自发性荨麻疹患者外周血辅助性T细胞9检测及其临床意义

Changes in Th9 cells and related cytokines in peripheral blood of patients with spontaneous urticaria

目的:检测自发性荨麻疹(SU)患者外周血辅助性T细胞(Th)9表达水平,并探讨其在疾病过程中的作用。方法:收集56例SU患者,将其分为急性自发性荨麻疹(ASU)组和慢性自发性荨麻疹(CSU)组,各28例;同时选择年龄和性别匹配的健康对照者28例作为对照组。采用流式细胞仪检测外周血Th9细胞比例,反转录聚合酶链式反应(RT-PCR)检测外周血单个核细胞(PBMCs)转录因子PU.1 mRNA水平,Luminex200液相芯片检测血清白细胞介素(IL)-4、IL-9、IL-17A、IL-33、IL-1β和转化生长因子(TGF)-β1浓度。结果:与对照组和CSU组相比,ASU组患者Th9细胞比例、PU.1 mRNA、IL-9及IL-4水平表达均升高,差异均有统计学意义(P<0.05);而CSU患者和对照组比较,差异无统计学意义(P>0.05)。ASU患者Th9细胞比例与PBMCs PU.1 mRNA表达水平呈正相关(r=0.57,P<0.05)。ASU组和CSU组外周血细胞因子TGF-β1浓度均升高,差异无统计学意义(P>0.05)。另外,ASU患者外周血中Th9细胞比例与IL-9(r=0.42,P<0.05)和IL-4(r=0.60,P<0.05)均呈正相关,但与疾病的严重程度评分无相关性(r=0.23,P>0.05)。结论:Th9细胞在ASU的发病机制中可能发挥一定作用,通过调控Th9细胞可能是治疗ASU的新途径。

Objective： To explore the pathogenic role of Th9 cells in spontaneous urticarial（SU） by determining proportion of Th9 cells in peripheral blood. Methods： This study included 28 cases of acute spontaneous urticaria（ASU）, 28 cases of chronic spontaneous urticaria（CSU） and 28 age-matched healthy controls. The percentage of Th9 cells was detected by flow cytometry（FCM）. The expression levels of transcription factor PU.1 mRNA in peripheral blood mononuclear cell（PBMCs） were measured using reverse transcription polymerase chain reaction（RT-PCR）. Luminex 200 was used to measure Th9 related serum cytokines, including interleukin（IL）-4, IL-9, IL-17A, IL-33, IL-115 and transforming growth factor-β1（TGF-β1）. Results： Proportion of Th9 cells, and levels of PU.lmRNA, IL-4 and IL-9 in PBMCs were significantly higher in ASU patients than in either the control or CSU group（P〈0.05 for all）, while no difference between CSU patients and normal controls（P〉0.05）. Moreover, pro- portion of Th9 cells and PU.lmRNA levels were positively correlated in ASU group（r=0.57, P〈0.05）. Elevated levels of TGF-β1 were comparable levels in ASU and CSU group. In addition, proportion of Th9 positively correlated with levels of IL-4（r=0.60, P〈0.05） and IL-9（r=0.42, P〈0.05）, but not with the disease severity（r=0.23, P〉0.05） in peripheral blood of ASU patients. Conclusions： Th9 cells may play a role in the pathogenesis of acute spontaneous urticaria. Regulation of the Th9 cells could he an option for the treatment of ASU.