Prens E P, van Joost T, Hegmans J P, t Hooft-Benne K, Ysselmuiden O E, Benner R
Department of Immunology, University Hospital Rotterdam-Dijkzigt, The Netherlands.
J Am Acad Dermatol. 1995 Dec;33(6):947-53. doi: 10.1016/0190-9622(95)90285-6.
Oral cyclosporine is effective in the treatment of recalcitrant psoriasis. However, the precise mechanism(s) are not fully understood. A possible mode of action may be via down-modulation of proinflammatory cytokines that are increased in psoriatic lesions.
This study was designed to monitor the effects of cyclosporine treatment on the expression of cytokines, cytokine receptors, and other markers of inflammation in psoriatic skin.
Ten patients with recalcitrant psoriasis were treated with cyclosporine. The in vivo effects of cyclosporine on cytokines and their receptors were studied by the use of cryostat-cut sections and a panel of antibodies. The in vitro effects were studied with flow cytometry of epidermal cell suspensions prepared from psoriatic lesions and control skin.
Clinical improvement was noted in all patients after 2 weeks of cyclosporine treatment. The expression of interleukin-1 beta, interleukin-8, CD25(IL-2R), CD36 and E-selectin were significantly decreased, whereas the number of tumor necrosis factor-receptor-positive epidermal cells was significantly increased in psoriatic lesions.
Clinical improvement of psoriasis with cyclosporine treatment is accompanied by down modulation of proinflammatory epidermal cytokines and decreased dermal inflammation. Thus besides suppressing cytokine production by the inflammatory infiltrate, the beneficial effect of cyclosporine in psoriasis also depends on the inhibition of the epidermal cytokine network.
口服环孢素对顽固性银屑病有效。然而，其确切机制尚未完全明确。一种可能的作用方式可能是通过下调银屑病皮损中升高的促炎细胞因子。
本研究旨在监测环孢素治疗对银屑病皮肤中细胞因子、细胞因子受体及其他炎症标志物表达的影响。
10例顽固性银屑病患者接受环孢素治疗。利用低温恒温切片和一组抗体研究环孢素对细胞因子及其受体的体内作用。通过对银屑病皮损和对照皮肤制备的表皮细胞悬液进行流式细胞术研究体外作用。
环孢素治疗2周后所有患者均有临床改善。银屑病皮损中白细胞介素-1β、白细胞介素-8、CD25（IL-2R）、CD36和E-选择素的表达显著降低，而肿瘤坏死因子受体阳性表皮细胞数量显著增加。
环孢素治疗银屑病临床改善的同时伴有促炎表皮细胞因子下调和真皮炎症减轻。因此，环孢素在银屑病中的有益作用除了抑制炎症浸润产生细胞因子外，还依赖于对表皮细胞因子网络的抑制。
