Treg/Th17细胞在不同时期慢性阻塞性肺疾病患者中的改变及意义探讨

Change and significance of regulatory T cell and Th17 cell in different stage of chronic obstructive pulmonary disease

目的 探讨CD4＋ CD25＋ CD127low调节性T细胞（Treg细胞）、Th17细胞特异性分泌因子IL-17在COPD急性加重期（AECOPD）及COPD稳定期中的改变及临床意义.方法 选取住院AECOPD患者26例,随访COPD稳定期患者20例,健康对照患者15例.流式细胞仪检测患者外周血CD4＋ CD25＋ CD1271.wTreg细胞比例、ELISA检测外周血IL-17浓度.结果 ①AECOPD组患者外周血Treg细胞比例较COPD稳定期组、对照组均明显升高[分别为（10.319±2.154）％,（6.406±1.498）％,（6.307±1.626）％;P＜0.05],COPD稳定期组患者Treg细胞比例高于对照组但差异无统计学意义;②A ECO PD组及COPD稳定期组外周血IL-17水平较对照组明显升高[分别为（0.813±0.233） ng/L,（0.547±0.157） ng/L,（0.408±0.169） ng/L;P＜0.001],AECOPD组IL-17水平高于COPD稳定期组（P＜0.01）,COPD稳定期组IL-17水平高于对照组（P=0.046）;③各组Treg细胞、IL-17水平与各指标之间未见相关性.结论 Treg细胞、IL-17在AECOPD及COPD稳定期中的水平异常说明在COPD的不同时期存在着不同的炎症,Treg/Th17细胞失衡可能导致COPD的免疫紊乱和慢性炎症持续.

Objective To explore the change and significance of CD4＋ CD25＋ CD127low regulatory T cell （Treg cell） and Th17 cell-specific cytokines：interleukin-17 （IL-17） in acute exacerated COPD and stable COPD.Methods Twenty-six inpatients with acute exacerbate COPD （AECOPD）,22 follow-up visit patients with stable COPD,and 15 healthy person as control group.Flow cytometry was used to detect the proportion of Treg cell in peripheral boood,ELISA method was used to detect the expresstion of IL-17 in peripheral boood.Results ① The proportion of Treg cell in group AECOPD increased significantly compared with group stable COPD and control group [（10.319 ± 2.154） %,（6.406 ± 1.498） %,（6.307± 1.626） %,P 〈 0.001].Group stable COPD is higher than control group,but there are no significance.②The level of IL-17 in peripheral boood in group AECOPD and group stable COPD increased significantly compared with control group [（0.813 ± 0.233） ng/L,（0.547 ±-0.157） ng/L,（0.408 ± 0.169） ng/L;P 〈 0.001],group AECOPD is higher than group COPD （P 〈 0.01）,group COPD is higher than control group （P =0.046）.③There was not correlated between the proportion of Treg cell and the level of IL-17 and other indicators in either group.Conclusions The abnormal of lever of regulatory T cell and IL-17 in AECOPD and COPD meant different inflammation may exist in different stage of COPD.The break of balance of Treg cell and Th17 cell may induce the disorder of immune and continue inflammation.