阿维A对寻常性银屑病皮损组织中Th1/Th2平衡的影响

Effect of Acitretin on the Th1/Th2 balance in lesions of psoriatic vulgaris patients

目的:通过对阿维A治疗前后寻常性银屑病(PV)患者皮损中Th1、Th2细胞的研究,了解局部Th1、Th2、Th1/Th2平衡在PV病情发展中的变化。探讨阿维A治疗PV的作用机制。方法:采用免疫荧光双重标记法检测健康对照、阿维A治疗前后PV患者皮损中Th1(CD3^+IFN-γ^+)、Th2(CD3^+IL-4^+)细胞的数量变化。结果:①阿维A治疗前后的PV患者皮损真皮浅层T细胞分别为(24.03±8.03)个和(15.32±5.26)个、Th1细胞分别为(15.57±6.73)个和(7.66±4.28)个,数量较健康对照组增多[T细胞(5.44±0.17)、Th1细胞(3.78±0.98)个],P<0.05;Th2细胞数量在治疗前后分别为(6.29±8.39)个和(7.46±10.28)个,与健康对照组(2.44±0.77)个相比,差异无统计学意义,P>0.05;②Th1/Th2平衡在治疗前明显偏向于Th1一方,治疗前比值为6.49±8.40,治疗后为1.86±1.75,与健康对照1.58±0.25相比差异无统计学意义;③Th1/Th2平衡比例与银屑病皮损面积和严重度指数(PASI)评分呈正相关,治疗前相关系数r=0.86,治疗后相关系数r=0.69。结论:PV患者皮损处T细胞遵循Th1型免疫应答理论:Th1/Th2平衡与PASI相关;阿维A治疗PV有效,可使PASI降低;阿维A治疗PV时可能通过干预Th1/Th2平衡而起作用。

Objective：To observe the effects of acitretin on Thl and Th2 lymphocytes in the lesions of psoriatic vulgaris（PV） patients, analyze the roles of Th1 ,Th2 lymphocytes and the Th1/Th2 balance in the pathogensis of PV. Methods：Immunofluorescent double staining was employed to study the quantity of CD3^＋IFN-γThl cells and CD3^＋IL-4^＋Fh2 cells in the lesions of normal controls ,pre-treatment patients and post-treatment patients. Results：The quantity of T cells and Thl cells in superficial layer of dermis of PV patient was significantly increased （P〈0.05）,but there was no difference in number of Th2 cells between the two groups（P〉0.05）. The shift of Th1/Th2 balance was toward Thl cells in the lesions of pre-treatment patients, there was no difference between posttreatment patients and normal controls. There was positive correlation between the ratio of Th1/Th2 and PASI. Conclusion：Th1 cells may contribute to pathogenesis of psoriasis. The effects of acitretin may influence Thl cell mostly in the lesions of PV.