尋常型銀屑病患者血清IL-17、IL-22水平的表達(dá)
發(fā)布時(shí)間：2018-08-03 21:40
【摘要】：目的:銀屑病(psoriasis)是一種常見并易復(fù)發(fā)的慢性炎癥性增生性皮膚病,臨床主要表現(xiàn)為頭皮,軀干及四肢伸側(cè)分布的大小不等的炎性紅色丘疹、斑塊,表面覆蓋有多層干燥的銀白色鱗屑,可有薄膜現(xiàn)象和點(diǎn)狀出血現(xiàn)象,多數(shù)患者皮損表現(xiàn)為冬重夏輕,復(fù)發(fā)率高,嚴(yán)重影響患者的身心健康和生活質(zhì)量,基本病理表現(xiàn)以表皮角質(zhì)形成細(xì)胞角化過度伴角化不全為特征,臨床一般分為尋常型、膿皰型、關(guān)節(jié)病型和紅皮癥型,尋常型為最多見的一型。尋常型銀屑病以病程又可分為進(jìn)展期,靜止期和消退期。其發(fā)病機(jī)制尚不完全清楚,以往研究大多認(rèn)為銀屑病是一種T淋巴細(xì)胞功能異常,以Th1細(xì)胞過度活化為優(yōu)勢的自身免疫性疾病[14]。近年來人們在對自身免疫性疾病和過敏原特異性反應(yīng)的研究中發(fā)現(xiàn)了一種能特殊產(chǎn)生白介素17的輔助型T細(xì)胞,稱為Th17細(xì)胞,該細(xì)胞除主要分泌特異性效應(yīng)分子IL-17外,還分泌IL-22、IL-21等細(xì)胞因子,從Th17細(xì)胞發(fā)現(xiàn)時(shí)起,人們就開始重新理解和評價(jià)Th1型細(xì)胞在自身免疫性疾病中的調(diào)節(jié)作用,更多有關(guān)Th17細(xì)胞及其效應(yīng)因子在自身免疫性疾病中的研究成為熱點(diǎn)。 本實(shí)驗(yàn)通過檢測尋常型銀屑病患者血清中白介素-17(interleukin 17,IL-17)、白介素-22(interleukin 22,IL-22)的表達(dá)水平并與健康對照組進(jìn)行比較,研究血清中IL-17和IL-22的表達(dá)水平與尋常型銀屑病發(fā)病的相關(guān)性以及對疾病的進(jìn)展的影響,進(jìn)一步探討Th17細(xì)胞及其效應(yīng)因子IL-17、IL-22在銀屑病的發(fā)病機(jī)制中的作用。 方法:選擇2010年6月至2010年11月期間就診于河北醫(yī)科大學(xué)第二醫(yī)院皮膚科門診的尋常型銀屑病患者29例做為病例組。入選標(biāo)準(zhǔn):1有尋常型銀屑病的典型臨床表現(xiàn)。2近2周內(nèi)未使用含有糖皮質(zhì)激素的外用藥物,近1月內(nèi)也未接受過系統(tǒng)性治療(尤其是使用皮質(zhì)類固醇激素或者免疫抑制劑)。3除外自身免疫性疾病(天皰瘡、多發(fā)性皮肌炎、系統(tǒng)性紅斑狼瘡、類風(fēng)濕性關(guān)節(jié)炎等)以及其它各種嚴(yán)重的慢性系統(tǒng)性疾病。其中男18例,女11例,年齡19~52歲,平均年齡31.60±9.29歲。并根據(jù)病情將病例組分為兩組:進(jìn)展期組21例和靜止期組8例。并由同一工作人員依據(jù)臨床表現(xiàn)進(jìn)行PASI評分。以11例本院健康醫(yī)護(hù)人員為健康對照組,其中男5例,女6例。年齡25～40歲,平均年齡(29.24±12.11)歲,經(jīng)t檢驗(yàn),性別、年齡與病例組無顯著差異。采集受試者靜脈血2ml放入(含10%EDTA1 mg/ml、抑肽酶500 kIU/ml)抗凝管中,在離心機(jī)中離心3000rpm,20min,將收集到的血清標(biāo)本放入-70℃的冰箱中保存。應(yīng)用雙抗體夾心ELISA方法檢測血清標(biāo)本中IL-17IL-22的表達(dá)水平,將所得數(shù)據(jù)用SPSS13.0軟件進(jìn)行統(tǒng)計(jì)學(xué)處理,經(jīng)正態(tài)性檢驗(yàn)所得數(shù)據(jù)呈偏態(tài)分布,故統(tǒng)計(jì)方法選用兩獨(dú)立樣本秩轉(zhuǎn)換的非參數(shù)檢驗(yàn)法,實(shí)驗(yàn)結(jié)果用中位數(shù)(四分位數(shù)間距)描述,對于尋常型銀屑病血清中IL-17、IL-22的表達(dá)水平,在病例組和正常對照組以及進(jìn)展期組和靜止期組之間分別進(jìn)行有無統(tǒng)計(jì)學(xué)差異的分析,檢驗(yàn)水準(zhǔn)取P0.05有統(tǒng)計(jì)學(xué)意義;對于尋常型銀屑病患者血清中IL-17、IL-22的表達(dá)水平與臨床皮損面積和嚴(yán)重程度(PASI評分值)之間的關(guān)系運(yùn)用兩變量的等級相關(guān)分析(spearman法)進(jìn)行統(tǒng)計(jì)學(xué)分析,檢驗(yàn)水準(zhǔn)取P0.05有統(tǒng)計(jì)學(xué)意義。 結(jié)果:經(jīng)ELISA方法檢測結(jié)果顯示尋常型銀屑病血清中IL-17表達(dá)水平高于正常對照組(u=-1.696 P=0.045 P0.05),差異有統(tǒng)計(jì)學(xué)意義,進(jìn)展期組高于靜止期組(u=-2.074 P=0.019 P0.05),差異有統(tǒng)計(jì)學(xué)意義,血清中IL-17表達(dá)水平與臨床皮疹和嚴(yán)重程度(PASI評分值)無直線相關(guān)關(guān)系(r=-0.048 P=0.799 P0.05);尋常型銀屑病患者血清中IL-22的表達(dá)水平高于正常對照組(u=-1.727 P=0.042 P0.05),差異有統(tǒng)計(jì)學(xué)意義;靜止期組高于進(jìn)展期組(u=-0.049 P=0.480 P0.05),但差異無統(tǒng)計(jì)學(xué)意義,血清中IL-22的表達(dá)水平與臨床皮疹和嚴(yán)重程度(PASI評分值)無直線相關(guān)關(guān)系(r=-0.149 P=0.442 P0.05)。 結(jié)論: 1尋常型銀屑病患者血清中IL-17、IL-22的表達(dá)水平高于正常對照組,證實(shí)了IL-17、IL-22的表達(dá)與尋常型銀屑病的發(fā)病機(jī)制密切相關(guān),同時(shí)間接反映了Th17細(xì)胞在尋常型銀屑病的發(fā)病中具有重要作用。 2尋常型銀屑病血清中IL-17的表達(dá)水平在進(jìn)展期組高于靜止期組,說明IL-17在銀屑病皮疹炎癥進(jìn)展過程中起主要作用,可能與其作為前炎癥介質(zhì)主要在炎癥的進(jìn)展期發(fā)揮重要的功能有關(guān)。 3尋常型銀屑病血清中IL-17、IL-22的表達(dá)水平與銀屑病病情的皮疹面積與嚴(yán)重程度PASI評分值無相關(guān)性關(guān)系,說明IL-17、IL-22的表達(dá)水平與銀屑病皮損的面積及嚴(yán)重程度無明確關(guān)聯(lián),不能反映疾病的嚴(yán)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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R758.63
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