雌激素及其受体与IL-17在HPV16持续感染阶段的表达研究

Expression of IL-17 and estrogen and its receptor in HPV16 continuously infected patients

目的探讨雌激素、雌激素受体及白介素-17(IL-17)在人乳头瘤病毒(HPV)感染与清除过程中的作用。方法选取上海市浦东新区人民医院2014年8月至2017年1月门诊或住院部宫颈细胞学正常、HPV阴性或单一人乳头瘤病毒16型(HPV16)阳性的患者,采用宫颈TCT对所有研究对象进行细胞学检测,反向斑点杂交技术进行HPV亚型分析及实时荧光PCR进行HPV16 DNA定量;用酶联免疫吸附试验(ELISA)方法检测血清中雌激素(E2)水平及宫颈灌洗液中IL-17浓度,免疫组化检测雌激素受体(ER)表达水平。上述实验每3个月重复一次。按照HPV16感染结局的不同,将实验分为HPV阴性组、HPV16清除组和HPV16持续感染组。结果将所有研究对象最后一次检查结果与第一次检查结果对比发现,HPV阴性组、HPV16清除组及HPV16持续感染组之间E2比较,差异无统计学意义(P>0.05),ER在各组之间的差异也不明显,差异均无统计学意义(P>0.05)。IL-17表达浓度差在HPV阴性组与HPV16持续感染组间差异无统计学意义,二者与HPV16清除组之间IL-17浓度差异显著,HPV16清除组中IL-17浓度明显增高。结论在细胞学正常,而仅为HPV16感染阶段,内源性E2及宫颈局部组织中的ER可能并没有发挥作用,抑或E2或ER对HPV感染影响不大,而局部免疫因子IL-17在HPV16清除过程中发挥了重要作用,IL-17浓度的增加有利于HPV16的清除。

Objective To understand the role of estrogen,estrogen receptor and IL-17 in human papillomavirus（ HPV） infection and clearance. Methods We selected the clinic or the hospitalized patients in People＇s Hospital of Pudong New District hospital with HPV negative or single-HPV16 positive during the period of August 2014 to January 2017. Cervical exfoliated cells were harvested by Thinprep cytologic test（ TCT）. The reverse spot hybridization technique was carried out for HPV subtype analysis. RT-PCR was employed for HPV16 DNA viral load. The levels of E2 and IL-17 were detected by ELISA. Immunohistochemical was used to detect ER expression. The experiments were repeated every three months. According to the difference in the outcome of human papilloma virus 16 infection,the experiment was divided into three groups. The first group was HPV negative,which was negative for one year. The second group was HPV16 positive,but within one year the difference was gradually cleared. The third group was HPV16 positive,but the HPV16 persistently existed after one year. Results The results of the last test were compared with the first test results. We found that There was no significant difference among the three groups in the expression of E2 and ER. Also,there was no significant difference between the HPV negative group and the HPV16 persistently infected group in variation of IL-17 concentration. But the difference between the HPV16 cleared group and the anyone of the two groups above was significantly. The variation of IL-17 concentration was significantly higher in the HPV16 cleared group. Conclusion In normal cytology,and only HPV16 infected stage,endogenous E2 and ER of cervix may not play a role in HPV infection,or they may have little effect on HPV infection. Local immune factor IL-17 plays an important role in the process of HPV16 removal,and the increase of IL-17 concentration can help to eliminate HPV16.