ABSTRACT
Objective To investigate the clinical significance of dynamic change of serum IL‐17A/IL‐23 in131 I treatment of Graves hyperthyroidism by dynamically detecting the serum IL‐23/Th17 axis related factor levels before and after 131 I treatment of Graves hyperthyroidism .Methods 30 untreated inpatients with Graves disease(GD) in our hospital were selected as the T0 group , those treated by 1- ,3- ,6-month 131 I treatment were taken as the group T1 ,T3 and T6 .Contemporeneous 30 individuals under‐going healthy physical examination were selected as the normal control (NC) group .The various groups had no statistical differences in the aspects of the age ,gender and disease course ,and had the comparability (P>0 .05) .Serum concentration of IL‐17A and IL‐23 was measured by the enzyme‐linked immunosorbent assay (ELISA) technique .FT3 ,FT4 and TSH were detected by combing with clinic .Results The levels of serum IL‐17A and IL‐23 before131I treatment were significantly higher than those in the NC group(P<0 .05);with the treatment proceeding ,which at ,1 ,3 ,6 months were gradually decreased ,the differences were statistically signifi‐cant but(P<0 .05);after 6 -month 131 I treatment in the GD patients ,the effects of IL‐17A and IL‐23 double negative in the T6 group were better than those of single negative ,and better than those of double positive ,the differences were statistically (Fisher value=13 .273 ,P<0 .05) .Conclusion Dynamically monitoring the serum IL‐23/Th17 axis related factor levels has the significance for guiding treatment ,judging the curative effect and predicting recurrence .
ABSTRACT
La psoriasis es una enfermedad inflamatoria crónica de la piel mediada por células T que afecta a individuos con predisposición genética y presenta varios subtipos clínicos. Se caracteriza por la presencia de placas eritematosas bien definidas, escamosas y de bordes irregulares, que afectan fundamentalmente las regiones de los codos, las rodillas, el cuero cabelludo y el tronco. El alelo HLA-Cw6 del sistema principal de histocompatibilidad está relacionado con la presencia y severidad de la enfermedad. Desde el punto de vista fisiopatogénico, la psoriasis es una enfermedad inmune de tipo Th1, en la que es fundamental el eje IL-23/Th17. Las células Th17 producen las citocinas proinflamatorias (IL-17A, IL-17F, IL-22 e IL-26) que activan los queratinocitos y causan hiperproliferación y mayor producción de citocinas proinflamatorias y péptidos antimicrobianos, los que a su vez reclutan y activan otras células inmunes de la piel inflamada. Se produce así una amplificación de la respuesta inflamatoria que conduce a las manifestaciones clínicas de la enfermedad. El tratamiento de la psoriasis incluye agentes antiinflamatorios tópicos, fototerapia, inmunosupresores sistémicos y agentes biológicos, entre los que se encuentran las proteínas de fusión, los inhibidores del factor de necrosis tumoral alfa y los inhibidores de las interleucinas 12 y 23
Psoriasis is a T cell-mediated chronic inflammatory disease of the skin. It affects genetically predisposed individuals and presents several subtypes. It is characterized by the presence of well-defined erythematous, scaly, irregular border plaque or lesions, affecting mainly the elbows, knees, scalp, and trunk. The HLA-Cw6 allele of major histocompatibility system is related to the presence and severity of this disease. From the physiopathogenic viewpoint, psoriasis is a Th1-type immune disease in which the axle IL-23/Th17 is fundamental. Th17 cells produce proinflammatory cytokines (IL-17A, IL-17F, IL-22 and IL-26) which activate keratinocytes and cause hyperproliferation and increased production of proinflammatory cytokines and antimicrobial peptides. The latter, in turn, recruit and activate other immune cells of swollen skin. There is thus an amplification of the inflammatory response that leads to clinical manifestations of this disease. The treatment of psoriasis includes topical antiinflammatory agents, phototherapy and systemic immunosuppressive biological agents, including those which are fusion proteins, inhibitors of alpha tumor factor necrosis, and interleukin inhibitors 12 and 23