Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland.
Int J Environ Res Public Health. 2022 Jul 8;19(14):8345. doi: 10.3390/ijerph19148345.
The natural course of psoriasis is characterized by the long-term persistence of lesions and a predilection for relapse in the same area. It is caused by the inherence of TRM (tissue resident memory T cells) in apparently healthy skin. These cells are able to initiate an inflammatory cascade and induce relapse of the disease. These cells are characterized by high resistance to damaging factors and apoptosis, which determines their longevity.
The aim of our study was to evaluate the presence of TRM in psoriatic plaques before, during and after 12 weeks of therapy in patients treated with topical calcipotriol and betamethasone dipropionate (Cal/BD) foam.
TRM markers (CD4, CD8, CD103, CD69, CD49, CXCR6) and tissue expression of cytokines (IL-17A, IL-22) in the lesional psoriatic skin from 10 patients compared to 10 healthy skin samples were estimated by immunohistochemistry. Biopsy samples from the area of the same psoriatic plaque were collected three times: before the initiation of therapy, 4 and 12 weeks after its initiation.
The presence of TRM markers in the epidermis and dermis of psoriatic lesions was significantly higher when compared to the skin of control group patients. A reduction in the expression of the characteristic TRM markers (CD8, CD4, CD103, CD69, CXCR6, IL-17A and IL-22) was observed in the epidermis on week 12 of therapy, while a depletion in the expression of TRM in the dermis was demonstrated only in CD4 and IL-22.
Topical treatment with Cal/BD foam significantly decreased the expression of TRM markers mainly in the epidermis, and to a lesser extent in the dermis, during the 12-week observation period. It probably results from a worse penetration of the drug into the dermis and the effect of the preparation mainly on the epidermis. The persistence of a high expression of TRM markers in the dermis may result in the rapid recurrence of lesions after discontinuation of topical treatment.
银屑病的自然病程以皮损的长期存在和同一部位的复发倾向为特征。它是由明显健康皮肤中的 TRM（组织驻留记忆 T 细胞）内在引起的。这些细胞能够引发炎症级联反应，并诱导疾病复发。这些细胞的特征是对损伤因素和细胞凋亡具有高抗性，这决定了它们的寿命。
我们的研究目的是评估在接受外用钙泊三醇和倍他米松二丙酸酯（Cal/BD）泡沫治疗的患者中，在治疗前、治疗期间和治疗 12 周后，TRM 在银屑病斑块中的存在情况。
通过免疫组织化学法比较 10 例患者的病变银屑病皮肤与 10 例健康皮肤样本，评估 TRM 标志物（CD4、CD8、CD103、CD69、CD49、CXCR6）和组织中细胞因子（IL-17A、IL-22）的表达。在治疗开始前、治疗开始后 4 周和 12 周，从同一银屑病斑块的同一区域采集活检样本。
与对照组患者皮肤相比，银屑病皮损表皮和真皮中 TRM 标志物的存在明显更高。在治疗的第 12 周，观察到表皮中特征性 TRM 标志物（CD8、CD4、CD103、CD69、CXCR6、IL-17A 和 IL-22）的表达减少，而真皮中 TRM 的表达减少仅在 CD4 和 IL-22 中得到证实。
在 12 周的观察期内，外用 Cal/BD 泡沫治疗显著降低了 TRM 标志物的表达，主要在表皮，在真皮中则略有降低。这可能是由于药物向真皮的渗透较差以及制剂主要作用于表皮的结果。TRM 标志物在真皮中高表达的持续存在可能导致外用治疗停止后病变迅速复发。
