银屑病患者皮损中Toll样受体2及相关因子的检测

目的探讨Toll样受体2(TLR2)、信号途径下游分子NF-κBp65以及可能的效应分子TGF-α在银屑病患者皮损中的表达及其与银屑病严重程度的关系。方法采用EliVision免疫组化法对40例银屑病患者进行期皮损、11例非皮损区及15例正常人皮肤中TLR2,NF-κBp65,TGF-α的表达进行检测,对其在皮损中的表达进行相关性分析,并将结果与PASI评分进行相关性分析。结果与正常人皮肤及银屑病患者非皮损区相比,银屑病患者皮损表皮中TLR2,NF-κBp65,TGF-α的表达明显上调,而非皮损区TLR2的表达也高于正常人皮肤,差异均有统计学意义(P<0.05)。银屑病患者皮损表皮中TLR2,NF-κBp65的表达水平与PASI评分之间存在正相关(P<0.05)。银屑病患者皮损表皮中TLR2与NF-κBp65,TLR2与TGF-α,NF-κBp65与TGF-α表达水平之间均存在正相关(P<0.05)。结论TLR2,NF-κBp65,TGF-α在银屑病中表达异常,可能共同参与了银屑病的发病过程。     

寻常性银屑病皮损及非皮损中IL-23(p19/p40)和IL-12(p35/p40)mRNA的表达

目的检测寻常性银屑病患者皮损及非皮损处IL-23(p19/p40)和IL-12(p35/p40)mRNA表达,探讨其临床意义。方法采用逆转录-聚合酶链反应(RT-PCR)检测寻常性银屑病患者皮损、非皮损处及正常人皮肤中IL-23(p19/p40)和IL-12(p35/p40)mRNA的表达水平。结果寻常性银屑病患者皮损中IL-23p19及p40(IL-23/IL-12)mRNA的表达均高于非皮损组织和正常皮肤组织(P<0.05),且非皮损处高于正常对照组,差异有显著性(P<0.05);IL-12p35mRNA在银屑病皮损处、非皮损处和正常对照中表达水平差异无显著性(P>0.05)。结论在寻常性银屑病发病过程中,IL-23可能发挥较IL-12更重要的作用。     

Changing paradigms in dermatology: tumor necrosis factor alpha (TNF-alpha) blockade in psoriasis and psoriatic arthritis

Psoriasis is an inflammatory T cell-mediated disease characterized by epidermal hyperplasia and parakeratosis, resulting in lesional areas of thick and scaling skin. Elevated levels of proinflammatory cytokines, including TNF-alpha, are found in psoriatic lesions. TNF-alpha has many effects in producing an inflammatory response such as stimulating production of pro-inflammatory molecules (eg, IL-1, IL-6, IL-8, NF-kappaB) and adhesion molecules (eg, ICAM-1, P-selectin, E-selectin). As such, TNF-alpha is a target for immunotherapy in the treatment of psoriasis and psoriatic arthritis. The role of TNF-alpha in the pathogenesis of psoriasis is reviewed, along with clinical trials demonstrating the efficacy of new anti-TNF-alpha immunobiologics in the treatment of psoriasis and psoriatic arthritis.     

过氧化物酶体增殖物激活受体在寻常性银屑病患者表皮中的表达

目的 研究过氧化物酶体增殖物激活受体（PPAR）在寻常性银屑病患者表皮角质形成细胞中的表达和意义。方法 采用免疫组化方法检测PPARα、β/δ、γ在5例正常人表皮、17例寻常性银屑病患者皮损及非皮损表皮中的表达,并用图像分析方法进行半定量分析。结果 PPARα、β/δ、γ在正常人表皮角质形成细胞中均有不同程度的细胞核表达;在银屑病皮损表皮中的表达强度均较非皮损处下降（P ＜ 0.01）。在银屑病非皮损表皮中,PPARβ/δ、γ的表达强度均较正常人表皮明显升高（P ＜ 0.01）。结论 PPARα表达下调可能参与了银屑病表皮角质形成细胞过度增生和分化不全的病理过程,而PPARβ/δ、γ在维持表皮细胞正常增生分化稳态中可能发挥协同作用。     

Clinical improvement in chronic plaque-type psoriasis lesions after narrow-band UVB therapy is accompanied by a decrease in the expression of IFN-gamma inducers -- IL-12, IL-18 and IL-23

Type-1 cytokine-producing T cells are important in the pathogenesis of psoriasis vulgaris, for which efficient therapy is provided by means of narrow-band ultraviolet-B (NB-UVB). The expression of the type-1 cytokine interferon-gamma (IFN-gamma) is regulated by interleukin-12 (IL-12), IL-15, IL-18 and IL-23; however, not much is known about the effect of this therapy on the levels of these cytokines in lesional psoriatic skin in situ. In this study, we investigated the effects of NB-UVB therapy on the expression of IFN-gamma-inducing cytokines. Ten patients with chronic plaque-type psoriasis selected to be treated with NB-UVB therapy were recruited for these experiments and the expression of cytokines IL-12, IL-15, IL-18, IL-23 and IFN-gamma in lesional psoriatic skin before, during and after therapy was determined with the help of immunohistochemistry. Double staining was performed in order to determine the cell types expressing these cytokines. The decrease in the psoriasis area and severity index was accompanied by a significant decrease in the expression of IFN-gamma, and concomitantly, significant reduction of IFN-gamma inducers -- IL-12, IL-18 and IL-23. Thus, we concluded that the decrease of IFN-gamma expression in psoriasis lesions after NB-UVB therapy could be a result of diminished expression of IL-12, IL-18 and IL-23 in lesional skin. Therapies targeting these three cytokines should, therefore, be considered in the treatment of psoriasis.     

In situ expression of messenger RNA of interleukin-1 and interleukin-6 in psoriasis: interleukin-6 involved in formation of psoriatic lesions

Summary Psoriasis is a disease of abnormal proliferation and differentiation of epidermal cells. Several cytokines released by keratinocytes are implicated as factors responsible for this pathological condition of the epidermis. In order to elucidate the role of these cytokines in psoriasis, messenger RNA (mRNA) expression of interleukin-1 (IL-1) and IL-6 in psoriatic epidermis was investigated using biotin-labelled complementary DNA (cDNA) of the cytokines. Messenger RNA of IL-1 was weakly detected in some normal healthy epidermis specimens and more strongly in all the perilesional uninvolved psoriatic epidermis specimens. It was also expressed in the transitional zone between uninvolved and fully developed psoriatic skin, but was not expressed in lesional skin. In contrast, IL-6 mRNA was rarely expressed in normal healthy epidermis, but was expressed in perilesional uninvolved psoriatic epidermis, in the transitional zone and in the fully developed lesional epidermis, with the maximum intensity in the transitional zone. Expression of mRNA of IL-6 receptor showed a similar tendency to that of IL-6. It was expressed in psoriatic epidermis, most strongly in the transitional zone, but not in normal healthy epidermis. IL-6 was demonstrated immunohistochemically in psoriatic epidermis, but IL-6 receptor was demonstrated only in the transitional zone. Thus IL-6 and its receptor expression correlated well with the formation of psoriatic lesions where IL-1 may initiate their expression. IL-6 may play an important role in the pathogenesis of psoriasis.     

HDAC activity is required for p65/RelA-dependent repression of PPARdelta-mediated transactivation in human keratinocytes

Peroxisome proliferator-activated receptors (PPARs) play a key role in differentiation, inflammation, migration, and survival of epidermal keratinocytes. The NF-kappaB has long been known to play pivotal roles in immune and inflammatory responses, and furthermore NF-kappaB has been implicated in the regulation of epidermal homeostasis. Recent studies have established that p65/RelA is a potent repressor of PPARdelta-mediated transactivation in human keratinocytes. In this article we further investigate the molecular mechanisms dictating the NF-kappaB-dependent repression of PPARdelta in human keratinocytes. We demonstrate that repression is unique to p65/RelA, as no other member of the NF-kappaB family had an impact on PPARdelta-mediated transactivation. Interestingly, our results show that p65/RelA only represses PPARdelta-dependent transactivation when PPARdelta is bound to DNA via its DNA-binding domain. We show that repression is sensitive to inhibition of histone deacetylases (HDACs) by tricostatin A (TSA), suggesting that HDAC activity is indispensable for p65/RelA-mediated repression. Accordingly, we demonstrate that a ternary complex consisting of PPARdelta, p65/RelA, and HDAC1 is formed in vivo. Finally, we demonstrate that TSA relieves tumor necrosis factor-alpha (TNFalpha)-induced repression of PPARdelta-mediated transactivation of the PPARdelta target gene adipose differentiation-related protein (ADRP) indicating that cross-talk between PPARdelta and NF-kappaB is of biological significance in human keratinocytes.     

The mitogen-activated protein kinases p38 and ERK1/2 are increased in lesional psoriatic skin

BACKGROUND: Alterations in specific signal transduction pathways may explain the hyperproliferation and abnormal differentiation of the keratinocytes as well as the increased expression of inflammatory cytokines seen in psoriasis. Major signalling pathways used by eukaryotic cells to transduce extracellular signals into cellular responses impinge on the mitogen-activated protein kinases (MAPKs). OBJECTIVES: To investigate the expression of the MAPK p38, extracellular signal-regulated kinase (ERK) and c-Jun NH2-terminal kinase (JNK) in psoriatic skin. METHODS: Keratome biopsies were taken from patients with plaque-type psoriasis. Western blot analysis was used to determine p38, ERK and JNK activity and protein levels, whereas kinase assays were used to examine the kinase activity of p38. RESULTS: We demonstrated increased levels of the phosphorylated forms of p38 and ERK1/2 in lesional psoriatic skin compared with nonlesional psoriatic skin. No abnormality was found in the activation and expression of JNK1/2. Ex vivo kinase assays confirmed the increased activation of p38, and furthermore demonstrated increased kinase activity of the p38 isoforms p38alpha, p38beta and p38delta in lesional compared with nonlesional psoriatic skin. p38gamma was not detected in the psoriatic skin. Clearance of the psoriatic lesions, induced by climatotherapy at the Dead Sea for 4 weeks, led to a normalization in the activity of both p38 and ERK1/2. CONCLUSIONS: Taken together, our results demonstrate that the activity of the MAPKs p38alpha, p38beta and p38delta and ERK1/2 are increased in lesional psoriatic skin compared with nonlesional psoriatic skin, and that clearance of psoriasis normalizes the p38 and ERK1/2 activity. Thus, p38 and ERK1/2 might be potential targets in the treatment of psoriasis.     

Mast cell density and IL-8 expression in nonlesional and lesional psoriatic skin

BACKGROUND: An important cellular aberration at sites of psoriatic inflammation is an increase in the number of dermal mast cells. Being multifactorial immune effector cells, it is believed that mast cells play an essential role in perpetuating the inflammatory process of psoriasis. However, factors responsible for the infiltration and accumulation of mast cells in psoriatic lesions are largely unknown. Recent studies have demonstrated that Interleukin-8 (IL-8) exerts strong chemotactic effects on mast cells in vitro. Overexpression of IL-8 has also been reported in psoriatic lesions. In this study, we have found a correlation between the expression of IL-8 and dermal mast cell density in lesional psoriatic skin as compared to nonlesional psoriatic skin. METHODS: Four-mm punch biopsies were taken from 14 psoriatic patients and eight healthy volunteers. Using immunohistochemical techniques, 8 microm sections of lesional psoriatic, nonlesional psoriatic, and normal control samples were evaluated for dermal mast cell density and the density of IL-8 expressing keratinocytes. RESULTS: It was found that dermal mast cell density in lesional psoriatic, nonlesional psoriatic, and normal skin was 105.4 +/- 71.2, 42.3 +/- 30.1, and 47.5 +/- 32.5 mast cells/mm(2), respectively. IL-8+ keratinocyte density in lesional psoriatic, non lesional psoriatic, and normal skin was 171.5 +/- 67.1, 25.4 +/- 14.9 and 20.6 +/- 8.7 IL-8+ Keratinocytes/mm(2), respectively. CONCLUSIONS: The results of this study suggest that increased levels of IL-8 in the keratinocytes of psoriatic plaques play a contributing role in the migration of mast cells to lesion sites.     

IL-4 expression by neutrophils in psoriasis lesional skin upon high-dose UVB exposure

BACKGROUND: Upon a single high dose of UVB irradiation of psoriatic lesional skin, IFN-gamma expression is decreased, whereas IL-4 expression is enhanced. A similar type 1 to type 2 shift was found in dermal T cells derived from irradiated lesional skin as compared to unexposed lesional psoriatic skin. We have found recently that the IL-4 protein detected in situ upon UVB exposure of normal skin was not associated with T cells but with infiltrating neutrophils. OBJECTIVE: To determine which cell types express IL-4 in psoriatic skin after UVB irradiation. METHODS: Skin biopsies were obtained from healthy controls and psoriasis patients before and after local UVB exposure. Double immunohistochemical stainings were performed to determine the identity of IL-4-expressing cells. RESULTS: In the irradiated skin of both healthy controls and patients, IL-4-positive cells coexpressed elastase and CD15, but not CD3. CONCLUSION: IL-4-expressing cells found in psoriatic skin after a single high-dose UVB exposure appeared to be neutrophils.     

Systemic photochemotherapy decreases the expression of IFN-γ, IL-12p40 and IL-23p19 in psoriatic plaques

Psoriasis vulgaris (PV) is a chronic skin disease with unclear pathogenesis. In the present study we investigated the effect of systemic photochemotherapy (PUVA therapy- psoralen and UVA therapy) on the expression of IFN-γ, IL-12p40 and IL-23p19 in lesional psoriatic skin. Fifteen patients with chronic plaque type psoriasis selected to be treated with PUVA therapy were recruited for this study. Expression of IFN-γ, IL-12p40 and IL-23p19 in psoriatic lesions before and after twenty PUVA treatments was established by using immunohistochemistry (IHC). A significant decrease in expression (p?相似文献   

白介素8及其受体CXCR2在银屑病角质形成细胞中的表达

目的 观察白介素8（IL－8）及基受体CXCR2在银屑病角质形成细胞中的表达及在银屑病的临床及病理表现中的作用。方法 培养银屑病患者皮损处角质形成细胞，通过微孔小室实验检测其上清液的趋化功能，通过酶联免疫吸附法（ELISA）检测上清液中IL－8的表达，通过流式细胞仪分析银屑病患者皮损处角质形成细胞的趋化因子受体CXCR2的表达。结果 银屑病患者皮损处角质形成细胞分泌上清液对中性粒细胞的趋化能力明显强于正常对照组，其分泌的IL－8水平也高于正常人，皮损处角质形成细胞CXCR2的表达也明显强于正常对照组。结论 银屑病患者皮损局部表面出的角质形成细胞高度增殖与角质形成细胞高分泌、高表达具有促增殖作用的IL－8及其受体CXCR2有关，同时皮损局部大量的炎性细胞的浸润部分可能是由于角质形成细胞高分泌具有趋化能力的IL－8，它们可能在银屑病的发生、发展中起着重要作用。     

结合珠蛋白在银屑病皮损及皮损周边外观正常皮肤中的表达

目的 从mRNA及蛋白质水平研究结合珠蛋白在银屑病皮损及皮损周边外观正常皮肤中的表达,探讨其与朗格汉斯细胞的关系及在银屑病发病中的作用.方法采用免疫组化、免疫荧光双标记和原位杂交技术检测银屑病皮损及皮损周边外观正常皮肤中结合珠蛋白的表达.结果与正常人皮肤相比,银屑病皮损处角质形成细胞中结合珠蛋白mRNA的表达均明显增强(P＜0.001);皮损周边外观正常皮肤中的表达与正常人皮肤差异无显著性(P＞0.05).免疫组化显示:皮损处部分角质形成细胞胞浆中有结合珠蛋白表达;皮损及皮损周边外观正常皮肤中均可见结合珠蛋白在部分朗格汉斯细胞中呈阳性表达,且两者中结合珠蛋白阳性朗格汉斯细胞与朗格汉斯细胞总计数的比值较正常皮肤显著增高(P＜0.001).结论银屑病皮损处角质形成细胞中结合珠蛋白mRNA的表达增强,并能合成结合珠蛋白.合成结合珠蛋白的角质形成细胞可能在银屑病发病机理中起负反馈调节作用。     

过氧化物酶增殖物激活受体β/δ在银屑病角质形成细胞中的表达

【摘要】 目的 探讨过氧化物酶增殖物激活受体β/δ（PPARβ/δ）在银屑病患者表皮角质形成细胞（KC）中的表达和调节因素。 方法 免疫组化方法检测PPARβ/δ在银屑病患者皮损及非皮损表皮中的表达。分离、培养银屑病患者非皮损区和皮损区的KC,以RT-PCR和Western印迹法分别检测银屑病患者皮损区和非皮损区KC中PPARβ/δ mRNA和蛋白质的表达水平。利用PPARβ/δ外源性激动剂GW501516及Ca2+刺激银屑病非皮损区KC,观察其对PPARβ/δ表达的调节影响。 结果 免疫组化显示,银屑病皮损区PPARβ/δ的表达强度显著高于正常对照组（t = 19.28,P < 0.01）和非皮损区（t = 23.26,P < 0.01）。银屑病皮损区PPARβ/δ mRNA和蛋白质的表达水平均高于正常对照组（P < 0.01）和非皮损区（P < 0.01）。10 ng/ml GW501516最大效能促进PPARβ/δ的表达（P < 0.01）;1.0 mmol/L Ca2+对KC中PPARβ/δ的表达促进效应最明显（P < 0.01）。 结论 PPARβ/δ在银屑病患者皮损区表达显著升高,GW501516 和Ca2+能够促进角质形成细胞PPARβ/δ表达水平。     

银屑病表皮热休克蛋白27、70、60的表达

目的：探讨热休克蛋白（HSP）在银屑病发病中的作用。方法：通过免疫组化和图像分析检测了25例银屑病患者治疗前后皮损、非皮损区表皮组织中HSP27、HSP70和HSP60的表达，并与6例正常人作对照。结果：HSP27、HSP70在非皮损、正常人表皮中呈基础表达，在银屑病患者皮损中的表达很弱，治愈后表皮后HSP27、HSP70的表达又恢复；HSP60的表达在银屑病皮损组表皮中均为阳性，而银屑病非皮损组、治愈后组表皮中及正常人对照表皮组织中HSP60的表达均阴性。结论：热休克蛋白在银屑病应激保护机制中可能发挥一定的作用。