| Objective：Psoriasis is a common chronic, recurrent, inflammatory skindisease, characterized by round, circumscribed, erythematous, dry scalingpapules of various sizes, which covered by silvery white imbricated andlamellar scales. The lesions have a predilection for the scalp, nails, extensorsurfaces of limbs, elbows, knees regions. It could be seen at any age, there isno significant difference in the incidence of male and female, it often onsets inyoung adults. In recent years, there was no large-scale study about theprevalence of psoriasis in China. Predisposing factors and pathogenesis ofpsoriasis is not fully clear so far. It is believed that the occurrence of thedisease is relevant with the excessive activation and abnormal function of Tlymphocytes, particularly Th1cells, psoriasis is an autoimmune disorder.Th22cells are a new type of T helper cells, characterized by producinginterleukin22(IL-22), but not producing IL-17and IFN-γ. Stefanie Eyerich etal proved Th22cells represented a distinct human T-cell subset involved inepidermal immunity and remodeling by immune pathology. Th22cells werefirstly discovered in psoriatic lesions, played an important role in psoriasis.Quantity and function of Th22cells in the blood are unclear.IL-22has aneffect on epithelial cells.It regulates keratinocyte differentiation and epithelialhyperplasia and plays a crucial role on inflammatory skin with a significantthickening of the spinosum stratum. In the experiment, we used flowcytometry to confirm and count Th22(CD4+IL-22+) cells in the peripheralblood of patients with psoriasis vulgaris and detected the expression of IL-22in the serum by double antibody sandwich ELISA test, then analyzeddifference in different stages and the relationship between the expression ofTh22cells and IL-22with the PASI score value respectively. Explored the function of Th22cells and IL-22in the pathogenesis and maintenance ofpsoriasis vulgaris.Methods：Patients with psoriasis vulgaris from the dermatology clinic ofthe Second Hospital of Hebei Medical University during March2011toDecember2011were choosed as the case group. Selection standard: P atientswith psoriasis vulgaris had typical skin lesions and a clear diagnosis, had notreceived system treatment of glucocorticoids, immunosuppressants and otherdrugs which affected the immune function in last January before theexperiment, and none of them had autoimmune diseases or other seriouschronic systemic diseases, such as systemic lupus erythematosus, diabetes.Normal control group came from healthy hospital care staff. The case grouphad25cases,12males and11females, age range19to53years, mean age33.30±11.30years. According to the disease stage, case group were dividedinto the progressive stage group of12cases and stationary stage group of11cases. PASI score was evaluated by the same one according to psoriasis areaand severity. Normal control group had11cases,5males and6females, agerange20to52years, mean age27.27±8.63years. Through t-test, the sex andage had no significant difference with the case group.The detection of Th22cells in peripheral blood: Adopted vein venousblood4ml from case group and normal control group into heparinanticoagulation tubes, and isolated peripheral blood mononuclear cells (PBMC)in8hours, and followed by stimulation with PMA, Ionomycin, Monensinsolution for4hours in37°C,5%carbon dioxide couveuse, then surfacestained, fixed, permeabilized and intracellular cytokine stained. Finallydeceted the proportion of Th22cells in the PBMC by flow cytometry.The detection of IL-22in the serum: Adopted vein venous blood2ml fromcase group and normal control group into EDTA anticoagulant tubes,centrifuged to collect serum samples and saved at-20°C refrigerator. Finnalydetected expression of IL-22in the surem by double antibody sandwichELISA test.Applicated SPSS13.0software for statistical analysis, datas of case group and control group, progressive stage group and stationary stage group showednormal distribution by normality test, so the statistical results were describedby mean±standard deviation, we used two independent sample t test toanalyze whether the difference between case group and control group,progressive stage group and stationary stage group about the expression ofTh22cells in the peripheral blood and IL-22in the serum had significantdifference or not. The psoriasis PASI score value data were skewnessdistribution by normality test. We used the variables rank correlation analysis(Spearman method) to analyze the relationship between the expression ofTh22cells and IL-22in the blood of case group and PASI score valuesrepectively. P <0.05had statistically significance.Result:1Flow Cytometry results: The proportion of Th22cells in the peripheralblood of case group1.90±1.73%and that of normal control group1.47±0.96was not statistically significant (t=1.115P=0.273P＞0.05). The differencebetween progressive stage group2.30±1.63and stationary stage group1.75±1.29was not statistically significant (t=0.923P=0.367P＞0.05).Theexpression of Th22cells in the peripheral blood of case group and PASI scorevalue had no correlation (r=0.379P=0.074P＞0.05).2ELISA test results: The expression level of IL-22in serum of casegroup8.46±6.23was higher than that of normal control group5.28±2.67, thedifference was statistically significant (t=2.727P=0.01P<0.05). Progressivestage group was8.75±4.58and stationary stage group was6.35±2.46, thedifference was statistically significant (t=-2.509P=0.023P<0.05). Theexpression level of IL-22in the serum of case group and PASI score value hadpositive correlation (r=0.415P=0.049P<0.05).Conclusion:1The proportion of Th22cells in the peripheral blood of case group andthat of normal control group had no significant difference. The proportion ofTh22cells in the peripheral blood of the progressive stage group and that ofthe stationary stage group had no significant difference. Indicating the proportion of Th22cells in the peripheral blood maybe have no directcorrention with pathogenesis of psoriasis vulgaris and the maintenance anddevelopment of psoriasis vulgaris.2There was no correlation between the expression level of Th22cells inthe peripheral blood of case group with PASI score value, so the expressionlevel of Th22cells in the peripheral blood had no clear relevance with thepsoriasis skin lesions area and severity, it could not be an indicator for theevaluation of psoriasis vulgaris severity.3IL-22expression level in the serum of case group was higher than thatof normal control group. Indicating that IL-22may mediate the pathogenesisof psoriasis vulgaris, IL-22expression level in the serum may playe animportant role on the maintenance and development of psoriasis vulgaris. Itcould indirectly reflecte the function of Th22cells in psoriasis vulgaris.4Expression level of IL-22in serum of case group and psoriasis PASIscore had a positive correlation.The higher PASI score, the higher expressionlevel of IL-22in the serum. Expression levels of IL-22in the serum could bean indicator for the evaluation of psoriasis vulgaris severity. |
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