阿维A 对寻常型银屑病患者趋化因子RANTES 和MCP-1的影响

目的 观察阿维A 对寻常型银屑病患者血清中和外周血单一核细胞(PBMC)内RANTES 和 MCP-1 表达水平的影响.方法 分离并提取30 例健康对照者及48 例阿维A 治疗前、后银屑病患者的血清 及PBMC,血清采用ELISA 检测其中RANTES 和MCP-1 的分泌水平,PBMC 接受实时荧光定量PCR 法检测细 胞内RANTES 和MCP-1 的mRNA 的水平,并进行临床PASI 评分.结果 经ELISA 检测发现,寻常型银屑病 患者血清中RANTES 和MCP-1 水平明显高于健康对照组(P <0.01),应用阿维A 治疗后,两因子水平均显著 降低(P <0.01);QRT-PCR 检测发现,患者PBMC 中RANTES 和MCP-1 的mRNA 相对表达量均明显高于健 康对照组(P <0.01);治疗后PBMC 中RANTES 和MCP-1 均显著降低(P <0.01).治疗后患者PASI 评分明 显下降,且治疗前后银屑病患者PASI 评分差值与血清RANTES 和MCP-1 水平差值均呈正相关性(r1 ＝ 0.469,P <0.01;r2 ＝0.431,P <0.01),与PBMC 中RANTES mRNA 表达量差值呈正相关(r ＝0.484,P < 0.01).结论 阿维A 对寻常型银屑病的疗效显著,降低CC 型趋化因子RANTES 和MCP-1 的水平可能是阿 维A 治疗银屑病的机制之一.

Effect of acitretin on RANTES and MCP-1 in patients with psoriasis vulgaris

Objective To investigate the effect of acitretin on expression of CC chemotactic factor,monocyte chemoattractant protein-l（MCP-1）and regulated upon activation normal T cell expressed and secreted protein（RANTES）,in the peripheral blood and PBMCs of patients with psoriasis vulgaris.Methods Sera and PBMCs were obtained from the venous blood sample of 48 patients with psoriasis vulgaris（before and after treatment of acitretin respectively）and 30 normal human controls.Enzyme-linked immunosorbent assay（ELISA）was used to examine the RANTES and MCP-1 protein level in the sera,and meanwhile the mRNA expression of RANTES and MCP-1 in PBMCs was detected by quantitative real-time RT-PCR method.The clinical outcome was scored carefully by PASI index.Results The serum protein level and the mRNA expression in PBMCs of RANTES and MCP-1 were significantly higher in patients with psoriasis vulgaris than those in normal group（P〈0.01）,and was significant decreased after treatment of acitretin（P〈0.01）.PASI Score was decreased after therapy of acitretin in patients with psoriasis（P〈0.01）.The D-value of PASI score had positive correlation with the D-value of RANTES and MCP-1 in the sera（before and after treatment of acitretin respectively）（r1=0.469,P〈0.01;r2=0.431,P〈0.01）,so was D-value of the mRNA expression of RANTES in PBMCs（r=0.484,P〈0.01）.Conclusions Acitretin shows great clinical effect on psoriasis vulgaris,it′s treatment mechanism may be associated with down-regulation the expression of RANTES and MCP-1.