棘球蚴感染患者血清细胞因子检测的应用价值探讨

Application value of serum cytokine detection in patients with echinococcosis infection

目的通过对棘球蚴感染患者血清中细胞因子的检测,探索棘球蚴感染不同阶段外周血免疫特性异常的关键细胞因子及其复杂网络相关性。方法对新疆医科大学第一附属医院收治的20例肺泡性棘球蚴病(AE)患者建立随访,收集患者信息及临床资料,获取同一患者AE术前及AE术后的外周血标本,同期来自同一医院的20例健康体检人员作为正常对照组并获取正常对照组外周血标本,使用流式微珠阵列技术对收集的血清标本进行标记检测,分析正常对照组与AE术前术后的13种细胞因子之间的相关性与差异性。结果与正常对照组比较,AE术前血清中IFN-α2、IL-12、IL-18、IL-6、IL-33水平明显升高(P<0.05);与AE术前比较,AE术后外周血中IL-10、IL-18水平较AE术前升高,差异有统计学意义(P<0.05);而IL-17A、IL-23水平均降低,差异有统计学意义(P<0.05)。经相关性分析,Th1(IFN-α2,IL-12,IFN-γ)和Th2细胞因子IL-33(r值分别为0.877、0.595、0.807)表现出密切的相关性,且IL-12与IFN-α2显著相关(r值为0.772);IL-17A和IL-12、IL-23和IFN-γ、IL-23和IL-12表现出密切的相关性(r值分别为0.621、0.548、0.613);趋化因子IL-8与IL-17A及IFN-α2显著相关(r值分别为0.533、0.548,P<0.001)。与AE术前比较,AE术后外周血中血小板计数,球蛋白含量、淋巴细胞/单核细胞比率(LMR)较AE术前降低(P<0.05),且LMR与IFN-γ及Th17型(IL-17、IL-23)表达呈正相关。结论细胞因子相关性与差异性可能与包虫感染不同阶段密切相关,这可能为监测疾病进展的免疫学识别标志物提供一些有用的信息。

Objective To explore the key cytokines and the complex network correlation ofabnormal immune characteristics of peripheral blood in different stages of echinococcal infection by detecting cytokines inserum of the patients with echinococcal infection.Methods A follow-up study was conducted on 20 patients with alveolar echinococcosis(AE)admitted to the hospital.Collect information and clinical data,access to the same AE in patients with preoperative and postoperative AE peripheral blood specimens,same with the healthy check-up of 20 cases from the hospital staff as a peripheral blood specimens of normal control group.The serum samples were labeled and detected by flow microbead array technology,and normal control group and AE were analyzed correlation and difference between 13cytokines before and after operation.Results Compared with normal control group,the levels of IFN-α2,IL-12,IL-18,IL-6 and IL-33 in serum before AE were significantly increased(P<0.05).Compared with before AE,the levels of IL-10 and IL-18 in peripheral blood after AE were significantly higher than those before AE(P<0.05).The levels of IL-17A and IL-23 were decreased,and the differences were statistically significant(P<0.05).The correlation analysis showed that Th1(IFN-α2,IL-12,IFN-γ)and Th2 cytokine IL-33(r=0.877,0.595,0.807,respectively)were closely correlated,and IL-12 was significantly correlated with IFN-α2(r=0.772).There was a close correlation between IL-17A and IL-12,IL-23 and IFN-γ,IL-23 and IL-12(r=0.621,0.548,0.613).The chemokine IL-8 was significantly correlated with IL-17A and IFN-α2(r=0.533,0.548,P<0.001).The platelet count,globulin content and lymphocyte/monocyte ratio(LMR)in peripheral blood after AE were significantly lower than those before AE(P<0.05),and LMR was positively correlated with the expression of IFN-γand Th17 type(IL-17,IL-23).Conclusion The correlation and difference of cytokines may be closely related to the different stages of echinococcal infection,which may provide the useful information for immunological identification markers to monitor disease progression.