氨甲环酸对玫瑰痤疮患者皮肤屏障功能和炎症反应的影响

The influence of tranexamic acid on skin barrier function and inflammation in rosacea

目的:研究氨甲环酸对玫瑰痤疮患者皮肤屏障功能及炎症反应的影响。方法:对30例玫瑰痤疮患者采用自身左右脸对照的方法,治疗侧外用3%氨甲环酸溶液,对照侧外用基质溶液,每天2次。2周后评价双侧红斑程度、炎症性皮损数量及屏障相关生理指标[角质层含水量、经皮水分丢失(TEWL)、pH值1,并检测角质层完整性、角质层丝氨酸蛋白酶活性以及LL-37表达。结果:治疗侧较对照侧红斑程度轻,炎症性皮损数量显著减少(P<0.05);皮肤屏障相关生理指标、角质层完整性及乳酸刺激试验结果有显著改善,差异有统汁学意义(P<0.05);氨甲环酸还可以明显抑制角质层丝氨酸蛋白酶活性(P<0.05)和LL-37的表达。结论:外用氨甲环酸可通过抑制角质层丝氨酸蛋白酶活性及抗菌肽LL-37表达改善玫瑰痤疮患者受损的屏障功能,同时抑制炎症反应.可作为玫瑰痤疮治疗的辅助用药。

Objectives： To examine the influence of tranexamic acid on rosacea lesions and skin barrier function. Methods： Thirty patients with rosacea were included in the split-face study. 3% tranexamic acid solution was applied on one half of the face and matrix solution on the other side. After 2 weeks, the severity of erythema and number of inflammatory lesions were assessed. Skin barrier related indexes （water content in the stratum corneum, pH value and TEWL） were measured by non-in- vasive skin physiological test, and the integrity of the stratum corncum, serine protease activity and amount of LL-37 were tested. Results： Compare to the control side, the severity of crythema and the number of the inflammatory lesions of the test side reduced significantly （P 〈 0.05）; skin barrier related indexes, the integrity of the stratum corneum and the result of the lactic test improved obviously （P〈 0.05）; tranexamic acid can also inhibit the stratum corneum serine protease activity （P 〈 0.05） and the expression of LL-37. Conclusions： Tranexamic acid can inhibit serine protease activity and reduce the process- ing of LL-37 in stratum corneum, it can also improve the damaged skin barrier function in patients with rosacea. Clinically, it can also inhibit the inflammation. It may serve as an adjuvant therapy in rosacca.