全身型幼年特发性关节炎患儿T辅助细胞及细胞因子变化  

Thelper lymphocyte subsets and cytokines in children with systemic-onset juvenile idiopathic arthritis

作　　者：徐凌云[1] 屠志强[1] 薛海燕[1] 曹兰芳[1] 

机构地区：[1]上海交通大学医学院附属仁济医院儿科,上海200001

出　　处：《临床儿科杂志》2014年第2期140-143,共4页Journal of Clinical Pediatrics

基　　金：上海市中医药事业发展三年行动计划第二批重大研究项目(No:ZYSNXD-CC-ZDYJ030)

摘　　要：目的探讨辅助性T淋巴细胞及相关细胞因子在全身型幼年特发性关节炎(SoJIA)患儿中表达的变化。方法 2012年1月至2013年6月住院的36例SoJIA患儿,按疾病活动情况分为活动期组、缓解期组,另以健康儿童20例为对照组。比较各组流式细胞技术检测的外周血单个核细胞中Th1、Th2和Th17细胞比例,及酶联免疫吸附法检测的血清INF-γ、IL-4、IL-17水平的差异。结果 SoJIA活动期组、缓解期组和对照组的Th17占CD3+CD8-细胞比例分别为(3.30±2.15)%、(1.78±1.14)%和(1.22±1.14)%,差异有统计学意义(H=14.437,P=0.001),活动期组高于缓解期组和对照组,差异有统计学意义(P均<0.05);三组间Th1、Th2占CD3+CD8-细胞比例的差异无统计学意义(P>0.05)。SoJIA活动期组、缓解期组和对照组的血清IL-17水平分别为(125.82±45.87)pg/ml、(57.79±25.84)pg/ml和(50.02±18.37)pg/ml,差异有统计学意义(F=31.82,P=0.000),活动期组高于缓解期组和对照组,差异有统计学意义(P均<0.05);三组血清INF-γ和IL-4水平的差异无统计学意义(P>0.05)。结论获得性细胞免疫参与SoJIA发病,且Th1、Th17细胞比例升高及其相关细胞因子变化与SoJIA患儿疾病活动有关。Objectives To explore the changes of T helper （Th） lymphocyte and its related factors in children with syste-mic-onset juvenile idiopathic arthritis （SoJIA）. Methods A total of 36 SoJIA inpatients, hospitalized from January 2012 to June 2013, were divided into active phase group and remission group. In addition, 20 healthy children were selected as normal con-trols. Th1, Th2 and Th17 cell ratios in peripheral blood mononuclear cells were detected and compared between each group by flow cytometry. Serum interferon-γ（INF-γ）, interleukin-4 （IL-4）, interleukin-17 （IL-17） levels were measured by enzyme-linked immunosorbent assay. Results The proportions of Th17 cells over CD3＋CD8-cell were （3.30＆#177;2.15）%, （1.78＆#177;1.14）%and （1.22＆#177; 1.14）%in active phase group, remission group and control group. The difference among three groups was significant （H=14.437, P=0.001）, and the active phase group had higher proportion of Th17 than the other two groups （P＆lt;0.05）. The ratio of Th1 and Th2 over CD3＋CD8-cell between each group was not significantly different （P＆gt;0.05）. The serum IL-17 levels were （125.82 ＆#177; 45.87） pg/ml, （57.79＆#177;25.84）pg/ml and（50.02＆#177;18.37）pg/ml in active phase group, remission group and control group with signifi-cant difference among three groups （F=31.82, P=0.000）, and the active phase group had higher level of IL-17 than the other two groups （P＆lt;0.05）. But serum INF-γ and IL-4 were not significantly different between each group （P＆gt;0.05）. Conclusions Acquired cellular immunity is involved in pathogenesis of SoJIA, the increased proportion of Th1 and Th17 cell and the changes of related cytokines seem to correlate with active phage of SoJIA.

关 键 词：全身型幼年特发性关节炎 辅助性T细胞 细胞因子 

分 类 号：R725.9[医药卫生—儿科]