肠易激综合征患者的免疫学机制探讨

The investigation of the Immunological mechanism in patients with irritable bowel syndrome

目的用ELISA法对IBS患者的外周血Th1型细胞因子IFN-γ、IL-12和Th2型细胞因子ID-4、IL-10的含量进行检测分析,以探讨IBS患者体内免疫应答的变化规律。方法采用ELISA法检测IBS患者外周血PBMC体外培养上清液中Th1型细胞因子IL-12、IFN-γ及Th2型细胞因子IL-4、IL-10水平。结果1·同正常组比较,腹泻型IBS患者外周血Th1型细胞因子IFN-γ、IL-12的水平有升高趋势,但差异无显著性(P>0·05);Th2型细胞因子IL-4、IL-10的水平较正常对照显著降低(P<0·05);Th1/Th2的比值较正常对照显著升高(P<0·05)。2·同正常组比较,便秘型IBS患者外周血Th1型细胞因子IFN-γ、IL-12和Th2型细胞因子IL-4、IL-10的含量均无显著性差异;Th1/Th2的比值较正常对照差异亦无显著性(P>0·05)。结论腹泻型IBS患者PBMC体外培养时Th1、Th2细胞因子产生了失衡,Th1/Th2较正常对照显著升高,呈Th1优势反应。便秘型IBS患者Th1型细胞因子和Th2型细胞因子较正常对照无显著差异,表明便秘型IBS患者Th1/Th2反应仍趋于平衡状态,Th1/Th2反应可能对其发病并无重要影响,亦进一步说明不同分型的IBS其病理生理学机制存在差异。

Objective To investigate possible immunoregulation disturbance in patients with irritable bowel syndrome （IBS） .Methods The Thl cytokine （IFN-γ,IL-12）and Th2 cytokines（IL-4,IL-10） from peripheral blood mononuelear cells （PBMC） were detected by ELISA.Results Compared with controls, the levels of Thl cytokine （IFN-γ） and interleukin 12 （IL-12） in diarrhea predominant IBS （D-IBS） patients were increased, but no significant difference compared with controls; the levels of Th2 cytokines（IL-4,IL-10） in D-IBS patients were decreased significantly; Th1/Th2 ratio were increased significantly. In constipation-predominant IBS（C-IBS） patients, the levels of Thl and Th2 cytokines had no statistical difference compared with controls; Th1/ Th2 ratio had no significant difference compared with controls. Conclusion The shift of Th1/ Th2 balance in D-IBS patients was demonstrated along with the enhanced Thl activity. Th1/Th2 balance has been maintained in C-IBS patients.