窄谱中波紫外线对银屑病患者白细胞介素17、22水平的影响  

Effects of narrow-band ultraviolet B on the levels of interleukin-17 and -22 in patients with psoriasis

作　　者：单秀娟[1] 于亮[2] 郭文臣[2] 

机构地区：[1]潍坊市人民医院皮肤科,山东261041 [2]潍坊市人民医院检验科,山东261041

出　　处：《中华皮肤科杂志》2015年第8期575-577,共3页Chinese Journal of Dermatology

基　　金：潍坊市2012年科学技术发展计划（20122001）

摘　　要：目的：探讨窄谱中波紫外线（NB-UVB）在银屑病治疗中的作用机制。方法42例银屑病患者仅用 NB-UVB 照射治疗20次，治疗前及治愈患者分别进行标本采集及皮损面积和严重程度指数（PASI）评分；采用酶联免疫吸附试验（ELISA）测定患者治疗前后外周血 IL-17和 IL-22水平的变化情况，并与20例健康对照比较，同时利用 RT-PCR 法检测10例患者治疗前后皮肤组织中 IL-17和 IL-22 mRNA 表达水平的差异，并与10例健康对照进行对比分析。结果银屑病患者外周血中 IL-17（34.26±10.05 ng/L）和 IL-22（13.72±4.45 ng/L）水平明显高于健康对照组（分别为16.34±4.73 ng/L 和5.03±1.84 ng/L），均 P 〈0.01。患者皮损 IL-17 mRNA（13.43±2.12）和 IL-22 mRNA（16.53±2.65）表达水平明显高于健康对照组（分别为5.26±0.87和7.72±2.13），均 P 〈0.01。银屑病患者 PASI 与外周血中 IL-17和 IL-22水平呈正相关（r 值分别为0.76和0.70，均 P 〈0.05），与皮损中 IL-17和 IL-22水平亦呈正相关（r 值分别为0.65和0.68，均 P 〈0.05）。42例银屑病患者经 NB-UVB 照射治疗20次后，15例治愈，且治愈后外周血及皮损中 IL-17和 IL-22 mRNA 及蛋白水平、PASI均明显低于治疗前组，均 P 〈0.05。结论 NB-UVB 照射治疗银屑病有效的机制之一可能与抑制患者外周血及皮损组织中 IL-17及 IL-22水平有关。Objective To explore the therapeutic mechanism of narrow-band ultraviolet B （NB-UVB）in psoriasis. Methods Forty-two patients with psoriasis vulgaris and 20 healthy controls were enrolled into this study. All the patients received 20 sessions of NB-UVB radiation. Psoriasis area severity index （PASI）was used to evaluate the severity of psoriasis. Blood samples were collected from all the patients before and 15 cured patients after the treatment as well as from 20 healthy controls, and skin samples from 10 patients before and after the treatment as well as from 10 healthy controls. Enzyme-linked immunosorbent assay （ELISA）was performed to determine the serum levels of IL-17 and IL-22, and real-time fluorescence-based quantitative PCR to measure the mRNA expressions of IL-17 and IL-22 in skin specimens. Statistical analysis was carried out by using the two-sample t-test, paired t-test and Pearson correlation analysis. Results After 20 sessions of NB-UVB radiation, 15 out of the 42 patients were cured with a significant decrease in PASI. Compared with the healthy controls, the 15 cured patients showed a significant elevation in the levels of IL-17and IL-22 proteins（IL-17： 34.26 ± 10.05 ng/L vs. 16.34 ± 4.73 ng/L, t = 7.016, P 〈 0.01; IL-22： 13.72 ± 4.45 ng/L vs. 5.03 ± 1.84 ng/L, t = 8.282, P 〈 0.01）and mRNAs （IL-17： 13.43 ± 2.12 vs. 5.26 ± 0.87, t = 6.312, P 〈 0.01; IL-22：16.53 ± 2.65 vs. 7.72 ± 2.13, t = 6.823, P 〈 0.01）before the treatment. The PASI score was positively correlated with the levels of IL-17 and IL-22 proteins in sera （r = 0.76, 0.70, respectively, both P 〈 0.05）and their mRNAs in skin lesions （r = 0.65, 0.68, respectively, both P 〈 0.05）in these patients. The serum levels and mRNA expressions of IL-17 and IL-22 all significantly reduced in the cured patients after the treatment compared with those before the treatment（all P 〈 0.05）. Conclusion NB-UVB may treat psoriasis by downregulating the levels of IL-17 and IL-22 in peripheral blood an

关 键 词：银屑病 白细胞介素17 白细胞介素22 紫外线 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]