HLA-B_(27)相关急性前葡萄膜炎患者IL-10、IL-23、TNF-α、INF-γ的水平分析

Investigation of IL-10,IL-23,TNF-α,INF-γ in Patients with HLA-B_(27) Related Acute Anterior Uveitis.

目的观察HLA-B27相关急性前葡萄膜炎(AAU)患者治疗前后外周血中IL-10、IL-23、TNF-α、INF-γ等指标的变化,以期为此类患者的预防和治疗提供有益的思路。方法应用ELISA法检测技术,对AAU患者外周血血浆中上述4种因子水平进行检测,用PCR法对患者进行HLA-B27基因检测。结果 41例HLA-B27相关AAU患者外周血中发作期各指标分别是IL-10(461.3±34.5pg/ml)、IL-23(457.1±35.6pg/ml)、TNF-α(228.8±23.6pg/ml)、INF-γ(34.4±2.8pg/ml)经糖皮质激素及复方龙胆泻肝胶囊治疗后缓解期各指标均显著低于急性发作期(P<0.01),分别为IL-10(145.7±29.8 pg/ml)、IL-23(123.1±30.9pg/ml)、TNF-α(61.2±20.1pg/ml)、INF-γ(12.0±2.2pg/ml),缓解期与健康对照组比较无统计学差异(P>0.05),其中INF-γ、IL-10、TNF-α略高于健康对照组,IL-23略低于健康对照组。所有41例患者全部为HLA-B27基因阳性,对照组37例中有1例(2.7%)阳性。结论糖皮质激素结合复方龙胆泻肝胶囊能显著调节HLA-B27相关葡萄膜炎患者体内的细胞因子水平,改善患者体内的免疫失衡状态,有效地抑制炎症。

Objective To study the changes of the levels of IL - 10,IL - 23,TNF - ct,INF - 3＇ in the plasma of patients with HLA - B2v related acute anterior uveitis（AAU）. Methods The method of sequnce special prime polymerase chain reaction （ SSP - PCR） was used to detect HLA - B27. The ELISA technology was applied to detect IL - 10,IL - 23, TNF - α, INF - γ, in the plasma of patients. Results In 41 patients with AAU,during the uveitis acute period, levels of IL - 10 （461.3±34.5pg/ml） , IL - 23 （457. 1±35.6pg/ ml） ,TNF-α （228.8±23.6pg/ml）, IN F-γ（ 34.4 ± 2.8pg/ml） expression in peripheral blood of the patients were higher than those in the normal volunteers（ P 〈 0.01 ） , and were decreased after treatment with corticosteroids and fufanglongdanxieganjiaonang. The difference between patients during the uveitis remission period and healthy controls wasn＇t significant （P 〉 0.05）. In patients with AAU,dl patients （100%） were with HLA -B27 gene and 1 （2.7%） of 37 normaI objectives was with HLA -B27 gene. Conclusion Corticosteroids and fufanglongdanxieganjiaonang have significantly intervention effect on the expression of cytokines in the patients with HLA - B27 related acute anterior uveitis. It can improve immunity and effectively restrain the inflammation.