IL-17、IL-5、IL-4、IL-33等细胞因子在哮喘发病机制中的作用

Effects of IL-17, IL-5, IL-4, IL-33 and other cytokines in the pathogen-esis of asthma

目的探讨白细胞介素-17（IL-17）、白细胞介素-33（IL-33）、白细胞介素-4（IL-4）、白细胞介素-5（IL-5）等细胞因子在哮喘发病机制中的作用。方法选择浙江省乐清市人民医院2011年2月。2014年8月收治的82例哮喘患者作为研究对象，根据患者的临床表现分为急性发作组（45例）、缓解期组（37例），并选取同期健康人群40例作为对照组，比较三组患者相关指标的差异及其相关性。结果缓解期组呼气流量峰值（PEF）、第1秒用力呼气量（FEV。）、第1秒用力呼气量佣力肺活量（FEV，FVc）、哮喘控制测试评分（ACT）均显著高于急性发作组（P〈0．01）。急性发作组IL-17、IL-5、IL-4、IL-6、IL-8、IFN-y、IgE值均显著高于缓解期组、对照组，IL-2显著低于缓解期组、对照组（P〈0．05）；缓解期组IL-17、IL-5、IL-4、IL-8、IFN—Y、IgE值显著高于对照组，IL-2显著低于对照组（JP〈0．05）。三组CD3＋．CD4＋,CD4＋／CD8＋定值比较差异有高度统计学意义（P〈0．01），急性发作组CD3＋、CD4＋、CD47CD8值显著高于缓解期组、对照组（P〈0．05）；缓解期组患者的CD3＋、CD4＋,CD47CD8值显著高于对照组（P〈0．05）。结论哮喘患者的T细胞亚群、细胞因子与健康人群存在显著差异，急性发作期患者与缓解期患者的T细胞亚群、细胞因子、肺功能指标差异显著，提示免疫功能紊乱、炎症介质分泌增加与哮喘发作关系密切。

Objective To study the effect of interleukin-17 （IL-17）, interleukin-33 （IL-33）, interleukin-4 （IL-4）, interleukin-5 （IL-5） and other eytokines in the pathogenesis of asthma. Methods 82 cases of patients with asthma admitted to Yueqing People＇s Hospital from February 2011 to August 2014 were selected as the research objects, they were divided into acute group （45 cases） and remission group （37 cases） according to the clinical manifestations, 40 cases of healthy people at the same period were selected as control group, the differences and correlation of the related indexes among the three groups were compared. Results The asthma patients peak expiratory flow （PEF）, the first second forced expiratory volume （FEV1）, the first second forced expiratory volume/forced vital capacity （FEV1/FVC）, asthma control test scores （ACT） Of remission group were all significantly higher than those of acute group （P 〈 0.01）. The levels of IL- 17, IL-5, IL-4, IL-6, IL-8, IFN-Y IgE in acute group were significantly higher than those of remission group and the control group, IL-2 was significantly lower than those of remission group and control group （P 〈 0.05）; the levels of IL- 17, IL-5, IL 4, IL-8, IFN-% IgE in remission group were all significantly higher than those of control group, IL-2 was significantly lower than that of control group （P 〈 0.05）. The levels of CD3＋, CD4＋, CD4＋/CD8＋ among the three groups had highly statistically significant differences （P 〈 0.01）, the levels of CD3＋, CD4＋, CD4＋/CD8＋ in acute group were significantly higher than those of remission group and control group （P 〈 0.05）; the levels of CD3＋, CD4＋, CD4＋/CD8＊ in remission group were significantly higher than those of control group （P 〈 0.05）. Conclusion There are significant differences in asthma T cell subsets and cytokines between asthma patients and healthy people, and there are significant differences in asthma T cell subsets, cytokines and lung function between acute patients and remission patients, which indicates that immune dysfunction, increased secretion of inflammatory mediators is closely associated with asthma.