重症肌无力与IL-17、RORγt水平的关系

The relationship between IL-17,RORγt,and myasthenia gravis

目的探讨重症肌无力(MG)患者外周血IL-17水平和RORγt表达。方法收集确诊MG患者80例,根据Osserman分型将MG患者分为眼肌型组(20例)、轻度全身型组(24例)、中度全身型组(20例)及急性重症型组(16例)4组,并设立健康对照组(对照组:30例)。采用ELISA法检测各组外周血IL-17水平,并分析IL-17水平与MG病情严重程度(以临床绝对评分法评价)的相关性;采用RT-PCR法检测各组RORγt mRNA表达。结果眼肌型组、轻度全身型组、中度全身型组及急性重症型组患者血清IL-17水平分别为(17.87±9.28)ng/L、(33.05±11.95)ng/L、(50.49±12.37)ng/L、(58.18±16.11)ng/L,均高于对照组〔(4.70±2.18)ng/L,P<0.05〕;MG各组间比较差异有统计学意义(F=96.12,P<0.05),轻度全身型组高于眼肌型组,中度全身型组高于轻度全身型组和眼肌型组,急性重症型组高于轻度全身型组和眼肌型组(均P<0.05),中度全身型组与急性重症型组比较差异无统计学意义(P>0.05)。眼肌型组、轻度全身型组、中度全身型组、急性重症型组及对照组RORγt mRNA相对表达量分别为0.99±0.45、1.68±0.59、2.48±0.58、3.43±0.53、0.69±0.22,除眼肌型组外,轻度全身型组、中度全身型组、急性重症型组均高于对照组(P<0.05),MG各组间比较差异有统计学意义(F=109.82,P<0.05),轻度全身型组高于眼肌型组,中度全身型组高于轻度全身型组和眼肌型组,急性重症型组高于中度全身型组、轻度全身型组和眼肌型组(均P<0.05)。外周血IL-17水平与MG病情严重程度呈正相关(r=0.867,P<0.05)。结论 MG患者外周血IL-17水平和RORγt mRNA表达水平高于对照组,且外周血IL-17水平与MG严重程度呈正相关。

Objective To study the changes of IL-17 and RORγt in myasthenia gravis （MG）. Methods Eighty Chinese MG patients were divided into 4 groups according to Osserman classification： ocular type group （20 patients）, mild systemic type group （24 patients）, moderate systemic type group （20 patients）, and acute severe type group （16 patients）. Thirty healthy Chinese volunteers were included as normal controls. Concentration of IL-17 in plasma was measured by ELISA to assess the relationship between IL-17 and the severity of MG. The expression of the specific transcription factor ROR）＇t mRNA of Thl7 cells was measured by RT-PCR from peripheral blood. Results The levels of IL-17 in ocular type group, mild systemic type group, moderate systemic type group, and acute severe type group were （17.87±9.28） ng/L, （33.05±11.95） ng/L, （50.49±12.37） ng/L, and （58.18±16.11） ng/L; the level of IL-17 in normal controls was （4.70±2.18） ng/ L. The levels of IL-17 in each MG group were significantly increased compared with normal controls （P〈0.05）. The levels of RORγt mRNA in ocular type group, mild systemic type group, moderate systemic type group, and acute severe type group were 0.99±0.45, 1.68±0.59, 2.48±0.58, and 3.43±0.53; the levels of RORyt mRNA in normal controls was 0. 69±0. 22. The levels of RORγt mRNA in mild systemic type group, moderate systemic type group, and acute severe type group were significantly increased compared with normal controls （P 〈0.05）. The level of IL 17 was higher in mild systemic type group than that of ocular type group, higher in moderate systemic type group than mild systemic type group and ocular type group, higher in acute severe type group than mild systemic type group and ocular type group, the difference in the four MG groups were all statistically significant （F= 96.12, P〈0.05）. The level of RORγt mRNA was higher in mild systemic type group than that of ocular type group, higher in moderate systemic type group than mild systemic type group and ocular type group, higher in acute severe type group than the moderate systemic type group, mild systemic type group and ocular type group; the differences in the four MG groups were all statistically significant （F= 109.82, P〈0.05）. The level of IL-17 was positively correlated with severity of MG （ r=0. 867, P〈0.05）. Cenelusiens The levels of IL 17 and RORγt in MG were significantly elevated, the difference of the levels of II.-17 and RORγt in the four MG groups were statistically significant. The levels of IL 17 were positively correlated with the severity of MG.