中华皮肤科杂志 ›› 2017, Vol. 50 ›› Issue (12): 889-893.doi: 10.3760/cma.j.issn.0412-4030.2017.12.007

• 论著 • 上一篇    下一篇

维生素D受体基因多态性与寻常性银屑病易感性及卡泊三醇疗效的相关性

刘军麟    曾慧明    林岷格    鞠梅    吴智明    李梅娇    李毓阳    殷梅   

  1. 570311 海口,海南医学院第二附属医院皮肤性病科(刘军麟),检验科(吴智明),体检中心(殷梅);海南医学院第一附属医院皮肤性病科(曾慧明、林岷格);中国医学科学院北京协和医学院  皮肤病研究所理疗科(鞠梅);海南省中医院皮肤性病科(李梅娇);海南省第三人民医院皮肤性病科(李毓阳)
  • 收稿日期:2017-05-31 修回日期:2017-08-27 出版日期:2017-12-15 发布日期:2017-11-30
  • 通讯作者: 刘军麟 E-mail:liujunlin0759@163.com
  • 基金资助:
    海南省自然科学基金

Association of vitamin D receptor polymorphisms with susceptibility to psoriasis vulgaris and clinical response to calcipotriol in patients with psoriasis vulgaris

Jun-Lin LIU 2, 2, 3,LI Mei-Jiao4, 4, 3   

  • Received:2017-05-31 Revised:2017-08-27 Online:2017-12-15 Published:2017-11-30
  • Contact: Jun-Lin LIU E-mail:liujunlin0759@163.com
  • Supported by:
    Natural Science Foundation of Hainan Province of China

摘要: 目的 探讨维生素D受体(VDR)基因多态性与寻常性银屑病易感性及卡泊三醇软膏疗效的关系。方法 收集110例寻常性银屑病患者与183例健康对照,均为海南籍汉族人,采用连接酶检测反应对受试者rs2228570、rs731236、rs1544410及rs7975232位点基因分型,进行基于单核苷酸多态性和单倍型的病例-对照联分析。75例银屑病面积和严重程度指数(PASI) < 10的患者单用卡泊三醇软膏治疗,6周后评估其疗效,并与个体的基因型进行关联分析。结果 银屑病组rs7975232位点等位基因A的频率为39.09%,对照组为27.05%,携带该等位基因的个体患病风险高于非携带者(OR = 1.731,95% CI: 1.213 ~ 2.471,P < 0.05);AA基因型与AC基因型个体患病风险高于CC基因型个体(分别为OR = 2.404,95% CI:1.085 ~ 5.328,P < 0.05;OR = 2.143,95% CI:1.283 ~ 3.579,P < 0.05)。携带CTGA(分别对应 rs2228570、rs731236、rs1544410、rs7975232位点)单倍体的个体患病风险高于非携带者(OR = 1.907,95% CI:1.132 ~ 3.214,P < 0.05)。在72例PASI < 10的轻、中度银屑病患者中,卡泊三醇对rs7975232位点为CC基因型患者的疗效好于AC基因型患者(OR = 3.798,95% CI: 1.061 ~ 13.590,P < 0.05)和AA基因型患者(OR = 9.667,95% CI: 1.556 ~ 60.040,P < 0.05)。结论 寻常性银屑病患病风险及卡泊三醇疗效差异与维生素D受体基因多态性相关。

Abstract: Liu Junlin, Zeng Huiming, Lin Min′ge, Ju Mei, Wu Zhiming, Li Meijiao, Li Yuyang, Yin Mei Department of Dermatology and Venereology, The Second Affiliated Hospital of Hainan Medical University, Haikou 570311, China(Liu JL); Clinical Laboratory, The Second Affiliated Hospital of Hainan Medical University, Haikou 570311, China(Wu ZM); Health Examination Center, The Second Affiliated Hospital of Hainan Medical University, Haikou 570311, China(Yin M); Department of Dermatology and Venereology, The First Affiliated Hospital of Hainan Medical University, Haikou 570102, China(Zeng HM, Lin MG); Department of Physical Therapy, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China (Ju M); Department of Dermatology and Venereology, Chinese Medicine Hospital of Hainan Province, Haikou 570203, China(Li MJ); Department of Dermatology and Venereology, The Third People′s Hospital of Hainan Province, Sanya 572000, China(Li YY) Corresponding author: Liu Junlin, Email: liujunlin0759@163.com 【Abstract】 Objective To investigate association of vitamin D receptor (VDR) polymorphisms with susceptibility to psoriasis vulgaris and clinical response to calcipotriol in patients with psoriasis vulgaris. Methods A total of 110 patients with psoriasis vulgaris and 183 healthy controls were enrolled into this study, and they were all of Han nationality from Hainan province. Ligase detection reaction (LDR) was conducted to determine the genotypes of VDR gene polymorphisms rs2228570, rs731236, rs1544410 and rs7975232. Single nucleotide polymorphism (SNP)-based association analysis in genotypic and allelic models, and haplotype-based association analysis were then performed. Then, 75 patients with psoriasis area and severity index (PASI) scores less than 10 were topically treated with calcipotriol ointment alone. After 6-week treatment, the efficacy of calcipotriol ointment was evaluated, and the correlation between the efficacy and individual genotypes was analyzed. Results The frequency of A allele of rs7975232 in the psoriasis group and control group was 39.09% and 27.05% respectively, and the risk of developing psoriasis in rs7975232 A allele carriers was significantly higher than that in non-carriers (OR = 1.731, 95% CI: 1.213 - 2.471, P < 0.05). Additionally, the risk of developing psoriasis in individuals with AA genotype (OR = 2.404, 95% CI: 1.085 - 5.328, P < 0.05), as well as in individuals with AC genotype (OR = 2.143, 95% CI: 1.283 - 3.579, P < 0.05), was significantly higher than that in patients with CC genotype. CTGA haplotype carriers (rs2228570, rs731236, rs1544410, rs7975232, respectively) had significantly higher risk of developing psoriasis compared with non-carriers (OR = 1.907, 95% CI: 1.132 - 3.214, P < 0.05). Among 72 patients with mild-to-moderate psoriasis whose PASI scores were less than 10, patients with CC genotype of rs7975232 showed better response to calcipotriol ointment compared with those with AC genotype (OR = 3.798, 95% CI: 1.061 - 13.590, P < 0.05) and those with AA genotype (OR = 9.667, 95% CI: 1.556 - 60.040, P < 0.05). Conclusion VDR polymorphisms are associated with psoriasis susceptibility and clinical response to calcipotriol in patients with psoriasis individuals.