卡介苗核酸联合CO_2激光治疗后白癜风患者皮损组织Th17细胞及相关细胞因子减少

Treatment of BCG polysaccharide nucleic acid combined with CO_2 laser reduces Th17 cells and their related cytokines in cutaneous lesion of vitiligo patients

目的探讨卡介苗核酸联合CO2激光治疗白癜风的疗效及对患者Th17细胞及其相关因子水平的影响。方法选取2011-06/2013-10期间在我院接受治疗的白癜风患者102例,随机分为对照组和观察组,每组51例。对照组给予CO2激光治疗,观察组在对照组基础上给予卡介苗核酸联合治疗。分别评定2组的治疗效果。并采用流式细胞术分析患者外周血Th17细胞亚群变化,采用ELISA分析外周血血清中白细胞介素17(IL-17)和IL-23水平变化,采用实时荧光定量PCR分析患者皮损组织中IL-17和IL-23 mRNA水平变化。结果观察组治疗有效率明显高于对照组,观察组治疗后外周血Th17细胞亚群变化较对照组显著下降,观察组治疗后外周血清中IL-17和IL-23水平较对照组治疗后明显下降。与对照组治疗后比较,观察组患者皮损组织中IL-17 mRNA和IL-23 mRNA水平显著性下调。结论卡介苗核酸联合CO2激光治疗白癜风疗效显著,可显著降低患者外周和皮损组织Th17细胞及其相关细胞因子。

Objective To explore clinical effect of Bacillus Calmette-Guerin polysaccharide nucleic acid（BCG PSN）combined with CO2 laser for vitiligo and its impact on Th17 cells and Th17 associated cytokines in patients with vitiligo.Methods The patients（ n = 102） with vitiligo from June 2011 to October 2013 in our hospital were randomly divided into control group（n = 51） and observation group（n = 51）. Patients in the control group were treated with CO2 laser. Patients in the observation group were treated with BCG PSN besides CO2 laser. The total treatment efficacy in the two groups was appraised. Th17 cell populations in peripheral blood were analyzed by flow cytometry. IL-17 and IL-23 levels in peripheral blood were determined by ELISA. The expressions of IL-17 and IL-23 mRNA in cutaneous lesion tissues were detected by real-time quantitative PCR. Results Total treatment efficacy in the observation group was significantly better than that of the control group. Compared with the control group after treatment,Th17 lymphocyte subsets in the observation group after treatment were significantly reduced in peripheral blood,the levels of serum IL-17 and IL-23 in the peripheral blood significantly dropped,and the expressions of IL-17 and IL-23 mRNA in cutaneous lesion tissues also decreased significantly. Conclusion BCG PSN combined with CO2 laser can down-regulate Th17 lymphocyte subsets and Th17 associated cytokines in peripheral blood and cutaneous lesion. It has a good clinical efficacy for treating vitiligo.