| Objective: In recent years, the study about the pathogenesis of psoriasis had great progress. Most studies indicated that psoriasis is a disease of dysimmunity on the background of polygenic inheritance. Activated T cells and cytoklnes play a major role in the pathogenesis. Interleukin-2 (IL-2) is the key factor in the immune network. It can activate T cells and promote the expression of the high affinity IL-2 receptors. Also, it can stimulate the proliferation of the keratinocytes and enhance the expression of intercellular adhesion molecule, further to modulate the interaction of other cells, such as endotheliocytes, antigen presenting cells and so on. Intercellular adhesion molecule-1 (ICAM-1) belongs to the immunoglobulin superfamily. In normal case, it expresses lowly on the surface of endotheliocytes and lymphocytes, but not in keratinocytes. In the psoriatic lesion, there is high expression of ICAM-1 in the endotheliocytes, lymphocytes, even keratinocytes. Soluble 1C AM-1 (sICAM-1) has the most alignment of 1C AM-1, it is thought separated from the membrance. Recent evidence indicates that serum level of sICAM-1 is correlated with the PASI score, and can reflect the disease activity and response to treatment. Atpresent, there is no satisfied method to the psoriasis therapy. Chinese medicine is super to other medicines for its persistent effect and little side effect. We treated 30 patients with psoriasis vulgaris with Chinese medicine Xiaoyinwan, observed the effect and measured the serum levels of IL-2 and sICAM-1 before and after treatment. Our purpose is to evaluate the effect of Xiaoyinwan objectively and accurately, at the same time observe the affection of Xiaoyuinwan to the serum levels of IL-2 and sICAM-1, further to research the mechanism of Xiaoyinwan treat psoriasis, thereby, provide evidence to clinical treatment for psoriasis.Materials and methods: 30 patients with psoriasis vulgaris were collected from the dermatology department of the Second Affiliated Hospital of Hebei Medical University from 2000.10 to 2001.10. Among which, 15 in the progressing phase, 14 in stable phase, 1 in declining phase. 8 patients were acute guttate type, 22 patients were chronic plaque type. All patients were classic psoriasis vulgaris, excluded SLE pemphigus dermatomyositis and other autoimmune diseases. Any drugs affected immune function had not used in recent two months. 20 healthy persons were taken as normal controls. Chinese medicine Xiaoyinwan were taken orally by patient group (6g,tid) for 1-3 months. Recorded the PASI score before and after treatment. In the same time, collected 3 ml blood from patients, separated serum, measured the levels of IL-2 and sICAM-1 by ELISA .Results: 1. After treatment, most patients symptom remitted, the PASI score decreased significantly. The total effective rate was 76.7%, no side effect was found. 2. The serum level of IL-2 was significantly increased compared to normal controls. A significant correlation was found between the concentrations of IL-2 and the PASI scores. There was no difference between the two phases or the two types. After treatment, the level of IL-2 had not significantly changed. 3. The serum level of sICAM-1 was significantly increased compared to normal controls. A significant correlation was found between the concentrations of sICAM-1 and the PASI scores. The level of sICAM-1 was higher in the progressing phase than in the stable phase. The difference between the two types was not found. After treatment, the level of sICAM-1 decreased significantly.Conclusion: Our result proved that Chinese medicine Xiaoyinwan is an effective and safe drug for psoriasis. Our findings showed that the serum levels of IL-2 and sICAM-1 in psoriatic patients were correlated to the PASI scores, so the two markers could reflect the severity of psoriasis. It was showed that serum level of sICAM-1 was reduced followed the PASI scores decrease, which suggested that sICAM-lmay be used as a marker for monitoring disease activity and response to treatment in psor...
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