IL-1ra、IL-1β在Graves眼病发病及治疗中的意义

Serum IL-1 Receptor Antagonist and IL-1β in Patients with Graves' Opthalmopathy

目的研究IL-1ra、IL-1β与Graves眼病(GO)的发病机理及治疗效果的关系。方法分别用酶联免疫吸附法和放射免疫分析法测定了20例Graves病(GD)无眼病者、20例健康对照者及20例GO(NOSPACES≥4级)患者糖皮质激素治疗前后血中IL-1ra、IL-1β水平的变化,并分析IL-1ra、IL-1β水平、IL-1ra/IL-1β与治疗效果之间的关系。结果GO患者治疗前与GD、健康对照的IL-1ra水平差异无统计学意义,但糖皮质激素治疗后明显升高;而IL-1β在未治疗的GO患者明显升高,经糖皮质激素治疗后有降低趋势。IL-1ra与IL-1β的比值在GO患者明显低于健康对照,经糖皮质激素治疗后明显上升。结论GO患者存在内源性IL-1ra的相对不足,经糖皮质激素治疗,可促进IL-1ra的产生,抑制IL-1β产生。

Objective To investigate the mechanism of Graves＇ ophthalmopathy （GO） and the relationship between serum IL-1ra and IL-1β and the effectiveness of glucocoids in treating GO. Methods Serum IL-1ra and IL-1β were measured by Enzyme linked immunosorbent assay （ELISA） and Radioimmunoassay （RIA） in three groups of people, which included 20 patients with severe GO （NOSPACES≥Ⅳ ）, 20 patients with Graves＇ disease （GD） without ophthalmopathy, and 20 healthy volunteers. Repeated measurements were undertaken in GO patients before and after glucocoids treatment to analyze the relationship between serum IL-1ra, and IL-1β and the effectiveness of glucocoids therapy. Results Before glucocoids therapy,GO patients had higher serum IL-1β and lower IL-1ra/IL-1β ratio. Glucocoids therapy increased serum IL-1ra and decreased IL-1β, and thus increased the IL-1ra/IL-1β ratio. Conclusion Patients with GO have deficiency in IL-1ra synthesis. Glucocoids therapy can stimulate IL-1ra synthesis and inhibit IL-1βsynthesis.