窄谱中波紫外线对寻常型银屑病患者外周血Th17细胞及血清IL-17、IL-22、IL-23表达的影响
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摘要
目的观察窄谱中波紫外线(NB-UVB)治疗寻常型银屑病的临床疗效并分析Th17细胞及相关细胞因子在治疗前后与银屑病皮损面积和严重程度(psoriasis area and severity index,PASI)评分的相关性。方法选取符合寻常型银屑病诊断标准的患者40例作为治疗组,采用NB-UVB照射治疗,以PASI评分评价疗效。另随机选取30名健康者作为对照组。分别检测对照组和患者治疗前、后外周血Th17细胞百分比及血清中IL-17、IL-22及IL-23的水平,并分析其与PASI评分的相关性。结果外周血Th17细胞比较:患者治疗前Th17细胞百分比明显高于健康对照组,差异有统计学意义(P<0.05);光疗12周后,患者外周血Th17细胞百分比与光疗前相比显著下降,差异有统计学意义(P<0.05);此外,NB-UVB治疗前后患者Th17、IL-17、IL-22及IL-23水平与PASI评分均呈正相关(P<0.05)。结论 NB-UVB照射可明显下调外周血Th17细胞及IL-17、IL-22和IL-23的水平,可能是NB-UVB治疗银屑病的机制之一。NB-UVB治疗寻常型银屑病疗效好,安全性高。
Objective To evaluate the clinical effect of narrow spectrum UVB(NB-UVB)in the treatment of psoriasis vulgaris and analyze the relevance of Th17 cells and related cytokines before and after treatment with psoriasis area and severity(psoriasis area and severity index, PASI). Methods 40 cases of patients with psoriasis vulgaris treated with NB-UVB irradiation were selected as the treatment group and the efficacy was evaluated by PASI score. Another randomly selected 30 healthy persons were enrolled as the control group.The percentage of peripheral blood Th17 cells and the content of IL-17,IL-22 and IL-23 in the serum of the two groups were detected before and after the treatment, and the correlation between the levels of the PASI score before and after treatment were analyzed. Results The comparison results of Th17 cells before and after treatment:the percentage of Thl7 cells pre-treatment was significantly higher than that of the healthy control group(P<0.05). After 12 weeks of phototherapy,the percentage of Th17 cells in peripheral blood decreased significantly compared with that of before phototherapy( P < 0. 05). In addition, the levels of Th17, IL-17,IL-22 and IL-23 were positively correlated with PASI scores before and after NB-UVB treatment(P <0.05). Conclusion NB-UVB irradiation can significantly decrease the levels of peripheral blood Th17 cells,along with levels of IL-17,IL-22 and IL-23, which may be one of the working mechanisms of NB-UVB in the treatment of psoriasis. NB-UVB has a positive curative effect and high safety in the treatment of psoriasis vulgaris.
Objective To evaluate the clinical effect of narrow spectrum UVB(NB-UVB)in the treatment of psoriasis vulgaris and analyze the relevance of Th17 cells and related cytokines before and after treatment with psoriasis area and severity(psoriasis area and severity index, PASI). Methods 40 cases of patients with psoriasis vulgaris treated with NB-UVB irradiation were selected as the treatment group and the efficacy was evaluated by PASI score. Another randomly selected 30 healthy persons were enrolled as the control group.The percentage of peripheral blood Th17 cells and the content of IL-17,IL-22 and IL-23 in the serum of the two groups were detected before and after the treatment, and the correlation between the levels of the PASI score before and after treatment were analyzed. Results The comparison results of Th17 cells before and after treatment:the percentage of Thl7 cells pre-treatment was significantly higher than that of the healthy control group(P<0.05). After 12 weeks of phototherapy,the percentage of Th17 cells in peripheral blood decreased significantly compared with that of before phototherapy( P < 0. 05). In addition, the levels of Th17, IL-17,IL-22 and IL-23 were positively correlated with PASI scores before and after NB-UVB treatment(P <0.05). Conclusion NB-UVB irradiation can significantly decrease the levels of peripheral blood Th17 cells,along with levels of IL-17,IL-22 and IL-23, which may be one of the working mechanisms of NB-UVB in the treatment of psoriasis. NB-UVB has a positive curative effect and high safety in the treatment of psoriasis vulgaris.
引文
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[6] HIDEKI N,KIMIKO N,MASAHITO T,et al. Kinetics of circulating Th17 cytokines and adipokines in psoriasis patients[J]. Arch Dermatol Res,2011,303(6):451-455.
[7] MEGLIO P D,VILLANOVA F,NAPOLITANO L,et al. The IL23R aGln381 allele promotes IL-23 unresponsiveness in human memory Thelper 17 cells and impairs Th17 responses in psoriasis patients[J].J Invest Dermatol,2013,133(10):2381-2389.
[8] SABAT R, WOLK K. Research in practice:IL-22 and IL-20:significance for epithelial homeostasis and psoriasis pathogenesis[J].J Dtsch Dermatol Ges,2011,9(7):518-523.
[9] HO J C,LEE C H,LIN S H. No significant reduction of circulating endothelial-derived and platelet-derived microparticles in patients with psoriasis successfully treated with anti-IL12/23[J]. Biomed Res Int,2016,2016:3242143.
[2]王明星,王燕,赵京霞,等.银屑病发病机制研究进展[J].辽宁中医杂志,2017,44(6):1334-1338.
[3]赵辨.中国临床皮肤病学(下册)[M].南京:江苏科学技术出版社,2010:1008-1025.
[4] HAGG D,SUNDSTROM A,ERIKSSON M,et al. Severity of psoriasis differs between men and women:a study of the clinical outcome measure psoriasis area and severity index(PASI)in 5438 Swedish register patients[J]. Am J Clin Dermatol,2017,18(4):583-590.
[5]陈晋广,任小丽.寻常型银屑病患者外周血Th17细胞的检测[J].中华中医药学刊,2010,28(3):557-558.
[6] HIDEKI N,KIMIKO N,MASAHITO T,et al. Kinetics of circulating Th17 cytokines and adipokines in psoriasis patients[J]. Arch Dermatol Res,2011,303(6):451-455.
[7] MEGLIO P D,VILLANOVA F,NAPOLITANO L,et al. The IL23R aGln381 allele promotes IL-23 unresponsiveness in human memory Thelper 17 cells and impairs Th17 responses in psoriasis patients[J].J Invest Dermatol,2013,133(10):2381-2389.
[8] SABAT R, WOLK K. Research in practice:IL-22 and IL-20:significance for epithelial homeostasis and psoriasis pathogenesis[J].J Dtsch Dermatol Ges,2011,9(7):518-523.
[9] HO J C,LEE C H,LIN S H. No significant reduction of circulating endothelial-derived and platelet-derived microparticles in patients with psoriasis successfully treated with anti-IL12/23[J]. Biomed Res Int,2016,2016:3242143.