5-氨基酮戊酸光动力疗法对高危型HPV感染尖锐湿疣患者血清白细胞介素-17、白细胞介素-23、白细胞介素-10及外周血Treg/Th17细胞平衡的影响

Effect of 5-aminolevulinic acid photodynamic therapy on serum IL-17,IL-23,IL-10 and Treg/Th17 cell balance in patients with condyloma acuminatum at high risk of HPV infection

目的探讨5-氨基酮戊酸光动力疗法(5-ALA-PDT)对高危型人乳头状瘤病毒(HPV)感染尖锐湿疣患者血清白介素-17(IL-17)、白介素-23(IL-23)、白介素-10(IL-10)及外周血Treg/Th17细胞平衡的影响。方法选自本院于2016年1月-2018年9月收治的高危HPV感染尖锐湿疣患者68例作为研究对象,按照随机表法分为对照组34例与观察组34例。对照组给予冷冻治疗并重组人干扰素α-2b凝胶治疗,观察组在对照组基础上结合5-ALA-PDT治疗。2组患者观察疗程均为3个月,评价疗效及相关指标变化。比较2组治疗疗效,治疗前后血清IL-17、IL-23、IL-10和外周血Treg/Th17细胞平衡变化,并随访3个月复发情况。结果观察组总有效率(97.06%)高于对照组(76.47%)(P<0.05)。2组治疗后血清IL-17和IL-23水平较治疗前升高,而IL-10水平较治疗前降低(P<0.05);观察组治疗后血清IL-17和IL-23水平高于对照组,而IL-10水平低于对照组(P<0.05)。2组治疗后Treg和Treg/Th17较治疗前降低,而Th17较治疗前升高(P<0.05);观察组治疗后Treg和Treg/Th17低于对照组,而Th17高于对照组(P<0.05)。观察组随访3个月复发率(14.71%)低于对照组(41.18%)(P<0.05)。结论5-ALA-PDT对高危型HPV感染尖锐湿疣患者疗效良好,可提高血清IL-17和IL-23水平和降低IL-10水平,改善外周血Treg/Th17细胞失衡。

Objective To investigate the effects of 5-aminolevulinic acid photodynamic therapy(5-ALA-PDT)on serum interleukin-17(IL-17),interleukin-23(IL-23),interleukin-10(IL-10)and Treg/Th17 cell balance in patients with condyloma acuminatum infected by high-risk human papillomavirus(HPV).Methods The 68 Condyloma acuminatum patients with high-risk HPV infection admitted to our hospital from January 2016 to September 2018 were selected as the research objects and divided into the control group(34 cases)and the observation group(34 cases)according to the random table method.The control group was treated with iontophoresis and recombinant human interferonα-2b gel.The observation group was treated with 5-ALA-PDT on the basis of the control group.Two groups of patients were observed for 3 months,and the curative effect and related indicators were evaluated.The therapeutic efficacy,serum IL-17,IL-23,IL-10 and Treg/Th17 cell balance were compared between the two groups before and after treatment,and the recurrence was followed up for 3 months.Results The total effective rate of the observation group(97.06%)was higher than that of the control group(76.47%)(P<0.05).After treatment,serum IL-17 and IL-23 levels in the two groups were higher than those before treatment,while IL-10 levels were lower than those before treatment(P<0.05);after treatment,serum IL-17 and IL-23 levels in the observation group were higher than those in the control group,while IL-10 levels were lower than those in the control group(P<0.05).Treg and Treg/Th17 in the two groups decreased after treatment,while Th 17 increased after treatment(P<0.05);Treg and Treg/Th17 in the observation group were lower than those in the control group after treatment,while Th17 was higher than those in the control group(P<0.05).The recurrence rate in the observation group(14.71%)was lower than that in the control group(41.18%)(P<0.05).Conclusion 5-ALA-PDT has a good effect on Condyloma acuminatum patients with high-risk HPV infection.It can increase the serum levels of IL-17 and IL-23,decrease the IL-10 level and improve the imbalance of Treg/Th17 cells in peripheral blood.