IL-17A和骨桥蛋白在老年肺结核患者中的表达及意义

Expression and significance of IL-17A and osteopontin in elderly patients with pulmonary tuberculosis

目的探究白细胞介素(interleukin,IL)-17A骨桥蛋白(osteopontin,OPN)、在老年肺结核患者中的表达及意义。方法选取2018年7月至2019年7月合肥市第三人民医院收治的87例肺结核患者为肺结核组,同期选取50例健康体检者为对照组,比较两组人群血清IL-17A、OPN、IL-6、IL-23、IL-10、IL-12、干扰素-γ(interferon-γ,IFN-γ)、干扰素诱导蛋白-10(interferon inducible protein-10,IP-10)水平,采用Pearson相关分析肺结核患者血清IL-17A与IL-6、IL-23、IL-10相关性及血清OPN与IL-12、IFN-γ、IP-10相关性。结果肺结核组血清IL-17A、OPN水平显著高于对照组[IL-17A:(112.15±10.96)pg/mL比(21.66±1.53)pg/mL,OPN:(570.18±122.34)ng/mL比(40.13±11.16)ng/mL,t值分别为-75.737和-40.122,P值均<0.05];肺结核组血清IL-6、IL-23水平显著高于对照组[IL-6:(58.47±6.34)pg/mL比(16.56±2.83)pg/mL;IL-23:(28.88±3.57)ng/mL比(9.46±1.28)ng/mL,t值分别为-53.132、-45.868,P值均<0.05);肺结核组血清IL-10水平显著低于对照组[(21.27±5.68)pg/mL比40.87±11.76,t=11.067,P<0.05];肺结核组血清IL-12、IFN-γ、IP-10水平显著高于对照组[IL-12:(168.42±58.28)pg/mL比(40.17±17.93)pg/mL;IFN-γ:(977.45±13.09)pg/mL比(108.91±9.66)pg/mL,IP-10:(1997.41±956.63)pg/mL比(893.30±259.36)pg/mL,t值分别为-19.019、-443.466和-10.137,P值均<0.05];肺结核患者血清IL-17A与IL-6、IL-23呈正相关(r值分别为0.549和0.602,P<0.05);肺结核患者血清IL-17A与IL-10呈负相关(r=-0.487,P<0.05);肺结核患者血清OPN与IL-12、IFN-γ、IP-10呈正相关(r值分别为0.532、0.519和0.497,P值均<0.05)。结论结核杆菌感染引起外周血中IL-6、IL-23水平升高并诱导Th17细胞分泌IL-17A,抑制Treg细胞分泌IL-10,同时结核杆菌感染引起OPN在外周血中的水平升高并增加IL-12、IFN-γ分泌,促进IP-10表达,导致肺部免疫损伤。

Objective To investigate the expression and significance of interleukin(IL)-17A osteopontin(OPN)in elderly patients with pulmonary tuberculosis.Methods A total of 87 tuberculosis patients admitted to the Third People's Hospital of Hefei from July 2018 to July 2019 were selected as the tuberculosis group,and 50 healthy subjects in the same period were selected as the control group.Serum(interleukin)(IL)-17A,OPN,IL-6,IL-23,IL-10,IL-12,interferon-γ(IFN-γ)and interferon inducible protein-10(IP-10)levels were compared between the two groups.The correlation between serum IL-17A and IL-6,IL-23,IL-10 and the correlation between serum OPN and IL-12,IFN-γ,IP-10 in pulmonary tuberculosis patients were analyzed by Pearson correlation.Results The levels of serum IL-17A and OPN in the pulmonary tuberculosis group were significantly higher than those in the control group[IL-17A:(112.15±10.96)pg/mL vs(21.66±1.53)pg/mL,OPN:(570.18±122.34)ng/mL vs(40.13±11.16)ng/mL,t values were-75.737 and-40.122 respectively,both P values<0.05].The levels of serum IL-6 and IL-23 in the pulmonary tuberculosis group were significantly higher than those in the control group[IL-6:(58.47±6.34)pg/mL vs(16.56±2.83)pg/mL;IL-23:(28.88±3.57)ng/mL vs(9.46±1.28)ng/mL,t values were-53.132 and-45.868 respectively,both P values<0.05].The serum level of IL-10 in pulmonary tuberculosis group was significantly lower than that in control group(21.27±5.68)pg/mL vs 40.87±11.76,while the levels of IL-12,IFN-γand IP-10 in pulmonary tuberculosis group were significantly higher than those in control group[IL-12:(168.42±58.28)pg/mL vs(40.17±17.93)pg/mL].IFN-γ:(977.45±13.09)pg/mL vs(108.91±9.66)pg/mL,IP-10:(1997.41±956.63)pg/mL vs(893.30±259.36)pg/mL,t values were-19.019,-443.466 and-10.137 respectively,all P values<0.05.The serum IL-17A in patients with pulmonary tuberculosis was positively correlated with IL-6 and IL-23(r values were 0.549 and 0.602 respectively,both P values<0.05).There was a negative correlation between serum IL-17A and IL-10 in patients with pulmonary tuberculosis,and a positive correlation between serum OPN and IL-12,IFN-γand IP-10 in patients with pulmonary tuberculosis(r values were 0.532,0.519 and 0.497 respectively,all P values<0.05).Conclusion Tuberculosis infection caused an increase in the levels of IL-6 and IL-23 in the peripheral blood and induced IL-17A secretion of Th17 cells,which inhibited IL-10 secretion from Treg cells,while OPN caused IL-12 and IFN-γSecretion,promoting IP-10 expression,both of which contribute to lung immune injury.