摘要
目的观察窄谱中波紫外线(NB-UVB)治疗寻常性银屑病的疗效以及对患者外周血单一核细胞RORγt和Foxp3 mRNA表达的影响,探讨NB-UVB治疗寻常性银屑病的作用机制。方法选取90例中、重度寻常性银屑病患者(进行期45例,稳定期45例),使用NB-UVB照射治疗8周,采用实时荧光定量逆转录聚合酶链反应(QRT-PCR)方法,检测光疗前后外周血转录因子RORγt和Foxp3 mRNA的表达水平。以银屑病皮损面积和严重程度(PASI)评分评价临床疗效。同时选50例健康体检者作为正常对照组。结果治疗前,进行期及稳定期银屑病患者外周血RORγt mRNA表达量(9.12±1.46,8.77±1.25)显著高于正常对照组(3.01±0.71),差异有统计学意义(P<0.01);患者RORγt/Foxp3的比值(5.79±1.86,5.21±1.73)也显著高于正常对照组(0.91±0.42)(P<0.01);而Foxp3 mRNA的表达量(1.56±0.92,1.70±0.89)则显著低于正常对照组(3.26±1.05)(P<0.01)。NB-UVB照射治疗8周后外周血RORγt mRNA的表达量及RORγt/Foxp3的比值较治疗前明显下降,而Foxp3 mRNA的表达量较治疗前明显升高,与治疗前相比差异均有统计学意义(P<0.01)。NB-UVB治疗后PASI评分明显下降,与治疗前相比,差异有统计学意义(P<0.01)。总有效率达85.56%。患者治疗前、后PASI评分与RORγt mRNA表达量和RORγt/Foxp3比值呈正相关,而与Foxp3 mRNA的表达量呈负相关(P均<0.01)。结论寻常性银屑病的发生及病情严重程度可能与外周血RORγt mRNA的高表达及Foxp3mRNA的低水平有关;NB-UVB可明显下调外周血RORγt mRNA的表达,上调Foxp3 mRNA的表达,从而调节RORγt/Foxp3比值的失衡,这可能是NB-UVB治疗银屑病的机制之一。NB-UVB治疗各期寻常性银屑病疗效好,安全性高。
Objective To observe the efficacy of narrow-band ultraviolet B（NB-UVB）on psoriasis and impact on RORγt and Foxp3 genes in peripheral blood mononuclear cells（PBMC）of patients, to further clarify the therapeutic mechanisms of NB-UVB.Methods Ninety patients were treated with NB-UVB therapy for 8 weeks.The mRNA levels of RORγt and Foxp3 in PBMC were determined by quantitative Real-time PCR（QRT-PCR）in healthy controls and patients with psoriasis before and after treatment with NB-UVB. The efficacy of treatment was evaluated by Psoriasis Area and Severity Index（PASI）scores.Results The level of RORγt and ratio of RORγt/Foxp3 in peripheral blood of patients with psoriasis vulgaris were significantly higher than that in normal control group（P〈0.01）, while the expression of Foxp3 was significantly lower than that in normal control group（P〈0.01）. After 8 weeks of treatment with NB-UVB, level of RORγt and ratio of RORγt/Foxp3 in psoriasis patients were decreased significantly（P〈0.01）, and level of Foxp3 was increased significantly（P〈0.01）. The mean PASI scores were significantly decreased after treatment with NB-UVB therapy（P〈0.01）.Conclusion The pathogenesis and severity of psoriasis vulgaris have a relationship with higher RORγt mRNA and lower Foxp3 mRNA expression in peripheral blood. NB-UVB therapy was significantly effective in the treatment of moderate to severe psoriasis vulgaris. Level of RORγt and ratio of RORγt/Foxp3 were significantly reduced by NB-UVB in patients with psoriasis. NB-UVB can down- regulate the expression of RORγt and progress the expression of Foxp3. Which may be one of the mechanisms of the NB-UVB therapy in psoriasis.
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2016年第8期783-786,819,共5页
The Chinese Journal of Dermatovenereology
基金
山东省科技发展计划(2011YD18008)
山东省医药卫生科技发展计划(2011HW003)
