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Objective To investigate the relationship of the expression of peripheral T helper type 9 (Th9) cells and their related cytokines with the severity and clinical course of alopecia areata,and to explore their significance in the occurrence of alopecia areata.Methods From May to December in 2017,74 outpatients with alopecia areata enrolled from Department of Dermatology,Huashan Hospital,Fudan University served as the alopecia areata group,and 57 health checkup examinees in Huashan Hospital served as the control group.Peripheral blood samples were obtained from the patients and controls.Enzyme-linked immunosorbent assay (ELISA) was performed to detect the serum levels of interleukin (IL)-9,IL-4,transforming growth factor (TGF)-β1 and interferon (IFN)-γ,flow cytometry to determine the proportion of Th9 cells (CD4+IL-9+ T helper cells) in peripheral blood mononuclear cells (PBMC),and real-time fluorescence-based quantitative PCR to measure the mRNA expression of IL-9 and PU.1 in the PBMCs.Data were recorded in Microsoft Excel 2017 software,and statistically analyzed with SPSS17.0 software using two-sample t test and Spearman rank correlation analysis.Statistical charts were drawn with Graphpad prism 6 software.Results Compared with the control group,the alopecia areata group showed significantly decreased serum level of IL-9 (190.40 ± 12.33 ng/L vs.288.10 ± 17.38 ng/L,t =4.71,P ＜ 0.01),but significantly increased serum levels of TGF-β1 (6 191.00 ± 355.50 ng/L vs.4 026.00 ± 258.00 ng/L,t =4.41,P ＜ 0.05) and IFN-γ(15.71 ± 3.00 ng/L vs.8.79 ± 0.60 ng/L,t =2.001,P ＜ 0.05).However,there was no significant difference in the serum level of IL-4 between the alopecia areata group and control group (P ＞ 0.05).The serum level of IFN-γ was significantly lower in the patients with severe alopecia areata than in the patients with mild alopecia areata (P =0.02),and the serum level of IFN-γ in the patients with alopecia areata was negatively correlated with the severity of alopecia tool (SALT) score (ru =-0.298,P =0.010).There were no significant differences in the serum levels of IL-9,IL-4 and TGF-β1 between the patients with severe alopecia areata and those with mild alopecia areata (all P ＞ 0.05).The serum levels of IL-9,IL-4,TGF-β1 and IFN-γdid not differ between the patients with active alopecia areata and those with stable alopecia areata,as well as between the patients with clinical course of ＜ 6 months and those with clinical course of ＞ 6 months (P ＞ 0.05).The alopecia areata group showed significantly decreased proportion of Th9 cells in the PBMCs (t =2.04,P =0.045) and mRNA expression of IL-9 and PU.1 (t =2.12,2.178,both P ＜ 0.05) compared with the control group.Condusion The serum level of IL-9 and proportion of peripheral blood Th9 cells both decrease in patients with alopecia areata,and Th9 cells and their related cytokines may be involved in the occurrence of alopecia areata.
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Objective To estimate the efficacy of Xiaoyin decoction combined with calcipotriol ointment in patients with mild to moderate vulgaris psoriasis of blood heat type as well as their effects on the expression of interleukin (IL)-17,-22 and tumor necrosis factor (TNF) α.Methods Sixty patients with mild to moderate vulgaris psoriasis of blood heat type were enrolled in this study,and equally divided into 2 groups to be treated with Xiaoyin decoction and placebo respectively for 12 weeks.Calcipotriol ointment was applied in both groups of patients.Thirty healthy volunteers served as the controls.Bicolor flow cytometry was conducted to determine the proportion of peripheral blood Th17 cells,and enzyme linked immunosorbent assay (ELISA) to measure the serum levels of IL-17,IL-22 and TNF-α,in the controls and patients before and after treatment.Clinical efficacy was evaluated by psoriasis area and severity index (PASI) score.Results Increased proportion of Th17 cells and serum levels of IL-17,IL-22 and TNF-α were observed in the patients with psoriasis before treatment compared with the controls (all P ＜ 0.05).After treatment,a significant decrease was noted in the proportion of Th17 cells ((8.32 ± 1.28)％ vs.(14.24 ± 1.97)％,P ＜ 0.05) and serum levels of IL-17,IL-22 and TNF-α in the Xiaoyin decoction group (all P ＜ 0.05 ),but not in the placebo group.The PASI score was significantly different between the Xiaoyin decoction and placebo group after treatment (1.83 ± 1.28 vs.2.91 ± 1.42,P ＜ 0.05).The total response rate was 93.33％ in the Xiaoyin decoction group,significantly higher than that in the placebo group (73.33％,P ＜ 0.05).Conclusions There is an abnormality in the proportion of Th17 cells and serum levels of IL-17,IL-22 and TNF-α,which may be ameliorated by the combined treatment with Xiaoyin decoction and calcipotriol ointment.
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Objective To evaluate the efficacy and safety of Qingpeng ointment in the treatment of eczema.Methods A multi-center,randomized,double-blind and placebo-controlled clinical trial was conducted.A total of 246 patients with eczema were randomly assigned with a ratio of 2∶1 to the treatment group and control group to topically apply Qingpeng ointment and placebo respectively twice daily for 3 weeks.Total symptom scores were calculated for the patients at the baseline,on week 1,2 and 3 during the treatment according to the individual scores for pruritus,lesions including erythema,papules,papulovesicles or vesicles,desquamation,crusting,infiltration and lichenification.The occurrence of adverse events was recorded.Results Totally,228 patients completed the trial,including 154 patients in the treatment group and 74 patients in the control group.After 3 weeks of treatment,a statistical difference was observed in the response rate (85.71％ vs.41.89％,Z=47.16,P＜ 0.01) and cure rate (31.82％ vs.12.16％,Z=12.30,P＜ 0.01) between the treatment and control group.There was no significant difference in the incidence of adverse events between the two groups (2.48％ vs.2.56％,x2 =0,P ＞ 0.05).Conclusion Qingpeng ointment displays a promising efficacy for the treatment of mild to moderate eczema with a rapid onset and high safety.
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Objective To investigate the prevalence and pattern of androgenetic alopecia (AGA) in Shanghai through a community-based survey. Methods A cluster sampling survey was done among the residents in Beixinjing Community, Changning District, Shanghai. All the subjects were asked to fill a questionnaire to provide their general information, including sex, age, native place, physical status, life habit, family history, etc. The diagnosis of AGA was made by dermatologists. To determine the pattern of hair loss,Norwood-Hamilton classification system and Ludwig classification system were used for male AGA and female AGA, respectively. All the data were statistically analyzed by EpiData and SPSS11.5 software. Results Totally, 7056 subjects completed the questionnaire, including 3519 males and 3537 females, and the response rate was 72.5%. AGA was diagnosed in 809 patients, consisting of 701 males aging from 19 to 91 years (mean 64.16±11.9 years) and 108 females aging from 35 to 91 years (mean 70.46±18.89 years). The standardized prevalence (SP) was 9.47% in total, 15.73% in males and 2.73% in females; the difference was significant between males and females (χ2=356.00, P<0.001). A family history of AGA was observed in 52.7% of all subjects including 391 (55.78%) males and 35 (32.41%) females. Type Ⅲ vertex involvement was the most common type in men aging from 20 to 70 years old, and type Ⅵ in those over 70 years old. Grade Ⅰ and Ⅱ predominated in female AGA. Conclusions The results of this survey indicate that the prevalence of AGA is remarkably higher in men than that in women. Furthermore, the prevalence is steadily increased with advancing age in Shanghai.
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Objective To investigate the association of HLA-DRB31*03,*04 and *11 alleles with alopecia areata(AA)in Han Nationality in East China.Methods Polymerase chain reaction-sequence specific primer(PCR-SSP)method was conducted in 158 Chinese Han patients with AA as well as in 172 healthy human controls in East China.The relationships of HLA-DRB1 polymorphism to age of onset,episode frequency,clinical course,family history,and severity of AA were evaluated.Results No significant differences were observed for the frequency of HLA DRB1*03,*11 alleles between the patients and human controls,while increased frequency of HLA-DRB1*04 was observed in patients(OR=1.99,Pc=0.01).Multiple logistic regression analysis revealed that HLA-DRB1*04 was more prevalent in patients with an onset after 16 years of age(OR=1.94,Pc=0.02),those without family history(OR=1.97,Pc=0.02),those with recurrent AA(OR=2.49,Pc=0.02),those with a clinical course of more than 1 year(OR=2.94,Pc=0.01),those with severe AA(OR=3.53,Pc=0.00)and tbose with single episode of AA(OR=1.83,Pc=0.04)in comparison with the normal human controls.Conclusion This study demonstrates that HLA-DRB1*04 allele is associated with the occurrence and clinical types of AA in Han Nationality in East China.
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0.05).Conclusions These results suggest that the polymorphisms of triplet repeat GGC or combination of CAG and GGC of the androgen receptor is signifi- cantly associated with Han men with androgenetic alopecia in the Eastern China. However, genetic polymor- phism of 5?-reductase may not directly associated with androgenetic alopecia in our study population.