IL-33在隐球菌脑膜炎患者外周血单个核中的表达及临床意义

Expression of IL-33 in Patients with Cryptococcal Meningitis and Its Clinical Significance

目的探讨IL-33在隐球菌脑膜炎患者中的表达。方法纳入上海长海医院和长征医院2008年5月～2014年9月隐球菌脑膜炎患者28例，健康对照30例。分离外周血单个核细胞，采用实时荧光定量PCR检测IL-33mRNA表达量，ELISA法检测血清中IL-33蛋白浓度；同时采用流式细胞术检测外周血中Th1／Th2细胞亚群的百分比，并分析其与血清中IL-33浓度的相关性。结果隐球菌脑膜炎患者外周血单个核细胞及血清中IL-33水平明显增高（2．1±0．9VS1．0±0．2，U=136．0，P〈0．001；121．2±59．2VS56．7±19．7，U=141．0，P〈0．001）；外周血中Th1细胞比例降低（4．1±1．7VS5．9±1．6，U=191．0，P〈0．001），Th2细胞比例增高（2．8±0．9VS2．2±0．8，U=288．0，P〈0．05）；进一步分析发现血清中IL-33浓度与Th2细胞百分比正相关，差异具有统计学意义（R=0．69，P〈0．001）。结论IL-33可能参与了隐球菌脑膜炎的发病机制。

Objective To explore the expression of IL-33 in patients with cryptococcal meningitis. Methods 28 patients with cryptococcal meningitis admitted to Shanghai Changhai and Changzheng Hospital and 30 healthy controls from May 2008 to September 2014 were enrolled. Peripheral blood mononuelear cells （PBMCs） were separated. IL-33 mRNA expression was determination by quantitative real-time PCR. Serum IL-33 level was determined by ELISA. The percentage of Thl and Th2 cells was detected by flow cytometry,and their relation with serum IL-33 was analyzed. Results IL-33 mRNA and protein level were both increased in patients with ryptococcal meningitis （2.1 ± 0.9 vs 1.0 ±0.2, U = 136.0, P〈 0. 001 ; 121.2 ± 59.2 vs 56.7±19.7,U=141.0,P〈0. 001） ,compared to healthy controls. The percentage of Th1 cells （4.1±1.7 vs 5.9± 1.6,U=191.0,P〈0. 001） was decreased and Th2 cells （2.8±0.9 vs 2.2±0.8,U=288. 0,P〈0. 05） was increased,compared to healthy controls. Furthermore, serum IL-33 level was positively correlated with Th2 cells （R= 0.69,P〈0. 001）. Conclusion IL-33 may be involved in the pathogenesis of cryptococcal meningitis.