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生物制剂可调节银屑病患者的抗核抗体、免疫球蛋白 E 和嗜酸性粒细胞计数。

Biologics modulate antinuclear antibodies, immunoglobulin E, and eosinophil counts in psoriasis patients.

机构信息

Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Department of Dermatology, National Defense Medical College, Tokorozawa, Japan.

出版信息

J Dermatol. 2021 Nov;48(11):1739-1744. doi: 10.1111/1346-8138.16102. Epub 2021 Aug 8.

Abstract

Psoriasis is a chronic disease centered on tumor necrosis factor (TNF), interleukin (IL)-23, and IL-17 axis. While psoriasis patients benefit from biologics targeting TNF, IL-17s, and IL-23 nowadays, suppression of these molecules could modulate the balances of immune systems. However, the incidence of autoimmune disease and T-helper 2 reaction during biologic treatments for psoriasis patients is not well documented. We retrospectively examined antinuclear antibody (ANA), eosinophil counts, and immunoglobulin E (IgE) levels for psoriasis patients who underwent biologic treatments in our dermatology clinic from June 10, 2010 to January 29, 2020. A cumulative total of 199 biologic treatments were performed for a total of 128 psoriasis patients. Compared to the non-biologic group of 109 psoriasis patients who received non-biologic treatment, patients treated with infliximab showed more incidents of high ANA (14%, p = 0.039) and high eosinophils (14%, p = 0.021). The use of brodalumab increased incidents of high eosinophils (21%, p = 0.005) but did not affect increase in ANA and IgE. The increase in high IgE level was observed significantly more during the use of risankizumab (15%, p = 0.011). Methotrexate was the most frequently used concomitant systemic treatment, but methotrexate did not affect ANA, eosinophil counts, and IgE levels. Since the biologics for psoriasis treatment modulate the balance of T-helper cells, careful observation is required to detect unexpected changes of systemic immune conditions under biologic treatments.

摘要

银屑病是一种以肿瘤坏死因子(TNF)、白细胞介素(IL)-23 和 IL-17 轴为中心的慢性疾病。虽然银屑病患者现在受益于针对 TNF、IL-17s 和 IL-23 的生物制剂,但这些分子的抑制可能会调节免疫系统的平衡。然而,在银屑病患者的生物治疗中,自身免疫疾病和辅助性 T 细胞 2 反应的发生率尚未得到很好的记录。我们回顾性地检查了 2010 年 6 月 10 日至 2020 年 1 月 29 日在我们皮肤科诊所接受生物治疗的银屑病患者的抗核抗体(ANA)、嗜酸性粒细胞计数和免疫球蛋白 E(IgE)水平。共有 128 例银屑病患者接受了 199 次生物治疗。与接受非生物治疗的 109 例非生物组银屑病患者相比,接受英夫利昔单抗治疗的患者出现高 ANA(14%,p=0.039)和高嗜酸性粒细胞(14%,p=0.021)的情况更多。使用布罗达卢单抗会增加高嗜酸性粒细胞的发生(21%,p=0.005),但不会影响 ANA 和 IgE 的增加。在使用 risankizumab 时,高 IgE 水平的增加更为明显(15%,p=0.011)。甲氨蝶呤是最常使用的伴随全身治疗药物,但甲氨蝶呤不会影响 ANA、嗜酸性粒细胞计数和 IgE 水平。由于治疗银屑病的生物制剂会调节辅助性 T 细胞的平衡,因此需要仔细观察生物治疗下全身免疫状况的意外变化。

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