甲氨喋呤对银屑病患者Th1细胞优势转换的影响及其作用机制探讨

Effect of Methotrexate on Modulating Th1 Cell Shift in Psoriatic Patients and Investigation on its Mechanism

目的 探讨甲氨喋呤（MTX）对银屑病患者Th1细胞优势转换的影响和作用机制。方法 取MTX治疗前、后银屑病患者和正常人外周血，经伊屋诺霉素和佛波酯刺激后，用流式细胞仪检测Th1，Th2细胞数；同时用酶联免疫吸附试验检测T细胞培养上清中IFN-γ，IL-4水平。结果 MTX治疗前，银屑病患者外周血Th1细胞数明显高于正常对照组（P＜0.01），而Th2细胞数两组间差异无显著性意义（P＞0．05）；MTX治疗8～12w后银屑病患者外周血Th1细胞数与正常对照组差异无显著性意义（P＞0．05）；MTX治疗前，银屑病患者外周血T细胞培养上清中IFN-γ水平明显高于正常对照组（P＜0.01），而IL-4水平组间差异无显著性意义（P＞0．05），经MTX治疗8～12w后银屑病患者外周血T细胞培养上清中IFN-γ水平与正常对照组差异无显著性意义（P＞0．05）。结论 MTX可能通过影响Th1细胞的活性，抑制其分泌细胞因子，恢复银屑病Th1／Th2平衡。

Objective To study the effect of Methotrexate on modulating Thl cell shift in psoriatic patients and its medhanism. Methods The peripheral blood T cells of psoriatic patients and controls were stimulated with Ionomycin and PMA before and after MTX treatment, and detected the number of Thl and Th2 cells by flow cytometry, meanwhile detected IFN-3, and IL-4 level in serum by ELISA, Results ①Compared with controls,the number of Thl cells were significant increased in psoriatic patients before MTX treatment （P〈0.01 ）, but after treatment, there was no difference between the two groups, and the number of Th2 cells of the two groups had no difference（ P〉0. 05 ）. ②Compared with controls, the IFN-γ level in serum were significant increased in psoriatic patients before MTX treatment （P〈0.01 ）, but after treatment for 8 - 12 weeks, there was no difference between the two groups, and the IL-4 level in serum had no difference between the two groups （ P〉0. 05 ）. Conclusion MTX can switch T cell responses of from Th1 to Th2 in psoriasis by to interfere the activity of Thl cells in psoriatic patients blood and to inhibited the secretion of Th1 cytokines ,