辅助性T细胞22白细胞介素-22与类风湿关节炎及合并间质性肺疾病的相关性研究

Study on the relationship between T helper cells 22/interleukin-22 and rheumatoid arthritis with interstitial lung disease

目的探讨RA及合并间质性肺疾病（ILD）患者外周血辅助性T细胞22（Th22）数量和血清IL-22的水平及与临床指标的相关性。方法流式细胞术测定40例RA患者[合并ILD（RA．ILD）组和未合并ILD（RA-NILD）组各20例]和20名健康对照者外周血中Th22细胞的数量，ELISA法测定血清中IL--22的水平。统计分析采用t检验、秩和检验及直线相关分析。结果RA患者外周血Th22细胞数量[（0．15±0．07）％]，较健康对照组[（0．09±0．05）％]明显升高（f=4．097，P〈0．01）；RA患者血清IL-22水平[（83±7）ng／L]，较健康对照组[（61＋5）ng/L]明显升高（t=13．057，P〈0．01）。RA．ILD患者外周血Th22细胞数量[（0．18±0．07）％]明显高于RA．NILD组[（0．13±0．05）％]（t=2．919，P=0．008）；RA．ILD患者IL-22水平[（87±6）ng／L]，明显高于RA-NILD组[（80±6）ng／L]（t=3．624，P=-0．001）。RA患者外周血Th22细胞数量与ESR、RF及DAS28评分呈正相关关系（r值分别为0．336，0．377，0．577，P均〈0．05），RA患者血清IL-22水平与ESR及DAS28评分呈正相关关系（r值分别为0．406，0．576，P均〈0．05）。结论RA患者外周血Th22细胞数量及血清IL-22水平较健康对照组升高，Th22细胞数量和IL-22水平与患者ESR及DAS28呈正相关；RA-ILD患者外周血中Th22及IL-22水平较RA-NILD患者升高，提示Th22细胞及效应因子可能在RA及合并ILD的发病中有一定作用。

Objective To study the relationship between the T helper cells （Th22）/interleukin （IL）-22 and rheumatoid arthritis （RA） with interstitial lung disease （ILD）, and to define the clinical significance of Th22 cells for RA. Methods The quantity of Th22 cells in the peripheral blood from 40 patients with RA （20 RA with ILD, 20 RA without ILD） were examined by flow cytometry, the level of IL-22 in the sera was detected by enzyme-linked immunosorbent assay （ELISA）. Comparisons between groups were analyzed by t-test, rank sum test, and the correlation of parameters were tested by linear correlation analysis. Results The quantities of CD4＋ IL-22＋ cells （Th22） in RA patients [（0.15±0.07）%] were significantly higher than normal controls [（0.09±0.05）%] （t=4.097, P〈0.01）, and IL-22 levels in RA patients [（83＋7） ng/L] were significantly higher than normal controls [（61＋5） ng/L] （t=13.057, P〈0.01）. The quantities of Th22 cells in RA-ILD patients [（0.18±0.07）%] were significantly higher than RA-NILD patients [（0.13±0.05）%] （t=2.919, P=0.008）, and IL-22 levels in RA-ILD patients [（87±6） ng/L] were significantly higher than RA-NILD patients [（80±6）ng/L] （t=3.624, P=0.001）. The quantities of Th22 cells were positively correlated with erythrocyte sedimentation rate （ESR）, rheumatoid factor（RF） and 1.4 disease activity score （DAS）28 （r=0.336, 0.377, 0.577, P〈0.05）, and the level of IL-22 were also positively correlated with ESR and DAS28 （r=0.406, 0.576, P〈0.05）. Conclusion The quantities of Th22 cells and IL-22 level are increased in RA patients, especially in RA-ILD patients. The quantities of Th22 cells and IL-22 level are positively correlated with ESR and DAS28. It may play a certain role in RA especially in RA with ILD.