Kanayama Yoshifumi, Torii Kan, Ikumi Kyoko, Morita Akimichi
Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
JID Innov. 2021 May 24;1(3):100027. doi: 10.1016/j.xjidi.2021.100027. eCollection 2021 Sep.
Psoriasis is a chronic inflammatory proliferative skin disease involving various types of chemokines regulating immune cell migration, localization, and activation. Bath psoralen plus UVA (PUVA) treatment is an established phototherapy for psoriasis, but its effects on chemokine levels remain unknown. We investigated the levels of 22 serum chemokines in 20 patients with psoriasis first treated with bath PUVA therapy between 2007 and 2011 in a single center and analyzed the associations between the chemokines and disease severity (PASI) before and after therapy to investigate the mechanisms of action of bath PUVA therapy. Before bath PUVA therapy, the PASI scores correlated with the serum levels of CCL17 (r = 0.581), CCL18 (r = 0.462), CCL19 (r = 0.477), and CXCL16 (r = 0.524). After bath PUVA, the serum levels of CCL17, CCL22, CXCL1, and CXCL9 were significantly decreased. Heatmap clustering and network analysis based on statistically significant Spearman correlations among the chemokines showed distinctive changes in the chemokine signature. Our findings revealed that the levels of several chemokines correlated with the disease state of psoriasis. Furthermore, bath PUVA therapy reduced the secretion of keratinocyte-derived chemokines that induce the migration of immune cells important for psoriasis pathogenesis, partly revealing the mechanism of the therapeutic activity.
银屑病是一种慢性炎症性增殖性皮肤病，涉及多种调节免疫细胞迁移、定位和激活的趋化因子。沐浴补骨脂素联合紫外线A（PUVA）疗法是一种已确立的银屑病光疗方法，但其对趋化因子水平的影响尚不清楚。我们调查了2007年至2011年在单一中心首次接受沐浴PUVA治疗的20例银屑病患者的22种血清趋化因子水平，并分析了治疗前后趋化因子与疾病严重程度（银屑病面积和严重程度指数，PASI）之间的关联，以研究沐浴PUVA疗法的作用机制。在沐浴PUVA治疗前，PASI评分与CCL17（r = 0.581）、CCL18（r = 0.462）、CCL19（r = 0.477）和CXCL16（r = 0.524）的血清水平相关。沐浴PUVA治疗后，CCL17、CCL22、CXCL1和CXCL9的血清水平显著降低。基于趋化因子之间具有统计学意义的斯皮尔曼相关性进行的热图聚类和网络分析显示趋化因子特征有明显变化。我们的研究结果表明，几种趋化因子的水平与银屑病的疾病状态相关。此外，沐浴PUVA疗法减少了角质形成细胞衍生的趋化因子的分泌，这些趋化因子可诱导对银屑病发病机制重要的免疫细胞迁移，部分揭示了治疗活性的机制。
