哮喘患者诱导痰中IL-17A、IL-8及MMP-9水平变化及糖皮质激素对其的影响  

Changes of IL-17A,IL-8 and MMP-9 level in the airway inflammation with asthma

作　　者：张辉[1] 王静[1] 程哲[1] 包爱华[1] 付晓敏[1] 

机构地区：[1]郑州大学第一附属医院,河南郑州450052

出　　处：《山东医药》2009年第3期35-38,共4页Shandong Medical Journal

摘　　要：目的探讨哮喘患者气道炎症特点及糖皮质激素的作用机制。方法将33例哮喘患者(哮喘组)按病情程度分为轻、中度19例及重度14例,予规范吸入糖皮质激素治疗4周,行诱导痰炎性细胞分类并计数,采用ELISA法检测痰上清液炎性介质白细胞介素-17A(IL-17A)、IL-8、基质金属蛋白酶-9(MMP-9)水平,并与15例查体健康者(对照组)进行比较。对诱导痰细胞分类、1秒钟用力呼气量占预计值百分比(FEV1%)及炎性介质水平进行相关分析。结果重度哮喘者诱导痰中性粒细胞、嗜酸性粒细胞比值及上清液IL-17A、IL-8、MMP-9水平显著高于对照组及轻、中度者;轻～中度者除MMP-9无显著升高外,余各指标均显著高于对照组(P均<0.01)。诱导痰中性粒细胞及嗜酸性粒细胞比值与FEV1%呈显著负相关;中性粒细胞比值与IL-8、MMP-9呈正相关;IL-17A水平与中性粒细胞比值、IL-8呈正相关。糖皮质激素治疗后重度者中性粒细胞、嗜酸性粒细胞比值及MMP-9水平仍显著高于轻～中度者。结论中性粒细胞浸润性气道炎症是重度持续性哮喘的重要特征;IL-17A、IL-8与MMP-9可能在其中发挥重要作用。吸入糖皮质激素能抑制炎症细胞的趋化效应,阻止炎症释放,稳定细胞溶酶体膜,减轻组织损伤。Objective To investigate the airway inflammation features of asthma, and the mechanism of treating it by glucocorticoid. Methods Airway cells in the sputum induction obtained from 15 healthy and 33 asthmatic individuals were classified and counted, and the supernatant was assayed for the levels of IL-17A, IL-8, MMP-9. Then all of the asthmatics received inhaled glucocorticoid therapy for four weeks, and the above measurements were repeated. Results The percentage of sputum neutrophils and eosinophils and the level of MMP-9 in patients with severe asthma were significantly higher than that in patients with mild-to-moderate asthma and healthy controls（ P 〈0.01 ）, and the percentage of sputum neutrophils and eosinophils was strongly related to the FEV1 （P 〈0.01 ）. The levels of sputum IL-17A and IL-8 were significantly elevated in patients with severe asthma and mild-to-moderate asthma compared with healthy controls（P 〈0. O1 ）. The pereentage of sputum neutrophils positively correlated with the levels of IL-17A, IL-8, MMP-9. After steroid therapy, the percentage of eosinophils ,the levels of IL-17A, IL-8, MMP-9 decreased significantly in all patients, the percentage of neutrophils in severe asthmatics were still significantly higher than that in mild -to-moderate asthmatics. Conclusions Neutrophilic infiltration in the airways is prominent in severe persistent asthma, in wich the IL-17A, IL-8, MMP-9 may play im- portant role. Glucocorticoid inhalation can relieve the sererity of asthma.

关 键 词：哮喘 白细胞介素-17A 白细胞介素-8 基质金属蛋白酶-9 气道炎症 

分 类 号：R562.25[医药卫生—呼吸系统]