高原地区Hp相关性胃病患者血清Th1/Th2细胞因子的变化

Changes of serum Th1/Th2 cytoknies in patients with Hp-associated gastric diseases in the district of plateau

目的观察青海高原幽门螺杆菌(Hp)相关性胃病患者血清Th1/Th2细胞因子(IL-1β、IL-2、IL-4、IL-6、IL-8、TNF)水平变化,以探讨其在发病中的可能免疫致病机制。方法用放射免疫法(RIA)测定57例慢性萎缩性胃炎(CAG)、55例消化性溃疡(PU)和35例进展期胃癌(GC)患者血清IL-1β、IL-2、IL-4、IL-6、IL-8、TNF的含量。比较Hp感染者三组胃病之间;Hp感染与非感染CAG之间;Hp感染CAG活动与非活动之间;Hp感染单纯CAG、IM、Dys之间;Hp感染与非感染PU之间及Hp感染与非感染GC之间血清6种细胞因子含量的差异。结果Hp相关性CAG和PU血清IL-4含量非常显著低于GC(P<0.01);Hp感染与非感染CAG之间6种细胞因子含量均无差异(P>0.05);Hp相关性CAG活动者血清IL-4含量显著低于非活者(P<0.05),IM和Dys均非常显著低于单纯CAG(P<0.01),IL-2在Dys显著高于单纯CAG(P<0.05);Hp感染PU血清IL-4非常显著低于非感染者(P<0.01);Hp感染GC血清IL-β1显著低于非感染者(P<0.05)。结论Hp感染对本地区CAG患者血清Th1/Th2平衡影响不大;Hp感染后IL-4分泌减少与CAG炎症活动和胃黏膜癌前病变(IM和Dys)及PU的发生密切相关,Th2弱势应答为其主要的免疫致病机制;Hp相关性进展期GC患者IL-β1分泌减少,Th1应答减弱,IL-4分泌增加,Th2应答上调,对机体具有明显的抗炎抗肿瘤和保护作用。

Objective Toobserve the change of serum level of Th1/Th2 cytoknies （IL-1β, IL-2, IL-4, IL-6, IL-8, TNF） inpatients with Helicobacter pylori （ Hp）-associated gastric diseases for exploring the immunological pathogenesis of Hp. Methods Radioimmunoassay was employed to detemfine the levels of serum IL-1β, IL-2, IL-4, IL-6, IL-8, and TNF in 57 cases of chronic atrophic gastritis （CAG）, 55 cases of peptic ulcer （PU）, and 35 eases of gastric cancer （GC）. The six kinds of serum cytoknies in the three groups of patients with or without Hp infection was detemained. Results The level of serum IL-4 in Hp-associated CAG and PU was lower than that in GC （ P 〈 0.01 ）. No significant defference of the six cytokines was found between CAG with Hp and CAG without Hp （ P 〉 0.05）. The level of serum IL-4 in active CAG was lower than that in nonactive CAG （ P 〈 0.05） ; the levels of serum IL-4 in all IM and Dys were lower than that in pure CAG （ P 〈 0.01）. IL-2 in Dys was higher than that in pure CAG （ P 〈 0.05）. Serum IL-4 in PU with Hp infection was lower than that in PU without Hp infection （ P 〈 0.01）. Serum IL-1β in GC with Hp infection was lower than that in GC without Hp infection （ P 〈 0.05）. Conclusion The effects of Hp infection on serum Th1/Th2 balance in the patients with CAG in this district is not significant. Low-levd of IL-4 is close relative with active CAG, gastric mucosa precaneerosis （IM and Dys）, and Pu after Hp infection. The weakly reaction of Th2 is the main immunological pathogenesis. Down-regulation of IL-1β, weakness of Thl response, up-regulation of IL-4, and strengthening of Th2 response have effects of anti-inflammation, anticancer, and protection in progressive GC.