Anita Olejek1, Iwona Gabriel2, Anna Bilska-Janosik1, Iwona Kozak-Darmas1, Aleksandra Kawczyk-Krupka3. 1. School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Department of Gynecology, Obstetrics and Oncological Gynecology, Batorego 15, 41-902, Bytom, Poland. 2. School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Department of Gynecology, Obstetrics and Oncological Gynecology, Batorego 15, 41-902, Bytom, Poland; Division of Urogynecology, Brigham and Women's Hospital, Boston, USA. 3. School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Batorego 15, 41-902, Bytom, Poland. Electronic address: akawczyk@gmail.com.
Abstract
BACKGROUND: Lichen sclerosus (LS) is a difficult to treat, often relapsing disease with unknown background. Autoimmune diseases also coexist with LS. Over recent years photodynamic therapy (PDT) has been shown to be a noninvasive and successful therapeutic approach for the effective treatment of many conditions. However, the change of immune status of the patients based on ANA antibodies has not been yet reported. Our aim was to observe the clinical response followed by possible changes in autoimmune antibodies levels before and after PDT for LS. MATERIAL AND METHODS: We enrolled 100 women with Lichen sclerosus with or without a concomitant autoimmune disease. All patients received 10 cycles of PDT (65 treated with DIOMED Light, 35 with PhotoDYN Light). We assessed autoimmune antibodies before and after PDT in addition to the clinical response evaluation.Two-year prospective controlled before-and-after study. RESULTS: Following PDT, patients showed a significant attenuation in symptoms' intensity (itching, pruritus, vulvar discomfort). After therapy 41% of patients had partial response, 51% of patients had no symptoms and 8% had persistent or worsened symptoms. The most frequent autoimmune disease were thyroid disorders, followed by vitiligo and arthritis. 57% patients with an additional autoimmune disease before PDT had ANA antibodies. The mean level of ANA in this group diminished significantly after PDT treatment (261.74 IU/ml before vs. 123.20 IU/ml after treatment). CONCLUSION: Based on our results, we assume that PDT may influence the immune status of patients with Lichen sclerosus.
BACKGROUND:Lichen sclerosus (LS) is a difficult to treat, often relapsing disease with unknown background. Autoimmune diseases also coexist with LS. Over recent years photodynamic therapy (PDT) has been shown to be a noninvasive and successful therapeutic approach for the effective treatment of many conditions. However, the change of immune status of the patients based on ANA antibodies has not been yet reported. Our aim was to observe the clinical response followed by possible changes in autoimmune antibodies levels before and after PDT for LS. MATERIAL AND METHODS: We enrolled 100 women with Lichen sclerosus with or without a concomitant autoimmune disease. All patients received 10 cycles of PDT (65 treated with DIOMED Light, 35 with PhotoDYN Light). We assessed autoimmune antibodies before and after PDT in addition to the clinical response evaluation.Two-year prospective controlled before-and-after study. RESULTS: Following PDT, patients showed a significant attenuation in symptoms' intensity (itching, pruritus, vulvar discomfort). After therapy 41% of patients had partial response, 51% of patients had no symptoms and 8% had persistent or worsened symptoms. The most frequent autoimmune disease were thyroid disorders, followed by vitiligo and arthritis. 57% patients with an additional autoimmune disease before PDT had ANA antibodies. The mean level of ANA in this group diminished significantly after PDT treatment (261.74 IU/ml before vs. 123.20 IU/ml after treatment). CONCLUSION: Based on our results, we assume that PDT may influence the immune status of patients with Lichen sclerosus.