脾氨肽对结缔组织病相关间质性肺疾病的免疫调节治疗作用被引量：5

The Immunomodulatory Effects of Spleen Aminopeptide on Connective Tissue Disease-Related Interstilial Lung Disease

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摘要目的探讨结缔组织病相关间质性肺疾病(CTD-ILD)治疗中脾氨肽的免疫调节和抗肺纤维化作用。方法纳入2014年2月至2015年5月于我科就诊的90例CTD-ILD患者,随机分为常规治疗组(n=44)和脾氨肽治疗组(n=46),脾氨肽治疗组在同常规治疗组治疗基础上加用脾氨肽治疗12周。比较两组治疗前后免疫亚群与细胞因子表达谱改变以及肺部高分辨CT(HRCT)和肺功能变化,同时监测人巨细胞病毒(HCMV)阴转率,并随访治疗后6个月内呼吸道感染情况。结果脾氨肽治疗组肺功能及影像学较治疗前明显改善(P<0.05),调节性T细胞(Treg)、γ干扰素(IFN-γ)较治疗前显著上升;而常规治疗组上述指标并无明显改善,且白细胞介素6(IL-6)和IL-17水平明显高于脾氨肽治疗组(P<0.05)。脾氨肽治疗组HCMV阴转率明显高于常规组,随访期间呼吸道感染率显著低于常规组,应用脾氨肽治疗未见明显不良反应。结论脾氨肽联合常规治疗能够有效调节CTD-ILD紊乱的免疫微环境,抑制HCMV在体内的激活复制,进而可促进肺内炎症微环境的消散,阻止纤维化进展。 Objective To explore the therapeutic effects of spleen aminopeptide on connective tissue disease-related interstitial lung disease（ CTD-ILD） and its mechanism for anti-fibrosis. Methods Ninety patients with CTD-ILD admitted between February 2014 and May 2015 were recruited in the study.The CTD-ILD patients were randomly divided into group A（ conventional therapy alone） and group B（ conventional therapy plus spleen aminopeptide）. Peripheral blood collected from CTD-ILD patients were subjected to performance of flow cytometric analysis and cytokine / chemokines profiling by liquid Chip and ELISA assay. Pulmonary function test and high resolution CT（ HRCT） scan were performed before and after the treatments for 12 weeks. Human cytomegalovirus（ HCMV） DNA in the patients＇ blood was tested by Q-PCR. Results Significantly improved lung function and HRCT score were observed in group B,but not in group A. The levels of Treg and IFN-γ were significantly increased in group B,compared with those in group A where markedly increased IL-6,IL-10 and IL-17 were detected（ P〈 0. 05）. There was higher virus negative reversal rate in group B than that in group A（ P〈 0. 05）. Conclusion Spleen aminopeptid can effectively regulate deregulated immune microenvironment in CTD-ILD patients and inhibit HCMV replication,thereby block pulmonary fibrotic development.

作者吴彩云罗群王薇汪延生陈强于宝丹刘明张欢欢郑丽霞徐军

机构地区广州医科大学附属第一医院广州呼吸疾病研究所呼吸疾病国家重点实验室

出处《中国呼吸与危重监护杂志》 CAS 北大核心 2016年第3期222-226,共5页 Chinese Journal of Respiratory and Critical Care Medicine

基金国家自然科学基金(编号:81490530)

关键词结缔组织病相关间质性肺疾病脾氨肽人巨细胞病毒免疫调节 Connective tissue disease-related interstitial lung disease Spleen aminopeptid Human cytomegalovirus Immunomodulation

分类号 R563 [医药卫生—呼吸系统]

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