Eva-Maria Kokoschka

UVA- and UVB-induced changes in hairless mouse skin collagen

UVA- and UVB-induced alterations in dermal collagen were investigated in a murine animal model. Groups of hairless mice were exposed to UVA and UVB for 28 weeks at a dose of 60 J/cm2 three times weekly and 0.06 J/cm2 three times weekly, respectively. Untreated animals were used as controls. Every 4 weeks dorsal skin was examined for quantitative and qualitative changes in dermal collagen. Neither UVA nor UVB caused a significant alteration in total skin collagen content. However, after UVA treatment the ability of skin collagen to be digested by pepsin decreased dramatically (up to 65% of skin collagen remained insoluble after 4 months), whereas exposure to UVB had no significant effect. Furthermore a shift in the ratio of α1(I,III) chains to α2(I) chains was detected after UVA exposure. The amount of type V collagen in mouse skin, as determined by a sensitive ELISA method, was markedly decreased after UVA treatment, but not after UVB treatment.

Results and tissue healing after copper-vapour laser (at 578 nm) treatment of port wine stains and facial telangiectasias

Twenty‐four patients with port wine stains (PWS), and 33 patients with facial telangiectasias were treated with a copper‐vapour laser (CVL) operating at 578 nm. Good to excellent results were obtained in 52% of PWS and 69% of facial teiangiectasias. Enzyme histochemistry revealed vessel‐selective damage with energy densities up to 12 J/cm2, but a non‐specific coagulation necrosis with higher fluences (≥ 15 J/cm2). With vessel‐selective fluences only moderate blanching was obtained in two PWS. All other evaluated patients were treated using non‐selective energy densities. Tissue healing was comparable with that after argon laser treatment. The theoretically correct wavelength (578 nm) alone appeared to be no guarantee of vessel‐selective damage. The laser employed laeked adequate power (only 1.3 W maximum) to transmit sufficient energy into the tissues in a short exposure time. However, the clinical results confirm the value of the CVL in the treatment of superficial cutaneous angiodysplasias.

Serial Determination of Serum Ferritin Levels in Patients with Malignant Melanoma

In a pilot study, serum ferritin levels of patients with malignant melanoma were found to be increased in stage III of the disease. Therefore, serial determinations were carried out up to 24 months in patients at various stages of the disease undergoing either chemo- or immunotherapy. Serum ferritin was determined by a two-site IRMA technique. Serum samples of 91 patients in different clinical stages of histologically verified malignant melanoma were included in these investigations. 80 healthy individuals were also investigated to determine normal ranges of serum ferritin. In stage III serum ferritin levels were significantly elevated (p less than 0,0005), whereas in stages I and II the values were within the normal range. Repeated serum ferritin levels of 10 patients in stage I and 13 patients in stages II and III without evidence of tumor progression were within the normal range. In 9 patients in stage III the increases in serum ferritin concentration correlated with the degree of dissemination of metastasis. Because of the occurrence of increased ferritin levels only in melanoma patients with progressive metastatic disease, the measurement of serum ferritin might have limited utility in clinical evaluation of melanoma patients as well as in the prediction of recurrence and in monitoring response to therapy.

Phase II results with recombinant interferons: renal cell carcinoma and malignant melanoma.

There is as yet no effective treatment for renal cell carcinoma and metastasizing malignant melanoma. This fact, coupled with in vitro investigations showing growth inhibitory or cytotoxic effects of interferon (IFN) on renal cell carcinoma and melanoma cell lines, led to phase II clinical trials with recombinant (r) IFN-alpha 2C and rIFN-gamma. So far 8 patients with renal cell carcinoma have been treated with IFN-alpha 2C and 3 patients with rIFN-gamma. There has been one complete response to IFN-alpha 2C, two mixed responses and one partial response. One patient on rIFN-gamma has stable disease and the other 2 have progressed. Eleven patients with metastasizing malignant melanoma were treated with IFN-alpha 2C. One patient achieved a complete remission and 3 others had stable disease which later progressed in 2 of them. Side-effects were reversible.

Sex steroid hormone receptor analysis in malignant melanoma.

Melanomas, as well as benign pigmented nevi, long‐term cell cultures of melanoma cells and sixty‐six normal skin biopsies, were evaluated for oestrogen and androgen receptor activity by a dextran‐coated charcoal method.

Serum Lysozyme Levels in Patients with Solid Tumors

Serum lysozyme has been demonstrated to be an indicator for macrophage activity in the tumor-bearing host. Therefore, we investigated lysozyme levels in the sera of 336 untreated tumor patients (121 malignant melanoma, 61 lung cancers, 70 cervical cancers, 49 breast cancers and 35 benign breast tumors, and 36 healthy controls). Patients with malignant melanoma and lung cancer had significantly higher lysozyme levels than the healthy controls. Within the clinical stages in melanoma, there was a decrease of lysozyme in stages II and III in comparison to stage I, but still above that of the control values. Patients with benign breast tumors had normal levels, whereas in breast cancer patients of stages I and II there was a significant reduction in the lysozyme levels. In stages III and IV no differences to the control group could be detected. In patients with cervical cancer (FIGO II and III) serum lysozyme levels were found to be within the normal range. From this study it can not be concluded that serum lysozyme reflects the immunological reactivity of the tumor bearer. Nevertheless, the reduced levels in stages I and II of breast cancer might point to an immunological defect.

Experimental treatment of chronic lymphocytic leukemia with extracorporeal photochemotherapy

SummaryBased on the encouraging results obtained with extracorporeal photochemotherapy (EP) in the treatment of the exfoliative erythrodermic form of cutaneous T-cell lymphoma (CTCL), leukemic form, as well as other T-cell-mediated diseases we evaluated the therapeutic potential of EP in patients with chronic lymphocytic leukemia (B-CLL). Three patients with B-CLL were treated for a period of 1 year. Two patients showed stabilization of disease, as demonstrated by reduction in their peripheral white blood cell count, with one patient showing lymph-node resolution. A third patient with significant intolerance to previous chemotherapy did not respond within the observed period. No significant side effects of EP were observed. Our observations suggest that EP may have a positive effect on the course of B-CLL in selected patients. Additional clinical trials are warranted to further define the role of EP alone or in combination therapy in the management of B-CLL.