支气管哮喘患者诱导痰上清白细胞介素-17及38的表达水平及其临床意义

Expression levels and clinical significance of interleukin-17 and interleukin-38 in induced sputum supernatant from patients with bronchial asthma

目的探讨支气管哮喘患者诱导痰上清白细胞介素(IL)-17、IL-38水平及其临床意义。方法选取40例支气管哮喘患者作为观察组,40例健康体检者作为对照组,单次采集对照组患者的诱导痰上清,并分别于哮喘急性发作期与治疗缓解期时采集观察组的诱导痰上清。分别比较两组诱导痰上清中IL-17、IL-38水平,并分析观察组IL-17、IL-38与各肺功能指标间的相关性。结果观察组患者哮喘急性发作期时诱导痰上清中的IL-17水平高于缓解期水平及对照组,IL-38水平低于缓解期水平及对照组(P<0.05);观察组患者哮喘治疗缓解期时IL-38水平也低于对照组(P<0.05)。急性发作期,哮喘患者诱导痰上清中IL-17水平与IL-38水平呈负相关,IL-17水平与第1秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC、呼气流量峰值(PEF)、用力呼气50%肺活量的瞬间流量(FEF50%)、用力呼气75%肺活量的瞬间流量(FEF75%)、FEV1与预测值百分比、PEF与预测值百分比、FEF50%与预测值百分比呈负相关,IL-38水平与以上指标均呈正相关(均P<0.05)。而临床缓解期哮喘患者IL-17、IL-38水平与以上各肺功能指标均无相关性(P>0.05)。结论支气管哮喘患者诱导痰上清IL-17水平升高,IL-18水平降低,IL-17、IL-38可能参与哮喘的发病,且在一定程度上反映哮喘的严重程度。

Objective To investigate the levels and clinical significance of interleukin（IL）-17 and IL-38 in the induced sputum supernatant from patients with bronchial asthma. Methods Forty patients with bronchial asthma were enrolled as observation group, and 40 healthy individuals undergoing physical examination as control group. The induced sputum supernatant was collected once from patients in the control group, and was collected during the acute attach and the therapeutic remission period of asthma, respectively, from patients in the observation group. The levels of IL-17 and IL-38 in the induced sputum supernatant were compared separately between the two groups, then the correlations of IL-17 and IL-38 with puhnonary function indicators were analyzed in the observation group. Results The IL-17 level was higher and the IL-38 level was lower in the induced sputum supernatant from patients during the acute attach period of asthma in the observation group than the levels of patients during the therapeutic remission period or in the control group （P 〈 0. 05 ）, while the IL-38 level of patients during the therapeutic remission period of asthma in the observation group was lower than that in the control group （P 〈 0.05 ）. For patients during acute attach period of asthma,the IL-17 level negatively correlated with the IL-38 level in the induced sputum supernatant, and negatively correlated with forced expiratory volume in one second（FEV1 ） ,forced vital capacity（FVC） ,FEVI/FVC ratio,peak expiratory flow （PEF） ,forced expiratory flow at 50% of forced vital capacity（ FEFSO% ） ,forced expiratory flow at 75% of forced vital capacity （FEF75%）, FEV1% to predicted value ratio,PEF to predicted value ratio,and FEF50% to predicted value ratio as well,moreover,the IL-38 level positively correlated with the indicators above（ all P 〈 0. 05 ）. But neither the IL-17 level nor the IL-38 level correlated with pulmonary function indicators （P 〉0.05）. Conclusion The level of IL-17 increases while the level of IL-38 decreases in the induced sputum supernatant from patients with bronchial asthma. IL-17 and IL-38 might be involved in asthma attach ,which can indicate the severity of asthma to some extent.