特应性皮炎患者皮肤屏障与水闸蛋白1表达的相关性研究

Relationship between skin barrier function and claudin-1 expression in patients with atopic dermatitis

目的研究特应性皮炎（AD）患者皮肤屏障功能情况，并分析其与水闸蛋白1（claudin-1）表达的相关性。方法纳入AD患者和健康人各11例。应用皮肤经表皮失水率测定仪和皮肤高频超声检测仪测定受试者经表皮失水率、表皮厚度与表皮致密度，并用双抗体夹心ELISA法定量检测血清中脱落claudin-1表达量。应用单因素方差分析和t检验比较不同组别之间相关参数的差异；应用Pearson相关系数分析不同参数之间的相关性。结果AD患者皮疹部位经表皮失水率为（36．9±34．2）g·m-2·h-1，非皮疹部位为（9．1±6．0）g·m-2·h-1，均高于健康对照[（4．4±3．1）g·m-2·h-1]；AD患者皮疹部位表皮厚度（0．23±0．04）mm，显著高于非皮疹部位[（0．18±0．03）mm]和健康对照[（0．18±0．02）mm]。AD患者皮疹部位有其特征性表皮下低回声带。AD患者claudin-1表达量为（0．80±0．88）ng／m]，显著低于健康人[（1．73±1．85）ng／m1]；claudin-1与表皮厚度显著负相关（r=-0．61），与经表皮失水率的倒数显著正相关（r=0．44）。结论AD患者损伤的皮肤屏障功能与claudin-1表达相关，屏障功能状态可用经表皮失水率、经表皮失水率倒数和表皮厚度进行定量表述。

Objective To evaluate skin barrier function in patients with atopic dermatitis （AD）, and to assess its relationship with claudin-1 expression. Methods Totally, 11 patients with AD and 11 healthy human controls were recruited in this study. A Tewameter TM210 was used to measure transepidermal water loss （TEWL） value, and high-frequency ultrasound to determine epidermal thickness and density, in lesional and non-lesional skin of the patients and normal skin of the healthy controls. A double-antibody sandwich enzyme-linked immunosorbent assay （ELISA） was performed to determine the serum level of free claudin-1 in these subjects. One-way analysis of variance and t test were carried out to compare these parameters in different groups, and Pearson＇s correlation analysis to estimate the relationship between different parameters. Results The TEWL value was significantly higher in lesional skin than in nonlesional skin of patients with AD and normal skin of the healthy controls （ （36.9 ± 34.2） vs. （9.1 ± 6.0） and （4.4 ± 3.1） g·m-2·h-1, both P〈 0.05）. The epidermal thickness in AD lesions was （0.23 ± 0.04） mm, significantly higher than that in nonlesional skin （（0.18 ± 0.03 ） ram, P 〈 0.01 ） and normal control skin （（0.18 ± 0.02） mm, P 〈 0.01 ）. Ultrasound images revealed a characteristic subepidermal low eeho-genic band in the AD lesions. The patients with AD showed a significantly lower serum level of claudin-1 compared with the healthy controls （（0.80 ±0.88） vs. （1.73 ± 1.85） μg/L, P 〈 0.05）. Moreover, the serum level of claudin-1 was negatively correlated with epidermal thickness （r = -0.61, P 〈 0.01 ）, but positively correlated with the inverse of TEWL （ 1/TEWL, r = 0.44, P 〈 0.05）. Conclusions The impaired skin barrier function, which may be evaluated by TEWL, 1/TEWL and epidermal thickness, is associated with the expression of claudin-1 in patients with AD.