ABSTRACT

Psoriasis is a chronic autoimmune disorder that affects 3-4% of the world population. Keratinocytes and immune cells in patient’s skin secrets excess pro-inflammatory cytokines that in turn activates the differentiation of T helper cells (Th) into Th1 and Th17 and deactivates Th2 pathway. Several phototherapies have been used in treatment of moderate and severe psoriatic patients; among them narrowband ultraviolet B (NB-UVB, 311 nm) is the most effective. We aims to evaluate the therapeutic effect of NB-UVB exposure in 80 Egyptian plaque psoriatic patients with and without psoriasis arthritis development. This will be accomplished by measuring serum cytokines levels (IL-10, -12, -17, -23 and -34) and high sensitive C reactive protein before and after treatment. A significant elevation in Th2 pathway cytokine, IL-10, and significant decrease in Th1/Th17 pathway cytokines were observed after treatment. This indicates the success of NB-UVB therapy in down modulating IL-12 and IL-23/Th17 axis. The pathological conditions in psoriatic arthritis patients were improved by NB-UVB targeted to the skin. As serum cytokines levels in these patients indicated that the reduction in Th1/Th17 inflammatory cytokines and elevation of Th2 anti-inflammatory cytokines was not restricted to skin lesions only, but also, spread in patients’ body and improve their pathologic.

摘要

牛皮癣是一种慢性自身免疫性疾病，影响全世界3-4％的人口。患者皮肤中的角质形成细胞和免疫细胞会分泌过多的促炎细胞因子，进而激活T辅助细胞（Th）分化为Th1和Th17，并激活Th2通路。几种光疗已被用于治疗中度和重度银屑病患者。其中窄带紫外线B（NB-UVB，311 nm）最有效。我们旨在评估NB-UVB暴露对80例患有和不患有牛皮癣关节炎的埃及斑块型牛皮癣患者的治疗效果。这可以通过测量治疗前后的血清细胞因子水平（IL-10，-12，-17，-23和-34）和高敏感性C反应蛋白来实现。Th2通路细胞因子IL-10明显升高 治疗后观察到Th1 / Th17途径细胞因子显着减少。这表明NB-UVB疗法在下调IL-12和IL-23 / Th17轴方面的成功。通过针对皮肤的NB-UVB改善了银屑病关节炎患者的病理状况。这些患者的血清细胞因子水平表明，Th1 / Th17炎性细胞因子的减少和Th2抗炎性细胞因子的升高不仅限于皮肤病变，而且还扩散到患者体内并改善其病理状况。