寻常性银屑病患者外周血和皮损中Th17细胞及相关因子的表达

目的 探讨寻常性银屑病患者外周血和皮损中Th17细胞及相关因子IL-17、IL-22表达,分析其与疾病严重程度及病程的相关性.方法 抽取44例寻常性银屑病患者和28例正常人对照者外周血,用三色法流式细胞仪检测外周血n17细胞,ELISA法检测血清中IL-17、IL-22表达.取20例寻常性银屑病患者皮损和8例正常人对照者皮肤,用量子点免疫荧光双标法检测Th17细胞表达.结果 寻常性银屑病患者外周血Th17细胞百分比(4.71%±2.55%)高于正常人对照组(0.55%±0.39%),两组差异有统计学意义(P＜0.01).银屑病患者Th17细胞与银屑病病情严重度评分(PASI)呈显著正相关(r=0.53,P＜0.01),但与病程无相关性(r=0.09,P＞0.05).银屑病患者血清中IL-17(24.02±12.31 ng/L)、IL-22(18.32±8.14 ng/L)表达均高于正常人对照组(IL-17为7.16±4.04 ng/L,IL-22为6.52±4.15 ng/L),差异均有统计学意义(P＜0.01和＜0.05).银屑病患者血清IL-17、IL22表达与PASI呈显著正相关(r=0.47,P＜0.01;r=0.53,P＜0.01),与病程无相关性(r=0.03,P＞0.05;r=0.19,P＞0.05).银屑病患者皮损中可见Th17细胞浸润,主要集中在真皮浅层血管周围;而正常人皮肤中仅有微量CD4+T细胞表达,未见Th17细胞.结论 Th17细胞参与银屑病的发病,提示阻断相关因子IL-17、IL-22的药物可成为治疗银屑病的又一新靶点.

Abstract：

Objective To detect the quantity of Th17 cells and expressions of related cytokines including interleukin (IL)-17 and IL-22, in peripheral blood and skin lesions of patients with psoriasis vulgaris, and to analyze their correlation with disease severity and clinical course. Methods Peripheral blood was obtained from 44 patients with progressive psoriasis vulgaris and 28 normal human controls. Three-color flow cytometry was carried out to detect the quantity of Th17 cells, and ELISA to examine the levels of serum IL-17 and -22.Skin samples were obtained from 20 patients with psoriasis vulgaris and 8 normal human controls, and a quantum dot-based double labled immumofluorescence method was used to determine the quantity of Th17 cells.Results The percentage of peripheral blood Th17 cells was higher in patients with psoriasis vulgaris than in normal human controls (4.71% ± 2.55% vs. 0.55% ± 0.39%, P ＜ 0.01 ). Elevated expressions of IL-17 and IL-22 were noted in the patients compared with the normal human controls (24.02 ± 12.31 ng/L vs. 7.16 ±4.04 ng/L, P ＜ 0.05; 18.32 ± 8.14 ng/L vs. 6.52 ± 4.15 ng/L, P ＜ 0.01 ). The percentage of peripheral blood Th17 cells and serum levels of IL-17 and IL-22 were positively correlated with psoriasis area and severity index (r= 0.53, 0.47, 0.53, respectively, all P ＜ 0.01 ), but unrelated to the clinical course of psoriasis (r = 0.09,0.03, 0.19, respectively, all P ＞ 0.05). There was an infiltrate of Th17 cells in psoriatic lesions, which was mainly distributed around the blood vessels in superficial dermis, whereas there were only a small number of CD4+ T cells in the normal control skin with the absence of Th17 cells. Conclusions Th17 cells are involved in the development of psoriasis, and Th17 cell-secreted cytokines, such as IL-17 and IL-22, may serve as a new therapeutic target for psoriasis.

T-helper (Th) 17 cell quantity and related cytokine expressions in skin lesions and peripheral blood of patients with psoriasis vulgaris

Objective To detect the quantity of Th17 cells and expressions of related cytokines including interleukin (IL)-17 and IL-22, in peripheral blood and skin lesions of patients with psoriasis vulgaris, and to analyze their correlation with disease severity and clinical course. Methods Peripheral blood was obtained from 44 patients with progressive psoriasis vulgaris and 28 normal human controls. Three-color flow cytometry was carried out to detect the quantity of Th17 cells, and ELISA to examine the levels of serum IL-17 and -22.Skin samples were obtained from 20 patients with psoriasis vulgaris and 8 normal human controls, and a quantum dot-based double labled immumofluorescence method was used to determine the quantity of Th17 cells.Results The percentage of peripheral blood Th17 cells was higher in patients with psoriasis vulgaris than in normal human controls (4.71% ± 2.55% vs. 0.55% ± 0.39%, P ＜ 0.01 ). Elevated expressions of IL-17 and IL-22 were noted in the patients compared with the normal human controls (24.02 ± 12.31 ng/L vs. 7.16 ±4.04 ng/L, P ＜ 0.05; 18.32 ± 8.14 ng/L vs. 6.52 ± 4.15 ng/L, P ＜ 0.01 ). The percentage of peripheral blood Th17 cells and serum levels of IL-17 and IL-22 were positively correlated with psoriasis area and severity index (r= 0.53, 0.47, 0.53, respectively, all P ＜ 0.01 ), but unrelated to the clinical course of psoriasis (r = 0.09,0.03, 0.19, respectively, all P ＞ 0.05). There was an infiltrate of Th17 cells in psoriatic lesions, which was mainly distributed around the blood vessels in superficial dermis, whereas there were only a small number of CD4+ T cells in the normal control skin with the absence of Th17 cells. Conclusions Th17 cells are involved in the development of psoriasis, and Th17 cell-secreted cytokines, such as IL-17 and IL-22, may serve as a new therapeutic target for psoriasis.