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In photopheresis peripheral leukocytes are exposed to photoactivated 8-methoxypsoralen in an extra-corporeal flow system. The present study was performed to characterize the effect of photopheresis upon the function of peripheral circulating neutrophils. Superoxide generating capacity and chemotactic ability of peripheral circulating neutrophils were tested in seven patients immediately before and after treatment with photopheresis. Superoxide generation stimulated by phorbol-12-myristate-13-acetate and N-formyl-methionyl-leucyl-phenylalanine (fMLP) and fMLP-induced chemotaxis were found not to be influenced by photopheresis. We conclude that circulating neutrophils obtained from patients treated with photopheresis possess normal superoxide-generating capacity and chemotactic ability.

For the patient suffering from severe disabling psoriasis, there is now a choice of three possible therapeutic modalities: PUVA, retinoid, or cystostatics. We have had the most experience with methotrexate, as it has been used to treat psoriasis for more than 30 years. For this reason, there is also extensive experience with regard to the risk benefit ratio for this drug. Treatment with methotrexate requires normal kidney function, liver, and bone marrow function. Pregnancy is an absolute contraindication. Methotrexate is hepatotoxic. Fibrosis and cirrhosis are not uncommon when the cumulative dosage exceeds 1.5 g; methotrexate-induced liver cirrhosis is not, however, a rapidly progressing disease. Treatment with methotrexate requires regular laboratory control, and experience to date also indicates that liver biopsy specimens should be taken during treatment.

Urinary histamine was studied in 11 patients with severe atopic dermatitis and 17 controls, as well as in seven atopics prior to and 6 months following hyposensitization. No statistically significant differences were found between the groups. Urinary histamine seems to be of no value as an indicator of disease activity in atopic dermatitis.

Four patients with generalized pustular psoriasis were treated with oral colchicine in an open study. Three of the four patients went into total remission within two weeks while receiving colchicine. The monocyte- and neutrophil function was assessed by studying antibody-dependent cytotoxicity. Increased values observed before treatment decreased during treatment. The patient who responded poorest clinically also showed less changes in monocyte- and neutrophil antibody-dependent cytotoxicity.

The kinetics of migration of radiolabeled 8-methoxypsoralen into human cataract lenses were investigated in 12 patients undergoing operation. Lenses were examined from 2.5 - 72 h after intake of 3H-labeled 8-methoxypsoralen by mouth. Demonstrable amounts of activity was only found in two of three lenses studied 24 h after intake. The aqueous humor contained less 8-methoxypsoralen than serum. The results of the study may add support to the opinion that a less rigorous sunglass regimen than that recommended by certain PUVA centers may be justified.

Psoriasis has been treated systemically through most of this century, originally with arsenics, which have been given up due to their carcinogenic effect. Later glucocorticoids were used, but were then abandoned on account of their high frequency of side effects and the appearance of the rebound phenomenon. Cytostatic drugs have been employed for nearly 25 years. Methotrexate is the most common preparation. Methotrexate requires a normal liver-, kidney- and bone marrow function. Pregnancy is an absolute contraindication. Photochemotherapy with oral methoxalen and long wave ultraviolet light is a new treatment which seems promising. This regime, however, is still at a stage of clinical trial.

Twenty-one patients with alopecia were screened for the immune reactivity of their peripheral blood lymphocytes. Generally, patients had only eczematous reactions when rather strong solutions of dinitrochlorobenzene (DNCB) were applied. One-third of the patients had lymphocytes with in vitro reactivity towards dinitrofluorobenzene-albumin in a lymphocyte transformation test. The percentage of T lymphocyte subpopulations in blood was normal, together with a normal in vitro function after mitogen and antigen stimulation. Six of the patients were treated with 1 g cimetidine daily for 6 weeks. We could not find clinical or immunological changes during the therapy. The findings are discussed in relation to other immunological studies of patients with alopecia and the eventual effect of cimetidine on the immune system.

HLA types were determined in 19 patients and 9 healthy members of 2 Danish families with hereditary angioneurotic edema. The study revealed no connections between hereditary angioneurotic edema and the HLA system.

Monocyte antibody-dependent cell-mediated cytotoxicity (ADCC) was compared to intrinsic cyclic-adenosine-monophosphate (cAMP) levels in 14 patients with systemic sclerosis. Depressed monocyte cytotoxicity was observed. Elevated cAMP levels (2-5 times) in resting monocytes were found in 5 patients; the rest had normal cAMP values. Monocyte ADCC was inversely correlated to cellular cAMP content (r = -0.6659, P less than 0.02). Scleroderma patients with high basal cAMP levels showed impaired responses to beta-adrenergic stimulation but not to prostaglandin E (PGE1) and histamine. Patients with normal basal cAMP levels showed no defect in beta-adrenergic responses. No close correlation between monocyte abnormality and clinical state was found.