桐油联合阿维A酸对银屑病的疗效及其对IL-23/Th17信号通路的影响

Effect of Tung Oil Combined with Acitretin on Psoriasis Vulgaris and Its Effect on IL-23/Th17 Signaling Pathway

关键词:  桐油  阿维A酸  寻常型银屑病  IL-23/Th17信号通路

Key words:  Tung oil  acitretin  psoriasis vulgaris  IL-23/Th17 signaling pathway

摘要:

目的 观察桐油联合阿维A酸对轻、中度寻常型银屑病的疗效及其对IL-23/Th17信号通路的影响。方法 将196例寻常型银屑病患者随机分为桐油组及对照组，每组98例，对照组患者均给予阿维A酸联合窄谱中波紫外线（NB-UVB）治疗，桐油组患者在对照组治疗基础上给予桐油外敷。以银屑病皮损面积和严重程度指数（psoriasis area and severity index，PASI）评价桐油组及对照组疗效。酶联免疫吸附试验法（ELISA）检测治疗前后2组皮损组织中IL-17、IL-22、TNF-α和IL-23水平变化。免疫组织化学法分析治疗前后2组皮损组织中Th17细胞含量变化。结果 桐油组的总有效率（94.90%）显著高于对照组（76.53%）（P<0.05）。与治疗前相比，治疗后2组PASI评分均显著降低（P<0.01），且治疗后桐油组显著低于对照组（P<0.05）。与治疗前相比，治疗后2组皮损中IL-23、IL-17、IL-22和TNF-α水平均显著降低（P<0.05），且治疗后桐油组显著低于对照组（P<0.05）。治疗后2组患者皮损组织中Th17细胞百分比显著低于治疗前，且桐油组显著低于对照组（P<0.05）。桐油组不良反应发生率（14.29%）略高低于对照组（10.20%），但差异不具有统计学意义。结论 桐油外敷联合阿维A酸治疗轻、中度寻常型银屑病有较好的疗效，其机制可能与抑制患者皮损组织中IL-23/Th17信号通路的活性有关。

Abstract:

OBJECTIVE To observe the effect of Tung oil combined with acitretin on mild to moderate psoriasis vulgaris and its effect on IL-23/Th17 signaling pathway. METHODS One hundred and ninety six patients with psoriasis vulgaris were randomly divided into tung oil group(n=98) and control group(n=98). The control group were treated with acitretin combined with narrow-band UVB (NB-UVB) treatment. The patients of tung oil group were given a topical application of Tung oil on the basis of the control group. The efficacy of the tung oil group and the control group was evaluated by the psoriasis area and severity index(PASI). The levels of IL-17, IL-22, TNF-α and IL-23 in the lesions of the two groups before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry was used to analyze the changes of Th17 cell in the lesions of the two groups before and after treatment. RESULTS The total effective rate of the tung oil group (94.90%) was significantly higher than that of the control group (76.53%), and the difference was statistically significant (P<0.05). Compared with before treatment, the PASI scores of the two groups were significantly lower after treatment(P<0.01). And the PASI score of the tung oil group was significantly lower than that of the control group (P<0.05). Compared with before treatment, the levels of IL-23, IL-17, IL-22 and TNF-α in the lesions of the two groups were significantly lower after treatment(P<0.05), and the tung oil group were significantly lower than those in the control group after treatment(P<0.05). The percentage of Th17 cells in the lesions of the two groups was significantly lower than that before treatment, and the tung oil group was significantly lower than that in the control group (P<0.05). The incidence of adverse reactions in the tung oil group (14.29%) was slightly higher than that in the control group (10.20%), but the difference was not statistically significant. CONCLUSION Tung oil external application combined with acitretin has a good curative effect on mild to moderate psoriasis vulgaris. The mechanism may be related to the inhibition of IL-23/Th17 signaling pathway activity in skin lesions.