Analysis Of Th1/Th2Response Pattern For Erythrodermic Psoriasis

Aim:Aberrant levels of Thl/Th2can induce various types of skin diseases. Across all types of skin diseases, skin disease resulting from autoimmune related diffuse dermatitis was dominantly mediated by Th2. Erythrodermic Psoriasis (EP) was the serve type, clinically demonstrating diffuse erythema, various swelling and mass of desquamation. The pathology of EP was very complicated so far, and its risk factors and precise underlying mechanism were also uncertain. Clinic retrospective studies uncovered that some of EP patients had elevated level of IgE, and higher risk of infection by staphylococcus aureus compared with patients with psoriasis vulgaris (PV), suggesting EP has been linked to overreaction of cellular immune inhibition, body fluid immune. In this study, we aimed to detect the levels of Thl/Th2cytokine-associated transcription factors and T-lymphocyte clone in peripheral blood mononuclear cells derived from EP patients, and gene expression level of T-bet/GATA-3in skin lesion. We then discussed the potential role of Thl/Th2reaction pattern plays in the pathogenesis of EP.Methods:Serum Levels of IFN-y, IL-2, IL-4, IL-10were quantified by ELISA among36EP or PV patients and15healthy controls. Expression levels of T-bet/GATA-3in skin lesion and PBMCs were analyzed by Quantitative fluorogenic PCR assay (QPCR). Flow cytometry was applied to determine the ratio of Thl/Th2, which was then reflect the aberrant level of Thl/Th2in patients with psoriasis.Results:Compared with healthy controls, levels of four cells cytokines were higher in EP patients. Of these, levels of IL-4and IL-10were (69.44±11.45pg/ml) and (12.62±4.57pg/ml) respectively, significantly higher while IFN-y and IL-2were not (P<0.05). Flow cytometry analysis indicated both the levels of Thl and Th2among EP patients were both higher than those in healthy controls; meaning while, the proportion of Thl/Th2was dramatically lower compared with PV patients (P<0.01). Among EP patients, ratio of IFN-y over IL-4was0.97±0.73, and ratio of T-bet over GATA-3was0.59±0.27and0.94±0.42, which was a reversion when compared with the other two groups. Within lesions from EP patients and PV patients, GATA-3increased by2.41±0.79(P<0.001).In PV patients, IFN-yincreased significantly (86.14±18.92pg/ml), and ratio of IFN-y over IL-4was2.36±1.26, indicating Thl type was of predominance among PV patients.Conclusions:Our study indicated that the response pattern of EP patients was Thl/Th2bidirectional. The balance of Th cell subjects inclines to Th2, EP related immune-response pattern mainly acted via body fluid immune while cellule immune was mostly inhibited, such that changes may reveal one important machine in the pathogenesis of EP.