Keijsers Romy R M C, Joosten Irma, Hendriks Anke G M, Koenen Hans J P M, van Erp Piet E J, van de Kerkhof Peter C M
Department of Dermatology, Radboud university medical center, Nijmegen, The Netherlands; Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud university medical center, Nijmegen, The Netherlands.
Exp Dermatol. 2015 Jan;24(1):65-7. doi: 10.1111/exd.12575. Epub 2014 Nov 18.
Diminished suppressive capacity of regulatory T cells (Treg) has been demonstrated in blood and in lesional skin of psoriatic patients. Treatment with anti-TNFα restored the number and function of circulating Treg in psoriasis. We aimed to study Treg in the skin of psoriatic patients undergoing topical treatment with calcipotriol-betamethasone dipropionate (CBD) ointment (n = 12) or systemic treatment with anti-TNFα agent adalimumab (n = 10). Skin biopsies were collected from patients with chronic plaque psoriasis who responded to the above-mentioned treatments with a SUM-score improvement of at least 50% (at the end of treatment). Biopsies were processed for immunohistochemistry. As Treg function is associated with a numerical balance between Treg and effector T cells, Foxp3/CD4 ratios were calculated. It appeared that both treatments cause a significant decrease in the presence of Foxp3+ cells. However, in patients that were treated with CBD ointment, we observed lower Foxp3/CD4 ratios after 8 weeks of treatment compared to baseline (t = 0: 0.41 ± 0.08; t = 8: 0.22 ± 0.04, P = 0.033), whereas in patients who were treated with adalimumab we observed an increase of the Foxp3/CD4 ratios after 1.5 and 16 weeks of treatment compared to baseline (t = 0: 0.25 ± 0.04; t = 1.5: 0.32 ± 0.06; t = 16: 0.49 ± 0.10, P = 0.15). Based on Foxp3/CD4 ratios, we can conclude that adalimumab treated skin differs from CBD treated skin with regard to the anti-inflammatory/inflammatory balance. We suggest that, in contrast to CBD ointment, adalimumab favours local Treg function in the skin.
在银屑病患者的血液和皮损中，已证实调节性T细胞（Treg）的抑制能力减弱。抗TNFα治疗可恢复银屑病患者循环Treg的数量和功能。我们旨在研究接受卡泊三醇-倍他米松二丙酸酯（CBD）软膏局部治疗（n = 12）或抗TNFα药物阿达木单抗全身治疗（n = 10）的银屑病患者皮肤中的Treg。从慢性斑块状银屑病患者中收集皮肤活检样本，这些患者对上述治疗有反应，治疗结束时SUM评分改善至少50%。活检样本进行免疫组织化学处理。由于Treg功能与Treg和效应T细胞之间的数量平衡相关，因此计算了Foxp3/CD4比率。结果显示，两种治疗均导致Foxp3+细胞数量显著减少。然而，在接受CBD软膏治疗的患者中，与基线相比，治疗8周后Foxp3/CD4比率降低（t = 0：0.41±0.08；t = 8：0.22±0.04，P = 0.033），而在接受阿达木单抗治疗的患者中，与基线相比，治疗1.5周和16周后Foxp3/CD4比率升高（t = 0：0.25±0.04；t = 1.5：0.32±0.06；t = 16：0.49±0.10，P = 0.15）。基于Foxp3/CD4比率，我们可以得出结论，在抗炎/炎症平衡方面，阿达木单抗治疗的皮肤与CBD治疗的皮肤不同。我们认为，与CBD软膏相比，阿达木单抗有利于皮肤局部Treg功能。
