蜂针疗法对寻常性银屑病患者Th17的影响

Influence of Bee Needle Therapy on Th17 in Patients with Psoriasis Vulgaris

目的观察蜂针疗法对寻常性银屑病患者Th17相关因子IL-17,IL-22,IL-23水平的影响。方法入选的30例寻常性银屑病(稳定期)患者,均为蜂针试验阴性或弱阳性者。选取10日龄以上意大利蜂,用蜂量从2只开始,每1周治疗1次,4周为1个疗程,共治疗2个疗程。治疗前后采用双抗体夹心ELISA法,检测外周血Th17相关因子IL-17,IL-22,IL-23的水平。同时选择30例健康人为对照组。结果蜂针疗法后,银屑病患者外周血中IL-17,IL-23水平较治疗前有所下降,差异有统计学意义(P均<0.05);IL-22水平较治疗前有所下降,差异无统计学意义(P>0.05)。蜂疗结束后,有5例患者出现新的银屑病皮疹,皮疹主要分布在蜂疗外区域,占临床总有效患者的17.24%。结论蜂针疗法治疗寻常性银屑病效果明显,能有效改善银屑病皮损,蜂毒能有效降低银屑病患者血液中IL-17和IL-23的水平,通过降低IL-17的水平,促进皮损的消退。蜂针疗法在治疗寻常性银屑病方面,疗效显著,副作用小,复发率低,值得临床上推广使用。

Objective To investigate the effect of bee needle therapy on the expression of Th17 related cytokines （ IL- 17, IL-22, and IL-23 ） in patients with psoriasis vulgaris. Methods Thirty patients with stable psoriasis vulgaris and negative or weakly positive to bee needle test were enrolled. Patients were treated initially with two 10-day old Italian bees once weekly, 4 weeks/treatment course, for a total of 2 treatment courses. 30 healthy volunteers served as controls. Double antibody sandwich ELISA method was used to measure expression levels of IL-17, IL-22, IL-23 in peripheral blood before and after treatment. Results Bee needle therapy significantly lowered IL-17 and IL-23, not IL-22 levels, in peripheral blood of psoriatic patients （P 〈 0. 05）. After the therapy, 5 patients developed new psoriatic lesions out of the treated area, accounting for 17.24% of good responders. Conclusion Bee needle therapy is effective for psoriasis vulgaris. Bee venom can effectively lower IL-17 and IL-23 levels in peripheral blood of psoriatic patients. Reduction in IL-17 levels leads to clearance of psoriatic lesions. Bee needle therapy is safe and effective for psoriasis vulgaris with lower recurrence rate, it is worth to promote its clinical use.