维甲酸对银屑病红细胞表面天然免疫分子CD59表达及补体C3和C4的影响

Effect of Retinoids on CD59 on the Erythrocytes and Complements(C3 and C4)in Patients with Psoriasis

研究维甲酸治疗前后银屑病红细胞表面天然免疫分子CD59表达及血清补体C3、C4的变化,以探讨红细胞天然免疫功能变化在银屑病发病机制中的作用。对33例中重度寻常型银屑病患者阿维A口服20mg,1次/天,疗程3个月,同时用银屑病面积和严重度指数(PASI)评分评价疗效;治疗前后分别采用流式细胞仪定量测定红细胞CD59,用数率蛋白比浊法检测血清补体C3、C4含量。结果33例银屑病患者长期小剂量阿维A口服有效率84%,维甲酸治疗前后银屑病患者红细胞CD59定量存在明显差异(P<0.05),治疗前后红细胞CD59定量与PASI评分呈显著正相关(γ=0.913,P<0.001)。维甲酸治疗银屑病疗效确切,其对银屑病患者红细胞天然免疫功能的紊乱可能有免疫调节作用,并进一步影响特异性免疫的反应进行模式,从而发挥治疗作用。银屑病红细胞CD59测定可作为银屑病病情评估的指标。

We studied the change of CD59 on erythrocytes and complements （C3 and C4） in patients with psoriasis after retinoids treatment to explore red blood cell （RBC） innate immune function and find the possible role in the pathogenesis of psoriasis .Acitretin once a day for three months was adopted in the treatment of 33 cares of moderate serious psoriasis vulgaris .The efficacy was assessed by the change of PASI score .To measure the expression of CD59 on erythroctes by flow cytometry .Complements （C3 and C4） were measured with the rate nephelometry .All patients showed remarkable improvement with a total effective rate of 84% .The expression of CD59 on erythrocytes was significantly decreased after treatment （P〈0 .05） .CD59 were positively correlated to PASI index （r=0 .913 ,P〈0 .001） .Retinoids is effective in the treatment psoriasis vulgaris .The erythrocytes participated in regulation of chemkine and played a novel role in the pathogenesis of the psoriasis .Detection of the RBC innate immune molecular CD59 in patients with psoriasis may be served as an objective indicator in evaluating the clinical condition of the disease .