Pelletier Fabien, Garnache-Ottou Francine, Biichlé Sabeha, Vivot Aurore, Humbert Philippe, Saas Philippe, Seillès Estelle, Aubin François
University of Franche-Comté, INSERM UMR1098, Besançon, France; Dermatology Department, Besançon Hospital, Besançon, France; Hematology or Immunology Laboratory, EFS- Bourgogne Franche-Comté, UMR1098, Biomonitoring, Besançon, France.
Exp Dermatol. 2014 Dec;23(12):924-5. doi: 10.1111/exd.12551.
Psoriasis involves TNF-α secretion leading to release of microparticles into the bloodstream. We investigated the effect of TNF blockers on microparticles levels before and after treatment in patients (twenty treated by anti-TNF-α agents and 6 by methotrexate) with severe psoriasis. Plasmatic microparticles were labelled using fluorescent monoclonal antibodies and were analysed using cytometry. Three months later, 70% of patients treated with anti-TNF-α agents achieved a reduction in PASI score of at least 75%. The clinical improvement in patients treated with anti-TNF-α agents was associated with a significant reduction of the mean number of platelet microparticles (2837/μl vs 1849/μl, P = 0.02) and of endothelial microparticles (64/μl vs 22/μl, P = 0.001). Microparticles are significantly decreased in psoriatic patients successfully treated by anti-TNF-α. Microparticles levels as circulating endothelial cells represent signs of endothelial dysfunction and are elevated in psoriasis. Then, TNF blockade may be effective to reduce cardiovascular risk through the reduction of circulating microparticles.
银屑病涉及肿瘤坏死因子-α（TNF-α）的分泌，导致微粒释放到血液中。我们研究了TNF阻滞剂对重度银屑病患者治疗前后微粒水平的影响（20例接受抗TNF-α药物治疗，6例接受甲氨蝶呤治疗）。使用荧光单克隆抗体标记血浆微粒，并通过细胞计数法进行分析。三个月后，70%接受抗TNF-α药物治疗的患者达到银屑病面积和严重程度指数（PASI）评分至少降低75%。接受抗TNF-α药物治疗患者的临床改善与血小板微粒平均数量显著减少有关（2837/μl对1849/μl，P = 0.02），以及内皮微粒数量显著减少（64/μl对22/μl，P = 0.001）。在成功接受抗TNF-α治疗的银屑病患者中，微粒显著减少。作为循环内皮细胞的微粒水平代表内皮功能障碍的迹象，在银屑病中升高。因此，TNF阻断可能通过减少循环微粒有效降低心血管风险。
