不同证候银屑病患者外周血Th1／Th17细胞表达差异的研究  

Differences in the quantity of Thl/Thl7 cells among patients with psoriasis of different syndromes

作　　者：陈洁[1] 徐蓉[1] 李欣[1] 曹筱筱[1] 王一飞[1] 李福伦[1] 范斌[1] 李峰[1] 李斌[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院皮肤科,200437

出　　处：《中华皮肤科杂志》2013年第3期172-175,共4页Chinese Journal of Dermatology

基　　金：上海市自然科学基金（11ZR1438000）,上海市卫生局课题（2009171）,上海市科委中药现代化项目（11DZ1973600）

摘　　要：目的探讨不同证候银屑病的发病与外周血Thl／Thl7细胞轴漂移的相关性。方法用流式细胞仪检测CD4＋T细胞内细胞因子干扰素叮（IFN-y）、白介素17A（IL-17A）的表达情况，双抗体夹心法（ELISA）检测不同证候银屑病患者血清中，Th1型细胞因子IFN-1和Thl7型细胞因子IL-17A的水平。结果血热组银屑病患者外周血单-核细胞（PBMC）中CD4IFN-y冰平显著高于血瘀组及健康对照组（P〈0．05），而血瘀组与健康对照组外周血PBMC中CD4qFN-1水平差异无统计学意义。血热组银屑病患者PBMC中CD4’IFN叫冰平与PASI评分呈正相关（P〈0．05），血瘀组不具相关性（P〉0．05）。血热组、血瘀组银屑病患者及健康对照组PBMC中CD4qL-17A三组间差异无统计学意义。血热组银屑病患者PBMC中CD4IL-17A平与PASI评分不具相关性（P〉0．05），而血瘀组呈正相关（P〈0．05）。ELISA结果示，血热组银屑病患者外周血清中IFN-吖水平显著高于血瘀组及健康对照组（P〈0．05），而血瘀组与健康对照组差异无统计学意义（P〉0．05）；血热组银屑病患者血浆中IFN- Y水平与PASI评分呈正相关（P〈0．05），血瘀组银屑病患者呈负相关（P〈0．05）。血热组、血瘀组银屑病患者及健康对照血清中IL_17A水平三组间差异无统计学意义（P〉0．05），血热、血瘀组银屑病患者血清中IL-17A水平与PASI评分不具相关性（P〉0．05）。结论Th1细胞在血热型银屑病的发病中占主导地位，当血热型银屑病向血瘀型转化或正常转归时，Th1细胞的表达下降，而Th17细胞在不同证候银屑病患者中差异无统计学意义。Objective To estimate the relationship between the development of psoriasis of different syndromes and type 1 helper T （Thl）/Thl7 cell axis shift. Methods Venous blood samples were collected from 15 patients with blood-heat type psoriasis vulgaris （BHPV）, 15 patients with blood-stasis type psoriasis vulgaris （BSPV）, and 16 healthy human controls. Flow cytometry was performed to detect the expression of a Thl type cytokine interferon-Y （IFN-Y） and a Th17 type cytokine interleukin 17A （IL-17A） in CD4＋ T cells, and double- antibody sandwich enzyme linked immunosorbent assay （ELISA） to determine the serum level of IFN-Y and IL-17A. Statistical analysis was done by analysis of variance, least significant difference （LSD） procedure, and Spearman＇s correlation analysis. Results The patients with BHPV showed a statistical increase in the percentage of CD4IFN-Y cells in peripheral blood mononuclear cells （PBMCs） and in the serum level of IFN-/compared with the patients with BSPV and the healthy controls （25.94% Y- 11.44% vs. 18.43% ± 7.51% and 13.57% ± 7.70%, （86.48 ± 46.44） ng/L vs. （59.80 ±12.73） ng/L and （46.00 ± 0.67） ng/L, all P 〈 0.05）, while no significant difference was observed between the patients with BSPV and the healthy controls in either of the two parameters （all P 〉 0.05）. The percentage of CD4＋IFN-a cells in PBMCs and psoriasis area and severity index （PASI） were positively correlated in patients with BHPV （r = 0.723, P 〈 0.05）, but uneorrelated in those with BSPV （r = 0.493, P 〉 0.05）. No significant differences were observed between the patients with BSPV, BHPV and the healthy controls in the percentage of CD4IL-17A＋ cells or in the serum level of IL-17A （all P 〉 0.05）. The percentage of CD4＋IL-17A cells in PBMCs and PASI were uncorrelated in patients with BHPV （r = 0.186, P 〉 0.05）, but positively correlated in those with BSPV （r = 0.669, P 〈 0.05）. Serum IFN-3 level and PASI were positively correla

关 键 词：银屑病 证候 TH1细胞 TH17细胞 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]