十二指肠球部溃疡患者球部黏膜白细胞介素-10、白细胞介素-12和干扰素-γ的水平及其临床意义

The Levels of Interleukin-10, Interleukin-12 and Interferon-y in Duodenal Mucosa and the Clin-ical Significance in Patients with Duodenal Ulcer

背景:溃疡病患者常出现各种细胞免疫和体液免疫障碍。目的:探讨细胞因子白细胞介素（IL）-10、IL-12和干扰素（IFN）-γ在十二指肠球部溃疡（DU）发生中的作用。方法:在奥美拉唑、克拉霉素、替硝唑一周三联疗法治疗之前和之后4～6周从DU患者的球部钳取轴膜组织,应用酶联免疫吸附测定（ELISA）检测IL-10、IL-12和IFN-γ的含量,并对照组进行比较。结果:一周三联疗法治疗前,DU患者球部劾膜的IL-10、IL-12和IFN-γ含量（17.983pg/ml±8.676pg/ml、44098 pg/ml±12.842 pg/ml±和82.373pg/ml±17.264pg/ml±）均显著高于对照组（85.99 pg/ml±4.147 pg/ml、17.550 pg/ml±5.980 pg/ml和26.298pg/ml±10.385 pg/ml,p<0.01）,且IL-10与IL-12的含量呈正相关（r=0.87,P<0.01）,IL-10与IFN-γ的含量也呈正相关（r=0.92,P<0.01）。治疗后,DU患者球部轴膜的IL-10IFN-γ含量均有所下降（17.289 pg/ml±3.939 pg/ml和27.030 pg/ml±3.753 pg/ml,P<0.01）,但IL-10的含量仍持续维持在较高水平（26.098 pg/ml±15.152 pg/ml,P<0.01）。结论:细胞因子IL-10、IL-12和IFN-γ可能在DU的发生机制中起重要作用。一周三联疗法治疗后,促炎症细胞因子IL-12和IFN-γ分泌得到有效抑制,而抗炎症细胞因子IL-10持续维待在较高水平,为黏?

Background: Dysfunction of cellular immunity and humoral immunity always occur in patients with ulcerative diseases. Aims: To investigate the clinical significance of interleukin (IL)-10, ILL-12 and interferon (IFN)-y in duodenal mucosa in patients with duodenal ulcer (DU). Methods: Duodenal mucosal specimens were taken in patients with DU before and 4~6 weeks after the treatment with omeprazole, clarithromycin and tinidazole for one week. The levels of IL-10, IL-12 and IFN-y were de-termined by enzyme-linked immunosorbent assay (ELISA), and compared with the controls. Results: Prior to the one-week triple therapy, the levels of IL-10, IL-12 and IFN-y were markedly increased in patients with DU (17.983 pg/ml±8.676 pg/ml, 44.098 pg/ml±12.842 pg/ml and 82.373 pg/ml±17.264 pg/ ml) than those in controls (8.599 pg/ml±4.147 pg/ml, 17.550 pg/ml±5?.980 pg/ml and 26.298 pg/ml±10.385 pg/ml, P<0.01, respectively). A positive relationship between the IL-10 and IL-12 (r = 0.87, P< 0.01) was observed, so was the relationship between IL-10 and IFN-y (r = 0.92, P<0.01). After the treat-ment, the levels of IL-12 and IFN-y decreased (17.289 pg/ml±3?.939 pg/ml and 27.030 pg/ml ±3?.753 pg/ ml, P<0.01, respectively), but the IL-10 remained at a higher level (26.098 pg/ml±?15.152 pg/ml, P< 0.01). Conclusions: Cytokines IL-10, IL-12 and IFN-y may play important roles in DU. After one-week triple therapy, the secretions of the proinflammatory cytokine IL-12 and IFN-y were effectively re-stricted, in contrast, the contra-inflammatory cytokine IL-10 remained high for a period of time to build the favorable environment for mucosal reconstitution.