准分子激光照射对寻常型银屑病患者外周血Th17/Treg失衡及相关细胞因子表达的影响

Effects of Excimer Laser Irradiation on the Expression of the Th17,Treg and Their Cytokines in Patients with Psoriasis Vulgaris

目的:探讨激光照射对寻常型银屑病患者外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)和转化生长因子!1(TGF-β1)、白介素-6(IL-6)的影响。方法:选择稳定期寻常型银屑病患者38例作为治疗组,每周2次,共治疗8周。另选健康体检者38例作为对照组。采用流式细胞术检测各组治疗前后外周血Th17细胞和Treg细胞百分比,采用酶联免疫吸附法(ELISA)检测各组治疗前后血清中TGF-β1和IL-6的含量;治疗前后运用银屑病皮损面积和严重指数(PASI)进行加权评分测定银屑病皮损面积和严重程度。结果:经激光治疗后,银屑病患者外周血Th17百分比、Th17/Treg比值及IL-6水平均比治疗前有明显降低(P<0.01)而Treg百分比和血清中TGF-β1含量比治疗前有显著升高(P<0.01);激光照射对寻常型银屑病有效率为92.11%,治疗前后PASI评分有显著下降(P<0.01)。结论:准分子激光照射可改变寻常型银屑病患者外周血Th17/Treg细胞失衡比值及相关细胞因子的表达水平。

Objective. To study the impact of exeimer laser irradiation on the expression of the T helper 17 (Th17) and regulato- ry T (Treg) cell and their related cytokines transforming growth factor beta 1 (TGF-131) and interleukin-6 (IL-6) to further clarify how excimer laser treatment helps patients with psoriasis vulgaris. Methods: 38 patients with stationary stage psoriasis vulgaris were treated with excimer laser for 8 weeks. 38 healthy persons were used as normal controls. Peripheral blood levels of Thl7 and Treg were measured by flow cytometry. An enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of TGF-β1 and IL-6 before and after treatment. Clinical efficacy was evaluated in terms of the area of psoriasis and severity index (PASI) scores. Results: After the laser treatment, the Thl7 cells, the ratio of Thl7 to Treg cells and IL 6 had all decreased significantly (P<0.01). The percentage of Treg cells and TGF-β1 levels were significantly higher compared with before treatment (P<0.01). The effectiveness was 92. 11%, and the average PASI scores had decreased significantly (P <0.01). The excimer laser irradiation is able to significantly down-regulate the levels of ThlT, IL-6 and the progression of Treg levels and TGF-β1 expression. Conclusion: It can regulate the balance between Th17 and Treg, which may be one of the mechanisms of excimer laser treatment for psoriasis.