中华皮肤科杂志 ›› 2015, Vol. 48 ›› Issue (6): 378-381.

• 论著 • 上一篇    下一篇

窄谱中波紫外线联合干扰素治疗蕈样肉芽肿疗效及其与Treg/Th17细胞相关性研究

侯秀丽1,王平1,黎钊2,聂慧琼1,刘东银3   

  1. 1. 安徽医科大学附属杭州临床学院（杭州市第三人民医院）
    2. 浙江中医药大学附属杭州第三医院
    3. 杭州市第三人民医院
  • 收稿日期:2014-07-14 修回日期:2015-01-13 出版日期:2015-06-15 发布日期:2015-06-03
  • 通讯作者: 王平 E-mail:dermwang@aliyun.com
  • 基金资助:

    浙江省医药卫生科技计划项目

Effect of Treg /Th17cells in the Peripheral Blood of Patients with Mycosis Fungoides on the Therapeutic Response

  • Received:2014-07-14 Revised:2015-01-13 Online:2015-06-15 Published:2015-06-03

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摘要：

目的 观察窄谱中波紫外线（NB-UVB）单独或联合干扰素治疗覃样肉芽肿（MF）的疗效，探讨外周血调节性T（Treg）细胞和辅助性T细胞17（Th17）细胞与疗效的相关性。 方法 33例ⅠA期-ⅡA期MF患者按照治疗方法分为两组，分别应用NB-UVB单独照射（照射组）和NB-UVB照射联合重组人干扰素（INF）-α-2b肌内注射（联合组）治疗。于治疗前和治疗9个月后分别采集患者外周血，流式细胞仪检测Treg细胞和Th17细胞百分率。以10例健康人外周血为对照组（健康对照组）。 结果 平均治疗时间9个月，照射组15例中，完全缓解6例，部分缓解3例，无效6例，联合组18例中，完全缓解12例，部分缓解5例，无效1例，联合治疗效果显著优于单独治疗（P = 0.023）。治疗前两组患者外周血 Treg和Th17细胞百分率均明显高于健康人（均P < 0.05），两患者组间差异无统计学意义（P > 0.05）；治疗后两患者组Treg和Th17细胞百分率均显著下降，但仍高于健康对照组（均P < 0.05）。联合组Treg和Th17细胞降幅均大于照射组（均P < 0.05）。7例治疗无效患者治疗后外周血Treg细胞较治疗前亦有降低（P < 0.05），Th17细胞无显著下降（P > 0.05）。 结论 NB-UVB照射联合INF-α-2b肌内注射治疗MF临床疗效优于单独使用NB-UVB，疗效可能与外周血Treg和Th17细胞降幅有关。

Abstract:

Hou Xiuli *, Wang Ping, Li Zhao, Nie Huiqiong, Liu Dongyin. *Department of Dermatology, Hangzhou Clinical College Affiliated to Anhui Medical University, Hangzhou 310009, China Corresponding author: Wang Ping, Email: dermwang@aliyun.com 【Abstract】 Objective To evaluate the therapeutic effect of narrow band-ultraviolet B （NB-UVB） alone or in combination with interferon-alpha-2b （INF-alpha-2b） for mycosis fungoides （MF）, and to assess the correlation between the therapeutic effect and peripheral blood regulatory T （Treg）/T helper type 17 （Th17） cells. Methods Thirty-three patients with stage IA to IIA MF were randomly divided into two groups: NB-UVB group （n = 15） receiving NB-UVB radiation alone, combined group （n = 18） treated with NB-UVB radiation and intramuscular injection of INF-alpha-2b. Ten healthy volunteers were selected as the control group. Peripheral blood samples were collected before and 9 months after the start of treatment. Flow cytometry was performed to determine the percentages of Treg cells and Th17 cells. Statistical analysis was carried out by using t test, one-way analysis of variance, and Fisher′s exact test. Results The average treatment duration was 9 months among these patients. Therapeutic outcomes were significantly better in the combined group than in the NB-UVB group （P = 0.023）. Among the 15 patients in the NB-UVB group, 6 achieved complete remission, 3 partial remission, 6 showed no response; of the 18 patients in the combined group, 12 experienced complete remission, 5 partial remission, and 1 showed no response. Before the treatment, the percentages of both Treg and Th17 cells in peripheral blood were significantly higher in the NB-UVB group and combined group than in the control group （both P < 0.05）, but similar between the NB-UVB group and combined group （both P > 0.05）. After the treatment, the percentages of both Treg and Th17 cells in the NB-UVB group and combined group significantly decreased compared with those before the treatment, but were still higher than those in the control group （both P < 0.05）. Additionally, the degree of decrease in the percentages of Treg and Th17 cells was significantly greater in the combined group than in the NB-UVB group （both P < 0.05）. The seven patients with no response also showed a significant decrease in the percentage of Treg cells （P < 0.05）, but no obvious changes in that of Th17 cells （P > 0.05） after the treatment. Conclusions The therapeutic effect of NB-UVB radiation combined with intramuscular INF-alpha-2b is superior to that of NB-UVB radiation alone for MF, which may be associated with the degree of decrease in peripheral blood Treg and Th17 cells.