中华皮肤科杂志 ›› 2009, Vol. 42 ›› Issue (3): 163-166.

• 论著 • 上一篇    下一篇

窄谱中波紫外线对寻常性银屑病血管调节因子的作用机制研究

李福民 王雪 段西凌 宋林红 董丹丹 董巍 何迅 应川蓬   

  1. 成都市四川大学华西医院皮肤科 四川省人民医院皮肤科 四川省医学科学院·四川省人民医院皮肤科 成都市四川省人民医院病理科 成都市四川省人民医院临床医学检验中心 四川省人民医院
  • 收稿日期:2008-06-17 修回日期:2008-10-22 出版日期:2009-03-15 发布日期:2009-03-15
  • 通讯作者: 王雪 E-mail:lifumin@21cn.com

Action mechanism of narrow-band ultraviolet B on vascular regulatory factors in psoriasis vulgaris

He xun   

  • Received:2008-06-17 Revised:2008-10-22 Online:2009-03-15 Published:2009-03-15

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摘要：

目的 探讨窄谱中波紫外线（NB-UVB）对寻常性银屑病患者皮损中微血管密度（MVD）、血管内皮生长因子（VEGF）和基质金属蛋白酶-2（MMP-2）以及血清中VEGF的影响。方法 采用葡聚糖聚合物标记免疫组化法对15例寻常性银屑病患者NB-UVB治疗前后的皮损标本中MVD以及VEGF、MMP-2的表达水平进行测定，采用ELISA法测定血清VEGF水平，以10份正常人皮肤标本和15份正常人血清作为对照；在NB-UVB治疗前后对银屑病皮损进行PASI评分。结果 寻常性银屑病患者治疗前皮损组织中MVD为20.52 ± 5.02（单位：个/400倍镜下），明显高于治疗后（7.33 ± 1.24）和正常人对照组皮肤组织（4.26 ± 0.79）（F = 97.57，P < 0.05），且治疗后PASI评分较治疗前显著降低（t = 13.35，P < 0.01）；治疗前血清中VEGF表达水平为307.55 ± 121.65 ng/L，明显高于治疗后（163.92 ± 95.57 ng/L）和正常人对照组（139.78 ± 79.06 ng/L）（F = 9.903，P < 0.05），而治疗后VEGF表达水平与正常人对照组相比差异无统计学意义（P > 0.05 ）；银屑病皮损中MMP-2阳性表达在治疗前、后以及和正常人对照组之间的差异均无统计学意义（P ＞ 0.05）。银屑病患者PASI评分、MVD、皮损及血清中的VEGF表达四者互为正相关关系（P < 0.05）；皮损中的MVD、VEGF表达、MMP-2表达互为正相关关系（P < 0.05）；皮损中的MMP-2与PASI评分、血清中VEGF表达无相关关系（P ＞ 0.05）。结论 NB-UVB可以降低寻常性银屑病患者血清中VEGF的表达水平及其皮损中真皮浅层微血管增生状态；组织中VEGF、MMP-2可能共同参与了微血管的增生过程，但MMP-2没有参与NB-UVB对寻常性银屑病的治疗机制。

关键词: 窄谱中波紫外线;寻常型银屑病;微血管密度;血管内皮生长因子;基质金属蛋白酶-2

Abstract:

Objective To evaluate the influence of narrow-band ultraviolet B on lesional microvessel density （MVD）, vascular endothelial growth factor （VEGF）, matrix metalloproteinases 2 （MMP-2） as well as on serum VEGF in patients with psoriasis vulgaris （PV）. Methods Fifteen patients with PV were recruited into this study with 10 normal human controls. All patients received NB-UVB phototherapy thrice a week for 4-5 weeks. Prior and after the treatment, psoriasis area and severity index （PASI） was calculated, tissue specimens were taken from non-photoexposed lesions, and sera samples were obtained from these patients. Then, MVD and the expression level of VEGF and MMP-2 were measured by immunohistochemical labeled dextran polymer （LDP） method in the tissue specimens. Also, the serum level of VEGF was tested by enzyme-linked immunosorbent assay （ELISA）. Results PASI score remarkably decreased in patients after the phototherapy （t = 13.35, P < 0.01）. The MVDs were 20.52 ± 5.02, 7.33 ± 1.24 and 4.26 ± 0.79 capillaries per high power field （400 × amplification）, in psoriatic lesions before treatment, after treatment, and normal control tissues, respectively, with a significant difference among the three groups （F = 97.57, P < 0.05）, and a significant increase was observed in the lesions before treatment compared with those after treatment and normal controls. The serum level of VEGF was 307.55 ± 121.65 ng/L in psoriatic lesions before treatment, significantly higher than that after treatment （163.92 ± 95.57 ng/L）, and in normal control skin （139.78 ± 79.06 ng/L）, whereas there was no significant difference between the latter two groups （P > 0.05）. The positivity rate of MMP-2 was similar among the three groups without statistical difference （P > 0.05）. In psoriatic patients, a positive correlation was observed among PASI score, MVD, lesional and serum VEGF levels （P < 0.05）, also among the MVD, VEGF and MMP-2 levels in lesions （P < 0.05）, but lesional MMP-2 was unrelated to PASI score or serum VEGF （both P > 0.05）. Conclusions NB-UVB may regulate superficial dermal microvascular proliferation by acting on the expression of VEGF in sera and lesions of psoriatic patients. VEGF and MMP-2 may both participate in the proliferation process of microvessels, while MMP-2 is unlikely to be involved in the therapeutic mechanism of NB-UVB.

Key words: null

中图分类号: 

  • R758.63