The Relationship Between Serum IL-36α, IL-38 Levels And TCM Syndromes Of Psoriasis Vulgaris And The Theory Of Yin And Yang

In traditional Chinese medicine,psoriasis is equivalent to white mange,song pi xuan and so on,and the most common type is psoriasis vulgaris.At present,with regard to the syndrome differentiation and treatment of psoriasis vulgaris,"treatment from blood" is widely recognized by traditional Chinese medicine doctors,and it is mostly regarded as blood-heat syndrome,blood stasis syndrome and blood dryness syndrome.The pathogenesis of psoriasis is not clear,and the syndrome differentiation of psoriasis vulgaris is also lack of objective evidence.Existing studies have shown that a variety of inflammatory factors are involved in the pathogenesis of psoriasis,so new inflammatory factors IL-36α and IL-38 are also related to it.[Objective]To explore the role of IL-36α and IL-38 in the pathogenesis of psoriasis and the correlation between them,and to provide new clues for drug targeted treatment of psoriasis by comparing the expression of IL-36α and IL-38 in peripheral blood of patients with psoriasis vulgaris and healthy people.At the same time,the expression differences of IL-36α and IL-38 in peripheral blood of patients with different syndrome types of psoriasis vulgaris were compared to explore the correlation between them and psoriasis vulgaris syndrome types,so as to provide objective indicators for syndrome differentiation of psoriasis;we also discussed the relationship between IL-36α,IL-38 and the balance of yin and Yang in psoriasis vulgaris,[Methods]A total of 65 patients with psoriasis vulgaris who were hospitalized in the Department of Dermatology of Air Force characteristic Medical Center from September 2019 to January 2020 were selected as the case group,including 30 cases of blood heat syndrome and 17 cases of blood stasis syndrome.18 cases of blood dryness syndrome and 20 healthy people served as the control group.The main clinical data of patients were collected and the expression levels of IL-36α and IL-38 in serum of patients with psoriasis vulgaris were detected by ELISA method.SPSS21.0 software was used to analyze the data.For those who are in line with normal distribution and have the same variance,one way ANOVA is used for comparison among multiple groups;nonparametric test is used for those who do not conform to normaldistribution or have uneven variance.Nonparametric spearman correlation test was used to analyze the correlation between the two factors,P<0.05 was statistically significant..[Results]1.The levels of serum IL-36α and IL-38 in patients with psoriasis vulgaris weresignificantly higher than those in healthy subjects.2.There were significant differences in serum IL-36α and IL-38 expression among bloodheat syndrome,blood stasis syndrome and blood dryness syndrome in patients with psoriasis vulgaris.There was significant difference in the expression of IL-36α and IL-38 between blood heat syndrome and blood dryness syndrome,there was no significant difference in the expression of IL-36α and IL-38 between blood heat syndrome and blood stasis syndrome,there was significant difference in IL-36α expression between blood stasis syndrome and blood dryness syndrome,and there was no significant difference in IL-38 expression between blood stasis syndrome and blood dryness syndrome.3.The expression of IL-36α and IL-38 in serum of patients with psoriasis vulgaris waspositively correlated with each other,and the correlation coefficient was 0.585(P<0.01).4.There was a positive correlation between serum IL-36α and PASI score in patients withpsoriasis vulgaris,and the correlation is significant.Correlation coefficient was 0.309,P=0.012<0.05;IL-38 was also positively correlated with PASI score,and the correlation was significant.Correlation coefficient was 0.258,P=0.038<0.05.5.There was no correlation between serum IL-36α and the degree of pruritus in patientswith psoriasis vulgaris.Correlation coefficient was 0.087,P=0.490>0.05;There was no correlation between IL-38 and the degree of pruritus.Correlation coefficient was 0.153,P=0.223>0.05.[Conclusions]1.Compared with healthy subjects,the expression of IL-36α and IL-38 in serum ofpatients with psoriasis vulgaris increased,and there was a positive correlation between IL-36αand IL-38,suggesting that IL-36α and IL-38 may play an important role in the occurrence and development of psoriasis vulgaris.2.The expression of IL-36α and IL-38 was positively correlated with PASI score,suggesting that the expression of IL-36α and IL-38 increased with the aggravation of psoriasis vulgaris,and they can be used to evaluate the severity of psoriasis vulgaris.3.Compared with blood dryness syndrome,the expression level of IL-36α and IL-38 in serum of blood heat syndrome was significantly higher than that of blood dryness syndrome.It is suggested that the levels of serum IL-36α and IL-38 can be used as observation indexes for syndrome differentiation of blood heat syndrome and blood dryness syndrome.4.There is no significant difference in the expression levels of IL-36α and IL-38 between blood heat syndrome and blood stasis syndrome,suggesting that the inflammatory degree of blood stasis syndrome is similar to that of blood heat syndrome.Blood stasis syndrome can be regarded as the late stage of blood heat syndrome,that is,the stage of blood heat with blood stasis.5.In the level of molecular biology,IL-36α and IL-38 can be regarded as yin and yang factors.Through the detection of the two indexes,it is suggested that in the process of psoriasis,the body appears disorder in the process of reconciling yin and yang balance,which makes the yin and yang factors abnormal in pathological state and grow in a high level.Even if they reach a high balance,it is not the "physiological and dynamic balance between Yin and Yang" of the balance of yin and yang in the healthy state.