| [Background]Psoriasis is a chronic,recurrent and inflammatory disease characterized by erythema and scale.Currently,it is generally believed that its pathogenesis is mainly related to T cells,and that the abnormal immune response under the combined action of multiple factors such as multi-gene genetic background,environmental factors(such as diet,obesity,drugs,smoking,trauma and stress)and infection further leads to abnormal proliferation of epidermal keratinocytes,inflammatory cell infiltration and telangiectasis in the epidermis.TH22 cell related cytokines are believed to play a role in the pathogenesis of psoriasis.Methotrexate and Secukinumab are widely used in the treatment of moderate-to-severe plaque psoriasis,but it is unclear which Th22 cell related factors and signaling pathways are regulated by Secukinumab and methotrexate.[Objective]This study made a tentative exploration on the relationship between TH22cell-related cytokines IL-22,IL-23,IL-26,IL-13,IL-17 and their signaling pathway factors MEKl,MEK2,ERKl,ERK2,AKT,STAT1,STAT3,STAT5 and psoriasis in patients with plaque psoriasis.Meanwhile,the effects of Secukinumab and methotrexate on the above cytokines and pathways were explored in order to further understand the pathogenesis of psoriasis and provide new therapeutic ideas for psoriasis patients.[Method]This object of study was divided into three groups.Patients with plaque psoriasis included in this study were set as the experimental group.Experimental group A was treated with Secukinumab and experimental group B was treated with methotrexate.All patients were followed up for 12 weeks,the serum,BSA and PASI scores were collected at week 0 and week 12.At the same time,the healthy people from our laser clinic were collected as the control group.The expression levels of Th22-cell related cytokines IL-22,IL-23,IL-26,IL-13,IL-17 and their signaling pathway factors MEKl,MEK2,ERKl,ERK2,AKT,STAT1,STAT3,STAT5 in serum of the experimental group and control group were detected by Enzyme-linked immunosorbent assay(ELISA).The differences of the above indexes before treatment in serum between the experimental group and the control group,and the differences before and after treatment between experimental group A and experimental group B were compared,and the correlation between PASI score and the above indexes was evaluated.[Results]1、A total of 30 cases were included in the experimental group(25 patients were completed follow-up and 5 patients were loss to follow-up in our study),including11 cases in experimental group A,14 cases in experimental group B and 15 cases in the control group.The expression levels of IL-22,IL-26,IL-17,STAT1,STAT3,STAT5 in serum of the experimental group were higher than those of the control group(268.26±50.49 vs 208.49 ±80.63;704.18±158.35 vs 556.23±157.78;260.97±59.77 vs 208.8±38.47;644.78±112.82 vs 546.38±140.79;846.26±188.05 vs722.58±138.01;579.31±122.19 vs 450.32±80.58),and the differences were statistically significant(P<0.05).There were no significant differences in the expression levels of IL-23,IL-13,ERKl,MEK1、MEK2 and AKT between the experimental group and the control group(P >0.05).2、The expression levels of IL-22,IL-23,IL-17,ERKl,AKT,STAT1,STAT3 in peripheral blood serum of experimental group A were significantly decreased after treatment(266.72±44.9 vs 166.18±69.63;245±69.53 vs 193.92±52.04;265.17±44.24 vs 187.33±48.74;18.37±4.10 vs 14.41±2.77;21.95±2.99 vs17.34±3.82;625.80±88.65 vs 487.5±70.93;853.67±197.94 vs 681.57±121.54),and the differences were statistically significant(P<0.05).But there were no significant differences in the serum expression levels of IL-26,IL-13,MEK1,MEK2,ERK2,STAT5 before and after treatment(P>0.05).3、The expression levels of IL-22,IL-23,IL-26,IL-17,MEKl,MEK2,ERK2,AKT,STAT1,STAT3 and STAT5 in peripheral blood serum of experimental group B were significantly decreased after treatment(266.73±60.52 vs 145.07±51.20;246.62±53.82 vs 205.92±44.34;741.25±150.21 vs 517.3±120.99;257.38±71.32 vs181.34±52.13;8.34±1.83 vs 6.41±1.65;7.21±1.46 vs 5.66±1.23;186.4±24.57 vs157.87±29.47;21.45±3.80 vs 18.82±3.71;638.73±130.65 vs 506.61±141.01;800.71±199.21 vs 684.43±135.66;583.73±124.77 vs 488.54±98.84),and the differences were statistically significant(P<0.05).But there were no significant differences in the serum expression levels of IL-13 and ERK1 before and after treatment(P>0.05).4、The r values between IL-22,IL-23,IL-26,IL-13,IL-17,MEKl,MEK2,ERKl,ERK2,AKT,STAT1,STAT3,STAT5 and psoriasis area and severity index in the correlation analysis were respectively 0.201,0.275,0.308,0.109,0.087,0.239,0.321,0.141,0.031,0.175,0.115,0.19,0.273,and all of them were no statistical significance(P>0.05).[Conclusion]1、Th22-cell related cytokines IL-22,IL-26,IL-17 and signaling pathway factors STAT1,STAT3 and STAT5 were highly expressed in peripheral blood serum of patients with plaque psoriasis,but there was no significant correlation with Psoriasis area and severity index.2、Methotrexate is more advantageous in the treatment of psoriasis dominated by TH22 cell-related cytokines and their signaling pathways.3、TH22 cells function mainly through the JAK1-STAT3 transcriptional pathway. |
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