Meta-analysis of the Relationship between IFN-γ and Psoriasis_Chinese Journal of Evidence-Based Medicine

Authors：

XU Limin ¹ , RU Xueying ² ,  WU Taixiang ³

1. Changzheng Hospital of Tianjin, Tianjin 300120, China; 2. Department of Dermatology, Yongjiu Hospital of Tianjin, Tianjin 300450, China; 3. Evidence-Based Medicine and Clinical Epidemiology Centre, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding?author：

WU Taixiang, Email: txwutx@hotmail.com

Keywords：

Psoriasis; IFN-γ; Relationship study; Meta-analysis

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Objective 　To assess the relationship between IFN-γ and psoriasis.
Methods 　We searched The Cochrane Library (Issue 3, 2005), MEDLINE (1996 to 2005) and the China Biological Medicine Database (1978 to 2005). The search was conducted in November 2005. The quality of included clinical controlled trials, case studies and cohort studies was evaluated independently by three reviewers. RevMan 4.2.8 software was used. 　
Results 　In total, 23 studies were included, involving 612 psoriasis patients and 441 healthy controls. All studies did not provide sufficient detail, on the random sampling and the specificity of the kits used for the analyses. Compared with the controls, the serum or plasma IFN-γ in psoriasis patients showed significantly higher levels (SMD=0.89, 95%CI 0.29 to 1.48; and RR=6.20, 95%CI 1.78 to 21.61). The concentration of IFN-γ in supernatant obtained from cultured cells showed slightly higher levels (SMD=0.99, 95%CI -0.01 to 1.99; and RR=5.54, 95%CI 2.03 to 15.13).
Conclusion 　The evidence currently available shows that the increase of IFN-γ may be relevant to psoriasis. However, these results could be affected by the high risk of selection, confounding and detection bias of included studies. More persuasive evidence, from high quality studies, is needed.

Citation： XU Limin,RU Xueying,WU Taixiang. Meta-analysis of the Relationship between IFN-γ and Psoriasis. Chinese Journal of Evidence-Based Medicine, 2007, 07(7): 516-522. doi: Copy

1.	Jin BQ. Cytokine and receptor, In: Jin BQ, Editor-in-chief. Celluler and molecular immunology.2nd ed. Beijing: Science Publishing House, 2001. 97-172.
2.	He YQ, Zhang XB, Wu ZH. Cytokine and psoriasis. China J Lepr Skin Dis, 2003, 19(3): 248-250.
3.	He YQ, Zhang XB, Wu ZH, et al. Study of cytokines IFN-γ、IL-4 levels in psoriatic patients in vitro. J Clin Dermatol, 2002, 31(12): 762-763.
4.	Huang Q, Zheng ZZ, Zhu LC, et al. The determination of levels of nitric oxide, interleukin-8, interleukin-4 and interferon-gamma in serums of psoriatic. J Clin Dermatol, 2002, 31(6): 344-345.
5.	Jiang JH, Pu XM. Determination of serum IL-2, 6 and interferon-γin the psoriasis vulgaris patients of Uighur and Han nation. J Dermatology and Venereology, 2002, 24(2): 3-4.
6.	Wang YJ, Wu SM, Luo ZC. The levels and clinical significance of IL-2, IFN-γ, IL-12 and TNF-ain peripheral blood of patients with psoriasis vulgaris. China J Lepr Skin Dis, 2002, 18(4): 327-329.
7.	Xu LM, Wang YH, Li H, et al. Expression of IFN-γ and IL-18 in peripheral blood of psoriasis. Chin J Dermatol, 2003, 36(10): 577-579.
8.	Yan H, Ye QY, Hao F, et al. In vitro study on Th1/Th2 pattern of psoriasis. Acta Academiae Medicinae Militaris Tertiae, 2001, 23(11): 1335-1336.
9.	Zhang LF, Wu QX, Wang Q. Study on the levels of cytokines in sera of patients with various types of psoriasis. Chin J Dermatol, 2001, 34(2): 101-102.
10.	Zhang XB, He YQ, Wu ZH, et al. Investigation on methotrexate interfere on human keratinocytes proliferation in vitro. Chin J Dermatol, 2003, 36(3): 151-153.
11.	金伯泉. 細胞因子及其受體. 見：金伯泉. 主編. 細胞和分子免疫學. 第2版. 北京: 科學出版社, 2001. 97-172.
12.	何玉清, 張錫寶, 吳志華. 細胞因子與銀屑病. 中國麻風皮膚病雜志, 2003, 19(3): 248-250.
13.	Szegedi A, Aleksza M, Gonda A, et al. Elevated rate of Thelper1 (T(H)1) lymphocytes and serum IFN-gamma levels in psoriatic patients. Immunol Lett, 2003, (86): 277-280.
14.	Bonifati C, Ameglio F, Carducci M, et al. Interleukin-1-beta, Interleukin-6, and Interferon-gamma in suction blister fluids of involved and uninvolved skin and in sera of psoriatic patients. Acta Derm Venereol (Stockh), 1994, 186: 23-24.
15.	Mahmoud F, Abul A, Al-seleh Q, et al. Differential expression of interferon gamma by mitogen-stimulated peripheral blood mononuclear cells among Kuwaiti psoriasis patients. J Dermatol, 1999, 26(1): 23-28.
16.	Chodorowska G. Plasma concentrations of IFN-gamma and TNF-alpha in psoriatic patients before and after local treatment with dithranol ointment. J Eur Acad Dermatol Venereol, 1998, (10): 147-151.
17.	Ockenfels HM, Wagner SN, Keim-Maas C, et al. Lithium and psoriasis: cytokine modulation of cultured lymphocytes and psoriasis keratinocytes by lithium. Arch Dermatol Res, 1996, 288: 173-178.
18.	Rotsztejn H, Zalewska A, Trznadel-Budzko E, et al. Influence of systemic photochemotherapy on regulatory T cells and selected cytokine production in psoriatic patients: a pilot study. Med Sci Monit, 2005, 11(12): 594-598.
19.	Austin LM, Ozawa M, Kikuchi T, et al. The majority of epidermal T cells in Psoriasis vulgaris lesions can produce type 1 cytokines, interferon-gamma, interleukin-2, and tumor necrosis factor-alpha, defining TC1 (cytotoxic T lymphocyte) and TH1 effector populations: a type 1 differentiation bias is also measured in circulating blood T cells in psoriatic patients. J Invest Dermatol, 1999, 113(5): 752-759.
20.	Tigalonova M, Bjerke JR, Gallati H, et al. Serum levels of interferons and TNF-alpha are not correlated to psoriasis activity and therapy. Acta Derm Venereol(Stockh), 1994, 186: 25-27.
21.	Kagi MK, Wuthrich B, Montano E, et al. Differential cytokine profiles in peripheral blood lymphocyte supernatants and skin biopsies from patients with different forms of atopic dermatitis, psoriasis and normal individuals. Int Arch Allergy Immunol, 1994, 103: 332-340.
22.	Kanda N, Tani K, Enomoto U, et al. The skin fungus-induced Th1- and Th2-related cytokine, chemokine and prostaglandin E2 production in peripheral blood mononuclear cells from patients with atopic dermatitis and psoriasis vulgaris. Clin Exp Allergy, 2002, 32: 1243-1250.
23.	El Barnawi NY, Giasuddin AS, Ziu MM, et al. Serum cytokine levels in psoriasis vulgaris. Br J Biomed Sci, 2001, 58(1): 40-44.
24.	Jacob SE, Nassiri M, Kerdel FA, et al. Simultaneous measurement of multiple Th1 and Th2 serum cytokines in psoriasis and correlation with disease severity. Mediators of Inflammation, 2003, 12(5): 309-313.
25.	Gomi T, Shiohara T, Munakata T, et al. Interleukin 1 alpha, tumor necrosis factor alpha, and interferon gamma in psoriasis. Arch Dermatol, 1991, 127(6): 827-830.
26.	何玉清, 張錫寶, 吳志華, 等. 銀屑病患者細胞因子γ-干擾素、白介素4水平的體外研究. 臨床皮膚科雜志, 2002, 31(12): 762-763.
27.	黃瓊, 鄭志忠, 祝祿川, 等. 銀屑病患者血清中NO、IL-8、IL-4和IFN-γ水平測定. 臨床皮膚科雜志, 2002, 31(6): 344-345.
28.	蔣建華, 普雄名. 維、漢尋常型銀屑病患者血清白介素2、6及干擾素γ含量測定. 皮膚病與性病, 2002, 24(2): 3-4.
29.	王雨娟, 武三卯, 駱志成. 尋常型銀屑病患者外周血中IL-2、IFN-γ、IL-12和TNF-γ的測定及其臨床意義. 中國麻風皮膚病雜志, 2002, 18(4): 327-329.
30.	徐麗敏, 王彥紅, 李虹, 等. 銀屑病患者外周血干擾素γ和白介素18的表達. 中華皮膚科雜志, 2003, 36(10): 577-579.
31.	閻衡, 葉慶佾, 郝飛, 等. 銀屑病Th1/Th2模式的體外試驗. 第三軍醫大學學報, 2001, 23(11): 1335-1336.
32.	張良芬, 吳勤學, 王群. 銀屑病患者血清中細胞因子狀態的研究. 中華皮膚科雜志, 2001, 34(2): 101-102.
33.	張錫寶, 何玉清, 吳志華, 等. 銀屑病患者外周血CD4+T細胞內干擾素γ、白介素4表達與發病的關系. 中華皮膚科雜志, 2003,36(3): 151-153.

1. Jin BQ. Cytokine and receptor, In: Jin BQ, Editor-in-chief. Celluler and molecular immunology.2nd ed. Beijing: Science Publishing House, 2001. 97-172.
2. He YQ, Zhang XB, Wu ZH. Cytokine and psoriasis. China J Lepr Skin Dis, 2003, 19(3): 248-250.
3. He YQ, Zhang XB, Wu ZH, et al. Study of cytokines IFN-γ、IL-4 levels in psoriatic patients in vitro. J Clin Dermatol, 2002, 31(12): 762-763.
4. Huang Q, Zheng ZZ, Zhu LC, et al. The determination of levels of nitric oxide, interleukin-8, interleukin-4 and interferon-gamma in serums of psoriatic. J Clin Dermatol, 2002, 31(6): 344-345.
5. Jiang JH, Pu XM. Determination of serum IL-2, 6 and interferon-γin the psoriasis vulgaris patients of Uighur and Han nation. J Dermatology and Venereology, 2002, 24(2): 3-4.
6. Wang YJ, Wu SM, Luo ZC. The levels and clinical significance of IL-2, IFN-γ, IL-12 and TNF-ain peripheral blood of patients with psoriasis vulgaris. China J Lepr Skin Dis, 2002, 18(4): 327-329.
7. Xu LM, Wang YH, Li H, et al. Expression of IFN-γ and IL-18 in peripheral blood of psoriasis. Chin J Dermatol, 2003, 36(10): 577-579.
8. Yan H, Ye QY, Hao F, et al. In vitro study on Th1/Th2 pattern of psoriasis. Acta Academiae Medicinae Militaris Tertiae, 2001, 23(11): 1335-1336.
9. Zhang LF, Wu QX, Wang Q. Study on the levels of cytokines in sera of patients with various types of psoriasis. Chin J Dermatol, 2001, 34(2): 101-102.
10. Zhang XB, He YQ, Wu ZH, et al. Investigation on methotrexate interfere on human keratinocytes proliferation in vitro. Chin J Dermatol, 2003, 36(3): 151-153.
11. 金伯泉. 細胞因子及其受體. 見：金伯泉. 主編. 細胞和分子免疫學. 第2版. 北京: 科學出版社, 2001. 97-172.
12. 何玉清, 張錫寶, 吳志華. 細胞因子與銀屑病. 中國麻風皮膚病雜志, 2003, 19(3): 248-250.
13. Szegedi A, Aleksza M, Gonda A, et al. Elevated rate of Thelper1 (T(H)1) lymphocytes and serum IFN-gamma levels in psoriatic patients. Immunol Lett, 2003, (86): 277-280.
14. Bonifati C, Ameglio F, Carducci M, et al. Interleukin-1-beta, Interleukin-6, and Interferon-gamma in suction blister fluids of involved and uninvolved skin and in sera of psoriatic patients. Acta Derm Venereol (Stockh), 1994, 186: 23-24.
15. Mahmoud F, Abul A, Al-seleh Q, et al. Differential expression of interferon gamma by mitogen-stimulated peripheral blood mononuclear cells among Kuwaiti psoriasis patients. J Dermatol, 1999, 26(1): 23-28.
16. Chodorowska G. Plasma concentrations of IFN-gamma and TNF-alpha in psoriatic patients before and after local treatment with dithranol ointment. J Eur Acad Dermatol Venereol, 1998, (10): 147-151.
17. Ockenfels HM, Wagner SN, Keim-Maas C, et al. Lithium and psoriasis: cytokine modulation of cultured lymphocytes and psoriasis keratinocytes by lithium. Arch Dermatol Res, 1996, 288: 173-178.
18. Rotsztejn H, Zalewska A, Trznadel-Budzko E, et al. Influence of systemic photochemotherapy on regulatory T cells and selected cytokine production in psoriatic patients: a pilot study. Med Sci Monit, 2005, 11(12): 594-598.
19. Austin LM, Ozawa M, Kikuchi T, et al. The majority of epidermal T cells in Psoriasis vulgaris lesions can produce type 1 cytokines, interferon-gamma, interleukin-2, and tumor necrosis factor-alpha, defining TC1 (cytotoxic T lymphocyte) and TH1 effector populations: a type 1 differentiation bias is also measured in circulating blood T cells in psoriatic patients. J Invest Dermatol, 1999, 113(5): 752-759.
20. Tigalonova M, Bjerke JR, Gallati H, et al. Serum levels of interferons and TNF-alpha are not correlated to psoriasis activity and therapy. Acta Derm Venereol(Stockh), 1994, 186: 25-27.
21. Kagi MK, Wuthrich B, Montano E, et al. Differential cytokine profiles in peripheral blood lymphocyte supernatants and skin biopsies from patients with different forms of atopic dermatitis, psoriasis and normal individuals. Int Arch Allergy Immunol, 1994, 103: 332-340.
22. Kanda N, Tani K, Enomoto U, et al. The skin fungus-induced Th1- and Th2-related cytokine, chemokine and prostaglandin E2 production in peripheral blood mononuclear cells from patients with atopic dermatitis and psoriasis vulgaris. Clin Exp Allergy, 2002, 32: 1243-1250.
23. El Barnawi NY, Giasuddin AS, Ziu MM, et al. Serum cytokine levels in psoriasis vulgaris. Br J Biomed Sci, 2001, 58(1): 40-44.
24. Jacob SE, Nassiri M, Kerdel FA, et al. Simultaneous measurement of multiple Th1 and Th2 serum cytokines in psoriasis and correlation with disease severity. Mediators of Inflammation, 2003, 12(5): 309-313.
25. Gomi T, Shiohara T, Munakata T, et al. Interleukin 1 alpha, tumor necrosis factor alpha, and interferon gamma in psoriasis. Arch Dermatol, 1991, 127(6): 827-830.
26. 何玉清, 張錫寶, 吳志華, 等. 銀屑病患者細胞因子γ-干擾素、白介素4水平的體外研究. 臨床皮膚科雜志, 2002, 31(12): 762-763.
27. 黃瓊, 鄭志忠, 祝祿川, 等. 銀屑病患者血清中NO、IL-8、IL-4和IFN-γ水平測定. 臨床皮膚科雜志, 2002, 31(6): 344-345.
28. 蔣建華, 普雄名. 維、漢尋常型銀屑病患者血清白介素2、6及干擾素γ含量測定. 皮膚病與性病, 2002, 24(2): 3-4.
29. 王雨娟, 武三卯, 駱志成. 尋常型銀屑病患者外周血中IL-2、IFN-γ、IL-12和TNF-γ的測定及其臨床意義. 中國麻風皮膚病雜志, 2002, 18(4): 327-329.
30. 徐麗敏, 王彥紅, 李虹, 等. 銀屑病患者外周血干擾素γ和白介素18的表達. 中華皮膚科雜志, 2003, 36(10): 577-579.
31. 閻衡, 葉慶佾, 郝飛, 等. 銀屑病Th1/Th2模式的體外試驗. 第三軍醫大學學報, 2001, 23(11): 1335-1336.
32. 張良芬, 吳勤學, 王群. 銀屑病患者血清中細胞因子狀態的研究. 中華皮膚科雜志, 2001, 34(2): 101-102.
33. 張錫寶, 何玉清, 吳志華, 等. 銀屑病患者外周血CD4+T細胞內干擾素γ、白介素4表達與發病的關系. 中華皮膚科雜志, 2003,36(3): 151-153.

Chinese Journal of Evidence-Based Medicine

Meta-analysis of the Relationship between IFN-γ and Psoriasis

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