慢性阻塞性肺病稳定期患者外周血Th17/Treg失衡情况及与预后的关系

Roles of peripheral Th17/Treg in patients with stable chronic obstructive pulmonary disease

目的:观察慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)稳定期患者外周血中Th17与Treg细胞的水平。方法:选取本院2010年1月-2012年12月间确诊的40例COPD稳定期患者,选取同期40例健康体检健康人群作为对照组,收集两组人群的外周血后采用流式细胞术检测各个人群Th17与Treg细胞亚群的比例,采用ELISA法检测血清中的IL-17、TGF-β水平,采用RT-PCR检测转录因子RORγT与Foxp3mRNA水平。结果:COPD稳定期患者外周血中Th17比例为(3.14±0.31)%,显著高于对照组人群的(1.23±0.24)%,差异有统计学意义(P<0.05);COPD稳定期患者外周血中Treg比例为(6.27±0.32)%,显著高于对照组人群的(3.43±0.32)%,差异有统计学意义(P<0.01);COPD稳定期患者外周血中IL-17水平为(89.36±4.13)pg/mL,显著高于对照组的(30.35±2.53)pg/mL,差异有统计学意义(P<0.05);COPD稳定期患者外周血中TGF-β水平为(681.45±41.65)pg/mL,显著高于对照组人群的(519.36±30.43)pg/mL,差异有统计学意义(P<0.01);COPD稳定期患者外周血转录因子Foxp3与RORγT mRNA水平均显著高于对照组人群,差异有统计学意义(均P<0.01)。COPD稳定期患者Th17、Treg比例高水平的住院天数和病死率均高于对应低水平亚组(P<0.05)。结论:Th17、Treg细胞及IL-17、TGF-β水平在COPD稳定期患者外周血表达增加,且转录因子Foxp3与RORγT mRNA水平表达增加,提示其与COPD患者的预后有关,其外周血中Th17与Treg细胞的不平衡可能参与了COPD发病和病程的进展。

AIM：To observe the level of Th17 and Treg cells in peripheral blood of stable chronic obstructive plumonary disease （COPD） patients.METHODS：Froty patients that were diagnosed as COPD were selected as expperiment group from January 2010 to December 2012,another 40 healthy people were selected as control group at the same period.Peripheral blood was collected from two groups to analyze Th17 and the proportion of Treg cell subset by flow cytometry,to detect serum IL-17,TGF-β by ELISA,and detected the transcription factor Foxp3 and RORγT mRNA by RT-PCR.RESULTS：The percentage of Th17 in peripheral blood of SCOPD patients was （3.14±0.31）%,significantly higher than （1.23±0.24）% in control group,the difference was statistically significant （P〈0.05）; proportion of Treg in peripheral blood of SCOPD patients was （6.27± 0.32）%,significantly higher than that in the control group （3.43 ± 0.32） %,the difference was statistically significant （P〈0.01）; SCOPD patients with levels of IL-17 （89.36±4.13） pg/ mL,significantly higher than the control group （30.35±2.53） pg/mL,the difference was statistically significant （P 〈 0.05） ; SCOPD patients with the TGF-β levels （681.45±41.65） pg/mL,significantly higher than the population of control group （519.36 ± 30.43） pg/mL,the difference there was statistically significant （P〈 0.01） ; SCOPD patients with transcription factor Foxp3 and RORγT mRNA levels were significantly higher the control group,the difference was statistically significant （all P 〈 0.01）.CONCLUSION：Th17,Treg cells and IL-17,TGF-β levels in SCOPD patients increased and the transcription factor Foxp3 and RORγT mR-NA expression levels also increased.They played an important role in clinical research.