初发Graves病患者^(131)I治疗前后IL-23/Th17轴相关因子水平的变化及意义

Effects of ^(131)I treatment on the IL-23/Th17 axis relevant factor levels in graves disease patients

目的:通过检测初发Graves病(GD)患者131I治疗前后不同阶段IL-23/Th17轴相关因子水平,探讨IL-23/Th17轴在GD发病机制中的作用。方法:收集初发GD组和正常对照组各30例。初发GD组分治疗前(T0)及131I治疗后1个月(T1)、3个月(T3)三组。应用ELISA法检测各组血清IL-17A、IL-17F、IL-22、IL-23水平,电化学发光法检测游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、促甲状腺素受体抗体(TRAb)水平。结果:T0组血清IL-17A、IL-17F、IL-23水平明显高于正常对照组(P<0.01);IL-17A、IL-17F、IL-23水平在T0、T1、T3组逐渐下降,仍高于正常对照组(P<0.01);IL-22治疗前后无统计学差异(P>0.05)。采用双变量相关性分析得出IL-17A、IL-17F、IL-23与FT3、FT4呈正相关(rs>0.626,P=0.000),与TSH呈负相关(rs<-0.600,P=0.000)。结论:IL-23/Th17轴相关因子在初发GD中高表达,IL-23/Th17轴可能在GD的发病中起到重要作用。另外,放射性131I可能通过影响IL-23/Th17轴起到治疗GD的作用。

Objective：To explore the role of IL-23/Th17 axis in the pathogenesis of Graves disease（GD）,by detecting the IL-23/Th17 axis relevant factor levels before and after 131I treatment with GD patients（who were newly diagnosed）.Methods： The study subjects were divided into GD group and normal group.30 subjects were enrolled in each group.The GD group was divided into three groups such as before 131I treatment（T0）,one month（T1） and three months（T3） after the 131I treatment.The levels of serum IL-17A,IL-17F,IL-22 and IL-23 were measured by ELISA.FT3,FT4,TSH,TPOAb,TgAb and TRAb levels were determined by electrochemiluminescence.Results： The levels of serum IL-17A,IL-17F and IL-23 in the GD group were significantly higher than the normal group（P0.01）;the levels of serum IL-17A,IL-17F and IL-23 in T0,T1,T3 decreased gradually,but still higher than in normal group（P0.01）;there was no significant difference in the level of IL-22 before and after 131I treatment（P0.05）.Bivariate correlations revealed that IL-17A,IL-17F,IL-23 were strongly associated positively with FT3,FT4（rs0.626,P=0.000）,but correlated negatively with TSH（rs-0.600,P=0.000）.Conclusion： IL-23/Th17 axis factors are highly expressed in the GD group.IL-23/Th17 axis may play an important role in the pathogenesis of GD.In addition,radioactive 131I may also work on GD via IL-23/Th17 axis.