| 周 迪,侯晓阳,刘艳芳,季慧琳,魏志平.外周血Th1/Th2比值、IL-23/Th17轴与中重度斑块状银屑病患者颈动脉粥样硬化和临床疗效的关系[J].,2023,(21):4147-4151 |
| 外周血Th1/Th2比值、IL-23/Th17轴与中重度斑块状银屑病患者颈动脉粥样硬化和临床疗效的关系 |
| Relationship between Peripheral Blood Th1/Th2 Ratio and IL-23/Th17 Axis with Carotid Atherosclerosis and Clinical Efficacy in Patients with Moderate to Severe Plaque Psoriasis |
| 投稿时间：2023-05-16 修订日期：2023-06-12 |
| DOI：10.13241/j.cnki.pmb.2023.21.028 |
| 中文关键词: 斑块状银屑病 辅助T细胞1/辅助T细胞2 白介素-23/辅助T细胞17 颈动脉粥样硬化 疗效 |
| 英文关键词: Plaque psoriasis Helper T cell 1/Helper T cell 2 Interleukin-23/Helper T cell 17 Carotid atherosclerosis Efficacy |
| 基金项目:江苏省研究生科研创新课题（KYCX17＿1715） |
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| 中文摘要: |
| 摘要 目的：探讨外周血辅助T细胞（Th）1/Th2比值、白介素（IL）-23/Th17轴与中重度斑块状银屑病（PP）患者颈动脉粥样硬化和临床疗效的关系。方法：选取2021年1月～2022年1月徐州医科大学附属医院收治的97例中重度PP患者为中重度PP组，根据颈动脉内中膜厚度（CIMT）分为增厚组39例和正常组58例，根据甲氨蝶呤（MTX）治疗是否应答有效分为无应答组和应答组，另选取同期50例体检健康志愿者为对照组。采用流式细胞术检测外周血Th1、Th2百分比和Th1/Th2比值，酶联免疫吸附法检测外周血IL-23、IL-17A水平。采用Pearson相关性分析中重度PP患者外周血Th1、Th2、Th1/Th2比值和IL-23/Th17轴相关因子与CIMT的相关性，多因素Logistic回归分析中重度PP患者MTX治疗无应答的影响因素。结果：与对照组比较，中重度PP组外周血Th1、Th1/Th2比值、IL-23和IL-17A水平升高，Th2比例降低（P均＜0.001）。97例中重度PP患者颈动脉粥样硬化发生率为40.21%（39/97）。与正常组比较，增厚组外周血Th1、Th1/Th2比值、IL-23和IL-17A水平升高，Th2比例降低（P均＜0.001）。Pearson相关性分析显示，中重度PP患者外周血Th1、Th1/Th2比值、IL-23、IL-17A与CIMT呈正相关，Th2与CIMT呈负相关（r=0.695、0.706、0.688、0.650、-0.639，P均＜0.001）。97例中重度PP患者MTX治疗无应答率为21.65%（21/97）。多因素Logistic回归分析显示，重度PP和Th1、Th1/Th2比值、IL-23、IL-17A升高为中重度PP患者MTX治疗无应答的独立危险因素，Th2升高为独立保护因素（P均＜0.05）。结论：中重度PP患者外周血Th1/Th2比值和IL-23/Th17轴相关因子升高，与颈动脉粥样硬化和MTX治疗无应答有关，可能成为中重度PP患者颈动脉粥样硬化和临床疗效评估指标。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between peripheral blood helper T cell (Th)1/Th2 ratio and interleukin (IL)-23/Th17 axis with carotid atherosclerosis and clinical efficacy in patients with moderate to severe plaque psoriasis (PP). Methods: 97 patients with moderate to severe PP who were admitted to Xuzhou Medical University Affiliated Hospital from January 2021 to January 2022 were selected as the moderate to severe PP group, the patients were divided into 39 cases in thickening group and 58 cases in normal group according to the carotid intima media thickness (CIMT), and they were divided into non responsive group and responsive group according to whether methotrexate (MTX) treatment was effective in response, another 50 healthy volunteers who underwent physical examinations during the same period were selected as control group. Peripheral blood Th1, Th2 percentage and Th1/Th2 ratio were measured by flow cytometry, and peripheral blood IL-23 and IL-17A levels were measured by enzyme linked immunosorbent assay. The correlation between peripheral blood Th1, Th2, Th1/Th2 ratio and IL-23/Th17 axis related factors and CIMT in patients with moderate to severe PP were analyzed by Pearson correlation, the influencing factors of MTX treatment non response in patients with moderate to severe PP were analyzed by multivariate Logistic regression. Results: Compared with control group, the peripheral blood Th1, Th1/Th2 ratio, IL-23 and IL-17A levels in the moderate to severe PP group increased, while the Th2 ratio decreased (all P<0.001). The incidence of carotid atherosclerosis was 40.21% (39/97) in 97 patients with moderate to severe PP. Compared with normal group, the peripheral blood Th1, Th1/Th2 ratio, IL-23 and IL-17A levels in the thickening group increased, while the Th2 ratio decreased (P<0.001). Pearson correlation analysis showed that, the peripheral blood Th1, Th1/Th2 ratio, IL-23 and IL-17A were positively correlated with CIMT in patients with moderate to severe PP, the Th2 was negatively correlated with CIMT (r=0.695, 0.706, 0.688, 0.650, -0.639, all P<0.001). The non response rate of MTX treatment was 21.65% in 97 patients with moderate to severe PP (21/97). Multifactorial Logistic regression analysis showed that, severe PP and Th 1, Th 1 / Th 2 ratio, IL-23 and IL-17A increased were independent risk factors for non response to MTX treatment in patients with moderate to severe PP, and increased Th2 was independent protective factor (all P<0.05). Conclusion: The peripheral blood Th1/Th2 ratio and IL-23/Th17 axis related factors in patients with moderate to severe PP increase, which is related to carotid atherosclerosis and no response to MTX treatment, which may become an index for evaluating carotid atherosclerosis and clinical efficacy in patients with moderate to severe PP. |
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