隐球菌性脑膜炎患者中Th17细胞相关细胞因子的高表达及其临床意义

摘要

目的：研究Th17细胞相关细胞因子IL‐17A、IL‐17F、IL‐22在隐球菌性脑膜炎患者发病机制中的作用。方法收集了2011年2月至2013年2月期间来院就诊的免疫功能正常的隐球菌患者22例以及同期来院体检的健康个体20例，收集外周抗凝血，分离了外周血单个核细胞，采用RT‐PCR以及ELISA检测了隐球菌性脑膜炎患者和健康对照者外周血单个核细胞（PB‐MC）中Th17相关细胞因子1L‐17A、IL‐17F以及IL‐22的mRNA表达以及血浆中各蛋白水平的表达。并分析其与脑脊液蛋白浓度、颅内压、脑脊液隐球菌抗原滴度、脑脊液葡萄糖浓度的关系。结果隐球菌性脑膜炎患者外周血单个核细胞中IL‐17A、IL‐22的mRNA水平以及血浆中IL‐17A、IL‐22水平较健康对照组显著增高（P＜0．01），且与隐球菌性脑膜炎患者的预后因子脑脊液蛋白浓度、颅内压、脑脊液隐球菌抗原滴度、脑脊液葡萄糖浓度相关。结论 T h17细胞相关细胞因子IL‐17A、IL‐22可能参与了隐球菌性脑膜炎的发病机制，可能是潜在的评价隐球菌性脑膜炎病情的指标。%Objective To investigate the IL‐17A/F and IL‐22 ,the Th17 related cytokine ,in the serum of cryptococcal meningitis patients and its clinical implications .Methods We collected peripheral blood from 22 cryptococcal meningitis patients and 20 matched healthy controls from February 2011 to February 2013 .Then the peripheral blood mononuclear cells(PBMC)were seperat‐ed with isodensity centrifugation .The RT‐PCR and ELISA were used to detect the mRNA and protein lever of Th17 related cyto‐kine such as IL‐17A ,IL‐17F and IL‐22 .In addition ,the relationship between these cytokines and cerebrospinal fluid characteristics were analyzed .Results The serum concentration of IL‐17A and IL‐22 were much higher than that of healthy controls (P<0 .01) . Their concentration were even higher in patients with poor prognosis factors ,including higher cerebrospinal fluid protein level and cryptococcal antigen titer ,lower cerebrospinal fluid glucose concentration and increased cerebrospinal fluid open pressure .Conclusion IL‐17A and IL‐22 were involved in the pathogenesis of cryptococcal meningitis and may be a potential prognosis biomarker for cryptococcal meningitis.