支气管哮喘患者外周血IL-4、IL-9、IL-21的测定及临床意义

Alteration of peripheral blood IL-4,IL-9,and IL-21 in patients with bronchial asthma

目的:探讨哮喘患者血清细胞因子白细胞介素(interleukin,IL)-4、IL-9、IL-21在支气管哮喘患者中的表达及与哮喘的相关性。方法:选取48例急性发作期、41例缓解期哮喘患者及48例性别和年龄相匹配的健康对照作为研究对象,进行肺功能检查。采用ELISA和实时荧光定量PCR方法,分别从蛋白和基因转录水平测定血清中IL-4、IL-9、IL-21表达和单个核细胞m RNA的表达水平。结果 :1急性发作期哮喘患者IL-4、IL-9、IL-21在蛋白和基因水平上均显著高于缓解组,且差异具有统计学意义(P<0.05或P<0.01)。缓解组血清IL-4、IL-9水平高于对照组(P<0.05),并且IL-4、IL-9 m RNA水平显著高于对照组(P<0.01)。而血清IL-21以及m RNA水平在缓解组与对照组间差异均无统计学意义(P>0.05)。2哮喘患者血清IL-9与IL-4水平呈正相关(P<0.05),IL-21与IL-4,IL-9与IL-21间无明显相关性(P均>0.05)。血清IL-4、IL-9水平均与患者FEV1%成负相关(P<0.05),与总Ig E水平呈正相关(P<0.05)。而血清IL-21水平与FEV1%、血清总Ig E水平无明显相关性(P>0.05)。结论:Th2、Th9、c Tfh细胞特征细胞因子IL-4、IL-9、IL-21均参与了哮喘发病,检测IL-4和IL-9水平可评估哮喘病情发展状态,指导临床治疗。

Objective:To investigate the alteration of peripheral blood interleukin(IL)-4,IL-9,and IL-21 in patients with bronchial asthma. Methods:Forty-eight asthma patients in acute stage,41 patients in remission stage,and 48 sex and age paired healthy controls were enrolled in this study. The expression of IL-4,IL-9,and IL-21 from serum and peripheral blood mononuclear cells were analyzed by ELISA and real-time PCR. And the value of FEV1% and the expression level of serum Ig E were detected by allergy method and ELISA respectively. Results: 1 The m RNA and protein expression levels of IL-4,IL-9,and IL-21 were significantly increased in acute asthma patients compared with patients in remission group(P < 0.05 or P < 0.01). Also the m RNA and protein expression levels of IL-4 and IL-9 were significantly higher in remission group than that of control group(P < 0.05 or P < 0.01). But there was no significant difference in the m RNA and protein expression levels of IL-21 between remission group and control group(P >0.05). 2 In asthma patients,no correlation was found among the serum concentration of IL-4,IL-9 and IL-21,except of correlation between IL-9 and IL-4. The serum levels of IL-4 and IL-9 from asthma patients were positively correlated with the serum level of total Ig E(P < 0.05) but negatively correlated with FEV1%(P < 0.05). But no obvious correlation was found between the serum concentration of IL-21 and the serum level of total Ig E or FEV1%(P > 0.05). Conclusion:IL-4,IL-9,and IL-21 may play important roles in the pathogenesis of bronchial asthma. IL-4 and IL-9 monitoring allows for an assessment of the asthma status which is helpful to guide clinical treatment.