支气管哮喘患者血清中 Th17细胞相关细胞因子的检测及意义

摘要

Objective:To compare the serum levels of transforming growth factor-β1 (TGF-β1),interleukin-17 (IL-17),inter-leukin-23 (IL-23)in patients with bronchial asthma at different degrees of airway obstruction after standardized treatment,in order to explore the significance of TGF-β1,IL-17,IL-23 in airway remodeling in patients with asthma.Methods:Ninety-one asthma patients,who underwent standardized treatment for at least three months,were recruited by applying control study.By using FEV1%pred as grouping criterion,the 91 patients with asthma were divided into the mild asthma group (FEV1%pred≥80%),the moderate asthma group (60 %< FEV1 %< 80%)and the severe asthma group (FEV1 %≤60%).In addition, 27 healthy people were selected as control group.The serum levels of TGF-β1,IL-17,and IL-23 in each group were monitored and compared with each other.Results:1.Compared with that in the control group,the serum levels of TGF-β1 in asthma group were higher,while the levels of IL-17 were lower.There was no significant difference in serum IL-23 level between the two groups.2.Comparison were done among the asthma groups.There were significant differences in serum levels of TGF-β1 and IL-17 between mild asthma group and moderate-to-severe asthma group (P < 0.05 ),while there were no significant differences between moderate group and severe group.3.Serum IL-17 level was correlated negatively with TGF-β1 level. FEV1%pred was correlated negatively with serum TGF-β1 level and positively with serum IL-17 level,while it had no correla-tion with serum IL-23 level.Conclusions:In patients with asthma,the serum TGF-β1 level is negatively correlated with FEV1%pred,which indicates that TGF-β1 is an important index for airway remodeling.The serum levels of IL-17 in patients with asthma is lower than those in healthy people.Furthermore,the decrease of serum IL-17 level is more significant while the obstruction is worse.The probable answer is that persistent airway inflammation inhibits secretion and expression of IL-17,so that the expression of IL-17 declines in phase with severe impairment of pulmonary function and severe airway remodeling.%目的：比较规范治疗后的气道阻塞程度不同的支气管哮喘（哮喘）患者血清中的转化生长因子-β1（transforming growth factor-β1，TGF-β1）、白细胞介素-17（interleukin-17，IL-17）、白细胞介素-23（interleukin-23，IL-23）等指标，探讨上述指标在哮喘患者气道重塑中的意义。方法：采用病例对照的方法收集规范治疗至少3个月的哮喘患者91例。以第1秒用力呼气量占预计值百分比（FEV1％pred）作为分组标准，将91例哮喘患者分为轻度组（FEV1％pred≥80％）、中度组（60％＜FEV1％pred＜80％）、重度组（FEV1％pred≤60％）。选取同期27例健康体检者作为对照组。检测并比较各组血清中的 TGF-β1、IL-17、IL-23水平。结果：（1）哮喘组与对照组比较，血清 TGF-β1水平较高，IL-17水平较低，两组间血清 IL-23水平的差异无统计学意义。（2）各哮喘组间比较，轻度组血清 TGF-β1、IL-17水平与中、重度组的差异有统计学意义（P ＜0．05），中度组与重度组间差异无统计学意义；轻、中、重度组间血清 IL-23水平的差异无统计学意义。（3）血清 IL-17水平与血清 TGF-β1水平呈负相关；FEV1％pred 与血清 TGF-β1水平呈负相关，与血清 IL-17水 平 呈 正 相 关，与血清 IL-23水 平 不 相 关。结论：哮喘患者血清TGF-β1与 FEV1％pred 呈负相关，表明 TGF-β1是重要的气道重塑指标。哮喘患者血清 IL-17低于健康人，且气道阻塞越严重，IL-17降低越显著；这可能是由于持续的气道炎性反应可抑制 IL-17的分泌和表达，使其在肺功能损害、严重气道重塑阶段的表达水平下降。