MODULATION OF TOLL-LIKE RECEPTORS IN PSORIATIC PATIENTS DURING THERAPY WITH ADALIMUMAB
MODULATION OF TOLL-LIKE RECEPTORS IN PSORIATIC PATIENTS DURING THERAPY WITH ADALIMUMAB
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DOI：
10.1177/039463201102400121
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发表时间：
2011-01-01
影响因子：
3.5
通讯作者：
Pallotta, S.
中科院分区：
文献类型：
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作者：
De Pita, O.;Nardis, C.;Pallotta, S.
toll样受体（TLRs）是先天免疫系统中检测微生物病原体相关分子模式（pathogen-associated molecular patterns, PAMPs）的关键部分，其刺激导致信号通路的激活，从而调节炎症和免疫反应。由于银屑病是一种复杂的炎症性和免疫性皮肤病，其特征是免疫反应异常，角质形成细胞增殖增加，促炎细胞因子的产生增加，因此TLRs可能在银屑病的发病机制中发挥重要作用。我们建议评估阿达木单抗治疗和全身常规治疗对银屑病皮肤TLR表达的调节。因此，我们招募了15例患者：10例接受阿达木单抗治疗，5例接受全身常规治疗；采用PAS1指数分析患者的临床情况，采用免疫组化法检测皮肤活检组织TLR1和TLR2的表达。我们的数据表明，阿达木单抗不仅能够改善银屑病患者的临床状况，而且可以调节银屑病中TLR1和TLR2的表达，就像在健康皮肤中一样。阿达木单抗是一种最有前途的生物药物，能够协调银屑病病变的免疫和炎症反应，恢复基底角化细胞上TLR的表达，改善银屑病患者的临床状况，无明显副作用。
Toll-like receptors (TLRs) are a key part of the innate immune system that detect pathogen-associated molecular patterns (PAMPs) of microorganisms and their stimulation results in the activation of signaling pathways leading to the modulation of inflammatory and immune responses. Since psoriasis is a complex, inflammatory and immune skin disease, characterized by an abnormal immune response and increased proliferation of keratinocytes, with an increased production of proinflammatory cytokines, TLRs could play an important role in the pathogenesis of the disease. We propose to assess the modulation of TLR expression on psoriatic skin of patients treated with Adalimumab and systemic conventional therapies. We therefore recruited fifteen patients: ten were treated with adalimumab and five with systemic conventional therapies; their clinical conditions were analyzed by PAS1 index and skin biopsies were evaluated for TLR1 and TLR2 expression by immunohistochemistry assays. Our data suggest adalimumab is not only able to improve the clinical condition of psoriatic patients, but also to modulate TLR1 and TLR2 expression involved in psoriasis, as in healthy skin. Adalimumab is a most promising biological drug able to orchestrate immune and inflammatory responses in psoriatic lesions, recovering TLR expression on basal keratinocytes and improving clinical conditions of psoriatic patients, with no evident side effects.