维生素D类似物在银屑病治疗中的应用  

The Application of Vitamin D Analogues in the Treatment of Psoriasis

作　　者：毕新岭 顾军 

机构地区：[1]海军军医大学附属长海医院皮肤科,上海200433

出　　处：《皮肤科学通报》2018年第1期30-42,共13页Dermatology Bulletin

摘　　要：银屑病是一种遗传相关的免疫介导的慢性复发性炎症性皮肤病。维生素D及其类似物通过与其细胞核受体即维生素D受体结合调控靶基因转录,不仅能够调节钙、磷代谢,还能够作用于单核细胞、巨噬细胞、T细胞和树突状细胞等多种免疫细胞,发挥抗炎和免疫调节效应;抑制角质细胞的增殖并诱导分化从而有效地治疗银屑病。近30年来维生素D及其类似物在银屑病方面的基础和临床研究不断深入,从系统补充维生素D对银屑病有效的偶然发现到目前已成为广泛应用的一线外用治疗药物。现在市场上主要有卡泊三醇、骨化三醇、他卡西醇、马沙骨化醇等品种,并具备软膏、霜剂、凝胶、泡沫剂等多种剂型,和激素等外用药物、光疗、生物制剂、中药等系统治疗联合,提高了银屑病的治疗效果。Psoriasis is an immune-mediated chronic recurrent inflammatory skin disease associated with heredity. Vitamin D3 and its analogues regulate target gene transcription by blinding with nuclear receptors（ vitamin D receptors）. They not only regulate calciumand phosphorus metabolism,but also act on monocytes,macrophages,T cells,dendritic cells and other immune cells,releasing its anti-inflammatory,immunomodulatory effect. Meanwhile,vitamin D3 and its analogues can inhibit keratinocytes＇ proliferation and promote differentiation to cure psoriasis. In recent 30 years,the basic and clinical research of vitamin D and its analogues in psoriasis have been deeply conducted. Systematic supplementation of vitamin D leads to the accidental discovery of its anti-psoriasis,and at present vitamin D and its analogues including calcitriol,calcipotriol,tacalcitol,maxacalcitol have been widely applied as first-line topical drugs for psoriasis. In addition,there are ointment,cream,gel,foam and other forms to be used for different location. The dermatologists could combine vitamin D3 and its analogues with other topical drugs,phototherapy,biological agents and traditional Chinese medicine to improve treatment effect.

关 键 词：银屑病 维生素D 外用治疗 

分 类 号：R758.63[医药卫生—皮肤病学与性病学] R751.05[医药卫生—临床医学]