哮喘患儿血清IL-21、IL-23及IL-17的表达及意义

Expression and significance of serum IL-21,IL-23 and IL-17 in children with asthma

目的探讨哮喘患儿血清白细胞介素-21(IL-21)、IL-23及IL-17的表达及意义。方法选取2019年1月至2021年6月在郑州大学附属儿童医院治疗的哮喘患儿140例,其中轻度患儿46例,中度患儿58例,重度患儿36例。嗜酸性粒细胞型68例,中性粒细胞型72例。比较各类型患儿血清IL-21、IL-23、IL-17水平,以及第一秒用力呼气容积占预计值百分比(FEV1%pred)和第一秒用力呼气容积/用力肺活量(FEV1/FVC)差异。结果轻度、中度和重度患儿血清IL-21比较,差异无统计学意义(P>0.05)。重度患儿血清IL-23和IL-17分别为(253.30±49.80)pg/mL和(9.40±1.10)pg/mL,高于轻度和中度患儿(P<0.05),而FEV1%pred和FEV1/FVC分别为(68.83±9.95)%和(67.80±9.15)%,低于轻度和中度患儿(P<0.05)。嗜酸性粒细胞型患儿血清IL-21、IL-23和IL-17分别为(25.12±3.83)pg/mL、(232.32±48.10)pg/mL和(8.40±1.00)pg/mL,高于中性粒细胞型患儿(P<0.05)。IL-23、IL-17与FEV1%pred、FEV1/FVC呈正相关(r=0.443、0.412、0.398和0.435,P<0.05),IL-21与FEV1%pred、FEV1/FVC无明显相关性(P>0.05)。治疗有效患儿治疗后血清IL-21、IL-23和IL-17分别为(10.20±2.01)pg/mL、(150.40±32.28)pg/mL和(3.50±1.01)pg/mL,低于治疗无效患儿(P<0.05)。结论哮喘患儿血清IL-23和IL-17水平与病情严重程度、诱导痰细胞表型及肺功能存在相关性,而IL-21仅与诱导痰细胞表型有关。

【Objective】To investigate the expression and significance of serum interleukin-21(IL-21),IL-23 and IL-17 in children with asthma.【Methods】A total of 140 children with asthma who were treated in our hospital from January 2019 to June 2021 were selected,including 46 mild children,58 moderate children,and 36 severe children.There were 68 cases of eosinophil type and 72 cases of neutrophil type.The levels of serum IL-21,IL-23 and IL-17,the percentage of forced expiratory volume in the first second(FEV1%pred)and the difference of forced expiratory volume in the first second/forced vital capacity(FEV1/FVC)were compared.【Results】There was no significant difference in serum IL-21 among mild,moderate and moderate children(P>0.05).Serum IL-23 and IL-17 in severe children were 253.30±49.80 pg/mL and 9.40±1.10 pg/mL,respectively,which were significantly higher than those in mild and moderate children(P<0.05),while FEV1%pred and FEV1/FVC were(68.83±9.95)%and(67.80±9.15)%respectively,which were significantly lower than those in mild and moderate children(P<0.05).The serum levels of IL-21,IL-23 and IL-17 in children with eosinophil type were 25.12±3.83 pg/mL,232.32±48.10 pg/mL and 8.40±1.00 pg/mL,respectively,which were significantly higher than those in children with neutrophil type(P<0.05).IL-23 and IL-17 were positively correlated with FEV1%pred and FEV1/FVC(r=0.443,0.412,0.398 and 0.435,P<0.05),IL-21 was not significantly correlated with FEV1%pred and FEV1/FVC(P>0.05).After treatment,the serum levels of IL-21,IL-23 and IL-17 in children with effective treatment were 10.20±2.01 pg/mL,150.40±32.28 pg/mL and 3.50±1.01)pg/mL,respectively,which were significantly lower than those of children who failed to respond to treatment(P<0.05).【Conclusion】The levels of serum IL-23 and IL-17 in asthmatic children are correlated with the severity of the disease,the phenotype of induced sputum cells and lung function,while IL-21 is only related to the phenotype of induced sputum cells.