高压氧治疗溃疡性结肠炎患者的疗效及对Th17/Treg细胞免疫调节的影响

Effect of hyperbaric oxygen therapy on treatment of patients with ulcerative colitis and its influence on immune regulation of Th17/Treg cells

目的探讨高压氧治疗溃疡性结肠炎(UC)患者的疗效及其对外周血Thl7细胞(CD4+IL-17+T细胞)与Treg细胞(CD4+CD25+T细胞)数量的影响。方法选择74例UC患者,随机分为柳氮磺胺吡啶组(对照组)38例和高压氧联合柳氮磺胺吡啶组(高压氧组)40例。治疗4周后,比较2组总有效率,同时采用流式细胞仪检测治疗前后CD4+IL-17+T细胞与CD4+CD25+T细胞的表达百分比。结果 2组患者在治疗前外周血Thl7细胞所占比例、Treg细胞所占比例、Th17/Treg细胞的比值差异均无统计学意义(t=1.747,0.149,0.091,P>0.05)。治疗后,2组患者外周血Thl7细胞所占比例均明显下降(t=14.679,17.486,P<0.01),Treg细胞所占比例均明显升高(t=9.85,13.042,P<0.01),而Th17/Treg细胞的比值则下降(t=12.5,9.09,P<0.01)。高压氧组Thl7细胞所占比例下降程度、Treg细胞所占比例升高程度以及Th17/Treg细胞的比值下降程度较对照组更为明显(t=9.076,8.638,2.227,P<0.05)。结论 Th17/Treg失衡可能参与UC的发生发展,而HBO联合柳氮磺胺吡啶正是通过调节Th17/Treg的失衡关系,改善免疫抑制功能,抑制炎症因子的释放来达到抗炎-促炎平衡的治疗作用,这可能是其治疗UC的免疫调节重要机制之一。

Objective To explore the effect of hyperbaric oxygen therapy on treatment of ulcerative colitis （UC） and its influence on immune regulation of Thl7/Treg cells.Methods 74 UC patients were randomly divided into sulfasalazine group （control group,38 cases） and hyperbaric oxygen combined with sulfasalazine group （HBO group,40 eases）.After 4 weeks of treatment,the total efficacy was compared between two groups,and meanwhile CD4＋ IL-17＋ T cells and CD4 ＋ CD25 ＋ expressions before and after treatment were detected by flow cytometry.Results Before treatment,there were no significant differences of the proportion of the peripheral blood Thl7 and Treg cell percentage between two groups （t =1.747,0.149,0.091,P 〉0.05）.After treatment,the Thl7 cells in peripheral blood decreased significantly （t =14.679,17.486,P all〈 0.01）,Treg cells increased significantly （t =9.85,13.042,P〈0.01）,and the ratio of Th17/Treg cells decreased significantly （t =12.5,9.09,P 〈 0.01）.In hyperbaric oxygen group,Thl7 cells decreased,the ratio of Treg cells increased and Th17/Treg cells decreased much more greater than the control group （t =9.076,8.638,2.227,P〈0.05）.Conclusion Th17/Treg imbalance may be involved in the development of UC,and HBO combined with sulfasalazine plays a therapeutic role in regulating Th17/Treg unbalanced relationship,improving immune suppression and inhibiting the release of inflammatory cytokines,and of which might be one of its important mechanism for UC treatment.