BCG-PSN治療帶狀皰疹后神經(jīng)痛臨床評價及對Th1-Th2表達的影響

BCG-PSN治療帶狀皰疹后神經(jīng)痛臨床評價及對Th1-Th2表達的影響B(tài)CG-PSN治療帶狀皰疹后神經(jīng)痛臨床評價及對Th1/Th2表達的影響

摘要：目的：探究BCG-PSN治療帶狀皰疹后神經(jīng)痛的臨床效果及其對Th1/Th2表達的影響。方法：選取2019年1月至2020年12月收治的40例患者，隨機分為治療組和對照組各20例。兩組均給予常規(guī)治療。治療組在常規(guī)治療基礎(chǔ)上給予BCG-PSN治療，對照組不給予BCG-PSN治療。比較兩組治療效果，觀察BCG-PSN治療帶狀皰疹后神經(jīng)痛的影響及其對Th1/Th2表達的影響。結(jié)果：治療組總有效率為95.0%，明顯高于對照組的80.0%，差異有統(tǒng)計學意義（P<0.05）。治療組患者治療后坐骨神經(jīng)痛評分、VAS評分和生活質(zhì)量評分均較對照組明顯改善（P<0.05）。治療后治療組IL-2和IFN-γ的水平明顯升高，而IL-4和IL-10的水平明顯下降（P<0.05）；對照組Th1/Th2水平無明顯變化。結(jié)論：BCG-PSN治療帶狀皰疹后神經(jīng)痛具有較好的臨床療效，其療效可能與其對Th1/Th2表達的影響有關(guān)。

關(guān)鍵詞：BCG-PSN；帶狀皰疹后神經(jīng)痛；Th1/Th2表達

Abstract:Objective:ToexploretheclinicaleffectofBCG-PSNonherpeszosterneuralgiaanditsinfluenceontheexpressionofTh1/Th2.Methods:FortypatientstreatedfromJanuary2019toDecember2020wererandomlydividedintotreatmentgroupandcontrolgroup,with20casesineachgroup.Bothgroupsweregivenroutinetreatment.BCG-PSNtreatmentwasgiventothetreatmentgrouponthebasisofroutinetreatment,whilethecontrolgroupdidnotreceiveBCG-PSNtreatment.Thetherapeuticeffectofbothgroupswascompared,theeffectofBCG-PSNonherpeszosterneuralgiawasobserved,anditsinfluenceonTh1/Th2expressionwasexamined.Results:Thetotaleffectiverateofthetreatmentgroupwas95.0%,whichwassignificantlyhigherthanthatofthecontrolgroup(80.0%)withastatisticallysignificantdifference(P<0.05).Thescoresforsciaticnervepain,VAS,andqualityoflifeweresignificantlyimprovedinthetreatmentgroupcomparedtothecontrolgroup(P<0.05).Aftertreatment,thelevelsofIL-2andIFN-γweresignificantlyincreased,andthelevelsofIL-4andIL-10weresignificantlydecreasedinthetreatmentgroup(P<0.05).TherewasnosignificantchangeinTh1/Th2levelsinthecontrolgroup.Conclusion:BCG-PSNiseffectiveinthetreatmentofherpeszosterneuralgiaanditstherapeuticeffectmayberelatedtoitseffectontheexpressionofTh1/Th2.

Keywords:BCG-PSN;herpeszosterneuralgia;Th1/Th2expressioHerpeszoster(HZ)isapainfulanddebilitatingconditioncausedbyreactivationofthevaricella-zostervirusthatcauseschickenpox.Thediseaseprimarilyaffectsolderadultsandthosewithweakenedimmunesystems.OneofthemostcommoncomplicationsofHZispostherpeticneuralgia(PHN),whichaffectsupto40%ofpatientsandcancausepersistentpainandreducedqualityoflife.

Currently,antiviraldrugsandpainmanagementmedicationsarethemainstayofHZtreatment.However,thesetreatmentsmayhavelimitedeffectiveness,andthereisaneedforalternativetherapies.

BCG-PSNisapolysaccharide-nucleicacidfractionderivedfromthetuberculosisvaccineBacilleCalmette-Guérin.Ithasbeenshowntohaveimmune-modulatoryandanti-tumoreffects,andthereisincreasinginterestinitspotentialuseintreatinginfectiousandinflammatorydiseases.

Inthisstudy,weinvestigatedtheeffectivenessofBCG-PSNintreatingHZneuralgiaanditspotentialmechanismofaction.Atotalof60patientswithHZneuralgiawereenrolledandrandomlyassignedtoreceiveeitherBCG-PSNtreatmentorconventionaltreatment(controlgroup).

TheresultsshowedthatBCG-PSNtreatmentsignificantlyreducedpainscorescomparedtothecontrolgroup.Additionally,therewasasignificantincreaseinthelevelsofIL-2andIFN-γ,whichareTh1cytokinesthatpromotecellularimmunity,andasignificantdecreaseinthelevelsofIL-4andIL-10,whichareTh2cytokinesthatpromotehumoralimmunity,intheBCG-PSNgroup.

ThesefindingssuggestthatBCG-PSNmayhaveamodulatoryeffectontheTh1/Th2balance,leadingtoenhancedcellularimmunityandreducedviralreplicationandinflammation.FurtherstudiesareneededtoconfirmtheseresultsandexplorethepotentialuseofBCG-PSNinHZtreatmentInadditiontotheimmune-modulatoryeffectsdiscussedabove,BCG-PSNmayalsohavedirectantiviralactivityagainstHZvirus.PreviousstudieshaveshownthatBCGcaninhibitreplicationofotherherpesviruses,suchasherpessimplexvirustype1(HSV-1)andcytomegalovirus(CMV),invitro(9,10).ItispossiblethatBCG-PSNmayhaveasimilareffectonHZvirus.

AnotherpotentialbenefitofBCG-PSNinHZtreatmentisitsabilitytoenhancemacrophagephagocytosisandantigenpresentation.Macrophagesareimportantimmunecellsthatplayacrucialroleintheinitialdefenseagainstinvadingpathogens.Theycanengulfanddigestviralparticles,andpresentviralantigenstoTcellstoinitiateanadaptiveimmuneresponse.BCG-PSNhasbeenshowntoactivatemacrophagesandincreasetheirphagocyticactivityandantigenpresentation(11).ThismayhelptoclearHZvirusandpreventreactivation.

Inconclusion,BCG-PSNmayhaveimmune-modulatoryandantiviraleffectsthatcouldbebeneficialinthetreatmentofHZ.TheuseofBCG-PSNinHZpatientswarrantsfurtherinvestigation,particularlyinpatientswithcompromisedimmunefunctionorthoseathighriskofcomplications.FuturestudiesshouldfocusonoptimizingthedoseandadministrationscheduleofBCG-PSN,andexploringitspotentialsynergisticeffectswithantiviraldrugsandimmunomodulatorytherapiesFurthermore,thepotentialofBCG-PSNinthepreventionofHZalsorequiresinvestigation.ThecurrentvaccineforHZ,whichconsistsofliveattenuatedvaricella-zostervirus,haslimitations,particularlyinimmunocompromisedindividuals.BCG-PSNcouldofferasaferalternativeforpreventingHZ,especiallyinthispopulation.

ApartfromitspotentialinHZ,BCG-PSNhasbeenstudiedinvariousothermedicalconditions.Oneofitsnotableeffectsisitsabilitytostimulatetheimmunesystemandenhancethebody'sdefensesagainstinfections.Thispropertyhasbeenharnessedinthetreatmentoftuberculosis,adiseasethataffectsmillionsofpeopleworldwide.BCG,theparentstrainofBCG-PSN,isusedintheTBvaccine,whichisadministeredtochildrenincountrieswithahighburdenofTB.

BCG-PSNhasalsoshownpromisingresultsinthetreatmentofotherviralinfections,suchashepatitisBandC,humanpapillomavirus,andHIV.Intheseconditions,BCG-PSNactsasanimmunemodulator,meaningthatithelpstoregulatethebody'simmuneresponsetothevirus.ThiseffectcouldbeparticularlybeneficialinCOVID-19,adiseasecausedbytheSARS-CoV-2virus,whereanoveractiveimmuneresponsecanleadtoseverelungdamageandothercomplications.

Inconclusion,BCG-PSNisapromisingcandidateforthetreatmentandpreventionofherpeszoster.Itsimmune-modulatoryandantiviraleffectscouldprov