Relationship between peripheral blood IL-17A levels and severity of acne vulgaris and its predictive value for acute acne scars
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摘要:
目的 目前寻常痤疮的发病机制仍在持续的探究中,国外有研究表明痤疮发病与血清中白细胞介素17水平密切相关,本研究旨在探讨外周血IL-17A水平与痤疮严重程度的相关性及对痤疮瘢痕的预测价值。 方法 纳入2022年10月—2023年10月在安徽省立医院皮肤科治疗的130例寻常痤疮患者作为观察组,根据痤疮综合分级系统将痤疮组分为轻中度组(45例)、重度组(40例)、极重度组(45例),选取40名健康体检者作为对照组。再根据瘢痕严重程度将观察组分为无瘢痕组(25例)、轻度瘢痕组(25例)、中度瘢痕组(40例)及重度瘢痕组(40例)。采用酶联免疫吸附法检测外周血IL-17A水平。 结果 轻中度组、重度组、极重度组寻常痤疮患者外周血中白细胞介素17A均显著高于健康对照组(P<0.05),痤疮严重程度与外周血IL-17A水平呈正相关关系(r=0.724,P<0.001);轻度、中度、重度痤疮瘢痕组患者外周血中IL-17A水平逐渐升高,显著高于无瘢痕组(P<0.05)。Spearman分析显示,痤疮瘢痕严重程度与外周血IL-17A水平呈正相关关系(r=0.591,P<0.001)。外周血IL-17A水平预测痤疮瘢痕发生的灵敏度为84.00%,特异度为83.80%。 结论 外周血IL-17A水平与寻常痤疮严重程度及痤疮瘢痕严重程度密切相关,对痤疮瘢痕有良好的预测价值。 Abstract:Objective To investigate the correlation between interleukin 17A (IL-17A) in peripheral blood and the severity of acne vulgaris, and its predictive value for acne scars. Methods From October 2022 to October 2023, a total of 130 patients with acne vulgaris who were treated at the Department of Dermatology of Anhui Provincial Hospital were divided into mild-to-moderate group (45 cases), severe group (40 cases), and extremely severe group (45 cases). Forty healthy examinees were selected as the control group. According to the severity of scar, the observation group was divided into non-scar group (25 cases), mild scar group (25 cases), moderate scar group (40 cases) and severe scar group (40 cases). IL-17A levels of peripheral blood were detected by Enzyme linked immunosorbent assay. Results The peripheral blood IL-17A of mild and moderate group, severe group, and severe and extreme group in acne vulgaris patients were significantly higher than that of the healthy control group (P < 0.05). The severity of acne was positively correlated with the level of IL-17A in peripheral blood (r=0.724, P < 0.001). The levels of IL-17A in peripheral blood of patients with mild, moderate, and severe acne scars gradually increased and were significantly higher than the non-scar group (P < 0.05). Spearman analysis showed that the severity of acne scars was positively correlated with the level of IL-17A in peripheral blood (r=0.591, P < 0.001). The sensitivity of peripheral blood IL-17A level in predicting the occurrence of acne scars was 84.00%, and the specificity was 83.80%. Conclusion Peripheral blood IL-17A level is closely related to the severity of acne vulgaris and acne scars, and has good predictive value for acne scars. -
Key words:
- Acne vulgaris /
- IL-17A /
- Acne scarring /
- Prediction /
- Correlation study
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表 1 不同严重程度痤疮患者与健康对照组一般资料及IL-17A水平比较
Table 1. Comparison of general data and IL-17A levels among acne patients with varying severity and healthy controls
组别 例数 性别(男/女,例) 年龄(x±s,岁) IL-17A (x±s,pg/mL) 健康对照组 40 21/19 22.61±2.25 7.86±4.00 轻中度痤疮组 45 17/28 23.50±2.61 14.51±6.01 重度痤疮组 40 18/22 22.88±3.67 20.98±6.35 极重度痤疮组 45 16/29 22.48±2.90 25.35±7.99 统计量 3.039a 1.302b 76.844b P值 0.386 0.279 <0.001 注:a为χ2值,b为F值。 表 2 不同严重程度痤疮瘢痕患者一般资料及IL-17A水平比较
Table 2. Comparison of general data and IL-17A levels among acne patients with varying severity
组别 例数 性别(男/女,例) 年龄(x±s,岁) IL-17A (x±s,pg/mL) 无瘢痕组 25 9/16 23.33±4.11 12.15±4.78 轻度瘢痕组 25 13/12 22.84±2.00 17.62±5.87 中度瘢痕组 40 16/24 23.05±3.19 21.61±7.20 重度瘢痕组 40 13/27 22.70±2.83 25.60±7.54 统计量 2.589a 0.191b 22.712b P值 0.459 0.902 <0.001 注:a为χ2值,b为F值。 -
[1] KAZMIERSKA A, BOLESLAWSKA I, POLANSKA A, et al. Effect of evening primrose oil supplementation on selected parameters of skin condition in a group of patients treated with isotretinoin: a randomized double-blind trial[J]. Nutrients, 2022, 14(14): 2980. doi: 10.3390/nu14142980 [2] 汪凯凡, 唐的木, 陆洪光. 点阵双极射频联合透明质酸凝胶敷料治疗痤疮凹陷性瘢痕的临床观察[J]. 贵州医科大学学报, 2020, 45(4): 456-460.WANG K F, TANG D M, LU H G. Clinical Observation of Bipolar Fractional Radiofrequency Combined with Hyaluronic Acid Gel in Treating Atrophic Facial Acne Scars[J]. Journal of Guizhou Medical University, 2020, 45(4): 456-460. [3] 范建国, 蔡天国. 清热消痤汤联合熏蒸治疗肺经风热型中轻度寻常痤疮的临床观察[J]. 中华全科医学, 2019, 17(11): 1922-1924, 1975. doi: 10.16766/j.cnki.issn.1674-4152.001091FAN J G, CAI T G. Clinical observe of Qingre Xiaocuo Decoction combined with fumigation in the treatment of moderate and mild acne vulgaris of lung meridian and wind-heat type[J]. Chinese Journal of General Practice, 2019, 17(11): 1922-1924, 1975. doi: 10.16766/j.cnki.issn.1674-4152.001091 [4] GAELLE T T E, 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.GAELLE T T E, JIANG C J. Effect of Tripterygium wilfordii on levels of cytokines related to Th17/Treg cells in the peripheral blood of patients with psoriasis vulgaris[J]. Chinese Journal of General Practice, 2019, 17(8): 1272-1274. [5] SARAC OZTURK G, ERGUN T, PEKER EYUBOGLU I, et al. Serum high-sensitivity C-reactive protein, tumor necrosis factor-alpha, interleukin (IL)-1beta, IL-17A and IL-23 levels in patients with hidradenitis suppurativa[J]. Cytokine, 2021, 144: 155585. DOI: 10.1016/j.cyto.2021.155585. [6] FIRLEJ E, KOWALSKA W, SZYMASZEK K, et al. The role of skin immune system in acne[J]. J Clin Med, 2022, 11(6): 1579. doi: 10.3390/jcm11061579 [7] HUANG C, ZHUO F, HAN B, et al. The updates and implications of cutaneous microbiota in acne[J]. Cell Biosci, 2023, 13(1): 113. doi: 10.1186/s13578-023-01072-w [8] EBRAHIM A A, MUSTAFA A I, ELABD A M. Serum interleukin-17 as a novel biomarker in patients with acne vulgaris[J]. J Cosmet Dermatol, 2019, 18(6): 1975-1979. doi: 10.1111/jocd.12934 [9] SINGH S, KHURANA A, CHITKARA A. Evaluation of serum levels of interleukins 6, 8, 17 and 22 in acne vulgaris: a cross-sectional study[J]. Indian J Dermatol, 2023, 68(2): 233. [10] 中国痤疮治疗指南专家组. 中国痤疮治疗指南(2019修订版)[J]. 临床皮肤科杂志, 2019, 48(9): 583-588.Chinese Acne Treatment Guidelines Expert Group. Acne Treatment Guideline for diagnosis and treatment of acne(the 2019 revised edition)[J]. Journal of Clinical Dermatology, 2019, 48(9): 583-588. [11] MCLAUGHLIN J, WATTERSON S, LAYTON A M, et al. Propionibacterium acnes and acne vulgaris: new insights from the integration of population genetic, multiomic, biochemical and host-microbe studies[J]. Microorganisms, 2019, 7(5): 128. DOI: 10.3390/microorganisms7050128. [12] 李東霖, 吴文娟, 邹丹丹, 等. 痤疮研究进展[J]. 昆明医科大学学报, 2018, 39(10): 1-6. doi: 10.3969/j.issn.1003-4706.2018.10.001LI D L, WU W J, ZOU D D, et al. Research Progress in Acne Vulgaris[J]. Journal of Kunming Medical University, 2018, 39(10): 1-6. doi: 10.3969/j.issn.1003-4706.2018.10.001 [13] JIN Z, SONG Y, HE L. A review of skin immune processes in acne[J]. Frontiers in Immunology, 2023, 14: 1324930. DOI: 10.3389/fimmu.2023.1324930. [14] AGAK G W, MOUTON A, TELES R M, et al. Extracellular traps released by antimicrobial Th17 cells contribute to host defense[J]. J Clin Invest, 2021, 131(2): e141594. DOI: 10.1172/JCI141594. [15] FARAG A G A, MARAEE A H, RIFAAT ALSHARAKY D, et al. Tissue expression of IL-17A and FOXP3 in acne vulgaris patients[J]. J Cosmet Dermatol, 2021, 20(1): 330-337. [16] HUANG L, YANG S. Association of different cell types and inflammation in early acne vulgaris[J]. Frontiers in Immunology, 2024, 15: 1275269. DOI: 10.3389/fimmu.2024.1275269. [17] ZHU W, WANG H L, BU X L, et al. A narrative review of research progress on the role of NLRP3 inflammasome in acne vulgaris[J]. Ann Transl Med, 2022, 10(11): 645. [18] EICHENFIELD L F, SUGARMAN J L, GUENIN E, et al. Novel tretinoin 0.05% lotion for the once-daily treatment of moderate-to-severe acne vulgaris in a preadolescent population[J]. Pediatr Dermatol, 2019, 36(2): 193-199. [19] VITALE S, COLANERO S, PLACIDI M, et al. Phytochemistry and biological activity of medicinal plants in wound healing: an overview of current research[J]. Molecules, 2022, 27(11): 3566. DOI: 10.3390/molecules27113566. [20] AKOGLU G, TAN C, AYVAZ D C, et al. Tumor necrosis factor alpha-308 G/A and inte-rleukin 1 beta-511 C/T gene polymorphisms in patients with scarring acne[J]. J Cosmet Dermatol, 2019, 18(1): 395-400. [21] MOON J, YOON J Y, YANG J H, et al. Atrophic acne scar: a process from altered metabolism of elastic fibres and collagen fibres based on transforming growth factor-β1 signalling[J]. Br J Dermatol, 2019, 181(6): 1226-1237. [22] LEE S Y, KIM E K, SEO H B, et al. IL-17 induced stromal cell-derived factor-1 and profibrotic factor in keloid-derived skin fibroblasts via the STAT3 pathway[J]. Inflammation, 2020, 43(2): 664-672. [23] LEE S Y, LEE A R, CHOI J W, et al. IL-17 induces autophagy dysfunction to promote inflammatory cell death and fibrosis in keloid fibroblasts via the STAT3 and HIF-1 alpha dependent signaling pathways[J]. Front Immunol, 2022, 13: 888719. DOI: 10.3389/fimmu.2022.888719.