强直性脊柱炎患者Th17细胞与CD4^＋CD25^＋FoxP3^＋调节性T细胞的变化及意义

The alteration of Th17 cells and CD4^＋CD25^＋FoxP3^＋ regulatory T cells in patients with ankylosing spondylitis

目的探讨强直性脊柱炎（ankylosing spondylitis，AS）患者Th17和CD4^＋CD25^＋FoxP3^＋调节性T细胞比例及相关细胞因子水平的变化及意义。方法强直性脊柱炎患者40例，正常同年龄对照37例。采用流式细胞术检测外周血Th17与调节性T细胞的比例，双抗体夹心酶联免疫吸附法（ELISA）检测血清IL-6、IL-23、IL-17和TGF—β水平。结果As组患者外周血Th17细胞比例明显高于对照组[（1．02±0．34）％vs（0．68±0．29）％，P〈0．05]，CD4^＋CD25^＋FoxP3^＋细胞比例明显低于对照组[（3．77±0．81）％vs（4．69±1．23）％，P〈0．05]。AS患者血清中IL-6、IL-23、IL-17水平明显高于对照组[（6．15±2．71）ng／Lvs（3．31±1．65）ng／L；（9．44±3．12）ng／mlvs（5．82±2．61）ng／ml；（10．53±4．97）ns／Lvs（6．78±3．26）ng／L，P均〈0．01]；差异有统计学意义。与对照组相比，AS组TGF-β水平有下降的趋势[（4．76±2．15）ng／mlvs（5．16±2．02）ng／ml，P〉0．05]，但差异无统计学意义。AS患者血清各细胞因子含量与临床及实验室指标无相关性。结论强直性脊柱炎患者Th17与CD4^＋CD25^＋FoxP3^＋调节性T细胞比例失衡，血清IL-6、IL-23、IL-17和TGF-β水平变化，这些原因可能参与强直性脊柱炎免疫发病过程。

Objective To investigate the percentages of Th17 and CD4^＋CD25^＋FoxP3^＋ regulatory T（Tr） cells and the levels of related cytokines IL-6, IL-23, IL-17 and TGF-β in serum of patients with ankylosing spondylitis（AS）. Methods Forty patients with AS and 37 age-matched healthy donors were studied. Flow cytometry was used to analyze the percentages of blood Th17 and CD4^＋CD25^＋FoxP3^＋Tr cells. The levels of serum IL-6, IL-23, IL-17 and TGF-β were assayed by enzyme-linked immunosorbent assay （ELISA）. Results The proportion of Th17 cells in AS group was significantly higher than those in normal group [ （1.02±0.34） % vs （0.68±0.29） % , P〈0.05 ） ], and the proportion of CD4^＋ CD25^＋ FoxP3^＋ cells was lower in AS group comparing with normal group [ （3.77±0.81 ）% vs （4.69±1.23 ）%, P〈0.05 ） ]. Meanwhile, serum levels of IL-6, IL-23 and IL-17 were significantly higher in AS group than those in normal group [（6.15±2.71） ng/L vs （3.31±1.65） ng/L; （9.44±3.12） ng/ml vs （5.82±2.61） ng/ml; （10. 53±4.97） ng/L vs （6.78±3.26） ng/L, all P〈0.01 ]. In contrast, TGF-β level was decreased in AS group compared with the normal group [ （4.76±2.15） ng/ml vs （5.16±2.02） ng/ml, P〉0.05], but the difference was not significant. No associations of serum eytokine levels with clinical and laboratory parameters were found in AS. Conclusion The abnormality Th17 cells and Tr cells and their related cytokines IL-6, IL-23, IL-17 and TGF-β changes in patients with AS ,which may be involved in immunolagieal pathogenesis of AS.