目的:研究苏金单抗治疗银屑病对患者血清不同功能细胞因子和炎症介质的影响。方法:采用酶联免疫吸附法检测与固有免疫相关的白细胞介素(IL)-1β和IL-1RA;与中性粒细胞相关的IL-6,IL-18和生长调节癌基因α(GROα);IL-12,坏死因子(TNF)-α,和干扰素(IFN)-γ相关的Th1;IL-23,IL-17A,和IL-22与Th17相关;胸腺激活调节趋化因子(TARC),IL-13和防御素β2(DEFB2)与Th2相关;血管内皮生长因子(VEGF)-A和IL-10与血管生成相关;IFN-γ与12例接受苏金单抗治疗的普通银屑病患者和15例健康对照的外周血中败血症相关。IL-23,IL-17A,IL-22与Th17;TARC,IL-13,DEFB2与Th2相关;VEGF-A,与血管生成相关的IL-10和与脓毒症相关的降钙素原(PCT)。上述细胞因子在治疗前后的表达差异及其与银屑病病情严重程度的相关性[银屑病面积严重程度指数(PASI)评分],年龄,并对病程进行分析。
结果:纳入的中重度银屑病患者治疗前平均PASI评分为21.6±11.0,治疗后降低至1以下。血清IL-6;IL-18,GROα,IFN-γ,TNF-α,VEGF-A,IL-17A明显高于正常水平。IL-17A和IFN-γ与病程、年龄呈正相关,IL-18与PASI评分呈正相关。IL-6,GROα的表达水平,VEGF-A,IFN-γ,TNF-α,与治疗前相比,苏金单抗治疗后IL-17A和IL-23显著降低,但IFN-γ的表达水平,VEGF-A,TARC,结论:苏金单抗通过拮抗IL-17A,同时降低IL-6、GROα、VEGF-A,IFN-γ,TNF-α,IL-17A,IL-23
OBJECTIVE: To investigate the effects of secukinumab treatment for psoriasis on different functional cytokines and inflammatory mediators in patients\' serum METHODS: Enzyme-linked immunosorbent assay was used to detect interleukin (IL)-1β and IL-1RA associated with intrinsic immunity; IL-6, IL-18, and growth regulated oncogene alpha (GROα) associated with neutrophils; IL-12, tumour necrosis factor (TNF)-α, and interferon (IFN)-γ associated with Th1; IL-23, IL-17A, and IL-22 associated with Th17; Thymus activation regulated chemokine (TARC), IL-13, and defensin beta 2 (DEFB2) associated with Th2; Vascular endothelial growth factor (VEGF)-A and IL-10 associated with angiogenesis; and IFN-γ associated with sepsis in the peripheral blood of 12 patients with common psoriasis treated with secukinumab and 15 healthy controls. IL-23, IL-17A, IL-22 associated with Th17; TARC, IL-13, DEFB2 associated with Th2; VEGF-A, IL-10 associated with angiogenesis and procalcitonin (PCT) associated with sepsis. The differences in expression of the above cytokines before and after treatment and the correlation with psoriasis disease severity[Psoriasis Area Severity Index(PASI) score], age, and disease duration were analyzed.
RESULTS: The mean PASI score of the enrolled patients with moderate to severe psoriasis was 21.6 ± 11.0 before treatment and decreased to below 1 after treatment. Serum IL-6; IL-18, GROα, IFN-γ, TNF-α, VEGF-A, and IL-17A were significantly higher than normal. And IL-17A and IFN-γ were positively correlated with disease duration and age, and IL-18 was positively correlated with PASI score. The expression levels of IL-6, GROα, VEGF-A, IFN-γ, TNF-α, IL-17A and IL-23 were significantly lower after secukinumab treatment compared with those before treatment, but the expression levels of IFN-γ, VEGF-A, TARC, IL-13, and DEFB2 were still significantly higher than those of normal subjects after treatment CONCLUSIONS: secukinumab clears skin lesions by antagonizing IL-17A and simultaneously decreasing the expression levels of IL-6, GRO α, VEGF-A, IFN-γ, TNF-α, IL-17A, and IL-23.