摘要
探讨他克莫司联合窄谱中波紫外线(NB-UVB)治疗成人特应性皮炎(AD)对血清白细胞介素-25(IL-25)、胸腺基质淋巴细胞生成素(TSLP)及其受体水平的影响。选取宁夏医科大学总医院皮肤科门诊2019年1月—2020年6月收治的48例成人AD患者为研究对象,设为AD组;选取同期入院健康体检者48例作为对照,设为对照组。AD组患者均接受他克莫司(选择0.1%他克莫司软膏,于AD部位外涂一薄层,每日2次)联合NB-UVB(NB-UVB照射,每周3次,持续3个月)治疗,于治疗前后采用欧洲AD评分系统(SCORAD)评估病情严重度,统计其临床治疗效果,采用视觉模拟评分(VAS)评估瘙痒程度,采用双抗体夹心酶联免疫吸附试验(ELISA)法检测2组血清IL-25、TSLP水平,采用反转录-聚合酶链反应(RT-PCR)法检测2组外周血单一核细胞(PBMC)IL-25RmRNA、TSLPRmRNA表达水平。分析血清IL-25、TSLP水平与SCORAD评分的相关性。结果显示:治疗3个月后AD组患者SCORAD积分、VAS评分均明显低于治疗前((10.58±3.26)分vs(64.37±10.14)分\,(3.61±2.02)分vs(8.65±1.20)分)(P<0.05)。48例AD患者均完成治疗,共治愈5例,显效16例,有效18例,无效9例,总有效率为81.25%。治疗前AD组血清IL-25、TSLP水平及IL-25RmRNA、TSLPRmRNA表达水平均明显高于对照组,治疗后上述指标水平均较治疗前显著下降(P<0.05);治疗后血清IL-25水平与对照组对比无统计学意义(P>0.05);治疗后TSLP水平、IL-25RmRNA、TSLPRmRNA表达水平仍明显高于对照组(P<0.05)。相关性分析显示治疗前AD组患者血清IL-25与TSLP水平呈正相关(r=0.53,P<0.01),血清IL-25、TSLP水平与SCORAD积分均呈正相关(r=0.30,P<0.05;r=0.58,P<0.01)。研究表明,IL-25、TSLP在成人AD患者外周血中表达升高,且与患者病情严重程度呈正相关;他克莫司联合NB-UVB下调IL-25、TSLP及其受体表达水平可能是其治疗AD的机制之一。
The purpose of this paper is to explore the effect of tacrolimus combined with narrow-band ultraviolet B(NB-UVB)in the treatment of adult atopic dermatitis(AD)on serum interleukin-25(IL-25)and thymic stromal lymph and cytopoietin(TSLP)and its receptor levels.48 adult AD patients admitted to the Dermatology Clinic of the General Hospital of Ningxia Medical University from January 2019 to June 2020 were selected as the research objects and set them as the AD group.48 patients who admitted to the hospital for physical examination during the same period were selected as the control group.All patients in the AD group received tacrolimus(apply a thin layer of 0.1%tacrolimus ointment on the AD site,2 times a day)combined with NB-UVB(NB-UVB irradiation,3 times a week,for 3 Month)treatment.Before and after treatment,the European AD scoring system(SCORAD)was used to evaluate the severity of the disease,the clinical treatment effects were counted,the visual analogue score(VAS)was used to evaluate the degree of itching.The double antibody sandwich enzyme-linked immunosorbent test(ELISA)was used to detect the serum IL-25 and TSLP levels of the two groups,and the expression levels of IL-25RmRNA and TSLPRmRNA in peripheral blood mononuclear cells(PBMC)of the two groups were detected by reverse transcription-polymerase chain reaction(RT-PCR)method.Then it analyzed the correlation between serum IL-25,TSLP levels and SCORAD score.The study results showed that after 3 months of treatment,the scores of SCORAD and VAS of AD group were significantly lower than those before treatment(10.58±3.26vs64.37±10.14 points;3.61±2.02vs8.65±1.20 points)(P<0.05).All 48 AD patients completed the treatment,among them 5 were cured,16 had markedly effective results,18 were effective treated,and 9 were ineffective.The total effective rate was 81.25%.Before treatment,serum IL-25,TSLP levels and IL-25RmRNA and TSLPRmRNA expression levels in AD group were significantly higher than those in control group.After treatment,the above indicators were significantly lower than before treatment(P<0.05).The serum IL-25 levels after treatment,compared with the control group,was no statistical significance(P>0.05).After treatment,the levels of TSLP,IL-25RmRNA,and TSLPRmRNA expression levels were still significantly higher than those of the control group(P<0.05).Correlation analysis showed that before treatment,serum IL-25 and TSLP levels of patients in AD group were positively correlated(r=0.53,P<0.01),and serum IL-25 and TSLP levels were positively correlated with SCORAD points(r=0.30,P<0.05;r=0.58,P<0.01).It indicated that IL-25 and TSLP expression are elevated in the peripheral blood of adult AD patients,and are positively correlated with the severity of the patients'condition.Tacrolimus combined with NB-UVB could lower down the expression levels of IL-25,TSLP and their receptors,it may be one of the mechanisms of AD treatment.
作者
于英瑶
夏莉
王媛
李可心
尚元元
YU Yingyao;XIA Li;WANG Yuan;LI Kexin;SHANG Yuanyuan(General Hospital of Ningxia Medical University,Yinchuan 750004,China)
出处
《甘肃科学学报》
2022年第2期56-60,78,共6页
Journal of Gansu Sciences
作者简介
于英瑶(1982-),女,辽宁宽甸人,硕士研究生,主治医师,研究方向为皮肤免疫,E-mail:18161588828@163.com;通信作者:尚元元,E-mail:18161588828@163.com。
