老年特应性皮炎患者外周血Th1、Th2、Th17细胞与鳞状上皮细胞癌抗原水平的变化及意义

Changes in peripheral blood Th1, Th2, and Th17 cells in elderly patients with atopic dermatitis and their relationship with squamous epithelial cell Carcinoma antigen levels

摘要:

目的 探究外周血辅助性T细胞Th1、Th2、Th17和鳞状细胞癌抗原（SCCA）水平在老年特应性皮炎患者中的变化及其意义。方法 以2022年3月—2022年7月于四川省人民医院皮肤科就诊的25例老年特应性皮炎患者（老年特应性皮炎组）及同期33例健康体检者（健康对照组）为研究对象。采取流式细胞术测定外周血Th1、Th2和Th17细胞占CD4⁺T细胞的比例；检测老年特应性皮炎患者的外周血嗜酸性粒细胞（EOS）计数、总免疫球蛋白E（IgE）及血清SCCA水平；采用Spearman法进行相关性分析。结果 老年特应性皮炎患者皮损严重且分布广泛，主要表现为四肢伸侧及背部苔藓样湿疹，部分患者有1种或多种系统性疾病。老年特应性皮炎组的外周血EOS计数较健康对照组明显增加（P <0.05）。老年特应性皮炎组外周血中Th2和Th17细胞比例均高于健康对照组（P <0.05），而Th1细胞比例与健康对照组比较，差异无统计学意义（P >0.05）。老年特应性皮炎组外周血EOS计数与Th2细胞比例、SCCA水平有相关性（r_s =-0.399和0.607，均P <0.05）。老年特应性皮炎患者的SCCA水平与SCORAD评分呈正相关（r_s =0.416，P <0.05）。结论 老年特应性皮炎患者具有特有的临床特征，以Th2和Th17型炎症为主。老年特应性皮炎患者血清SCCA水平可在一定程度上反映其疾病的严重程度。

Abstract:

Objective To investigate the changes in peripheral blood helper T cells Th1, Th2, Th17, and squamous epithelial cell carcinoma antigen (SCCA) levels in elderly patients with atopic dermatitis (AD) and their clinical significance.Methods A total of 25 elderly patients with atopic dermatitis (elderly AD group) who visited the dermatology department of Sichuan People's Hospital from March 2022 to July 2022, along with 33 age-matched healthy individuals (healthy control group), were included in this study. Flow cytometry was used to determine the proportions of peripheral blood Th1, Th2, and Th17 cells among CD4⁺T cells. Peripheral blood eosinophil (EOS) counts, total immunoglobulin E (IgE) levels, and serum SCCA levels were measured in elderly AD patients. Spearman's correlation analysis was performed to assess relationships between these parameters.Results Elderly patients with atopic dermatitis exhibited severe and widespread skin lesions, primarily characterized by lichenified eczema on the extensor surfaces of the limbs and back. Some patients had one or more concomitant systemic diseases. The EOS counts in the peripheral blood of the elderly AD group were significantly higher than those in the healthy control group (P < 0.05). The proportions of Th2 and Th17 cells in the peripheral blood of the elderly AD group were higher than those in the healthy control group (P < 0.05), while the proportion of Th1 cells showed no statistically significant difference compared to the healthy control group (P > 0.05). EOS counts in the peripheral blood of elderly AD patients were correlated with the proportions of Th2 cells and SCCA levels (r_s = -0.399 and 0.607, respectively, both P < 0.05). Serum SCCA levels in elderly AD patients were positively correlated with SCORAD scores (r_s = 0.416, P < 0.05).Conclusion Elderly patients with atopic dermatitis exhibit distinct clinical features, with predominant Th2 and Th17 inflammation. Serum SCCA levels in elderly AD patients may reflect the severity of their disease to a certain extent.