炎性肌病患者血清中细胞因子水平与间质性肺疾病的相关研究

摘要

目的 检测皮肌炎(DM)、多肌炎(PM)患者血清中白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)水平,分析其与间质性肺疾病(ILD)的相关性,探索炎性肌病(IM)伴发ILD新的治疗靶点.方法 收集DM患者35例,其中DM-ILD组17例,DM-非ILD组18例,DM-ILD患者中急性/亚急性间质性肺炎(A/SIP)患者11例,慢性间质性肺炎(CIP)患者6例;PM组15例,其中PM-ILD组6例,PM-非ILD组9例;健康对照组10例,详细记录临床及实验室资料.采用流式CBA法检测血清中IL-6、IL-8和TNF-α的水平.分析三种血清因子与ILD的相关性.结果 (1)DM组IL-6、IL-8、TNF-α水平显著高于HC组(P<0.05);(2)PM组IL-6、IL-8、TNF-α水平显著高于HC组(P<0.05);(3)DM-ILD组IL-6、IL-8、TNF-α水平显著高于DM-非ILD组(P<0.001,<0.001,0.011);PM-ILD组与PM-非ILD组之间差异无统计学意义(P>0.05);(4)IL-6在DM-ILD组表达显著高于PM-ILD组(P=0.013),IL-8和TNF-α在两组之间差异无统计学意义(P>0.05);(5)在DM-ILD组中,IL-6、IL-8、TNF-α在A/SIP组较CIP组显著升高(P<0.05).结论 DM-ILD中IL-6 、TNF-α、IL-8水平均显著高于DM-非ILD患者;IL-6在DM-ILD患者中显著高于PM-ILD患者;IL-6可能在DM-ILD的发病过程中起到重要作用.%Objective To detect the levels of IL-6,IL-8 and TNF-α in serum of patients with dermatomyositis (PM) and polymyositis (DM),to analyze its correlation with interstitial lung disease,and to explore new therapeutic targets for inflammatory myopathy with interstitial lung disease (IM-ILD).Methods Thirty-five patients with DM,15 patients with PM and 10 healthy controls were enrolled in this study.DM patients included 17 patients with DM-ILD,among which 11 patients were acute/subacute interstitial pneumonia (A/SIP),and 6 patients were chronic interstitial pneumonia (CIP),and 18 patients with DM-nonILD.Detailed clinical and laboratory data were collected.The levels of IL-6,IL-8 and TNF-α in serum were measured by flow CBA.The correlation of three serum factors and interstitial lung disease of inflammatory myopathy was analyzed.Results The levels of IL-6,TNF-α and IL-8 in the DM group were significantly higher than those in HC group (P<0.05).The levels of IL-6,TNF-α and IL-8 in PM group were significantly higher than those in HC group (P<0.05).The levels of IL-6,IL-8 and TNF-α in DM-ILD group were significantly higher than that in DM-nonILD group (P<0.001,<0.001,0.011).There was no significant difference between PM-ILD group and PM-nonILD group (P>0.05).The expression of IL-6 in DM-ILD group was significantly higher than that in PM-ILD group (P=0.013),and there were no significant differences in IL-8 and TNF-α between the two groups(P>0.05).In DM-ILD group,the levels of IL-6,IL-8 and TNF-α in A/SIP group were significantly increased,higher than those in CIP group (P<0.05).Conclusions The levels of IL-6,TNF-α and IL-8 in DM-ILD patients were significantly higher than those in DM-ILD patients and the expression of IL-6 in DM-ILD patients was significantly higher than that in PM-ILD patients,which suggested that IL-6 may play an important role in the pathogenesis of DM-ILD.