Department of Dermatology and Venereology, Medical University of Bialystok, Bialystok, Poland.
Photodermatol Photoimmunol Photomed. 2010 Feb;26(1):36-40. doi: 10.1111/j.1600-0781.2009.00485.x.
The aim of the study was to analyze the relationship between smoking and the treatment with narrowband ultraviolet B (NB-UVB) in psoriasis patients and to examine the role of the soluble tumor necrosis factor-alpha receptor type one (sTNF-R1) in plasma and that of TNF-alpha-converting enzyme (TACE) released from peripheral blood mononuclear cells (PBMC) in this relationship.
The study has been conducted among 45 inpatients with plaque-type psoriasis vulgaris and 36 inpatients with other chronic inflammatory skin disorders from similar social background (controls). Taking into account the number of cigarettes smoked daily and the duration of smoking, subjects were classified as mild, moderate and heavy smokers. The severity of psoriasis was assessed using psoriasis area and severity index (PASI) score, concentrations of sTNF-R1 and TACE (expressed in ng/ml)--with quantitative sandwich enzyme immunoassays before (T(0)) and after 20 NB-UVB irradiations (T(20)).
The pretreatment concentration of sTNF-R1 was 2.55+/-0.17 in patients and 1.79+/-0.13 in controls (P<0.05) and that of TACE - 2.62+/-0.34 and 1.29+/-0.25, P<0.05, respectively. PASI score correlated with sTNF-R1 and with TACE concentrations (R=0.40 and R=0.38, P<0.05, respectively). PASI score, sTNF-R1 and TACE concentrations were similar in mild, moderate and in heavy smokers. PASI score and TACE concentration declined significantly after treatment in three groups; the lowest TACE concentration at T(20) was noticed in mild smokers, the highest in heavy smokers (0.86+/-0.26 and 1.91+/-0.20, P<0.05, respectively). The post-treatment PASI score correlated with the intensity of smoking and with TACE concentration (R=0.50 and R=0.47, P<0.05, respectively). The strong correlation between the pretreatment TACE concentration and the treatment outcome was observed in heavy smokers (R=0.63, P<0.05).
The baseline TACE concentration in PBMC may be of value in predicting the response to the treatment with NB-UVB in smoking psoriasis patients. Smoking may adversely influence this treatment and TACE may be one of mediators in this influence.
本研究旨在分析吸烟与窄谱中波紫外线（NB-UVB）治疗银屑病患者之间的关系，并探讨血浆中可溶性肿瘤坏死因子-α受体 1（sTNF-R1）和外周血单个核细胞（PBMC）中 TNF-α转换酶（TACE）的作用。
本研究纳入了 45 例斑块型寻常型银屑病住院患者和 36 例具有类似社会背景的其他慢性炎症性皮肤疾病住院患者（对照组）。根据每日吸烟量和吸烟时间，将受试者分为轻度、中度和重度吸烟者。采用银屑病面积和严重程度指数（PASI）评分评估银屑病严重程度，采用定量夹心酶免疫吸附法检测 sTNF-R1 和 TACE 浓度（以 ng/ml 表示），并在治疗前（T(0)）和 20 次 NB-UVB 照射后（T(20)）进行检测。
治疗前，患者的 sTNF-R1 浓度为 2.55±0.17ng/ml，对照组为 1.79±0.13ng/ml（P<0.05），TACE 浓度分别为 2.62±0.34ng/ml 和 1.29±0.25ng/ml（P<0.05）。PASI 评分与 sTNF-R1 和 TACE 浓度呈正相关（R=0.40 和 R=0.38，P<0.05）。在轻度、中度和重度吸烟者中，PASI 评分、sTNF-R1 和 TACE 浓度均相似。三组患者治疗后 PASI 评分和 TACE 浓度均显著下降，其中轻度吸烟者 TACE 浓度最低（T(20)时为 0.86±0.26ng/ml），重度吸烟者最高（T(20)时为 1.91±0.20ng/ml）（P<0.05）。治疗后 PASI 评分与吸烟强度和 TACE 浓度呈正相关（R=0.50 和 R=0.47，P<0.05）。重度吸烟者治疗前 TACE 浓度与治疗效果呈强相关（R=0.63，P<0.05）。
PBMC 中 TACE 浓度可能有助于预测吸烟银屑病患者对 NB-UVB 治疗的反应。吸烟可能会对这种治疗产生不利影响，而 TACE 可能是这种影响的中介之一。
