杨桂兰，陈志强，郑家润，李新宇，陈 沄，李遇梅，高建明 【摘要】 目的 测定CXC型趋化因子受体CXCR2 mRNA在银屑病患者中的表达情况，弄清该受体在银屑病患者中的病理生理状态，探讨其在银屑病发病机制中的作用。方法 应用逆转录—聚合酶链反应（RT-PCR）法检测33例进行期斑块型银屑病患者治疗前皮损部位、皮损周围外观正常皮肤和外周血中性粒细胞、单一核细胞及其中16例治疗至皮损消退70％以上的患者外周血中性粒细胞与单一核细胞中CXCR2 mRNA的表达水平，并设30例健康人为对照组。将检测结果与银屑病皮损面积及严重程度指数（PASI）及外周血中性粒细胞、单一核细胞中该受体的表达水平与皮损部位表达水平之间分别进行了相关性分析。结果 银屑病患者皮损部位表皮与真皮中CXCR2 mRNA表达水平分别为1.85±0.76和1.23±0.48，明显高于皮损周围外观正常皮肤表皮及真皮(分别为0.63±0.48和0.86±0.39；分别P＜0.001，P＜0.01)，及健康对照者皮肤表皮及真皮（分别为0.59±0.21和0.55±0.48，P均＜0.001)，且均与PASI呈显著正相关（表皮：r=0.86，P＜0.001; 真皮：r=0.38，P＜0.05）。银屑病患者外周血中性粒细胞中CXCR2 mRNA表达水平为1.45±0.87，明显高于健康对照及治疗后患者（分别为0.74±0.58，P＜0.001； 0.63±0.58，P＜0.01），并与PASI呈显著正相关（r=0.84，P＜0.001）。银屑病患者外周血单一核白细胞中CXCR2 mRNA的表达水平为1.38±0.87，明显高于健康对照组（0.73±0.58，P＜0.001)。银屑病患者皮损部位表皮中CXCR2 mRNA的表达水平与外周血中性粒细胞中该受体的表达水平呈正相关（r=0.61，P＜0.001）； 银屑病患者皮损部位真皮中CXCR2 mRNA的表达水平与外周血单一核白细胞中的该受体的表达水平呈正相关（r=0.64，P＜0.001）。结论 CXCR2在银屑病患者中的表达均异常增高，可能参与了银屑病的发病机制。
【关键词】 银屑病；受体；趋化因子
【Abstract】 Objective To investigate the expression levels of chemokine receptors CXCR2 in progressive plaque psoriasis and their clinical significance.Methods Reverse transcription-polymerase chain reaction(RT-PCR) technique was applied to semi-quantitatively analyze CXCR2 mRNA expression levels in epidermis and dermis from lesion and peri-lesion skin，Peripheral Blood polymorphonuclears(PMN)and peripheral blood mononuclear cells(PBMC) in each of 33 cases of psoriatic patients before treatment and PMN and PBMC in16 cases from the 33 patients treated until the skin lesions remission about 70% and 30 healthy controls.The correlations between CXCR2 mRNA values and psoriatic area and severity index (PASI)，and between the CXCR2 mRNA values in PBMC and PMN and in leision dermis and epidermis were evaluated，respectively.Results （1）The CXCR2 mRNA levels in lesion epidermis and dermis in psoriatic patients were 1.85±0.76 and 1.23±0.48，respectively，which were markedly higher than those in peri-lesion epidermis and dermis（0.63±0.48 and 0.86±0.39，respectively，P＜0.001，P＜0.01，respectively) and normal epidermis and dermis（0.59±0.21 and 0.55±0.48，respectively，both P＜0.001).Furthermore，positive correlation were noticed both between epidermis CXCR2 mRNA values and PASI (r=0.86，P＜0.001)，and dermis CXCR2 mRNA values and PASI(r=0.38，P＜0.05).（2）The CXCR2 mRNA levels in PMN from psoriatic patients were 1.45±0.87，which were markedly higher than those in normal controls and treated patients（0.74±0.58，P＜0.001 and 0.63±0.58，P＜0.01 respectively）. Positive correlation were noticed between CXCR2 mRNA values and PASI（r=0.84，P＜0.001）.（3） CXCR2 mRNA expression levels in PBMC from psoriatic patients were 1.38±0.87，which were markedly higher than those in normal controls（0.73±0.58，P＜0.001) but similar with treated patients(1.21±0.62)，furthermore，the later were also markedly higher than those in normal controls(P＜0.05).（4）Positive correlation were noticed between the CXCR2 mRNA values in lesion epidermis and inPMN，and in lesional dermis and in PBMC，respectively.Conclusion