摘要
目的研究银屑病各中医证型患者辅助性T细胞17(T helper cells 17,Th17)/调节性T细胞(Regulatory T cells,Treg)和相关细胞因子的表达特点及与病情的相关性。方法选取2019年6月—2020年6月就诊的银屑病患者90例,根据其中医证型分为血热、血燥、血瘀组,每组30例,另选健康志愿者30例为对照组。同时根据银屑病面积与严重程度评分法(Psoriasis area and severity index,PASI)将所有患者分为轻中度组和重度组。比较各组间Th17/Treg细胞和相关细胞因子的表达水平。采用Pearson相关分析分析银屑病患者Th17、Treg细胞比例及Th17/Treg比值与PASI评分的相关性。结果血热、血燥、血瘀组Th17细胞比例、Th17/Treg比值均高于对照组,差异有统计学意义(P<0.05),血热组Th17细胞比例和Th17/Treg比值均高于血燥、血瘀组,差异有统计学意义(P<0.05),Treg细胞比例均低于血燥组、对照组,差异有统计学意义(P<0.05);血热、血燥、血瘀组白介素-6(Interleukin-6,IL-6)、白介素-17(Interleukin-17,IL-17)、白介素-22(Interleukin-22,IL-22)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)表达水平均高于对照组(P<0.05),血热组IL-6、IL-17、IL-22、TNF-α表达水平均高于血燥、血瘀组,白介素-10(Interleukin-10,IL-10)、转化生长因子-β(Transforming growth factor-β,TGF-β)表达水平均低于血燥组、对照组,差异有统计学意义(P<0.05);重度组患者Th17细胞比例、Th17/Treg比值均高于轻中度组,差异有统计学意义(P<0.05),Treg细胞比例低于轻中度组,差异有统计学意义(P<0.05);Pearson相关分析显示,Th17细胞比例、Th17/Treg比值与PASI评分呈均正相关(r=0.807,r=0.828,P<0.001),Treg细胞比例与PASI评分呈负相关(r=-0.608,P<0.001)。结论外周血Th17/Treg细胞和相关细胞因子在银屑病患者血热、血燥、血瘀三证型之间存在表达差异,且以血热型最为显著,此可为银屑病的中医辨证治疗提供初步量化参考指标。此外,Th17细胞比例、Th17/Treg失衡程度越高,Treg细胞比例越低,银屑病患者病情越重。
Objective To explore the expression characteristics of T helper cells 17(Th17),regulatory T cells(Treg)and related cytokines in vulgaris psoriasis patiens with different traditional chinese medicine(TCM)syndromes and their correlation with the disease severity.Methods Total of 90 patients with psoriasis who were treated from June 2019 to June 2020 were selected and divided into blood heat,blood dryness,and blood stasis groups according to their medical syndromes,with 30 cases in each group.Another 30 healthy volunteers were selected as the control group.At the same time,all patients were divided into mild to moderate group and severe group according to the Psoriasis area and severity index(PASI)score.Compare the expression levels of Th17/Treg cells and related cytokines between groups.Pearson correlation was used to analyze the correlation between Th17,Treg cell ratio and Th17/Treg ratio and PASI score in patients with psoriasis.Results The Th17 cell ratio and Th17/Treg ratio in the blood heat,blood dryness,and blood stasis groups were higher than those in the control group(P<0.05),and the Th17 cell ratio and Th17/Treg ratio in the blood heat group were higher than those in the blood dryness and blood stasis groups(P<0.05),the proportion of Treg cells was lower than the blood dryness group and the control group(P<0.05);blood heat,blood dryness,blood stasis group interleukin-6(IL-6),interleukin-17(IL-17),interleukin-22(IL-22),and tumor necrosis factor-α(TNF-α)expression levels were higher than those of the control group(P<0.05),IL-6,IL-17,IL-22,TNF-αin blood heat group were higher than those in blood dryness and blood stasis group,interleukin-10(IL-10),transforming growth factor-β(TGF-β)were lower than those in the blood dryness group and the control group(P<0.05);the Th17 cell ratio and Th17/Treg ratio of patients in the severe group were higher than those in the mild-to-moderate group(P<0.05),and the Treg cell ratio was lower than the mild-to-moderate group Degree group(P<0.05);Pearson correlation analysis showed that Th17 cell ratio and Th17/Treg ratio were positively correlated with PASI score(r=0.807,r=0.828,P<0.001),and Treg cell ratio was negatively correlated with PASI score(r=-0.608,P<0.001).Conclusion The expression of Th17,Treg and related cytokines are different among patients with psoriasis and different TCM syndromes(blood heat type,blood dryness type,blood stasis type),and the blood heat type is the most significant,which can improve the preliminary quantitative reference index for syndrome differentiation and treatment of TCM.In addition,the higher the Th17 and Th17/Treg imblance and the lower the Treg,the more severe of the psoriasis patients.
作者
周振兴
周茹
洪燕英
郭宏林
孙立蕴
曹阳
ZHOU Zhen-xing;ZHOU Ru;HONG Yan-ying;GUO Hong-lin;SUN Li-yun;CAO Yang(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010;Beijing Ditan Hospital,Capital Medical University,Beijing 100015)
出处
《世界中西医结合杂志》
2021年第7期1314-1318,共5页
World Journal of Integrated Traditional and Western Medicine
基金
首都医科大学附属北京中医医院院级课题暨两院合作课题(LY201825)。
关键词
银屑病
中医证型
T细胞17
调节性T细胞
Psoriasis
Traditional Chinese Medicine Syndromes
T Cells 17
Regulatory T Cells
