炎症性肠病患者肠黏膜白细胞介素18的表达及意义

Expression of interleukin 18 in intestinal mucosa of patients with inflammatory bowel disease and its implications

目的 :探讨炎症性肠病患者肠黏膜白细胞介素 18(IL 18)的表达及与疾病活动性的关系。方法 :活动期克罗恩病 (CD)和溃疡性结肠炎 (UC)患者分别为 2 3例和 2 0例 ,其中CD 9例、UC 11例经药物 (SASP或SASP +糖皮质激素 )治疗后达缓解期 ;2 0例对照来自于非炎症性肠病患者手术切除之正常结肠组织。采用半定量RT PCR检测肠黏膜IL 18mRNA表达 ,免疫组化方法原位检测肠黏膜组织中IL 18蛋白表达量。结果 :活动期CD患者肠黏膜IL 18mRNA表达显著高于活动期UC和对照组 ,活动期UC与对照组比较差异无显著性。免疫组化显示肠黏膜上皮细胞和固有层单个核细胞 (主要是巨噬细胞和树突状细胞 )表达IL 18;活动期CD患者表达量显著高于活动期UC和对照 ,活动期UC与对照比较差异无显著性 ;缓解期CD患者IL 18表达与活动期相比显著下降 ,UC患者IL 18表达下降则差异无显著性。结论 :IL 18参与了炎症性肠病的发病过程 ,并与CD活动有关。

Objective: To investigate the expression of interleukin 18 (IL 18) in intestinal mucosa of patients with inflammatory bowel disease (IBD) and its relation with disease active state. Methods: IL 18mRNA transcripts were evaluated by using a semiquantitative RT PCR protocol. Specimens of 23 Crohn's disease (CD) and 20 ulcerative colitis (UC) patients and 20 controls were studied by immunohistochemical staining. Results: Transcripts of IL 18 were found to be increased significantly in intestinal mucosa from active CD compared with UC and control . Immunohistochemical staining analysis localized the expression of IL 18 to intestinal epithelial cells and lamina propria (macrophages and dendritic cells, mainly). Staining was more intense in active CD compared with UC and control. Both transcriptions and staining of IL 18 in active UC were elevated, but there was no significant difference compared with control. Expression of IL 18 decreased in inactive CD ( n =9) or UC ( n =11) compared with active state of the same patients, and the difference in CD had significance. Conclusion: IL 18 may be involved in the pathogenesis of IBD and related with CD activity.