Photochemotherapy of psoriasis: DNA damage in blood lymphocytes

DNA synthesis assessed by 3H thymidine incorporation was measured in lymphocytes from patients with psoriasis receiving photochemotherapy with 8-methoxypsoralen (8-MOP) and UV-A (PUVA). The emission from the UVA source contained sufficient short wavelengths (UV-B) to impair 3H-thymidine incorporation but could be screened out with clear plastic screens. When lymphocytes were irradiated in vitro in a 1/10 dilution of plasma containing 8-MOP, increasing doses of UV-A produced progressive inhibition of phytohaemagglutinin (PHA)-induced DNA synthesis. Cells from patients given several previous treatments were inhibited significantly more than those from patients receiving their first exposure. This was also true for unirradiated cells sugesting either an accumulation of 8-MOP within cells, persistence of DNA damage or alteration of the lymphocyte population. Lymphocytes removed immediately after patients were irradiated showed less 3H thymidine incorporation than cells taken just prior to irradiation, which confirms that PUVA treatment exerts in vivo effects on circulating lymphocytes.