色素障碍性皮肤病

20 0 12 54 8　白癜风患者血浆三种神经肽测定及其临床意义 /涂彩霞 (大连医大附一院皮肤科 )…∥中华皮肤科杂志 .- 2 0 0 1,34 ( 1) .- 39～ 4 0β内啡肽 (β- EP)、神经肽 Y ( N PY )及降钙素基因相关肽 ( CGRP)是重要的神经递质 ,同时也可作为免疫调节因子发挥作用。为观察这些神经肽与白癜风的发病关系 ,用放射免疫分析法测定 4 0例进展期或稳定期的不同类型白癜风患者 3种神经肽浓度 ,并与正常对照。结果寻常型 (局限性与泛发性 )、节段型、进展期和稳定期白癜风患者血浆β- EP、N PY水平较正常对照组显著增高 ;进展期白癜风 N…     

白癜风患者血浆与皮肤组织液神经肽Y测定及其临床意义

目的：观察神经肽Y（NPY）与白癜风发病关系。方法：用放射免疫分析法测定40例白癜风患者血浆NPY浓度,并与23例正常对照对照者比较,同时测定其中的25例患者白斑与非白斑部位皮肤组织液NPY浓度,结果：患者血浆NPY水平均比正常对照者显著增高,寻常型与节段型白癜风患者白斑部位皮肤组织液NPY浓度与非白斑部位相比无明显变化。结论：NPY与白癜风的发病可能存在一定关系。     

白癜风患者血浆与皮肤疱液降钙素基因相关肽测定

降钙素基因相关肽（CGRP）是重要的神经递质及免疫调节因子。研究旨在观察其是否可能与白癜风的发病有关。采用放射免疫分析法测定40例白癜风血浆CGRP浓度，并与正常对照作比较；同时测定部分患者白斑与非白斑处皮肤疱液CGRP浓度。结果显示寻常型与进展期白癜风血浆CGRP水平增高，白斑与非白斑处皮肤疱液其浓度无差别，认为CGRP与白癜风的发病可能存在一定关系。     

白癜风皮损中NPY VIP和SP的研究

目的 探讨NPY（神经肽Y）、VIP（血管活性肠肽）、SP（神经肽P物质）在白癜风发病机制中的作用。方法 采用SABC免疫组化法对20例白癜风患者（活动期10例，稳定期10例）的皮损、非皮损区以及10例正常人皮肤中的NPY、VIP和SP进行研究，并测定各组皮肤标本中NPY、VIP及SP的免疫反应性。结果 活动期白癜风皮损中NPY、VIP及SP的免疫反应性明显增强，与正常对照及未受累皮肤比较差异有差异性，NPY与SP的反应在白癜风活动期皮损与稳定期皮损比较差异也有显著性。VIP的免疫反应性在白癜风活动期皮损与稳定期皮损中相比稍增强，但差异无统计学意义。结论 神经多肽与白癜风的发病有关，尤其与白癜风的活动性有关。NPY和SP可能在白癜风的发病机制中也起一定的作用。     

寻常型白癜风患者外周血Th1/Th2细胞因子的研究

目的：研究寻常型白癜风患者外周血Th1型细胞因子（IFN-γ）和Th2型细胞因子（IL-10）水平,探讨其在白癜风发病机制中的作用及与疾病分期的关系。方法：采用ELISA方法检测35例寻常型白癜风患者（其中进展期20例、稳定期15例）和20例正常对照组外周血IFN-γ和IL-10的水平。结果：IFN-γ水平在各组之间差异均无统计学意义（P〉0.05）。进展期白癜风患者外周血IL-10水平与稳定期相比明显增加,差异有统计学意义（P〈0.05）;进展期白癜风患者外周血IL-10水平与正常对照组相比明显增高,差异有统计学意义（P〈0.05）;稳定期白癜风患者外周血IL-10水平与正常对照组相比明显增高,差异有统计学意义（P〈0.05）。结论：寻常型白癜风患者体内Th2型细胞因子占优势,可能参与了白癜风的发病过程。     

寻常型白癜风患者血浆内皮素-1的测定

为了了解内皮素－１（ＥＴ－１）在白癜风发病及预后中的作用，采用放射免疫方法检测了６８例白癜风血浆ＥＴ－１的水平。结果显示：稳定期白癜风患者血浆ＥＴ－１水平明显高于进展期白癜风患者及正常人。血浆ＥＴ－１可能在白癜风的色素恢复中起重要作用。     

白癜风患者血清白介素、肿瘤坏死因子α及粒细胞-巨噬细胞集落刺激因子检测

目的 探讨白介素1β(IL-1β)、白介素6(IL-6)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)及粒细胞-巨噬细胞集落刺激因子(GM-CSF)等在白癜风患者血清中的变化。方法 采用放射免疫分析法测定50例白癜风患者血清细胞因子水平,并用20例正常人作对照。结果 局限性、泛发性白癜风患者血清IL-6、GM-CSF水平及泛发性患者血清IL-1β水平均显著高于对照组。节段型患者血清细胞因子水平与对照组比较差异无显著性。局限性、泛发性患者血清GM-CSF水平及泛发性患者血清IL-6水平进展期显著高于稳定期。结论 IL-6和GM-CSF在非节段型白癜风自身免疫机制中可能起一定作用。     

白癜风患者白介素-17和转化生长因子-β水平的检测北大核心CSCD

目的 探讨白介素-17（IL-17）和 转化生长因子-β（TGF-β）与白癜风发病之间的关系。方法 双抗体夹心酶联免疫吸附试验（ELISA）检测120例白癜风患者和60例健康对照血清中IL-17和TGF-β水平。分析两种因子与白癜风患者性别、病期、病程、白斑面积、家族史的关系。 结果 进展期白癜风患者血清IL-17水平显著高于健康对照组和稳定期患者（P值均 〈 0.05）,随着白癜风患者白斑面积增大,IL-17水平逐渐升高（χ2 = 12.656,P 〈 0.05）;而进展期白癜风患者血清TGF-β水平也高于健康对照组和稳定期患者,但差异无统计学意义（P值均 〉 0.05）。 结论 白癜风患者血清IL-17和TGF-β水平与病情有一定关系,两者可能在白癜风发病中发挥作用。     

白癜风患者血清中抗黑素细胞IgG抗体的检测及意义

目的：检测白癜风患者血清中抗黑素细胞IgG抗体并分析其与疾病活动性及发病类型的关系。方法：通过体外黑素细胞培养，采用问接免疫荧光技术测定白癜风患者血清中抗黑素细胞IgG抗体。结果：进展期白癜风患者抗黑素细胞抗体水平明显高于稳定期及正常人，进展期寻常型白癜风中泛发性患者抗体滴度明显高于局限性者，差异均有统计学意义。结论白癜风患者血清中抗黑素细胞IgG抗体与疾病的活动性及发病类型有一定的关系，支持白癜风与自身免疫有关。     

68例白癜风患者血清β2—微球蛋白与免疫球蛋白水平的检测

测定６８例白癜风患者血清β２－微球蛋白（β２－Ｍ）与免疫球蛋白ＩｇＧ、ＩｇＡ、ＩｇＭ水平。测定结果，寻常型进展期与稳定期白癜风血清β２－Ｍ水平均显著性升高，以进展期尤甚（Ｐ＜０．０１），节段型白癜风血清β２－Ｍ水平无显著性改变（Ｐ＞０．０５）；寻常型白癜风血清免疫球蛋白ＩｇＧ、ＩｇＡ、ＩｇＭ均显著高于对照组（Ｐ＜０．０１），节段型白癜风除血清ＩｇＧ升高外（Ｐ＜０．０５），ＩｇＡ、ＩｇＭ无显著性变化（Ｐ＞０．０５）。提示β２－Ｍ与白癜风自身免疫发病学说之间有一定的关系。     

女性系统性红斑狼疮患者神经肽Y、神经降压素的检测及其意义

目的：探讨女性系统性红斑狼疮（SLE）患者血浆中神经肽Y和神经降压素水平的变化及其意义。方法：采用放射免疫分析法对30例女性SLE患者及20例正常对照血浆中神经肽Y、神经降压素水平进行检测。结果：女性SLE患者血浆中神经肽Y水平升高，神经降压素水平降低，二者与对照组相比，差异有显著性（P〈0．01）；与病情非活动期相比，病情活动期SLE患者神经肽Y水平显著升高、神经降压素水平显著降低，差异有显著性（P〈0．01），治疗3个月后，二种物质的水平趋于正常，与对照组相比，差异无显著性（P〉0．05）。结论：女性SLE患者血浆中神经肽Y和神经降压素水平的变化可能与SLE的发病有关．     

Detection of the levels of neuropeptides, ACTH and cortisol in the blood of patients with polymyositis/dermatomyositis and their significance

Recent research has shown that the neuroendocrine system can regulate the function of the immune system and that ACTH and cortisol play important roles in maintaining the immune homeostasis. Polymyositis and dermatomyositis (PM/DM) are autoimmune diseases with unclear pathogeneses closely related with immune disorders, so we detected the levels of neuropeptide Y (NPY), beta-endorphin (beta-EP), calcitonin gene-related peptide (CGRP), adrenocoricotropic hormone (ACTH), and cortisol in blood of patients with PM/DM to investigate the relationship between these indices and the pathogenesis of PM/DM. The detection of NPY, beta-EP, CGRP, and ACTH concentrations in plasma and cortisol in serum of 28 cases of PM/DM was carried out using radioimmunoassay methods, and the results were compared with those of 20 normal controls. The levels of NPY in the plasma of PM/DM was significantly higher than those of the controls, while beta-EP, CGRP and ACTH were significantly lower than those of the controls, and cortisol was not significantly different before treatment. Linear correlation analysis indicated that NPY was significantly positively correlated with CPK, and beta-EP and CGRP were significantly negatively correlated with CPK. There were no significant correlations among cortisol ACTH, and CPK and no significant correlations between NPY, beta-EP, CGRP, ACTH, cortisol and age or duration of disease before treatment. After treatment for three months, NPY, beta-EP and CGRP tended to become normal and no longer significantly different from the control values. However, ACTH fell further and was significantly lower than the level before treatment. Therefore the increase in NPY and the decreases in beta-EP, CGRP, and ACTH in the plasma of PM/DM patients may be related to the pathogenesis of PM/DM.     

Levels of neuropeptide-Y in the plasma and skin tissue fluids of patients with vitiligo

In order to study the possible role of neuropeptide-Y (NPY) in the pathogenesis of vitiligo, the authors measured the levels of NPY in the plasma from 47 patients with vitiligo compared with 25 healthy volunteers, and the tissue fluids of skin lesions and uninvolved skin from 32 patients, employing a NPY 125I RIA Kit. The results showed that the levels of NPY in the patients with vitiligo of all of the generalized, local and segmental types were significantly higher than the normal controls. In both local and segmental type, the levels in progressive stage were significantly higher than those in stable stage, while in generalized type, there was no significant difference between those in progressive stage and stable stage. The levels of NPY in the tissue fluids from skin lesions were significantly higher than those from uninvolved skin in both the local type and segmental type, while in the generalized type, there was no significant difference between the NPY level in the tissue fluid from skin lesion and that from uninvolved skin. It is speculated that NPY may play certain roles in the pathogenesis of vitiligo, via neuro-immunity mechanism or neuronal affection on the melanocytes.     

The role of selected neuropeptides in pathogenesis of atopic dermatitis

Background Atopic dermatitis (AD) is an inflammatory skin disease of a chronic course. The role of neuropeptides in pathogenesis of this disorder is probably not crucial; however, there is evidence that these substances influence the development and course of AD. Objective The aim of this study was to evaluate the plasma level of substance P, neuropeptide Y (NPY) and calcitonin gene related peptide (CGRP) in AD patients during exacerbation and remission of the disease. Material and methods Forty‐nine patients with AD, aged 17 to 56 years, participated in the study. Among this group, there were 25 males (51%) and 24 females (49%). The disease lasted from 1 to 55 years. The severity of the disease was assessed with SCORAD index. The severity of pruritus was evaluated with Visual Analog Scale and a specially designed questionnaire. Neuropeptides plasma level was detected with radioimmunoassay. Results Substance P plasma level in AD patients during exacerbation and remission was significantly higher than in the control group. There was a negative correlation between substance P plasma level and total IgE level. CGRP plasma level during exacerbation of AD was significantly lower than in healthy controls and increased in the remission. Significantly higher CGRP concentration was observed in patients suffering from severe pruritus; however, both in patients with more and less severe pruritus, CGRP plasma level was lower than in controls. Higher CGRP plasma level was also observed in patients with more severe disease. NPY plasma level in patients with AD was significantly increased both during exacerbation and remission. During remission of AD, NPY concentration was higher than during exacerbation.     

Plasma concentration of selected neuropeptides in patients suffering from psoriasis

The aim of this study was to evaluate plasma levels of substance P (SP), calcitonin gene-related peptide (CGRP), vasoactive intestinal peptide (VIP) and neuropeptide Y (NPY) during psoriasis course. METHODS: Seventy-three patients with psoriasis and 32 healthy volunteers were included. Detailed demographic and disease anamnesis was obtained from every patient. The disease severity was assessed using the Psoriasis Area and Severity Index score. Plasma levels of SP, CGRP, VIP and NPY were measured radioimmunologically. RESULTS: Plasma levels of SP and NPY did not significantly differ between patients with psoriasis and controls (median SP: 52.8 and 57.9 pg/ml, respectively; P = 0.32; median NPY: 8.5 and 8.2 pg/ml, respectively; P = 0.67). CGRP plasma concentration was significantly elevated in psoriatic individuals both before (median 43.1 pg/ml) and after treatment (median 45.4 pg/ml), in comparison with healthy donors (median 13.5 pg/ml; P < 0.01 and P = 0.03, respectively). Treatment did not significantly influence plasma CGRP levels (P = 0.3). Median VIP plasma concentration in psoriatics before treatment was significantly higher compared with healthy controls (medians 66.9 and 60.1 pg/ml, respectively; P = 0.04), but the therapy resulted in significant decrease in VIP plasma level (median 19.0 pg/ml; P < 0.001). In psoriatic patients significant correlations were noted between NPY and VIP (R = 0.34; P < 0.01), and VIP and CGRP plasma levels, both before (R = 0.28; P = 0.03) and after the treatment (R = 0.44; P < 0.01). CONCLUSIONS: Based on our results and previous literature data it could be suggested that neuropeptides may be involved in the development of psoriatic lesions.     

Neuropeptide and neuronal marker studies in vitiligo

Neuropeptide and neuronal marker immunoreactivity was studied in skin biopsies from lesional and marginal areas in 12 patients with vitiligo, and in seven normal controls. The vitiligo was active in seven, static in two, and of unknown activity in three. Antibodies against general neuronal marker PGP 9.5 (PGP 9.5), substance P (SP), calcitonin gene-related peptide (CGRP), vasoactive intestinal polypeptide (VIP), and neuropeptide Y (NPY), were used. The epidermis, dermo-epidermal junction, papillary and reticular dermis, and appendages, were assessed semiquantitatively for reactivity with each antibody. Staining with PGP 9.5 in the upper dermis was assessed quantitatively by image analysis. An increase in reactivity against NPY antibody was seen in five of 10 cases (three with active vitiligo) in the marginal areas, and in three of 12 subjects (all with active vitiligo) in the lesional vitiligo areas. VIP antibody reactivity showed a minimal increase in the marginal and lesional vitiligo areas (in two cases each, both of whom had active vitiligo), SP and CGRP reactivities did not differ from normal. PGP 9.5 staining was minimally increased at the dermo-epidermal junction and lower Malpighian layer in biopsies from marginal areas in three of 10 subjects (all with active vitiligo). Quantitative analysis of PGP 9.5 reactivity in the upper dermis showed no difference between vitiligo and normal biopsies. These findings support the concept of neuronal or neuropeptide involvement in vitiligo, and in particular suggest that NPY may have a role in the pathogenesis of the disease.     

Serum concentration of the soluble interleukin-2 receptor in vitiligo patients

Serum levels of sIL-2R can be used to monitor in vivo immune activation and its elevation have been shown to be correlated with T cell mediated immune disease such as atopic dermatitis, psoriasis, lymphoma and systemic sclerosis. Vitiligo is the disease of depigmentation caused by destruction of melanocytes, and there have been extensive studies on the immune pathogenesis. If the pathogenesis of vitiligo is correlated with the activation of T lymphocytes, the change of IL-2R will be detected compared with that of normal control. Therefore we sought the change in sIL-2R to determine whether T lymphocytes from patients with vitiligo show abnormal biological behavior. The quantitation of sIL-2R was done by sandwich enzyme-linked immunosorbent assay (ELISA) from the sera of 79 vitiligo patients and 40 normal controls. The results were summarized as following. The sIL-2R level in vitiligo patients (671.91 +/- 368.59 U/ml) was significantly increased compared with that of controls (370.8 +/- 71.8 U/ml; P < 0.005). According to clinical types, sIL-2R level in focal type of vitiligo patients was significantly higher than those in other types (segmental or generalized; P < 0.05). The sIL-2R level in patients less than 1 year duration was significantly higher than in patients more than 1 year duration (P < 0.05). The sIL-2R levels were not significantly different between active and inactive group. There was no significant differences among sIL-2R levels according to sex or age of onset. Our study showed that sIL-2R level was higher in vitiligo patients compared with that of normal controls, so the activation of T lymphocytes would be an important component in the pathogenesis of vitiligo. The higher sIL-2R levels in recent onset group would suggest that sIL-2R level might be an acute immunologic marker in vitiligo patients.     

斑秃患者血浆和皮损中降钙素基因相关肽、血管活性肠肽的研究

目的 探讨降钙素基因相关肽(CGRP)和血管活性肠肽(VIP)在斑秃发病中的作用。方法 利用放射免疫分析法检测30例斑秃患者和20例正常人血浆中的CGRP和VIP水平,利用免疫组化方法检测21例斑秃患者皮损和16例正常人头皮中的CGRP和VIP表达情况。结果 ①斑秃活动期患者血浆中的CGRP水平为(142.63±67.95)pg/mL,低于稳定期(197.33±67.15)pg/mL和正常人(188.40±72.95)pg/mL,差异均有显著性。②斑秃活动期血浆中的VIP水平为(105.94±55.42)pg/mL,低于斑秃稳定期(156.86±47.37)pg/mL和正常人(176.44±84.70)pg/mL,差异均有显著性。③CGRP和VIP在斑秃皮损及其周围的表达明显低于正常人,差异有显著性。结论 CGRP和VIP在斑秃发病中起一定的作用。