银屑病患者血清白介素36及其受体拮抗剂表达水平与病情严重度的相关性研究

Serum levels of interleukin-36 and its receptor antagonist in patients with psoriasis and their correlations with disease severity

目的探讨银屑病患者血清白介素（IL）36（IL-36-、IL-36β、IL-36γ）及其受体拮抗剂IL一36Ra水平与银屑病病情严重度的相关性。方法采用酶联免疫吸附试验（ELISA）比较45例泛发性脓疱性银屑病（GPP）患者、34例寻常性银屑病（PV）患者和37例健康对照者血清IL-36及IL-36Ra水平，并结合患者病情严重度进行相关性分析。结果IL-36及IL-36Ra在3组之间表达差异无统计学意义。银屑病患者按病期分组后，GPP脓疱发作期患者27例血清IL-36β、γ表达水平（中位数±四分位数间距分别为12．101±11．315和34．541±15．580ng／L）,显著高于健康对照组（分别为5．355±9．020和23．052±22．410ng／L），经非参数Mann—Whiteney检验，差异均有统计学意义（P〈0．05）。按病情严重度分组后，重度GPP患者7例血清IL-36β、^y表达水平（分别为11．218±9．318和38．536±17．332ng／L）均显著高于健康对照组（P〈0．01）。GPP组、PV组及健康对照组IL-36B与^y表达水平均呈显著正相关（r值分别为0．85、0．86、0．91，均P〈0．01）；且两者均与GPP病情严重度呈低度正相关（r值分别为0．33、0．41，均P〈0．05）；IL-36β表达水平尚与PV皮损面积严重指数显著正相关（r=0．54，P〈0．01）。结论GPP患者血清IL-36β、叫水平与病情严重度呈低度正相关，提示IL-36β、1可能在GPP的发病中发挥重要作用。

Objective To evaluate the relationship of serum levels of interleukin （IL）-36α, IL-36βand IL- 36γas well as their receptor antagonist IL-36Ra with disease severity in patients with psoriasis. Methods Venous blood samples were collected from 45 patients with generalized pustular psoriasis （GPP）, 34 patients with psoriasis vulgaris （PV）, and 37 healthy human controls. Enzyme-linked immunosorbent assay （ELISA） was performed to determine the serum levels of IL-36α, IL-36β, IL-36γ and IL-36Ra. Nonparametric Mann-Whitney test was conducted to compare the levels of IL-36 and IL-36Ra among these groups, and Spearman＇ s rank correlation analysis to assess the relationship between the serum levels of IL-36 and IL-36Ra and disease severity. Results No statistical difference was observed in the serum levels of IL-36 or IL-36Ra among the patients with GPP, patients with PV, and healthy human controls. The serum levels of IL-36β and IL-36γ （given as the median ~ interquartile range） were significantly higher in 27 patients with GPP during episodes of pustules （（ 12.101 ± 11.315） ng/L and （34.541 ± 15.580） ng/L respectively） and in 7 patients with severe GPP （（11.218 ± 9.318） ng/L and （38.536 ±17.332） ng/L respectively） than in the healthy human controls （（5.355± 9.020） ng/L and （23.052 ± 22.410） ng/L respectively, P 〈 0.05 or 0.01 ）. The serum level of IL-36~/was positively correlated with that of IL-3613 in patients with GPP, patients with PV, and the healthy human controls （r = 0.85, 0.86, 0.91, respectively, all P 〈 0.01）, and both IL-36β and IL-36γ/serum levels were lowly and positively correlated with the severity of GPP （r = 0.33, 0.41, respectively, both P 〈 0.05）. A positive correlation was also observed between the serum level of IL-36β and psoriasis area and severity index （PASI） scores in patients with PV （r = 0.54, P 〈 0.01 ）. Conclusions The serum levels of IL-36β and IL-36γ are lowly and positively correlated with disease severity in patients with GPP, suggesting that IL-36β and IL-36γplay an important role in the pathogenesis of GPP.