复方甘草酸苷对寻常性银屑病患者外周血Th17细胞及白细胞介素-22的影响

Effects of compound glycyrrhizin on circulating Th17 cells and IL-22 levels in patients with psoriasis vulgaris

目的:探讨复方甘草酸苷对寻常性银屑病患者外周血辅助性T细胞17(Th17)及白细胞介素(IL)-22表达水平的影响与其疗效间的相关性。方法:将30例轻、中度寻常性银屑病进展期患者分为治疗Ⅰ组(复方甘草酸苷+抗组胺药+外用药物治疗组)、治疗Ⅱ组(抗组胺药+外用药物治疗组),每组各15例,以12例健康正常人为对照组,以银屑病皮损严重程度指数(PASI)评分评价疗效,利用流式细胞技术及ELISA方法检测两治疗组患者治疗前、后及对照组外周血Th17细胞比例、IL-22的表达水平。结果:治疗前,两治疗组间的PASI积分和待测分子水平比较差异无统计学意义(P均>0.05);两治疗组外周血Th17细胞、IL-22表达水平均高于对照组,差异有统计学意义,且与PASI评分呈正相关,P均<0.05;治疗后,治疗Ⅰ组Th17细胞、IL-22表达水平降低,较治疗前差异有统计学意义(P均<0.05),治疗后两治疗组Th17细胞、IL-22表达水平相比较,差异有统计学意义(P均<0.05);治疗Ⅰ组Th17细胞、IL-22表达水平下降程度与PASI评分下降指数呈正相关(P均<0.05)。结论:影响外周血Th17、IL-22的表达可能是复方甘草酸苷治疗寻常性银屑病的机制之一。

Objective： To investigate the effects of compound glycyrrhizin on Th17 ceils and IL-22 expression in peripheral blood of patients with psoriasis vulgaris, and to determine the correlation of the effects of compound glycyrrhizin on Th17 cells and IL-22 with its therapeutic efficacy. Methods： 30 patients with mild to moderate progressive psoriasis vulgaris were equally divided into treatment group Ⅰ （compound glycyrrhizin＋antihistamine＋topical treatment） and Ⅱ （antihistamine＋topical treatment）. 12 healthy volunteers served as normal controls. PASI score was used to evaluate the efficacy. Before and after treatment, flow cytometry and ELISA methods were used to assess Th17 cells and expression levels of IL-22, respectively. Results： Before treatment, PASI scores, proportion of Th17 cells and IL-22 levels were similar between two patient groups （P〉0.05 for all）. But the circulating proportion of Th17 ceils and IL-22 levels were higher both patient groups than in the controls（P〈0.05）, and positively correlated with PASI scores（P〈0.05）. After treatment, the proportion of Th17 cells and IL-22 levels significantly reduced in both treatment groups（P〈0.05）. The extent of decline in Th17 cells and IL-22 expression was positively correlated with reduction in PASI score decline index（P〈0.05）. Conclusions： The expression of Th17 and IL-22 in peripheral blood may be one of the mechanisms of compound glycyrrhizin in the treatment of psoriasis vulgaris.