辅助性T细胞1、2及白细胞介素4、12在椎间盘突出症患者髓核组织中的表达

Expression of the Th1 cells, Th2 cells and related cytokines IL -12 and IL -4 in the lumbar disc herniation

目的探讨辅助性T细胞1（Th1）,辅助性T细胞2（Th2）及细胞因子白细胞介素12（IL-12）和白细胞介素4（IL-4）在椎间盘突出症患者髓核组织中的表达水平和临床意义。方法选取接受手术治疗的腰椎间盘突出症患者30例作为观察组,同时选取腰椎骨折需摘除椎间盘的患者10例作为对照组,运用流式细胞术检测Th细胞亚群中Th1和Th2的分布情况;酶联免疫吸附测定法（ELISA）测定髓核组织中Th1型细胞因子干扰素γ（IFN-γ）和IL-12的表达水平及Th2型细胞因子IL-4的表达水平;运用RTPCR检测Th1细胞转录因子STAT4以及Th2的转录因子STAT6的表达水平。结果与对照组比较,Th1、Th2细胞在观察组髓核中,细胞数量明显增加[（6.24±2.89）比（25.12±3.20）,t=16.26,P〈0.05;（2.68±0.58）比（8.16±1.20）,t=3.84,P〈0.05];Th1型细胞因子IL-12和IFN-γ在观察组体内表达水平高于对照组[（23.47±5.61）比（7.65±3.21）,t=8.422,P〈0.05;（1.52±0.87）比（5.34±1.39）pg/mL,t=8.135,P〈0.05];而在对照组织中未检测到Th2型细胞因子IL-4的表达;而在观察组中,IL-4在某些髓核组织中有一定的表达。且IL-12、IFNγ和IL-4在椎间盘突出症患者体内的表达呈负相关（r=-0.57,P〈0.05;r=-0.23,P〈0.05）;STAT4的表达水平在观察组患者髓核内明显高于对照组[（3.21±0.49）比（1.12±0.24）,t=13.15,P〈0.05],差异有统计学意义（P〈0.01）,而STAT6在腰椎间盘突出症患者与对照组差异无统计学意义（P〉0.05）。结论Th1和Th2细胞及其分泌的细胞因子在椎间盘突出症的发病机制中可能有重要的作用。

Objective To investigate the expression of T help cell 1（ Th1） , T help cell 2（ Th2） and relatedcytokines interleukin 12 （ IL -12） and interleukin 4 （ IL -4） in the lumbar disc herniation and their clinical significance.Methods 30 postoperative patients with lumbar disc herniation were included as observation group. The controlgroup included 10 patients with lumbar fracture. Flow cytometry was used to distinguish the Th1 and Th2 cells. ELISAwas used to measure the expression of interferon γ（ IFN - γ） , IL -12（ the cytokines secreted by Th1 cells） and IL -4（ the cytokine secreted by Th2 cells） . RT - PCR was used to detect the mRNA levels of STAT4 and STAT6. ResultsThe distribution of Th1/ Th2 cells was higher in patients with lumbar disc herniation compared to the control group[ （ 6. 24 ±2. 89） vs （ 25. 12 ±3. 20） , t =16. 26, P 〈0. 05; （ 2. 68 ±0. 58） vs （ 8. 16 ±1. 20） , t =3. 84, P 〈0. 05] .The levels of IFN - γ and IL -12 in the study group were significantly higher than the control group, the differenceswere statistically significant[ （ 23. 47 ±5. 61） vs （ 7. 65 ±3. 21） , t = 8. 422, P 〈 0. 05; （ 1. 52 ± 0. 87） vs （ 5. 34 ±1 39） , t =8. 135, P 〈0. 05] . The level of IL -4 was undetectable in the control group, however, IL -4 expressed inthe study group. The expressions of IL - 12, IFN - γ and IL - 4 in the study group were negatively correlated bySpearman correlation analysis （ r = -0. 57, P 〈0. 05; r = -0. 23, P 〈0. 05） . In addition, the mRNA level of STAT4was higher in patients with lumbar disc herniation compared to the control group[ （ 3. 21 ±0. 49） vs （ 1. 12 ±0. 24） ,t =13. 15, P 〈0. 05] . Conclusion The expressions of Th1 cells, Th2 cells and related cytokines were participated inthe pathogenesis of lumbar disc herniation.