Chen Yong, Yi Mei, Pang Xiaoyan, Du Mengfei, Chen Haizhou, Li Zhenshu
Department of Dermatology, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong Province, China.
Department of Pathology, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong Province, China.
Postepy Dermatol Alergol. 2024 Feb;41(1):113-120. doi: 10.5114/ada.2023.135605. Epub 2024 Feb 28.
Psoriasis is a T cell-mediated polygenic chronic inflammatory disease. Interleukin (IL)-17A plays a major role in psoriasis pathogenesis. Secukinumab is a high-affinity human monoclonal antibody against IL-17A.
This article explored efficacy and safety of secukinumab plus tretinoin in moderate to severe psoriasis (MSP) vulgaris, and assessed metabolism, liver function, and inflammation.
A total of 135 patients diagnosed with moderate or severe psoriasis vulgaris were enrolled and randomized into three groups at a 1 : 1 : 1 ratio, receiving treatment with rretinoin, secukinumab, or combination therapy for a duration of 16 weeks. Psoriasis area and severity index (PASI) scores, serum T lymphocyte subsets, glucose, lipid, and uric acid (UA) metabolism, liver enzymes, and inflammatory factors (IFs) were measured.
Following the therapy, subjects had decreased PASI scores, increased serum CD3+, CD4+, and CD4+/CD8+, decreased serum CD8+, and decreased serum UA and IL-2, IL-6, IL-23, interferon-γ (IFN-γ), and tumor necrosis factor (TNF)-α ( < 0.05). Total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, apolipoproteins A1, B, fasting blood glucose, alanine transaminase, aspartate transaminase, and alkaline phosphatase had no obvious differences among the subjects ( > 0.05). As against the Tretinoin and the Secukinumab groups, the PASI score was visiblysmaller, the changes in serum T lymphocyte subsets were more obvious, and serum UA and IFs were lower in the Combination group following the therapy ( < 0.05).
Secukinumab combined with tretinoin is more effective in MSP vulgaris, which can visibly reduce inflammatory response without affecting glucose and lipid metabolism and liver function.
银屑病是一种由T细胞介导的多基因慢性炎症性疾病。白细胞介素(IL)-17A在银屑病发病机制中起主要作用。司库奇尤单抗是一种针对IL-17A的高亲和力人单克隆抗体。
本文探讨司库奇尤单抗联合维甲酸治疗寻常型中度至重度银屑病(MSP)的疗效和安全性,并评估代谢、肝功能和炎症情况。
共纳入135例诊断为中度或重度寻常型银屑病患者,按1:1:1比例随机分为三组,分别接受维甲酸、司库奇尤单抗或联合治疗,疗程为16周。测量银屑病面积和严重程度指数(PASI)评分、血清T淋巴细胞亚群、血糖、血脂和尿酸(UA)代谢、肝酶和炎症因子(IFs)。
治疗后,受试者的PASI评分降低,血清CD3+、CD4+和CD4+/CD8+升高,血清CD8+降低,血清UA以及IL-2、IL-6、IL-23、干扰素-γ(IFN-γ)和肿瘤坏死因子(TNF)-α降低(<0.05)。受试者的总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、载脂蛋白A1、B、空腹血糖、丙氨酸转氨酶、天冬氨酸转氨酶和碱性磷酸酶无明显差异(>0.05)。与维甲酸组和司库奇尤单抗组相比,联合治疗组治疗后PASI评分明显更小,血清T淋巴细胞亚群变化更明显,血清UA和IFs更低(<0.05)。
司库奇尤单抗联合维甲酸治疗寻常型MSP更有效,可明显降低炎症反应,且不影响糖脂代谢和肝功能。