托法替布治疗的中、重度银屑病患者血清细胞因子及人β-防御素-2的水平

Study of Serum Levels of Cytokines and Human Beta-defensin-2 in Moderate-to-severe Psoriasis Treated with Tofacitinib

目的探讨中、重度斑块型银屑病患者接受JAK抑制剂托法替布治疗前后血清细胞因子、人β-防御素-2(h BD-2)水平变化。方法将18例中、重度银屑病患者随机给予安慰剂、托法替布5mg,2次/d或10mg,2次/d治疗16周。在基线、第8周、第16周,评价患者的银屑病皮损面积和严重程度指数(PASI),同时分别采用流式微珠检测技术(CBA)、酶联免疫吸附试验(ELISA)检测血清IL-2,IL-4,IL-6,IL-10,TNF-α,IFN-γ,IL-17A和血清h BD-2水平。结果经过16周,接受托法替布5mg,2次/d和10mg,2次/d治疗的银屑病患者的PASI显著下降(P<0.05),血清各细胞因子水平无明显差异。托法替布10mg治疗组的血清h BD-2显著降低且低于安慰剂组(P<0.05)。此外血清h BD-2与PASI显著相关(r=0.52,P<0.01)。而血清IL-6水平与PASI不相关。结论血清h BD-2水平和银屑病严重程度相关,并可以反映托法替布的疗效。

Objective This study aimed to explore the changes in serum levels of cytokines and human beta-defensin-2（hBD-2）in moderate-to-severe plaque psoviasis after treatment withwith JAK inhibitor, tofacitinib. Methods Eighteen patients with moderate-to-severe plaque psoriasis were randomized to receive either placebo or tofacitinib 5mg or 10mg twice daily（bid）for 16 weeks. Psoriasis area and severity index（PASI）scores were assessed at baseline, week 8 and week 16 of treatment. Meanwhile, levels of serum cytokines and human beta-denfensin-2 were measured with flow cytometric bead assay（CBA）and enzyme-linked immunosorbent assay（ELISA）, respectively. Results Treatments with either 5mg or 10mg of tofacitinib bid significantly lowered PASI scores（P〈 0.05）, without marked changes in serum levels of cytokines.Serum hBD-2 levels significantly decreasedin tofacitinib 10mg group and lowerthan the placebo-treated patients（P〈 0.05）. Moreover, serum levels of hBD-2, not IL-6, were correlated with PASI scores（r=0.52, P〈 0.01）. Conclusion Serum hBD-2 levels were significantly correlated with the severity of psoriasis and could be used as an indicator of the efficacy of tofacitinib.