支气管哮喘患者血清白介素17水平及吸入沙美特罗替卡松对其影响的研究

IL-17 levels in asthmatic patients and changes after salmeterol and fluticasone propionate powder inhalation

目的通过观测慢性持续期过敏性支气管哮喘（简称哮喘）患者外周血白介素17（IL-17）水平及其在吸人沙美特罗替卡松治疗后的变化情况，探讨IL-17在哮喘发病机制中的作用。方法哮喘组（23例）未经过规范化治疗的慢性持续期过敏性哮喘患者予以吸入沙美特罗替卡松治疗，分别于治疗前及治疗1个月后测定肺功能，并抽取外周静脉血测定血清IL-17、IL-10水平（酶联免疫吸附法，ELISA）及嗜酸粒细胞计数并进行比较；正常组（12例）为健康体检者，给予抽取外周静脉血测定血清IL-17、IL-10并与哮喘组相比较。结果哮喘组血清IL—17水平高于正常组（Pd0．01）而IL-10水平低于正常组（P＜0．01），治疗1个月后前者明显下降（Pd0．01）而后者显著增高（P＜0．01）；哮喘组治疗1个月后FEV-％pred、PEF％pred较治疗前升高（P〈O．01），嗜酸粒细胞计数均较治疗前降低（P＜0．01） 外周血血清IL-17水平与嗜酸粒细胞计数呈中度正相关（r=0．614，P=0．002）。结论IL-17参与了哮喘的发病，进一步提示哮喘发病机制的复杂性。哮喘患者吸人激素联合长效8。受体激动剂治疗后可显著降低血清IL-17水平。

Objective To investigate interleukin-17 （IL-17）＇s role in the pathogenesis of bronchial asthma （asthma） we observed serum IL-17 levels in asthmatic patients and healthy persons,and examined the changes of serum IL-17 in asthmatic patients treated with salmeterol and fluticasone propionate powder. Methods Twenty-three asthmatic patients inhaling salmeterol and fluticasone propionate powder for a month were detected their lung functions, peripheral blood eosinophils, and serum IL-17, IL-10 （using enzyme-linked immune assay） at the 0th and 31th day respectively. Twelve healthy volunteers just measured serum IL-17, IL-10 and compared with the asthma group. Results Serum IL-17 levels in asthmatic patients before treatment were significantly higher than healthy volunteers （ P 〈 0.01） and serum IL-10 levels were significantly lower than healthy volunteers （ P 〈0.01）. After 1 month treatment the levels of IL-17 decreased （ P 〈0.01） while IL-10 increased （ P 〈0.01）. After treatment, the FEV1%pred and PEF~ pred of asthmatic patients increased （P 〈 0.01）, while the eosinophils counts decreased （ P 〈0.01 ）. Serum IL-17 levels correlated positively with eosinophils for asthmatic patients （ P 〈 0.01）. Conclusions IL-17 may be involved in the pathogenesis of asthma and further indicated the complexity of the pathogenesis of asthma. Treatment with inhaled glucocorticosteroids and long-acting inhaled β2 agonists can significantly reduce serum IL-17 level in asthma.