【作者】 阎衡； 叶庆佾； 郝飞； 麦跃； 钟白玉； 向明明； 施宗萍；

【Author】 YAN Heng, YE Qing-yi, HAO Fei et al. Department of Dermatology, Southwest Hospital, Third Military Medical University, Chongqing 400038

【机构】 第三军医大学西南医院皮肤科；

【摘要】 目的 研究银屑病的Th1/Th2反应模式,并观察CTLA₄Ig在诱导银屑病Th1/Th2漂移中的作用。 方法 标本取自33例寻常型银屑病患者和20名健康献血者,利用植物血凝素（PHA）和金葡菌肠毒素B（SEB）单独及CTLA₄Ig协同作用下刺激外周血单个核细胞（PBMC）增殖,通过ELISA法检测PBMC培养上清中IL-2、IFN-γ和IL-4水平。 结果 SEB显著促进银屑病组3种细胞因子的分泌（P<0.01）;进行期IFN-γ/IL-4的比值明显高于静止期（P<0.01）。CTLA₄Ig可以抑制IL-2、IFN-γ的分泌,并呈剂量依赖关系;而IL-4相对于IL-2及IFN-γ分泌是增强的;当CTLA₄Ig浓度达到10μg/ml时,3种细胞因子的分泌均明显被抑制。 结论 银屑病属于TH1类反应模式:CTLA₄Ig可以下调Th1类细胞因子,上调Th2类细胞因子,提示CTLA4Ig具有诱导银屑病的Th1/Th2失衡向Th2漂移的作用。更多还原

【Abstract】 Objective To investigate the Th1/Th2 pattern in psoriasis and to study the effects of CTLA4Ig on Th1/ Th2 shift in psoriasis. Methods The levels of IL-2, IFN- Y and IL-4 secretion in the supernatant of the cultured peripheral blood mononuclear cells (PBMC) from 33 patients with psoriasis vulgaris and 20 healthy blood donors were assessed by ELISA respectively. Cytokine synthesis was induced by activation with phytohemagglutinin (PHA) and staphylococcal enterotoxin B (SEB) with or without CTLA4Ig. Results IL-2, IFN- γ and IL-4 were secreted at markedly increased levels by PBMCs from psoriatic patients on incubation with SEB (p<0.01); The ratio of IFN-γ/IL-4 was significantly higher in active stage than in static stage (p<0.01).CTLA4Ig inhibited the secretion of IL-2 and IFN- γ in a dose-dependent manner; Comparing to IL-2 and IFN- γ , IL-4 production was relatively enhanced; The secretion of three cytokines was significantly suppressed when the dose of CTLA4Ig reched to 10μg/ml. Conclusion The Th1/Th2 pattern of psoriasis belongs to Thl type.CTLA4Ig could down-regulate the Th1 cytokines and up-regulate the Th2 cytokines, which indicate that CTLA4Ig could swith T cell responses of psoriasis from Th2 to Th1.更多还原