溃疡性结肠炎(UC)肠黏膜中IL-2、IL-4、IL-17和IL-10的表达特点及其与疾病活动度的关系

The expressions of IL-2,IL-4,IL-17 and IL-10 in ulcerative colitis(UC) mucosa and its relation with disease activity

目的探讨溃疡性结肠炎(ulcerative colitis,UC)患者肠黏膜中的细胞因子IL-2、IL-4、IL-17和IL-10的表达特点,并分析其与疾病活动度的关系。方法收集UC患者36例,采用Sutherland疾病活动指数评估UC的炎症活动度。行结肠镜检查时对UC患者的病灶部位及病灶周围正常肠黏膜组织进行活检,以半定量PCR法检测肠黏膜组织中的细胞因子IL-2、IL-4、IL-17和IL-10的表达水平。从中选取10例以免疫组化法检测肠黏膜组织中上述各细胞因子的表达,同时检测该10例UC患者外周血的血沉(erythrocyte sedimentationrate,ESR)及C反应蛋白(c-reactive protein,CRP)值。结果 IL-2在UC患者肠黏膜病灶部位中的表达水平明显高于周围正常黏膜。在UC患者不同活动度组间,IL-2的蛋白表达水平无显著差异,但轻度组的IL-2mRNA表达水平高于中、重度组。IL-4在病灶部位中的表达水平明显高于正常黏膜,其中重度UC患者中的IL-4表达水平明显高于轻、中度UC患者。IL-17在病灶部位中的表达水平高于正常黏膜,其中重度UC患者中的IL-17表达水平明显高于轻、中度UC患者。IL-10在病灶部位中的蛋白及mRNA表达水平均高于正常黏膜,但前者差异无统计学意义,其中轻度UC患者中的IL-10表达水平明显高于中、重度UC患者。UC患者肠黏膜中上述细胞因子的表达水平与ESR、CRP值均无明显相关性。结论 IL-2、IL-4、IL-17及IL-10通过发挥不同的促炎或抑炎作用可能参与介导了UC发病,其mRNA表达水平与UC的炎症活动程度存在一定相关性,其中IL-4、IL-17及IL-10的蛋白表达水平亦与UC的炎症活动程度存在一定相关性,可用来评估UC的炎症程度。

] Objective To investigate the expression of cytokines including IL-2,IL-4,IL-17 and IL-10 in the mucosa of patients with ulcerative colitis （UC） ,in order to determine the correlation between the expression levels of these cytokines and disease activity. Methods Thirty-six cases of UC were enrolled in this study. The disease activity was scored by Sutherland DAI in UC patients. Endoscopic mucosa biopsy was performed when UC patients took colonoscopy examination. The expression levels of cytokines including IL-2, IL-4, IL-17 and IL-10 in the intestinal mucosa were assessed by semiquantitative PCR. In 10 cases, these cytokines were measured by immunohisochemistry, and peripheral blood erythrocyte sedimentation rate （ESR） and c-reactive protein （CRP） were measured simultaneously. Results The expression level of IL-2 was significantly higher in inflamed mueosa than in normal mueosa, but there was no evident difference in protein expression of IL-2 among subgroups of UC patients classified by disease activity. However, the mRNA expression of IL-2 was higher in mild group than in moderate and severe. The expression level of IL-4 was higher in inflamed mucosa than in normal mucosa. Among subgroups of UC patients, the expression level of IL-4 was higher in severe than in mild and moderate. The expression level of IL-17 was higher in inflamed mucosa than in normal mucosa. Among subgroups of UC patients, the expression level of IL-17 was higher in severe than in mild and moderate. The protein and mRNA expression levels of IL-10 were higher in inflamed mucosa than in normal mucosa,but no statistical significance in the former. Among subgroups of UC patients, the expression level of IL-10 was higher in mild than in moderate and severe. No correlation was seen between the expression levels of those cytokines and ESR or CRP level. Conclusions Cytokines like IL-2.IL-4.IL-17 and IL-10 may be involved in the pathogenesis of UC through pro-or anti-inflammation effect. The mRNA expression levels of these 4 cytokines and protein expression levels of IL-4.IL-17 and IL-10 are correlated with disease activity of UC to some extent,and can be used to evaluate the activity of UC.