Bellaud G, Gheit T, Pugin A, Prétet J L, Tommasino M, Mougin C, Aubin F
Service de Dermatologie, Centre Hospitalier Universitaire, Besançon, France.
J Eur Acad Dermatol Venereol. 2014 Dec;28(12):1816-20. doi: 10.1111/jdv.12308. Epub 2013 Nov 9.
Tumour necrosis factor alpha (TNF-α) inhibitors are associated with an increased risk of infections and with a still debatable risk of skin cancer. Furthermore, cutaneous human papillomavirus (HPV) infection may be involved in skin cancer.
Our primary objective was to assess the HPV DNA prevalence in psoriasis patients treated with TNF inhibitors and the secondary objective was to assess the same parameter before and during treatment.
Plucked eyebrow hairs were collected from 151 consecutive patients with moderate to severe chronic plaque psoriasis, including 48 patients treated with anti-TNF-α agents, 21 patients treated with methotrexate (MTX) and 82 patients with no previous systemic treatment. Among them, 38 patients were subsequently treated with either MTX or anti-TNF-α agents. HPV genotyping was performed using the HPV type-specific E7 PCR bead-based multiplex allowing the detection of 27 genus-α types, 25 genus-β types, 16 genus-γ types and one single genus-μ type. Follow-up provided a total of 972.7 person-months of overall exposure for patients treated with TNF inhibitors and 326.9 person-months for patients treated with MTX.
Our data confirm the high prevalence of β-HPV infection in healthy skin of psoriasis patients (68.9%), with no significant difference between untreated patients (64.6%), patients treated with MTX (76.2%) and patients treated with anti-TNF-α agents (72.9%). The mean number of different HPV types and the distribution of HPV types were similar in different groups of patients. Moreover, in prospectively treated patients, we did not observe any change in the HPV DNA prevalence in the distribution of HPV types and the number of HPV types after a mean duration of treatment of 332 ± 39.8 days.
Despite the small number of patients in our cohort, our results are quite encouraging in view of the increased use of anti-TNF-α agents in different auto inflammatory immune diseases.
肿瘤坏死因子α（TNF-α）抑制剂与感染风险增加以及皮肤癌风险仍存在争议有关。此外，皮肤人乳头瘤病毒（HPV）感染可能与皮肤癌有关。
我们的主要目的是评估接受TNF抑制剂治疗的银屑病患者中HPV DNA的患病率，次要目的是评估治疗前和治疗期间的同一参数。
从151例连续的中度至重度慢性斑块状银屑病患者中采集拔下的眉毛，其中48例接受抗TNF-α药物治疗，21例接受甲氨蝶呤（MTX）治疗，82例未接受过全身治疗。其中，38例患者随后接受了MTX或抗TNF-α药物治疗。使用基于HPV型特异性E7 PCR磁珠的多重检测方法进行HPV基因分型，可检测27种α属型、25种β属型、16种γ属型和1种μ属型。随访为接受TNF抑制剂治疗的患者提供了总共972.7人月的总体暴露时间，为接受MTX治疗的患者提供了326.9人月的暴露时间。
我们的数据证实了银屑病患者健康皮肤中β-HPV感染的高患病率（68.9%），未治疗患者（64.6%）、接受MTX治疗的患者（76.2%）和接受抗TNF-α药物治疗的患者（72.9%）之间无显著差异。不同患者组中不同HPV类型的平均数和HPV类型的分布相似。此外，在接受前瞻性治疗的患者中，平均治疗332±39.8天后，我们未观察到HPV DNA患病率、HPV类型分布和HPV类型数量有任何变化。
尽管我们队列中的患者数量较少，但鉴于抗TNF-α药物在不同自身炎症性免疫疾病中的使用增加，我们的结果相当令人鼓舞。
