Th17、Treg、IL-23和IL-17对强直性脊柱炎发病发展过程的影响

Effect of methylprednisolone therapy on T cell subsets and its cytokines of peripheral blood in patients with ankylosing spondylitis

目的探讨强直性脊柱炎(Ankylosing Spondylitis,AS)患者外周血Th17/Treg及IL-23/IL-17水平及甲基泼尼松龙对其水平的影响。方法前瞻性收集AS患者50例作为研究组,同时收集50例健康成人作为对照组,比较两组患者Th17、Treg、IL-23和IL-17mRNA表达水平。给予研究组甲基泼尼松龙治疗,比较研究组治疗前后Th17、Treg、IL-23和IL-17mRNA表达水平。结果与对照组比较,研究组IL-23mRNA表达水平显著升高(0.42±0.21vs.0.05±0.02,P=0.000);IL-17mRNA表达水平显著升高(0.97±0.56vs.0.23±0.13,P=0.000);Th17(%)水平显著升高(0.95±0.35vs.0.61±0.24,P=0.000);Treg(%)水平显著降低(1.35±0.73vs.2.64±1.64,P=0.000)。与治疗前相比,治疗结束后AS患者IL-23mRNA表达水平显著降低(0.21±0.09vs.0.42±0.21,P=0.000);IL-17mRNA表达水平显著降低(0.45±0.21vs.0.97±0.56,P=0.000);Th17(%)水平显著降低(0.74±0.24vs.0.95±0.35,P=0.002);Treg(%)水平显著升高(2.11±0.98vs.1.35±0.73,P=0.000)。Th17、IL-23和IL-17mRNA表达水平与Bath AS疾病活动度指数、Bath AS功能指数明显正相关(P<0.05);Treg与Bath AS疾病活动度指数、Bath AS功能指数明显负相关(P<0.05)。结论 Th17、Treg、IL-23和IL-17平衡失调可能参与了AS的发病与发展过程。

Objective To investigate the level of Th17,Treg,IL-23 and ILl7 in patients with ankylosing spondylitis （AS） and the influences of methyl prednisolone on these. Methods Fifty patients with AS were prospectively enrolled in this study as a study group while 50 healthy adults were enrolled as a control group. The Th17, Treg, IL-23 and IL17 mRNA were compared. Moreover, methyl prednisolone were given to the study group, and the level of Thl7, Treg,IL- 23 and IL17 mRNA of before treatment and after treatment were compared as well. Results When compared with the control group, patients in the study group got a significantly higher level of IL-23 mRNA （0.42±0.21 vs. 0.05 ± 0.02, P=0. 000） ;a significantly higher level of IL17 mRNA （0.97±0.56 vs. 0.23±0.13,P=0. 000） ;a significantly higher level of Th17（M） （0.95±0.35 vs. 0.61±0.24,P=0. 000） significantly higher level of Treg （%） （2.11±0.98 vs. 1.35 ± 0. 73,P= 0. 000）. When compared with AS patients before treatment,patients after the finish of treatment got a significantly lower level of IL-23mRNA （0.21-±0.09 vs. 0. 42±0. 21, P= 0. 000） ;a significantly lower level of IL-17 mRNA （0.45±0.21 vs. 0.97±0.56,P=0. 000）;a significantly lower level of Th17 （%） （0. 74±0. 24 vs. 0. 95± 0.35,P=0. 002）;a significantly higher level of Treg （±） （2.11±0.98 vs. 1.35±0.73,P=0. 000）. Th17,IL-23 and IL-17 mRNA were all positive associated with the Bath Ankylosing spondylitis disease activity index and Bath Ankylosing Spondylitis Functional Index （P〈0. 05） ,while Treg was negative associated withthe Bath Ankylosing spondylitis disease activity index and Bath Ankylosing Spondylitis Functional Index （P〈 0. 05）. Conclusion The imbalance of Th17/Treg and IL-23/IL-17 may be involved in the pathogenesis and development of AS.