哮喘儿童支气管肺泡灌洗液IL-17、IL-8和VEGF水平测定及意义

Levels of IL-17,IL-8 and VEGF in bronchoalveolar lavage fluid in asthma children

目的:Th17细胞是以分泌IL-17为主的新型T细胞亚群,其在哮喘中的作用尚不十分清楚。本文通过观察哮喘急性发作儿童支气管肺泡灌洗液(BALF)IL-17、IL-8、血管内皮生长因子(VEGF)等的水平变化,探讨其在哮喘急性发作儿童气道炎症中的作用。方法:我院2009年2月-2009年12月期间行纤维支气管镜检查患儿共88例,包括哮喘急性发作组(哮喘组,n=52)、非喘息组(肺炎组,n=25)及对照组(n=11),收集所有病例的BALF,进行细胞学分类,ELISA法测定BALF中细胞因子IL-17、IL-8、VEGF、IL-4、IFN-γ和IL-4/IFN-γ水平。结果:与对照组比较,哮喘组和肺炎组患儿的IL-17和IL-8水平均明显增高(均P<0.05);哮喘组患儿的IL-8水平较肺炎组低(P<0.05),而2组IL-17水平无显著差异(P>0.05);与肺炎组和对照组比较,哮喘组患儿VEGF水平明显增高(均P<0.01);肺炎组与对照组患儿VEGF水平无显著差异(P>0.05);3组患儿的IL-4,IFN-γ和IL-4/IFN-γ水平均无显著差异(均P>0.05)。与对照组比较,哮喘组及肺炎组患儿中性粒细胞百分比明显增高(均P<0.01),而哮喘组与肺炎组患儿的中性粒细胞百分比无显著差异(P>0.05)。结论:IL-17、IL-8及VEGF在哮喘儿童气道炎症中发挥重要作用,Th17细胞可能参与儿童哮喘急性发作的发病机制。

AIM： To investigate the mechanism of airway inflammation in children with asthma by determining the levels of IL-17,IL-8 and vascular endothelial growth factor（VEGF） in bronchoalveolar lavage fluid（BALF）.METHODS： Eighty-eight children were enrolled in the study and divided into asthma group（n=52）,pneumonia group（n=25） and control group（n=11）.BALF were collected from all 88 cases.The levels of IL-17,IL-8,VEGF,IL-4 and IFN-γ in BALF were measured by ELISA.The cell types in BALF were determined.RESULTS： Compared with the control,the levels of IL-17 and IL-8 were significantly elevated in asthma group and pneumonia group（all P〈0.05）.The level of IL-8（P〈0.05） in the patients with asthma was lower than that in the pneumonia patients.No statistical difference of the IL-17 level between asthma group and pneumoniae group was observed（P〉0.05）.Compared with pneumonia group and control group,the level of VEGF was significantly increased in asthma group（all P〈0.01）,and the VEGF level among control group and pneumonia groups was almost similar（P〉0.05）.The levels of IL-4 and IFN-γ,and ratio of IL-4/IFN-γ among groups were not statistically different.The percentage of neutrophils in BALF was significantly higher in asthma group and pneumonia group than that in control group（all P〈0.01）.CONCLUSION： IL-17,IL-8 and VEGF play important roles in airway inflammation in children with asthma.Th17 cells may participate in the pathogenesis of asthma in children.