阿维A对寻常性银屑病患者外周血中Th细胞相关趋化因子的影响

Influence of Acitretin on the Levels of T Helper Chemokines in Patients with Psoriatic Vulgaris

目的通过对阿维A治疗前后银屑病患者血清中的T辅助细胞相关的CXCL9,CXCL10,CCL17,CCL20,CCL22浓度影响,探讨阿维A治疗银屑病的作用机制。方法采集健康对照组和寻常性银屑病患者治疗前后的外周血样本,检测其中的CXCL9,CXCL10,CCL17,CCL20,CCL22浓度变化。结果治疗前患者血液样本中的CXCL9浓度为3 089.98±1 020.89pg/mL,CCL10浓度为1 523.49±817.98pg/mL,CCL20浓度为2 560.41±750.69 pg/mL,都明显高于正常对照组。而用药前后,患者血液样本中的CXCL9浓度为2 640.56±563.12 pg/mL,CXCL10浓度为882.86±203.49 pg/mL,CCL20浓度为914.56±230.65,与治疗前相比有明显下降(P<0.01)。而CCL17、CCL22浓度变化差异无统计学意义。结论银屑病患者血清中各类T辅助细胞相关因子浓度上升揭示了银屑病是系统性炎症疾病。而阿维A作用机制在于针对Th1和Th17细胞进行相关调节,而对Th2细胞无相关作用。

Objective To investigate the effect of acitretin on the levels of T helper （ Thl,Th2, Thl7） chemokines in the peripheral blood of patients with psoriatic vulgaris （ PV ） , and to further reveal its therapeutic mechanisms. Methods The levels of Thl-associated chemokines CXCL9 and-10, Th2-associated CCL17 and CCL22, and Thl7-associated ,CCL20, in serum of patients with PV and normal controls were detected by Millipore Launches MILLIPLEX^TMMAP. Results Before acitretin therapy,the levels of the Thl-associated chemokines and the Thl7-associated chemokine were higher in psoriatic patients than in normal controls （3 089.98±1 020.89pg/mL for CXCL9,1 523.49± 817.98pg/mL for CXCL10,2 560.41 ± 750.69 pg/mL for CCL20; vs. normal eontrols,P 〈 0.01 for all）. After acitretin therapy, the levels of CXCL9, CXCL10, CCL20 in plasma significantly decreased （ P 〈 〈 0.01 ）, but the levels of CCL17, CCL22 remained no significant changes （ P 〉 0.05 ）. Conclusion The sustained high expression levels of inflammatory chemokines in psoriasis suggest that psoriasis is a systemic inflammatory disorder. Aeitretin therapy may be a more effective for Thl and Th17 cells,but not Th2 cells.