IL-21在原发性胆汁性肝硬化发病机制中的作用

Role of IL-2 1 in the Pathogenesis of Primary Biliary Cirrhosis

目的：探讨白细胞介素-21（IL-21）在原发性胆汁性肝硬化（PBC）发病机制中的作用。方法2011年1月～2014年1月选取深圳市宝安区福永人民医院和深圳市第三人民医院首诊的38例PBC患者为研究对象，选取35例健康体检者为对照组，酶联免疫吸附法（ELISA）测定两组血清 IL-21，IL-17水平，流式细胞仪测定两组外周血辅助性 T淋巴细胞17（Th17）、调节性T淋巴细胞（Treg）的比率。另通过建立体外试验分析丙酮酸脱氨酶复合体 E2亚基（PDC-E2）多肽与Th17及Treg 细胞水平的关系。结果 PBC 组 IL-17，IL-21，Th17，Th17／Treg 和 Treg 分别为（18.23±4.12）ng／L，（512.25±18.25）ng／L，（3.98±0.98）％，（39.25±3.25）％和（3.11±0.85）％，对照组分别为（7.89±3.26）ng／L，（212.98±21.52）ng／L，（0.92±0.21）％，（12.98±3.12）％和（8.36±1.12）％，差异有统计学意义（t＝8.886，7.021，4.448，10.112，5.125；P值均＜0.05）。体外试验表明，加入 IL-21的培养体系中，Th17（2.41±0.82）％，Th17／Treg 细胞比例（32.98±3.12）％显著高于空白对照组（0.98±0.21）％，（12.25±3.25）％，而 Treg（4.75±0.68）％则低于空白对照组（11.85±0.96）％，差异有统计学意义（t＝8.521，6.489，8.236；P＜0.05）。结论 IL-21水平升高与 PBC发病具有密切的关系，其可通过促进PDC-E2反应而引起Th17／Treg免疫失衡，从而介导PBC的发生。

Objective To investigate the pathogenesis of interleukin-21 （IL-21）role in primary biliary cirrhosis （PBC）.Meth-ods 38 cases of PBC were selected for the study.35 caeses of healthy subjects were selected as the control group in January 2012 to January 2014 from Shenzhen Fuyong People’s Hospital of Baoan District and the Third People’s Hospital of Shenz-hen.The levels of IL-21,IL-17 of two groups were measured with Enzyme-linked immunosorbent assay （ELISA）.The levels of T helper lymphocytes 17 （Th17）,regulatory T cells （Treg）cells ratios of two groups were measured with flow cytome-try.The relationship of IL-2 1 and liver function were analyzed with pearson correlation.Another analysis of pyruvate through the establishment of in vitro deaminase complex E2 subunit （PDC-E2）peptides relationship with Th17 and Treg cell.Results The levles of IL-17 （18.23±4.12）ng/L,IL-21 （512.25±18.25）ng/L,Th17 （3.98±0.98）%,Th17/Treg （39.25±3.25）% of PBC group were significantly higher than the control group （7.89±3.26）ng/L,（212.98±21.52）ng/L,（0.92±0.21）% and （12.98±3.12）%,while the PBC group Treg （3.11±0.85）% were lower than the control group （8.36±1.12）%.IL-21 were positive correlation with IL-17,Th17 （t=8.886,7.021,4.448,10.112,5.125,P＆lt;0.05）.In vitro experiments showed that the addition of IL-21 in the culture system,the levels of Th17 （2.41±0.82）%,Th17/Treg cells（32.98±3.12）% were significantly higher than the control group（0.98±0.21）%,（12.25±3.25）%,while Treg （4.75 ±0.68）% were lower than the control group（11.85±0.96）%,the difference was statistically significant （8.521,6.489, 8.236,P＆lt;0.05）.Conclusion IL-21 levels increased with the pathogenesis of PBC has a close relationship,which can pro-mote the reaction of PDC-E2 Th1 7/Treg immune imbalance caused thereby occurs mediated by PBC.