不同证型特应性皮炎患者皮损中TNF-α、IL-6、eNOS及iNOS的表达研究

Expression of TNF-, il-6, eNOS and iNOS in skin lesions of patients with atopic dermatitis of different syndromes

目的通过检测不同证型特应性皮炎(Atopic dermatitis,AD)患者皮损中TNF-α、IL-6、eNOS及iNOS的表达水平,研究其在AD中发病机制中的可能作用,为中医辨证分析提供量化依据。方法收集广西中医药大学第一附属医院2017年2月至2019年2月皮肤科门诊经临床或病理确诊的104例AD患者,根据中医辨证分型标准将AD患者分为湿热内蕴组36例,脾虚湿蕴组43例,血虚风燥组25例。另选25例作为正常对照组。采用qPCR方法检测所有列入对象皮损中TNF-α、IL-6、eNOS及iNOS的表达水平。结果 AD组TNF-α、IL-6、eNOS的表达水平均显著高于正常对照组,差异具有统计学意义(P<0.05),而iNOS在各组中呈阴性表达。其中TNF-α及eNOS在湿热内蕴组中表达水平最高,显著高于脾虚湿蕴组、血虚风燥组,差异有统计学意义(均P<0.01)。IL-6在脾虚湿蕴组的表达水平明显高于血虚风燥组、湿热内蕴组,差异有统计学意义(均P<0.01)。结论特应性皮炎患者皮损中TNF-α、IL-6及eNOS在不同证型中存在差异性表达,TNF-α、eNOS与"热"相关而IL-6与"湿"相关,检测其表达水平有助于AD的中医辨证分型,为AD的中医药辨证治疗提供一定指导作用。

Objective By detecting the expression levels of TNF-α, IL-6, eNOS and iNOS in the skin lesions of patients with Atopic dermatitis of different syndrome types, the possible roles of TNF-α, IL-6, eNOS and iNOS in the pathogenesis of AD were studied. It provides quantitative basis for dialectical analysis of different syndrome types.Methods 104 AD patients diagnosed clinically or pathologically in the dermatology department of the first affiliated hospital of Guangxi University of Traditional Chinese medicine from February 2017 to February 2019 were collected. According to the syndrome differentiation criteria, AD patients were divided into the damp-heat accumulation group(n = 36), spleen-deficiency group(n = 43) and blood-deficiency group( Vn = 25). Another 25 cases were selected as the normal control group. The expression levels of TNF-α, IL-6, eNOS and iNOS in all skin lesions were detected by qPCR.Results The expression levels of TNF-α, IL-6 and eNOS in AD group were significantly higher than those in normal control group(P<0.01), while iNOS was negative in each group. The expression levels of TNF-α and eNOS were the highest in the damp-heat intrinsic group, which was significantly higher than that in the spleen-deficiency group and the blood-deficiency group(P<0.01). The expression level of IL-6 in spleen-deficiency and dampness group was significantly higher than that in Xuexufengzao group and damp-heat intrinsic group, and the difference was statistically significant(P<0.01).Conclusion TNF-α, IL-6 and eNOS were differentially expressed in different syndrome types in patients with atopic dermatitis. TNF-α and eNOS were associated with "heat" and IL-6 was associated with "wet". The level contributes to the TCM syndrome differentiation of AD, which provides a certain guiding role for the differentiation and treatment of traditional Chinese medicine for AD.