重症肌无力胸腺瘤Th17细胞及细胞因子变化

Thymoma T helper type 17 cells and related cytokines in myasthenia gravis

目的研究伴胸腺瘤重症肌无力（MG）患者外周血中Th17细胞及其相关细胞因子变化。方法采用流式细胞术检测MG患者及健康对照外周血单个核细胞（PBMCs）Th17细胞比例，实时定量PCR检测PBMCs中Th17细胞相关细胞因子mRNA转录；ELISA检测血清中Th17细胞相关细胞因子表达。结果MG伴胸腺瘤组外周血Th17细胞比例[（1．53±0．59）％]显著高于对照组[（0．94±0．32）％，P〈0．05]；MG伴胸腺瘤组IL-17mRNA转录相对值显著高于对照组（23．7±4．5比13．4±3．2，P〈0．01），IL-1β、IL-6及IL-23mRNA转录量明显升高；MG伴胸腺瘤组血清IL-17表达量高于对照组[（30．4±7．3）ng／L比（19．2±4．9）ng／L，P〈0．05]，IL-1β及IL-23表达量升高，与对照组相比差异有统计学意义。结论MG胸腺瘤中Th17细胞增多，可能导致免疫调节功能紊乱，从而引起MG发病。

Objective To investigate the immunoregulatory role of Thl7 cell and the related cytokines in myasthenia gravis. Methods Totally 51 myasthenia gravis （MG） patients were divided into MG with thymomas （TM group） and the MG with normal thymus （NT group）, as well as 22 healthy subjects as controls. Thl7 cells from peripheral blood mononuclear cells were measured by flow cytometry. Thl7 related eytokines were detected by ELISA and real-time quantitative-PCR. Results The quantity of Thl7 cells in MG patients with thymomas （ 1.53 ± 0. 59 ） % were significantly increased compared with that of healthy control （0. 94%±0. 32%, P 〈 0. 05 ）. There was no significant difference in the number of Thl7 cells between healthy controls and NT group. The expression levels of IL-17 mRNA （ 23.7 ± 4. 5 ） were up- regulated significantly versus those in healthy controls （ 13.4 ± 3.2, P 〈 0. 01 ）. The levels of mRNA expression of IL-1β, IL-6 and IL-23 were up-regulated significantly in TM group. The mean concentration of IL-17 was up-regulated significantly in TM group （30. 4 ±7.3） ng/L versus healthy controls I （ 19. 2 ±4. 9） ng/L, P 〈 0. 05 1. Serum levels of IL-23 and IL-1β were always increased in TM group versus healthy controls. Conclusion The elevated levels of IL-17 and other Thl7 related cytokines in thymomas may aggravate the autoimmunity disorder.