吸烟介导的COPD呼吸道微生态失调对Treg/Th17失衡的影响

The effect of smoking-mediated respiratory microecological disorder on Treg/Th17 imbalance in COPD

目的探究吸烟介导的慢性阻塞性肺疾病(COPD)患者呼吸道微生态失调对调节性T细胞(Treg)/辅助性T细胞17(Th17)免疫失衡的影响。方法选取本院30例COPD患者、30例肺功能正常者作为研究对象,根据吸烟、肺功能情况分为吸烟COPD组(15例)、吸烟肺功能正常组(15例)、不吸烟COPD组(15例)、不吸烟肺功能正常组(15例)。比较4组一般资料包括(性别、年龄、BMI)、外周血、BAL中Treg/Th17、中性粒细胞、单核细胞、血清与BAL上清中白介素-10(IL-10)、IL-35、IL-17、IL-6、IL-8水平,评价吸烟、肺微生态菌群、Treg/Th17免疫失衡之间相关性。结果 4组ACE指数、Chao指数、Shannon指数、外周血、BAL中Treg细胞、Treg/Th17比例及血清、BAL上清IL-35比较:吸烟COPD组<不吸烟COPD组<吸烟肺功能正常组<不吸烟肺功能正常组(P<0.05),Simpson指数、Th17细胞、中性粒细胞、单核细胞及血清、BAL上清IL-17、IL-6、IL-8、IL-10比较:吸烟COPD组>不吸烟COPD组>吸烟肺功能正常组>不吸烟肺功能正常组,差异均有统计学意义(P<0.05);吸烟与肺部菌群ACE指数、Chao指数、Shannon指数、外周血、肺泡灌洗液(BAL)中Treg细胞、Treg/Th17比例呈负相关,与Simpson指数、外周血、BAL中Th17细胞呈正相关(P<0.05);肺部菌群ACE指数、Chao指数、Shannon指数与外周血、BAL中Treg细胞、Treg/Th17比例呈正相关,与Th17细胞呈负相关,Simpson指数与外周血、BAL中Treg细胞、Treg/Th17比例呈负相关,与Th17细胞呈正相关(P<0.05)。结论吸烟介导的COPD患者呼吸道微生态失调与Treg/Th17免疫失衡密切相关,吸烟-肺微生态失调-肺免疫紊乱-炎症浸润可能是COPD的发病机制。

Objective To explore the effects of smoking-mediated chronic obstructive pulmonary disease(COPD)patients with respiratory tract microecological dysfunction on T regulatory cell(Treg)/T helper cell 17(Th17)immune imbalance. Methods From September 2018 to June 2020 in our hospital,30 COPD patients and 30 patients with normal pulmonary function were selected as the research objects. According to smoking and pulmonary function,they were divided into smoking COPD group(15 cases),smoking normal pulmonary function group(15 cases),non-smoking COPD group(15 cases),non-smoking normal pulmonary function group(15 cases). Results The ACE index,Chao index,Shannon index,Treg cells,Treg/Th17 ratio in peripheral blood and BAL,and IL-35 in the serum and BAL supernatant in the smoking COPD group non-smoking COPD group >smoking normal pulmonary function group >nonsmoking normal pulmonary function group(P<0.05). Smoking was negatively correlated with the ACE index,Chao index,Shannon index,Treg cells and Treg/Th17 ratio in peripheral blood and the alveolar lavage fluid(BAL),and positively correlated with Simpson index,and Th17 cells in peripheral blood and BAL(P<0.05).The ACE index,Chao index and Shannon index of the lung flora were positively correlated with Treg cells and Treg/Th17 ratio in peripheral blood and BAL,and negatively correlated with Th17 cells. Simpson index was negatively correlated with the of Treg cells and Treg/Th17 ratio in peripheral blood and BAL,and positively correlated with Th17 cells(P<0.05). Conclusion Smoking-mediated respiratory tract microecological disorders in COPD patients are closely related to Treg/Th17 immune imbalance. Smoking-pulmonary microecological disorders-pulmonary immune disorders-inflammatory infiltration may be the pathogenesis of COPD.