白细胞介素-17、白细胞介素-23和肿瘤坏死因子-α在吉兰-巴雷综合征发病中的作用

Function of Interleukin-17,Interleukin-23 and Tumor Necrosis Factor-α in the Pathogenesis of Guillain-Barre Syndrome

目的研究IL-17、IL-23和TNF-α在吉兰-巴雷综合征(GBS)发病过程中的作用,及采用IVIG治疗后GBS患儿血清IL-17、IL-23和TNF-α水平的变化。方法将38例GBS患儿分为2组:A组,发病7 d内给予IVIG;B组,发病8～12 d给予IVIG;均给予IVIG 0.4 g·kg-1·d-1连续治疗5 d。采用ELISA法检测2组患儿血清IL-17、IL-23和TNF-α水平,并与健康对照组血清IL-17、IL-23和TNF-α水平进行比较。结果 GBS患儿治疗前血清中IL-17、IL-23和TNF-α水平较健康对照组显著升高(t=4.498～16.418,Pa<0.05);GBS患儿经IVIG治疗后,其血清IL-17、IL-23和TNF-α水平较用药前显著降低(Pa<0.05);A,B 2组治疗前血清IL-17、IL-23和TNF水平无显著性差异,治疗后血清IL-17、IL-23和TNF水平亦无显著性差异(Pa>0.05)。结论 GBS患儿急性期血清IL-17、IL-23和TNF-α水平升高,可能在GBS的发病中起重要作用,采用IVIG治疗后能有效抑制IL-17、IL-23和TNF-α分泌,从而控制GBS患儿的细胞炎症反应。

Objective To investigate the function of interleukin-17（IL-17）,interleukin-23（IL-23） and tumor necrosis factor-α（TNF-α） in the pathogenesis of Guillain-barre syndrome（GBS）,and to analyze the influence of intravenous immunoglobulin（IVIG） on the serum levels of IL-17,IL-23 and TNF-α in GBS patients. Methods Fifty-one pediatric patients with GBS were divided into 2 groups.Patients in group A received IVIG within 7 days after GBS onset.Patients in group B received IVIG during 8-12 days after GBS onset.IVIG was injected in the dose of 0.4 g·kg^-1·d^-1or 5 days.The serum levels of IL-17,IL-23 and TNF-α were detected by ELISA before and after IVIG treatment.The data were compared between patients and normal children. Results The serum levels of IL-17,IL-23 and TNF-α in pediatric patients with GBS were significantly higher than that of normal controls（t=4.498-16.418,Pa〈0.05）.After treatment of IVIG,the serum levels of IL-17,IL-23 and TNF-α in pediatric patients with GBS became obviously lower than those before treatment（Pa〈0.05）.There was no significant difference between the 2 groups before and after treatment（Pa〈0.05）. Conclusions Increases in serum levels of IL-17,IL-23 and TNF-α of pediatric patients with GBS at acute stage play an important role in the development of GBS.IVIG treatment can restrain the secretion of IL-17,IL-23 and TNF-α,thus alleviate cellular inflammatory response of patients with GBS.