甲氨蝶呤对银屑病患者皮损T细胞内IFN-γ mRNA影响的研究  

Inhibition Effects of Methotrexate on IFN-γ mRNA Expression in T Cells of Psoriatic Lesional Skin

作　　者：张锡宝[1] 李常兴[1] 何玉清[2] 罗权[2] 黄振明[2] 吴志华[1] 胡斌[3] 刘玉梅[2] 

机构地区：[1]广东医学院附属医院皮肤病研究所,广东湛江524001 [2]广州市皮肤病防治所,广东广州510095 [3]中山大学达安基因诊断中心,广东广州510080

出　　处：《中国皮肤性病学杂志》2005年第10期592-594,622,共4页The Chinese Journal of Dermatovenereology

基　　金：广东省医学科学技术研究基金资助(A2004581);广东省重点科技攻关项目(99050)

摘　　要：目的研究甲氨蝶呤(MTX)对银屑病皮损内γ干扰素(IFNγ)的影响,探讨其对银屑病的治疗机理。方法随机选择12例正常对照者和13例中重度银屑病患者,所有患者治疗前和治疗6周后行皮肤活检。利用荧光定量聚合酶链反应法测定12例正常对照和13例银屑病患者治疗前及治疗6周后皮损细胞内IFNγmRNA的定量表达。结果银屑病皮损细胞内IFNγmRNA水平明显高于正常对照者(P=0.001)。银屑病患者经过MTX治疗6周后,皮损明显改善,皮损细胞内IFNγmRNA的水平明显低于治疗前的水平(P=0.007),但与正常对照者皮肤比较差异无显著性(P=0.999)。结论MTX能调节银屑病皮损的局部免疫功能,抑制皮损T细胞内IFNγmRNA的过度表达,恢复Th1型细胞因子平衡,这可能是MTX治疗银屑病的作用机制之一。Objective To determine whether methotrexate integers in gamma IFN-γ mRNA expression in psoriatic lesional skin. Methods Thirteen adult patients with moderate to severe psoriasis and 12 health control were sequentially enrolled in this study,and all patients＇ biopsies were taken before methotrexate treatment from untreated lesions and after 6 weeks methotrexate treatment from resolving lesions. The production IFN-γ mRNA was measured by fluorescent quantitative polymerase chain reaction （FQ-PCR）. Results Expression of IFN-γ mRNA in psoriasis lesional skin was significantly higher than that in control subject （P =0. 001 ）. Expression of IFN-γ mRNA in psoriasis lesional skin was significantly decreased after 6 weeks methotrexate treatment （P = 0. 007 ）. Expression of IFN-γ mRNA from psoriatic resolving lesions after treatment similar to the control subject （ P = 0. 999）. Conclusion Our results show that MTX could modulate local immunology by decrease expression of IFN-γ, mRNA in T ceils. MTX has an effect on modulating the type 1 polarized response in psoriatic lesions. These changes could be part of the therapeutic effects of MTX on psoriasis.

关 键 词：甲氨蝶呤 银屑病 Γ-干扰素 荧光定量PCR 

分 类 号：R758.63[医药卫生—皮肤病学与性病学] R979.5[医药卫生—临床医学]