系统性红斑狼疮患者血清IL-10和IL-17水平检测的临床意义

Clinical Significance of Serum IL-10 and IL-17in Patients with Systemic Lupus Erythematosus

目的通过系统性红斑狼疮(SLE)患者血清中IL-10和IL-17的水平,探讨SLE患者炎症反应情况及Treg细胞与Th17细胞在SLE发病中的作用。方法选取2013年7月~2015年7月南京医科大学附属苏州市立医院本部临床已经确诊的SLE患者54例为研究对象,同期健康体检者19例为对照组,采用酶联免疫吸附试验(ELISA)双抗体夹心法检测两组血清IL-10和IL-17水平,采用间接免疫荧光法及免疫印迹法测定SLE患者ANA,dsDNA及RNP,Sm,SSA,SSB,并对IL-10和IL-17水平进行比较及相关性分析,同时分析ANA,RNP,Sm,SSA和dsDNA分组IL-10和IL-17的水平差异。结果 SLE患者IL-10和IL-17水平为63.7±89.0pg/ml和87.7±123.0pg/ml,和对照组20.8±8.9pg/ml和18.5±111.6 pg/ml比较,差异有统计学意义(t_(IL-10)=3.484,t_(IL-17)=4.076,P均<0.01);SLE患者中IL-10和IL-17阳性组结果为176.5±93.2 pg/ml和237.2±107.5 pg/ml,阴性组为16.2±5.7 pg/ml和12.9±8.3 pg/ml,差异有统计学意义(t_(IL-10)=6.875,t_(IL-17)=8.843,P均<0.01);SLE患者IL-10与IL-17水平呈正相关关系(r=0.96,P<0.05)。ANA高滴度组IL-10和IL-17水平为91.8±100.8 pg/ml和135.5±140.9 pg/ml,ANA低滴度组为44.5±76.7 pg/ml和54.4±98.5 pg/ml,差异有统计学意义(t_(IL-10)=2.215,t_(IL-17)=2.345,P均<0.05)。抗ds-DNA抗体阳性组IL-10和IL-17水平为87.1±101.1pg/ml和122.4±137.1 pg/ml,抗ds-DNA抗体阴性组为27.4±50.1 pg/ml和28.6±61.6 pg/ml,差异有统计学意义(t_(IL-10)=2.904,t_(IL-17)=3.443,P均<0.05)。结论系统性红斑狼疮患者的抗炎细胞因子IL-10和促炎细胞因子IL-17的高水平及高度正相关,说明SLE患者抗炎和促炎反应同时存在,SLE患者Treg细胞与Th17细胞存在失衡,可能在SLE的发生和发展中同时起重要作用。

Objective To investigate the effect of Treg cells and Th17 cells on the pathogenesis of SLE in patients with SLE, by detecting levels of serum IL-10 and IL-17 in patients with systemic lupus erythernatosus （SLE）. Methods Selected 54 patients with SLE diagnosed in Suzhou Municipal Hospital Affiliated to Nanjing Medical University from July 2013 to July 2015 as subjects,and 19 healthy persons were selected as control group. Using double antibody sandwich method （ELISA） to detect the levels of IL-10 and IL-17 in two groups. Using indirect immunofluorescence and western blot method to detect ANA, dsDNA, RNP,Sm, SSA and SSB in patients with SLE. Then compared and correlation analysed the level of IL-10 and 11.-17, the levels of IL-10 and IL-17 in ANA, RNP, Sm, SSA and dsDNA groups were analyzed simultaneously. Results The level of IL-10 and IL-17 in SLE were 63.7±89.0 pg/ml and 87.7±123.0 pg/ml,and control group were 20. 84-8.9 pg/ml and 18.5±111.6 pg/ml,with the statistically significant difference （tIL-10 =3. 484 ,tIL-17 =4. 076,P〈0. 01）. The level of positive group in SLE were 176.5±93.2 pg/ml and 237.2±107.5 pg/ml,and negative group were 16.24-5.7 pg/ml and 12.9 ± 8.3 pg/ml, with the statistically significant difference （tm-17 = 6. 875, tIL-17 = 8, 848, P〈0.01）. The level of IL-10 was positively correlated with IL-17 level in SLE （r=0.96,P〈0.05）. The level of IL-10 and IL-17 in ANA high titer group were 91.8±100.8 pg/ml and 135.5±140.9 pg/ml,ANA low titer group were 44.5±76.7 pg/ml and 54.4＋98.5 pg/ml,with the statistically significant difference （tIL-10 = 2. 215, tIL-7 = 2. 345, P〈0.05）. The level of IL-10 and IL-17 in anti ds-DNA antibody positive group were 87.1± 101.1 pg/ml and 122.4±137.1 pg/ml, negative group were 27.4 ± 50.1 pg/ml and 28.6±61.6 pg/ml,with the statistically significant difference （tIL-10=2. 904,tIL-7 =3. 443,P〈0.05）. Conclusion The lev-els of IL-10 and IL-17 were significantly increased and there was positive correlation. It was explained that the anti-inflammatory and pro-inflammatory response existing at the same time in SLE patients and Treg cell and Th17 cell may also play an important role in the occurrence and development in SLE.