银屑病不同证候血清细胞因子的表达差异研究

Study on Serum Levels of Cytokines in Patients with Psoriasis Vulgaris of Different Chinese Medicine Syndromes

目的:观察银屑病不同证候(血热证、血瘀证、血虚证)患者及健康人群血清中TNF-α、IFN-γ、CRP、IL-17 A、IL-6、IL-8、VEGF含量的变化,探讨其与银屑病不同证候的关系。方法:入选寻常型银屑病患者共90例,其中血热证、血瘀证、血虚证各30例,另取健康人30名作为对照。ELISA法检测不同证候银屑病患者血清中主要细胞因子TNF-α、IFN-γ、CRP、IL-17 A、IL-6、IL-8、VEGF水平,并对银屑病患者皮损面积和严重程度指数(PASI)评分。结果:血热证组银屑病患者血清中TNF-α、IFN-γ、IL-6、IL-8、CRP含量较正常组明显升高,血瘀证组TNF-α、IFN-γ、IL-6血清含量较正常组明显升高,血虚证组TNF-α血清含量较正常组明显升高差异有统计学意义,血热证组血清TNF-α、IFN-γ含量与其PASI值正相关。结论:银屑病不同证候患者血清中细胞因子的表达存在差异,某种或某几种细胞因子可被用于判断银屑病的证候。

Objective： To observe serum levels of cytokines in the healthy individuals and the psoriatic patients diagnosed of blood-stasis syndrome （BSS） , blood-dryness syndrome （BDS） and blood-heat syndrome （BHS）. Meanwhile, the relationship between cytokine expression and psoriasis of different syndromes was investigated. Methods： A total of 90 psoriatic patients were recruited and assigned to 3 groups according to their CM syndromes, including 30 patients of BSS, 30 of BDS and 30 of BHS. Another 30 sex- and age-matched healthy subjects were enrolled into the control group. Serum concentrations of multiple cytokines, including tumor necrosis factor-α （TNF-α） , interferon γ（1FN-γ） , C-reactive protein （CRP） , interleukin-17A （ IL-17 A ） , interleukin-6 （ IL-6 ） , interleukin-8 （ IL-8 ） and vascular endothelial growth factor （VEGF） , were measured by a ELISA. The Psoriasis Area and Severity Index （PASI） is used to quantify the extent of the disease. Results： Serum levels of TNFα,IFN-γ ,IL-6,IL-8 ,CRP were substantially increased in the BHS group compared with the control group; Serum levels of TNF-α,IFN-γ,IL-6 were elevated in the BSS group compared with the control group; Meanwhile, Serum levels of TNF-α were substantially increased in the BDS group compared with the control group. Serum levels of TNF-α and IFN-γ, had correlation with PASI scores in the BHS group. Conclusions ： The expression profiles of cytokines in serum were different in psoriatic patients with different CM syndromes. The serum concentrations of one or more cytokines could be determined for TCM syndromes of psoriasis. A larger sample of clinical research is necessary.