Tom 6, Nr 2 (2020)
Prace oryginalne
Opublikowany online: 2020-07-09
Pobierz cytowanie

Can topical cefazolin be a useful treatment for psoriasis?

Marta Kołt-Kamińska, Katarzyna Koziak, Małgorzata Dutkiewicz, Oliwia Zegrocka-Stendel, Adam Reich
DOI: 10.5603/FD.a2020.0005
·
Forum Dermatologicum 2020;6(2):43-49.

dostęp płatny

Tom 6, Nr 2 (2020)
Prace oryginalne
Opublikowany online: 2020-07-09

Streszczenie

Introduction: A better understanding of psoriasis pathogenesis resulted in significant development of new, effective anti-psoriatic therapies, albeit new treatment options, especially topical ones, are still awaited. In vitro studies have shown that cefazolin, the first-generation cephalosporin, has the properties of a specific inhibitor of several pro-inflammatory cytokines. This study aimed to evaluate the effects of cefazolin in 3D human psoriasis skin model and to assess the efficacy and tolerability of topical cefazolin in comparison to topical hydrocortisone butyrate in the treatment of psoriasis.  Material and methods: Commercially available 3D human psoriasis skin model was used to evaluate the effect of cefazolin on psoriasis-related gene expression: human β-defensin 2 (HBD2, DEFB-4A), psoriasin (S100A7) and skin-derived peptidase inhibitor 3 (PI3), as well IL-6 and IL-8 secretion. H&E staining was performed to evaluate tissue morphology. The clinical test was an open-label, comparative, left to right study with an active comparator. Ten adult subjects with psoriasis were asked to apply 5% cefazolin emulsion twice daily on the psoriatic plaques located in extensor area of the right elbow, and 0.1% hydrocortisone butyrate ointment on the same body area on the opposite side. The treatment continued for 7 days. The disease severity was assessed according to the modified PASI (mPASI) and Investigator Global Assessment (IGA). Patients were also asked to rate concomitant subjective symptoms, treatment tolerability and global therapeutic effect.  Results: Cefazolin down-regulated gene expression of HBD2 (DEFB-4A) and psoriasin (S100A7) and did not affect PI3. In the tested conditions the drug did not reduce IL-6 and IL-8 secretion. Histological evaluation revealed a slight thinning of the epithelium in tissues treated with cefazolin. In patients, both of the treatments resulted in a significant reduction of psoriatic plaques, although the therapeutic effect was significantly better for hydrocortisone butyrate ointment. Both drugs equally significantly reduced pruritus intensity. The treatment with cefazolin was well tolerated and any significant adverse events were observed.  Conclusions: Cefazolin can be considered an interesting therapeutic option as a topical immunomodulatory, anti-inflammatory drug, but its anti-psoriatic properties have to be confirmed in well-designed, prospective and vehicle-controlled studies. 

Streszczenie

Introduction: A better understanding of psoriasis pathogenesis resulted in significant development of new, effective anti-psoriatic therapies, albeit new treatment options, especially topical ones, are still awaited. In vitro studies have shown that cefazolin, the first-generation cephalosporin, has the properties of a specific inhibitor of several pro-inflammatory cytokines. This study aimed to evaluate the effects of cefazolin in 3D human psoriasis skin model and to assess the efficacy and tolerability of topical cefazolin in comparison to topical hydrocortisone butyrate in the treatment of psoriasis.  Material and methods: Commercially available 3D human psoriasis skin model was used to evaluate the effect of cefazolin on psoriasis-related gene expression: human β-defensin 2 (HBD2, DEFB-4A), psoriasin (S100A7) and skin-derived peptidase inhibitor 3 (PI3), as well IL-6 and IL-8 secretion. H&E staining was performed to evaluate tissue morphology. The clinical test was an open-label, comparative, left to right study with an active comparator. Ten adult subjects with psoriasis were asked to apply 5% cefazolin emulsion twice daily on the psoriatic plaques located in extensor area of the right elbow, and 0.1% hydrocortisone butyrate ointment on the same body area on the opposite side. The treatment continued for 7 days. The disease severity was assessed according to the modified PASI (mPASI) and Investigator Global Assessment (IGA). Patients were also asked to rate concomitant subjective symptoms, treatment tolerability and global therapeutic effect.  Results: Cefazolin down-regulated gene expression of HBD2 (DEFB-4A) and psoriasin (S100A7) and did not affect PI3. In the tested conditions the drug did not reduce IL-6 and IL-8 secretion. Histological evaluation revealed a slight thinning of the epithelium in tissues treated with cefazolin. In patients, both of the treatments resulted in a significant reduction of psoriatic plaques, although the therapeutic effect was significantly better for hydrocortisone butyrate ointment. Both drugs equally significantly reduced pruritus intensity. The treatment with cefazolin was well tolerated and any significant adverse events were observed.  Conclusions: Cefazolin can be considered an interesting therapeutic option as a topical immunomodulatory, anti-inflammatory drug, but its anti-psoriatic properties have to be confirmed in well-designed, prospective and vehicle-controlled studies. 
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Słowa kluczowe

cefazolin; psoriasis; treatment

Informacje o artykule
Tytuł

Can topical cefazolin be a useful treatment for psoriasis?

Czasopismo

Forum Dermatologicum

Numer

Tom 6, Nr 2 (2020)

Strony

43-49

Data publikacji on-line

2020-07-09

DOI

10.5603/FD.a2020.0005

Rekord bibliograficzny

Forum Dermatologicum 2020;6(2):43-49.

Słowa kluczowe

cefazolin
psoriasis
treatment

Autorzy

Marta Kołt-Kamińska
Katarzyna Koziak
Małgorzata Dutkiewicz
Oliwia Zegrocka-Stendel
Adam Reich

Referencje (10)
  1. Samotij D, Nedoszytko B, Bartosińska J, et al. Pathogenesis of psoriasis in the “omic” era. Part I. Epidemiology, clinical manifestation, immunological and neuroendocrine disturbances. Advances in Dermatology and Allergology. 2020; 37(2): 135–153.
  2. Urticaria. Interdisciplinary diagnostic and therapeutic recommendations of the Polish Dermatological Society and the Polish Society of Allergology. Dermatology Review. 2020; 107(1): 1–14.
  3. Żyżyńska-Granica B, Trzaskowski B, Dutkiewicz M, et al. The anti-inflammatory potential of cefazolin as common gamma chain cytokine inhibitor. Scientific Reports. 2020; 10(1).
  4. Żyżyńska-Granica B, Trzaskowski B, Niewieczerzał S, et al. Pharmacophore guided discovery of small-molecule interleukin 15 inhibitors. European Journal of Medicinal Chemistry. 2017; 136: 543–547.
  5. Bożek A, Reich A. The reliability of three psoriasis assessment tools: Psoriasis area and severity index, body surface area and physician global assessment. Advances in Clinical and Experimental Medicine. 2017; 26(5): 851–856.
  6. Ständer S, Augustin M, Reich A, et al. Pruritus Assessment in Clinical Trials: Consensus Recommendations from the International Forum for the Study of Itch (IFSI) Special Interest Group Scoring Itch in Clinical Trials. Acta Dermato Venereologica. 2013; 93(5): 509–514.
  7. Narbutt J, Lesiak A. Jak zrozumieć łuszczycę – aspekty medyczne i medycyna uzupełniająca. Wydawnictwo Termedia, Poznań 2019.
  8. Tohyama M, Shirakata Y, Hanakawa Y, et al. Bcl-3 induced by IL-22 via STAT3 activation acts as a potentiator of psoriasis-related gene expression in epidermal keratinocytes. European Journal of Immunology. 2017; 48(1): 168–179.
  9. Bruin G, Loesche C, Nyirady J, et al. Population Pharmacokinetic Modeling of Secukinumab in Patients With Moderate to Severe Psoriasis. The Journal of Clinical Pharmacology. 2017; 57(7): 876–885.
  10. D’Amico F, Skarmoutsou E, Granata M, et al. S100A7: A rAMPing up AMP molecule in psoriasis. Cytokine & Growth Factor Reviews. 2016; 32: 97–104.

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