NB-UVB对特应性皮炎患者外周血CLA^+CD8^+T细胞的影响  

Effects of Narrow-band Ultraviolet B on Peripheral Blood CLA^+CD8^+T Cells in Patients with Atopic Dermatitis

作　　者：王玉洁 李婷婷 张宝祥[1] 吴振涛 冯佃芹[1] 孙广美[1] WANG Yujie1, LI Tingting1, ZHANG Baoxiang1, WU Zhentao2, FENG Dianqin1, SUN Guangmei1(1. Department of Dermatology,Yidu Central Hospital of Weifang City,Weifang 262500,China; 2. Dermatology Prevention and Treatment Station of Qingzhou,Qingzhou 262500,Chin)

机构地区：[1]潍坊市益都中心医院皮肤性病科,山东潍坊262500 [2]青州市皮防站,山东潍坊262500

出　　处：《中国皮肤性病学杂志》2018年第8期883-886,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的观察窄谱中波紫外线(NB-UVB)治疗特应性皮炎(AD)患者的临床疗效,并分析其对外周血皮肤归巢的CD8^+T细胞数量及表达杀伤功能相关蛋白水平的影响,探讨NB-UVB治疗AD的作用机制。方法选取19例AD患者,予NB-UVB照射治疗8周,采用特应性皮炎积分指数(SCORAD)判断病情严重程度;并用流式细胞术检测外周血表达皮肤淋巴细胞相关抗原(cutaneous lymphocyte-associated antigen,CLA)的CD8^+T细胞(CLA^+CD8^+T细胞)的比例,分析其杀伤功能相关蛋白穿孔素、颗粒酶B的表达。另选15例健康体检者作为正常对照。结果 (1)SCORAD评分在AD治疗前组明显高于治疗后组,差异有统计学意义(P<0.01);(2)CLA^+CD8^+T细胞的比例在AD治疗前组明显高于对照组,差异有统计学意义(P<0.01),且AD治疗前组CLA^+CD8^+T细胞的比例与SCORAD评分正相关(Pearson相关,P<0.01);穿孔素和颗粒酶B的表达在AD治疗前组均明显高于对照组,差异均有统计学意义(P均<0.01);(3)NB-UVB治疗后,AD患者血清CLA^+CD8^+T细胞的比例较治疗前明显降低,差异有统计学意义(P<0.05),且表达穿孔素和颗粒酶B水平也均较治疗前明显下降,差异均有统计学意义(P均<0.05)。结论 NB-UVB照射可明显下调AD患者外周血CLA^+CD8^+T细胞的比例及杀伤功能相关蛋白的表达,这可能是NB-UVB治疗AD的机制之一。NB-UVB治疗AD安全有效。Objective To observe the efficacy of narrow-band ultraviolet B（NB-UVB）in the treatment of Atopic Dermatitis（AD）,further to analyze its influence on the percentages of CLA＋CD8＋T cells and expressions of cytotoxic molecules,and to investigate the mechanism. Methods Nineteen patients with AD were treated with NB-UVB for 8 weeks. Peripheral blood was obtained from the patients and 15 healthy human controls. Flow cytometric analysis was performed to determine the percentages of CLA＋CD8＋T cells and their expressions of cytotoxic molecules. The clinical efficacy was evaluated by scoring atopic dermatitis（SCORAD）.Results ①SCORAD index decreased significantly in the treatment group compared with the AD group（P〈0.01）; ②The percentage of CLA＋CD8＋ T cells and the expression of perforin and granzyme B were higher in the AD group compared with the control group（all P〈0.01）; ③After the NB-UVB treatment,the percentage of CLA＋CD8＋ T cells and the expression of both perforin and granzyme B decreased significantly（all P〈0.05）. Conclusion NB-UVB is able to down-regulate the percentage of CLA＋CD8＋ T cells and the expression of perforin and granzyme B significantly,which may contribute to the pathogenesis of AD. NB-UVB treatment is a safe and efficacious therapy for AD.

关 键 词：谱中波紫外线 皮肤淋巴细胞相关抗原 CD8+T细胞 穿孔素 颗粒酶B 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]