Soluble E-selectin levels in psoriatic patients treated with cyclosporin

There is accumulating evidence that endothelial adhesion molecules, and particularly E-selectin, are important for the transendothelial migration of leucocytes in psoriatic lesions. We investigated the effect of an eight week course of low dose cyclosporin A (CsA) on the serum levels of sE-selectin in psoriatic patients. Thirteen patients with severe, plaque-type psoriasis were treated for 8 weeks with 3 mg/kg/day of oral CsA. Serum sE-selectin levels were measured by enzyme-linked immunosorbent assay before and after CsA treatment. There was a highly significant (p < 0.005) clinical response after 8 weeks of CsA as assessed by the psoriasis area and severity index (PASI) score. Post-therapeutic circulating levels of sE-selectin showed a significant decrease compared with pre-treatment levels but remained significantly elevated compared with healthy controls. Persistence of elevated serum sE-selected levels in psoriatic patients after CsA treatment could reflect maintenance of endothelial activation at the dermal level. Such vascular activation could partially explain clinical relapse commonly observed after CsA treatment.