类天疱疮和天疱疮患者肿瘤坏死因子α及可溶性肿瘤坏死因子Ⅰ型受体的测定

Levels of Tumour Necrosis Factor o and Its Soluble Receptor Type Ⅰ in Sera and Blister Fluids of Patients with Autoimmune Bullous Dermatoses

目的探讨肿瘤坏死因子α（TNFα）则及其可溶性Ⅰ型受体（sTNF-RI）在类天疱疮（BP）、天疱疮（PV）患者疱液和血清中的变化及其临床意义。方法应用ELISA方法对比研究31例BP、9例PV患者血液和疱液中TNFα和sTNF-RI的含量。并以15例正常人吸疱液和30例正常人血清作对照。结果BP、PV患者活动期癌液和血液中sTNF-RI水平均高于对照，且疱液中浓度更高；BP缓解初期血中sTNF-RI水平高于活动期；BP患者血液和疱液中均未测到或有极少量TNFα，PV患者血液中仅测到低浓度的TNF。而疱液中TNFα浓度明显高于对照。结论细胞因子sTNF-RI和TNFα可能参与了BP和PV的发病，sTNF-RI在BP中可能对机体起保护作用，有望成为病情好转和治疗有效的新的观察指标。

Objective To determine the relationship between tumour necrosis factor ix(TNFα) and its soluble receptor type Ⅰ(sTNF-RI) and their significance in autoimmune hullous dermatoses. Methods The levels of TNFα and sTNF-R I in both sera and blister fluids of 31 cases with bullous pemphigoid(BP) and 9 cases with pemphigus vulgaris(PV) were investigated by ELISA. Fifteen suction blister fluids and 30 sera from normal individuals were taken as the control. Results At active stage, the levels of sTNF-R I were higher in hoth the sera and blister fluids from patients with BP and PV than those from the controls, and were much higher in hlister fluids than in sera. The serum level of sTNF-R I was even higher at early remission stage than at active stage of BP. There were traces or undetectable amount of TNFcr in both sera and hlister fluids of BP cases. TNFα level was much low in sera of PV cases, but higher in PV patients' blister fluids than in control group's. Conclusion s'FNF-R I and TNFα might be related to the pathogenesis of the two diseases, and the former might exert a pro-tective effect on the inflammatory reaction and might serve as a new indicator for evaluation of the severity of BP and the effectiveness of therapy. The effects of sTNF-R I and TNFα in BP and PV might be different. TNFαmight be much important for blister formation in PV.[