Treatment of recalcitrant pustular psoriasis with infliximab:: effective reduction of chemokine expression
Treatment of recalcitrant pustular psoriasis with infliximab:: effective reduction of chemokine expression
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DOI：
10.1111/j.1365-2133.2004.05960.x
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发表时间：
2004-05-01
影响因子：
10.3
通讯作者：
Goebeler, M
中科院分区：
文献类型：
--
作者：
Benoit, S;Toksoy, A;Goebeler, M
肿瘤坏死因子（TNF）-α被认为在银屑病的病理生理学中起主要作用。最近已经证明银屑病对抗TNF-α治疗的良好临床反应。我们研究了英夫利西单抗（一种抗TNF-α的单克隆抗体）对脓疱型银屑病趋化因子表达的影响。一名患有2年von Zumbusch型严重脓疱性银屑病病史的61岁男性，对常规治疗无反应，对英夫利西单抗治疗迅速反应。通过皮损皮肤的mRNA原位杂交测定，嗜中性粒细胞趋化因子白细胞介素（IL）-8和生长相关癌基因（Gro）-α以及单核细胞趋化蛋白（MCP）-1的立即有效减少反映了临床反应。在治疗前或治疗后，没有观察到干扰素（IFN）-γ（IFN）和IFN诱导蛋白（IP）-10诱导的单核因子的表达。因此，在脓疱型银屑病中，趋化因子表达模式由嗜中性粒细胞吸引趋化因子和MCP-1主导，而与斑块型银屑病相反，IFN-γ诱导的淋巴细胞吸引趋化因子如IP-10和MCP-1并不丰富。我们的结论是，抗TNF-α治疗英夫利西单抗是一种有效的治疗严重脓疱型银屑病，这是反映了疾病促进趋化因子，如IL-8，Gro-α和MCP-1的下调。
Tumour necrosis factor (TNF)-alpha is thought to play a major role in the pathophysiology of psoriasis. Good clinical responses of psoriasis to anti-TNF-alpha-based therapies have recently been demonstrated. We studied the effect of infliximab, a monoclonal antibody against TNF-alpha, on chemokine expression in pustular psoriasis. A 61-year-old man with a 2-year history of severe pustular psoriasis of von Zumbusch type who did not respond to conventional therapies responded rapidly to treatment with infliximab. The clinical response was reflected by an immediate and effective reduction of the neutrophil-attractant chemokines interleukin (IL)-8 and growth-related oncogene (Gro)-alpha as well as of monocyte chemoattractant protein (MCP)-1, as determined by mRNA in situ hybridization of lesional skin. No expression before or after treatment was seen for monokine induced by interferon (IFN)-gamma (MIG) and IFN-inducible protein (IP)-10. Thus, in pustular psoriasis the chemokine expression pattern is dominated by neutrophil-attractant chemokines and MCP-1 while, in contrast to plaque psoriasis, IFN-gamma-inducible lymphocyte-attractant chemokines such as IP-10 and MIG are not abundant. We conclude that anti-TNF-alpha treatment with infliximab is an effective therapy in severe pustular psoriasis which is reflected by downregulation of disease-promoting chemokines such as IL-8, Gro-alpha and MCP-1.