The Correlation Between The Expression Of Skin PDPN,GITR,GILZ And Clinical Indicators In Psoriasis Patients Receiving Mongolian Mind-body Interactive Psychotherapy

Psoriasis is a chronic autoimmune skin disease that is currently difficult to cure clinically,and its etiolgoy is diverse and complex.Psoriasis can be divided into several types,the most common being the Psoriasis Vulgaris,with the main manifestation being silver white scales and red plaques accompanied by itching.More and more studies have shown that psoriasis is a psychosomatic disease closely related to patients’ mental stress.For example,appearance anxiety about the affected skin area further exacerbates the skin deterioration.Through the psychotherapy,this psychological burden can be reduced,thereby relieving the patient’s skin symptoms.Mongolian Mind-body Interactive Psychotherapy(MMIP)is a comprehensive psychotherapy that combines narrative therapy and hypnosis,invented by Professor Nagon Bilger.Clinical observations have found that MMIP has significant therapeutic effects on psoriasis.Therefore,a clinical study with a Western medicine control group(Chi CTR1800015533)was conducted in2018,with mild to moderate psoriasis vulgaris as the recruitment target.As of now,the cure rate is 25%.The topic of this thesis is part of this clinical study.We selected three immune related proteins: Podoplanin(PDPN)、Glucocorticoid-induced leucine zipper(GILZ)、 Glucocorticoid-induced TNF receptor family-related protein(GITR)based on there functions and relation to mental stress(PDPN)and glucocorticoid(GILZ and GITR).Evaluted their expression in the affected skin through immunohistochemistry,and analyzed their correlation with clinical questionnaire scores,blood data,and disease information of patients using statistical methods.Clinical questionnaire scores include the Psoriasis Disability Index(PDI),Dermatology Life Stress Inventory,Psoriasis Life Stress Inventory,and Hospital Anxiety and Depression Scale.Blood data includes blood routine,liver function indicators,kidney function indicators,and IL-23.The psoriasis information includes Psoriasis Area and Severity Index(PASI)and Treatment cycle(the duration of MMIP treatment for patients,with the first 60 days being the requirement of the clinical trial protocol,and the subsequent duration determined by the patient based on their own situation).Attempt to identify the correlation between indicators and factors that reflect the severity of psoriasis or the duration of MMIP treatment for patients.The main results are as follows:1.Urea is the main factor affecting GITR,indicating that renal function affected skin GITR expression.2.The expression of PDPN protein in the affected skin was positively correlated with the PASI score(r>0.5).ALT,AST and PDI were factors affecting PDPN,indicating that disability index and liver function affected skin PDPN expression.3.IL-23 and the number of eosinophils in the blood are negative factors affecting the expression of GILZ protein in the affected skin,which is in accordance with its role as a immune suppressor.In summary,our discovery laid the foundation for the analysis of the mechanism of MMIP,and also supported the overall medical concept.