系统性红斑狼疮血清IL-17和ICAM-1的检测及其免疫学意义

Immunological Significance of the Detection of IL-17 and ICAM-1 in Systemic Lupus Erythematosus

目的探讨白细胞介素17（IL-17）和细胞黏附分子-1（ICAM-1）在SLE免疫机制中的作用。方法参照Valentijn法判断标准，收集龙岗中心医院2008年5月～2011年8月间46例SLE患者，其中活动期29例，缓解期17例。清晨取空腹静脉血并且制备外周血单个核细胞培养上清液。运用ELISA法检测SLE患者血清和PMBC上清液中IL-17和ICAM-1值，同时取42名健康者作为对照。将所测定的IL-17和ICAM-1等指标与实验室常用指标ANA，抗ds-DNA比较。结果SLE患者血清中IL-17及ICAM-1浓度水平分别为59．12±5．69pmol／L和494．5±86．51μg／L，明显高于SLE缓解组血清IL-17及1CAM-1浓度水平27．13±3．05pmol／L和185．80±32．11μg／L和正常对照组血清IL-17及ICAM-1浓度水平9．50±1．24pmol／L和191．73±30．10μg／L，t值3．859，P值0．021；同样SLE患者PBMC上清液中1L-17及ICAM-1浓度水平分别为187．76±27．10pmol／L和582．20±91.87μg／L，明显高于SLE缓解组PBMC上清液中1L-17及ICAM-1浓度水平45．83±3．97pmol／L和191．73±30．10μg／L和正常对照组PBMC上清液中IL-17及ICAM-1浓度水平12．64±2．52pmol／L和214．48±40．07μg／L，t值4．051，P值0．028。且ANA，抗ds-DNA阳性SLE患者血清中IL-17及ICAM—1浓度水平分别为68．36±6．09pmol／L和600．24±91．61μg／L，t值5．909，P值0．024。明显高于ANA，抗ds-DNA阴性SLE患者血清中IL-17及ICAM-1浓度水平24．05±3．17pmol／L和89．55±34．81μg／L，t值2．790，P值0．038。且治疗后IL-17及1CAM-1降低。结论IL-17及ICAM-1在SLE患者中可能是引起免疫功能失衡的发病因素之一，SLE活动期血清ICAM-1水平增高，可能为判定SLE活动的参考指标。

Objective To explore the immunological machamism of interleukin-17 （IL-17） and intercellular adhesion molecular-1（ICAM-1） in the progress of Systemic Lupus Erythematosus（SLE）. Methods According to valentijn method to determine the standard reference to collect 46 SLE patients in Longgang Central Hospital from May 2008 to August 2011, then classfied the activities of the 29 cases and 17 cases of remission. Venous blood was taken early in the morning and peripheral blood mononuclear cell culture supernatants was prepared. The sera of SLE patients and PMBC supematant IL-17 and ICAM-1 was tesed by ELISA,at the same time the 42 healthy controls was taken. The parameters of IL-17 and ICAM-1 was compared with the commonly used laboratory parameters ANA,anti ds-DNA indicators. Results IL-17 and ICAM-1 levels in the serum of patients with SLE were 59.12±5.69 pmol/L and 494.5±86.51μg/L, significantly higher than SLE remission group of serum IL-17 and ICAM-1 levels 27.13 ＋3.05 pmol/L and 185.80 ± 32.11 μg/L and normal control serum IL-17 and ICAM-1 levels 9. 50±1.24 pmol/L and 91.73±30.10 μg/L, t value of 3. 859, P value 0. 021. Similarly,patients with SLE PBMC supernatant IL-17 and ICAM-1 levels 187.76± 27.10 pmol/L and 582. 20 ± 91.87 μg/L, significantly higher than SLE remission group PBMC supernatant IL-17 and ICAM-1 levels 45.83 ± 3.97 pmol/L and 191.73±30. 10 big/L） and normal control group PBMC supernatant IL-17 and ICAM-1 levels 12. 64±2.52 pmol/L and 214.48±40. 07μg/ L, t value 4. 051, P-value of 0. 028. And serum IL-17 and ICAM-1 levels 68. 36±6.09 pmol/L and 600. 24 ± 91.61 μg/L, tvalue of 5. 909, P-value of 0. 024 in the ANA,antids-DNA-positive patients with SLE were Significantly higher than the serum IL-17 and ICAM-1 levels 24. 05±3.17 pmol/L and 289.55 ± 34.81 μg/L, t value 2. 790, P value of 0. 038 in the ANA, anti ds-DNA negative SLE. And IL-17 and ICAM-1 were deceased significantly after effective therapy. Conclusion IL-17 and ICAM-1 may be one of the immunological function disorders, at the same time, the quantity detection of IL-17 and ICAM-1 is benefit to predict the progress and outcome of SLE. The increase of serum ICAM-1 levels during the active periodof SLE d may determine the reference index.