Metwally D, Sayed K, Abdel Hay R, Rashed L
Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Clinical Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt.
Clin Exp Dermatol. 2015 Jun;40(4):416-20. doi: 10.1111/ced.12517. Epub 2014 Dec 31.
Plasmin (PL) is a potent inflammatory cell activator, and ultraviolet (UV)B has immunomodulatory effects on cutaneous inflammatory responses. There are no previous studies comparing the effect of narrowband (NB)-UVB on tissue PL levels in psoriasis.
To estimate the possible role of PL in the pathogenesis of psoriasis, and to evaluate the effect of NB-UVB on tissue PL in psoriasis.
This case-control study enrolled 21 patients with psoriasis and 20 clinically healthy volunteers matched for age and sex. Patients underwent 24 sessions of NB-UVB radiation. Biopsy samples using a 4 mm punch were taken from all patients before and after treatment and from the controls for estimation of tissue PL level by ELISA.
Tissue PL was significantly upregulated in psoriasis before treatment (mean ± SD 1.73 ± 1.23 ng/mg protein) compared with controls (0.21 ± 0.15 ng/mg protein) (P < 0.001). A statistically significant positive correlation (P = 0.02) was found between the tissue PL before treatment and the Psoriasis Area and Severity Index. Patients received 24 sessions of NB-UVB, with a mean cumulative dose of 23.25 ± 8.14 mJ/cm(2) . Tissue PL levels were reduced by a mean of 30.3% post-treatment compared with baseline (P < 0.001). The reduction in Pl levels was significantly correlated with the cumulative dose of NB-UVB, and with the percentage reduction in PASI (P < 0.001).
Our study highlights the possible role played by tissue PL level in the pathogenesis of psoriasis. PL level appears to reflect disease severity, and is a possible marker of therapeutic efficacy of NB-UVB on psoriatic skin.
纤溶酶（PL）是一种强效的炎症细胞激活剂，而紫外线（UV）B对皮肤炎症反应具有免疫调节作用。此前尚无研究比较窄谱（NB）-UVB对银屑病组织PL水平的影响。
评估PL在银屑病发病机制中的可能作用，并评价NB-UVB对银屑病组织PL的影响。
本病例对照研究纳入了21例银屑病患者和20名年龄及性别匹配的临床健康志愿者。患者接受24次NB-UVB照射。在治疗前后从所有患者以及对照者身上采集4毫米打孔活检样本，通过酶联免疫吸附测定法（ELISA）评估组织PL水平。
与对照组（0.21±0.15纳克/毫克蛋白质）相比，银屑病患者治疗前组织PL显著上调（均值±标准差为1.73±1.23纳克/毫克蛋白质）（P<0.001）。治疗前组织PL与银屑病面积和严重程度指数之间存在统计学上显著的正相关（P = 0.02）。患者接受了24次NB-UVB照射，平均累积剂量为23.25±8.14毫焦/平方厘米。与基线相比，治疗后组织PL水平平均降低了30.3%（P<0.001）。PL水平的降低与NB-UVB的累积剂量以及银屑病面积和严重程度指数（PASI）的降低百分比显著相关（P<0.001）。
我们的研究突出了组织PL水平在银屑病发病机制中可能发挥的作用。PL水平似乎反映了疾病的严重程度，并且可能是NB-UVB对银屑病皮肤治疗效果的一个标志物。
