Objective To evaluate the clinical efficacy of compound lidocaine cream in the treatment of hormone dependent dermatitis (HDD) and the effect on serum IL-17, IL-22 and IL-23 expression levels and its clinical significance. Methods Treatment group (34 cases) of HDD were coated with compound lidocaine cream, and control group (34 cases) were coated with heparin sodium ointment. The two groups were both treated for 8 weeks, and the illness scores before the treatment, and after 1, 2, 4, 8 weeks of the treatment and 2 weeks after the 8-week-long treatment were recorded respectively, and then the clinical efficacy was evaluated. In addition, 30 healthy volunteers were chosen as health control group, IL-17, IL-22 and IL-23 levels in the peripheral blood of healthy control group and two groups of patients before and after the treatment and 2 weeks after the treatment were detected by double antibody enzyme linked immunosorbent assay (ELISA). Results After 1 week of the treatment and 2 weeks after the treatment, the illness scores of patients were significantly decreased, and the difference was statistically significant as compared with that before treatment (P<0.05 or P<0.01). After 2 weeks of the treatment and 2 weeks after the treatment, as compared with the illness scores of the control group, the difference was statistically significant (P<0.05 or P<0.01). The effective rate of the treatment group (91.18%) was significantly higher than that of the control group (61.76%,P<0.01). Before treatment, the expression levels of IL-17, IL-22 and IL-23 were not statistically significantly different between the treatment group and the control group (P>0.05), but they were significantly higher than those of the healthy control group (P<0.01). After the treatment and 2 weeks after the treatment: 3 indexes of the treatment group were significantly lower than those before treatment [IL-17: (19.61±3.85), (20.05±3.63) pg·mL-1vs. (41.36±6.19) pg·mL-1, P<0.01; IL-22: (33.07±4.67), (33.18±4.36) pg·mL-1vs. (35.64±5.78) pg·mL-1, P<0.05; IL-23: (24.56±3.71), (24.95±3.45) pg·mL-1vs. (54.97±8.19) pg·mL-1, P<0.01]; 2 indexes of the control group were significantly lower than those before the treatment [IL-17: (37.83±5.07), (38.32±5.21) pg·mL-1vs. (40.77±6.45) pg·mL-1, P<0.05; IL-23: (51.86±6.22), (52.14±6.70) pg·mL-1vs. (55.46±7.81) pg·mL-1, P<0.05]; the 3 indexes of the treatment group were significantly different as compared with the control group (P<0.05 or P<0.01); IL-17, IL-22, IL-23 levels of the treatment group and IL-17, IL-23 levels of the control group had a significant positive correlation with the disease scores. Conclusion Compound lidocaine cream is effective in treating HDD, perhaps by down-regulating the expression levels of Th17-related cytokines (IL-17, IL-22 and IL-23) in serum of patients.
表2
两组患者治疗前后及健康组血清细胞因子含量比较
Tab.2
Comparison of serum cytokine content among two groups of patients and the healthy group before and after the treatment pg·mL-1,x¯±s
组别
例数
IL-17
IL-22
IL-23
健康组
30
17.74±3.15
15.65±2.76
19.23±4.07
对照组
34
治疗前
40.77±6.45*1
36.23±5.41*1
55.46±7.81*1
治疗后
37.83±5.07*2
35.15±4.58
51.86±6.22*2
疗后2周
38.32±5.21*2
35.46±4.65
52.14±6.70*2
治疗组
34
治疗前
41.36±6.19*1
35.64±5.78*1
54.97±8.19*1
治疗后
19.61±3.85*3*4
33.07±4.67*3*5
24.56±3.71*3*4
疗后2周
20.05±3.63*3*6
33.18±4.36*3*7
24.95±3.45*3
Compared with the healthy group, *1P<0.01; compared with the same group before the treatment, *2P<0.05,*3P<0.01; compared with control group after the treatment,*4P<0.01,*5P<0.05;compared with control group 2 weeks after the treatment, *6P<0.01,*7P<0.05
ASARCHA,BARAKO,LOO DS,et al.Th17 cells:A new therapeutic target in inflammatory dermatoses[J].,2008,19(6):318-326.
Th17 cells, named for their of interleukin-17 (), are a new class of T-cells involved in a wide range of cutaneous autoimmune and inflammatory conditions. An overactive Th17 cell response in the skin can produce damaging results. There appears to be a partial role for the Th17 axis in the of a range of including , , , and . Immunologists have also discovered a unique association between Th17 cells and . The Th17 branch has been linked to a number of additional systemic with significant cutaneous pathology such as , , , and . Newly developed treatment modalities for neutralizing the Th17 branch of the immune system are proving to be valuable additions to the current therapeutic armamentarium.
SANJABIS,ZENEWICZ LA,KAMANAKAM,et al.Anti-inflammatory and pro-inflammatory roles of TGF-beta,IL-10,and IL-22 in immunity and autoimmunity[J].,2009,9(4):447-453.
Cytokines play a major role in maintaining lymphocyte under both steady-state and inflammatory conditions. Unregulated lymphocytes in steady-state conditions can lead to autoimmunity, whereas during inflammation they can cause excessive tissue damage. Regulatory cytokines function in combination with other environmental signals to properly modulate the function and the extent of . Many recent studies have highlighted the importance of regulatory cytokines in controlling the differentiation and function of lymphocytes under steady-state and inflammatory conditions, as well as minimizing tissue damage.