Graves眼病患者血浆细胞因子浓度与临床活动度的相关性分析

Analysis of the correlation between levels of cytokines and the clinical active severity in patients with Graves ophthalmopathy

目的Graves眼病(Graves ophthalmopathy,GO)是一种器官特异性自身免疫疾病,是成人最常见的眼眶疾病之一,其导致的眼部损害给患者带来了沉重的身心负担。GO的发病机制包括炎症细胞(淋巴细胞、浆细胞、肥大细胞和巨噬细胞)增多,分泌多种细胞因子导致炎症反应。在本研究中,测定活动期及非活动期GO患者血浆12种细胞因子的浓度,探讨其与疾病临床活动度的相关性。方法选取2021年1月-2023月1月在首都医科大学附属北京同仁医院内分泌科诊断为GO患者27例,并按照其临床活动性评分(Clinical Activity Score,CAS)将其划分为活动期组(CAS≥3)14例及非活动期组(CAS<3)13例。采用多重微球流式免疫荧光发光法检测血浆12项细胞因子[包括白细胞介素(interleukin,IL)-1β、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-17、IL-12P70,干扰素(interferon,IFN)-α、IFN-γ、肿瘤坏死因子(tumor necrosis factor,TNF)-α]浓度,同时收集所有研究对象的性别、年龄、肝肾功能、甲状腺功能及抗体等临床指标。结果与非活动期组相比,活动期GO患者的IL-1、IL-4、IL-5、IL-8、IL-10、IL-17、TNF-α及IFN-γ浓度明显升高,差异均有统计学意义(P<0.05)。Spearman相关性分析显示IL-1、IL-4、IL-5、IL-8、IL-10、IL-17、TNF-α及IFN-γ与CAS评分呈现显著正相关。单因素Logistic回归分析显示IL-1、IL-4、IL-5和IL-17升高会增加活动期风险。结论(1)活动期GO患者IL-1、IL-4、IL-5、IL-8、IL-10、IL-17、TNF-α及IFN-γ浓度明显高于非活动期组,提示这些细胞因子可能参与了GO的免疫反应。(2)单因素回归分析显示,IL-1、IL-4、IL-5和IL-17升高会增加活动期风险,推测这4种细胞因子有望作为评判GO病情活动性的指标。

Objective To explore the correlation between plasma levels of 12 cytokines and the clinical activity of the disease in patients with Graves ophthalmopathy(GO)in active and inactive phases.Methods A total of 27 patients with GO were enrolled,who were diagnosed in the Department of Endocrinology,Beijing Tongren Hospital,Capital Medical University from January 2021 to January 2023.According to their Clinical Activity Score(CAS),the patients were divided into active phase group(14 cases,CAS≥3)and inactive phase group(13 cases,CAS<3)The levels of 12 cytokines in plasma were measured by multiple microsphere flow immunofluorescence luminescence method,including interleukin(IL)-1βIL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-17,IL-12P70,interferon(IFN)-α,IFN-γ,and tumor necrosis factor(TNF)-α.The clinical characteristics such as gender,age,liver and kidney function,thyroid function,and antibody of all the subjects were collected.Results The levels of IL-1,IL-4,IL-5,IL-8,IL-10,IL-17,IFN-γand TNF-αin active GO patients were significantly higher than those in inactive GO patients.Levels of TNF-αand IFN-γwere significantly increased in active GO patients,with statistically significant difference(P<0.05).Spearman correlation analysis showed that IL-1,IL-4,IL-5,IL-8,IL-10,IL-17,TNF-αand IFN-γwere significantly positively correlated with CAS score(P<0.05).The univariate logistic regression showed that the elevated levels of IL-1,IL-4,IL-5 and IL-17 increase the risk of active phase.Conclusion The levels of IL-1,IL-4,IL-5,IL-8,IL-10 and IL-17 in active GO patients are significantly higher than those in inactive patients,suggesting that these cytokines may participate in the immune response of the disease.Elevated levels of IL-1,IL-4,IL-5 and IL-17 increase the risk of active phase,indicating a potential of these four cytokines as indicators for judging the activity of GO disease.