银屑病的瘙痒特征及相关因素分析

目的调查银屑病患者中瘙痒发生率、瘙痒程度等临床特征及其影响瘙痒的相关因素。方法采用问卷调查的形式调查了112例银屑病患者,评价其瘙痒特征及影响瘙痒的相关因素。结果 112例银屑病患者中83%存在不同程度瘙痒,相关分析显示:患者瘙痒与否与年龄、疾病活动度呈显著相关(P0.05),而与患者性别、病程、家族史、吸烟、饮酒及身体质量指数(BMI)无相关性,瘙痒程度与银屑病皮损面积及严重程度指数(PASI)评分、浸润程度呈显著相关(P0.05),而与红斑、鳞屑无相关性。结论大多数银屑病患者存在不同程度的瘙痒症状,年纪越大、皮损越广泛、浸润程度越高以及处在进展期的银屑病患者瘙痒越剧烈。     

窄谱中波紫外线对寻常型银屑病神经生长因子及其受体mRNA的影响

目的：观察窄谱中波紫外线（NB—UVB）治疗寻常型银屑病的疗效及治疗前后皮损中神经生长因子（NGF）及受体的表达。方法：用NB—UVB治疗23例寻常型银屑病患者,每周3次,连续21次,以PASI评价疗效,并以原位杂交技术和图像分析系统分析皮损部位光疗前后NGF及受体mRNA的表达情况。结果：临床总有效率为91％,光疗后PASI评分较光疗前显著降低（P〈0．001）;光疗前银屑病皮损处NGFmRNA在从基底层到颗粒层均有阳性表达,P140TrkAmRNA在表皮各层均有染色,以棘细胞层和颗粒层染色较强,P75mRNA在棘细胞层和颗粒层有较强染色;光疗后三者mRNA表达强度明显降低（P〈0．01）。结论：NB—UVB是治疗银屑病的安全有效的方法,下调皮损中NGF及受体的表达可能是NB—UVB治疗寻常型银屑病的机制之一。     

Itching in patients suffering from psoriasis

Some psoriatic patients suffer from intensive itching, however, literature data on its prevalence and especially on clinical manifestation are very limited. This study was undertaken to evaluate the frequency and clinical characteristics of itching in patients with psoriasis and to correlate the presence and intensity of pruritus with clinical severity of psoriasis. One hundred psoriatic individuals (psoriasis vulgaris in 77% and arthropatic psoriasis in 23%) were included in the study. The severity of psoriasis was assessed according to PASI score. Itching was evaluated using two methods: visual analog scale (VAS) and a specially designed questionnaire method. Itching was found in 80% of psoriatic patients. The severity of psoriasis in pruritic patients was significantly (p<0.004) higher as compared to non-pruritic subjects. Significant correlations were found between PASI scores and intensity of itching, as assessed by both scales: VAS and the questionnaire method (r=0.29, p<0.01 for both analyses). The presence and intensity of itching did not depend on age and gender of patients, type of psoriasis, duration of disease, and last outbreak of psoriasis. Generalized itching was reported by 28.7% of pruritic patients. The most common sites of itching were lower limbs (50%), trunk (48.7%), upper limbs (48.7%) and scalp (35%). Face appeared to be the least commonly affected skin area by itching (only 1.2%). We conclude that itching is a common symptom in patients with psoriasis, and its intensity correlates with clinical severity of the disease.     

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。     

银屑病瘙痒机制及治疗研究进展

瘙痒是银屑病患者的一种常见症状,严重影响患者的生活质量.但其瘙痒的机制尚不清楚,许多常规治疗瘙痒的药物并不能有效缓解银屑病的瘙痒.目前认为,银屑病皮损中神经分布异常增多和敏感性增加,炎症细胞在病灶中聚集、活化并释放炎症介质是银屑病瘙痒的主要原因.抗组胺药不能有效控制银屑病瘙痒,而神经肽受体拮抗剂、免疫抑制剂及光疗等为治疗银屑病瘙痒的有效方法.

Abstract：

Pruritus is an important symptom of psoriasis.It seriously affects the quality of life of psoriatic patients,but its pathogenesis remains unanswered.Many routine treatments cannot relieve the pruritus in psoriasis effectively.It has been demonstrated that the pruritus in psoriasis is mainly attributed to the abnormally increased innervation and sensitivity of sensory nerves,as well as the aggregation,activation of and release of inflammatory mediators by inflammatory cells.Antihistamine drugs are usually ineffective for the treatment of pruritus in psoriasis,while antagonists of neuropeptide receptors,immunosuppressants and phototherapy have shown favorable efficacy.     

Prolactin level is significantly elevated in lesional skin of patients with psoriasis

Background Accumulating data point to a potential role of prolactin in the pathogenesis of psoriasis. Methods We initiated a study including psoriasis patients (n = 15) and healthy volunteers (n = 15) as controls. Psoriasis area and severity index (PASI) score was evaluated, and prolactin levels in serum and blister fluid were assessed by enzyme‐linked immunosorbent assay (ELISA). Results Prolactin levels were significantly (P < 0.01) elevated in blister fluid of psoriatic lesional skin. Correlations between PASI score and different serum prolactin levels in lesional and non‐lesional skin were insignificant. Significant positive correlations of prolactin level were observed between lesional and non‐lesional skin in psoriasis (P < 0.05) and between serum and clinically normal skin in both psoriasis and control subjects (P < 0.05). Conclusions Locally produced prolactin may be involved in the pathogenesis of psoriatic lesions.     

Relationship between smoking‐induced oxidative stress and the clinical severity of psoriasis

Background Psoriasis is a chronic and recurrent inflammatory skin disease, known as an oxidative stress condition. Smoking augments the risk of development of psoriasis. Although the relative importance of potential mechanisms of smoking‐induced psoriasis is unknown, direct delivery of oxidants has been implicated in the pathogenesis of smoking‐induced psoriasis. Objectives This study aimed to investigate the smoking‐induced oxidative stress in psoriatic patients and its correlation with the severity of the disease. Methods The levels of malondialdehyde (MDA) and superoxide dismutase (SOD) were measured in 25 psoriatic patients (10 smokers, 10 non‐smokers and 5 ex‐smokers) and 20 healthy control subjects (10 smokers and 10 non‐smokers). Clinical severity of psoriasis was determined according to the Psoriasis Area Severity Index (PASI) score. Results Our results showed a significant increase in serum MDA and decrease in the blood SOD levels in psoriatic patients compared with those in control subjects and those in smokers compared with those in non‐smokers. The concentrations of MDA and SOD were significantly correlated with PASI score. There was a significant increase in PASI score in smoker patients compared with that in non‐smokers and it increased with increasing the pack‐years of smoking. Conclusions Our results indicate that smoking‐induced oxidative damage resulting from increased reactive oxygen species production along with insufficient capacity of antioxidant mechanisms may be involved in the pathogenesis of psoriasis.     

银屑病患者中性粒细胞中CXC型趋化因子受体CXCR1、CXCR2 mRNA的表达

目的 了解银屑病患者外周血中性粒细胞中CXC型趋化因子受体CXCR1及CXCR2的表达情况。方法 应用逆转录-聚合酶链反应(RT-PCR)法检测了进行期斑块状银屑病患者及健康人对照各30例(其中治疗后患者14例)外周血中性粒细胞中CXCR1及CXCR2mRNA的表达,并将结果与患者皮损面积及严重程度指数(PASI)进行了相关性分析。结果 斑块状银屑病患者外周血中性粒细胞中CXCR1及CXCR2mRNA表达水平分别为1.30±1.18和1.62±0.97,明显高于正常人对照(分别为0.56±0.36、0.74±0.58,P<0.01),并随治疗后患者PASI评分的下降而降低,治疗后CXCR1、CXCR2分别为0.49±0.34、0.51±0.51,(P<0.01),银屑病患者外周血中性粒细胞中CXCR2mRNA水平高于CXCR1mRNA水平,二者均与PASI呈显著正相关。CXCR1:r=0.60,P<0.001;CXCR2:r=0.84,P<0.001。结论 银屑病患者外周血中性粒细胞中增高的CXCR1与CXCR2可能与白细胞向皮损部位的移行和聚集有关,CXCR1及CXCR2参与了银屑病的发病机制。     

Expression of tachykinins and their receptors in plaque psoriasis with pruritus

Background Various mediators of pruritus have been suggested that might be responsible for the mechanism of pruritus in psoriasis. Objectives To study the expression levels of members of the tachykinin family, substance P and neurokinin (NK) A and their receptors, NK‐1 and NK‐2, in psoriasis and to correlate their expression with the intensity of pruritus. A possible correlation with chronic stress and depression was also evaluated. Methods Biopsies were obtained from 28 patients with chronic plaque psoriasis; the majority had pruritus. The samples were taken from lesional and nonlesional areas on the back and also from 10 healthy controls, for immunohistochemistry staining, and from lesional skin for radioimmunoassay. Prior to biopsy, the clinical severity of the psoriasis of each patient was assessed by the Psoriasis Area and Severity Index (PASI) and the intensity of pruritus was measured by using a visual analogue scale (VAS). Levels of depression and stress were measured using Beck’s Depression Inventory (BDI) and the salivary cortisol test, respectively. Results Substance P‐, NKA‐ and NK‐2 receptor‐immunoreactive nerves, and non‐neuronal inflammatory cells positive for substance P and NKA and their respective receptors, NK‐1 and NK‐2, were numerous in psoriasis compared with healthy controls. The numbers of substance P‐positive nerves and NK‐2 receptor‐positive cells in lesional skin were significantly correlated to pruritus intensity. The cortisol ratio was inversely correlated with the number of NK‐1 receptor‐immunoreactive inflammatory cells in lesional and nonlesional psoriasis skin. There was also a positive correlation between the BDI score and the number of substance P‐positive cells in nonlesional skin and with NK‐1 receptor‐positive cells in lesional and nonlesional skin. Conclusions Tachykinins may play a role in psoriasis per se, in addition to pruritus in this disease. Targeting the combined NK‐1 and NK‐2 receptors might be a possible treatment.     

银屑病患者皮损中VEGF受体FLT-1和KDR的表达

目的:检测VEGF受体FLT-1与KDR在寻常型银屑病皮损中的表达水平,探讨其在银屑病发病中的意义。方法:应用免疫组化SABC法,检测37例寻常型银屑病患者皮损和37例正常人皮肤组织FLT-1蛋白、KDR蛋白的表达。结果:寻常型银屑病皮损处的FLT-1蛋白和KDR蛋白的表达水平明显强于正常对照组(P<0.001);KDR的表达强度与寻常型银屑病严重程度指数PASI评分有显著正相关(r=0.93,P<0.001),且KDR的表达强度高于FLT-1的表达强度(P<0.05)。结论:VEGF的两种受体FLT-1与KDR在银屑病新生血管形成中具有重要作用,其中KDR起主要作用。通过阻断VEGF受体KDR以抗血管生成,可望为治疗银屑病提供一种新的有效方法。     

Study of substance P and its receptor neurokinin-1 in psoriasis and their relation to chronic stress and pruritus

Substance P and its receptor(R) neurokinin (NK)-1 may have a role in the pathogenesis of psoriasis. Stress has been reported to play a role in the onset and exacerbation of psoriasis, which might include the substance P-NK-1 receptor(R) pathway. A feature of psoriasis, that has been correlated to the severity of stress and secretion of substance P, is pruritus. The objective of this study was to investigate the expression of substance P and the NK-1R in involved and noninvolved psoriatic skin, using a biotinylated streptavidin technique. Moreover, a possible correlation between the patient′s level of chronic stress, measured by salivary cortisol samples, degree of lesional pruritus, measured by means of a visual analogue scale, and the expression of substance P- and the NK-1R, was investigated. There was a low number of substance P positive nerve fibres in noninvolved and involved skin, the major immunoreactivity for substance P being found in inflammatory cells. The number of substance P- and NK-1R positive inflammatory cells was increased in involved compared to noninvolved psoriatic skin. The substance P positive cells were mostly lymphocytes, while most of the NK-1R positive cells were mast cells. NK-1R immunoreactivity was also seen as a reticular pattern in the upper part of the epidermis of involved skin in the majority of the patients. Low cortisol ratios in the patients, being an indicator of chronic stress, were correlated to an increased number of substance P- and NK-1R positive inflammatory cells in noninvolved psoriatic skin, and higher cortisol ratios to the presence of keratinocyte NK-1R immunoreactivity in involved skin. The degree of pruritus could not be correlated to the number of substance P positive fibers nor cells. Nonneuronal substance P and its receptor NK-1 might have a role in psoriasis, also during chronic stress.     

银屑病患者自身免疫性甲状腺炎调查分析

目的:调查我院银屑病患者中自身免疫性甲状腺炎的发生率。方法:纳入157例银屑病患者和年龄、性别及BMI相匹配的100例对照病例(非炎症性皮肤病患者)进行回顾性分析,测定三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)、甲状腺球蛋白(TG)、甲状腺球蛋白抗体(TGAb)、抗甲状腺过氧化物酶抗体(TPOAb)水平。其中,TGAb和(或)TPOAb阳性界定为自身免疫性甲状腺炎。比较两组中自身免疫性甲状腺炎的发生率、甲状腺激素水平,并进行危险因素分析。结果:银屑病组中自身免疫性甲状腺炎发生率高于对照组(11.5%vs 9%),但两组间无明显差异(x~2=0.40,P>0.05)。银屑病中自身免疫性甲状腺炎的发生与发病年龄、病程、PASI评分和肥胖无关(P值均>0.05)。银屑病中血清TT3、FT3和TSH水平显著高于对照组(P<0.05),差异有统计学意义。结论:银屑病患者与正常人群相比,发生自身免疫性甲状腺炎的风险无增加;但血清T3可能在银屑病发病中发挥作用。     

寻常性银屑病患者表皮中DNA总体甲基化水平检测

目的通过检测寻常性银屑病患者表皮DNA总体甲基化水平,探讨DNA甲基化在银屑病发生发展过程中的作用。方法采用荧光比色法检测寻常性银屑病患者表皮DNA总体甲基化水平,与同一患者非皮损部位及健康对照者表皮进行对照研究,并分析其与病情严重程度的相关性。以PASI评分评估银屑病病情严重程度。结果在30例银屑病患者皮损、非皮损部位表皮及28名健康对照者表皮中检测到不同程度的DNA甲基化,分别为(4.92±2.12)%、(2.85±1.35)%和(2.32±0.99)%。银屑病患者皮损部位表皮DNA总体甲基化水平显著高于同一患者的非皮损部位(P<0.0001)及健康对照者(P<0.0001),而非皮损部位DNA总体甲基化水平与健康对照者之间差异无统计学意义(P>0.05)。银屑病患者皮损部位表皮中DNA总体甲基化水平与PASI评分之间存在显著相关性(P<0.0001)。结论寻常性银屑病患者表皮中DNA总体甲基化水平明显升高,且与疾病严重程度呈正相关。     

Characteristics of Pruritus according to Morphological Phenotype of Psoriasis and Association with Neuropeptides and Interleukin-31

BackgroundPruritus is a common symptom in psoriasis. However, few studies have assessed the characteristics of pruritus according to morphological phenotypes of psoriasis.ObjectiveTo investigate the characteristics of pruritus according to morphological phenotypes of psoriasis and to assess the association with inflammatory mediators related to pruritus.MethodsPsoriasis patients were divided into 2 groups according to clinical phenotype: eruptive inflammatory (EI) and chronic stable (CS). Clinical data of pruritus were assessed by an itch questionnaire. Serum neuropeptides and cytokines including substance P, histamine, vasoactive intestinal peptide, neuropeptide Y, calcitonin gene-related peptide and interleukin-31 (IL-31) were quantitatively measured.ResultsIn total, 50 patients with psoriasis (30 male, 20 female; mean age, 45.7 years) were studied (EI, n=15 and CS, n=35). Pruritus was reported by 80% of EI and CS patients. There were no significant differences in prevalence of pruritus, pruritus intensity, severity of psoriasis, serum neuropeptides, or IL-31 between the 2 groups.ConclusionThe morphological phenotype does not seem to be an important factor affecting the prevalence and characteristics of pruritus in psoriasis.     

寻常性银屑病患者表皮p16INK4a基因启动子高甲基化与临床资料的相关性研究

目的：探讨斑块状银屑病患者表皮p16^INK4a基因启动子甲基化状态,并分析与其临床资料的相关性。方法：按银屑病皮损面积和严重度指数（PASI）评分评估患者病情严重程度。采用甲基化特异PCR（MAP）方法检测p16^INK4a甲基化状态。结果：①银屑病患者皮损和非皮损表皮p16^INK4a基因的甲基化率分别为32．14％（9／28）和7．14％（2／28）,皮损处明显高于非皮损处（P〈0．05）,正常对照组中无表皮p16^INK4a基因甲基化（0/38）;②进行期皮损表皮p16^INK4a基因的甲基化率明显高于稳定期皮损（P〈0．05）;③皮损表皮p16^INK4a基因甲基化阳性患者的PASI评分明显高于甲基化阴性患者（P〈0．05）。结论：斑块状银屑病患者皮损表皮p16^INK4a基因启动子甲基化率明显增高,并与皮损严重程度和活动性有关,提示p16^INK4a基因启动子高甲基化在银屑病的发病中可能起作用。     

Cross-sectional study reveals that HLA-C*07:02 is a potential biomarker of early onset/lesion severity of psoriasis

Psoriasis is a common chronic autoimmune skin disease, with T cells playing a predominant role in its pathogenesis. Here, we aimed to investigate the relation of T-cell repertoires (TCR) and major histocompatibility complex (MHC) in psoriatic patients to further understand mechanisms in disease pathogenesis. We conducted a cross-sectional study involving nine pairs of monozygotic twins with inconsistent psoriasis and examined the TCR diversity and MHC haplotype of the individuals using multiple-PCR and high-throughput sequencing. Additionally, 665 psoriatic patients were applied to validate the relation of human leucocyte antigen (HLA) class I allele HLA-C*07:02 and early onset or lesion severity of psoriasis. The immune diversity was lower in psoriatic patients compared with unaffected individuals within the twin pairs, although the difference was not significant. The clonotypes of TCR significantly decreased in psoriatic patients with high PASI score and early onset. HLA-C*07:02, a haplotype associated with psoriasis, was positively correlated with the diversity of the TCRV gene. Moreover, HLA-C*07:02 clustered in patients with high PASI and early onset. In the replication stage, we found that the PASI and onset age in psoriasis with HLA-C*07:02 were significantly different from those without HLA-C*07:02 and without HLA-C*06:02. Our observations indicate that HLA-C*07:02 is positively correlated with the diversity of TCRV gene in psoriasis and maybe a potential biomarker of early onset/severe lesions of psoriasis.     

The association of PASI scores with CRH-R1 expression in patients with psoriasis

Stress is a well-known triggering factor along with genetic predisposition on the onset and during the course of psoriasis by altering the cellular constituents of the immune system. In the skin, there is a local hypothalamic–pituitary–adrenal (HPA) axis which is the equivalent of the central HPA axis. Corticotropin-releasing hormone (CRH) is a major regulator of the HPA axis in response to stress. This study was planned to show the role of CRH receptor type 1 (CRH-R1) in pathogenesis of psoriasis, the relation with the severity of psoriasis, and interpersonal variance in skin biopsy specimens of the psoriasis patient. Study involved 46 patients with psoriasis and 20 healthy control subjects who were older than 18 years. The clinical sign and PASI scores of psoriasis patients were recorded. Immunohistochemically, expression of CRH-R1 was investigated in psoriatic lesions and control group skin. A statistically significant increase of the expression of CRH-R1 was found in the skin biopsies of psoriasis patients compared with the control group patients. In patients with psoriasis, there was a positive correlation between the expressions of CRH-R1 and PASI scores (p = 0.001, r = +0.572). In addition, a statistically significant increase of PASI scores was found in the intense-stained CRH-R1 group compared with the weakly stained CRH-R1 patient group. The present study has demonstrated that CRH-R1 could have a role in pathogenesis of the psoriasis and stress may increase the intensity of psoriasis.     

Pruritogenic mediators in psoriasis vulgaris: comparative evaluation of itch-associated cutaneous factors

BACKGROUND: Although some patients with psoriasis vulgaris also complain of severe pruritus, the data available regarding pruritus in psoriasis are sparse. OBJECTIVES: To clarify the mechanism and mediators involved in the pruritus of psoriasis vulgaris, we compared itch-associated factors in lesional skin from psoriatic patients vs. skin without pruritus quantitatively using a panel of histological and immunohistological parameters. PATIENTS AND METHODS: Biopsied specimens were obtained from 38 patients with psoriasis vulgaris who were divided into two groups according to the presence or absence of pruritus. RESULTS: When compared with psoriatic patients devoid of pruritus, lesional skin from patients with pruritus showed the following characteristic features: (i) a rich innervation both in the epidermis and in the papillary dermis; (ii) an increase in neuropeptide substance P-containing nerve fibres in perivascular areas; (iii) decreased expression of neutral endopeptidase in the epidermal basal layer as well as in the endothelia of blood vessels; (iv) many mast cells showing degranulating processes in the papillary dermis; (v) a strong immunoreactivity for nerve growth factor (NGF) throughout the entire epidermis and an increased NGF content in lesional skin homogenates; (vi) an increase in the expression of high-affinity receptors for NGF (Trk A) in basal keratinocytes and in dermal nerves; (vii) an increased population of interleukin-2-immunoreactive lymphocytes; and (viii) a strong expression of E-selectin on vascular endothelial cells. A significant correlation was observed between the severity of pruritus and protein gene product 9.5-immunoreactive intraepidermal nerve fibres, NGF-immunoreactive keratinocytes, expression of Trk A in the epidermis and the density of immunoreactive vessels for E-selectin. These findings indicate that possible pruritogenic mediators in psoriatic lesional skin are neurogenic factors including innervation, neuropeptide substance P, neuropeptide-degrading enzymes and NGF, activated mast cells, one or more cytokines and endothelial-leucocyte adhesion molecules. CONCLUSIONS: These data document for the first time itch-related local markers in psoriasis, and suggest complex and multifactorial mechanisms of pruritus in the disease. These results provide the groundwork for further studies to evaluate the efficacy of antipruritic treatment for psoriatic patients.     

Neuropeptides in psoriasis: an immunocytochemical and radioimmunoassay study

The present study examines the presence of neuropeptides in the skin and plasma of patients with psoriasis using the techniques of immunocytochemistry and radioimmunoassay. Immunocytochemistry failed to demonstrate differences in the pattern of neuropeptide innervation in psoriatic lesional skin when compared to normal skin. However, radioimmunoassay of skin biopsy extracts, both substance P and vasoactive intestinal polypeptide, were significantly elevated in psoriatic lesional skin when compared with both psoriatic non-lesional and normal control skin (p less than 0.001). There was no significant difference between the plasma levels of neuropeptides in psoriatic patients compared to those of control subjects, and no significant correlation among the plasma levels of neuropeptides with the surface area of involvement with psoriasis. The finding of elevated levels of substance P and vasoactive intestinal polypeptide in lesional psoriatic skin suggests that these peptides may be involved in the pathogenesis or maintenance of the psoriatic skin lesion and the development of safe and stable antagonists of these neuropeptides may have applications in the treatment of psoriasis.     

银屑病患者血清和皮损中血管内皮细胞粘附分子的对比研究

目的 探讨银屑病患者血清和皮损中4种血管内皮粘附分子表达与银屑病疾病活动性之间的关系。方法 采用ELISA法检测36例银屑病患者治疗前后和36例健康人的血清中可溶性粘附分子（sICAM-1、sICAM-3、sVCAM-1、sELAM）的浓度。同时用ABC免疫组化染色技术检测了36例银屑病患者皮损和临床治愈处皮肤粘附分子（ICAM－1、ICAM－3、VCAM－1、ELAM）的表达情况。结果 与正常人相比，银屑病患者皮损部位4种粘附分子的原位表达呈明显上调（P＜0.005），同时患者血清中4种可溶性粘附分子浓度也明显升高（P＜0.001）。经治疗后银屑病患者皮损部位4种粘附分子的原位表达明显下调（P＜0.05），同时血清中4种可溶性粘附分子浓度比前也下降（P＜0.05）；血清中4种可溶性粘附分子的浓度与银屑病疾病活动严重指数（PASI）均呈正相关，但治疗前后sVCAM-1的水平上升和下降的幅度最大，且与PASI的相关性最好。结论 血管内皮细胞粘附分子参与银屑病的发病机制；患者血清中可溶性粘附分子浓度的升高可能与皮损部位血管内皮细胞上相应的粘附分子高表达有关；血清VCAM－1的水平可以作为反映银屑病疾病活动的一个新的敏感指标。