急性加重期支气管扩张症患者血清白细胞介素13的表达及其基因多态性的意义

Expression of serum interleukin-13 and significance of gene polymorphism on the patients with bronchiectasis in acute exacerbation period

目的探讨急性加重期支气管扩张症患者血清白细胞介素13（IL-13）的表达及其基因多态性的意义。方法纳入2014年12月至2016年3月于福建省立医院呼吸科病房住院的急性加重期支气管扩张患者43例（支扩加重组）及同期进行健康体检者33名（对照组），皆抽取空腹外周血5ml，采用酶联免疫吸附测定（ELISA）法测定其血清IL-13，采用聚合酶链反应（PCR）结合基因测序方法检测两组人群IL-13基因＋1923C／T、＋2044G／A基因多态性。43例患者中病情好转30例（支扩好转组），于入院后1周抽取空腹外周血3ml采用ELISA法测定其血清IL-13。分析比较支扩加重组与对照组的血清IL-13及基因多态性及急性加重期与好转期的血清IL-13变化。结果支扩加重组IL-13水平显著低于对照组[（31．1±26，3）比（70．6±53．6）μg/L，P〈0．05]；＋1923位点等位基因c、T频率在两组间分布差异无统计学意义（x2=0．915，P〉0．05），支扩加重组等位基因C、T的频率为79．1％、20．9％；IL-13基因＋1923C／T与＋2044G／A显著相关（R2=0．835，P〈0．001）；支扩加重组T携带基因组的血清IL-13与CC基因组之间的差异及A携带基因组的血清IL-13与GG基刚组之间的差异均无统计学意义（均P〉0．05）。结论急性加重期支气管扩张患者血清IL-13特异性下降；但IL-13基因＋1923C／T、＋2044G／A基因多态性与支气管扩张易感性无显著相关性。

Objective To explore the expression of serum interleukin-13 （IL-13） and significance of its gene polymorphism on the patients with acute exacerbation of bronchiectasis in acute exacerbation period. Methods Forty-three patients with bronchiectasis in acute exacerbation period admitted into the respiratory ward of Fujian Provincial Hospital from December, 2014 to March, 2016 were included as bronchiectasis group. Thirty-three healthy controls from normal people of health examination were included as control group during the corresponding period. A total of 5 ml fasting peripheral blood sample was extracted from each individual. The IL-13 levels were determined by enzyme-linked immunosorbent assay （ELISA）. IL-13 gene polymorphisms in ＋1923 C/T site and ＋2044 site were genotyped in these two groups by using polymerase chain reaction （PCR） combined with gene sequencing methods. About 7 days aider admission, thirty patients with improved condition among the 43 patients were included as bronchiectasis improvement group, all had the extraction of 3 ml peripheral blood for IL-13 detection determined by ELISA. The expression of serum IL-13 and gene polymorphisms between bronchiectasis group and control group were analyzed statistically. The changes of serum IL-13 between bronchiectasis group and bronchiectasis improvement group were also analyzed statistically. Results The serum IL-13 level was lower in the bronchiectasis group in acute exacerbation period than that of the healthy controls [ （ 31.1 ± 26. 3 ） vs （70. 6 ± 53.6 ） μg/L, P 〈 0. 05 ] . There was no significant difference of the genotype distribution in ＋1923C/T site of IL-13 gene between the two groups （X2 = 0. 915, P 〉 0. 05）. In the bronchiectasis group, the C and T allele frequencies at ＋1923 site of IL-13 gene were 79.1% and 20. 9%, respectively, and its single nucleotide polymorphism （SNP） was in strong linkage disequilibrium with the SNP IL-13 ＋204gG/A site （R2 = 0. 835, P 〈 0. 001 ）. There was no significant difference of the serum IL-13 between allele T1 groups and allele CC group, and also no significant difference between allele A_ groups and allele GG group （P 〉 0.05 ）. Conclusion The IL-13 levels decreased specifically in the bronchiectasis group in acute exacerbation period, but IL-13 ＋1923 C/T and ＋2044 G/A polymorphisms are not significantly related to the susceptibility of bronchiectasis.