重型再生障碍性贫血患者血清白细胞介素17水平及免疫功能状态  

Association between serum interleukin-17 level and abnormal cellular immunological status in patients with severe aplastic anemia

作　　者：齐薇薇[1] 付蓉[1] 王化泉[1] 刘春燕[1] 刘惠[1] 邵媛媛[1] 任悦[1] 陶景莲[1] 邵宗鸿[1] 

机构地区：[1]天津医科大学总医院血液科,300052

出　　处：《中华医学杂志》2014年第20期1539-1542,共4页National Medical Journal of China

基　　金：国家自然科学基金（81170472、81370607）;天津市自然科学基金重点项目（12JCZDJC21500）;天津市抗癌重大专项攻关计划（12ZCDZSY17900、12ZCDZSY18000）;天津市卫生行业重点攻关项目（11KG135）;卫生行业科研专项（201202017）

摘　　要：目的 探讨白细胞介素（IL）-17在重型再生障碍性贫血（SAA）患者发病机制中的作用.方法 收集2012年10月至2013年10月天津医科大学总医院血液科诊断明确的SAA患者40例（初治组25例、缓解组15例）及10名健康对照的外周血标本,采用流式液相多重蛋白定量技术检测血清IL-17水平,分析其与T细胞亚群（CD4^＋/CD^8＋比值）、树突细胞（DC）亚群[髓样树突细胞（mDC）/淋系树突细胞（pDC）比值]、调节性T细胞（Treg）及血常规表达的相关性.结果 SAA初治组IL-17水平为（17.07±15.18） ng/L,明显高于恢复组[（7.09 ±3.84） ng/L,P＜0.01]和对照组[（3.53±2.08） ng/L,P＜0.01];SAA恢复组IL-17水平亦明显高于对照组（P＜0.05）.初治组CD4^＋/CD^8＋比值为0.32±0.08明显低于恢复组（1.11±0.31,P＜0.01）及对照组（1.07±0.26,P＜0.01）;初治组mDC/pDC比值为3.16±0.55明显高于恢复组（1.60 ±0.43,P＜0.01）及对照组（1.43±0.38,P＜0.01）;初治组Treg占外周血单个核细胞比例（CD4^＋ CD^25＋ CD127dim/PBL）为0.80％±0.31％明显低于恢复组（1.78％±0.69％,P＜0.01）及对照组（2.23％±0.66％,P＜0.01）.初治组IL-17水平与CD4^＋/CD^8＋比值及CD4^＋ CD^25＋ CD127dim/PBL均呈负相关（r=-0.421,P ＜0.05;r=-0.650,P＜0.01）,与mDC/pDC比值呈正相关（r=0.414,P＜0.05）,与白细胞水平呈负相关（r=-0.689,P＜0.01）;恢复组IL-17水平与白细胞水平呈负相关（r=-0.640,P＜0.05）.结论 SAA患者血清IL-17升高,并与SAA免疫功能状态及病情严重程度相关.Objective To explore the role of interleukin-17 （IL-17） in the pathogenesis of severe aplastic anemia （SAA）.Methods Peripheral blood samples were obtained from 40 SAA patients （25 untreated,15 recovery） and 10 normal controls from October 2012 to October 2013.The level of IL-17in peripheral blood was measured with cytometric bead array （CBA）.The correlations between IL-17 and T cells subset （CD4^＋/CD^8＋）,dendritic cells （DC） subset （mDC/pDC）,regulatory T cells （Treg） and hemogram were analyzed.Results The serum level of IL-17 in untreated patients was higher than that in recovery patients and normal controls （（17.07 ± 15.18） vs （7.09 ±3.84） and （3.53 ±2.08） ng/L,both P 〈 0.01）.Also significant differences existed between the latter two groups （P 〈 0.05）.The ratio of CD4^＋/CD^8＋ was （0.32 ± 0.08） in untreated patients and it was lower than that in recovery patients （1.11 ±0.31,P 〈 0.01） and normal controls （1.07 ± 0.26,P 〈 0.01）.The ratio of mDC/pDC was （3.16 ±0.55） in untreated patients was higher than that in recovery patients （1.60 ±0.43,P 〈0.01）and normal controls （1.43 ± 0.38,P 〈 0.01）.The percentage of Tregs in peripheral blood lymphocyte （CD4^＋CD^25＋ CD127dim/PBL） was 0.80% ± 0.31% in untreated patients and it was lower than that in recovery patients （1.78% ±0.69%,P 〈 0.01） and normal controls （2.23% ± 0.66%,P 〈 0.01）.The serum level of IL-17 in untreated SAA patients was related positively with mDC/pDC ratio （r =0.414,P 〈 0.05）and negatively with CD4^＋/CD^8＋ ratio （r =-0.421,P 〈 0.05） and CD4^＋ CD^25＋ CD127dim/PBL （r =-0.650,P 〈 0.01）.And significant negative correlations existed between serum IL-17 and white blood cells in untreated patients （r =-0.689,P 〈 0.01） and recovery patients （r =-0.640,P 〈 0.05）.Conclusion The elevated serum level of IL-17 in SAA is related with the immunological status and disease severity.

关 键 词：贫血 再生障碍性 白细胞介素17 流式液相多重蛋白定量技术 

分 类 号：R556.5[医药卫生—血液循环系统疾病]