JAAD:自身免疫性皮肤病患者免疫刺激性中草药补充剂的使用频率

2022-01-28 医路坦克 MedSci原创

某些草本植物补充剂有免疫刺激作用,包括螺旋藻、水华假单胞菌、小球藻、紫锥菊和紫花苜蓿。该文研究了自身免疫皮肤病患者使用草本植物补充剂频率及免疫刺激的关系。

     补充和替代医学(CAM)的使用在美国很常见。然而,某些草本植物补充剂有免疫刺激作用,包括螺旋藻、水华假单胞菌、小球藻、紫锥菊和紫花苜蓿。患者可能会服用免疫刺激性CAM,因为他们声称对健康有影响。然而,这给自身免疫性皮肤病患者带来了潜在的风险。为了确定这类患者使用免疫刺激性CAM的频率,我们对患有皮肌炎(DM)、皮肤红斑狼疮(CLE)、自身免疫性水泡病(AIBD)的成年人和没有自身免疫性疾病的健康对照组进行了一项单中心病例对照研究,研究对象为服用中草药补充剂(螺旋藻、紫锥菊、小球藻、金黄色葡萄球菌和紫花苜蓿)。

    主要研究人员诊所的患者在疾病发作前的任何时候都被系统地调查了草药补充剂的使用情况。为了确保标准化和最大限度地减少回忆偏差,患者被要求以循序渐进的方式使用CAM。健康对照在普通皮肤科诊所接受调查。图表回顾信息包括疾病队列、CAM使用史和人口统计学。人口统计数据采用描述性统计方法进行分析。对DM、CLE和AIBD队列中的健康对照组进行Fisher精确测试,以比较CAM的使用频率。结果以优势比表示,显著性水平为0.05。

    450名患者纳入本研究糖尿病158例,慢性脑血管病122例,AIBD 31例,对照组139例)。DM队列的19.6%、CLE的5.7%、AIBD的6.5%和对照组的5.0%报告了CAM的使用情况。螺旋藻是最常用的CAM,队列中14.6%的DM患者报告使用螺旋藻,4.1%使用CLE,0%使用AIBD,4.3%使用对照。在糖尿病患者中,小球藻(7.6%)、水花假单胞菌(2.5%)、紫花苜蓿(1.9%)和紫锥菊(2.5%)的使用率较低。与慢性肺水肿(p=0.0956)或急性肠梗阻(p=0.6688)相比,糖尿病患者使用Journal预先证实的免疫刺激凸轮的可能性显著高于对照组(OR4.58,p=0.0002)。与对照组相比,糖尿病患者使用螺旋藻的可能性明显更大(OR3.76,p=0.0031)。紫锥菊、水华紫锥菊、小球藻和紫花苜蓿与任何自身免疫队列均无明显关联。

    这些结果表明,在这个队列中,与CLE、AIBD和对照组相比,免疫刺激性CAM的使用在DM患者中可能更普遍。在DM队列中,螺旋藻是最常见的CAM。局限性包括回忆偏差、病例对照研究设计以及本研究的单中心性质。这项研究没有说明使用CAM和疾病发作或红斑病史之间的时间。目前尚不清楚螺旋藻是否会影响糖尿病的进程,也不清楚糖尿病发作患者是否可能服用螺旋藻。需要进行前瞻性的盲法研究来确定螺旋藻和糖尿病之间的联系。虽然免疫刺激性CAM对自身免疫性皮肤病的作用目前还不清楚,但我们的工作表明,一些皮肤病患者正在使用它们。临床医生应该询问自身免疫性皮肤病患者使用补充剂的情况,并评估补充剂对患者临床病程和健康的潜在影响。

文献来源:Ravishankar A,  Bax CE,  Grinnell M,Frequency of Immunostimulatory Herbal Supplement Use Among Patients with Autoimmune Skin Disease.J Am Acad Dermatol 2022 Jan 05; 

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    2022-04-06 zll0637
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    2022-01-29 查查佳佳

    其理论上的肠道选择性可能会降低肠

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    2022-01-28 ms4000001513304915

    学习#学习#

    0

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