) monotherapy. Skin biopsies were taken from the affected areas in 10 patients from the 1st group before and after therapy for immunohistochemical study to determine the level of expression of Ki-67 and Bcl-2. Healthy skin bioptats were taken from patients operated on for appendicitis and used as the control samples. RESULTS: An immunohistochemical study revealed a statistically significant increase in the initial indicators of the expression level of Ki-67 and Bcl-2 in all patients with psoriasis compared with the control group. As a result of the combined therapy, there was a significant decrease in the expression of Ki-67 and Bcl-2. CONCLUSION: The combined method of treatment of patients with psoriasis has an immunosuppressive effect, as evidenced by a significant decrease in the expression of the proliferation marker Ki-67 and the apoptosis inhibitor Bcl-2.