IL-17与IL-23免疫轴在结核性胸膜炎免疫致病机制中的作用

Pathological effects of IL-17 and IL-23 in tuberculosis pleurisy patients

目的拟探讨IL-17和IL-23在结核性胸膜炎中的致病机制及其对诊断和预后的预示意义。方法根据诊断标准,入选38例结核性胸膜炎患者,留取外周血标本5 mL,胸膜腔积液5 mL。ELISA法检测患者血清及胸膜腔积液中IL-17和IL-23。同时选取20例无感染征象患者血清和胸膜腔积液作为对照组。对照组和结核性胸膜炎组IL-17和IL-23水平由t检验进行比较分析,并对IL-17和IL-23与结核性胸膜炎组不同病期的相关性用Pearson检验进行分析。结果结核性胸膜炎患者血清和胸腔积液中IL-17水平分别为(78.81±19.91)pg/mL和(206.4±53.77)pg/mL,与对照组血清和胸腔积液中IL-17相比均增高,差异有统计学意义(P<0.01)。结核性胸膜炎患者血清和胸腔积液中IL-23水平分别为(103.1±32.1)pg/mL和(327.8±68.13)pg/mL,与对照组血清(12.79±0.82)pg/mL和胸腔积液(3.24±0.17)pg/mL相比均增高(P<0.01)。并且,IL-17和IL-23升高水平与结核性胸膜炎患者胸膜腔积液中白细胞的数量呈正相关。结论 Th17细胞分泌的IL-17和IL-23在结核性胸膜炎患者胸膜腔积液中显著增高,并与其白细胞数量相关。说明IL-17和IL-23在结核性胸膜炎的免疫病理过程中起着重要的作用。

Objective To reveal the diagnostic values of IL-17 and IL-23 in the tuberculosis pleurisy patients. Methods A total of 38 tuberculosis pleurisy patients were included and 20 patients who had pleural effusion without infection sign were as a control group. Serum and pleural effusion were collected to detect IL-17 and IL-23 by ELISA. The differences of IL-17 and IL-23 between the tuberculosis pleurisy group and the control group were analyzed by the t test. The correlation among IL-17 and IL-23 changes and the parameters of pleural effusion were analyzed by Pearson test. Results The IL-17 levels in the serum and pleural effusion of the tuberculosis pleurisy patients were 78.81 ± 29.91 and 206.4 ± 53.77 respectively, which were higher than those of the control group （4.5 ± 0.5, 3.4 ± 0.4）, and the differences were significant. IL-23 in the serum and pleural effusion of the tuberculosis pleurisy patients were 103.1 ± 32.1 and 327.8 ± 68.13 respectively, which were higher than those of the control group （12.79 ± 0.82, 3.24 ± 0.17）, and the differences were significant. Moreover, IL-17 and IL-23 in the pleural effusion had a correlation with WBC numbers. Conclusions IL-17 and IL-23 are related to the immunological pathology of tuberculosis pleurisy and they are the potential diagnostic indicators of tuberculosis pleurisy.