白塞病患者外周血Th细胞亚群比例变化的研究

The changes of Th lymphocyte subsets in patients with Behcet disease

目的探讨白塞病患者外周血CD4＋淋巴细胞亚群Thl、Th2、Thl7及调节性T细胞（Tregs）的变化。方法病例对照实验研究。收集2007年6月至2009年1月在北京同仁医院、北京同仁眼科中心就诊的白塞病患者30例，年龄21～45岁，男性16例，女性14例，平均年龄35岁。所有患者均根据国际葡萄膜炎研究组诊断标准予以确诊，并排除全身其他系统炎性疾病，所有患者均未进行过抗炎治疗。30名健康对照组样本（男性15名，女性15名，平均年龄31岁）由我院体检中心体检健康、无全身炎性及其他系统疾病的人群中选取。抽取外周血应用四色免疫荧光流式细胞仪测定其中Th细胞亚群比例，用酶联免疫吸附测定法（ELISA）测定其血浆中白细胞介素（IL）17、IL-23、IL-6、IL-10和转化生长因子β1（TGF-β1）含量并与30名健康人作对照。患病组与正常对照组数据之间差异进行对比采用两独立样本t检验。结果白塞病患者外周血中Thl细胞所占CD4＋T细胞的百分比（25．08％±7．23％）及Thl／Th2（13，34±2．66）与健康对照组（17．58％±6．60％，8．45±3．68）相比明显升高（t=－1．43、－1．41，P〈0．05），Th2细胞所占CD4＋T细胞的百分比（1．88％±1．31％）无明显差异（t=0．32，P〉0．05）；Thl7细胞所占CD4＋T细胞的百分比（36．38％±17．47％）明显高于对照组（25．97％±5．35％）（t=～2．187，P〈0．05），Tregs所占CD4＋T细胞的百分比（4．11％±1．32％）明显低于对照组（5．60％±2．06％）（t=3．70，P〈0．05），Thl7／Tregs（9．52±5．82）明显高于对照组（4．81±1．66）（t=－2．218，P〈0．05）。白塞病患者I－．17（13．21±4．20）ng／L、IL-23（10．86±7．86）ng/L、IL-6（6．37±6．51）ng/L和TGF—B1（4477．20±2146．60）ng/L含量明显高于正常人IL-17（9．55±1．02）ng/L、IL-23（6．71±0．76）ng／L、IL-6（0．99±0．34）ng／L和TGF—B1（1721．94±1269．82）ng／L的含量（t=-3．61、-2．33、～2．15、-3．18，P〈0．05）；IL-10（6．27±5．56）ng／L含量低于正常人（22．04±7．36）ng／L（t=5．95，P〈0．05）。结论在白塞病发病过程中，Thl7、Tregs所占CD4＋T细胞的百分比，Thl7／Treg以及Thl7、Tregs相关因子含量均发生了明显变化，Thl7、Tregs可能参与了白塞病的发病过程。

Objective To investigate the changes of Th lymphocyte subsets in patients with Behcet disease. Methods From June 2007 to January 2009, thirty patients （ male 16, female 14 ） with Behcet Disease who got treatment at Beijing Tongren Hospital were collected, whose age range was 21-45 years old and the average age was 35 years old. All the patients were diagnosed according to the diagnostic criteria of International Uveitis Study Group, and the other system inflammatory diseases were ruled out. None the patients did receive any anti-inflammatory treatment before getting treatment in the hospital. Thirty health controls （male 15, female 15 ） were collected in Beijing Tongren Hospital Physical Examination Center. There was on significant difference in age and gender composition between the two groups. Peripheral blood and sera were obtained from 30 patients with Behcet disease and 30 normal persons. The ratio of the subsets of Th cells in peripheral blood was detected by automatic flow cytometer and the IL-17, IL-23, IL-6, IL-10 and TGF-β1 in sera was detected by ELISA. T-test of independent sampler was used to analysis all the scores of the two groups. Results Compared to normal controls, the patients with Behcet disease had significant higher percentages of Thl （25.08% ± 7.23% ） and Thl7 （36. 38% ± 17. 47% ） （t = - 1.43, - 2. 187 ; P 〈 0. 05 ） cells and lower percentages of T regulatory cells （Tregs） （4. 11% ± 1.32% ） （ t = 3.70, P 〈 0. 05 ）, and the Thl/Th2 （ 13.34 ± 2. 66） （ t = - 1. all, P 〈 0. 05 ） and ThlT/Tregs （9. 52 ± 5.82） （ t = -2. 218 ,P 〈0. 05 ） ratio was higher. No differences in the percentages of Th2 cells between patients with Behcet disease and normal controls were observed. Patients with Behcet disease revealed significant increase in peripheral Thl7 related cytokines [ IL-17 （ 13.21 ± 4. 20） ng/L, IL-6 （6. 37 ± 6. 51 ） ng/L, TGF-β1 （4477.20 ±2146. 60） ng/L, IL-23（10. 86 ±7.86）ng/L] levels（t = -3.61, -2. 33, -2. 15 and -3. 18; P 〈 0. 05） and obvious decrease in Tregs related cytokines [ IL-10 （ 6. 27 ± 5.56） ng/L ] （ t = 5.95, P 〈 0. 05）, compared with normal controls. Conclusion There are obvious changes in the number of Thl7 and Tregs and their related cytokines during the process of Behcet disease, so it can be inferred that Thl7 and Tregs probably have some effects on the onset of Behcet disease.