Effect of pharmacological intervention on MIP-1α,MIP-1β and MCP-1 expression in patients with psoriasis vulgaris

Objective:To detect the expression level of macrophage inflammatory protein-1(MIP-1)α,MIP-1βand monocyte chemoattractant protein-1(MCP-1)in with psoriasis vulgaris and explore the role in the pathogenesis of psoriasis vulgaris.Methods:The level of MIP-1α,MIP-1βand MCP-1 in peripheral blood from 50 patients with psoriasis vulgaris and 50 normal controls were measured by enzyme linked immunosorbent assay.The correlation with psoriasis area and severity index(PASI)was analyzed.The level of MIP-1α,MIP-1βand MCP-1 was compared between psoriasis vulgaris patients at active stage and resting stage.And the change in MIP-1α,MIP-1βand MCP-1 before and after therapy was also observed.Results:The content of MIP-1α,MIP-1βand MCP-1 in patients with psoriasis vulgaris was(1342.78±210.30),(175.28±28.18)and(266.86±32.75)ng/L,respectively,significantly higher than those in control group(P<0.05).The expression level of MIP-1α,MIP-1βand MCP-1 in peripheral blood of patients with psoriasis vulgaris was positively correlated wilh PASI(P<0.01).After acitretin therapy,expression level of MIP-1α,MIP-1βand MCP-1 in peripheral blood of patients with psoriasis vulgaris was significantly decreased.Conclusions:Chemokine factor MIP-1α,MIP-1βand MCP-1 may be involved in the pathogenesis of psoriasis vulgaris.

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.

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.

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.

Traditional Chinese Medicine nursing protocols for psoriasis vulgaris（英文）

Psoriasis is a common chronic inflammatory skin disease with a spectrum of clinical phenotypes including psoriasis vulgaris, pustular psoriasis, guttate psoriasis and erythrodermic psoriasis, in which psoriasis vulgaris is most common. In recent years, Traditional Chinese Medicine(TCM) has attracted widespread attention in the treatment of psoriasis because of better efficacy and a lower incidence of adverse reactions. In TCM, psoriasis is considered to be caused by blood heat and the stagnation of Qi and blood. This article primarily investigated the key points of common syndromes, TCM nursing methods and healthy guidance of psoriasis vulgaris, aiming at maintaining and developing the strengths of TCM, improving its efficacy and standardizing its behavior.

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.

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.

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.

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.

Relationship between serum levels of IL-4,IL-8,TNF-alpha,T cell subsets and prognosis in patients with psoriasis vulgaris

Objective:To study the relationship between serum levels of IL-4,IL-8,TNF-alpha,T cell subsets and prognosis in patients with psoriasis vulgaris.Methods:A total of 120 patients with psoriasis vulgaris who were treated in our hospital from January 2018 to January 2019 were selected as the study group,and 50 normal subjects who underwent health examination in our hospital during the same period were selected as the control group.The levels of serum IL-4,IL-8,TNF-alpha and T cell subsets in the observation group and the control group were detected and compared.The levels of IL-4,IL-8,TNF-alpha and T cell subsets in the observation group at different time after treatment were compared after standardized western medicine treatment.Pearson test was used to analyze the correlation between IL-4,IL-8,TNF-alpha and T cell subsets.Results:The levels of IL-4,IL-8 and TNF-a in the observation group were higher than those in the control group,while the levels of CD3+,CD4+,CD4+/CD8+in the observation group were lower than those in the control group,and the levels of CD8+in the observation group were higher than those in the control group.There was a significant difference between the two groups.In the observation group,after 8 weeks of treatment,the levels of IL-4,IL-8 and TNF-alpha continued to decrease,CD3+,CD4+,CD4+/CD8+increased and CD8+decreased with the prolongation of treatment time.There was significant difference among the groups.Pearson correlation test was used.IL-4,IL-8,TNF-a had negative correlation with CD3+,CD4+,CD4+/CD8+,and positive correlation with CD8+.Conclusion:The incidence of psoriasis vulgaris is related to the elevation of IL-4,IL-8,TNF-alpha levels and immunodeficiency.The prognosis of psoriasis vulgaris can be judged by monitoring the levels of IL-4,IL-8,TNF-alpha and T cell subsets.

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.

皮损组织Cx26蛋白及信使RNA表达与PV患者PASI评分的关联性

目的分析皮损组织Cx26蛋白含量及信使RNA表达与寻常型银屑病(PV)患者皮损面积和严重程度指数(psoriasis area and severity index,PASI)评分的关联性。方法2018年7月-2019年7月选取本院PV患者60例作为研究组,另选同期健康体检者32例作为对照组,分析皮损组织Cx26蛋白、信使RNA水平与PV患者PASI评分的关联性。结果研究组Cx26蛋白含量及信使RNA表达水平均高于对照组(P<0.05);研究组轻度患者Cx26蛋白含量及信使RNA表达水平低于中度,中度患者Cx26蛋白含量及信使RNA表达水平低于重度(P<0.05);经Spearman分析可知,PASI评分与Cx26蛋白含量(r=0.625)及信使RNA表达水平(r=0.541)存在明显正相关关系(P<0.05)。结论PV患者Cx26蛋白含量及信使RNA表达水平与PASI评分密切相关,可作为评判疾病进展、预后指标,为临床治疗提供指导依据。

MPVLR、LMR比值与寻常型银屑病及银屑病关节炎的相关性分析

目的探讨平均血小板体积/淋巴细胞比值(MPVLR)、淋巴细胞与单核细胞的比值(LMR)与寻常型银屑病(PsV)及银屑病关节炎的相关性。方法选取2018年4月—2021年4月我院治疗的102例银屑病患者,其中PsV 85例,银屑病关节炎17例,另选取同期于我院皮肤外科及美容科的健康人群60例作为对照组。收集患者及健康对照的年龄、性别、首发年龄、病程、家族史及血液常规检测指标,计算MPVLR、LMR比值。绘制受试者工作特征曲线(ROC)并计算曲线下面积(AUC),分析MPVLR、LMR对银屑病患者的诊断价值,多因素Logistic回归分析探讨银屑病患者关节炎的相关因素。结果与正常对照组相比,PsV组和银屑病关节炎组的白细胞计数(WBC)、单核细胞计数(MONO)、C反应蛋白(CRP)、MPVLR均显著上升,血红蛋白(Hb)、LMR均显著下降(均P<0.05)。银屑病关节炎组的血小板计数(PLT)明显高于对照组,淋巴细胞计数(LYM)明显低于对照组(均P<0.05)。与PsV组相比,银屑病关节炎组的PLT、CRP、MPVLR明显升高,LYM、Hb、LMR均明显降低(均P<0.05)。Spearman相关分析结果:MPVLR与CRP、银屑病皮损面积和严重程度指数(PASI)评分呈正相关,LMR与CRP、PASI呈负相关(r分别为0.663、0.611、-0.616、-0.678,均P<0.05)。MPVLR、LMR在预测银屑病的ROC AUC分别为0.794(95%CI:0.726~0.861)、0.748(95%CI:0.674~0.817)。在5.65的临界值下,MPVLR的敏感度为76.5%,特异度为80.3%;在4.56的临界值下,LMR预测的敏感度为74.4%,特异度为76.8%。多因素Logistic回归分析结果显示:MPVLR、CRP是银屑病患者发生关节炎的危险因素,OR及95%CI分别为1.742(1.122~2.714)及1.539(1.007~2.349)。LMR是银屑病患者发生关节炎的保护因素,OR及95%CI为0.694(0.532~0.906)。结论PsV患者MPVLR升高、LMR降低,银屑病关节炎患者MPVLR更高、LMR更低,MPVLR、LMR对银屑病有较好的诊断效能,有望成为反映银屑病严重程度的生物标志物。

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.

基于五脏一体观探析从肝辨治寻常型银屑病

寻常型银屑病是临床中最常见的银屑病类型,疾病主要表现为皮肤表面出现红色斑丘疹,覆有银白色鳞屑,拭去可见出血点,伴有瘙痒等症状。银屑病与中医“白疕”相对应,病虽发于体表,然司外揣内。肝主疏泄,心主血脉,肺主皮毛,脾主运化,肾为先天之本,五脏精津、气血共同作用于肌肤才使得皮肤润泽。五脏之关键脏腑在于肝,以肝为切入点,结合五脏一体观进行整体辨治。文章提出肝脾湿热、肝心火旺、肝火犯肺、肝郁肾虚的寻常型银屑病主要病机,并施以相对应治法,协同治疗,祛邪补虚,和五脏,实肌肤。经临床验证,治疗上以治肝为主,兼顾他脏,基于五脏一体观思想,从肝辨治寻常型银屑病顺应整体观念,调和气血,调整阴阳,辨证施以对应治法,以达肝畅条达,五脏清明,从而使皮肤疮消肌愈,“屑”去肤安,取得良好疗效。因考虑到本病病程长,易反复发作,患者多伴有抑郁、精神焦虑等情志问题,在治疗时重视调肝治肝,运用疏肝解郁、清热解毒、清心凉血等法随证治之,基于五脏一体观进行辨证论治,使郁遏得疏,脏虚得养,疏泄有序,阴平阳秘,诸脏平和,取得较好的临床效果。

长三角地区寻常型银屑病中医临床诊疗专家共识

银屑病是一种免疫介导的慢性、易复发的炎症性皮肤病,其典型皮损为皮肤鳞屑样红斑。临床上将银屑病分为寻常型、红皮病型、脓疱型和关节病型4种类型。其中寻常型银屑病最为常见,根据病程分为进行期、静止期和退行期[1]。中医对寻常型银屑病有独特理解,将其归于“白疕”“干癣”“蛇虱”等范畴。中医药治疗寻常型银屑病疗效确切,能有效改善其临床症状,减少复发率。长三角地区在银屑病诊疗中具有独特的地域性和流行病学特征,但对其遣方用药尚无统一标准,因此有必要制定适用于该地区的中医药诊疗寻常型银屑病专家共识,以更科学地指导临床实践,发挥中医药诊疗的特色与优势。

走罐疗法对寻常型斑块状银屑病患者皮损面积和严重程度评分的影响

目的分析走罐疗法对寻常型斑块状银屑病患者皮损面积和严重程度评分的影响。方法选取2020年12月至2022年12月新疆医科大学附属中医医院收治的100例寻常型斑块状银屑病患者,按随机信封法分为研究组和对照组,每组50例。对照组采用常规干预措施,研究组则在常规干预措施的基础上增加走罐疗法治疗。比较2组患者干预前后的皮损面积和严重程度、症状表现评分、生活质量评价和不良反应发生率。结果干预8周后,研究组的银屑病皮损面积与严重程度评估量表(PASI)评分,皮损颜色、瘙痒、皮肤甲错和舌症各项证候评分,以及世界卫生组织生活质量评价简表(WHOQOL-BREF)各维度评分均优于对照组,差异均有统计学意义(P均<0.05)。2组在干预期间所出现的不良反应发生率无统计学差异(P>0.05)。结论走罐疗法可缓解寻常型斑块状银屑病患者的皮损症状,减轻严重程度,提高生活质量,并且无明显不良反应。

基于文献研究及德尔菲法构建寻常型银屑病脾虚湿蕴证的诊断标准

【目的】采用文献研究、专家主观经验评价及数理统计分析三者结合以构建寻常型银屑病脾虚湿蕴证的诊断标准。【方法】通过文献研究构建寻常型银屑病脾虚湿蕴证相关症状、体征备选条目池,运用德尔菲法对全国32位专家进行4轮问卷调查,分析专家对各备选条目意见的集中程度及协调程度。第三轮调查根据各条目的权重系数将诊断指标分为主症及次症,形成多个证候诊断判断条件选项,再通过第四轮专家调查,明确脾虚湿蕴证的诊断模式及诊断条件。【结果】根据专家意见集中程度、变异系数对各证候诊断备选条目进行筛选,经同类合并,形成诊断指标24个,形成主症3个(纳呆食少、便溏、舌淡胖边有齿印),次症21个(如腹胀、口淡不渴、形体肥胖、嗜睡、倦怠乏力、脉细滑、脉濡、大便完谷不化、皮损颜色淡红等)。第四轮专家调查确认了“病位脾”“病性气虚”“病性湿”为诊断的必要条件;银屑病脾虚湿蕴证的诊断条件确定为:(1)具有3个主要症状;(2)具备2个主要症状+任2个次要症状。【结论】所构建的寻常型银屑病脾虚湿蕴证的诊断标准包含主症及次症,条件要求明确,易于临床操作,具有较好的临床适用性。