IL-17和TGF-β1在支气管哮喘患儿血清及支气管肺泡灌洗液中的变化及临床意义

Changes in IL-17 and TGF-β1 levels in serum and bronchoalveolar lavage fluid and their clinical significance among children with asthma

目的探讨白细胞介素-17(IL-17)和转化生长因子-β1(TGF-β1)在哮喘患儿血清和支气管肺泡灌洗液(BALF)中的变化及临床意义。方法 56例哮喘患儿为哮喘组,依据病情严重程度分为中重度组(37例)和轻度组(19例);18例非哮喘患儿为对照组。显微镜下计数各组BALF中细胞数,采用ELISA法检测血清与BALF中IL-17和TGF-β1含量。结果中重度、轻度哮喘组患儿与对照组患儿BALF中细胞总数及巨噬细胞百分比的差异无统计学意义(P>0.05),中重度、轻度哮喘患儿与对照组患儿中性粒细胞、嗜酸性粒细胞及上皮细胞百分比差异有统计学意义(P<0.05);哮喘患儿血清与BALF中IL-17和TGF-β1水平较对照组高,差异有统计学意义(P<0.05),中重度哮喘患儿血清与BALF中IL-17和TGF-β1水平高于轻度哮喘患儿,差异有统计学意义(P<0.05);哮喘患儿血清中IL-17和TGF-β1与相应的BALF中IL-17和TGF-β1呈正相关(均P<0.05),血清IL-17与BALF中中性粒细胞、嗜酸性粒细胞及上皮细胞百分比呈正相关(均P<0.05),血清中IL-17与TGF-β1亦呈正相关(P<0.05)。结论哮喘患儿血清与BALF中IL-17和TGF-β1水平明显升高,IL-17、TGF-β1可能参与了哮喘的发生发展,在哮喘的急性发作与加重中起重要作用。

Objective To investigate the changes in the levels of interleukin-17 （IL-17） and transforming growth factor beta 1 （TGF-β1） in serum and bronchoalveolar lavage fluid （BALF） and their clinical significance among children with asthma. Methods Fifty-six children with asthma were divided into moderate or severe asthma （n=37） and mild asthma groups （n=19） and 18 children without asthma were selected as the control group. Cells in BALF were counted under a microscope. The levels of IL-17 and TGF-β1 in serum and BALF were measured using ELISA. Results There were no significant differences in total cell count and percentage of macrophages between the two asthma groups and the control group （P〉0.05）. The percentages of neutrophils, eosinophils and epithelial cells in BALF were significantly higher in the two asthma groups than in the control group （P〈0.05）. The two asthma groups had significantly higher levels of IL-17 and TGF-β1 in serum and BALF than the control group （P〈0.05）, and the moderate or severe asthma group had significantly higher levels of IL-17 and TGF-β1 in serum and BALF than the mild asthma group （P〈0.05）. Levels of IL-17 and TGF-β1 in serum were significantly positively correlated with those in BALF （r=0.935 and 0.943, P〈0.05 for both）. In children with asthma, serum IL-17 level was significantly positively correlated with the percentage of neutrophils; eosinophils and epithelial cells in BALF （r=0.802, 0.799, and 0.674, P〈0.05 for all）, and a significant positive correlation was also seen between serum levels of IL-17 and TGF-β1 （r=0.878, P〈0.05）. Conclusions Levels of IL-17 and TGF-β1 in serum and BALF are elevated in children with asthma. IL-17 and TGF-β1 may be involved in the occurrence and development of asthma, and they play important roles in asthma attack and aggravation.