白细胞介素17A等细胞因子在复发性外阴阴道假丝酵母菌病发病中的作用

The role of interleukin 17A and other related cytokines in recurrent vulvovaginal candidiasis

目的:通过检测复发性外阴阴道假丝酵母菌病(RVVC)不同时期IL-17A等细胞因子的变化,探讨Th17细胞在RVVC发病过程中的作用。方法:选取致病菌为白假丝酵母菌RVVC患者33例、外阴阴道假丝酵母菌病(VVC)患者32例以及8例健康对照者,收集不同时期阴道冲洗液。采用液相悬浮芯片技术(luminex)检测IL-10、IL-17A、IL-22、IL-23和IFN-γ等细胞因子浓度。结果:RVVC组与VVC组发作期阴道冲洗液中IL-17A浓度分别为(79.08±78.80)pg/ml和(68.67±85.67)pg/ml,明显高于对照组[(4.52±3.89)pg/ml],差异均有统计学意义(P<0.01);RVVC组与VVC组比较差异无统计学意义(P>0.05)。RVVC组缓解期阴道冲洗液IL-17A浓度为(3.53±2.03)pg/ml,明显低于对照组,差异有统计学意义(P=0.013)。RVVC组阴道冲洗液IFN-γ、IL-17A及IL-23浓度在发作期明显高于缓解期,差异均有统计学意义(P<0.05);RVVC组阴道冲洗液IL-10浓度在发作期明显低于缓解期,差异有统计学意义[(1.58±1.12)pg/ml vs(2.45±0.92)pg/ml,P=0.041]。VVC组阴道冲洗液IL-17A浓度在发作期明显高于缓解期,差异有统计学意义(P<0.01)。结论:IL-17A在阴道黏膜防御白假丝酵母菌的免疫反应中起非常重要的作用。缓解期阴道局部IL-17A低水平表达可能引起VVC反复发作。RVVC发作期IL-10没有参与阴道局部的免疫调节反应,可能也是VVC反复发作的原因之一。

Objective： To investigate the role of Th17 cell in recurrent vulvovaginal candidiasis（ RVVC） by detecting the change of IL-17 A and other related cytokines in different periods of RVVC.Methods： 33 cases of RVVC and 32 cases of VVC infected with candida albicans were selected. 8 cases of healthy control were compared. Their cervicovaginal lavage fluid（ CVL） was collected and checked. The levels of IL-10,IL-17 A,IL-22,IL-23 and IFN-γ were measured by using luminex test.Result： The concentration of IL-17 A in CVL in attack stage was（ 79.08±78.80） pg/ml in RVVC group and（ 68.67±85.67） pg/ml in VVC group respectively,which was significantly higher than that in the control group[（ 4.52 ± 3.89） pg/ml]（ P〈0.01）.There was no statistical difference between RVVC and VVC group（ P〉0.05）.The concentration of IL-17 A in CVL was（ 3.53±2.03） pg/ml in RVVC group in remission stage,which was significantly lower than that in the control groups（ P = 0.013）.IFN-γ,IL-17 A and IL-23 production in CVL were significantly higher in attack stage than those in remission stage in RVVC group（ P〈0.05）. IL-10 production in CVL was significantly lower in attack stage than that in remission stage in RVVC group[（ 1.58±1.12） pg/ml vs（ 2.45±0.92） pg/ml,P = 0.041].IL-17 A production in CVL was significantly higher in attack stage than that in remission stage in VVC group（ P〈0.01）.Conclusion： IL-17 A may play an important role in resistance to Candida albicans in RVVC.The low level expression of IL-17 A in remission stage may be associated with recurrent episodes of VVC. In RVVC,IL-10 is not involved in vaginal immunoregulation. which may be one of the causes of VVC relapse.