Troglitazone Improves Psoriasis and Normalizes Models of Proliferative Skin Disease

Background: Psoriasis is often treated with agents that activate nuclear hormone receptors for glucocorticoids, retinoids, and vitamin D. The peroxisome proliferatoractivated receptor-g (PPARg) is a related nuclear hormone receptor that can be activated by its ligands, including the thiazolidinediones. Objective: To assess whether treatment with troglitazone, a currently available thiazolidinedione used to treat diabetes mellitus, has an effect on psoriasis in normoglycemic patients and whether ligands for PPARg have an effect on models of psoriasis. Design: Open-label administration of troglitazone in patients with psoriasis and evaluation of drug actions in cellular, organ, and transplant models of psoriasis. Setting: University and community hospital outpatient departments and university laboratories. Patients: Patients with chronic, stable plaque psoriasis and control subjects. Five patients with psoriasis received troglitazone (none withdrew); 10 different untreated patients and 10 controls provided tissue samples. Interventions: Oral troglitazone therapy at various dosages in patients with psoriasis; also, use of troglitazone, ciglitazone, and 15-deoxy-D-12,14-prostaglandin J2 in psoriasis models. Main Outcome Measures: Investigator-determined