间质性膀胱炎与1型／2型辅助性T淋巴细胞漂移的相关研究

Study on the shifting of Th1/ Th2 balance in patients with interstitial cystitis

目的探讨间质性膀胱炎（IC）患者血浆及膀胱黏膜1型／2型辅助性T淋巴细胞（Th1／Th2）与免疫调节失衡的关系。方法女性IC患者血浆及黏膜标本16例，输尿管结石患者标本16例作为对照组。2组患者性别及年龄匹配。IC患者符合美国糖尿病、消化及肾病协会诊断标准。依据盆腔疼痛和尿急／尿频症状评分（PUF评分）结果分为低评分（0～20分）和高评分（21～35分）2组。采用酶联免疫吸附试验和免疫组化染色检测2组患者血浆和膀胱黏膜中Th1（IFN-γ和IL-2）和Th2（IL-4和IL-10）细胞因子表达情况。结果①IC患者血浆IFN-γ、IL-2表达量分别为（4．57±2．92）、（17．52±7．52）pg／ml，对照组分别为（4．11±2．27）、（20．99±5．09）pg／ml，2组间较差异均无统计学意义（P〉0．05）；IC患者血浆IL-4、IL-10表达量分别为（0．34±0．22）、（4．37±2．34）pg／ml，对照组分别为（0．14±0．07）、（1．18±0．61）pg／ml，2组间比较差异均有统计学意义（P〈0．05）。②IC患者和对照组膀胱黏膜标本中IFN-γ、IL-2表达强度比较χ2值=1．900、0．514，差异均无统计学意义（P〉0．05）；2组IL-4、IL-10表达强度比较χ2值=8．237、8．209，差异均有统计学意义（P〈0．05）。③IC患者PUF低评分组血浆IL-4、IL-10表达量分别为（0．16±0．11）、（2．42±1．27）pg／ml，高评分组分别为（0．53±0．12）、（6．31±1．21）pg／ml，2组间比较差异均有统计学意义（P〈0．05）。2组膀胱黏膜标本IL-4表达强度比较χ2=7．608，rs=0．467，差异有统计学意义（P〈0．05）；IL-10表达强度比较χ2=8．844，rs=0．517，差异有统计学意义（P〈0．05）。结论IC患者存在免疫调节失衡，Th2介导的体液免疫反应增强，且免疫失衡随症状程度而加重。

Objective To investigate possible disturbance of Th1/Th2 immunoregulation of blood serum and bladder mucosa in patients with interstitial cystitis（IC）. Methods Blood serum and bladder mucosal specimens were collected from 16 female patients with IC and 16 female normal controis. The age of IC patients was 51. 3 ±10. 2 years. The age of normal controls was 53. 1 ±9. 6 years. The expressions of Th1（IFN-γ,IL-2） and Th2 cytokines（IL-4, IL-10） were determined by en zyme linked immunosorbent assay and immunohistochemical staining. Results （1）The expressions of IFN-γ and IL-2 in IC blood serum were （4.57±2.92）, （17.52±7.52）pg/ml and in normal blood set um were （4.11±2.27）, （20.99±5.09）pg/ml. Such two factors bad no significant differences in these two groups. The expressions of IL-4 and IL-10 in IC blood serum were （0.34±0.22） ,（4.37±2.34） pg/ml and in normal blood serum were （0.14±0.07） ,（1.18±0.61）pg/ml. Such two factors had significant differences in these two groups. （2）The expressions of IFN-γ and IL-2 in IC bladder tissues had no significant differences with normal bladder tissues （IFN-γ ：χ2= 1. 900, IL-2 ：χ2= 0.514）. The expressions of IL-4 and IL-10 in IC bladder tissues had significant differences with normal bladder tissues （IL-4：χ2=8. 237, IL-4：χ2=8. 209）. （3）The expressions of IL-4 and IL-10 in low PUF group were （0.16±0.11） and（2.42±1.27）pg/ml but in high PUF group were （0.53±0.12） and（6.31± 1.21）pg/ml. The expressions of these two factors had significant correlations with the degree of PUF, which intensified in the IC of high PUF. Conclusion The expression of Th2 type cytokines is predominant in IC blood plasm and bladder tissues, the expression of Th2 type eytokines in IC blood plasm and bladder tissues has positive correlation with the degree of PUF.