The Expression of Interleukin-17, Interferon-gamma, and Macrophage Inflammatory Protein-3 Alpha mRNA in Patients with Psoriasis Vulgaris

Summary: To investigate the role of Interleukin-17 (IL-17), Interferon-gamma (IFN-γ), and macrophage inflammatory protein-3 alpha (MIP-3α) in the pathogenesis of psoriasis, reverse transcriptase-polymerase chain reaction (RT-PCR) was used to semi-quantitatively analyze the mRNA expression of IL-17, IFN-γ, and MIP-3α in 31 psoriatic lesions and 16 normal skin tissues. The results showed that the mRNA of the three cytokines was present in all specimens. And the expression level of IL-17 mRNA in skin lesions was 1.1416±0.0591, which was significantly higher than that in normal controls (0.8788±0.0344, P<0.001). The expression levels of IFN-γ mRNA were 1.1142±0.0561 and 0.9050±0.0263, respectively, with significant difference(P<0.001). And the expression levels of MIP-3α mRNA in psoriatic lesions was 1.1397±0.0521, which was markedly higher than that in normal controls (0.8681±0.0308, P<0.001). These findings indicate that up-regulated expression of IL-17, IFN-γ, and MIP-3α might be involved in the pathogenesis of psoriasis.

Clinical Observation on Effect of Triptolide Tablet in Treating Patients with Psoriasis Vulgaris

Objective: To investigate the effects of triptolide tablet in the treatment of patients with psoriasis vulgaris. Methods: By an open clinical study of 103 patients with psoriasis vulgaris. Psoriasis area severity index (PASI) was measured and recorded before and after treatment for efficacy evaluation. Results: Of the 103 patients, markedly effective was got in 41 (39.7%), improved in 37 (35.8%) and ineffective in 25 (24.5%), the total effective rate being 75.7%, and the adverse reaction was shown only in few patients with decreased WBC during the treatment period. Conclusion: Triptolide tablet is effective for the treatment of psoriasis vulgaris during the one-year follow-up.

Effect of Yinxieling decoction on PASI,TNF-α and IL-8 in patients with psoriasis vulgaris

Objective:To study the effect of Yinxieling decoction on PASI,TNF-α and IL-8 in patients with psoriasis vulgaris.Methods:A total of 120 cases of psoriasis vulgaris were divided into 4 groups according to syndrome differentiation of TCM and randomized controlled method:wind heat syndrome group(group A).blood stasis syndrome group(group B) blood dryness syndrome group(group C)nd control group(group D)(n=30 per group).Patients in observation groups were treated with Yinxieling decoction,while patients in control group were treated by placebo for 8 weeks.Levels of TNT-α and IL-8 were determined before treatment.4 and 8 weeks after treatment.psoriasis area and severity index score was also performed before and after treatment.Results:psoriasis area and severity index score and serum level of TNF-α,IL-8 were significantly decreased in all groups.The decrease in three observation groups was more significant(P<0.05 or P<0.01),and the decrease in wind heat syndrome group was the most significant(P<0.01).psoriasis area and severity index was positively correlated with TNF-α and IT.-8,respectively(P<0.05).Conclusions:Yinxieling decoction has therapeutical effect on psoriasis vulgaris via regulating TNF-α and IL-8.

The Expression of Interleukin-22 and S100A7, A8, A9 mRNA in Patients with Psoriasis Vulgaris

In order to study the expression of interleukin-22 （IL-22） and S 100A7, A8, A9 mRNA in the skin lesions of patients with psoriasis vulgaris and their relationship, the biopsies were taken from skin lesions in 35 patients with psoriasis vulgaris and the skin of 16 normal controls, and the expression levels of 1L-22 and S 100A7, A8 and A9 mRNA were detected by semi-quantitative RT-PCR. The results showed that （1） IL-22 and S 100A8, A9 mRNA were positively expressed in the psoriatic skin lesions but negatively expressed in the normal controls; The expression level of S 100A7 was （1.133±0.040） in the psoriatic skin lesions, significantly higher than that in the normal controls （0.744±0.037, P〈0.01）. （2） There were significantly positive correlations between the expression of IL-22/S100A7 mRNA, IL-22/S100A8 mRNA, IL-22/S100A9 mRNA in the psoriasis vulgaris （r1=-0.543, r2=0.774, r3=0.621, P〈0.01）. It was concluded that IL-22 and S 100A7, A8, A9 might play important roles in the occurrence and progression of psoriasis.

EFFECT OF CAPSAICIN ON SUBSTANCE P IN PSORIASIS VULGARIS

Objective To the investigate the mechanism of capsaicin in psoriasis vulgaris. Methods Substance P(SP) in psoriatic lesions before and 6 weeks after the treatment with capsaicin was detedted by radioimmunoassary. Results After 3 weeks and 6 weeks treatment with capsaicin, SP in psoriatic lesions was decreased ( P <0.05), while it in the self control group was not decreased; Overall the efficient incidence in therapeutic group was 78.8% , while it in the control group was 36.8% . There was significant difference between them (χ 2 =16.30, P<0.001). Conclusion Capsaicin inhibits dermal inflammatory responses and proliferation of keratinocytes by decreasing the expression of SP in psoriasis vulgaris.

Effect of acitretin on the T helper cells of psoriasis vulgaris

Objective To investigate the effects of acitretin on T helper cell(Th)1/Th2 balance and Th17 cells in psoriasis vulgaris(PV)patients.Methods A total of 13 men and 17 women with PV were investigated.10 mg of acitretin was administered twice a day for 8 weeks for intervention therapy.Serum levels of interferon-gamma(IFN-γ),interleukin(IL)-4 and IL-17 were measured by enzyme-linked immunosorbent assay.T,Th1,Th2 and Th17 cells in skin biopsies were counted with double-labeled immunofluorescence.Psoriasis Area and Severity Index(PASI)score was calculated before and 8 weeks after treatment.Results Before treatment PV patients had higher serum levels of IFN-γ and IL-17,and increased T,Th1 and Th17 cells in skin biopsies.After treatment,both serum levels of IFN-γ and IL-17,and T,Th1 and Th17 cells infiltrating in PV skin decreased significantly.Th1/Th2 balance was restored to normal.However,their IL-4 and Th2 cells showed no significant change throughout the therapy.Conclusion Acitretin exerts influence on dermal Th1/Th2 balance and Th17 cell infiltration,so does it on production of systematic inflammatory cytokines IFN-γ and IL-17 in PV patients.However,Th2 cells and its derivative cytokine—IL-4 are not affected.

Meta-analysis of traditional Chinese medicine dampness-removing therapy in the treatment of psoriasis vulgaris

Objective:To systematically evaluate the clinical effect and safety of dampness-removing therapy in the treatment of psoriasis vulgaris by Meta analysis.Methods:The clinical studies on the treatment of psoriasis with removing dampness therapy in CNKI,Wanfang,VIP,SinoMed,Medline,Embase and Cochrane Library were searched from the establishment of the database to June 2021.After screening,data extraction and bias risk assessment,the retrieved literature was statistically analyzed by Revman5.3 software.Results:A total of 2063 subjects were included in 24 clinical studies.The results of Meta analysis showed that the experimental group was superior to the control group in terms of total effective rate of treatment(OR=3.31,95%CI[2.55,4.31]),reducing PASI score(MD=-2.57,95%CI[-3.08,-2.06])and improving quality of life(MD=-3.23,95%CI[-3.70,-2.76]).The adverse reactions in the experimental group were slighter than those in the control group(OR=0.42,95%CI[0.29,0.61]).Conclusion:The method of removing dampness in traditional Chinese medicine is safe and effective in the treatment of psoriasis vulgaris,but in view of the low overall quality of the included research,larger samples and higher quality clinical trials are still needed to obtain more sufficient evidence.

Analysis of herbs-combination of Professor Yang Su-qing in the treatment of psoriasis vulgaris with blood stasis syndrome

Objective:To explore Professor Yang Suqing’s experience in treating blood stasis syndrome of psoriasis vulgaris and analyze the characteristics of its prescription;Methods:Outpatient prescriptions for the treatment of psoriasis vulgaris with blood stasis syndrome were selected and extracted traditional Chinese medicine for standardized processing.Then analyze the data by using set visualization analysis and Apriori algorithm.Results:A total of 149 traditional Chinese herbs were extracted.Among them,and the top 12 commonly used herbs with frequency>30 were Licorice,Saposhnikovia,Schizonepeta tenuifolia,Angelica sinensis,Paeonia lactiflora,Ligusticum chuanxiong,Rehmannia glutinosa,Cicada slough,Oyster and Keel through the set visualization analysis,herbs association rules analysis,and herbs combination analysis.Saposhnikovia,Liquorice,Schizonepeta tenuifolia,Angelica sinensis and Paeonia Alba are the most commonly used combination of herbs by Professor Yang Suqing in the treatment of blood stasis syndrome of psoriasis vulgaris.Conclusion:In addition to invigorating blood circulation and removing blood stasis herbs,which are preferred for the treatment of blood stasis syndromes,Saposhnikovia and Schizonepeta tenuifolia,etc.,are used to synergistically exert the functions of invigorating blood circulation and removing blood stasis and eliminating wind expression,with remarkable efficacy.

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.

A Randomized Controlled Single-Blind Clinical Trial on 84 Outpatients with Psoriasis Vulgaris by Auricular Therapy Combined with Optimized Yinxieling Formula(银屑灵优化方)

Objective：To explore the therapeutic effect of auricular therapy combined with optimized Yinxieling Formula（银屑灵优化方） on psoriasis vulgaris.Methods：A randomized controlled single-blind clinical trial on 84 outpatients with psoriasis vulgaris was conducted.The patients were randomized to a treatment group（43 cases treated by auricular therapy combined with optimized Yinxieling Formula） and a control group （41 cases treated by optimized Yinxieling Formula alone） according to a random number generated by SPSS 17.0 software.The treatment duration for both groups was 8 weeks.The therapeutic effect was comprehensively measured by the primary outcome measure[Psoriasis Area and Severity Index（PASI） reduction rate]and the secondary outcome measure[PASI,Visual Analogue Scale（VAS）,Dermatology Life Quality Index（DLQI）, Self-rating Depression Scale（SDS）,and Self-rating Anxiety Scale（SAS）].The outcomes of both groups were obtained and compared before and after the intervention.Results：The PASI reduction rate in the treatment group was 74.4%（32/43）,which was higher than that in the control group（36.6%,15/41,P0.01）.The PASI scores decreased in both groups after treatment and was lower in the treatment group compared with the control group （P0.01）.With stratified analysis,there were significant differences between the PASI scores in the following subgroups：age 18-30,baseline PASI10 and stable stage（P0.05）.DLQI decreased in both groups on some categories after treatment,but there were no significant differences between the two groups in SDS,SAS and VAS（P0.05）.No obvious adverse reactions were found in either group.Conclusion：The therapeutic effect of auricular therapy combined with Optimized Yinxieling Formula was superior to Optimized Yinxieling Formula alone with no obvious adverse reaction.

Circulating Levels of Inflammatory Cytokines in Patients with Psoriasis Vulgaris of Different Chinese Medicine Syndromes

Objective： To investigate whether the serum levels of inflammation-related cytokines might be different between the healthy individuals and the psoriatic patients diagnosed of three varied Chinese medicine （CM） syndromes [blood-stasis syndrome （BSS）, blood-dryness syndrome （BDS） and wind-heat syndrome （WHS）]. Methods： A total of 62 psoriatic patients were recruited and assigned to 3 groups according to their CM syndromes, including 27 patients of BSS, 21 of BDS and 14 of WHS. Another 20 sex- and age- matched healthy subjects were enrolled into the control group. Serum concentrations of multiple cytokines, including monocyte chemotactic protein-1 （MCP-1）, macrophage inflammatory protein-1α （MIP-1α）, soluble CD40 ligand （SCD40L）, tumor necrosis factor-α （TNF-α）, epidermal growth factor （EGF）, interleukin-8 （IL-8）, interleukin-17 （IL-17）, interferon γ inducible protein-10 （IP-10） and vascular endothelial growth factor （VEGF）, were measured by a multiplexed flow cytometric assay. Results： The circulating levels of MIP-1α, TNF-α, IL-8, and IP-10 were significantly increased in the psoriatic patients compared with the healthy controls （P〈0.01）. Male and female patients tended to have higher serum levels of MCP-1 and IP-10, respectively （P〈0.05）. Interestingly, compared with the control group, 6 out of the 9 cytokines （MCP-1, MIP-1α, TNF-α, EGF, IL-8 and IP-10） were substantially increased in the BSS group （P〈0.05 or P〈0.01）, whereas only MIP-1α and IL-8 levels were elevated in the BDS group （P〈0.05 or P〈0.01） concurrent with lowered concentrations of SCD40L and IL-17 （P〈0.05）. In the WHS group, MIP-1α was the only cytokine whose level was evidently increased （P〈0.01）, in contrast to IL-17 which was decreased as compared with the control （P〈0.05）. The psoriatic patients overall owned higher levels of MIP-1 a and IL-8 in the circulation which were comparable among the 3 groups of CM syndromes （P〈0.01）. In contrast, TNF-α level of the BSS group was the highest among the three （P〈0.01）, followed by the BDS and the WHS groups. Conclusions： The expression profiles of cytokines in the circulation might not be necessarily identical for psoriatic patients with different CM syndromes. Accordingly, the serum concentrations of certain cytokines could potentially be used as the ancillary indices for the clinical classification of psoriatic CM syndromes.

Literature Research of Chinese Medicine Recipes for the Treatment of Psoriasis Vulgaris with Blood-heat Syndrome Type

Objective：To analyze and investigate the rules for drug utilization of Chinese medicine for the treatment of psoriasis vulgaris with blood-heat syndrome.Methods：The literatures that met the following inclusion criteria were screened out from China National Knowledge Infrastructure（CNKI） from January 1998 to December 2008,including the compositions and dosages of the recipes reported completely and accurately, the sample size being30 cases and the total effective rate being70%.Results：In total,289 papers meeting the inclusion criteria were retrieved,involving 301 recipes;in which 111 recipes consisting of 145 individual drugs were the function for clearing the heat,accounting for 52.84%.The three drugs with the highest utilized frequency were Radix Rehmanniae,Radix Arnebiae seu Lithospermi and Cortex Moutan.Meridian adscription of the drugs was mainly the Gan（肝）-meridian.Conclusion：There were rules for the treatment of psoriasis vulgaris of blood-heat syndrome with Chinese medicine prescriptions.

Treatment of Psoriasis Vulgaris with Medicated Thread Moxibustion of Zhuang Medicine:A Multicenter Randomized,Parallel Controlled Trial

Objective:To explore the efficacy and safety of Zhuang medicine medicated thread moxibustion(ZMTM)on psoriasis vulgaris.Methods:A multicenter,randomized,parallel controlled clinical trial was designed.A total of 241 outpatients with psoriasis vulgaris were randomly divided into a control group(120 cases)and a treatment group(121 cases)using a central block randomization from June 2015 to May 2018.The control group was treated with Western medicines alone including pidotimod dispersible tablets,vitamin B compound tablets,and compound cod liver oil-zinc oxide ointment.The treatment group was treated with ZMTM every 2 days combined with Western medicines.The two groups received continuous intervention for 30 days.The primary outcome was Psoriasis Area and Severity Index(PASI),and the secondary outcomes included Itch Rating Scale,Dermatology Quality of Life Index(DLQI),Hamilton Anxiety Rating Scale(HAMA),as well as PASI response rate.Meanwhile,adverse events were evaluated during the whole clinical trial.Follow-up was carried out 30 days after treatment.Results:There were 5 cases of shedding in this trial.In intention-to-treat analysis,236 cases were included and each group contained 118 cases.On the 30th and 60th days,PASI scores of patients in each group were significantly lower than that at baseline(P<0.01)and the PASI score reduction of the treatment group was greater than that of the control group(P<0.01).Itch Rating Scale,DLQI,and HAMA scale were decreased in both groups after treatment,and the treatment group showed a better therapeutic effect(P<0.01).The response rates of PASI 50 and 75 were significantly higher than those in the control group[81.4%(96/118),43.2%(51/118)vs.41.5%(49/118),11.0%(13/118),respectively,P<0.05].During follow-up,the improvements in scores of PASI,Itch Rating Scale,DLQI,and HAMA of the treatment group were significantly greater than those of the control group(P<0.01).The response rates of PASI 50 and 75 in the treatment group were significantly higher than those in the control group,respectively(both P<0.05).No obvious adverse reaction was found in either group.Conclusion:ZMTM combined with Western medicines showed a better therapeutic effect in the treatment of psoriasis vulgaris without obvious adverse reaction.(Trial Registration No.ChiCTR-IOR-16008159)

Efficacy and safety of Liangxue Jiedu decoction for the treatment of progressive psoriasis vulgaris: a multicenter, randomized, controlled study

OBJECTIVE: To determine the clinical efficacy and safety of Liangxue Jiedu decoction(LJD) for the treatment of progressive psoriasis vulgaris and to provide the basis for the development of a standardized treatment protocol for psoriasis vulgaris.METHODS: In this multicenter, randomized, controlled study, patients with blood-heat type psoriasis were randomly assigned to receive either Chinese herbal medicine(LJD;treatment group) or Western Medicine(cetirizine hydrochloride, vitamin C, and vitamin B complex;control group). Psoriasis Area and Severity Index(PASI) scores were calculated in addition to the number of patients who achieved ≥ 50% or ≥ 75% improvement in PASI score from baseline. The change in symptoms of Chinese medicine(color of rash, burning sensation,itchiness, severity of irritation, and anger) was evaluated and safety was assessed as adverse events and laboratory analysis. t test, independent sample non-parametric test and χ2 test were used to analyze the results.RESULTS: A total of 238 participants were included in the study [treatment group, n = 122(PP analysis117);control group, n = 116(PP analysis 104)]. LJD treatment was associated with a significant improvement in skin lesions and symptoms com-pared with Western Medicine treatment. At the end of the 8-week treatment period, 23.77%(PP analysis 24.79%) of patients in the treatment group had achieved PASI75 and 57.38%(PP analysis 58.97%)had achieved PASI50;the corresponding figures in the control group were 9.48%(9.62%) and 25.00%(25.00%), respectively. The between-group differences were statistically significant(P < 0.05).CONCLUSION: Treatment of psoriasis vulgaris of the blood-heat type using LJD was associated with significantly better outcomes compared with those achieved using standard Western Medicine.

Applying latent tree analysis to classify Traditional Chinese Medicine syndromes(Zheng)in patients with psoriasis vulgaris

OBJECTIVE:To treat patients with psoriasis vulgaris using Traditional Chinese Medicine(TCM),one must stratify patients into subtypes(known as TCM syndromes or Zheng)and apply appropriate TCM treatments to different subtypes.However,no unified symptom-based classification scheme of subtypes(Zheng)exists for psoriasis vulgaris.The present paper aims to classify patients with psoriasis vulgaris into different subtypes via the analysis of clinical TCM symptom and sign data.METHODS:A cross-sectional survey was carried out in Beijing from 2005-2008,collecting clinical TCM symptom and sign data from 2764 patients with psoriasis vulgaris.Roughly 108 symptoms and signs were initially analyzed using latent tree analysis,with a selection of the resulting latent variables then used as features to cluster patients into subtypes.RESULTS:The initial latent tree analysis yielded a model with 43 latent variables.The second phase of the analysis divided patients into three subtype groups with clear TCM Zheng connotations:'blood deficiency and wind dryness';'blood heat';and'blood stasis'.CONCLUSIONS:Via two-phase analysis of clinic symptom and sign data,three different Zheng subtypes were identified for psoriasis vulgaris.Statistical characteristics of the three subtypes are presented.This constitutes an evidence-based solution to the syndromedifferentiation problem that exists with psoriasis vulgaris.

A Prototype for Diagnosis of Psoriasis in Traditional Chinese Medicine

Psoriasis is a chronic,non-communicable,painful,disfiguring and disabling disease for which there is no cure,with great negative impact on patients’quality of life(QoL).Diagnosis and treatment with traditional Chinese medical technique based on syndrome differentiation has been used in practice for a long time and proven effective,though,up to now,there are only a few available studies about the use of semantic technologies and the knowledge systems that use Traditional Chinese Medicine(TCM)-syndrome differentiation for information retrieval and automated reasoning.In this paper we use semantic techniques based on ontologies to develop a prototypical system for the diagnosis of Psoriasis.For this purpose,a domain ontology is developed for syndrome differentiation of psoriasis vulgaris(PV).This ontology is founded on an adapted version of the general formal ontology(GFO),with the evidence-based clinical practice guideline of TCM for psoriasis vulgaris(Guideline 2013)as the primary data sources.The implemented prototype,called ONTOPV,contains this domain ontology and is aimed at a decision support system for diagnosis and treatment of PV.This system uses a case-database for Case Based Reasoning(CBR),combined with fuzzy pattern recognition.Experimental results show that the ONTOPV realizes the basic functionalities of data collection,querying,browsing and navigation,and supports rule-based knowledge reasoning,and integrates fuzzy pattern recognition.It can provide users with clinical decision support for TCM syndrome differentiation in diagnosis of psoriasis.

Application and Prospect of Cold Hoop Confining Method in Psoriasis from Dermatopathology in Integrated Chinese and Western Medicine

In the pathological changes of psoriasis vulgaris,excessive proliferation of keratinocytes,proliferation of microvessels,infiltration of a large number of inflammatory cells,and great shortening of epidermal replacement time,are the manifestations of Qi and Yin depletion,and they all correspond with pathological changes of nutrient Qi and blood deficiency caused by excessive loss.The treatment of psoriasis should focus on cold straight fire,convergence and fixation.Therefore,it is feasible to treat psoriasis with hoop in theory,and it is found that"cold hoop confining medicine"may be more suitable for the treatment of psoriasis vulgaris in the gradual progress of the experiment.The research could provide theoretical basis for the application of cold hoop confining medicine represented by brusatol in psoriasis vulgaris and related diseases.

A Study on the Expression of Interleukin(IL)-10 and IL-12 P35, P40 mRNA in the Psoriatic Lesions

To investigate the possible role of interleukin (IL) 10 and IL 12 in the pathogenesis of psoriatic lesions and to supply theoretical basis for the gene therapy for psoriasis, the expression of IL 10 and IL 12 P35, P40 mRNA in 12 cases of psoriatic lesions and 6 normal skin tissues was detected by using RT PCR technique. The results showed that the expression of IL 10 mRNA in the psoriatic lesions was significantly lower than that in the normal skin tissues ( P <0.001). The expression of IL 12 P35 was positive both in the psoriatic lesions and in the normal skin tissues. IL 12 P40 mRNA was expressed positively only in the psoriatic lesions but negatively in the normal skin tissues. It was suggested that IL 12 might take an important role in the occurrence and progression of psoriasis, but IL 10 might have certain role in the regression of psoriasis.

Chinese Medicine as Supporting Therapy for Psoriasis:Past,Present,and Future

Psoriasis is a chronic skin disease and an important health concern.Western medicine and therapies are the main treatment strategies for psoriasis vulgaris(PV);however,the overall prognosis of patients with PV is still poor.Therefore,PV prevention is especially crucial.Chinese medicine(CM)has a long history of treating psoriasis,and it has unique wisdom in different cognitive angles and treatment modes from modern medicine.In this review,we first summarized the herbs and ancient CM formulas that have therapeutic effects on PV.Second,the research status and obstacles to the current development of CM in modern medicine were reviewed.Finally,the future of CM in the context of precision medicine and integrated medicine was discussed.After a detailed reading of the abundant literature,we believe that CM,through thousands of years of continuous development and clinical practice,has achieved high effectiveness and safety for PV treatment,despite its surrounding controversy.Moreover,precise analyses and systematic research methods have provided new approaches for the modernization of CM in the future.The treatment of PV with CM is worth popularizing,and we hope it can benefit more patients.

Study on the Expression of IL-18, AcPL and IL-18BP mRNA in the Psoriatic Lesions

To investigate the role of IL-18 and IL-18 binding protein (IL-18BP) in the pathogenesis of psoriasis, PT-PCR was used to semi-quantitatively analyze the mRNA expression of IL-18, AcPL (accessory protein-like) and IL-18BP in 12 psoriatic lesions and in 6 normal skin tissues. The results showed that IL-18 and AcPL mRNA were present in all specimens from 6 normal skin and 12 pieces of psoriatic skin, and IL-18 and AcPL showed relatively stronger intensity in the psoriatic skin compared with those seen in normal skin (P<0.01). Amplified bands indicating the expression of IL-18BP mRNA were weakly positive in all samples of normal skin. In contrast, the PCR products for IL-18BP were distinctly visible in all specimens of psoriatic lesions (P<0.01). These findings demonstrate that IL-18 is constitutively synthesized by human keratinocytes and involved in the development of the Th1 response in psoriatic lesions, and its bioactivity appears to be closely regulated by cutaneous inflammation.