系统性红斑狼疮患者Th17和Th1细胞及其细胞因子水平的变化及临床意义

The changes and clinical significance on the expressions of Th17,Th1 and cytokines in patients with systemic lupus erythematosus

目的研究系统性红斑狼疮(SLE)患者外周血中辅助性T细胞17(Th17)和辅助性T细胞1(Th1)及其细胞因子白细胞介素17(IL-17)、白细胞介素23(IL-23)和干扰素-γ(IFN-γ)的表达情况及其临床意义。方法将38例SLE患者根据SLE活动指数(SLEDAI)评分分为活动组(SLEDAI≥10分)20例和非活动组(SLEDAI<10分)18例;采用流式细胞术检测38例SLE患者和20名健康对照者外周血中Th17和Th1细胞的比例;酶联免疫吸附试验(ELISA)检测血清中相关细胞因子IL-17、IL-23及IFN-γ的水平,并进行统计学分析。结果 SLE组外周血中Th17细胞比例高于对照组(P<0.05),且SLE活动组Th17细胞比例高于非活动组(P<0.05);而Th1细胞比例与对照组比较差异无统计学意义(P>0.05);SLE组血清IL-17、IL-23及IFN-γ水平明显高于对照组(P<0.05);Th17细胞比例及IL-17、IL-23水平与SLEDAI评分呈正相关(r值分别为0.537、0.428、0.525,P值<0.05)。结论 SLE患者外周血中Th17细胞及血清IL-17、IL-23和IFN-γ水平明显升高,提示Th17与Th1细胞可能在SLE发病机制中发挥重要作用。

Objective To investigate the expressions of T helper cell 17 （Th17） , T helper cell 1 （Thl） and cytokines such as interleukin 17 （IL-17） , interleukin 23 （IL-23） and interferon-gamma （IFN-γ） in peripheral blood from patients with systemic lupus erythematosus （ SLE）, and their clinical significance. Methods According to SLE disease activity index （SLEDAI） ,38 patients with SLE were classified into active group（ SLEDAI ≥ 10,20 patients） and inactive group（ SLEDAI 〈 10,18 patients）. Flow cytometry was used to analyze the percentages of Th17 and Thl in 38 patients with SLE and 20 healthy controls. The expressions of IL-17, IL-23 and IFN-γ were determined by enzyme- linked immunosorbent assay（ELISA） ,and the results were analyzed statistically. Results The percentage of Th17 in patients with SLE was significantly higher than that in healthy controls（ P 〈 0.05 ）, and the percentage of Th17 in active group was higher than that in inactive group（P 〈 0.05 ）, but the expression of Thl had no statistical significance with that of healthy controls（P 〉0.05） . The expressions of IL-17, IL-23 and IFN-γ in patients with SLE were higher than those in healthy controls（ P 〈 0.05 ）. The expression of Th17 and the levels of IL-17 and IL-23 were positively correlated with SLEDAI （ r = 0.537, 0.428 and 0.525, P 〈 0.05 ）. Conclusions The expression of Th17 and the levels of IL-17, IL-23 and IFN-γ increase in patients with SLE, and Th17 and Thl may play important roles in the pathogenesis of SLE.