窄谱中波紫外线对特应性皮炎患者外周血Th17细胞比例及IL-17A、IL-23的影响  

Effects of Narrow-Band Ultraviolet B on Th17 Percentage,IL-17A and IL-23 Levels in Patients with Atopic Dermatitis

作　　者：马蕾[1] 薛海波[1] 管秀好[2] 刘宇博[2] 舒春梅[1] 张玉杰[1] 安荣真[1] 

机构地区：[1]滨州医学院附属医院,山东滨州256603 [2]中国医科大学附属第一医院,辽宁沈阳110001

出　　处：《中国临床医学》2012年第2期105-107,共3页Chinese Journal of Clinical Medicine

基　　金：山东省自然科学基金(编号:ZR2010HQ013);山东省科技发展计划(编号:2011YD18069);山东省高等学校科技计划(编号:J10LF90);山东省医药卫生科技发展计划(编号:2011QZ003);滨州市科技发展计划(编号:2011ZC0914)

摘　　要：目的:评价窄谱中波紫外线(narrow-band ultraviolet B,NB-UVB)治疗特应性皮炎(atopic dermatitis,AD)的临床疗效及其对外周血Th17细胞比例与IL-17A、IL-23含量的影响。方法:AD患者34例(研究组)采用NB-UVB照射治疗,治疗前及治疗后应用疾病严重程度评分(scoring atopic dermatitis,SCORAD)判断疾病严重程度和视觉模拟标尺法(visual analoguescale,VAS)评价瘙痒程度;采用流式细胞术检测照射治疗前后外周血单一核细胞(peripheral blood mononuclear cells,PB-MC)中Th17细胞占CD4+T细胞的比例(Th17%),采用酶联免疫吸附试验检测血清中IL-17A、IL-23的含量;以30例健康志愿者作为对照组。结果:研究组经NB-UVB照射治疗后总有效率达79.41%,SCORAD评分[(33.75±8.91)比(17.63±5.09),t=9.156,P<0.01]及VAS评分[(8.95±2.86)比(4.46±2.08),t=7.406,P<0.01]均较治疗前显著降低。治疗前,研究组PBMC中Th17%及血清中IL-17A、IL-23含量较对照组显著升高[Th17%:(1.37%±0.41%)比(0.53%±0.11%),t=11.392;IL-17A:(40.38±8.23)pg/mL比(17.74±2.43)pg/mL,t=15.310;IL-23:(54.25±9.29)pg/mL比(23.23±3.47)pg/mL,t=18.101,均P<0.01];NB-UVB照射治疗后上述3个指标较治疗前均显著降低[Th17%:(0.72±0.15)%,t=8.556;IL-17A:(22.18±4.48)pg/mL,t=12.131;IL-23:(25.41±4.12)pg/mL,t=18.012,P均<0.01]。结论:NB-UVB照射对AD具有显著的临床疗效,NB-UVB可下调外周血Th17比例与IL-17A、IL-23含量,这可能是NB-UVB治疗AD的机制之一。Objective：To investigate the efficacy of narrow-band ultraviolet B（NB-UVB） in atopic dermatitis（AD） patients and its effects on Th17 cell percentage,IL-17A and IL-23 concentrations in their peripheral blood.Methods： A total of 34 AD patients were treated with NB-UVB and the clinical efficacy was evaluated by scoring atopic dermatitis（SCORAD） and visual analogue scale（VAS） before and after treatment.Flow cytometric analysis（FCM） was performed to detect the percentage of Th17 cells and the serum concentrations of IL-17A and IL-23 were measured by enzyme linked immunosorbent assay（ELISA）.Thirty healthy persons were recruited as normal controls.Results： After NB-UVB treatment,the total effective rate of AD patients was 79.41%,and both the SCORAD index and VAS index decreased significantly0.11%）,t=11.392,P〈0.01] and serum IL-17A concentration[（40.38±8.23）pg/mL vs.（17.74±2.43）pg/mL,t=15.310,P〈0.01] and IL-23 concentration[（54.25±9.29）pg/mL vs.（23.23±3.47）pg/mL,t=18.101,P〈0.01].After NB-UVB treatment,Th17 cell percentage [（0.72%±0.15%）,t=8.556,P〈0.01] and IL-17A concentration[（22.18±4.48）pg/mL,t=12.131,P〈0.01] and IL-23 concentration[（25.41±4.12）pg/mL,t=18.012,P〈0.01] in AD patients decreased significantly.Conclusions： NB-UVB is a good therapy for patients with AD and it can decrease serum Th17 cell percentage and IL-17A and IL-23 concentrations.

关 键 词：特应性皮炎 窄谱中波紫外线 Th17细胞 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]