寻常型银屑病患者血清IL-4、IL-8、TNF-α水平和T细胞亚群结构与预后转归的关系  

Relationship between serum IL-4,IL-8,TNF-α,T lymphocyte subset and prognosis of patients with psoriasis vulgaris

作　　者：肖勤 黄巍 汪亚利 梅海 任亚莉 袁勇谋 张小林 XIAO Qin;HUANG Wei;WANG Yali(Wuhan Hospital for Prevention-Treatment of Dermatosis,Hubei,Wuhan 430030,China)

机构地区：[1]湖北省武汉市皮肤病防治院

出　　处：《河北医药》2019年第22期3376-3379,3384,共5页Hebei Medical Journal

摘　　要：目的探究寻常型银屑病患者血清IL-4、IL-8、TNF-α水平、T细胞亚群结构与患者预后转归的关系。方法选取收治的94例寻常型银屑病患者作为试验组,同期94例健康体检者为对照组。用酶联免疫吸附试验(ELISA)试剂盒测定血清IL-4、IL-8和TNF-α水平。用密度梯度离心法从2 ml抗凝血中分离新鲜外周血单核细胞(PBMCs),采用实时定量PCR技术进行基因表达检测。用高纯RNA提取试剂盒,从PBMC中提取总RNA。用cDNA合成试剂盒从提取RNA中合成cDNA。使用ABI 7300实时定量PCR系统,用Taqman引物探针ΔCT比较法检测TNF-α基因的表达量。以30β-肌动蛋白管家基因作为内源对照。采用独立t检验和χ2检验,检测血清IL-4、IL-8、TNF-α水平及TNF-α基因表达,用Pearson相关系数计算变量间的相关性。采用多个线性回归方法,倒向法分析各种因素对这些细胞因子的同时作用。将P<0.2作为模型的排除标准。校正R2作为模型拟合优度的判据。结果寻常型银屑病患者的IL-8、TNF-α水平及TNF-α基因表达水平显著高于对照组;血清IL-4和IL-8水平与疾病严重程度有显著相关性(P<0.001)。患者血清TNF-α水平在病情严重程度上明显高于对照组(P=0.008)。根据PASI评分,TNF-α基因在患者组中的表达无显着性差异(P=0.667)。线性多元回归分析显示BMI、血清IL-4和IL-8水平对PASI评分有正向影响。这类模型主要表现为高拟合度(校正R2=0.64)。模拟血清IL-4、IL-8和TNF-α水平对银屑病严重程度的影响,还发现了较高的拟合优度(校正R2=0.623)。联合血清IL-8和TNF-α水平是评价银屑病严重程度的合适标准(校正R2=0.608)。结论银屑病患者血清IL-8和TNF-α水平及TNF-α基因表达水平升高。这种测量可能是评估疾病严重程度的工具,也可能是疾病诊断的反映。Objective To investigate the relationship between serum IL-4,IL-8,TNF-α,T lymphocyte subset and prognosis of patients with psoriasis vulgaris.Methods A total of 94 patients with psoriasis vulgaris were enrolled as experimental group and 94 healthy subjects were enrolled as control group.The serum levels of IL-4,IL-8,and TNF-αwere measured by enzyme-linked immunosorbent assay ELISA.The fresh peripheral blood mononuclear cells(PBMCs)were separated from anticoagulated blood 2ml by Ficoll-Hypaque density gradient centrifugation.The gene expression assay was conducted by real-time PCR.Total RNA was extracted from PBMC by using high pure RNA isolation kit,and cDNA was synthesized from the extracted RNA by using Transcriptor First Strand cDNA Synthesis Kit.The expression levels of TNF-αgene were detected by Taqman primer probe ComparativeΔCT method,withβ-actin housekeeping gene being used as endogenous control.Results The expression levels of IL-8,TNF-αand TNF-αgene in experimental group were significantly higher than those in control group,and the serum levels of IL-4 and IL-8 were significantly correlated with the severity of the disease(P<0.01).The serum levels of TNF-αin experimental group were significantly higher than those in control group(P<0.01).According to PASI score,there was no significant difference in the expression of TNF-αgene in experimental group(P>0.05).Linear multiple regression analysis showed that the BMI,serum levels of IL-4 and IL-8 had positive effects on PASI score.The model showed a high fitting degree(adjusted R2=0.64).The simulated serum levels of IL-4,IL-8 and TNF-αhad obvious effects on the severity of psoriasis,with higher fitting degree(adjusted R2=0.623).Moreover the combination detection of serum levels of IL-8 and TNF-αshowed a proper criterion in the evaluation of the severity of psoriasis(adjusted R2=0.608).Conclusion The serum levels of IL-8 and TNF-αand gene expression levels of TNF-αare increased in patients with psoriasis vulgaris,which may be regarded as a tool to

关 键 词：寻常型银屑病 IL-4 IL-8 TNF-Α 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]