背景:对T辅助细胞(Th)17和远离T调节细胞(T-regs)的反应倾斜已被认为部分参与了自身免疫性疾病,如白癜风。
目的:通过组织测量明确Th17和T-regs在白癜风中的可能作用和关系,白细胞介素(IL)-17,IL-22和叉头盒P3的全身水平。
方法:84例非节段性白癜风患者和80例对照。白癜风地区评分指数,确定白癜风疾病活动和应激评分。皮肤活检进行IL-17,IL-22和FoxP3的免疫组织化学染色,并通过ELISA和实时定量PCR确定其全身水平。
结果:ve免疫染色的平均面积百分比以及IL-17(34.12±5.12,23.62±8.17pg/mL)和IL-22(48.63±19.23,43.53±11.95pg/mL)的血清水平明显高于对照组(15.33±4.19,12.83±3.29pg/mL)(13.44±3.82,9.92±4.7)。与对照组(7.12±0.18,1.48±0.49)相比,患者的+ve免疫染色的平均面积%和FoxP3的外周血水平显著降低(2.67±0.54,0.574±0.32)(P<0.001)。在患者中,IL-17与IL-22呈正相关(r=0.671,P<0.001),均与FoxP3呈负相关(r=-0.548,P<0.001),(r=-0.382,P<0.001)。VASI,VIDA和应激评分与IL-17、IL-22呈正相关,与FoxP3呈负相关。
结论:Th17和T-reg在白癜风的复杂性中交织在一起,通过控制它们之间微妙的平衡的辅助治疗给了治疗的希望。
BACKGROUND: Skewing of responses towards T helper (Th) 17 and away from T regulatory cells (T-regs) has been suggested to be partially involved in autoimmune diseases like vitiligo.
OBJECTIVE: Clarify the possible role and relationship between Th17 and T-regs in vitiligo by measuring tissue, systemic levels of interleukin (IL)-17, IL-22 and Forkhead box P3.
METHODS: 84 non-segmental vitiligo patients and 80 controls were included. Vitiligo Area Scoring Index, Vitiligo Disease Activity and stress score were determined. Skin biopsies underwent immunohistochemical staining for IL-17, IL-22 and FoxP3 and their systemic levels were determined by ELISA and quantitative real time PCR.
RESULTS: Mean area % of +ve immunostaining and serum levels of IL-17 (34.12 ± 5.12, 23.62 ± 8.17 pg/mL) and IL-22 (48.63 ± 19.23, 43.53 ± 11.95 pg/mL) were significantly higher in patients compared to controls (15.33 ± 4.19, 12.83 ± 3.29 pg/mL) (13.44 ± 3.82, 9.92 ± 4.7 pg/mL) (P<0.001). Mean area % of +ve immunostaining and peripheral blood levels of FoxP3 were significantly lower in patients (2.67 ± 0.54, 0.574 ± 0.32) compared to controls (7.12 ± 0.18, 1.48 ± 0.49) (P<0.001). In patients, a positive correlation between IL-17 and IL-22 was detected (r = 0.671, P<0.001), each showing negative correlation with FoxP3 (r = -0.548, P<0.001), (r = -0.382, P<0.001). VASI, VIDA and stress score correlated positively with IL-17, IL-22 and negatively with FoxP3.
CONCLUSIONS: Th17 and T-regs are intertwined in the complexity of vitiligo giving hope of treatment through adjuvant therapies controlling the delicate balance between them.