多发性硬化患者外周血辅助性T细胞17比率和血清辅助性T细胞17相关细胞因子水平的Meta分析

Levels of peripheral T helper17 cells and serum T helper17-related cytokines in patients with multiple sclerosis: a Meta-analysis

目的本研究采用Meta分析的方法系统评估多发性硬化(MS)患者外周血辅助性T细胞17(Th17)比率及Th17相关细胞因子IL-17、IL-23在血清中的水平,从而明确Th17细胞是否参与了MS的发病过程。 方法在PubMed、Embase、Cochrane、WebofKnowledge、FDA.gov、ClinicalTrials.gov、中国知网数据库、万方数据知识服务平台数据库进行检索,对符合纳入标准的文献进行数据提取。本研究提取的数据为外周血中Th17细胞比率及Th17相关细胞因子IL-17、IL-23在血清中的浓度。该研究已经在PROSPERO平台注册(编号CRD42017059113)。使用Oxford Center for Evidence-Based Medicine指南(2011)评估纳入研究的证据水平,采用渥太华纽卡斯尔文献质量评价量表(病例对照研究)(NOS)对纳入的病例对照研究进行质量评估。该研究使用Stata12.0软件,采用随机效应模型对数据进行Meta分析。结果在检索出的587项研究中最终入选16项进行Meta分析。结果显示:与对照组相比,MS患者组的Th17细胞的比率有所增加[1.89%(1.10%,2.69%),P<0.01];与对照组相比,MS患者血清IL-17水平显著升高[2.77(1.77,3.77)pg/ml,P<0.01];MS患者血清IL-23水平高于对照组[2.96(1.51,4.40)pg/ml,P<0.01]。结论 与对照组相比,MS患者组外周血中Th17细胞比率升高,同时MS患者组血清IL-17、IL-23浓度也升高。表明Th17以及IL-17、IL-23可能在MS的发病过程中发挥了一定作用。

Objective To test whether T helper 17 (Th17) cells was involved in the pathogenesis of multiple sclerosis (MS) by conducting a meta-analysis of the researches documenting the levels of Th17 cells and Th17-related cytokines [interleukin (IL)-17, IL-23] in patients with MS.Methods We identified articles reporting proportion of Th17 cells and the serum levels of IL-17, IL-23 in MS patients by searching CNKI, Wanfang med online, Embase, PubMed, Cochrane, WebofKnowledge, Food and Drug Administration (FDA). gov, and ClinicalTrials.gov. We registered this study at the International Prospective Register of Systematic Reviews (PROSPERO) (number CRD42017059113). The evidence level of selected studies was identified by guidelines from the Oxford Center for Evidence-Based Medicine 2011. We employed the Newcastle-Ottawa Quality Assessment Scale (Case Control Studies) to perform the included resear. Stata 12.0 was adopted for processing Meta-analysis of the data by using a random effects model.Results A total 16 researches were included in our Meta-analysis from 587 identified studies. The proportion of Th17 cells [1.89%(1.10%, 2.69%),P<0.01] and the levels of serum IL-17 [2.77(1.77, 3.77) pg/ml, P<0.01] and IL-23 [2.96(1.51, 4.40) pg/ml, P<0.01] increased dramatically in MS individuals compared with control subjects.Conclusion The results of this Meta-analysis has demonstrated that MS patients have a higher proportion of Th17 cells in higher levels of serum IL-17 and IL-23 compared to control subjects, which has demonstrated that Th17 cells may play an vital role in the pathogenesis process of MS patients.