T_H17细胞及IL-17在原发性抗磷脂综合征中的表达及临床意义

Expression and clinical significance of T_H17 cells and its related cytokine IL-17 in primary antiphospholipid syndrome

目的观察T_H17细胞及相关细胞因子IL-17在原发性抗磷脂综合征(PAPS)中的表达水平,并初步探讨其临床意义。方法收集32例PAPS患者及33例健康对照者静脉血标本,分离外周血单个核细胞(PBMC),流式细胞术检测T_H17细胞百分率,ELISA法检测血浆IL-17的表达水平,并分析IL-17水平与PAPS患者临床病理特征及实验室指标[抗心凝脂抗体(a CL)、抗β2糖蛋白Ⅰ(β2GPⅠ)和狼疮抗凝物(LA)]的关系。结果 PAPS患者外周血T_H17细胞百分率为(1.98±0.78)%,血浆IL-17水平为(60.72±18.71)pg/m L,均显著高于健康人对照组(P均<0.01),且T_H17细胞百分率与血浆IL-17水平呈正相关(r=0.586,P<0.01)。PAPS患者血浆IL-17水平与患者a CL、抗β2GPⅠ抗体和LA均无明显相关性(P均>0.05)。与近期(≥3月)无相关临床事件发生的PAPS患者相比,新近(≤1月)发生动脉血栓事件的患者血浆IL-17水平差异无统计学意义(P=0.074),静脉血栓和血小板减少的PAPS患者IL-17蛋白水平显著升高(P<0.01)。结论 T_H17细胞及IL-17与PAPS血栓形成和血小板减少密切相关,提示T_H17细胞及IL-17参与了PAPS脉管症状的发病机制。

Objective To investigate the expression levels of T_H17 and its related cytokine interleukin 17（ IL-17） in the patients with primary antiphospholipid syndrome（ PAPS）, and its clinical significance. Methods The peripheral blood mononuclear cells（ PBMC） were collected from 32 patients with PAPS and 33 healthy controls. The percentage of TH17 cells was detected by flow cytometry,and the plasma IL-17 levels were determined by ELISA. The correlations of plasma IL-17 levels with clinical patho-characteristics and laboratory markers such as anticardiolipin antibody（ a CL）,anti-β2glycoprotein Ⅰ（ β2GPⅠ） antibody and lupus anticoagulant（ LA） were further analyzed. Results The percentage of TH17 cells in peripheral blood [（ 1. 98 ± 0. 78） %] and the plasma IL-17 levels [（ 60. 72 ± 18. 71） pg / m L]in PAPS patients were significantly higher than those in healthy controls（ all P〈0. 01）. Moreover,there was a significant positive correlation between the percentage of TH17 cells and plasma IL-17 levels in PAPS patients（ r = 0. 586,P〈0. 01）. The plasma IL-17 levels were not related to a CL,anti-β2GPⅠ anyibody and LA levels in PAPS patients（ P〉0. 05）. The plasma IL-17 levels in PAPS patients with newly arterial thrombosis（ ≤1 month） were higher than that in patients without clinical events recently（ ≥3 months）（ P = 0. 074）,and the plasma IL-17 levels in PAPS patients with newly venous thrombosis and thrombocytopenia increased significantly（ P〈0. 05）. Conclusion TH17 and its related cytokine IL-17 are closely related to thrombosis and thrombocytopenia in PAPS patients,indicating that TH17 / IL-17 may participate in the occurrence of vascular changes in PAPS patients.