龙胆泻肝胶囊对HLA-B_(27)相关性急性前葡萄膜炎患者血清相关细胞因子水平的影响

Effect of Longdan-xiegan Capsule on the Levels of Cytokine in Patients with Positive HLA-B_(27) Acute Anterior Uveitis

目的观察龙胆泻肝胶囊对HLA-B27相关性急性前葡萄膜炎(AAU)患者治疗前后外周血中IL-10、IL-23、TNF-α、INF-γ等细胞因子水平的变化,探讨其可能的作用机制。方法 68例AAU患者随机分为龙胆泻肝胶囊加激素治疗组(治疗组)36例42眼及单纯激素治疗组(对照组)32例37眼,并与19例健康人群对比。对患者进行HLA-B27及外周血血浆上述4种因子水平检测。结果治疗组及对照组IFN-γ、TNF-α、IL-23在AAU发作期显著高于健康人群(P<0.01),且治疗后均显著降低(P<0.01);其中TNF-α、IL-23治疗后治疗组水平下调接近健康人群(P>0.05),但对照组仍高于健康人群(P1<0.05,P2<0.01);IFN-γ在治疗后两组均高于健康人群(P<0.05)。IL-10在治疗前均显著高于健康人群(P<0.01),治疗后对照组较治疗前升高(P<0.05),而治疗组呈一定程度下降(P<0.05),基本接近健康人群(P=0.10)。IL-10测定结果与其他3者基本一致,相关系数均达0.8以上。结论糖皮质激素结合龙胆泻肝胶囊能显著调节HLA-B27相关性急性前葡萄膜炎患者的相关血清细胞因子水平,改善患者体内的免疫失衡状态,是其可能的作用机制之一。

Objective To investigate the effect of longdan - xiegan capsules on the levels of IL - 10, IL - 23, TNF - α, INF - γ in the plasma of patients with positive HLA - B27 acute anterior uveitis（ AAU）. Methods Sixtyeight cases with positive HLA - B27 AAU were randomly allocated into two groups. There were 36 cases in the treatment group treated with corticosteroids combined Longdan - xiegan capsules,and 32 cases in the control group treated simply with cortieosteroids, and 19 healthy volunteers were as normal control groups. All cases were detected for HLA - B27 by the method of PCR. And the IL - 10, IL - 23 ,TNF - α, INF - γ expression in sera of the patients were measured by the ELISA technology before and after treatment. Results The levels of the IL - 23, TNF - α, INF - γ in AAU patients were significant increased compared with the normal group（ P 〈 0.01 ）. They were significantly lower after treatment （P 〈 O. 01 ） compared with the acute phase. After treatment, the TNF - α, IL - 23 levels of the treatment group was close to normal group （P1 = 0.84, P2=0.54 ） , but the control group was still higher than the normal group （ P1 = O. 035, P2 = 0. 003 ）. The IFN - γlevel of the treatment and con- trol group were still higher than the normal group（P1 =0. 043 ,P2 =0. 017）. The IL- 10 level in AAU patients were significantly higher than the normal group （ P 〈 0.01 ）. After treatment, It was significantly higher than before in the control group （ P = O. 029 ） , while in the treatment group it was deceased more certain degree（ P = 0. 027 ） , close to normal group （P = 0. 100 ）. （3）IFN -γ ,TNF -α, IL -10 level and IL -23 level showed a positive correlation before treatment. Conclusion Cortieosteroids combined longdan -xiegan capsules have significantly effect on the expression of cytokines in the patients with positive HLA - B27 AAU. It can accommodate patient＇s immunity unbalance and effectively restrain the inflammation.