阿维A对寻常型银屑病皮肤组织中Th1、Th17细胞的影响

采用免疫荧光双重标记法检测健康对照、阿维A治疗前、后寻常型银屑病患者皮损中Th1细胞(CD3+IFN-γ+)和Th17细胞(CD3+IL-17+)的数量变化.阿维A治疗前的寻常型银屑病患者皮损真皮浅层T细胞数量、Th1细胞数量、Th17细胞数量较健康对照组T细胞、Th1细胞、Th17细胞明显增多(P＜0.01);治疗后较治疗前皮损真皮浅层T细胞、Th1细胞、Th17细胞数明显下降(P＜0.01).阿维A治疗寻常型银屑病的作用可能涉及到其对Th1和Th17细胞的影响;同Th1细胞一样,Th17细胞可能是寻常型银屑病病情演变过程中关键的T细胞亚群之一.     

阿维A对寻常性银屑病患者外周血细胞因子IFN-γ,IL-4及IL-17的影响

目的通过对阿维A治疗前后寻常性银屑病患者血清中Th1,Th2,Th17细胞的相关细胞因子IFN-γ,IL-4及IL-17的研究,探讨阿维A治疗寻常性银屑病的作用机制。方法采用ELISA法检测健康对照、阿维A治疗前后寻常性银屑病患者血清中IFN-γ,IL-4,IL-17浓度的变化。结果阿维A治疗前血清IFN-γ(98.97±15.29pg/mL)、IL-17(103.05±12.53pg/mL)浓度较健康对照(IFN-γ48.39±17.83pg/mL、IL-1773.75±12.53pg/mL)显著增高(P<0.01),治疗后血清IFN-γ(41.62±19.73pg/mL)、IL-17(65.92±16.19pg/mL)浓度较治疗前显著下降(P<0.01),与健康对照比较差异无统计学意义(P>0.05)。IL-4的血清浓度治疗前(36.70±34.87pg/mL)、治疗后(38.20±26.63pg/mL)与健康对照(30.81±34.87pg/mL)比较差异无统计学意义(P>0.05)。结论阿维A在治疗寻常性银屑病过程中,可能降低患者血清中Th1,Th17细胞相关细胞因子IFN-γ,IL-17的浓度,而对Th2细胞相关细胞因子IL-4可能无明显影响。     

阿维A治疗寻常性银屑病的临床疗效观察

目的探讨阿维A治疗寻常性银屑病的疗效及安全性。方法55例患者随机分为两组,治疗组35例口服阿维A胶囊30mg/d,对照组20例口服复方丹参片9片/d,症状控制后药物逐渐减至维持量,维持治疗半年,两组外用药相同。结果治疗组见效时间12.00±2.51天,显著短于对照组,治疗组痊愈率34.29%,有效率62.86%,复发率16.6%,与对照组相比差异有显著性。结论阿维A治疗寻常性银屑病疗效好,复发率低,副作用少。     

阿维A治疗寻常性银屑病106例

我院于2004年3月至2005年10月期间,应用阿维A胶囊(商品名方希,重庆华邦制药股份有限公司生产)。治疗寻常性银屑病106例,取得满意疗效,现报道如下。1临床资料对象:所有患者均为门诊及住院病例。①治疗组:106例,男40例,女66例,年龄20～55岁,平均年龄36.85±6.3岁。病程1.5个月至20年,平均6±0.5年,其中滴状30例,斑块状62例,混合状14例。②对照组:100例,男44例,女56例,年龄18～60岁,平均年龄32.91±5.8岁,病程1个月至18年,平均8±0.2年,其中滴状24例,斑块状60例,混合状16例。上述两组患者PASI评分均在15～40分。两组患者在年龄、病程以及病情…     

阿维A联合PUVA治疗寻常性银屑病疗效观察

目的探讨阿维A联合PUVA治疗寻常性银屑病的临床疗效。方法将90例患者随机分为两组,治疗组45例口服阿维A 0.5 mg/(kg.d)并加用光化学疗法(PUVA),对照组45例仅口服阿维A 0.5-0.8 mg/(kg.d),两组均外用本院自制冰霜。结果治疗组有效率为88.89%,对照组为73.33%,两组比较差异有显著性(P<0.05)。结论阿维A联合PUVA治疗寻常性银屑病安全有效,值得临床应用。     

阿维A与平阳霉素联合治疗寻常性银屑病疗效观察

目的观察阿维A与平阳霉素联合治疗寻常性银屑病的临床疗效。方法治疗组32例予阿维A与平阳霉素联合治疗,对照组予阿维A治疗。结果治疗组有效率为75.0%,对照组为46.9%,两组有效率比较差异有显著性(P<0.05)。结论阿维A与平阳霉素联合是一种有效的治疗寻常性银屑病的方法,可以减少单一药物的用量,减轻副作用,达到提高疗效、缩短疗程的作用。     

阿维A联合中药治疗寻常性银屑病疗效观察

斑块状寻常性银屑病,是银屑病中常见的类型,病情顽固,病程常数月至数年,治疗疗程相对较长,我们于2005年9月—2006年6月采用阿维A(重庆华邦制药有限公司研制生产)联合中药治疗46例斑块状寻常性银屑病,取得较好疗效,现总结如下。     

阿维A与甲氨蝶呤治疗寻常性银屑病疗效观察

我们应用阿维A治疗寻常性斑块状银屑病,甲氨蝶呤(MTX)作对照观察,现将其疗效及安全性的比较报道如下。1资料与方法1.1病例选择:43例寻常性斑块状银屑病患者均为本科门诊和住院患者,临床表现典型。治疗组24例,年龄22～58岁,平均35.1±10.2岁,男16例,女8例,病程5个月～15年;对照组19例,年龄18～56岁,平均37.2±12.2岁,男12例,女7例,病程5个月至15年;两组的年龄、性别、病情、病程差异无统计学意义(P﹥0.05)。2组患者均无其他系统疾患。1.2治疗方法:治疗组采用阿维A(商品名方希,重庆华邦制药股份有限公司)20～50mg/d,分1～2次口服治疗,见效…     

阿维A联合苦参素治疗寻常性银屑病的临床疗效观察

目的探讨阿维A胶囊与苦参素联合治疗寻常性银屑病的疗效及安全性。方法采用随机分组试验方法将108例患者分为3组。治疗组口服阿维A胶囊联合苦参素,两对照组分别单纯口服阿维A胶囊和苦参素治疗,同时3组均外用他扎罗汀和硫软膏。于治疗前后分别作PASI积分评测。结果①3组治疗后PASI积分均降低,治疗前后积分对比差异有统计学意义(P<0.05)。②治疗组痊愈28例(77.78%),显效6例(16.67%),好转1例(2.78%),无效1例(2.78%);阿维A对照组痊愈16例(45.71%),显效5例(14.29%)、好转12例(34.29%),无效2例(5.71%);苦参素对照组痊愈15例(42.86%),显效8例(22.86%),好转10例(28.57%),无效2例(5.71%)。联合治疗方案的疗效与单独用药组比较差异有统计学意义(P<0.05)。结论阿维A胶囊联合苦参素治疗寻常性银屑病具有疗效好及安全性高的特点,值得临床推广应用。     

寻常性银屑病患者皮损及外周血单一核细胞中IL-17A的表达

目的研究Th17细胞及Th17细胞特异性因子IL-17A在寻常性银屑病发病中的作用。方法收集30例寻常性银屑病患者以及18例正常人对照的外周血单一核细胞(PBMC)和皮肤组织,通过实时定量逆转录聚合酶链反应法(RT-PCR)检测IL-17AmRNA的表达水平;免疫组化法分析IL-17A的蛋白表达及IL-17A阳性细胞数百分比。结果银屑病组PBMC与皮损中IL-17AmRNA的相对表达量分别为2.962±1.398和2.023±1.890,对照组分别为0.807±0.839和0.262±0.104,t血IL-17A=-2.133,P<0.05;t皮IL-17A=-2.575,P<0.05;患者组和正常对照PBMC中IL-17A的蛋白表达强度分别为0.467±0.050,0.368±0.065(t=4.495,P<0.05);PBMC中IL-17A+细胞的百分率分别为0.143±0.090和0.090±0.039(t=2.159,P<0.05);患者组皮肤组织IL-17A阳性表达的平均光密度值为0.320±0.038,对照组为0.257±0.041(t=-4.357,P<0.05)。结论银屑病患者外周血及皮损内Thl7细胞因子IL-17A的mRNA与蛋白水平均明显升高,Thl7细胞数目增多,提示其可能与银屑病的发生有一定的相关性。     

Acitretin exerted a greater influence on T‐helper (Th)1 and Th17 than on Th2 cells in treatment of psoriasis vulgaris

T‐helper (Th) cells, including Th1, Th2 and Th17 cells, may play an important role in the pathogenesis of psoriasis vulgaris (PV). Acitretin is an effective treatment for PV; however, its influence on Th cells during the treatment of PV is unclear. This study aimed to investigate the influence of acitretin on Th1, Th2 and Th17 cells in PV patients. PV patients (n = 30) received acitretin p.o. (20 mg/day) for 8 weeks. Sera and skin biopsies were obtained before and after treatment. Double‐labeled immunofluorescence was used to analyze T, Th1, Th2 and Th17 cells in skin lesions. Enzyme‐linked immunosorbent assay and western blot were used to analyze the expressions of interferon (IFN)‐γ, interleukin (IL)‐4 and IL‐17 in sera and skin lesions. The expressions of IFN‐γ mRNA, IL‐4 mRNA and IL‐17 mRNA in skin lesions were detected by in situ hybridization. Acitretin decreased the quantity of T, Th1 and Th17 cells in PV lesions, but had no significant influence on Th2 cells. Acitretin also decreased the expression of IFN‐γ and IL‐17 in serum and lesions. The expressions of IFN‐γ mRNA and IL‐17 mRNA decreased significantly after 8 weeks of therapy. However, acitretin had no significant influence on the expression of IL‐4 protein and mRNA. Acitretin can reverse Th1 and Th17 preponderance in PV patients to some degree. This may be due to the mechanism of acitretin on PV; however, Th2 cells were not affected by acitretin treatment.     

寻常型银屑病中医辨证分型与Th1/Th2的相关性研究

目的:确定寻常型银屑病中医辨证分型与Th1/Th2的相关性,为辨证施治提供依据.方法:将100例寻常型银屑病分为血热证、血瘀证、血燥证,分别检测患者血清TNF-α、IL-2、IL-4、IL-6和IL-8因子,并与30例健康人血清对照.结果:TNF-α和IL-8在血燥证与健康组之间无显著性差异(P>0.05),而其他组别两两比较有显著性差异(P<0.01),血热证水平最高.IL-4在四组之间比较具有显著性差异(P<0.05),血瘀证水平最高.IL-2、IL-6在四组两两比较无显著性差异(P>0.05).结论:寻常型银屑病患者体内存在免疫失调情况,与健康对照组均有差异.以Th1型介导为主的细胞因子TNF-α、IL-8在血热证中占优势,与血瘀证及血燥证比较有显著性差异;IL-4在血瘀证中占优势,与血热证及血燥证比较有显著性差异.     

糖皮质激素对系统性红斑狼疮Th1和Th2类细胞因子的影响

目的:观察糖皮质激素(以下简称激素)治疗对系统性红斑狼疮(SLE)患者Th1和Th2细胞因子表达的影响.方法:采用反转录-聚合酶链反虚(RT-PCR)法,检测SLE患者在激素治疗前、后,外周血单个核细胞(PBMC)中Th1类细胞因子γ干扰索(IFN-γ)和Th2类细胞因子白介素(IL)-4、IL-10 mRNA水平,并与正常人群比较.结果:激素治疗前SLE患者外周血内Th1和Th2类细胞凶子均高于正常人(P＜0.05),以Th2类细胞因子增高显著;治疗后两类细胞因子均明显下降(P＞0.05),但以Th1类细胞因子下降显著.结论:SLE患者存在T辅助细胞亚群失衡,激素治疗可部分纠正分泌失衡的细胞因子.     

Psoriasis vulgaris lesions contain discrete populations of Th1 and Th17 T cells

The importance of T helper 17 (Th17) cells in inflammation and autoimmunity is now being appreciated. We analyzed psoriasis skin lesions and peripheral blood for the presence of IL-17-producing T cells. We localized Th17 cells predominantly to the dermis of psoriasis skin lesions, confirmed that IL-17 mRNA increased with disease activity, and demonstrated that IL-17 mRNA expression normalized with cyclosporine therapy. IL-22 mRNA expression mirrored IL-17 and both were downregulated in parallel with keratin 16. Th17 cells are a discrete population, separate from Th1 cells (which are also in psoriasis lesions), and Th2 cells. Our findings suggest that psoriasis is a mixed Th1 and Th17 inflammatory environment. Th17 cells may be proximal regulators of psoriatic skin inflammation, and warrant further attention as therapeutic targets.     

Peripheral blood mononuclear cells proliferation and Th1/Th2 cytokine production in response to streptococcal M protein in psoriatic patients

BACKGROUND: Psoriasis is a chronic skin disease that is probably a T cell-mediated autoimmune condition which is strongly associated with streptococcal throat infections. Although some groups have associated the involved response with different streptococcal antigens, M protein has been described as the major virulence factor of Streptococcus pyogenes. Thus, it is necessary to describe some features of the cellular responses to this streptococcal antigen. METHODS: Proliferation and Th1/Th2 cytokine production of peripheral blood mononuclear cells (PBMC) in response to total soluble extracts from type M5 S. pyogenes with (TSE37Sp) and without (M(-)TSESp) M protein were analyzed in 10 psoriatic patients and 10 healthy controls. RESULTS: PBMC from both patients and controls proliferated to both extracts. Responses to M(-)TSESp were significantly lower than those to TSE37Sp (P < 0.05). PBMC IL-2 and gammaIFN production after TSE37Sp stimulus was much higher than after M(-)TSESp antigenic stimulation in both groups (P < 0.05). Meanwhile, IL-4 production was quite low in both groups and in response to both extracts. We found a differential production of IL-10 between groups. PBMC from healthy controls responded to TSE37Sp with a much higher production of this cytokine as compared to the responses showed to M(-)TSESp while the cells from psoriatic patients responded without differences in the production of IL-10. CONCLUSION: Results obtained suggest an important Th1 response to M protein in psoriatic patients which could be associated with the cellular responses involved in psoriasis, while healthy subjects respond in a probably non-Th2 IL-10 producing regulatory T cells fashion.     

Topical imiquimod and intralesional interleukin-2 increase activated lymphocytes and restore the Th1/Th2 balance in patients with metastatic melanoma

Background  Patients with metastatic skin disease in malignant melanoma are difficult to treat, with unresectable lesions proving the biggest challenge. We have recently published data showing a significant clinical response in patients with multiple in-transit melanoma metastases treated with a combination of topical imiquimod and intralesional interleukin (IL)-2. Here we report the results of immunological analysis with the aim of highlighting correlations with our clinical findings.
Objectives  To investigate the systemic effects of our localized combination treatment in patients with accessible metastases of melanoma, and to correlate this with their clinical responses.
Methods  The peripheral blood mononuclear cells of patients were collected at various time points throughout the treatment. Using antibodies to T-cell subsets we measured the changes in cell populations, and along with polyclonal stimulation, changes in cytokine production from these cells over a treatment course.
Results  We report an increase in the mean CD4/CD8 ratio from 2·78 to 3·54 with treatment ( P  < 0·01), and a rise in the percentage of CD25+ cells in the CD4+ population from 14·52% to 38·56%. Furthermore, staining with activation and T-regulatory markers showed that the majority of this population is activated T cells. Cytokine analysis on polyclonally stimulated peripheral blood mononuclear cells showed an increase in the ability of cells to produce interferon (IFN)-γ over the treatment course, with an initial rise in the IFN-γ/IL-5 ratio in five of six patients.
Conclusions  The results of this study provide evidence that, in the majority of patients with in-transit metastases of melanoma, therapy with a combination of topical imiquimod and intralesional IL-2 induces a systemic immunological effect by reversing some of changes noted in patients with malignant disease.     

寻常型银屑病皮损中Th17细胞相关因子的表达

目的:研究Th17细胞相关因子在银屑病发病机制中的作用.方法:用逆转录-聚合酶链反应法(RT-PCR)半定量分析寻常型银屑病患者皮损区、非皮损区及正常人皮肤组织中Th17细胞相关因子IL-17和IL-23(p19/p40)、IL-6 mRNA的表达.结果:银屑病患者皮损中IL-17、IL-23p19、IL-23p40和IL-6的 mRNA平均相对表达量分别为1.231±0.843、1.166±0.142、1.125±0.104和1.186±0.222.皮损组织中该4种细胞因子mRNA表达水平均高于非皮损组和正常皮肤组,非皮损组四者表达高于正常对照组,差异均有统计学意义(均P<0.05).结论:Th17细胞相关因子在银屑病患者皮损中过度表达,提示Th17型细胞因子在银屑病的免疫发病机制中可能起着非常重要的作用.     

复方甘草酸苷对斑秃患者Th1/Th2型细胞因子水平的影响

目的观察复方甘草酸苷对斑秃患者血清Th1/Th2型细胞因子表达的调节作用。方法应用酶联免疫吸附试验(ELISA)法检测正常对照组和治疗组在治疗前、后轻型斑秃组和重型斑秃组患者血清IFNγ和IL-10水平。结果斑秃患者血清IFN-γ水平显著高于正常对照组,且重型斑秃组明显高于轻型斑秃组(P均<0.01);IL-10水平在轻型斑秃组、重型斑秃组、正常对照组间无显著性差异(P>0.05)。复方甘草酸苷治疗后斑秃患者血清IL-10水平较治疗前显著增高(P<0.01);而IFN-γ水平治疗前后无显著性差异(P>0.05)。结论复方甘草酸苷在治疗斑秃过程中,可能通过促进IL-10分泌,纠正Th1/Th2平衡失调而发挥治疗作用。     

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。