外用他克莫司对寻常型银屑病患者CD4^＋CD25^＋调节性T细胞的影响

Effect of tacrolimus onitment on CD4^＋ and CD25^＋ Treg cells in patients with psoriasis vulgaris

目的 探讨外用他克莫司对寻常型银屑病患者外周血CD4^＋CD25^＋调节性T细胞（CD4^＋CD25^＋Treg）的影响.方法 给予48例寻常型银屑病患者他克莫司软膏,每日2次外用,用药8周.治疗前和治疗后,用流式细胞仪检测患者外周血CD4^＋CD25^＋调节性T细胞的表达水平,并对患者进行PASI评分.结果 治疗8周后,总有效率为91.5%.治疗前,银屑病进行期、静止期患者及正常人外周血CD4^＋CD25^＋Treg与CD4＋淋巴细胞的百分比为（2.64±0.86）%、（3.98±0.96）%、（8.46±1.54）%,三者比较,差异均有极显著性（P＜0.01）;治疗后,进行期和静止期患者外周CD4^＋CD25^＋Treg与CD4＋淋巴细胞的百分比较治疗前均有明显升高（P＜0.01）,但仍低于正常人,三者比较,差异均有极显著性（P＜0.01）.结论 寻常型银屑病存在CD4^＋CD25^＋调节性T细胞异常,他克莫司可通过上调CD4^＋CD25^＋调节性T细胞来治疗寻常型银屑病.

Objective To explore the effect of tacrolimus onitment on the changes of CD4^＋ and CD25^＋ Treg cells in peripheral blood from patients with psoriasis vulgaris. Methods 48 patients with psoria-sis vulgaris were treated with a topical immunomodulator, tacrolimus ointment 0.1%, twice daily for 8 weeks.The proportion of CD4^＋ and CD25^＋ Treg cells population in total T cells were evaluated by flowing cytometry before and after treatment. PASI was measured in all the patients. Results After 8-week treatment, the response rates was 91.5%. Before treatment, in the active stage and resting stage of psoriasis vulgaris and healthy controls, the proportion of CD4^＋ and CD25^＋ Treg cells population in total T cells was （2.64 ± 0.86） %,（3.98 ± 0.96） %, and （8.46 ± 1.54） %, with a significant difference among the three groups （P〈0.01）. After treatment, the proportion of CD4^＋ and CD25^＋ Treg cells population was obviously increased, but still lower than that in the healthycontrols （P〈0.01）. Conclusions CD4^＋ and CD25^＋ Treg cells are abnormal in patients with psoriasis vulgaris. Tacrolimus can treat psoriasis vulgaris by upregulating CD4^＋ and CD25^＋ Treg cells.