摘要
目的探讨血清白介素-30(IL-30)、自噬相关基因5(ATG5)在寻常型银屑病(PV)中的表达及临床意义。方法选取2022年1月-2024年8月成都市第二人民医院皮肤科收治的PV患者100例(PV组)和同期来院体检健康者100例(健康对照组),PV患者根据病情程度分为轻度PV亚组27例、中度PV亚组37例、重度PV亚组36例。采用酶联免疫吸附法检测血清IL-30、ATG5、辅助性T细胞17(Th17)下游因子(IL-6、IL-17A)和调节性T细胞(Treg)下游因子[IL-10、转化生长因子-β1(TGF-β1)]水平,流式细胞术检测外周血Treg、Th17比例,并计算Treg/Th17比值;通过Pearson相关分析PV患者血清IL-30、ATG5与病情程度和Th17、Treg相关因子及外周血Th17/Treg比值的相关性,ROC曲线分析血清IL-30、ATG5对中重度PV的评估效能。结果与健康对照组比较,PV组血清IL-30、ATG5、IL-6、IL-17A和外周血Th17、Th17/Treg比值升高(t/P=10.276/<0.001、10.621/<0.001、20.729/<0.001、29.252/<0.001、17.046/<0.001、16.972/<0.001),血清IL-10、TGF-β1和外周血Treg比例降低(t/P=18.426/<0.001、28.000/<0.001、12.506/<0.001);轻度PV亚组、中度PV亚组、重度PV亚组血清IL-30、ATG5、IL-6、IL-17A和外周血Th17、Th17/Treg比值依次升高(F/P=176.054/<0.001、201.964/<0.001、172.705/<0.001、192.062/<0.001、213.010/<0.001、256.673/<0.001),血清IL-10、TGF-β1和外周血Treg比例依次降低(F/P=105.130/<0.001、211.495/<0.001、123.180/<0.001)。PV患者血清IL-30、ATG5水平与病情程度、IL-6、IL-17A和外周血Th17、Th17/Treg比值呈正相关(r/P=0.703/<0.001、0.723/<0.001、0.686/<0.001、0.712/<0.001、0.772/<0.001、0.790/<0.001、0.702/<0.001、0.790/<0.001、0.710/<0.001、0.719/<0.001),与IL-10、TGF-β1和外周血Treg比例呈负相关(r/P=-0.633/<0.001、-0.678/<0.001、-0.768/<0.001、-0.767/<0.001、-0.643/<0.001、-0.707/<0.001);血清IL-30、ATG5水平及二者联合评估中重度PV的AUC为0.799、0.784、0.876,二者联合的AUC大于血清IL-30、ATG5水平各自单独评估(Z/P=2.274/0.023、2.414/0.016)。结论PV患者血清IL-30、ATG5水平升高,与病情程度加重和Th17/Treg失衡密切相关,血清IL-30、ATG5水平联合评估中重度PV的效能较高。
Objective To investigate the expression and clinical significance of serum interleukin-30(IL-30)and autophagy-related gene 5(ATG5)in psoriasis vulgaris(PV).Methods A total of 100 PV patients(PV group)and 100 healthy controls(control group)were enrolled from January 2022 to August 2024 at the Department of Dermatology,Chengdu Second People’s Hospital.Based on disease severity,PV patients were further divided into mild PV subgroup(27 cases),moderate PV subgroup(37 cases),and severe PV subgroup(36 cases).Serum levels of IL-30,ATG5,T helper 17(Th17)downstream factors(IL-6,IL-17A),and regulatory T cell(Treg)downstream factors[IL-10,transforming growth factor-β1(TGF-β1)]were measured by ELISA.Peripheral blood proportions of Treg,Th17,and the Treg/Th17 ratio were assessed using flow cytometry.Pearson correlation analyses were conducted to explore relationships between serum IL-30,ATG5 levels and disease severity,Th17-and Treg-related factors,and the peripheral blood Th17/Treg ratio.The ROC curve was used to evaluate the diagnostic performance of serum IL-30 and ATG5 for moderate to severe PV.Results Compared with the control group,the PV group showed significantly elevated serum IL-30,ATG5,IL-6,IL-17A,and peripheral Th17 levels and Th17/Treg ratio,while IL-10,TGF-β1(t/P=10.276/<0.001,10.621/<0.001,20.729/<0.001,29.252/<0.001,17.046/<0.001,16.972/<0.001),and Treg proportions were decreased(t/P=18.426/<0.001,28.000/<0.001,12.506/<0.001).Serum IL-30,ATG5,IL-6,IL-17A,and peripheral Th17 levels and Th17/Treg ratio progressively increased across mild,moderate,and severe PV subgroups(F/P=176.054/<0.001,201.964/<0.001,172.705/<0.001,192.062/<0.001,213.010/<0.001,256.673/<0.001),whereas IL-10,TGF-β1,and Treg levels progressively decreased(F/P=105.130/<0.001,211.495/<0.001,123.180/<0.001).Serum IL-30 and ATG5 levels were positively correlated with disease severity,IL-6,IL-17A,peripheral Th17 levels,and the Th17/Treg ratio(r/P=0.703/<0.001,0.723/<0.001,0.686/<0.001,0.712/<0.001,0.772/<0.001,0.790/<0.001,0.702/<0.001,0.790/<0.001,0.710/<0.001,0.719/<0.001),and negatively correlated with IL-10,TGF-β1,and Treg levels(r/P=-0.633/<0.001,-0.678/<0.001,-0.768/<0.001,-0.767/<0.001,-0.643/<0.001,-0.707/<0.001).The AUCs for serum IL-30,ATG5,and their combined assessment in evaluating moderate to severe PV were 0.799,0.784,and 0.876,respectively,with the combined AUC significantly outperforming each individual marker(Z/P=2.274/0.023,2.414/0.016).Conclusion Elevated serum IL-30 and ATG5 levels in PV patients are closely associated with disease severity and Th17/Treg imbalance.The combined assessment of IL-30 and ATG5 levels provides high diagnostic efficacy for moderate to severe PV.
作者
姚明
路永红
陈浩
裴宝强
李在兵
Yao Ming;Lu Yonghong;Chen Hao;Pei Baoqiang;Li Zaibing(Department of Dermatology,Chengdu Second People's Hospital,Sichuan,Chengdu 610017,China)
出处
《疑难病杂志》
2025年第3期354-358,366,共6页
Chinese Journal of Difficult and Complicated Cases
基金
四川省卫生健康委员会医学科技项目(21ZD010)。
