支气管哮喘患者血清中Th17细胞相关细胞因子的检测及意义

Detection and Significance of Serum Th17 Cell Related Cytokines in Patients with Bronchial Asthma

目的:比较规范治疗后的气道阻塞程度不同的支气管哮喘(哮喘)患者血清中的转化生长因子-β1(transforming growth factor-β1,TGF-β1)、白细胞介素-17(interleukin-17,IL-17)、白细胞介素-23(interleukin-23,IL-23)等指标,探讨上述指标在哮喘患者气道重塑中的意义。方法:采用病例对照的方法收集规范治疗至少3个月的哮喘患者91例。以第1秒用力呼气量占预计值百分比(FEV1%pred)作为分组标准,将91例哮喘患者分为轻度组(FEV1%pred≥80%)、中度组(60%<FEV1%pred<80%)、重度组(FEV1%pred≤60%)。选取同期27例健康体检者作为对照组。检测并比较各组血清中的TGF-β1、IL-17、IL-23水平。结果:(1)哮喘组与对照组比较,血清TGF-β1水平较高,IL-17水平较低,两组间血清IL-23水平的差异无统计学意义。(2)各哮喘组间比较,轻度组血清TGF-β1、IL-17水平与中、重度组的差异有统计学意义(P<0.05),中度组与重度组间差异无统计学意义;轻、中、重度组间血清IL-23水平的差异无统计学意义。(3)血清IL-17水平与血清TGF-β1水平呈负相关;FEV1%pred与血清TGF-β1水平呈负相关,与血清IL-17水平呈正相关,与血清IL-23水平不相关。结论:哮喘患者血清TGF-β1与FEV1%pred呈负相关,表明TGF-β1是重要的气道重塑指标。哮喘患者血清IL-17低于健康人,且气道阻塞越严重,IL-17降低越显著;这可能是由于持续的气道炎性反应可抑制IL-17的分泌和表达,使其在肺功能损害、严重气道重塑阶段的表达水平下降。

Objective：To compare the serum levels of transforming growth factor-β1 （TGF-β1）,interleukin-17 （IL-17）,inter-leukin-23 （IL-23）in patients with bronchial asthma at different degrees of airway obstruction after standardized treatment,in order to explore the significance of TGF-β1,IL-17,IL-23 in airway remodeling in patients with asthma.Methods：Ninety-one asthma patients,who underwent standardized treatment for at least three months,were recruited by applying control study.By using FEV1%pred as grouping criterion,the 91 patients with asthma were divided into the mild asthma group （FEV1%pred≥80%）,the moderate asthma group （60 %〈 FEV1 %〈 80%）and the severe asthma group （FEV1 %≤60%）.In addition, 27 healthy people were selected as control group.The serum levels of TGF-β1,IL-17,and IL-23 in each group were monitored and compared with each other.Results：1.Compared with that in the control group,the serum levels of TGF-β1 in asthma group were higher,while the levels of IL-17 were lower.There was no significant difference in serum IL-23 level between the two groups.2.Comparison were done among the asthma groups.There were significant differences in serum levels of TGF-β1 and IL-17 between mild asthma group and moderate-to-severe asthma group （P 〈 0.05 ）,while there were no significant differences between moderate group and severe group.3.Serum IL-17 level was correlated negatively with TGF-β1 level. FEV1%pred was correlated negatively with serum TGF-β1 level and positively with serum IL-17 level,while it had no correla-tion with serum IL-23 level.Conclusions：In patients with asthma,the serum TGF-β1 level is negatively correlated with FEV1%pred,which indicates that TGF-β1 is an important index for airway remodeling.The serum levels of IL-17 in patients with asthma is lower than those in healthy people.Furthermore,the decrease of serum IL-17 level is more significant while the obstruction is worse.The probable answer is that persistent airway inflammation inhibits secretion and expression of IL-17,so＆amp;nbsp;that the expression of IL-17 declines in phase with severe impairment of pulmonary function and severe airway remodeling.