Studies On The Cytokine Expression In Lesions And PBMCs From Patients Of Psoriasis Vulgaris And The Association Between The Cytokine Expression And Clinical Efficacy

Psoriasis is a common chronic, relapsing and inflammatory disease and its pathogenesis is still unknown. It is considered that it is one kind of genetic and immunological disease controlled by multiple genes. Even though the exact pathogenesis is still unknown, many studies showed that T cells mediated immune response played a very important role in the pathogenesis of psoriasis. Objective: Our purpose was to investigate the pathogenic effects of Th1/Th2 cytokine and proinflammatory cytokine profile in psoriasis vulgaris and study the association between the expression of Th1/Th2 cytokines and proinflammatory cytokines and the effects of Chinese medicine plus UVA therapy. Methods: The PBMCs and the lesions,the lesions-free,normal skin were taken from 37 patients with psoriasis vulgaris and 30 normal controls. In each case, 6 mm punch biopsies and PBMCs were obtained from lesional skin and blood before and after 30 days of treatment with Chinese plus UVA, respectively.Total RNA was extracted from the lesions,the lesions-free,normal skin and PBMCs by Triozl kit. The expression of IL-1β,IL-2,IL-4,IL-6,IL-8,IL-10,IFN-γ,TNF-αmRNA was detected by using RT-PCR technique. Results: Thirty-two of thirty-seven were responded well to Chinese medicine plus UVA. Compared with nonlesional skin and normal skin, the mRNA expression of IL-2,IFN-γ,IL-8,TNF-αin the lesions of patients with psoriasis vulgaris was significantly increased (P<0.01). However, the mRNA expression of IL-1β,IL-6,IL-4,IL-10 in lesions was not significantly different compared with nonlesional skin and normal skin (P>0.05). The expression of IL-8,IFN-γ,TNF-αmRNA in PBMCs from psoriasis vulgaris patients was obviously higher than that from the healthy controls (P<0.01). However, compared with PBMCs from the healthy controls, the expression of IL-2,IL-1β,IL-4,IL-6,IL-10 mRNA in PBMCs from psoriatic patients was not significantly different (P>0.05). 3. After 30 days of treatment with Chinese medicine plus UVA, the expression of IL-8,IFN-γ,TNF-α mRNA in lesions was significantly decreased (p<0.05). The expression of IL-4 mRNA in lesions was elevated compared with pretreatment lesions (p<0.01). However, the expression of IL-1β,IL-2,IL-6,IL-10 mRNA was not significantly different between them (p>0.05). The expression of IL-8,IFN-γ,TNF-α mRNA in PBMCs from patients was downregulated after Chinese medicine plus UVA therapy (p<0.01 or 0.05). The mRNA expression of IL-1β,IL-2,IL-4,IL-6,IL-10 in PBMCs was no significant difference before and after treatment (p>0.05). Conclusion: Chinese medicine plus UVA was proved to be effective in the treatment of psoriasis vulgaris. The Th1-type cytokine IL-2,IFN-γ and proinflamatory IL-8,TNF-α expression in lesions or PBMCs from psoriasis vulgaris patients is upregulated, which might take an important role in the occurrence and progression of psoriasis vulgaris. But the Th2-type cytokine IL-4 expression in posttreatment lesions is upregulated, compared to pretreatment lesions, which might have certain role in the regression of psoriasis vulgaris.