寻常性痤疮患者皮损感染病原菌及NF-κB p50 mRNA、NF-κB p65 mRNA、SP、NLRP3水平与病情的关联

Pathogenic bacteria in skin lesions infection of patients with acne vulgaris and relationship between NF-κB p50 mRNA, NF-κB p65 mRNA, SP, NLRP3 and the disease

    摘要
  • 摘要:
    目的 探究寻常性痤疮患者皮损感染病原菌，分析核因子κB（NF-κB）p50信使核糖核酸（mRNA）、NF-κB p65 mRNA、P物质（SP）、核苷酸结合寡聚结构域样受体蛋白3（NLRP3）表达诊断价值及四者与病情严重程度相关性。
    方法 将福建省立医院2020年1月-2022年12月收治的寻常性痤疮皮损发生感染患者71例作为研究组，另选73例寻常性痤疮皮损未发生感染患者作为对照组；根据研究组的病情严重程度分为轻中度组（41例）和重度组（30例）；统计研究组病原菌分布情况；比较研究组、对照组之间，轻中度组、重度组之间NF-κB p50 mRNA、NF-κB p65 mRNA、SP、NLRP3表达情况；采用Spearman分析NF-κB p50 mRNA、NF-κB p65 mRNA、SP、NLRP3水平与寻常性痤疮患者皮损感染病情严重程度的相关性；利用受试者工作特征（ROC）曲线分析NF-κB p50 mRNA、NF-κB p65 mRNA、SP、NLRP3对寻常性痤疮患者皮损感染的诊断价值。
    结果 71例寻常性痤疮皮损感染患者共检出71株厌氧菌，主要为痤疮丙酸杆菌（69.01%），表皮葡萄球菌（15.49%）次之；研究组NF-κB p50 mRNA、NF-κB p65 mRNA、SP、NLRP3水平2.04±0.63、4.01±1.23、（87.98±23.39）ng/ml、3.25±1.03高于对照组（P < 0.05）；重度组NF-κB p50 mRNA、NF-κB p65 mRNA、SP、NLRP3水平2.73±0.88、4.92±1.54、(102.51±26.67)ng/ml、3.73±1.14高于轻中度组（P < 0.05）；NF-κB p50 mRNA、NF-κB p65 mRNA、SP、NLRP3水平与寻常性痤疮患者皮损感染病情严重程度均呈正相关（r=0.723、0.708、0.695、0.751，P < 0.05）；NF-κB p50 mRNA、NF-κB p65 mRNA、SP、NLRP3联合检测诊断寻常性痤疮患者皮损感染的曲线下面积（AUC）值（0.919）比其单一检测值要高（P < 0.05），且联合检测的敏感度、特异度分别为84.51%、87.67%。
    结论 寻常性痤疮患者皮损感染的病原菌主要为痤疮丙酸杆菌，其NF-κB p50 mRNA、NF-κB p65 mRNA、SP、NLRP3水平高表达，四者联合检测可提高对寻常性痤疮患者皮损发生感染的诊断价值，且这些指标水平与寻常性痤疮患者皮损感染病情严重程度有相关性。

     

    Abstract:
    OBJECTIVE To investigate the pathogenic bacteria of skin lesions infection in patients with acne vulgaris, analyze the expression of nuclear factor κB (NF-κB) p50 mRNA, NF-κB p65 mRNA, substance P (SP) and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) and their relationships with the severity of acne vulgaris.
    METHODS A total of 71 patients of acne vulgaris with infected skin lesions treated in Fujian Provincial Hospital from Jan. 2020 to Dec. 2022 were selected as the study group, and 73 patients without infected lesions were as the control group. According to the severity, the study group was divided into mild-moderate (41 cases) and severe group (30 cases). The distributions of pathogenic bacteria in the study group were analyzed in the study group; expressions of NF-κB p50 mRNA, NF-κB p65 mRNA, SP and NLRP3 were compared among the different groups; the correlations of NF-κB p50 mRNA, NF-κB p65 mRNA, SP, NLRP3 levels with the severity of infected lesions were analyzed by Spearman; the diagnostic values of NF-κB p50 mRNA, NF-κB p65 mRNA, SP and NLRP3 were analyzed by receiver operating characteristic (ROC) curve.
    RESULTS A total of 71 strains of anaerobic bacteria were detected in the infected skin lesions of the study group, mainly were Propionibacterium acnes (69.01%), followed by Staphylococcus epidermidis(15.49%). The levels of NF-κB p50 mRNA, NF-κB p65 mRNA, SP and NLRP3 in study group 2.04±0.63, 4.01±1.23, (87.98±23.39) ng/ml, 3.25±1.03, respectively were higher than those in control group (P < 0.05), while the levels in severe group 2.73±0.88, 4.92±1.54, (102.51±26.67)ng/ml, 3.73±1.14, respectively were higher than those in mild-moderate group (P < 0.05). Expressions of NF-κB p50 mRNA, NF-κB p65 mRNA, SP and NLRP3 were positively correlated with the severity of infected of acne vulgaris (r=0.723, 0.708, 0.695, 0.751, respectively, P < 0.05). The area under the curve (AUC) values of NF-κB p50 mRNA, NF-κB p65 mRNA, SP and NLRP3 combined for infected lesions was 0.919, which was higher than that of single detection (P < 0.05), with the sensitivity 84.51% and specificity 87.67%.
    CONCLUSIONS The acne vulgaris patients with skin lesions infection are mainly infected by P.acnes with high expressions of NF-κB p50 mRNA, NF-κB p65 mRNA, SP and NLRP3. The combined detection of the four indexes can improve the diagnosis and correlate with the severity of the infected lesions in acne vulgaris.

     

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