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度普利尤单抗治疗特应性皮炎的疗效及其对血清胸腺和活化调节趋化因子、人β-防御素2及特异性IgE水平和外周血辅助性T细胞亚群的影响。

Effect of dupilumab for the therapy of atopic dermatitis and the effect on serum TARC, HBD2 and SEA-IgE levels and peripheral blood T helper cell subtypes.

作者信息

Tian Xin, Li Junlong, Xu Haiyan, Liang Jingyao, Yang Yan, Gao Aili, Zhao Xiaolan, Shao Lei, Zhang Jing, Ye Qianru, Xue Rujun, Huang Qiongxiao, Yu Yihui, Xia Manqi, Li Xiaodong, Wu Jiang, Fang Ruihua, Wang Jianqin, Liu Yumei

机构信息

Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, P.R. China.

Department of Dermatology, Guangzhou First People's Hospital, Guangzhou, Guangdong 510180, P.R. China.

出版信息

Exp Ther Med. 2025 May 16;30(1):138. doi: 10.3892/etm.2025.12888. eCollection 2025 Jul.

Abstract

Atopic dermatitis (AD) presents as a prevalent chronic, relapsing, inflammatory skin condition. While dupilumab has proven effective in treating moderate-to-severe AD, some patients still experience unsatisfactory outcomes with this therapy in clinical settings. Patients with AD receiving dupilumab were selected for inclusion in the present study for prospective observations. Over an 8-week period, the patients underwent monitoring and changes in serum biomarkers and circulating T helper (Th) cell levels were analyzed using questionnaires, ELISA and flow cytometry. The Scoring Atopic Dermatitis (SCORAD), Objective-SCORAD, Itch Numeric Rating Scale (NRS), Dermatology Life Quality Index, Patient Oriented Eczema measure and Atopic Dermatitis Control Tools scores in patients with AD significantly decreased at week 8 compared with those before treatment (P<0.05). Moderate positive correlations were demonstrated between serum thymus and activation-regulated chemokine (TARC) and human β-defensin 2 levels and Eczema Area and Severity Index (EASI) and SCORAD scores (P<0.05). A weak negative correlation was shown between serum IgE against enterotoxin A level and the EASI and SCORAD scores, although these were not statistically significant (P>0.05). There was a notable increase in the proportion of Th2 cells in peripheral blood at week 2 (P<0.05). The proportion of Th22 cells in the peripheral blood was weakly correlated with the NRS score (P>0.05). Patients were categorized into rapid or slow groups depending on whether they achieved EASI-75 scores by week 8. The proportion of Th17 cells in peripheral blood in the rapid group at week 8 of treatment was lower than that compared with the slow group at week 2 (P<0.05). The SCORAD scores of the rapid group were significantly lower compared with those of the slow group at week 8 of treatment (P<0.05). The conventional dupilumab treatment regimen led to a marked remission in patients with exogenous AD after 8 weeks of therapy. Significant correlations were observed between serum TARC levels and clinical disease scores (P<0.05), which changed notably during treatment and remained valuable for monitoring disease progression at follow-up. Additionally, the elevated ratio of Th17 cells in peripheral blood at week 2 of treatment showed potential for predicting the attainment of EASI-75 by week 8 after treatment.

摘要

特应性皮炎(AD)是一种常见的慢性、复发性炎症性皮肤病。虽然度普利尤单抗已被证明对治疗中度至重度AD有效,但在临床环境中,一些患者接受这种治疗的效果仍不尽人意。本研究选取接受度普利尤单抗治疗的AD患者进行前瞻性观察。在8周的时间里,对患者进行监测,并通过问卷调查、酶联免疫吸附测定(ELISA)和流式细胞术分析血清生物标志物和循环T辅助(Th)细胞水平的变化。与治疗前相比,AD患者在第8周时的特应性皮炎评分(SCORAD)、客观SCORAD、瘙痒数字评定量表(NRS)、皮肤病生活质量指数、患者导向性湿疹测量和特应性皮炎控制工具评分均显著降低(P<0.05)。血清胸腺和活化调节趋化因子(TARC)及人β-防御素2水平与湿疹面积和严重程度指数(EASI)及SCORAD评分之间呈中度正相关(P<0.05)。血清抗肠毒素A IgE水平与EASI及SCORAD评分之间呈弱负相关,尽管差异无统计学意义(P>0.05)。在第2周时,外周血中Th2细胞比例显著增加(P<0.05)。外周血中Th22细胞比例与NRS评分呈弱相关(P>0.05)。根据患者在第8周时是否达到EASI-75评分,将其分为快速组或缓慢组。治疗第8周时,快速组外周血中Th17细胞比例低于缓慢组第2周时的比例(P<0.05)。治疗第8周时,快速组的SCORAD评分显著低于缓慢组(P<0.05)。常规度普利尤单抗治疗方案在治疗8周后使外源性AD患者显著缓解。血清TARC水平与临床疾病评分之间存在显著相关性(P<0.05),其在治疗期间有显著变化,且在随访中对监测疾病进展仍有价值。此外,治疗第2周时外周血中Th17细胞比例升高显示出预测治疗后第8周达到EASI-75的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f099/12131307/151f7e22d7cd/etm-30-01-12888-g00.jpg

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