Faculdade de Farmácia, Serviço de Bioquímica, Universidade do Porto, Porto, Portugal.
J Eur Acad Dermatol Venereol. 2010 Jul;24(7):789-96. doi: 10.1111/j.1468-3083.2009.03527.x. Epub 2009 Dec 11.
Psoriasis vulgaris is a chronic recurrent inflammatory skin disease and psoriatic lesions have shown leucocyte infiltration.
We aimed to study C-reactive protein (CRP) and leucocyte activation markers/inhibitors as potential monitors of psoriasis vulgaris.
A cross-sectional (n = 73) and a longitudinal study (before, at 3, 6 and 12 weeks of therapy; n = 47) was performed; 10 patients started topical treatment, 17 narrow-band ultraviolet light B (NBUVB) and 20 psolaren associated to UVA (PUVA); psoriasis severity was defined by Psoriasis Area and Severity Index (PASI).
Compared with control (n = 38), we found higher CRP levels, total leukocyte/neutrophil count, elastase, lactoferrin and alpha1-antitrypsin. Increasing PASI was linked to increasing CRP and a trend to higher elastase and lactoferrin, suggesting that worsening enhances inflammatory response with neutrophil activation. CRP correlated with PASI, total leucocytes, neutrophils, elastase, lactoferrin and alpha1-antitrypsin. NBUVB and PUVA presented similar effects.
We propose CRP as a useful marker of psoriasis severity that could be used to monitor psoriasis and its treatment, and, together with PASI and elastase, could also be used as a global index of severity.
寻常型银屑病是一种慢性复发性炎症性皮肤病，银屑病皮损有白细胞浸润。
我们旨在研究 C 反应蛋白（CRP）和白细胞激活标志物/抑制剂作为寻常型银屑病潜在的监测指标。
进行了横断面（n = 73）和纵向研究（治疗前、3、6 和 12 周时；n = 47）；10 例患者开始接受局部治疗，17 例接受窄带紫外线 B（NBUVB）治疗，20 例接受光化学疗法（PUVA）；银屑病严重程度用银屑病面积和严重程度指数（PASI）来定义。
与对照组（n = 38）相比，我们发现 CRP 水平、总白细胞/中性粒细胞计数、弹性蛋白酶、乳铁蛋白和α1-抗胰蛋白酶较高。PASI 增加与 CRP 增加以及弹性蛋白酶和乳铁蛋白增加呈正相关，表明病情恶化会增强炎症反应和中性粒细胞的激活。CRP 与 PASI、总白细胞、中性粒细胞、弹性蛋白酶、乳铁蛋白和α1-抗胰蛋白酶相关。NBUVB 和 PUVA 有相似的效果。
我们提出 CRP 是一种有用的银屑病严重程度标志物，可用于监测银屑病及其治疗，与 PASI 和弹性蛋白酶一起，也可作为严重程度的综合指标。
