Article(id=1198622901835494202, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198622898320671473, articleNumber=null, orderNo=null, doi=10.16438/j.0513-4870.2022-0727, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1655136000000, receivedDateStr=2022-06-14, revisedDate=1658419200000, revisedDateStr=2022-07-22, acceptedDate=null, acceptedDateStr=null, onlineDate=1763703569133, onlineDateStr=2025-11-21, pubDate=1673452800000, pubDateStr=2023-01-12, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763703569133, onlineIssueDateStr=2025-11-21, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763703569133, creator=13701087609, updateTime=1763703569133, updator=13701087609, issue=Issue{id=1198622898320671473, tenantId=1146029695717560320, journalId=1189982191388893191, year='2023', volume='58', issue='1', pageStart='1', pageEnd='234', issueExtLink='null', onlineDate='null', pubDate='1673452800000', pubDateStr='2023-01-12', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1763703568296, creator='13701087609', updateTime=1763703697615, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1198623440782586642, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198622898320671473, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1198623440782586643, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198622898320671473, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=149, endPage=155, ext={EN=ArticleExt(id=1198622902632411992, articleId=1198622901835494202, tenantId=1146029695717560320, journalId=1189982191388893191, language=EN, title=The therapeutic efficacy of compound lidocaine cream on psoriasis, columnId=null, journalTitle=Acta Pharmaceutica Sinica, columnName=null, runingTitle=null, highlight=null, articleAbstract=

Psoriasis is a non-infectious chronic inflammatory skin disease. It′s acknowledged that interleukin (IL)-17 signaling pathway dominantly drives the development of psoriasis. Recently, the role of neuro-immune axis in psoriasis has attracted widespread attention. Lidocaine, a local anesthetic, has ability to block the conduction of nerve impulses, while its therapeutic efficacy on psoriasis remains to be confirmed. Here, we evaluated the therapeutic efficacy of topical application of compound lidocaine cream (LIDO) on imiquimod (IMQ)-induced mouse psoriasis model. Animal welfare and experimental procedures follow the regulations of the Ethics Committee of China Pharmaceutical University. The psoriasis area and severity index (PASI) scoring was used to evaluate the severity of psoriasis-like symptoms. Hematoxylin-eosin staining was used to examine histopathological changes and epidermal thickness was measured. Ki67 immunofluorescence staining was used to evaluate the proliferation of keratinocytes. The relative mRNA expression of inflammatory cytokines (including Il17, Il22, Il23 and Il36) in skin was measured by real-time quantitative PCR. Results show that IMQ-induced increases in the PASI score, epidermal thickness, number of Ki67+ cells and the mRNA expression of inflammatory cytokines are significantly alleviated by topical application of LIDO, whose therapeutic efficacy is also better than that of the positive control drug calcipotriol. Our study suggests that LIDO could be used for psoriasis treatment.

, authors=null, authorsList=Ke-jun JIAO, Yu-jing WANG, Zheng-yu CAO, authorCompany=null, correspAuthors=Zheng-yu CAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2023 Acta Pharmaceutica Sinica. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1198622904553403376, articleId=1198622901835494202, tenantId=1146029695717560320, journalId=1189982191388893191, language=CN, title=复方利多卡因乳膏对银屑病的治疗作用, columnId=1190335348896011050, journalTitle=药学学报, columnName=研究论文, runingTitle=null, highlight=null, articleAbstract=

银屑病是一种非传染性的慢性皮肤炎症疾病, 其发展主要受白细胞介素(interleukin, IL)-17信号路径调控。近年来, 神经-免疫轴在银屑病发展中的作用得到广泛关注。利多卡因作为局部麻醉药能够阻断神经冲动的传导, 然而其对银屑病的疗效有待确证。本研究考察皮肤局部涂抹复方利多卡因乳膏(compound lidocaine cream, LIDO) 对咪喹莫特(imiquimod, IMQ) 诱导的小鼠银屑病的治疗效果。动物福利和实验过程均遵循中国药科大学伦理委员会的规定。通过银屑病面积与严重性指数(psoriasis area and severity index, PASI) 评价银屑病样症状的严重程度; 通过苏木精-伊红染色考察皮肤组织病理学变化并测量表皮厚度; Ki67免疫荧光染色用于考察角质形成细胞增殖; 实时荧光定量PCR用于考察皮肤中炎症因子(Il17Il22Il23Il36) mRNA的表达水平。结果显示, 局部涂抹LIDO显著降低IMQ引起的PASI评分增加、表皮增厚、Ki67+细胞数目增加及炎症因子mRNA水平上调, 而且其效果优于阳性药卡泊三醇, 说明LIDO可能用于治疗银屑病。

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*曹征宇, Tel: 15651937388, E-mail:
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J Allergy Clin Immunol, 2022, 149: 1348-1357., articleTitle=Cav1.4 calcium channels control cytokine production by human peripheral TH17 cells and psoriatic skin-infiltrating T cells, refAbstract=null)], funds=[Fund(id=1198702079427576215, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, awardId=81972960, language=CN, fundingSource=国家自然科学基金资助项目(81972960), fundOrder=null, country=null), Fund(id=1198702079570182555, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, awardId=21777192, language=CN, fundingSource=国家自然科学基金资助项目(21777192), fundOrder=null, country=null), Fund(id=1198702079721177509, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, awardId=82100585, language=CN, fundingSource=国家自然科学基金资助项目(82100585), fundOrder=null, country=null), Fund(id=1198702079893143983, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, awardId=2018ZX09101003-004-002, language=CN, fundingSource=科技部新药创制重大专项任务(2018ZX09101003-004-002), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1198702073257755595, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, xref=null, ext=[AuthorCompanyExt(id=1198702073278727120, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, companyId=1198702073257755595, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China), AuthorCompanyExt(id=1198702073308087253, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, companyId=1198702073257755595, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=中国药科大学中药学院, 江苏 南京 211198)])], figs=[ArticleFig(id=1198702078018289951, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, language=EN, label=null, caption=null, figureFileSmall=zN5AZIOsVIr1AETj6N19MA==, figureFileBig=IhAsCsYPpNjOlvQXFr7Ygw==, tableContent=null), ArticleFig(id=1198702078139924781, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, language=CN, label=Figure 1, caption= Topical application of LIDO alleviates IMQ-induced symptoms. A: Representative images (left) and enlarged images (right) of the gross appearance of the back skins of C57BL/6 mice treated with 62.5 mg per day of VAS, LIDO, IMQ+VAS, IMQ+LIDO and IMQ+CAL for 5 days. Scale bar = 5 mm; B: Changes in PASI score of mice treated with VAS, LIDO, IMQ+VAS, IMQ+LIDO and IMQ+CAL. <i>n</i> = 6, mean ± SEM. <sup>**</sup><i>P</i> < 0.01 <i>vs</i> VAS; <sup>##</sup><i>P</i> < 0.01 <i>vs</i> IMQ+VAS. IMQ: Imiquimod; LIDO: Compound lidocaine cream; CAL: Calcipotriol; VAS: Vaseline; PASI: Psoriasis area and severity index , figureFileSmall=zN5AZIOsVIr1AETj6N19MA==, figureFileBig=IhAsCsYPpNjOlvQXFr7Ygw==, tableContent=null), ArticleFig(id=1198702078299308346, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, language=EN, label=null, caption=null, figureFileSmall=um51gh6e7jR+VX0SHA+XhQ==, figureFileBig=VCEtvZZBmcKeSCqMPMjzXQ==, tableContent=null), ArticleFig(id=1198702078441914698, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, language=CN, label=Figure 2, caption= Topical application of LIDO improved IMQ-induced acanthosis and inflammatory infiltration. A: Representative H & E stained images (200×, left) and enlarged images (right) of the back skins of C57BL/6J mice treated with VAS, LIDO, IMQ+VAS, IMQ+LIDO and IMQ+CAL. The blue lines and the green triangles indicate the thickness of epidermis and inflammatory cells, respectively. Scale bar = 100 µm; B: Quantification of the epidermal thickness of the back skins in mice treated with VAS, LIDO, IMQ+VAS, IMQ+LIDO and IMQ+CAL. <i>n</i> = 6, mean ± SEM. <sup>**</sup><i>P</i> < 0.01 <i>vs</i> VAS; <sup>##</sup><i>P</i> < 0.01 <i>vs</i> IMQ+VAS; <sup>&&</sup><i>P</i> < 0.01 <i>vs</i> IMQ+CAL , figureFileSmall=um51gh6e7jR+VX0SHA+XhQ==, figureFileBig=VCEtvZZBmcKeSCqMPMjzXQ==, tableContent=null), ArticleFig(id=1198702078559355219, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, language=EN, label=null, caption=null, figureFileSmall=RpTwvCx8iwa2AxpWG8Y+/Q==, figureFileBig=Cgt00XMIrfjxr8mxUQVF8w==, tableContent=null), ArticleFig(id=1198702078739710299, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, language=CN, label=Figure 3, caption= Topical application of LIDO reduced IMQ-induced keratinocytes (KCs) proliferation. A: Representative immunofluorescent images (200×, left) and enlarged images (right) of the back skins of C57BL/6J mice treated with VAS, LIDO, IMQ+VAS, IMQ+LIDO and IMQ+CAL. The dashed lines define the epidermis stratum. Ki67 positive (Ki67<sup>+</sup>) KCs were stained with green. Nuclei were stained with blue by Hoechst. Scale bar = 100 µm; B: Quantification of the percentage of Ki67<sup>+</sup> KCs in total cells of epidermis stratum in mice treated with VAS, LIDO, IMQ+VAS, IMQ+LIDO and IMQ+CAL. <i>n</i> = 6, mean ± SEM. <sup>**</sup><i>P</i> < 0.01 <i>vs</i> VAS; <sup>##</sup><i>P</i> < 0.01 <i>vs</i> IMQ+VAS , figureFileSmall=RpTwvCx8iwa2AxpWG8Y+/Q==, figureFileBig=Cgt00XMIrfjxr8mxUQVF8w==, tableContent=null), ArticleFig(id=1198702078836179299, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, language=EN, label=null, caption=null, figureFileSmall=hfbfXExBn/8XX4TEBA8nsw==, figureFileBig=8y4JEkJUuPi9RiQNarKh4A==, tableContent=null), ArticleFig(id=1198702078962008429, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, language=CN, label=Figure 4, caption= Topical application of LIDO reduced IMQ-induced inflammatory cytokines expression. Relative mRNA levels of <i>Il17a</i> (A), <i>Il17f</i> (B), <i>Il17c</i> (C), <i>Il22</i> (D), <i>Il23</i> (E), <i>Il36a</i> (F), <i>Il36b</i> (G), and <i>Il36g</i> (H) in the back skins of C57BL/6 mice treated with VAS, LIDO, IMQ+VAS, IMQ+LIDO and IMQ+CAL. <i>n</i> = 6, mean ± SEM. <sup>**</sup><i>P</i> < 0.01 <i>vs</i> VAS; <sup>##</sup><i>P</i> < 0.01 <i>vs</i> IMQ+VAS , figureFileSmall=hfbfXExBn/8XX4TEBA8nsw==, figureFileBig=8y4JEkJUuPi9RiQNarKh4A==, tableContent=null), ArticleFig(id=1198702079096226168, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
Gene Forward primer (5′-3′) Reverse primer (5′-3′)
Il17a TTTAACTCCCTTGGCGCAAAA CTTTCCCTCCGCATTGACAC
Il17c CTCCTGCTTCTAGGCTGGTTG CCACCTGGCACTTCGAGTTAG
Il17f TGCTACTGTTGATGTTGGGAC AATGCCCTGGTTTTGGTTGAA
Il22 ATGAGTTTTTCCCTTATGGGGAC GCTGGAAGTTGGACACCTCAA
Il23 ATGCTGGATTGCAGAGCAGTA ACGGGGCACATTATTTTTAGTCT
Il36a CCACGTACATGGGAGTGCAA GGGAAGGCTGCAGACTCAAA
Il36b AGATGGTATGGGTCCTGACTGG GCCCTCCATCTCAACACAGC
Il36g GCAGGTGTGGATCTTTCGTAATCA GCAGCAAAGTAGGGTGTCCA
Gapdh AGGTCGGTGTGAACGGATTTG TGTAGACCATGTAGTTGAGGTCA
), ArticleFig(id=1198702079184306563, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198622901835494202, language=CN, label=Table 1, caption=

Primer sequence used for real-time quantitative PCR. IL: Interleukin

, figureFileSmall=null, figureFileBig=null, tableContent=
Gene Forward primer (5′-3′) Reverse primer (5′-3′)
Il17a TTTAACTCCCTTGGCGCAAAA CTTTCCCTCCGCATTGACAC
Il17c CTCCTGCTTCTAGGCTGGTTG CCACCTGGCACTTCGAGTTAG
Il17f TGCTACTGTTGATGTTGGGAC AATGCCCTGGTTTTGGTTGAA
Il22 ATGAGTTTTTCCCTTATGGGGAC GCTGGAAGTTGGACACCTCAA
Il23 ATGCTGGATTGCAGAGCAGTA ACGGGGCACATTATTTTTAGTCT
Il36a CCACGTACATGGGAGTGCAA GGGAAGGCTGCAGACTCAAA
Il36b AGATGGTATGGGTCCTGACTGG GCCCTCCATCTCAACACAGC
Il36g GCAGGTGTGGATCTTTCGTAATCA GCAGCAAAGTAGGGTGTCCA
Gapdh AGGTCGGTGTGAACGGATTTG TGTAGACCATGTAGTTGAGGTCA
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复方利多卡因乳膏对银屑病的治疗作用
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焦珂珺 , 王雨晶 , 曹征宇 *
药学学报 | 研究论文 2023,58(1): 149-155
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药学学报 |研究论文 2023 , 58 (1) : 149 -155
复方利多卡因乳膏对银屑病的治疗作用
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焦珂珺, 王雨晶, 曹征宇*
作者信息
  • 中国药科大学中药学院, 江苏 南京 211198
通讯作者:
*曹征宇, Tel: 15651937388, E-mail:
The therapeutic efficacy of compound lidocaine cream on psoriasis
Ke-jun JIAO, Yu-jing WANG, Zheng-yu CAO*
Affiliations
  • School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
出版时间: 2023-01-12 doi: 10.16438/j.0513-4870.2022-0727
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银屑病是一种非传染性的慢性皮肤炎症疾病, 其发展主要受白细胞介素(interleukin, IL)-17信号路径调控。近年来, 神经-免疫轴在银屑病发展中的作用得到广泛关注。利多卡因作为局部麻醉药能够阻断神经冲动的传导, 然而其对银屑病的疗效有待确证。本研究考察皮肤局部涂抹复方利多卡因乳膏(compound lidocaine cream, LIDO) 对咪喹莫特(imiquimod, IMQ) 诱导的小鼠银屑病的治疗效果。动物福利和实验过程均遵循中国药科大学伦理委员会的规定。通过银屑病面积与严重性指数(psoriasis area and severity index, PASI) 评价银屑病样症状的严重程度; 通过苏木精-伊红染色考察皮肤组织病理学变化并测量表皮厚度; Ki67免疫荧光染色用于考察角质形成细胞增殖; 实时荧光定量PCR用于考察皮肤中炎症因子(Il17Il22Il23Il36) mRNA的表达水平。结果显示, 局部涂抹LIDO显著降低IMQ引起的PASI评分增加、表皮增厚、Ki67+细胞数目增加及炎症因子mRNA水平上调, 而且其效果优于阳性药卡泊三醇, 说明LIDO可能用于治疗银屑病。

复方利多卡因乳膏  /  局部麻醉药  /  银屑病  /  银屑病面积与严重性指数  /  增殖

Psoriasis is a non-infectious chronic inflammatory skin disease. It′s acknowledged that interleukin (IL)-17 signaling pathway dominantly drives the development of psoriasis. Recently, the role of neuro-immune axis in psoriasis has attracted widespread attention. Lidocaine, a local anesthetic, has ability to block the conduction of nerve impulses, while its therapeutic efficacy on psoriasis remains to be confirmed. Here, we evaluated the therapeutic efficacy of topical application of compound lidocaine cream (LIDO) on imiquimod (IMQ)-induced mouse psoriasis model. Animal welfare and experimental procedures follow the regulations of the Ethics Committee of China Pharmaceutical University. The psoriasis area and severity index (PASI) scoring was used to evaluate the severity of psoriasis-like symptoms. Hematoxylin-eosin staining was used to examine histopathological changes and epidermal thickness was measured. Ki67 immunofluorescence staining was used to evaluate the proliferation of keratinocytes. The relative mRNA expression of inflammatory cytokines (including Il17, Il22, Il23 and Il36) in skin was measured by real-time quantitative PCR. Results show that IMQ-induced increases in the PASI score, epidermal thickness, number of Ki67+ cells and the mRNA expression of inflammatory cytokines are significantly alleviated by topical application of LIDO, whose therapeutic efficacy is also better than that of the positive control drug calcipotriol. Our study suggests that LIDO could be used for psoriasis treatment.

compound lidocaine cream  /  local anesthetic  /  psoriasis  /  psoriasis area and severity index  /  prolife-ration
焦珂珺, 王雨晶, 曹征宇. 复方利多卡因乳膏对银屑病的治疗作用. 药学学报, 2023 , 58 (1) : 149 -155 . DOI: 10.16438/j.0513-4870.2022-0727
Ke-jun JIAO, Yu-jing WANG, Zheng-yu CAO. The therapeutic efficacy of compound lidocaine cream on psoriasis[J]. Acta Pharmaceutica Sinica, 2023 , 58 (1) : 149 -155 . DOI: 10.16438/j.0513-4870.2022-0727
银屑病是一种非传染性的慢性皮肤炎症疾病, 患者数量约占全球总人口的2%~3%[1]。白介素(interleukin, IL)-23/IL-17轴系免疫应答的过度活化是公认的银屑病病理机制。当皮肤受到外界刺激时, 活化的树突状细胞(dendritic cells, DCs) 释放IL-23, 进而激活17型辅助性T细胞(T helper cell 17, Th17)、Th1细胞和Th22细胞, 产生大量IL-17、IL-22和肿瘤坏死因子α (tumor necrosis factor alpha, TNF-α) 等炎症因子, 这些炎症因子作用于角质形成细胞(keratinocytes, KCs), 诱导KCs过度增殖并释放趋化因子和促炎因子, 进一步放大免疫应答[2-4]。研究发现感觉神经元对皮肤免疫应答具有重要的调节作用, 一方面, 在皮肤受到外界刺激时, 与DCs接触的感觉神经末梢能够直接调节DCs活化, 进而启动IL-23/IL-17轴系免疫应答; 另一方面, 活化的感觉神经元能够通过释放降钙素基因相关肽(calcitonin gene related peptide, CGRP) 调节17型免疫应答, 并促进由神经反射弧介导的预防性免疫应答[5-7]。此外, 利用去神经术切断支配皮肤的感觉神经末梢, 能够减轻KCs特异性过表达血管生成素受体Ⅱ (KC-Tie2) 所引起的自发银屑病样症状(包括棘层增厚和炎性细胞浸润); 相反, 在去神经的基础上, 皮内注射神经肽[P物质(substance P, SP) 和CGRP] 后, KC-Tie2引起的银屑病样症状再次出现; 而且, 在受神经支配的皮肤上, 抑制神经肽信号足以产生与去神经术类似的缓解作用, 说明皮肤内感觉神经元可通过释放神经肽参与银屑病发生发展[5]
局部麻醉药(简称局麻药) 在临床上用于在保持患者意识清醒的情况下, 可逆地引起局部组织痛觉消失, 其作用与神经纤维的直径及解剖特点有关, 因此神经末梢对局麻药最为敏感。利多卡因是一种氨基酰胺类局麻药, 通过阻断电压门控钠离子通道(voltage-gated sodium channel, VGSCs) 可逆地阻断神经冲动的产生和传导。此外, 利多卡因还被证明具有抗炎[8, 9]、免疫调节[10]、抗心律失常[11]、抗菌[12]及抗癌[13]等作用。1972年, Perlman医生[14]意外发现在手术过程中脊椎注射利多卡因使得患者皮肤表面的银屑病斑块逐渐消退。但是, 皮肤表面局部应用利多卡因对银屑病的疗效尚不明确。本文在咪喹莫特(imiquimod, IMQ) 诱导的小鼠银屑病模型上[15], 考察局部涂抹复方利多卡因乳膏(compound lidocaine cream, LIDO) 对银屑病的治疗效果。
实验动物  30只清洁级野生型C57BL/6小鼠购于扬州大学比较医学中心[实验动物生产许可证号: SCXK (苏) 2017-0007], 6~8周龄, 雌雄各半, 体重18~20 g。饲养于室温23 ± 2 ℃、湿度55%、光照与黑暗时间比为1∶1的环境中, 小鼠自由进食和饮水。本研究的动物实验方案得到中国药科大学实验动物管理和使用委员会(实验动物使用许可证号: SYXK 2018-0019) 的批准。
药物及主要试剂  IMQ (批号: GVJ005C, 3M公司, 每克乳膏含50 mg咪喹莫特); LIDO (批号: 200812, 北京紫光制药有限公司, 每克乳膏含25 mg利多卡因和25 mg丙胺卡因); 卡泊三醇软膏(calcipotriol, CAL, 批号: C37772, 爱尔兰利奥制药有限公司, 每克软膏含0.05 mg卡泊三醇); 凡士林软膏(vaseline, VAS, 批号: 181102, 山东名德医疗科技有限公司); Ki67抗体[货号: ab15580, 艾博抗(上海) 贸易有限公司]; Trizol RNA裂解液(货号: R401-01, 南京诺唯赞生物科技股份有限公司); RNA逆转录试剂盒[货号: 11141ES60, 翌圣生物科技(上海) 股份有限公司]; 实时荧光定量PCR (real-time quantitative PCR, qPCR) 试剂盒[货号: 11202ES08, 翌圣生物科技(上海) 股份有限公司]。
实验仪器  Nikon Eclipse Ti型倒置显微镜、NIS-element BR软件(Nikon公司); 徕卡荧光倒置显微镜(Leica公司); 实时荧光定量PCR系统QuantStudio3 (Thermo Fisher Scientific公司)。
模型构建及给药方案  30只C57BL/6小鼠, 剃除背毛, 适应性饲养3天后, 随机分成5组: VAS组、LIDO组、IMQ+VAS组、IMQ+LIDO组和IMQ+CAL组, 每组6只。每天上午涂抹62.5 mg IMQ于小鼠背部皮肤诱导银屑病样皮损, VAS组和LIDO组给予同等剂量的VAS, 连续5天; 每天下午涂抹62.5 mg LIDO或CAL, VAS组和IMQ组给予同等剂量的VAS, 连续5天。
临床症状评价  小鼠银屑病模型的临床症状采用银屑病面积与严重性指数(psoriasis area and severity index, PASI) 评分标准, 从红斑、鳞屑和浸润增厚3项指标进行评价, 以0~4分进行记分, 将3个指标的积分相加得到总积分。PASI评分标准如下: 0分, 无症状; 1分, 轻度; 2分, 中度; 3分, 重度; 4分, 极重度。每天于涂抹IMQ乳膏之前由受过训练的实验人员进行单盲评价并拍照记录。
组织病理学检查  采集小鼠背部给药区域的皮肤组织, 于4% (质量分数) 多聚甲醛溶液固定48 h后, 石蜡包埋并进行3 μm切片, 进行苏木精-伊红(hematoxylin-eosin, H & E) 染色。使用Eclipse Ti型倒置显微镜于200倍放大倍数下观察并拍照, 使用NIS-element BR软件对皮肤表皮层厚度进行测量, 每张切片随机选取3个视野。
表皮层KCs增殖检测  小鼠皮肤组织石蜡切片脱蜡至水, 0.3% Triton X-100透化30 min, 磷酸缓冲盐溶液(phosphate buffered saline, PBS) 润洗3次后, 置于盛满抗原修复缓冲液(0.4 g柠檬酸和3 g柠檬酸钠溶于1 000 mL纯水中, 调pH至6.0) 的玻璃器皿, 进行抗原微波热修复, 自然冷却后PBS润洗3次, 在组织上滴加含5% 牛血清白蛋白(bovine serum albumin, BSA) 的PBS, 封闭30 min, 轻轻甩掉封闭液, 在切片上滴加含1% BSA的PBS配置的Ki67一抗(稀释比为1∶300), 4 ℃孵育过夜。次日, PBS润洗3次后, 室温避光孵育荧光二抗60 min, 用含Hoechst的抗荧光淬灭剂封片。使用徕卡荧光倒置显微镜拍摄, 每张切片随机选取3个视野。KCs增殖率以表皮层中Ki67阳性的细胞数目与细胞总数的比值表示。
炎症因子mRNA水平检测  称取20 mg皮肤组织, 液氮研磨至粉末, 使用Trizol法提取总RNA, 用10 μL DEPC水溶解RNA后, 取1 μL进行浓度检测; 再取1 μg RNA进行逆转录反应, 按RNA逆转录试剂盒说明书进行操作。逆转录步骤具体如下: 逆转录反应体系为1 μg RNA, 加水至12 μL, 加入3 μL gDNA digester buffer后于42 ℃孵育2 min以去除gDNA, 然后加入5 μL逆转录酶进行逆转录反应, 逆转录程序为: ① 25 ℃ 5 min; ② 42 ℃ 30 min; ③ 85 ℃ 5 min。逆转录产物于-20 ℃保存, 备用。引物由南京擎科生物有限公司合成, 其序列见表 1。qPCR反应在实时荧光定量PCR系统QuantStudio3中进行。反应体系为1 μL逆转录产物, 0.5 μL 10 μmol·L-1前引, 0.5 μL 10 μmol·L-1后引, 8 μL水和10 μL SYBR Green染料预混液; 热循环步骤为: ① 95 ℃预变性5 min; ② 95 ℃变性30 s; ③ 60 ℃退火/延伸40 s, 并采集荧光信号; ②~③循环45次后, 进入温度梯度变化流程, 以获得PCR产物熔解曲线。经内参基因(Gapdh) 校正后, 通过2-ΔΔCt法计算, 炎症因子表达水平以相对于VAS组样本的倍数来表示。
统计学分析  采用GraphPad Prism 6.0软件进行数据的统计分析及制图, 所有数据以平均值±标准误(mean ± SEM) 表示。PASI评分采用two-way ANOVA分析, 其他数据采用one-way ANOVA分析, 利用Dunnett's多重检验分析组间差异的显著性, 当P < 0.01时, 组间差异极显著, 具有统计学意义。
图 1所示, 连续涂抹IMQ诱导小鼠背部皮肤出现潮红、鳞屑及浸润增厚的银屑病样皮炎症状(图 1A), PASI评分结果显示, IMQ+VAS组在第2、3、4、5天的PASI评分分别为2.33 ± 0.45、2.83 ± 0.50、4.00 ± 0.47、5.00 ± 0.67, 相对于VAS对照组小鼠, 具有显著性差异(P < 0.01, 图 1B), 表明IMQ诱导的银屑病模型构建成功; 连续涂抹LIDO及阳性药物CAL能够缓解IMQ诱导的银屑病样症状(图 1A), IMQ+LIDO组在第1、2、3、4、5天的PASI评分分别为0.33 ± 0.19、0.33 ± 0.19、0.50 ± 0.31、0.50 ± 0.31、0.83 ± 0.37, 而IMQ+CAL组在第1、2、3、4、5天的PASI评分分别为0.50 ± 0.20、0.83 ± 0.44、1.00 ± 0.33、0.67 ± 0.19、1.00 ± 0.24, 与IMQ+VAS组相比, IMQ+LIDO组和IMQ+CAL组在第2、3、4、5天的PASI评分均显著降低(P < 0.01, 图 1B), 说明连续涂抹LIDO或CAL能够延缓IMQ诱导的银屑病进程。
皮肤切片的H & E染色结果显示, 正常皮肤结构由外至内分为表皮层、真皮层和皮下结缔组织, 而IMQ+VAS组皮肤出现典型的银屑病样病理变化, 包括表皮层增厚和真皮层中炎性浸润(图 2A); 相对于IMQ+VAS组, IMQ+LIDO组和IMQ+CAL组皮肤的表皮层厚度降低且真皮层中炎性浸润减轻(图 2A, 放大图)。各组皮肤表皮层厚度统计如图 2B所示, VAS对照组的表皮层厚度为17.66 ± 1.11 μm, IMQ涂抹使表皮层厚度增加至73.98 ± 3.24 μm (P < 0.01 vs VAS); 单独给予LIDO组, 表皮层厚度为21.14 ± 1.35 μm (P > 0.05 vs VAS)。LIDO可显著抑制IMQ诱导的表皮层增厚, 抑制率为83.6% ± 4.2% (P < 0.01 vs IMQ+VAS); 阳性药CAL也可显著降低IMQ诱导的表皮层增厚, 抑制率为35.0% ± 6.8% (P < 0.01 vs IMQ+VAS); 与阳性药比较, LIDO对IMQ诱导的表皮层增厚的抑制作用优于CAL (P < 0.01)。
为了进一步考察LIDO对IMQ诱导的表皮层KCs增殖的影响, 利用Ki67免疫荧光染色技术对表皮层KCs的增殖进行了检测。结果如图 3A所示, 虚线区域为表皮层, 其中, Ki67阳性(Ki67+) 细胞具有绿色荧光, 而细胞核被Hoechst染成蓝色。VAS组表皮层中Ki67+细胞占比为15.2% ± 1.0%, 而IMQ+VAS组表皮层Ki67+细胞占比增加至48.0% ± 2.8%, 与VAS组相比, 具有极显著差异(P < 0.01); 连续涂抹LIDO和CAL分别将Ki67+细胞占比降低至28.1% ± 2.1%和27.3% ± 1.4%, 与IMQ+VAS组相比, 具有显著差异(P < 0.01), 但两组之间差异不显著。
银屑病的发生发展依赖IL-23/IL-17轴系炎症因子(IL-17、IL-22和IL-23等), 而KCs释放的促炎因子(IL-36α、IL-36β和IL-36γ等) 能进一步放大炎症应答[16], 因此, 本研究进一步考察了LIDO对小鼠皮肤中IMQ诱导的炎症因子表达的影响。如图 4所示, 相对于VAS组, IMQ使小鼠皮肤组织中Il17aIl17fIl17cIl22Il23Il36aIl36bIl36g的mRNA水平分别增加了79.76 ± 8.51、8.62 ± 3.13、2.35 ± 0.18、3.28 ± 0.70、1.83 ± 0.32、25.21 ± 6.06、9.09 ± 2.69和8.69 ± 1.94倍, 差异均具有统计学意义(P < 0.01); LIDO对IMQ诱导的Il17aIl17fIl17cIl22Il23Il36aIl36bIl36g的转录上调有显著的抑制作用(P < 0.01 vs IMQ+VAS), 分别抑制了98.2% ± 0.8%、93.8% ± 4.2%、74.0% ± 15.3%、64.1% ± 5.6%、90.3% ± 11.0%、103.0% ± 0.1%、106.2% ± 0.5%及107.4% ± 0.8%; 阳性药CAL对IMQ诱导的Il17aIl17fIl17cIl23Il36aIl36bIl36g的转录上调有显著的抑制作用(P < 0.01 vs IMQ+VAS), 分别抑制了93.2% ± 3.1%、74.6% ± 9.7%、94.0% ± 8.5%、112.2% ± 17.5%、102.5% ± 0.5%、106.2% ± 1.6%及102.4% ± 0.8%, 但CAL对IMQ诱导的Il22转录上调没有显著的抑制作用, 说明LIDO和CAL治疗银屑病的作用方式有所差别。
本研究利用IMQ诱导的小鼠银屑病模型, 通过考察外观症状、病理变化、表皮层KCs增殖及皮肤炎症因子表达等指标, 对皮肤表面局部涂抹LIDO治疗银屑病的效果进行评价, 并与阳性药CAL的效果进行对比。结果表明, 局部涂抹LIDO能够显著缓解IMQ诱导的小鼠银屑病样症状、改善皮肤病理变化、降低表皮层KCs增殖并抑制皮肤炎症因子表达, 且治疗效果略优于CAL。而且局部涂抹LIDO的动物未出现不良反应。
目前临床上常用的银屑病治疗方法包括局部疗法、光疗法及生物制剂靶向疗法等, 其中, 局部疗法是轻中度银屑病的首选疗法, 也是重度银屑病的辅助疗法[17]。常用的外用药物主要有以下几类: ①皮质类固醇类, 如曲安奈德, 主要通过干扰丝裂原活化蛋白激酶(mitogen-activated protein kinase, MAPK) 途径抑制IL-1β、IL-6等促炎因子的表达来发挥抗炎、抗增殖和局部血管收缩作用, 但是长期使用可能会造成皮肤萎缩和毛细血管扩张等, 突然停药还可能引起病情反弹[18, 19]; ②维生素D类似物, 如卡泊三醇, 主要通过与KCs上的维生素D受体结合, 抑制KCs增殖并促进其分化, 同时降低KCs产生的促炎因子, 进而阻碍不断放大的免疫应答[20], 常见的不良反应为皮肤水肿, 并伴有灼痛和瘙痒; ③钙调磷酸酶抑制剂, 如他克莫司, 通过调节核因子κB抑制蛋白(inhibitor of NF-κB, IκB) 表达来抑制TNF-α/IL-17A对KCs的促炎作用[21], 但起效较慢; ④维A酸类, 如他扎罗汀, 可以抑制KCs的增殖, 并有助于分解病灶部位的鳞屑, 但对皮肤刺激性较大[22]。因此, 开发出一种见效快、疗效好且不良反应少的银屑病治疗药物具有极高的临床价值。LIDO是市售的常用药物, 本研究发现皮肤表面局部涂抹LIDO, 在IMQ诱导的小鼠银屑病模型上取得了良好的治疗效果, 优于CAL的疗效, 且单独涂抹LIDO未见不良反应。以上结果提示, 以利多卡因为代表的局麻药在皮肤表面的局部应用在银屑病的预防或治疗中有很大的应用潜力。
皮肤中分布着丰富的自主神经末梢和感觉神经末梢, 这些神经末梢的功能的改变能够影响皮肤的炎症状态。痛觉神经末梢的活化不仅能通过Th2型免疫应答介导皮肤过敏反应[23], 而且能启动Th17型免疫应答, 从而发挥皮肤的宿主防御功能[24]。大鼠皮下注射瞬时受体电位离子通道V1 (transient potential receptor vallinoid 1, TRPV1) 的激动剂辣椒素可诱发特应性皮炎样症状[25], 相反, 抑制TRPV1可以减轻IMQ诱导的银屑病症状[26]。最近的研究报道共表达TRPV1和电压门控钠离子通道1.8 (voltage-gated sodium channels 1.8, Nav1.8) 的感觉神经末梢能够释放CGRP, 调节邻近的DCs活化, 进而驱动依赖IL-23/IL-17轴的银屑病样免疫应答[24, 26]。这些研究进一步揭示了银屑病的发生发展依赖神经-免疫轴。局麻药通过抑制VGSCs来降低皮肤感觉神经元的兴奋性, 从而发挥麻醉效果。因此, LIDO对银屑病的治疗效果可能与其对表达Nav1.8的感觉神经元的阻滞有关。有研究表明LIDO也能够通过激动并敏化TRPV1, 诱导小鼠感觉神经元释放CGRP[27]。鉴于LIDO对Nav1.8的亲合力(IC50为104 μmol·L-1) 强于TRPV1 (EC50为3.4 mmol·L-1)[27, 28], 本课题组猜测LIDO发挥疗效的主要作用靶点是以Nav1.8为代表的VGSCs[26]。除了感觉神经元, VGSCs也在KCs表达[29]。而Ki67免疫荧光染色结果表明涂抹LIDO能够抑制IMQ诱导的表皮层KCs增殖, 提示LIDO也可能通过调节VGSCs影响KCs增殖。据报道, LIDO对钾离子通道和钙离子通道有一定抑制作用[30, 31], 而这些靶点亦陆续被证实参与对银屑病进程的调控[32, 33]。因此, 以LIDO为代表的局麻药治疗银屑病的作用机制可能涉及多个靶点。
综上所述, 皮肤表面局部应用LIDO能够有效缓解IMQ诱导的小鼠银屑病样皮炎, 且无不良反应。LIDO可能通过抑制VGSCs对皮肤的神经-免疫轴或KCs发挥调节作用, 进而影响银屑病的病理进程。因此, 作为一种现有的临床药物, 皮肤局部涂抹LIDO可能成为治疗银屑病的一种新策略。
作者贡献: 焦珂珺和王雨晶是本研究的实验设计者和实验研究的执行人, 完成数据分析、论文初稿的写作; 曹征宇是项目的构思者及负责人, 指导实验设计、数据分析、论文写作与修改。
利益冲突: 本文作者声明没有利益冲突。
  • 国家自然科学基金资助项目(81972960)
  • 国家自然科学基金资助项目(21777192)
  • 国家自然科学基金资助项目(82100585)
  • 科技部新药创制重大专项任务(2018ZX09101003-004-002)
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2023年第58卷第1期
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doi: 10.16438/j.0513-4870.2022-0727
  • 接收时间:2022-06-14
  • 首发时间:2025-11-21
  • 出版时间:2023-01-12
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  • 收稿日期:2022-06-14
  • 修回日期:2022-07-22
基金
国家自然科学基金资助项目(81972960)
国家自然科学基金资助项目(21777192)
国家自然科学基金资助项目(82100585)
科技部新药创制重大专项任务(2018ZX09101003-004-002)
作者信息
    中国药科大学中药学院, 江苏 南京 211198

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2种不同金属材料的力学参数

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genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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