IL-17BR在炎症性肠病中的表达及其临床意义

Expression and Clinical Significance of IL-17BR in Inflammatory Bowel Disease

背景:炎症性肠病(IBD)目前尚无特效的治疗方式,其发病机制仍不明确。目的:探讨IL-17BR在IBD患者结肠黏膜和外周血单个核细胞(PBMC)中的表达情况及其临床意义。方法:收集40例克罗恩病(CD)患者、32例溃疡性结肠炎(UC)患者和25例健康对照者内镜结肠黏膜标本以及30例CD患者、27例UC患者和25例健康对照者的PBMC标本。采用免疫组化、流式细胞术分别检测结肠黏膜和PBMC中IL-17BR表达,并分析其与CRP、ESR以及CDAI、Mayo评分的相关性。采用ELISA法检测英夫利西单抗(IFX)治疗前后血清TNF-α浓度,并分析其与IL-17BR的相关性。结果:与正常对照者相比,CD和UC患者结肠黏膜中IL-17BR表达均显著升高(P<0.05),且活动期CD和UC患者IL-17BR表达显著高于缓解期患者(P<0.05)。CD、UC患者和正常对照者PBMC中IL-17BR阳性率差异相比无统计学意义(P>0.05)。CD、UC患者结肠黏膜IL-17BR表达与CRP、ESR、CDAI评分、Mayo评分均呈正相关(P<0.05)。IFX治疗后CD患者结肠黏膜IL-17BR表达、血清TNF-α浓度均较治疗前明显下调(P<0.01),且两者呈正相关(P<0.05)。结论:IBD患者结肠黏膜IL-17BR表达与炎症程度和TNF-α水平密切相关,IL-17BR可能参与IBD肠黏膜免疫应答,因此可作为反映IBD疾病活动度的指标之一。

Background: There is no specific therapy for inflammatory bowel disease( IBD),and the pathogenesis of IBD is not fully clear. Aims: To explore the expression and clinical significance of IL-17 BR in colon mucosa and peripheral blood mononuclear cell( PBMC) of patients with IBD. Methods: Colon mucosal biopsy specimens of 40 Crohn's disease( CD)patients,32 ulcerative colitis( UC) patients and 25 healthy controls and PBMC of 30 CD patients,27 UC patients and 25 healthy controls were collected. The expressions of IL-17 BR in colon mucosa and PBMC were determined by immunohistochemistry and flow cytometry,respectively,and correlations between IL-17 BR expression and levels of CRP,ESR,CDAI score and Mayo score were analyzed. Serum levels of TNF-α before and after infliximab( IFX) treatment were determined by ELISA,and correlations with IL-17 BR were analyzed. Results: Compared with healthy controls,IL-17 BR expressions in colon mucosa of CD and UC patients were significantly increased( P < 0. 05). IL-17 BR expressions were significantly higher in active CD and UC patients than in remission CD and UC patients( P < 0. 05). No significant differences in IL-17 BR expression in PBMC were found among CD,UC patients and healthy controls( P > 0. 05). The expression of IL-17 BR in colon mucosa was positively correlated with CRP,ESR,CDAI score or Mayo score in CD,UC patients( P < 0. 05). After treatment with IFX,expression of IL-17 BR in colon mucosa and serum TNF-α level were significantly decreased in CD patients( P < 0. 01). Expression of IL-17 BR was positively correlated with serum TNF-αlevel in CD patients( P < 0. 05). Conclusions: The increasing of IL-17 BR expression in IBD patients is closely correlated with activity of inflammation and TNF-α level. IL-17 BR may play a vital role in immune response of intestinal mucosa,and can be used as a new marker for reflecting the activity of IBD.