寻常性银屑病患者皮损及外周血单一核细胞中IL-17A的表达

目的研究Th17细胞及Th17细胞特异性因子IL-17A在寻常性银屑病发病中的作用。方法收集30例寻常性银屑病患者以及18例正常人对照的外周血单一核细胞(PBMC)和皮肤组织,通过实时定量逆转录聚合酶链反应法(RT-PCR)检测IL-17AmRNA的表达水平;免疫组化法分析IL-17A的蛋白表达及IL-17A阳性细胞数百分比。结果银屑病组PBMC与皮损中IL-17AmRNA的相对表达量分别为2.962±1.398和2.023±1.890,对照组分别为0.807±0.839和0.262±0.104,t血IL-17A=-2.133,P<0.05;t皮IL-17A=-2.575,P<0.05;患者组和正常对照PBMC中IL-17A的蛋白表达强度分别为0.467±0.050,0.368±0.065(t=4.495,P<0.05);PBMC中IL-17A+细胞的百分率分别为0.143±0.090和0.090±0.039(t=2.159,P<0.05);患者组皮肤组织IL-17A阳性表达的平均光密度值为0.320±0.038,对照组为0.257±0.041(t=-4.357,P<0.05)。结论银屑病患者外周血及皮损内Thl7细胞因子IL-17A的mRNA与蛋白水平均明显升高,Thl7细胞数目增多,提示其可能与银屑病的发生有一定的相关性。     

白细胞介素17A单克隆抗体在非银屑病性皮肤病中的应用

白细胞介素（IL）-17在多种疾病的发病机制中起着重要作用。近年来，靶向IL-17家族成员IL-17A的单克隆抗体已经应用于多种皮肤病的治疗。该文对司库奇尤单抗、依奇珠单抗等靶向IL-17A的药物在化脓性汗腺炎、毛发红糠疹、白塞综合征、人乳头瘤病毒感染、SAPHO综合征、扁平苔藓、坏疽性脓皮病和酒渣鼻等非银屑病性皮肤病中的治疗情况作一综述。     

Th17细胞相关因子与寻常性进行期银屑病的相关性研究

目的探讨Th17细胞相关因子白细胞介素(IL)-17A、IL-17F、IL-21、IL-22与寻常性进行期银屑病发病的相关性。方法通过实时定量反转录聚合酶链式反应(RT-PCR)分别检测30例患者和20名正常人外周血单个核细胞(PBMC)、12例患者皮损、12名正常皮肤组织中上述4种细胞因子的mRNA表达水平。结果患者组PBMC中IL-17A、IL-17F、IL-21和IL-22的mRNA表达水平较正常组显著升高(P均0.05),患者组皮损中4种细胞因子的mRNA表达明显高于正常组(P均0.05)。结论 Th17细胞因子IL-17A、IL-17F、IL-21和IL-22的mRNA水平在患者组PBMC及皮肤组织中明显升高,提示Th17细胞因子可能与寻常性银屑病的发病有一定相关性。     

白细胞介素17A介导银屑病及心血管合并症的研究进展

白细胞介素（IL）-23/IL-17轴是寻常型斑块状银屑病发病的主要通路,IL-17A是相关免疫通路中的关键节点,介导了动脉粥样硬化和银屑病的重叠炎症通路,促进炎症、凝血和血栓形成,在银屑病心血管合并症的发生发展中起重要作用。抑制IL-17A的炎症作用能减少重度银屑病患者心血管合并症的发生率及病死率。本文综述近年来IL...     

IL-17A、VEGF在寻常型银屑病皮损中的表达及其与PASI评分相关性的研究

目的研究白细胞介素17A(IL-17A)、血管内皮生长因子(VEGF)在寻常型银屑病患者皮损中的表达,并分析其与患者银屑病皮损面积和严重程度指数(PASI)的相关性,从而进一步探讨IL-17A、VEGF在银屑病发病机制中的作用。方法采用免疫组织化学法检测寻常型银屑病皮损组织和健康对照组皮肤组织中IL-17A、VEGF的表达水平并进行比较。结果寻常型银屑病患者皮损中IL-17A、VEGF的表达水平显著高于健康对照组,差异有统计学意义(均P0.05),皮损中IL-17A、VEGF的表达水平与患者PASI呈正相关(r_1=0.61,P0.01;r_2=0.58,P0.01)。结论 IL-17A、VEGF在银屑病发病过程中起着重要作用,在皮损中的表达水平可作为反映银屑病严重程度的一个指标。     

寻常型银屑病患者外周血中Th17细胞的表达及临床意义

目的:探讨银屑病患者外周血PBMC中的Th17细胞的表达及与其临床相关性,初步明确Th17细胞在银屑病发病中的作用机制及临床意义.方法:抽取43例寻常型银屑病患者(进行期25例,静止期18例)及30例正常对照者外周血,采用流式细胞术检测外周血单核细胞CD4(+)IL-17(+)细胞表达水平,并分析进行期银屑病组和静止期银屑病组与对照组间的差异.结果:流式细胞染色示银屑病患者PBMC CD4(+)IL-17(+)细胞数量相对于正常人明显上调(t=12.057,P<0.01),对照组、进行期组、静止期组三者差异有统计学意义(F=142.34,P<0.01).银屑病患者PBMC CD4(+)IL-17(+)细胞的表达与寻常型银屑病严重程度指数PASI呈正相关.结论:银屑病患者外周血Th17细胞数量上调,其水平与寻常型银屑病严重程度呈正相关,Th17细胞在银屑病的发病中可能有着重要作用.提示针对Th17细胞的生物靶向治疗也许可以作为治疗银屑病的新的有效方法.     

调节性T淋巴细胞和Th17细胞与银屑病的研究进展

银屑病是一种与T淋巴细胞相关的自身免疫性疾病,新近研究发现,除了与Th1细胞有关外,调节性T淋巴细胞尤其叉头/翅膀状螺旋转录因子诱导表达的调节性T细胞和Th17细胞在银屑病的发病过程中起着非常重要的作用。其中,叉头/翅膀状螺旋转录因子（＋）调节性T细胞平衡免疫抑制和免疫激活的转换在银屑病加重方面起到关键作用,Th17细胞分泌的细胞因子IL-17A、IL-17F、IL-22、IL-23、IL-36及肿瘤坏死因子α等在皮肤疾病发生发展中起到重要的作用。银屑病是由调节性T细胞和Th17细胞等多种免疫细胞和细胞因子共同参与的疾病。     

银屑病性关节炎患者Th17/Treg相关细胞因子的检测

目的探讨Th17/Treg细胞相关细胞因子IL-17,IL-6,IL-23和TGF-β在银屑病性关节炎(PsA)发病机制中的作用。方法采用酶联免疫吸附法(ELISA)测定31例PsA患者和30例正常对照者血清中IL-17,IL-6,IL-23和TGF-β的水平。结果 PsA患者血清中IL-17,IL-6和IL-23水平明显高于健康对照组,TGF-β的水平低于健康对照组,差异均有统计学意义(P均<0.05)。结论外周血中Th17/Treg细胞相关的细胞因子IL-17,IL-6,IL-23和TGF-β表达异常参与了PsA的发病过程。     

IL-23/IL-17/IL-36免疫环路在银屑病发病和治疗中的作用研究进展

银屑病是一种由免疫介导的慢性炎症性皮肤病,发病机理复杂,不易根治。除先天遗传性的因素外,银屑病的发病因素主要是获得性免疫系统及先天性免疫系统的功能紊乱。由各类免疫细胞调控形成的细胞因子免疫环路在银屑病发生和发展中发挥重要作用,其中IL-23/IL-17/IL-36免疫环路近年来备受关注。本文从树突状细胞活化与免疫失衡、树突状细胞源性的IL-23与Th17细胞分化、Th17细胞源性的IL-17与银屑病皮肤炎症、角质形成细胞源性的IL-36与正反馈环形成4个环节综述了IL-23/IL-17/IL-36免疫环路在银屑病发病和治疗中的研究进展。并从IL-23相关抑制剂、IL-17相关抑制剂及IL-36相关抑制剂3个方面分析了国内外IL-23/IL-17/IL-36免疫环路的靶向药物研究现状。最后提出同时针对IL-23/IL-17/IL-36免疫环路中的多靶点干预可能是下一代生物制剂开发的热点。为银屑病的发病机制研究及相关药物开发提供参考。     

真皮IL-17分泌型γδT细胞在炎症性皮肤病中起关键作用

表达白细胞介素-23（IL-23）和白细胞介素-17A（IL-17A）的辅助性细胞（Th17细胞）轴在慢性炎症性疾病的银屑病发生发展中起着重要作用。但IL-17等是否来源于Th17细胞尚未明确,其是否在银屑病的炎症浸涧和棘层肥厚皮损形成中起作用是本文研究的重点。     

抗白细胞介素17生物制剂治疗银屑病的疗效和安全性

银屑病是一种多基因遗传和环境相互作用下,主要由细胞免疫异常介导的慢性炎症性增生性皮肤病,其确切的发病机制尚未完全清楚.目前认为,白细胞介素17细胞因子对角质形成细胞的增生及异常激活十分重要,是银屑病发病机制中的关键环节.新研发的3种针对白细胞介素17通路的生物制剂已应用于银屑病的临床治疗或试验,包括直接拮抗白细胞介素17A的苏金单抗(secukinumab)、ixekizumab及通过拮抗白细胞介素17RA,从而抑制白细胞介素17下游信号分子通路的brodalumab.其治疗寻常性银屑病及关节病性银屑病的有效性和安全性在临床试验中得到肯定,给银屑病患者带来新的治疗选择,但其安全性仍需长远评价.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.     

IL-17 and IL-17R: an auspicious therapeutic target for psoriatic disease

The continuous discovery of new T cell subpopulations in human autoimmune diseases is making the immunopathological network more complex. Th17 cells are one such newly identified subset of T cells, characterized by the production of signature cytokine IL-17. In last few years, several studies have strongly established the regulatory role of Th17 cells and its signature cytokine IL-17 in autoimmune diseases including psoriasis, psoriatic arthritis, rheumatoid arthritis, inflammatory bowel disease, systemic lupus erythematosus and multiple sclerosis. Psoriasis and PsA are immune mediated hyperproliferative diseases, affecting skin and joint respectively. Before the discovery of Th17 cells, psoriasis and psoriatic diseases were thought to be chiefly Th1 mediated diseases; later on IL-17 knockout animal studies as well as human experimental data indicate the crucial role of Th17 cells and its signature cytokine IL-17 in the pathogenesis of these diseases. In vitro human studies have shown the abundance of Th17 cells in the psoriatic plaques. Subsequently our research group has extended this observation in psoriatic arthritis and found the abundance of CD4+IL-17+ T cells in the synovial fluid and majority of these T cells are of memory phenotype (CD4RO+CD45RA-CD11a+). In addition, we showed the significant presence of functional IL-17 receptor in synovial fibroblast of psoriatic arthritis patients. Considering the strong association of IL-17 and psoriatic disease, IL-17 targeted therapy have shown promises in preclinical and clinical trials. In this review article, we have discussed the pathogenic role of IL-17 in psoriatic disease and summarized the therapeutic efficacy and safety profile of different anti IL-17 therapy as an anti-psoriatic agent.     

Dendritic cells: The driver of psoriasis

Psoriasis is a chronic skin inflammatory disorder, the immune mechanism of which has been profoundly elucidated in the past few years. The dominance of the interleukin (IL)-23/IL-17 axis is a significant breakthrough in the understanding of the pathogenesis of psoriasis, and treatment targeting IL-23 and IL-17 has successfully benefited patients with the disease. The skin contains a complex network of dendritic cells (DC) mainly composed of epidermal Langerhans cells, bone marrow-derived dermal conventional DC, plasmacytoid DC and inflammatory DC. As the prominent cellular source of α-interferon, tumor necrosis factor-α, IL-12 and IL-23, DC play a pivotal role in psoriasis. Thus, targeting pathogenic DC subsets is a valid strategy for alleviating and preventing psoriasis and other DC-derived diseases. In this review, we survey the known role of DC in this disease.     

Role of IL-17 and IL-22 in autoimmunity and cancer

The dysregulation of inflammatory cytokines can cause a variety of diseases, such as autoimmunity and cancer. Since their identification in 2005, Th17 cells and its signature cytokine IL-17, have been implicated in the pathogenesis of autoimmune diseases such as psoriasis and rheumatoid arthritis (RA), and inflammatory associated cancers such as colorectal carcinoma (CRC). Recently, IL-22 a Th17 related cytokine has been shown to be pathogenic in psoriasis and RA. In this review, we will summarize the biological functions of IL-17 and IL-22, their role in autoimmune diseases and briefly review results from clinical trials targeting IL-17 or its receptor for the treatment of autoimmune diseases. Next, we will discuss pre-clinical and clinical data supporting the rationale of targeting other cytokines implicated in the Th17/IL-17 pathway, such as IL-22 and IL-23. Finally, we discuss the role of IL-17, and in particularly IL-22 in tumour immunity and possible therapeutic interventions.     

Anti-IL-17 Medications Used in the Treatment of Plaque Psoriasis and Psoriatic Arthritis: A Comprehensive Review

Our ability to successfully treat patients with moderate to severe psoriasis has improved significantly over the last several years with the development of more targeted therapies. IL-17A, a member of the IL-17 family of interleukins, is involved in regulating the innate and adaptive immune systems and has been identified as a key cytokine involved in the pathogenesis of psoriasis and psoriatic arthritis. In this review, we summarize our understanding of IL-17 and its role in psoriasis and psoriatic arthritis, as well as key findings from clinical trials using anti-IL-17 medications for the treatment of the aforementioned diseases. Secukinumab, ixekizumab, and brodalumab are three anti-IL-17 medications used for treating psoriasis, of which only secukinumab is FDA approved; ixekizumab and brodalumab remain under clinical development. Results from clinical trials show that these three medications are highly effective in treating psoriasis and appear to be as safe as other biologic treatments that are FDA approved.     

Interleukin-17A suppresses granular layer formation in a 3-D human epidermis model through regulation of terminal differentiation genes

Immunotherapies targeting interleukin (IL)-17 greatly improve plaque psoriasis. Most previous studies on IL-17 focused on the T-helper (Th)17 immune response, but investigation of the effects of IL-17A on psoriatic epidermal structure are limited. Using an in vitro 3-D human epidermis model, we investigated the effects of IL-17A and IL-17C on morphological changes and gene expression. IL-17A directly suppressed the formation of the granular layer, whereas IL-17C did not. IL-17A significantly downregulated the gene expression of profilaggrin (FLG), which is a major component of keratohyalin granules in the granular layer. Global gene expression analysis of this 3-D epidermis model showed that both IL-17A and IL-17C upregulated S100A7A and type 1 interferon-related genes including MX1, IFI44L, XAF1 and IFIT1. However, only IL-17A directly downregulated keratinocyte differentiation-related and cornified envelope-related genes including FLG, LOR, C1ORF68, LCE1E, LCE1B, KRT10, CST6 and RPTN. In conclusion, IL-17A, a systemic inflammatory cytokine, affected keratinization in our 3-D epidermis model. In contrast, IL-17C, a locally produced cytokine, did not have strong effects on keratinization. Targeting IL-17A does not only reduce inflammation but it may also directly affect epidermal differentiation in psoriasis.