重型斑秃患者外周血和头皮细胞因子的检测

The detection of cytokines in peripheral blood and scalp of patients with severe alopecia areata

目的检测重型斑秃患者外周血和头皮皮损处细胞因子的表达水平,进一步探讨斑秃的发病机制。方法选取33例重型斑秃患者及20例健康体检者。收集外周血标本,采用酶联免疫吸附试验法(ELISA)检测血清中免疫细胞因子干扰素γ(IFN-γ)、白介素2(IL-2)、白介素4(IL-4)、白介素5(IL-5)、白介素10(IL-10)、白介素12(IL-12)的表达水平。收集头皮组织标本,采用荧光半定量RT-PCR方法检测头皮处IFN-γ、IL-2、IL-4、IL-5、IL-10、IL-12 mRNA表达水平。结果与正常对照组比较,重型斑秃组血清中IFN-γ和IL-12表达水平显著升高,IL-5表达水平显著降低(P<0.01),IL-2、IL-4、IL-10表达水平差异无统计学意义(P>0.05)。与正常对照组比较,重型斑秃组头皮皮损IFN-γ和IL-12 mRNA表达水平显著升高,IL-4mRNA表达水平显著降低(P<0.01),IL-2、IL-5、IL-10 mRNA表达水平差异无统计学意义(P>0.05)。结论重型斑秃患者外周血及局部头皮均存在Th1和Th2的免疫失衡,即表现为Th1占优势而Th2抑制。

Objective To investigate the pathogenesis of alopecia areata（ AA） through the tests of cytokines in peripheral blood and scalp of patients with severe AA.Methods We enrolled 33 patients with severe AA and 20 healthy people.Their peripheral blood were collected,and enzyme-linked immunosorbent assay（ ELISA） was performed to determine the serum levels of immune cytokines such as interferon（ IFN）-γ,interleukin（ IL）-2,IL-4,IL-5,IL-10 and IL-12.Their scalp tissue specimens were also collected,and the mRNA expression levels of INF-γ,IL-2,IL-4,IL-5,IL-10 and IL-12 were determined by reverse transcription and polymerase chain reaction（ RT-PCR）.Results Compared with the healthy group,the serum levels of IFN-γ and IL-12 in patients with severe AA were significantly higher（ P〈0. 01） while the serum level of IL-5 was significantly lower（ P〈0. 01）.No significant difference in the serum levels of IL-2,IL-4 and IL-10 was found between the two groups（ P〉0. 05）.Compared with the healthy group,the mRNA expression levels of these cytokines in the scalp of patients with severe AA were similar to those in the peripheral blood.Conclusion There is a Th1/Th2 imbalance in peripheral blood and scalp of patients with severe AA,which is characterized by Th1 hyperactivity and Th2 inhibition.