雷公藤多苷对寻常型银屑病患者外周血Th17/Treg 相关细胞因子的影响

目的观察雷公藤多昔治疗前后寻常型银屑病患者血清辅助性T细胞17(Thl7)/调节性T细胞(Treg)相关细胞因子白介素-17(1L-17),白介素-23(IL-23)和白介素-10(IL-10)的含量,探讨雷公藤多昔治疗寻常型银屑病的作用机制。方法对蚌埠医学院第一附属医院皮肤科2016年12月—2017年6月就诊的41例寻常型银屑病患者采用口服雷公藤多昔片治疗,每日3次,每次20mg,疗程8周,以银屑病皮损面积和严重程度(PASI)评分评价疗效;采用酶联免疫吸附法(ELISA)检测正常对照组及患者治疗前后血清中IL-17、L-23和IL-10水平变化。结果寻常型银屑病患者外周血Thl7相关细胞因子IL-17和IL-23水平显著高于正常对照组(均P<0.01);而Treg相关细胞因子IL-10水平显著低于正常对照组。雷公藤多昔治疗后IL-17和IL-23水平明显降低,与治疗前相比差异有统计学意义(均P<0.01);而IL-10水平明显升高,与治疗前相比差异也有统计学意义(P<0.01)。雷公藤多昔治疗后PASI评分与治疗前相比显著下降,差异有统计学意义(P<0.01).患者雷公藤多昔治疗前后PASI评分与IL-17和IL-23水平呈正相关性,而与IL-10呈负相关性(均P<0.01).结论雷公藤多昔治疗寻常型银屑病疗效显著,可能通过调节Thl7/Treg相关细胞因子水平发挥其治疗作用。

Effect of Tripterygium wilfordii on levels of cytokines related to Th17/Treg cells in the peripheral blood of patients with psoriasis vulgaris

Objective To investigate the effect of Tripterygium wilfordii on levels of IL-17, IL-23 and IL-10 associated with Thl7/Treg Cells in the peripheral blood of patients with psoriasis vulgaris, and analyze its therapeutic mechanism. Methods Forty one cases of psoriasis vulgaris in our hospital from December 2016 to June 2017 were orally administrated with Tripterygium wilfordii tablets (20 mg, 3 times a day, for 8 weeks). The efficacy of treatment was evaluated by using Psoriasis Area and Severity Index (PASI) scores. The serum levels of IL-17, IL-23 and IL-10 in normal controls and patients with PV before and after the treatment was tested by using ELISA. Results The serum levels of IL-17 and IL-23 in the patients were significantly higher than those in the normal controls (all P＜0.01), while the serum level of IL-10 was significantly lower in patients as compared with the normal control (P＜0.01). After the treatment with Tripterygium wilfordii, the serum levels of IL-17 and IL-23 were significantly decreased (all P＜0.01), while the serum level of IL-10 was significantly increased (P＜0.01). PASI scores were decreased significantly after the treatment. The PASI score in patient was positively correlated with serum levels of IL-17 and IL-23, and negatively correlated with the level of IL-10 (all P＜0.01). Conclusion Tripterygium wilfordii shows a remarkable curative effect on psoriasis vulgaris. Its regulation on the levels of cytokines related to Th17/Treg cells may be involved in the mechanisms of Tripterygium wilfordii action.