甲氨蝶呤对寻常型银屑病外周血TLR4及TLR9表达调控的研究

Regulation of methotrexate on TLR4 and TLR9 in the peripheral blood of patient with psoriasis vulgaris

目的:研究甲氨蝶呤(MTX)对寻常型银屑病患者外周血Tol1样受体(TLR)4和TLR9表达的影响。方法:利用荧光定量聚合酶链反应法测定22例寻常型银屑病患者治疗前后外周血及20例正常对照者外周血中TLR4mRNA及TLR9mRNA的定量表达。结果:银屑病外周血中TLR4mRNA及TLR9mRNA的表达均高于正常对照者外周血的表达水平(t=11.26,P<0.001;t=8.39,P<0.001)。银屑病患者经过MTX治疗4w后,病情明显改善,外周血中TLR4mRNA及TLR9mRNA的表达水平低于患者治疗前的表达水平(t=3.49,P=0.0015;t=7.75,P<0.001),但与正常对照者的表达水平差异无统计学意义(t=1.76,P=0.0925;t=1.38,P=0.1741)。结论:TLR4及TLR9的表达增高与银屑病的发病有关。MTX能抑制寻常型银屑病外周血TLR4mRNA及TLR9mRNA的过度表达,这可能是MTX治疗银屑病的作用机制之一。

Objective:To study the regulation of methotrexate on TLR4 and TLR9 in the peripheral blood of patient with psoriasis vulgaris. Methods:Tweenty-two adult patients with psoriasis vulgaris and 20 health control were sequentially enrolled in this study. Serum levels of TLR4mRNA and TLR9mRNA were measured by real-time polymerase chain reaction in 22 cases with psoriasis vulgaris before and after treatment with MTX for 4 weeks and 20 health control. Results:The serum levels of TLR4mRNA and TLR9mRNA before treatment were significantly higher than that after treatment and health control, respectively(t =11.26, P <0.001; t =8.39, P <0.001). Expression of serum TLR4mRNA and TLR9mRNA in psoriasis was decreased after 4 weeks methotrexate treatment, respectively(t =3.49, P =0.0015; t = 7.75, P <0.001).The serum levels of TLR4mRNA and TLR9mRNA were no significant different between after treatment group and health control group, respectively(t =1.76, P = 0.0925;t =1.38, P = 0.1741). Conclusion:Our data suggest an important role of TLR4 and TLR9 in the development and advance of psoriasis vulgaris.Theses results show that MTX could inhabit the over expression of TLR4mRNAand TLR9mRNA in patients with psoriasis vulgaris.