特发性肺纤维化患者肺泡灌洗液及血清中前列腺素E_2和白细胞介素12、13水平变化的意义

Change of prostaglandin E_2 and interleukin-12, interleukin-13 in the bronchoalveolar lavage fluid and the serum of the patients with idiopathic pulmonary fibrosis

目的 探讨特发性肺纤维化 (IPF)患者肺泡灌洗液及血清中前列腺素E2 (PGE2 )和白细胞介素 12、13(IL 12、IL 13)水平变化的意义。方法 用放射免疫法及酶联免疫吸附法 ,检测 30例IPF患者 (IPF组 )血清及支气管肺泡灌洗液 (BALF)中PGE2 和IL 12、IL 13的水平 ;健康非吸烟的自愿献血者 30名 ,为血清对照组 ,检测其血清PGE2 和IL 12、IL 13的水平 ;以胸痛为主诉进行BALF检查证实为健康者 9名 ,作为BALF对照组 ,检测其BALF中PGE2 和IL 12、IL 13的水平。结果 IPF组患者BALF中PGE2 为 (5 91± 88)ng/L、IL 12为 (1 34± 0 2 5 )ng/L、IL 13为 (38± 5 )ng/L ,对照组BALF中PGE2 、IL 12、IL 13分别为 (2 38± 7)、(2 2 9± 0 2 6 )、(2 0± 4 )ng/L ,两组相比差异有显著意义 (P值均 <0 0 1) ;血清IL 13水平的变化与BLAF一致 ,但IPF组患者血清PGE2 为 (2 35± 13)ng/L、IL 12为 (2 35± 0 14 )ng/L ,与血清对照组相比差异无显著性 (P >0 0 5 )。结论 IPF患者BALF中PGE2 水平升高 ,可能与IL 13的增高和IL 12水平的下降有关 ,并在IPF的发生、发展中起重要的作用。肺纤维化患者PGE2水平增高主要发生在肺的局部 ,而并非全身性的。

Objective To detect the levels of prostaglandin E 2(PGE 2) and interleukin-12(IL-12), IL-13 in the bronchoalveolar lavage fluid(BALF) and the serum of patients with idiopathic pulmonary fibrosis (IPF) and to investigate the significance of their change in the pathogenesis of IPF. Methods Radioimmunoassay(RIA) and enzyme-linked immunoadsordent assay(ELISA) were used to detect the levels of PGE 2 and IL-12,IL-13 in the BALF and the serum of patients with IPF. Results In the BALF of patients with IPF, the levels of PGE 2(591±88)ng/L and IL-13(38±5)ng/L were higher than that of the control group(P<0.01),and the level of IL-12(1.34±0.25)ng/L was lower than that of control group. In the patients with IPF, the change of IL-13 in the serum was consistent with the change in the BALF. But the levels of PGE 2(235±13)ng/L and IL-12(2.35±0.14)ng/L in the serum showed no significant difference between the patients with IPF and the control group. Conclusions In the patients with IPF the increase of PGE 2 may be correlated with the increase of IL-13 and the decrease of IL-12. It suggests that disequilibrium of Th1/Th2 plays an important role in the development of IPF.The increase of PGE 2 in IPF is a local event rather than a systemic effect.