不同阶段神经梅毒与血清固定患者外周血Th1、Th2和Th17相关细胞因子分析

Analysis of Th1,Th2 and Th17 Related Cytokines in Peripheral Blood of Patients with Different Stages of Neurosyphilis and Serofast Syphilis

目的检测不同临床阶段神经梅毒与梅毒血清固定患者外周血Th1、Th2及Th17相关细胞因子表达水平,以了解患者细胞免疫相关因子状况。方法收集苏州大学附属第二医院及苏州高新区人民医院2017年9月-2021年10月期间确诊为神经梅毒的患者79例(包括无症状型6例,早期23例,晚期50例),血清固定患者65例,对照组(健康体检者)30例。采用酶联免疫吸附法检测各组外周血中Th1细胞因子(IL-2、IFN-γ)、Th2细胞因子(IL-4、IL-6、IL-10)及Th17细胞因子(TNF、IL-17A)的表达水平,统计分析检测结果。结果IL-2、IFN-γ、IL-4、IL-17A在神经梅毒、血清固定患者和对照组间的水平差异有统计学意义(P<0.05)。神经梅毒和血清固定患者外周血IL-2、IFN-γ、IL-4高于对照组且IL-17A低于对照组,差异均有统计学意义(P<0.05)。神经梅毒与血清固定患者外周血Th1、Th2、Th17相关细胞因子差异无统计学意义(P>0.05)。IL-2、IFN-γ、IL-4、IL-17A在不同临床阶段神经梅毒患者和对照组间的含量变化差异有统计学意义(P<0.05)。IL-17A在早期神经梅毒与对照组之间差异无统计学意义(P>0.05),晚期神经梅毒患者IL-17A低于对照组,差异有统计学意义(P<0.05)。结论神经梅毒和血清固定患者的Th1、Th2及Th17类细胞因子存在异常,且神经梅毒不同阶段之间也存在差异,可能与神经梅毒和血清固定的发病机制有关。

Objective To detect the expression level of Th1,Th2 and Th17 related cytokines in peripheral blood of patients with different stages of neurosyphilis and serofast syphilis,so as to understand the status of immune-related factors in cells of patients.Methods A total of 79 patients diagnosed with neurosyphilis(including 6 asymptomatic patients,23 early syphilis and 50 late syphilis)and 65 patients with serofast syphilis from September 2017 to October 2021 in our hospital were included in the study,and 30 healthy physical examinees as the control group.The levels of Th1 cytokines(IL-2,IFN-γ),Th2 cytokines(IL-4,IL-6,IL-10)and Th17 cytokines(TNF,IL-17A)in peripheral blood were detected by enzyme-linked immunosorbent assay(ELISA).Results There were significant differences in the levels of IL-2,IFN-γ,IL-4 and IL-17A in patients with neurosyphilis,those with serofast syphilis and control group(P<0.05).The levels of IL-2,IFN-γand IL-4 in patients with neurosyphilis and patients with serofast syphilis were higher than those in the control group,whereas IL-17A levels were lower than those in the control group(P<0.05).There was no significant difference in the levels of Th1,Th2 and Th17 related cytokines between neurosyphilis patients and serofast syphilis patients(P>0.05).The levels of IL-2,IFN-γ,IL-4,and IL-17A in patients with neurosyphilis at different clinical stages were also statistically different from those in the control group(P<0.05),but no significant difference in IL-17A was found between early neurosyphilis patients and the control group(P>0.05).The level of IL-17A in patients with advanced neurosyphilis was markedly lower than that of the control group(P<0.05).Conclusion Th1,Th2 and Th17 related cytokines are abnormal in patients with neurosyphilis and those with serofast syphilis,and there are also differences between different stages of neurosyphilis,which may be related to the pathogenesis of neurosyphilis and serofast syphilis.