IL-23／IL-17炎症轴在溃疡性结肠炎中的作用

IL-23/IL-17 axis in pathogenesis of ulcerative colitis

目的探讨IL-23／IL-17炎症轴在溃疡性结肠炎（UC）中的变化及意义。方法按照2007年济南标准选择UC组患者20例，对照组16例。利用细胞内细胞因子染色和四色荧光抗体流式细胞术对肠黏膜固有层单个核细胞作表型分析，比较Th1、Th2、Th17比例的改变。Westernblot检测肠黏膜IL-17、IL-23表达。数据以中位数和四分位间距即M（QR）形式表示，行相关统计。结果（1）肠黏膜中Th17的比例在UC组中较对照组明显增加（P〈0．05），为3．75％比1．25％，且重度活动较轻度活动患者增加明显（P〈0．05），为8．30％比1．20％。肠黏膜中Th1的比例在UC组和对照组中分别为13．60％和9．10％，Th2的比例在UC和对照组中分别为1．10％和1．15％，差异均无统计学意义（P〉0．05），不同活动度患者间差异亦无统计学意义（P〉0．05）。（2）UC组患者肠黏膜中IL-17表达较对照组明显升高（P〈0．05），为0．20％比0．10％，且IL-17表达与UC患者疾病评分呈正相关（r=0．50，P=0．02）。（3）IL-23表达在UC组和对照组分别是0．13％和0．07％，差异有统计学意义（P〈0．05）。结论IL-23／IL-17炎症轴在溃疡性结肠炎的发病中具有重要作用，它可能成为UC治疗的有效靶点。

Objective To explore the role of IL-23/IL-17 inflammation axis in pathogenesis of ul- cerative colitis （UC）. Methods A total of 20 UC cases diagnosed according to 2007 Jinan criteria and 16 healthy subjects were recruited. The distribution of Thl, Th2 and Thl7 cells in colonic lamina propria was analyzed with intracellular cytokine staining and four-color- fluorescence antibody flow cytometry. Western blot was used to determine the expressions of IL-23 and IL-17 in colonic mucosa. Results The proportion of Thl7 cell in colonic mucosa was significantly higher in UC patients （ 3.75% ） than in controls （ 1.25% ） （P 〈0. 05 ）, as well as in severely active patients （8.30%） than in slightly active ones （1.20%）（ P 〈 0. 05）. No significant differences were found in the proportions of Thl （13.6% vs. 9. 10% ） and Th2 （ 1.10% vs. I. 15% ） in colonic mucosa between UC and controls, nor were they found between patients of different severity. IL-17 expression in colonic mucosa increased in UC patients than that in controls （0. 20% vs. 0. 10% ） （P 〈0. 05）, and was positively correlated with disease severity （r =0. 50, P =0. 02）. IL-23 expression in colonic mucosa was also significantly higher in UC （0. 13% ） than that in controls （0. 07% ） （P 〈0. 05）. Conclusion IL-23/IL-17 inflammation axis plays an important role in the pathogenesis of UC, which might be a target for treatment.