慢性阻塞性肺疾病患者肺泡灌洗液中IL-17和IL-23检测的意义

Clinical significance on the determinations of IL-17 and IL-23 from bronchoalveolar lavage fluid in patients with chronic obstructive pulmonary disease

目的检测慢性阻塞性肺疾病(COPD)患者支气管肺泡灌洗液(BALF)中白细胞介素17(IL-17)、白细胞介素23(IL-23)在发病过程中的变化,为临床判断和了解COPD的炎症发展提供依据。方法参照BALF的细胞百分计数分类、临床资料及肺功能第1秒用力呼气容积占预计值百分比(FEV1%)实验对COPD急性期组、COPD缓解期组及非COPD对照组分别进行检测。采用酶联免疫吸附试验(ELISA)对BALF中IL-17、IL-23的浓度进行测定。结果 COPD急性期组BALF中IL-17、IL-23的浓度较COPD缓解期组、对照组明显增加(P<0.01);COPD急性期组FEV1%较COPD缓解期组和对照组亦明显增加(P<0.01);COPD患者BALF中IL-23与IL-17浓度呈直线正相关(r2=0.698 5,P<0.001),COPD患者BALF中IL-17、IL-23浓度与FEV1%均呈直线负相关(r2=-0.527 9、-0.541 0,P均<0.001)。结论肺局部炎症时IL-17、IL-23的浓度与COPD的变化和临床症状呈一定的相关性,其中IL-17的浓度与局部炎症情况相关性较IL-23强,其浓度的维持可能与炎症的持续存在有一定关系。检测COPD患者BALF中IL-17、IL-23水平对病情判断和治疗具有指导意义。

Objective To determine the changes of interleukin 17 （IL-17） and interleukin 23 （IL-23） from bronchoalveolar lavage fluid （BALF） in patients with chronic obstructive pulmonary disease （COPD） , and to provide the reference for diagnosing and understanding the inflammation development of COPD. Methods On the basis of cytological classification for BALF, clinical data and forced expiratory volume in first second to forced vital capacity ratio （FEV1% ） , acute exacerbation COPD group, stable phase COPD group and non-COPD control group were determined, respectively. The IL-17 and IL-23 levels were determined by enzyme-linked immunosorbent assay （ELISA）. Results The IL-17 and IL-23 levels and FEVI% increased more significantly in acute exacerbation COPD group than in stable phase COPD group and control group （ P 〈 0.01 ） . There was a positive linear correlation between BALF IL-17 and IL- 23 in COPD groups （r2 =0. 698 5,P 〈 0. 001 ） , however, there was a negative linear correlation of BALF IL-17 and IL- 23 with FEVI% in COPD groups （r2 = -0. 527 9 and -0. 541 0, P 〈 0. 001 ）. Conclusions The IL-17 and IL-23 levels with local lung inflammatory have correlations with the changes of COPD and the clinical manifestations, especially for IL-17 ,which may lead to persistent inflammation. Overall, the determinations of IL-17 and IL-23 are useful for the diagnosis and surveillance of COPD.