寻常型银屑病患者血清IL-17、IL-22水平的表达
发布时间：2018-08-03 21:40
【摘要】：目的:银屑病(psoriasis)是一种常见并易复发的慢性炎症性增生性皮肤病,临床主要表现为头皮,躯干及四肢伸侧分布的大小不等的炎性红色丘疹、斑块,表面覆盖有多层干燥的银白色鳞屑,可有薄膜现象和点状出血现象,多数患者皮损表现为冬重夏轻,复发率高,严重影响患者的身心健康和生活质量,基本病理表现以表皮角质形成细胞角化过度伴角化不全为特征,临床一般分为寻常型、脓疱型、关节病型和红皮症型,寻常型为最多见的一型。寻常型银屑病以病程又可分为进展期,静止期和消退期。其发病机制尚不完全清楚,以往研究大多认为银屑病是一种T淋巴细胞功能异常,以Th1细胞过度活化为优势的自身免疫性疾病[14]。近年来人们在对自身免疫性疾病和过敏原特异性反应的研究中发现了一种能特殊产生白介素17的辅助型T细胞,称为Th17细胞,该细胞除主要分泌特异性效应分子IL-17外,还分泌IL-22、IL-21等细胞因子,从Th17细胞发现时起,人们就开始重新理解和评价Th1型细胞在自身免疫性疾病中的调节作用,更多有关Th17细胞及其效应因子在自身免疫性疾病中的研究成为热点。 本实验通过检测寻常型银屑病患者血清中白介素-17(interleukin 17,IL-17)、白介素-22(interleukin 22,IL-22)的表达水平并与健康对照组进行比较,研究血清中IL-17和IL-22的表达水平与寻常型银屑病发病的相关性以及对疾病的进展的影响,进一步探讨Th17细胞及其效应因子IL-17、IL-22在银屑病的发病机制中的作用。 方法:选择2010年6月至2010年11月期间就诊于河北医科大学第二医院皮肤科门诊的寻常型银屑病患者29例做为病例组。入选标准:1有寻常型银屑病的典型临床表现。2近2周内未使用含有糖皮质激素的外用药物,近1月内也未接受过系统性治疗(尤其是使用皮质类固醇激素或者免疫抑制剂)。3除外自身免疫性疾病(天疱疮、多发性皮肌炎、系统性红斑狼疮、类风湿性关节炎等)以及其它各种严重的慢性系统性疾病。其中男18例,女11例,年龄19~52岁,平均年龄31.60±9.29岁。并根据病情将病例组分为两组:进展期组21例和静止期组8例。并由同一工作人员依据临床表现进行PASI评分。以11例本院健康医护人员为健康对照组,其中男5例,女6例。年龄25～40岁,平均年龄(29.24±12.11)岁,经t检验,性别、年龄与病例组无显著差异。采集受试者静脉血2ml放入(含10%EDTA1 mg/ml、抑肽酶500 kIU/ml)抗凝管中,在离心机中离心3000rpm,20min,将收集到的血清标本放入-70℃的冰箱中保存。应用双抗体夹心ELISA方法检测血清标本中IL-17IL-22的表达水平,将所得数据用SPSS13.0软件进行统计学处理,经正态性检验所得数据呈偏态分布,故统计方法选用两独立样本秩转换的非参数检验法,实验结果用中位数(四分位数间距)描述,对于寻常型银屑病血清中IL-17、IL-22的表达水平,在病例组和正常对照组以及进展期组和静止期组之间分别进行有无统计学差异的分析,检验水准取P0.05有统计学意义;对于寻常型银屑病患者血清中IL-17、IL-22的表达水平与临床皮损面积和严重程度(PASI评分值)之间的关系运用两变量的等级相关分析(spearman法)进行统计学分析,检验水准取P0.05有统计学意义。 结果:经ELISA方法检测结果显示寻常型银屑病血清中IL-17表达水平高于正常对照组(u=-1.696 P=0.045 P0.05),差异有统计学意义,进展期组高于静止期组(u=-2.074 P=0.019 P0.05),差异有统计学意义,血清中IL-17表达水平与临床皮疹和严重程度(PASI评分值)无直线相关关系(r=-0.048 P=0.799 P0.05);寻常型银屑病患者血清中IL-22的表达水平高于正常对照组(u=-1.727 P=0.042 P0.05),差异有统计学意义;静止期组高于进展期组(u=-0.049 P=0.480 P0.05),但差异无统计学意义,血清中IL-22的表达水平与临床皮疹和严重程度(PASI评分值)无直线相关关系(r=-0.149 P=0.442 P0.05)。 结论: 1寻常型银屑病患者血清中IL-17、IL-22的表达水平高于正常对照组,证实了IL-17、IL-22的表达与寻常型银屑病的发病机制密切相关,同时间接反映了Th17细胞在寻常型银屑病的发病中具有重要作用。 2寻常型银屑病血清中IL-17的表达水平在进展期组高于静止期组,说明IL-17在银屑病皮疹炎症进展过程中起主要作用,可能与其作为前炎症介质主要在炎症的进展期发挥重要的功能有关。 3寻常型银屑病血清中IL-17、IL-22的表达水平与银屑病病情的皮疹面积与严重程度PASI评分值无相关性关系,说明IL-17、IL-22的表达水平与银屑病皮损的面积及严重程度无明确关联,不能反映疾病的严重程度。
[Abstract]:Objective: psoriasis (psoriasis) is a common and recurring chronic inflammatory proliferative dermatosis. It is mainly characterized by inflammatory red papules in the scalp, trunk, and limb extensor distribution. The plaque and the surface are covered with multi-layered and dry silver white scales. There are thin film phenomena and punctate bleeding, and most of the skin lesions are in the skin. It is light in winter and light in summer and high in recurrence rate, which seriously affects the physical and mental health and quality of life of the patients. The basic pathological manifestations are hyperkeratinization and keratinization of epidermal keratinocytes, which are usually divided into ordinary, pustular, arthrosis and erythroderma, and the most common type. The pathogenesis is not completely clear. Most of the previous studies suggest that psoriasis is a kind of T lymphocyte dysfunction and the autoimmune disease with Th1 cell overactivation as the predominance of [14]. has been found in recent years in the study of the specific response to autoimmune diseases and allergens. The adjunctive T cells, which produce interleukin 17, are called Th17 cells. The cells secrete IL-22, IL-21 and other cytokines in addition to the main secretion of the specific effector molecule IL-17. From the discovery of Th17 cells, people begin to re understand and evaluate the regulatory role of Th1 cells in autoimmune diseases, more related to Th17 cells and their effects. The research of cytokines in autoimmune diseases has become a hot topic.
In this experiment, the expression level of interleukin -17 (interleukin 17, IL-17), interleukin -22 (interleukin 22, IL-22) in the serum of patients with psoriasis vulgaris was detected and compared with that of the healthy control group. The correlation between the expression level of IL-17 and IL-22 in serum and the pathogenesis of psoriasis vulgaris and the effect on the progression of the disease were further studied. Objective to investigate the role of Th17 cell and its effector factor IL-17 and IL-22 in the pathogenesis of psoriasis.
Methods: 29 cases of psoriasis vulgaris in the Department of Dermatology of the second hospital of Hebei Medical University from June 2010 to November 2010 were selected as the case group. The standard of admission: 1 typical clinical manifestations of psoriasis vulgaris.2 did not use glucocorticoid external drugs in nearly 2 weeks, and no systematic treatment had been accepted in nearly January. Treatment (especially with corticosteroids or immunosuppressants).3 except for autoimmune diseases (pemphigus, multiple dermatomyositis, systemic lupus erythematosus, rheumatoid arthritis) and other serious chronic systemic diseases, including 18 male, 11 female, age 19~52, average age of 31.60 + 9.29 years, and according to the condition of the disease. The case group was divided into two groups: 21 cases in the progressive group and 8 cases in the stationary phase group. The same staff were evaluated on the basis of PASI. 11 cases of health care workers in our hospital were healthy control group, including 5 males and 6 women. The average age was 25~40 years, the average age was (29.24 + 12.11) years, and there was no significant difference between sex, age and case group by t test. In the intravenous blood 2ml (including 10%EDTA1 mg/ml, aprotinin 500 kIU/ml) in the anticoagulant tube, centrifuge 3000rpm and 20min in the centrifuge, the collected serum specimens were stored in the refrigerator of -70 C. The expression level of IL-17? IL-22 in the serum samples was detected by the double antibody sandwich ELISA method, and the data were statistically analyzed with SPSS13.0 software. The data obtained by normality test are partial distribution, so the statistical method uses the non parametric test method of two independent sample rank conversion. The experimental results are described with median (four quantile spacing). The expression level of IL-17 and IL-22 in serum of psoriasis vulgaris, in the case group and the normal control group, the progressing group and the stationary phase group. There were statistically significant differences in the level of P0.05, and the relationship between the level of IL-17, IL-22 and the area of clinical lesions and severity (PASI score) in the serum of patients with psoriasis vulgaris was statistically analyzed by the two variable grade phase correlation analysis (Spearman method), and the test level was tested. P0.05 was statistically significant.
Results: the results of ELISA test showed that the expression of IL-17 in the serum of psoriasis vulgaris was higher than that of the normal control group (u=-1.696 P=0.045 P0.05), the difference was statistically significant, and the progression group was higher than the stationary phase group (u=-2.074 P=0.019 P0.05), the difference was statistically significant, the level of IL-17 expression in the blood and the clinical rash and severity (PASI evaluation). No linear correlation (r=-0.048 P=0.799 P0.05); the expression level of IL-22 in serum of patients with psoriasis vulgaris was higher than that of normal control group (u=-1.727 P=0.042 P0.05), the difference was statistically significant; the static period group was higher than the progression group (u=-0.049 P=0.480 P0.05), but the difference was not statistically significant, the expression level of IL-22 in the serum and clinical There was no linear correlation between rash and severity (PASI score) (r=-0.149 P=0.442 P0.05).
Conclusion:
The expression of IL-17 and IL-22 in serum of 1 psoriasis vulgaris patients is higher than that in the normal control group, which confirms that the expression of IL-17, IL-22 is closely related to the pathogenesis of psoriasis vulgaris, and indirectly reflects the important role of Th17 cells in the pathogenesis of psoriasis vulgaris.
The expression level of IL-17 in serum of 2 psoriasis vulgaris is higher than that in the stationary phase group, indicating that IL-17 plays a major role in the progression of psoriatic rashes, and may be related to the important function of the proinflammatory mediators as the main inflammatory mediators in the progression of inflammation.
The expression level of IL-17 and IL-22 in serum of psoriasis vulgaris has no correlation with the rash area of psoriasis and the PASI score of severity, indicating that the expression level of IL-17, IL-22 has no definite association with the area and severity of psoriasis skin lesions and does not reflect the severity of the disease.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R758.63
[Abstract]:Objective: psoriasis (psoriasis) is a common and recurring chronic inflammatory proliferative dermatosis. It is mainly characterized by inflammatory red papules in the scalp, trunk, and limb extensor distribution. The plaque and the surface are covered with multi-layered and dry silver white scales. There are thin film phenomena and punctate bleeding, and most of the skin lesions are in the skin. It is light in winter and light in summer and high in recurrence rate, which seriously affects the physical and mental health and quality of life of the patients. The basic pathological manifestations are hyperkeratinization and keratinization of epidermal keratinocytes, which are usually divided into ordinary, pustular, arthrosis and erythroderma, and the most common type. The pathogenesis is not completely clear. Most of the previous studies suggest that psoriasis is a kind of T lymphocyte dysfunction and the autoimmune disease with Th1 cell overactivation as the predominance of [14]. has been found in recent years in the study of the specific response to autoimmune diseases and allergens. The adjunctive T cells, which produce interleukin 17, are called Th17 cells. The cells secrete IL-22, IL-21 and other cytokines in addition to the main secretion of the specific effector molecule IL-17. From the discovery of Th17 cells, people begin to re understand and evaluate the regulatory role of Th1 cells in autoimmune diseases, more related to Th17 cells and their effects. The research of cytokines in autoimmune diseases has become a hot topic.
In this experiment, the expression level of interleukin -17 (interleukin 17, IL-17), interleukin -22 (interleukin 22, IL-22) in the serum of patients with psoriasis vulgaris was detected and compared with that of the healthy control group. The correlation between the expression level of IL-17 and IL-22 in serum and the pathogenesis of psoriasis vulgaris and the effect on the progression of the disease were further studied. Objective to investigate the role of Th17 cell and its effector factor IL-17 and IL-22 in the pathogenesis of psoriasis.
Methods: 29 cases of psoriasis vulgaris in the Department of Dermatology of the second hospital of Hebei Medical University from June 2010 to November 2010 were selected as the case group. The standard of admission: 1 typical clinical manifestations of psoriasis vulgaris.2 did not use glucocorticoid external drugs in nearly 2 weeks, and no systematic treatment had been accepted in nearly January. Treatment (especially with corticosteroids or immunosuppressants).3 except for autoimmune diseases (pemphigus, multiple dermatomyositis, systemic lupus erythematosus, rheumatoid arthritis) and other serious chronic systemic diseases, including 18 male, 11 female, age 19~52, average age of 31.60 + 9.29 years, and according to the condition of the disease. The case group was divided into two groups: 21 cases in the progressive group and 8 cases in the stationary phase group. The same staff were evaluated on the basis of PASI. 11 cases of health care workers in our hospital were healthy control group, including 5 males and 6 women. The average age was 25~40 years, the average age was (29.24 + 12.11) years, and there was no significant difference between sex, age and case group by t test. In the intravenous blood 2ml (including 10%EDTA1 mg/ml, aprotinin 500 kIU/ml) in the anticoagulant tube, centrifuge 3000rpm and 20min in the centrifuge, the collected serum specimens were stored in the refrigerator of -70 C. The expression level of IL-17? IL-22 in the serum samples was detected by the double antibody sandwich ELISA method, and the data were statistically analyzed with SPSS13.0 software. The data obtained by normality test are partial distribution, so the statistical method uses the non parametric test method of two independent sample rank conversion. The experimental results are described with median (four quantile spacing). The expression level of IL-17 and IL-22 in serum of psoriasis vulgaris, in the case group and the normal control group, the progressing group and the stationary phase group. There were statistically significant differences in the level of P0.05, and the relationship between the level of IL-17, IL-22 and the area of clinical lesions and severity (PASI score) in the serum of patients with psoriasis vulgaris was statistically analyzed by the two variable grade phase correlation analysis (Spearman method), and the test level was tested. P0.05 was statistically significant.
Results: the results of ELISA test showed that the expression of IL-17 in the serum of psoriasis vulgaris was higher than that of the normal control group (u=-1.696 P=0.045 P0.05), the difference was statistically significant, and the progression group was higher than the stationary phase group (u=-2.074 P=0.019 P0.05), the difference was statistically significant, the level of IL-17 expression in the blood and the clinical rash and severity (PASI evaluation). No linear correlation (r=-0.048 P=0.799 P0.05); the expression level of IL-22 in serum of patients with psoriasis vulgaris was higher than that of normal control group (u=-1.727 P=0.042 P0.05), the difference was statistically significant; the static period group was higher than the progression group (u=-0.049 P=0.480 P0.05), but the difference was not statistically significant, the expression level of IL-22 in the serum and clinical There was no linear correlation between rash and severity (PASI score) (r=-0.149 P=0.442 P0.05).
Conclusion:
The expression of IL-17 and IL-22 in serum of 1 psoriasis vulgaris patients is higher than that in the normal control group, which confirms that the expression of IL-17, IL-22 is closely related to the pathogenesis of psoriasis vulgaris, and indirectly reflects the important role of Th17 cells in the pathogenesis of psoriasis vulgaris.
The expression level of IL-17 in serum of 2 psoriasis vulgaris is higher than that in the stationary phase group, indicating that IL-17 plays a major role in the progression of psoriatic rashes, and may be related to the important function of the proinflammatory mediators as the main inflammatory mediators in the progression of inflammation.
The expression level of IL-17 and IL-22 in serum of psoriasis vulgaris has no correlation with the rash area of psoriasis and the PASI score of severity, indicating that the expression level of IL-17, IL-22 has no definite association with the area and severity of psoriasis skin lesions and does not reflect the severity of the disease.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R758.63
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