支气管哮喘患者诱导痰中IL-17水平变化及意义的探讨

Research on the Levels of lnterleukin-17 in Induced Sputum from Patients with Asthma

目的:探讨不同程度和分期的支气管哮喘患者诱导痰中IL-17水平变化及临床意义。方法:随机收集急性发作期哮喘患者(A组)27例,其中轻度者15例,中重度者12例,正常对照组(C组:)20例,经治疗后缓解的A组哮喘患者(B组)27例。测量A、B和C组研究对象诱导痰中的中性粒细胞占白细胞百分比(Neu/Leu%),并测定1 s用力呼气容积(FEv.)占预计值％(FFV,％),用夹心法ELISA诱导痰上清液中IL-17浓度。结果:A组的IL-17的浓度为(37.22±5.67)ng/L,明显高于C组(27.96±3.26)ng/I.和B组(30.20±3.99)ng/L,差异均具有显著性(均P<0.05);A组(55±4)％、B组(72±7)％的FEV1％均明显低于C组(97±3)％(均,P<0.05);诱导痰Neu/Leu％分别为:A组(37.2±10.4)％、B组(26.2±4.2)％、C组(24.1±3.9)％,A组与B组和C组相比较差异均有显著性(均P<0.05),B组与C组相比较差异无统计学意义。相关分析发现,在哮喘急性发作组(A组)中,Neu/Leu％与IL-17的浓度呈正相关(r=0.80,P<0.01);FEV1％与IL-17的浓度呈负相关(r=-0.41,P<0.05);FEV,％也与Neu/Leu％数量呈负相关(r=-0.64,P<0.01)。在哮喘缓解组(B组)中,Neu/Len％与IL-17呈正相关,相关系数(r=0.42,P<0.05),而FEV1％与IL-17无明显相关。结论:在哮喘急性发作、加重及恶化的患者诱导痰中,IL-17水平升高;IL-

To investigate interlenkin-17(IL-17) levels from the patients with asthma of different stages and the clinical implications. Methods: Twenty-seven patients with bronchial asthma were recruited as group A when they were at exacerbated stage and as group B when at controlled stage. Twenty healthy volunteers were selected as controls. Their pulmonary functions were evaluated to identify the stage and degree of asthma. IL-17 levels were measured with sandwich enzyme linked immunosorbent assay (ELISA). The percentage of neutrophils in induced sputum was measured in all subjects. Results: The levels of IL-17 from the sputum of group A (37. 22 ± 5. 67)ng/L were significantly higher than those in group B (30. 20 ± 3. 99)ng/L and control group (27. 96 ± 3. 26)ng/L (all P < 0. 05); the first second forced expiratory volume/predicted value (FEV1% ) both in group A (55 ±4)% and group B (72 ±7)% were significantly lower than those in control group (97 ±3)% (all P < 0. 05); the percentage of neutrophils in group A (37. 2 ±10. 4)% was higher than those in group C (24. 1 ±3. 9)% and group B(26. 2±4. 2)% (all P < 0. 05), and there was no difference between group B and group C. In group A, the levels of IL-17 were positively correlated with the percentage of neutrophils ( r = 0. 80, P < 0. 01) and negatively correlated with the FEVi% ( r = - 0. 41 , P < 0. 05), and the FEV1% was also negatively correlated with the percentage of neutrophils ( r = 0. 64, P < 0. 01). In group B the percentage of neutrophils was positively correlated with IL-17 ( r = 0. 42 , P < 0. 05). Conclusion: The levels of IL-17 at the exacerbated stage of asthma were significantly increased. The cause of the exacerbation of asthma may be in association with the neutrophils which were chemoattracted into the airway by IL-17. Possibly, the levels of IL-17 from induced sputum may be valuable parameters in monitoring or evaluating the degrees and treatment efficacy of asthma.