Quantitative Assessments of Physiological and Biological Parameters in Psoriatic Lesions And Its Correlations to the Clinical Severity of Psoriasis

乾癬病變處皮膚生理及生物指標與其臨床嚴重度之相關性

陳國熏(Gwo-Shing Chen) ； 吳姿滿(Tzu-Man Wu) ； 楊森安(Sen-An Yang) ； 余幸司(Hsin-Su Yu)

《The Kaohsiung Journal of Medical Sciences》 17卷8期 (2001/08) Pp. 408-418

https://doi.org/10.6452/KJMS.200108.0408

摘要

二十九位乾癬患者以結合臨床、生理與病理學檢查之評估模式檢視其病灶。此模式包括：（１）臨床：乾癬面積及嚴重度指數（PASI）（２）皮膚生理及微小循環檢查：角質層含水量、水份保持能力、經表皮水份散失率、生體內動態微血管顯微鏡測量指甲近端皺襞處微血管徑及血流速、合併螢光造影術測量經微血管NaF通透性（３）病理組織免疫學檢查：包括增殖標記（Ki67Ag），分化標記（involucrin）與發炎相關標記（neutrophil elastase-ICAM-1,ELAM-1）。結果顯示微血管顯微鏡合併螢光造影之經微血管NaF通透性分析，表皮層Ki67Ag陽性率，真皮層neutrophil elastase陽性率，及ELAM-1表現度與臨床PASI指數具線性相關（P＜0.05）。因此我們以為乾癬病灶處之血管通透性、發炎指標及Ki67Ag表現度增加與PASI呈有意義之線性相關，可以作為乾癬患者臨床嚴重度評估之良好指標。

並列摘要

Twenty-nine psoriatics were examined using a model with clinical, physiological and pathological assessment parameters. The three parts in this assessment model include: (1) clinical assessment: psoriasis area and severity index (P ASI); (2) assessment of skin physiology and microcirculation: water content of stratum corneum, water-holding capacity of stratum corneum, transepidermal water loss, intravital dynamic videocapillaroscopy- measuring the capillary diameters and blood cell velocity in proximal nailfold of ring finger, and fluorescence angiography-measuring transcapillary Na-fluorescein(NAF) diffusion; and (3) immunohistochemistry examination: markers of proliferation (Ki67 Ag), differentiation (involucrin), and inflammation ( neutrophil elastase, intercellular adhesion molecule-l (ICAM-l), endothelial leukocyte adhesion molecule-( ELAM-1). Our results showed both the transcapillary diffusion of NAF and the expression of cell markers – dermal neutrophil elastase, epidermal ELAM-l and Ki67 Ag – correlated significantly to P ASI scores (P＜0.05, linear regression). According to our results, the increased capillary permeability and inflammation markers, and enhanced expression of Ki67 Ag correlated very well with P ASI score. These markers could serve as alternative methods for assessment of the clinical severity of psoriatic patients.

並列關鍵字

Psoriasis ； dynamic capillaroscopy ； neutrophil elastase ； Ki67 Ag ； endothelial leukocyte adhesion molecule-l( ELAM-l)