卡介菌多糖核酸联合中药对白癜风患者T细胞亚群及Fas/FasL系统表达的调节  

Modulation of T lymphocyte subsets and Fas/Fas ligand system in vitiligo patients by the combination of polysaccharide nucleic acid fraction of bacillus calmette guerin and a traditional Chinese medicine

作　　者：吴蓓玲[1] 孙洁[1] 杨晓红[1] 汤国根 刘改荣[3] 陈琼[3] 王虹 程立峰[3] 戴文静[3] 

机构地区：[1]浙江省中医院皮肤科,杭州310006 [2]桐乡市第二人民医院皮肤科 [3]浙江中医药大学研究生 [4]杭州市下沙街道社区卫生服务中心皮肤科

出　　处：《中华皮肤科杂志》2012年第6期426-428,共3页Chinese Journal of Dermatology

摘　　要：目的 探讨卡介菌多糖核酸（BCG-PSN）联合中药白癜风颗粒治疗白癜风临床疗效及对免疫的调节作用。 方法 流式细胞仪和ELISA法检测BCG-PSN联合白癜风颗粒治疗白癜风前后T细胞亚群及外周血淋巴细胞Fas及FasL的表达水平，并与BCG-PSN及白癜风颗粒单一治疗对照组进行比较。结果 BCG-PSN联合白癜风颗粒治疗组总有效率达82.86%，明显高于BCG-PSN对照组的40.63%（P ＜ 0.01）。各组治疗前外周血CD3＋、CD3＋CD4＋、CD3＋CD8＋均低于健康对照组（P ＜ 0.01）， CD4＋/CD8＋比值升高（P ＜ 0.01）， Fas表达明显降低（P ＜ 0.01）。治疗后CD3＋、CD3＋CD4＋、CD3＋CD8＋较治疗前升高 （P ＜ 0.05），CD4＋/CD8＋比值下降（P ＜ 0.05），Fas明显上升（P ＜ 0.01）。结论 BCG-PSN可通过逆转外周血淋巴细胞的Fas/FasL表达异常，诱导淋巴细胞的正常凋亡，与中药合用起协同作用。Objective To estimate the clinical efficacy and immunomodulatory effect of polysaccharide nucleic acid fraction of bacillus calmette guerin （BCG-PSN） combined with a traditional Chinese medicine in patients with vitiligo. Methods This study recruited 99 patients with vitiligo aged from 13 to 65 （35.6 ± 5.8） years. The patients were classified into 3 groups to be treated with BCG-PSN and a traditional Chinese medicine （Baidianfeng granules） alone or in combination. BCG-PSN was intramuscularly injected at a dose of 2 ml every other day and baidianfeng granules were given orally thrice a day, for 3 months. Peripheral blood samples were obtained from the patients at the baseline and after the end of treatment and from 30 healthy controls. Flow cytometry and enzyme linked immunosorbent assay （ELISA） were performed to detect T cell subsets and expression level of Fas and Fas ligand （FasL）, respectively. Data were analyzed by t test and chi-square test. Results The response rate was significantly higher in patients treated with BCG-PSN combined with Baidianfeng granules than in those with BCG-PSN alone （82.86% vs. 40.63%, P 〈 0.01）. Before the treatment, patients showed a lower percentage of CD3＋ cells, CD3＋CD4＋ cells and CD3＋CD8＋ cells in peripheral blood （all P 〈 0.01）, weaker expression of Fas （P 〈 0.01）, but a higher CD4/CD8 ratio （P 〈 0.01） compared with the controls. The treatment with BCG-PSN and Baidianfeng granules alone or in combination all induced an increase in the percentage of CD3＋ cells, CD3＋CD4＋ cells and CD3＋CD8＋ cells in peripheral blood （P 〈 0.05） and in the expression of Fas （P 〈 0.01）, but a decrease in CD4/CD8 ratio （P 〈 0.05）. Conclusions BCG-PSN may induce the normal apoptosis in lymphocytes via reversing the abnormality in the expression of Fas/FasL by peripheral blood lymphocytes, and the effect of BCG-PSN may be enhanced by a traditional Chinese medicine, Baidianfeng granules.

关 键 词：卡介菌多糖核酸 白癜风颗粒剂 白癜风 T细胞亚群 FAS/FASL 

分 类 号：R758.41[医药卫生—皮肤病学与性病学]