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1.黑龙江中医药大学,哈尔滨 150040
2.黑龙江中医药大学 附属第一医院,哈尔滨 150040
Received:06 July 2021,
Published Online:09 August 2021,
Published:05 October 2021
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曹爽,周妍妍,杨素清等.中医药干预银屑病Th17/Treg平衡的研究进展[J].中国实验方剂学杂志,2021,27(19):225-232.
CAO Shuang,ZHOU Yan-yan,YANG Su-qing,et al.Effect of Intervention with Traditional Chinese Medicine on Th17/Treg Balance in Psoriasis: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(19):225-232.
曹爽,周妍妍,杨素清等.中医药干预银屑病Th17/Treg平衡的研究进展[J].中国实验方剂学杂志,2021,27(19):225-232. DOI: 10.13422/j.cnki.syfjx.20211992.
CAO Shuang,ZHOU Yan-yan,YANG Su-qing,et al.Effect of Intervention with Traditional Chinese Medicine on Th17/Treg Balance in Psoriasis: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(19):225-232. DOI: 10.13422/j.cnki.syfjx.20211992.
银屑病表现出炎症背景下自身免疫性疾病的特征,角质形成细胞增殖分化缺陷和异常的免疫反应是其发病的主要因素,但某些细胞和分子机制仍未明确。尽管使用了各种药物和物理疗法来控制病情,但由于其短暂的疗效、高昂的成本和严重的不良反应,这些策略仅限于短期使用,使银屑病的治疗难以收获令患者满意的远期疗效。随着网络药理学、分子生物学领域的发展及中医药现代化的推进,中医药的多成分、多靶点作用效果凸显,各医家学者针对中医药领域的研究逐渐深入,但目前尚未有针对中医药干预辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡防治银屑病的详尽机制进行整理。该文通过检索近几年文献数据资料发现,中药单体、中药有效成分和中药复方对银屑病发病机制中Th17/Treg轴有明显调节作用,Th17细胞具有促炎作用,Treg细胞有助于维持外周耐受,他们在效应发挥上相互排斥,维系二者的平衡关系可有效减轻炎症反应、调节免疫稳态。因此,中医药领域基于银屑病Th17/Treg轴开展了一系列临床及实验研究,包括降低Th17细胞百分率,增加Treg细胞百分率,以及调节二者相关细胞因子、转录因子水平,以缓解银屑病炎症病情,重建免疫环境稳态,为银屑病病理机制的进一步阐明提供新切入点,为开发银屑病新治疗手段提供备选方案。
Psoriasis is an autoimmune disease presented in the context of inflammation, and it mainly results from proliferation and differentiation defects of keratinocytes and abnormal immune response. However, some cellular and molecular mechanisms remain unclear. Although a variety of drugs and physiotherapies are applicable to this disease, they can only be utilized for a short-term period considering their transient effect, high cost, and serious adverse reactions. It is difficult to achieve satisfactory long-term results in the treatment of psoriasis. With the development of network pharmacology and molecular biology and the modernization of traditional Chinese medicine (TCM), the multi-component and multi-target characteristics of TCM have become prominent, promoting the in-depth research on TCM by doctors and scholars. Nevertheless, there is no detailed summarization on the mechanisms of TCM in interfering with T helper 17 (Th17)/regulatory T (Treg) cell balance to prevent and treat psoriasis. After reviewing the recent literature data, this paper has found that Chinese herbal monomers, active ingredients, and compounds obviously regulate the Th17/Treg axis in psoriasis. Th17 cells have a pro-inflammatory effect, while Treg cells are responsible for maintaining peripheral tolerance. They function in a mutually exclusive manner, and maintaining the Th17/Treg balance helps to effectively reduce inflammatory reaction and regulate immune homeostasis. As revealed by a series of clinical and experimental studies carried out based on the Th17/Treg axis in psoriasis, reducing the percentage of Th17 cells,increasing the percentage of Treg cells,and regulating the levels of related cytokines and transcription factors are conducive to alleviating inflammation and regaining immune homeostasis,which has provided new ideas for further elucidating the pathological mechanism of psoriasis and alternative plans for developing new treatments against psoriasis.
LOWES M A , SUÁREZ-FARIÑAS M , KRUEGER J G . Immunology of psoriasis [J]. Annu Rev Immunol , 2014 , 32 : 227 - 255 .
SABAT R , PHILIPP S , HÖFLICH C , et al . Immunopathogenesis of psoriasis [J]. Exp Dermatol , 2007 , 16 ( 10 ): 779 - 798 .
MICHALEK I M , LORING B , JOHN S M . A systematic review of worldwide epidemiology of psoriasis [J]. J Eur Acad Dermatol Venereol , 2017 , 31 ( 2 ): 205 - 212 .
RENDON A , SCHÄKEL K . Psoriasis pathogenesis and treatment [J]. Int J Mol Sci , 2019 , 20 ( 6 ): 1475 .
DENG Y , CHANG C , LU Q . The inflammatory response in psoriasis:a comprehensive review [J]. Clin Rev Allergy Immunol , 2016 , 50 ( 3 ): 377 - 389 .
吕邵娃 , 高健 , 尚尔雨 , 等 . 银屑病的现代中医治疗方法 [J]. 辽宁中医药大学学报 , 2021 , 23 ( 3 ): 19 - 24 .
王宁丽 , 李建伟 , 王刚 . 基于网络药理学与分子对接探讨紫草治疗银屑病的作用机制 [J]. 世界中西医结合杂志 , 2021 , 16 ( 4 ): 658 - 664,672 .
丁小洁 , 王亚琴 , 刘艳 . 银屑病患者外周血Th17、Treg细胞检测及临床意义 [J]. 川北医学院学报 , 2019 , 34 ( 3 ): 341 - 343 .
王英杰 , 刘杰 , 罗瑞静 , 等 . Th17细胞及其相关因子在银屑病中西医治疗中的研究现状 [J]. 陕西中医 , 2016 , 37 ( 2 ): 251 - 253 .
XUE X , DE LEON-TABALDO A , LUNA-ROMAN R , et al . Preclinical and clinical characterization of the ROR γ t inhibitor JNJ-61803534 [J]. Sci Rep , 2021 , 11 ( 1 ): 11066 .
王英 , 王丽丽 , 韩朔 , 等 . CD4 + T淋巴细胞亚群与银屑病关系的研究进展 [J]. 细胞与分子免疫学杂志 , 2016 , 32 ( 6 ): 834 - 836 .
LYNDE C W , POULIN Y , VENDER R , et al . Interleukin 17A:toward a new understanding of psoriasis pathogenesis [J]. Am Acad Dermatol , 2014 , 71 ( 1 ): 141 - 150 .
MURDACA G , COLOMBO B M , PUPPO F . The role of Th17 lymphocytes in the autoimmune and chronic inflammatory diseases [J]. Intern Emerg Med , 2011 , 6 ( 6 ): 487 - 495 .
KORN T , BETTELLI E , OUKKA M , et al . IL-17 and Th17 Cells [J]. Annu Rev Immunol , 2009 , 27 : 485 - 517 .
MARTIN D A , TOWNE J E , KRICORIAN G , et al . The emerging role of IL-17 in the pathogenesis of psoriasis:preclinical and clinical findings [J]. J Invest Dermatol , 2013 , 133 ( 1 ): 17 - 26 .
GERSHON R K , KONDO K . Cell interactions in the induction of tolerance:the role of thymic lymphocytes [J]. Immunology , 1970 , 18 ( 5 ): 723 - 737 .
TODA A , PICCIRILLO C A . Development and function of naturally occurring CD4 + CD25 + regulatory T cells [J]. J Leukoc Biol , 2006 , 80 ( 3 ): 458 - 470 .
MATTOZZI C , SALVI M , D'EPIRO S , et al . Importance of regulatory T cells in the pathogenesis of psoriasis:review of the literature [J]. Dermatology , 2013 , 227 ( 2 ): 134 - 145 .
ULIVIERI C , BALDARI C T . T-cell-based immunotherapy of autoimmune diseases [J]. Expert Rev Vaccines , 2013 , 12 ( 3 ): 297 - 310 .
PICCIRILLO C A , SHEVACH E M . Naturally-occurring CD4 + CD25 + immunoregulatory T cells:central players in the arena of peripheral tolerance [J]. Semin Immunol , 2004 , 16 ( 3 ): 81 - 88 .
VIGNALI D A , COLLISON L W , WORKMAN C J . How regulatory T cells work [J]. Nat Rev Immunol , 2008 , 8 ( 7 ): 523 - 532 .
HIRAHARA K , NAKAYAMA T . CD4 + T-cell subsets in inflammatory diseases:beyond the Th1/Th2 paradigm [J]. Int Immunol , 2016 , 28 ( 4 ): 163 - 171 .
SHI Y , CHEN Z , ZHAO Z , et al . IL-21 Induces an imbalance of Th17/Treg cells in moderate-to-severe plaque psoriasis patients [J]. Front Immunol , 2019 , 10 : 1865 .
MA L , XUE H , GAO T , et al . Notch1 signaling regulates the Th17/Treg immune imbalance in patients with psoriasis vulgaris [J]. Mediators Inflamm , 2018 , doi: 10.1155/2018/3069521 http://dx.doi.org/10.1155/2018/3069521 .
廖晓容 , 黄慧 . 寻常型银屑病患者中Th17细胞、CD4 + 、CD25 + 调节性T细胞表达水平及意义 [J]. 河北医药 , 2020 , 42 ( 1 ): 54 - 57 .
陶建兆 , 韩秋月 , 曾令斌 , 等 . 银屑病中NLRP3炎症小体通过调控Treg/Th17失衡对角质形成细胞增殖及趋化能力的影响 [J]. 中国皮肤性病学杂志 , 2020 , 34 ( 11 ): 1238 - 1248 .
张红阳 , 李波 , 钟国跃 , 等 . 土大黄提取物及其有效成分药理活性研究进展 [J]. 中药新药与临床药理 , 2018 , 29 ( 2 ): 240 - 246 .
热比姑丽·伊斯拉木 , 艾西木江·热甫卡提 , 阿布都吉力力·阿布都艾尼 , 等 . 土大黄对银屑病小鼠皮肤组织转化生长因子- β 1 及神经纤维蛋白-1表达的影响 [J]. 中国药业 , 2020 , 29 ( 3 ): 20 - 24 .
井佳楠 , 吕邵娃 , 王秋红 , 等 . 洋金花化学成分和药理作用及临床应用研究进展 [J]. 中草药 , 2016 , 47 ( 19 ): 3513 - 3521 .
苏阳 , 任文晨 , 李珊珊 , 等 . 基于肠-免疫-皮肤轴探讨洋金花对银屑病小鼠肠道Th17/Treg轴的影响 [J]. 现代中药研究与实践 , 2018 , 32 ( 5 ): 27 - 30 .
苏阳 , 张雪婷 , 杨炳友 , 等 . 洋金花单体化合物对CD4 + T细胞亚群的影响 [J]. 现代中药研究与实践 , 2017 , 31 ( 3 ): 25 - 28 .
姚骥如 , 孙莹 , 罗顺葵 , 等 . 雷公藤多苷的临床应用进展 [J]. 中国新药与临床杂志 , 2010 , 29 ( 3 ): 179 - 182 .
姜淼 , 张海波 , 丁樱 . 雷公藤多苷药理作用及临床应用研究进展 [J]. 中华中医药学刊 , 2021 , 39 ( 3 ): 59 - 63 .
TUEKAM E G , 江从军 . 雷公藤多苷对寻常型银屑病患者外周血Th17/Treg相关细胞因子的影响 [J]. 中华全科医学 , 2019 , 17 ( 8 ): 1272 - 1274 .
祝德秋 , 刘皋林 . 木樨草素的药理作用研究进展 [J]. 中国药房 , 2010 , 21 ( 19 ): 1807 - 1810 .
LV J , ZHOU D , WANG Y , et al . Effects of luteolin on treatment of psoriasis by repressing HSP90 [J]. Int Immunopharmacol , 2020 , 79 : 106070 .
金少举 , 金道欣 , 王文宝 , 等 . 苦豆碱药理学研究进展 [J]. 中药药理与临床 , 2015 , 31 ( 3 ): 214 - 217 .
周海锋 . 苦豆碱通过调控IL-23/Th17轴和促进Treg稳定性缓解IMQ诱导的小鼠银屑病样皮炎 [D]. 武汉 : 华中科技大学 , 2019 .
陈星宇 , 王小艳 , 张洪英 , 等 . 白芍总苷治疗寻常型银屑病疗效评价及对Th17/Treg相关细胞因子的影响 [J]. 中国麻风皮肤病杂志 , 2015 , 31 ( 10 ): 583 - 585 .
LI X Q , CHEN Y , DAI G C , et al . Abietic acid ameliorates psoriasis-like inflammation and modulates gut microbiota in mice [J]. J Ethnopharmacol , 2021 , 272 : 113934 .
DI T T , RUAN Z T , ZHAO J X , et al . Astilbin inhibits Th17 cell differentiation and ameliorates imiquimod-induced psoriasis-like skin lesions in BALB/c mice via Jak3/Stat3 signaling pathway [J]. Int Immunopharmacol , 2016 , 32 : 32 - 38 .
ZHANG X , LI J , YU Y , et al . Shikonin controls the differentiation of CD4 + CD25 + regulatory T cells by inhibiting Akt/mTOR pathway [J]. Inflammation , 2019 , 42 ( 4 ): 1215 - 1227 .
齐潇丽 , 李莹 , 蒋俊青 , 等 . 清热凉血方对咪喹莫特诱导的银屑病样小鼠模型JAKs/STATs通路表达影响的研究 [J]. 中国中西医结合皮肤性病学杂志 , 2021 , 20 ( 2 ): 162 - 166 .
李锘 , 押丽静 , 王磊 , 等 . 清热凉血方对IMQ诱导银屑病小鼠模型IL-17A、IL-10的影响及miR-210激动剂的干预作用 [J]. 中国皮肤性病学杂志 , 2019 , 33 ( 8 ): 885 - 889 .
李锘 , 押丽静 , 王磊 , 等 . 清热凉血方对咪喹莫特诱导银屑病样小鼠模型Th17/Treg细胞失衡的影响及miR-210激动剂的干预作用 [J]. 北京中医药大学学报 , 2018 , 41 ( 11 ): 910 - 917 .
翟春艳 , 底婷婷 , 王燕 , 等 . 健脾养血解毒方通过调节Treg/Th17免疫平衡改善脾虚-银屑病复合模型小鼠银屑病样皮损 [J]. 中华中医药学刊 , 2019 , 37 ( 12 ):2888-2893, 3103 - 3106 .
刘丽娟 , 赵瑞芝 , 卢传坚 . 基于“药效-成分分析”的银屑灵优化方2号方抗银屑病配伍规律探讨 [J]. 中华中医药杂志 , 2020 , 35 ( 8 ): 4171 - 4174 .
CHEN H , LIU H , LU C , et al . PSORI-CM02 formula increases CD4 + Foxp3 + regulatory T Cell frequency and ameliorates imiquimod-induced psoriasis in mice [J]. Front Immunol , 2017 , 8 : 1767 .
胡辉莹 , 胡银霞 , 刘昌顺 , 等 . 润燥止痒胶囊对银屑病样皮损大鼠肠道菌群和炎症反应的影响 [J]. 中国临床解剖学杂志 , 2020 , 38 ( 5 ): 574 - 577 .
李鹏英 , 丰靓 , 刘红霞 . 中药2号方联合健脾解毒汤治疗寻常型银屑病脾虚湿盛证的疗效观察及对外周血T淋巴细胞的表达影响 [J]. 中华中医药学刊 , 2019 , 37 ( 11 ): 2609 - 2613 .
吴然 , 唐挺 , 贺爱娟 , 等 . 清热凉血消疕汤对寻常型银屑病(血热证)患者调节性T细胞及其细胞因子的影响研究 [J]. 中药材 , 2017 , 40 ( 12 ): 2974 - 2977 .
魏中平 , 林明和 . 菝葜槐花凉血汤对老年银屑病患者外周血辅助性T细胞/调节性T细胞平衡及其相关细胞因子表达的影响 [J]. 中华老年医学杂志 , 2020 , 39 ( 11 ): 1314 - 1317 .
胡霞 . 基于“伏邪”理论之加味凉血消风散调控复发型银屑病进行期(血热证)Th17/Treg轴的免疫机理研究 [D]. 四川 : 成都中医药大学 , 2020 .
张益生 . 莪仙化斑汤对斑块型银屑病(血瘀证)患者Th1/Th2、Th17/Treg、Th22影响研究 [D]. 北京 : 北京中医药大学 , 2020 .
李皓月 , 李超然 , 王远红 , 等 . 银屑病中医文献简述 [J]. 中国中医基础医学杂志 , 2019 , 25 ( 9 ): 1331 - 1334 .
宋坪 , 李博鉴 . 从血论治 诸法合用——朱仁康研究员治疗银屑病经验(一) [J]. 中国中西医结合皮肤性病学杂志 , 2004 , 3 ( 1 ): 1 - 2 .
高丽萍 , 毛小荣 . Th17和Treg细胞可成为自身免疫性疾病治疗的新靶点 [J]. 胃肠病学和肝病学杂志 , 2019 , 28 ( 3 ): 341 - 344 .
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