İbrahim KÖKÇAM, Nursel DİLEK, Ahmet GÖDEKMERDAN, Nusret AKPOLAT, NAFİYE FULYA İLHAN

Psöriazisli hastalarda deri lezyonlarında T hücreleri ve periferik kanda sitokin düzeyleri

Amaç: Bu çalışmada kalsipotriol-betametazon dipropionat ile tedavi edilen plak psöriazisli olgularda doku düzeyinde hücresel immunitenin ve serumda sitokin düzeylerinin rolünün araştırılması amaçlandı. Gereç ve yöntem: Çalışmaya plak tip psöriazisli 20 olgu alındı. Hastaların tedavi öncesi ve sonrası psöriatik lezyonları ile sağlam deriden biyopsi ve periferik kan örnekleri alındı. Bulgular: İmmünohistokimyasal incelemede, CD4+, CD8+ ve CD25+ T lenfositler, tedavi öncesi lezyonlu dokuda sağlam doku ve tedavi sonrası doku ile kıyaslandığında anlamlı bir şekilde yüksekti (sırasıyla, p0.05). Sonuç: Çalışmamızda lezyonlu deride CD4+ ve CD8+ hücre birikimi olduğunu ve CD4+ T lenfositlerin daha hâkim hücre grubu olduğu gösterildi. Uygulanan topikal tedavinin etkinliğine paralel olarak lezyonlarda düzelme olması ve lezyonlu bölgelerde CD4+ ve CD8+ T hücrelerinde anlamlı bir azalma meydana gelmesi, Th lenfositlerin hastalığın immunopatogenezinde önemli rolünün olduğu tezini desteklemektedir. Ancak, sonuçlarımız, hastalığın kronik özelliği ile uyumlu olarak T hücrelerin dokuda yine de yeterince kaldığını ve topikal tedavinin hastalığın aktivasyonunu engelleyemediğini göstermektedir.

lymphocytes in the lesional skin and the levels of peripheral blood cytokines in patients with psoriasis

Objective: In the current study, it was aimed to investigate the roles of tissue cellular immunity and serum levels of cytokines in the patients with plaque psoriasis treated with calcipotriol-betamethasone dipropionate. Materials and methods: The study included 20 patients with psoriasis. Peripheral blood and biopsy samples were collected from lesional and normal skins before and after treatment. The results were compared with each other. Results: Immunohistochemical examination revealed significant elevations of CD4+, CD8+ and CD25+ T lymphocytes in the lesional tissues when compared to that in the healthy tissues and post treatment tissue (p<0.001, p=0.013 and p<0.001, respectively). These lymphocytes in the lesional tissues at post-treatment period were not higher than those in the healthy tissues (p>0.05). The levels of IL–4, IL–10, TNF-α, IFN-γ and TGF-β1 in serum were not significantly different between before and after treatment periods (p>0.05). Conclusion: Our study demonstrated that there were infiltration of CD4+ and CD8+ cell in the lesional skin and CD8+ T-lymphocytes were the dominant cell types. The improvement of the lesions and significant decreases in CD4+ and CD8+ T-cells in accordance with the treatment strongly support the hypothesis that Th lymphocytes may have prominent roles in the immunopathogenesis of the disease. However, our findings showed that sufficient T-cells still remains in the tissue, which is consistent with the chronic characteristic of the disease, and the topical treatment could not be able to prevent the activation of the disease.

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