钙泊三醇倍他米松软膏联合卡泊三醇软膏序贯治疗寻常型银屑病疗效评价

目的：评价钙泊三醇倍他米松软膏联合卡泊三醇软膏治疗寻常型银屑病的临床疗效。方法：30例银屑病患者全身左右侧皮损随机分为治疗组或对照组。治疗组外用钙泊三醇倍他米松软膏和卡泊三醇软膏;对照组外用卡泊三醇软膏。治疗第2、4、8周末进行疗效评价。结果：治疗2、4、8周后治疗组有效率（53.33%、70%和86.67%）均明显高于对照组（30%、46.67%和66.67%）,组间差异均有统计学意义（P〈0.05）。结论：钙泊三醇倍他米松软膏联合卡泊三醇软膏治疗寻常型银屑病疗效较单独使用卡泊三醇好。     

卡泊三醇治疗前后银屑病皮损中Caspase-3和bcl-2的表达

目的：探讨卡泊三醇治疗前后银屑病皮损中Caspase-3和bcl-2中的表达及意义。方法采用免疫组化技术对12例银屑病患者经卡泊三醇治疗前后皮损及非皮损区皮肤中Caspase-3和bcl-2表达进行检测。结果经卡泊三醇治疗后银屑病患者皮损角质形成细胞中bcl-2的表达明显增加（P＜0.05）,Caspase-3的表达无明显差异（P＞0.05）。结论卡泊三醇治疗银屑病的可能作用机制之一是促进bcl-2诱导角质形成细胞的凋亡。     

卡泊三醇对银屑病患者角质形成细胞的细胞周期素D1,周期蛋？…

一、材料和方法 (一 )病例及取材：病例选自门诊及住院确诊的寻常型银屑病患者 30例,其中进行期 6例,静止期 24例。实验前 3个月未接受治疗,不伴有肿瘤及其他严重疾患。实验开始,患者接受大力士软膏（ CPT软膏,为丹麦利昂制药有限公司产品）外用治疗,治疗 1～ 5周后取材。用药治疗后的皮损面积较治疗前变小,浸润减轻,鳞屑消失,但大部分患者的皮损尚未完全消退。对照组 10例标本取自正常人上臂皮肤 (2例 )和包皮 (环切术 8例 )。环钻取材（全层皮肤）,常规 10％甲醛固定,石蜡包埋。 (二 )原位杂交：体外转录法标记 cRNA探针…     

角质形成细胞生长因子与银屑病的关系

角质形成细胞生长因子是近年来发现的有着重要生物功能的生长因子,它属于成纤维细胞生长因子家族,由成纤维细胞产生。角质形成细胞生长因子可刺激角质形成细胞的增生、分化、移行,促进上皮细胞的再生、增厚,对银屑病的发病机制及其治疗可能有一定的启示。本文就角质形成细胞生长长因子和的生物学功能及其与角质形成细胞及银屑病的关系做一定综述。     

骨化三醇软膏与卡泊三醇软膏治疗银屑病多中心随机研究

目的 评价骨化三醇软膏外用治疗斑块状银屑病的疗效及安全性。方法 采用随机、单盲、阳性药物平行对照方法。5个中心共231例斑块状银屑病患者完成治疗，其中骨化三醇软膏组117例，卡泊三醇软膏组114例。入组时两组患者的性别、年龄、病情严重程度（靶皮损总积分）等方面差异无统计学意义（P > 0.05）。每日外用药物2次，连续12周，于治疗后2，4，8和12周分别进行疗效和安全性评价。结果 治疗8周时，试验组基愈率为4.2%，有效率为67.5%；对照组基愈率为14.4%，有效率为74.6%，两组有效率比较，差异无统计学意义（P > 0.05）。12周结束时，研究者对总体疗效进行评价。试验组基愈37例，显效76例，有效率91.1%；对照组基愈43例，显效56例，有效率81%，两组疗效比较，差异无统计学意义（P = 0.78）。两组未见药物系统不良反应，局部刺激反应的发生率试验组和对照组分别为4%和11.2%，试验组发生率低于对照组（P < 0.01）。结论 骨化三醇软膏治疗斑块状银屑病安全、有效。     

0.005%卡泊三醇软膏治疗寻常型银屑病文献回顾

目的回顾国内卡泊三醇软膏治疗寻常型银屑病的临床文献,总结其治疗效果。方法检索和阅读卡泊三醇软膏自1995年开始国内应用至2011年治疗寻常型银屑病随机、对照的临床研究文献,整理和分析其有效性和安全性。结果单用卡泊三醇软膏的总有效率分别为43.3%(4周),75.8%(6周),45.1%(8周),77.6%(12周)。可统计的不良反应率为15.70%。偶见实验室指标异常。单用与他扎罗汀凝胶、哈西奈德乳膏、蒽林软膏、骨化三醇软膏相当,逊于他克莫司软膏、钙泊三醇倍他米松软膏。联合、序贯、封包等方法提高疗效、降低不良反应。结论卡泊三醇软膏治疗寻常型银屑病安全、有效,联合、序贯、封包可优化治疗结果。     

角质形成细胞生长因子与银屑病的关系

角质形成细胞生长因子是近年来发现的有着重要生物学功能的生长因子 ,它属于成纤维细胞生长因子家族 ,由成纤维细胞产生。角质形成细胞生长因子可刺激角质形成细胞的增生、分化、移行 ,促进上皮细胞的再生、增厚 ,对银屑病的发病机制及其治疗可能有一定的启示。本文就角质形成细胞生长因子的生物学功能及其与角质形成细胞及银屑病的关系做一综述。     

卡泊三醇软膏两种不同用法治疗轻中度斑块状银屑病的疗效观察

目的:观察卡泊三醇软膏分别按疗程和症状两种不同用药方法治疗轻中度斑块状银屑病的疗效及安全性.方法:斑块状银屑病患者60例,随机分为疗程治疗组及症状治疗组,每组30例,前者给予卡泊三醇软膏每日2次,共8周;后者给予卡泊三醇软膏每日2次,4周症状改善后改为每日1次,共8周,治疗前及治疗后第2、4、8周分别进行PASI评分,治疗前及治疗结束时测血钙浓度,判定疗效及记录不良反应.结果:经过8周观察,疗程治疗组治愈率和有效率分别为50.00%和76.67%,症状治疗组治愈率和有效率分别为23.33%和66.67%,两组治愈率有统计学差异,但有效率无统计学差异.疗程治疗组8例出现不良反应,对照组6例出现不良反应,均可耐受.结论:卡泊三醇治疗轻中度斑块状银屑病应足疗程用药.     

凉血消沱汤对角质形成细胞凋亡的影响

目的研究自拟方剂凉血消疕汤对角质形成细胞株HaCaT的增殖凋亡及细胞周期的影响作用。方法用MTT法和Annexin-V/PI双标流式细胞术分别检测自拟方剂凉血消疕汤的水提取液对HaCaT细胞株增殖、凋亡的影响;PI单标流式细胞术测该方的水提取液对HaCaT细胞株细胞DNA分布的影响。结果自拟方剂凉血消疕汤对角质形成细胞株HaCaT具有明显的增殖抑制作用,其抑制增殖作用呈量效关系。凉血消疕汤作用48h可诱导HaCaT细胞凋亡,10mg/mL作用48h时HaCaT细胞凋亡率达(31.77±5.88)%。凉血消疕汤处理组HaCaT细胞株细胞周期发生变化,细胞周期G_1期增加,S期缩短。结论自拟方剂凉血消疕汤可通过调控细胞周期进程、诱导细胞凋亡而有效抑制HaCaT细胞株细胞增殖。     

一氧化氮、角质形成细胞和银屑病

一氧化氮是一种多效性生物气体分子，在皮肤组织的生理和病理过程中均具有重要作用。银屑病皮损区释放的一氧化氮量和诱导型一氧化氮合酶的表达均高于非皮损区和正常皮肤，其在银屑病中的作用机理不清楚。现综述一氧化氮在角质形成细胞凋亡、增生分化和基因表达调控的研究进展及其在银屑病中的可能作用机制。     

Epidermal differentiation characteristics of the psoriatic plaque during treatment with calcipotriol

Treatment of psoriasis with vitamin D₃ analogues is well established in present dermatological practice. One of the clinical signs of the psoriatic plaque that reduces early and markedly during treatment with the vitamin D₃ analogue calcipotriol is scaling. Since scaling is the clinical manifestation of disordered epidermal differentiation, early changes in immunohistochemical markers for differentiation (transglutaminase, involucrin and filaggrin) were studied in patients who had been treated with calcipotriol for 4 weeks. Markers for proliferation (Ki-67 antigen) and inflammation (polymorphonuclear leucocytes and T lymphocytes) were also studied and correlated with the differentiation characteristics. Clinically, a major improvement was seen in all patients. A significant decrease in the percentage of transglutaminase-positive cell layers was observed during the first week of treatment. In contrast, an increase in transglutaminase activity in epidermal cell cultures following incubation with calcipotriol has been reported. Involucrin expression was only slightly modulated in vivo. However, a major restoration of the filaggrin-positive cell layer and significant reduction in the recruitment of cycling epidermal cells characterized the epidermal response to calcipotriol treatment. Markers for inflammation (T11-positive cells and elastase-positive cells) were also reduced substantially during the first week of treatment with calcipotriol. From this study it may be concluded that inhibition of epidermal growth and recovery of the filaggrin-positive cell layer are among the in vivo effects of calcipotriol. Received: 1 August 1995     

流式细胞仪分析银屑病表皮角朊细胞凋亡及细胞周期变化

本文采用流式细胞仪分析银屑病不同阶段皮损表皮朊细胞的凋亡状况。结果发现银屑病皮损表皮角朊细胞凋亡和细胞周期呈现连续性变化。提示银屑病皮损表皮角朊细胞的病理改变是始发于角朊细胞凋亡异常增多，继而出现角朊细胞过度增殖。     

Clobetasol propionate followed by calcipotriol is superior to calcipotriol alone in topical treatment of psoriasis

Background Although potent, topical corticosteroids offer effective and rapid healing of psoriatic lesions. Their long term use is limited because of the risk of side effects. Calcipotriol is safe for long-term treatment, but its initial efficacy is lower than with topical corticosteroids.
Objectives To investigate whether 2 weeks of treatment with clobetasol propionate 0.05% ointment bd followed by 4 weeks of treatment with calcipotriol 50 /μg/g bd would offer therapeutic advantages over 6 weeks of continuous treatment with calcipotriol.
Methods Forty-nine patients with moderate to severe plaque psoriasis were recruited from five centres in Norway. In a randomised, double-blind, right- versus left-side comparison, ointments were applied to two symmetrically-located areas.
Results Two weeks of treatment with clobetasol propionate produced a significantly greater decrease in total symptom score (combined scores of erythema, induration and scaling) than calcipotriol treatment ( P < 0.0001). This improvement on the clobetasol.propionate-treated side of the body was maintained throughout a subsequent 4-week treatment period when calcipotriol was applied to both sides of the body ( P < 0.0001). The superiority of the clobetasol propionate followed by calcipotriol treatment was maintained during a 4-week, treatment-free, observation period. Treatments were well tolerated with no rebound effect.
Conclusions Clobetasol propionate ointment bd for 2 weeks followed by treatment with calcipotriol ointment bd for 4 weeks was superior to calcipotriol ointment alone in the treatment of plaque psoriasis.     

砷化物抑制银屑病角质形成细胞增殖的研究

银屑病主要表现为角质形成细胞过度增殖及凋亡异常,其中角质形成细胞过度增殖是由于细胞凋亡功能障碍或失调所致,凋亡缺陷在银屑病的发病机制巾发挥着重要作用。研究表明,砷化物可以通过对Fas/Fas配体、端粒和端粒酶的影响以及联合阻断JNK等多种途径诱导角质形成细胞凋亡,从而抑制其过度增殖。因此,砷化物有望成为一种局部治疗银屑病的新型药物。     

卤米松对角质形成细胞维生素D受体表达的影响

目的观察卤米松对角质形成细胞维生素D受体(vitamin D receptor,VDR)表达的影响,以探讨糖皮质激素对维生素D3衍生物治疗银屑病效应的潜在影响。方法采用CCK8法观察不同浓度卤米松、卡泊三醇在不同时相点下对HaCaT角质形成细胞增殖的影响;采用反转录-实时荧光定量聚合酶链反应(PCR)、蛋白印迹法,观察不同浓度卤米松在不同时相点作用下HaCaT细胞VDR的表达情况。结果卤米松可增强卡泊三醇对HaCaT细胞增殖的抑制作用;卤米松作用24 h、48 h后,HaCaT细胞中VDR m RNA及蛋白水平均明显升高,并呈剂量依赖性效应。结论卤米松上调VDR的表达可能有助于提高角质形成细胞对维生素D3衍生物作用的反应性,从而有可能提高维生素D3衍生物对角质形成细胞的治疗效应。     

消银汤联合卡泊三醇软膏对血热型寻常性银屑病疗效及相关细胞因子水平的影响

目的 探讨消银汤联合卡泊三醇软膏治疗进展期血热型轻/中度（PASI评分 < 10）寻常性银屑病疗效和对IL-17、IL-22、TNF-α水平影响。方法 60例进展期血热型轻/中度寻常性银屑病患者分为治疗组及对照组,每组各30例。治疗组予消银汤口服;对照组予安慰剂口服,2组同时外用卡泊三醇软膏;另选志愿者30例作为健康对照组;疗程12周。记录治疗前、后PASI评分,检测治疗前、后Th17细胞、TNF-α、IL-22、IL-17水平。结果 治疗前,与健康对照组相比,治疗组及对照组在Th17细胞水平及血清IL-17、IL-22和TNF-α水平差异有统计学意义（P ＜ 0.05）,治疗组及对照组水平高于健康对照组;治疗后,上述指标与治疗前比较,差异有统计学意义（P ＜ 0.05）。治疗组治疗后PASI评分为（1.83 ± 1.28）,对照组为（2.91 ± 1.42）,差异有统计学意义（P ＜ 0.05）。治疗组总有效率为93.33%,与对照组总有效率73.33%比较差异有统计学意义（P ＜ 0.05）。治疗组在PASI评分,治疗总有效率及细胞因子水平改善方面优于对照组。结论 Th17细胞及血清IL-17、IL-22和TNF-α水平在轻/中度寻常性银屑病患者存在异常,消银汤联合卡泊三醇软膏对此有改善作用。     

Subphysiological concentrations of extracellular calcium sensitize normal human keratinocytes to UVB-induced apoptosis

Abstract Normal human keratinocytes are stimulated to proliferate in serum-free medium containing subphysiological concentrations of calcium (0.09 mM, low calcium). In this study, we examined the effect of increased levels of extracellular calcium (2.0 mM, normal calcium) on UVB-induced apoptosis. Apoptosis was assessed by changes in cellular morphology, annexind V-FITC flow cytometry, and the formation of internucleosomal DNA ladders. High doses of UVB induced keratinocytes grown in low calcium medium to undergo apoptosis. In contrast, keratinocytes grown for 72 h in normal calcium medium were completely resistant to UVB-induced apoptosis. No apoptosis was observed even at UVB doses as high as 1200 J/m². However, despite the lack of UVB-induced cell death, keratinocytes grown in normal calcium medium lost the ability to proliferate following high levels of UVB irradiation. High doses of UVB also increased the expression of the differentiation-specific proteins involucrin and cytokeratin 10 in a dose-dependent manner. In addition, growth in normal calcium medium lowered the UVB-induced stimulation of the p53 protein and altered the normal subcellular localization pattern of p53. UVB irradiation of human keratinocytes grown in normal calcium medium may be inducing further cell differentiation in the absence of overt cell death. Received: 16 April 1998 / Received after revision: 31 August 1998 / Accepted: 23 September 1998