窄谱中波紫外线联合他扎罗汀治疗的寻常性银屑病皮损他扎罗汀诱导基因2的表达

Expression of tazarotene induced gene-2 in lesions of patients with psoriasis vulgaris treated by narrow-band UVB alone or in combination with tazarotene

目的 探讨NB—UVB联合他扎罗汀治疗寻常性银屑病的作用机制。方法 用免疫组化和原位杂交的方法检测NB—UVB和（或）他扎罗汀治疗前后银屑病皮损及未受累皮肤中TIG2蛋白和mRNA水平的变化。结果 治疗前，银屑病皮损中几乎无TIG2的表达，单用NB—UVB治疗2周后，角化不全的角质层和棘层上部可见TIG2轻度着色，治疗6周后，可见TIG2阳性表达于棘层上中部。两者联合治疗2周后，可见棘层全层和基底层着色，且在棘层上部着色重于中下部，6周后则表达于表皮全层，且表皮变薄。用NB—UVB和（或）他扎罗汀治疗后，TIG2阳性表达起始于角化不全的角质层和棘层上部至中下部，直至基底层，而他扎罗汀和NB—UVB联合应用后可加速此过程。结论 NB—UVB联合他扎罗汀协同治疗银屑病的机制可能与上调银屑病皮损中rrIG2的表达有关。

Objective To investigate the possible therapeutic mechanism of narrow-band UVB （NB-UVB） plus tazarotene in psoriasis vulgaris. Methods Patients with psoriasis vulgaris were divided into UVB group （n = 27） and placebo group （n = 24）. The patients in UVB group were given topical tazarotene to lesions in the left side of body, and placebo in the right side, then received UVB irradiation; tazarotene was applied once per night and UVB was given once every other day. The placebo group were only given topical placebo to lesions without irradiation. Immunohistochemistry and in s/tu hybridization were used to detect the protein and mRNA expressions of tazarotene induced gene-2 （TIG2） in the psoriatic lesions at the baseline, and after 2, 6 weeks of treatment. Results Before treatment, there was almost no expression of TIG2 in psoriatic epidermis. After treatment with NB-UVB alone, TIG2 was slightly expressed in parakeratotic stratum corneum and the upper layer of stratum spinosum in 2 weeks, in the upper and middle layers of stratum spinosum in 6 weeks. After combination treatment with NB-UVB and tazarotenc, TIG2 was expressed throughout the whole stratum spinosum and basal layer with an increase in the upper layer compared with the middle and lower layers in 2 weeks, throughout the whole layer of epidermis that had become thinner in 6 weeks. TIG2 was firstly expressed in parakeratotic stratum corneum, then in the upper layers, middle and lower layers of stratum spinosum, finally in the basal layer after the treatment with NB- UVB alone or in combination with tazarotene, and the combination with tazarotene accelerated this expres- sion process. Conclusion The synergy between NB-UVB and tazarotene in the treatment of psoriasis may be related to the up-regulation of TIG2 expression in psoriatic epidermis.