Objectives: This study aims to assess the efficacy of UVBnb phototherapy alone,
and with methotrexate in plaque psoriasis, and comparing the side effects and relapse
between the two kinds of treatments.
Study Design: randomized experimental study.
Methods: A total of 40 psoriasis patients were included in the study, 16 patients
were treated with UVBnb and methotrexate, whereas 24 patients were treated with
UVBnb alone. PASI was calculated for every patient every 2 weeks through treatment, and
every 4 weeks after clearance. Side effects and relapse were compared between two kinds
of therapy.
Results: there were no statistical important differences between two groups of study
according to clearance, clearance rate in combination group was 75% vs. 46% in
phototherapy group, tanning and hyperpigmentation were the most common side effects
for both groups, recurrence rate was 22.7% in study patients, all of them were from
phototherapy group.
Conclusion: this study revealed that UVBnb phototherapy alone,and with
methotrexate have the same efficacy in the treatment of psoriasis, and the combined
therapy with methotrexate reduce the number of UVBnb treatments necessary for
clearance. Side effects were tolerated in both kinds of treatments. Relapse after clearance
occurs more likely with alone UVBnb phototherapy.
Increasing dose of Mithotrexate (25, 50, 100, 150, 200 mg/kg) were tested on Swiss
strain mouse by one intramuscular injection, and their effects were studied (15) days later.
The mean values of total spermatogonia and those of them undergoing mito
tic
division (in the metaphase) were evaluated in seminiferous tubular cross section, and the
mitotic index (MI) of the spermatogonia was also calculated.
Statistical analysis was performed by using IBM-Spss 19 program and for mean
values comparison (one way ANOVA: post Hos Test, Multiple Comparison, and Tukey
HSD) was used, while mitotic index was calculated by using Target Variable.
Our results showed that Methotrexate injection didn’t lead to a significant decrease
in spermatogonia mean values in the tested animals compared to the control, while it led to
a dose dependent gradual decrease in the mean values of the spermatogonia undergoing
mitotic division , and the greatest reduction was noticed in the two high doses: 150, 200,
mg/kg (7.10±9.4, 3.65±2.15 respectively) compared to the control (37.40±2.26), and which
led also to a severe reduction in the mitotic index (20.53%, 6.36% in the doses: 100, 200
mg/kg respectively) compared to the control (61.79%).
pemphigus vulgaris is a life threatening relapsing disease, the first line in its
treatment is systemic steroids, and due to the high rate of side effects caused by systemic steroids in
pemphigus vulgaris patients, some immunosuppressant drugs have
been introduced as an adjuvant
steroid sparing agents, and one of these immunosuppressants is methotrexate, and in spite of the lack of
its use in pemphigus vulgaris, a few studies have shown an encouraging results of its use, and have advised
to carry out more studies about it as an immunosuppressant which has been omitted from usage in
pemphigus vulgaris for a long time.
Intramuscular injection of increasing doses of Methotrexate Folateantagoniste
(25, 50, 100, 150, 250, 300 mg/ kg) on Swiss strain males mice ,
resulted in decreasing Spermatogenesis at stage VII whereas higher doses had
lethal effects.
In fact do
ses of 25 and 50 mg per kg were tolerable by mice and the
cytotoxic tolerance level decreased at higher doses (100 and 150 mg/kg).
Acute cytotoxic effect was noted at doses of 200 mg/kg and resulted in
destruction of cell line.
Doses of 250 and 300 mg/kg had lethal effect and the mice died 1 week after
injection.
In conclusion Methotrexate had cytotoxic effects on sperm cell lines.
100mg/kg doses decreased spermatogenesis while 200 mg/kg doses caused
greater side effects and higher doses were lethal to the mice 1 week after
injection.
Increasing intramuscular doses of Methotrexate (25 mg / kg, 50 mg / kg,
100 mg / kg, 150 mg/ kg, 200 mg / kg, 250 mg / kg, 300 mg / kg) were tested on
Swiss strain Mouse by intramuscular injection. The reproductive potency was
evaluated by total s
perm count and movement of the left testis and it's
epididymis (15) days after injection. The weights of the latter of all tested
animals were registered.
The result indicate that Methotrexate, a Folate antagonist, is a negative
factor for sperm production in a dose related manner. It was evident that the
high doses (ex. Dose 200 mg / kg) lead to oligospermia. It was concluded that
Methotrexate inhibits the reproductive potency during spermatogenesis and
causes cytotoxicity in high doses. Further investigations are needed.
