循环JNK通路相关磷酸酶可以预测肿瘤坏死因子抑制剂治疗银屑病的临床应答
对照。采用酶联免疫吸附方法测定受试者血浆JKAP表达水平。银屑病患者均接受依那西普治疗（etanercept，ETN）6个月，分别在治疗开始后的第1个月（M1）、第3个月（M3）和第6个月（M6）进行银屑病皮损面积及严重度指数（psoriasis area and severity index，PASI）评估，并计算PASI 75和PASI 90应答率。 结果 血浆JKAP在银屑病患者中的表达水平显著低于其在HCs中的表达水平（P<0.001），且其可以很好地预测银屑病患病风险（AUC=0.726）。同时，血浆JKAP水平与银屑病患者的PASI评分显著负相关（P=0.012）。治疗6个月后，65.3%的银屑病患者达到PASI 75，33.7%的患者达到PASI 90，同时，PASI 75（M6）应答者其血浆JKAP表达水平显著低于无PASI 75（M6）应答者（P=0.002），且血浆JKAP表达水平对PASI 75（M6）应答有预测价值（AUC=0.695），而对PASI 90（M6）应答无预测价值。多元逻辑回归模型分析表明，更高的血浆JKAP表达水平可以作为患者更不容易达到PASI 75（M6）应答的独立预测因素（P=0.009）。 结论 循环JKAP表达水平对于银屑病具有诊断价值，并且可以用来预测TNFi治疗银屑病患者的临床应答。
[關键词] JKAP;银屑病;TNFi;PASI;临床应答
[中图分类号] R725 [文献标识码] A [文章编号] 1674-0742（2019）08（b）-0004-07
[Abstract] Objective This study was designed to assess the association of plasma JNK pathway-associated phosphatase （JKAP） with the risk of psoriasis， disease severity， and JKAP for tumor necrosis factor inhibitors， TNFi） predictive effect of the treatment of psoriasis. Methods Convenient selected a total of 98 patients with moderate to severe plaque psoriasis who underwent TNFi therapy between May 2014 and April 2016 were eolled in the study. 100 healthy controls （HCs） were included as control group. The plasma JKAP expression level of the subjects was determined by enzyme-linked immunosorbent assay. Patients with psoriasis received etanercept （ETN） for 6 months， and the area and severity index of psoriasis lesions （psoriasis） were performed in the first month （M1）， the third month（M3）， and the sixth month（M6） after the start of treatment of psoriasis area and severity index （PASI） was evaluated and PASI 75 and PASI 90 response rates were calculated. Results The expression level of plasma JKAP in patients with psoriasis was significantly lower than that in HCs（P<0.001）， and it was a good predictor of the risk of psoriasis （AUC = 0.726）. At the same time， plasma JKAP levels were significantly negatively correlated with PASI scores in patients with psoriasis（P=0.012）. After 6 months of treatment， 65.3% of patients with psoriasis achieved PASI 75， 33.7% of patients achieved PASI 90， and PASI 75 （M6） responders had significantly lower plasma JKAP expression levels than those without PASI 75 （M6） responders （P=0.002）， and plasma JKAP expression levels have predictive value for PASI 75 （M6） response （AUC = 0.695）， while there is no predictive value for PASI 90 （M6） response. Multiple logistic regression analysis showed that higher plasma JKAP expression levels were an independent predictor of PASI 75 （M6） response in patients （P=0.009）. Conclusion Circulating JKAP expression levels have diagnostic value for psoriasis and can be used to predict the clinical response of TNFi in patients with psoriasis.