窄谱中波紫外线治疗对寻常性银屑病患者Th17/Treg失衡的影响

Effects of narrow band UVB irradiation on imbalance of Th17/Treg cells in psoriasis vulgaris patients

目的探讨窄谱中波紫外线(NB-UVB)治疗前后寻常性银屑病患者外周血辅助性T细胞17(Th17)和调节性T(Treg)细胞及其相关细胞因子表达变化,分析NB-UVB治疗前后寻常性银屑病患者Th17/Treg细胞免疫失衡的变化及临床意义。方法流式细胞仪检测67例寻常性银屑病患者NB-UVB治疗前后及20例健康对照者Th17细胞和Treg细胞的比例,同时用酶联免疫吸附试验(ELISA)检测患者血清中白细胞介素(IL)-17及转化生长因子β1(TGF-β1)的水平。结果寻常性银屑病患者使用NB-UVB治疗前外周血Th17细胞比例、 Th17/Treg、IL-17的水平均显著高于健康对照组(P <0.01);Treg细胞比例、TGF-β1水平明显低于健康对照组(P <0.01)。寻常性银屑病患者使用NB-UVB治疗后外周血Th17细胞比例、Th17/Treg、IL-17水平均显著低于治疗前(P <0.01),Treg细胞比例、TGF-β1水平明显高于治疗前(P <0.01)。与健康对照组相比较,NB-UVB治疗后寻常性银屑病患者Th17、Treg细胞比例、Th17/Treg、IL-17和TGF-β1的水平差异无统计学意义(P> 0.05)。寻常性银屑病患者银屑病皮损面积及严重度指数(PASI)评分与Th17细胞比例、Th17/Treg及IL-17的水平呈正相关(P <0.01)。Treg细胞比例及TGF-β1的水平与寻常性银屑病患者PASI评分呈负相关(P <0.01)。结论 Th17、Treg细胞及其细胞因子可能对寻常性银屑病的发生及发展起重要作用。NB-UVB治疗可能通过调节Th17、Treg细胞及其细胞因子的表达来治疗寻常性银屑病。

Objective To explore the effects and significance of narrow band ultraviolet B（NB-UVB） on the expression of Th17 and Treg cells in peripheral blood of the patients with psoriasis vulgaris（PV）. Methods A total of 67 PV patients given NB-UVB therapy and 20 healthy controls were enrolled. The levels of Thl7 cells and Treg cells in peripheral blood mononuclear cells（PBMC） before and after NB-UVB therapy were evaluated by flow cytometry. The levels of serum IL-17 and TGF-β1 were detected by ELISA. Results To be compared with healthy controls, the percentages of Th17 cells, the level of IL-17 and Th17/Treg of the PV patients increased（P〈0.01）, and the percentages of Treg cells and the level of TGF-β1 of the PV patients decreased（P〈0.01）. The percentage of Th17 cells, the level of Th17/Treg and IL-17 in peripheral blood of PV patients after NB-UVB treatment were significantly lower than those before treatment（P〈0.01）, but the percentage of Treg cells and the level of TGF-β1 of the PV patients after NB-UVB treatment were significantly higher than those before treatment（P〈0.01）. There was no significant difference in Th17, Treg cell ratio, Th17/Treg, IL-17 and TGF-β1 levels between the PV patients after NB-UVB treatment and healthy controls（P〉0.05）. The percentages of Th17 cell, the level of Th17/Treg and IL-17 were positively correlated with PASI scores（P〈0.01）, and the proportion of Treg cells and the level of TGF-β1 were negatively correlated with the PASI score（P〈0.01）. Conclusion The abnormal expression of Thl7 and Treg cells may play a critical role in pathogenesis and progression of psoriasis. NB-UVB therapy may be used to treat psoriasis vulgaris by regulating the expression of Th17, Treg cells and their cytokines.