| 卫建明,李 渝,张 丽,王 蕊,陈 璐,赵娇娇,李 佳.阿达木单抗治疗重度银屑病的临床疗效及对外周血Th1/Th2平衡和单核细胞p38MAPK/NF-κB信号通路的影响[J].,2023,(2):299-302 |
| 阿达木单抗治疗重度银屑病的临床疗效及对外周血Th1/Th2平衡和单核细胞p38MAPK/NF-κB信号通路的影响 |
| Clinical Efficacy of Adalimumab in the Treatment of Severe Psoriasis and its Effect on Peripheral Blood Th1/Th2 Balance and Monocyte p38MAPK/NF-κB Signaling Pathway |
| 投稿时间：2022-06-23 修订日期：2022-07-19 |
| DOI：10.13241/j.cnki.pmb.2023.02.018 |
| 中文关键词: 阿达木单抗 重度银屑病 临床疗效 Th1/Th2平衡 单核细胞p38MAPK/NF-κB信号通路 |
| 英文关键词: Adalimumab Severe psoriasis Clinical efficacy Th1/Th2 balance Monocyte p38MAPK/NF-κB signaling pathway |
| 基金项目:国家自然科学基金项目（31671413） |
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| 中文摘要: |
| 摘要 目的：观察阿达木单抗治疗重度银屑病的临床疗效及对外周血Th1/Th2平衡和单核细胞p38丝裂原活化蛋白激酶（MAPK）/核转录因子κB（NF-κB）信号通路的影响。方法：选择解放军总医院第五医学中心2019年3月-2022年3月期间收治的118例重度银屑病患者，根据随机数字表法分为对照组（常规治疗，59例）和研究组（对照组的基础上结合阿达木单抗治疗，59例）。观察两组疗效、症状评分变化、外周血Th1/Th2平衡和单核细胞p38MAPK/NF-κB信号通路的变化，记录两组不良反应发生情况。结果：研究组的临床总有效率高于对照组（P<0.05）。研究组治疗后的Th1、白细胞介素-2（IL-2）、γ-干扰素（IFN-γ）低于对照组，白细胞介素-4（IL-4）、白细胞介素-10（IL-10）、Th2高于对照组（P<0.05）。研究组治疗后的p38MAPK、NF-κB蛋白表达水平低于对照组（P<0.05）。研究组治疗后的银屑病皮损面积及严重程度指数（PASI）评分低于对照组（P<0.05）。两组不良反应发生率组间比较，差异不显著（P>0.05）。结论：阿达木单抗治疗重度银屑病的疗效较好，可能与调节外周血Th1/Th2平衡和单核细胞p38MAPK/NF-κB信号通路有关，且不增加不良反应发生率，具有较好的安全性。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the clinical efficacy of adalimumab in the treatment of severe psoriasis and its effect on peripheral blood Th1/Th2 balance and monocyte P38 mitogen-activated protein kinase (MAPK)/nuclear transcription factor κB (NF-κB) signaling pathway. Methods: 118 patients with severe psoriasis who were treated in the fifth medical center of PLA general hospital from March 2019 to March 2022 were selected, and they were divided into control group (routine treatment, 59 cases) and study group (adalimumab on the basis of the control group treatment, 59 cases) according to random number table method. The efficacy, symptom score changes, peripheral blood Th1/Th2 balance and monocyte p38MAPK/NF-κB signaling pathwayway changes were observed in the two groups, the incidence of adverse reactions in the two groups was recorded. Results: The total clinical effective rate in the study group was higher than that in the control group (P<0.05). After treatment, Th1, interleukin-2 (IL-2) and interferon-γ (IFN-γ) in the study group were lower than those in the control group, while interleukin-4(IL-4), interleukin-10(IL-10) and Th2 were higher than those in the control group(P<0.05). The expression levels of p38MAPK and NF-κB protein in the study group after treatment were lower than those in the control group(P<0.05). The psoriasis area and severity index(PASI) score in the study group was lower than that in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Adalimumab has a good efficacy in the treatment of severe psoriasis, which may be related to the regulation of peripheral blood Th1/Th2 balance and monocyte p38MAPK/NF-κB signaling pathway, without increasing the incidence of adverse reactions, and which has a good safety. |
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