慢性阻塞性肺疾病患者肺组织中树突状细胞、辅助性T细胞17/调节性T细胞的表达及其意义  

The potential role of lung dendritic cells and Th17/regulatory T tells in patients with chronic obstructive pulmonary disease

作　　者：张兰英[1] 陈杰[1] 张奕 顾延会[1] 饶习敏[1] 欧阳瑶[1] Zhang Lanying;Chen Jie;Zhang Yi;Gu Yanhui;Rao Ximin;Ouyang Yao(The First Department of Respiratory and Critical Care Medicine,The Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou 563000,China;Department of Internal Medicine,Affiliated Hospital of Maternal and Child Health Care of Zunyi Medical University,Zunyi,Guizhou 563000,China)

机构地区：[1]遵义医学院附属医院呼吸与危重症医学科呼吸一病区,563000 [2]遵义医学院附属妇幼保健院内科,563000

出　　处：《中华内科杂志》2019年第2期125-132,共8页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金(81460008).

摘　　要：目的通过观察慢性阻塞性肺疾病(COPD)患者肺组织中成熟树突状细胞、未成熟树突状细胞、辅助性T细胞17(Th17)、调节性T细胞的变化,探讨树突状细胞经Th17/调节性T细胞途径在COPD发病机制中的作用。方法取2015年9月至2016年3月因肺癌行肺叶切除术患者的肺组织,依据其病史资料分为无吸烟无COPD组(20例)、吸烟无COPD组(22例)、吸烟COPD组(20例)。免疫组化法检测3组患者肺组织CD80、趋化因子受体6(CCR6)、白细胞介素-17A(IL-17A)、叉头状转录因子P3(FoxP3)表达,流式细胞技术检测肺组织悬液中成熟树突状细胞、未成熟树突状细胞、Th17、调节性T细胞的变化,并进行相关性分析。结果(1)免疫组化显示,吸烟COPD组肺组织CD80(2.31±1.61)、FoxP3(2.20±1.38)阳性表达细胞数减少,CCR6(8.74±4.63)、IL-17A(9.43±3.81)阳性表达细胞数增多(P值均<0.05);(2)流式细胞术显示,吸烟COPD组肺组织悬液中成熟树突状细胞(0.55±0.15)、调节性T细胞(0.60±0.18)降低,未成熟树突状细胞(4.20±0.21)、Th17(4.79±1.16)增多(P值均<0.05);(3)吸烟COPD组,Th17、Th17/调节性T细胞比值与第1秒用力呼气容积(FEV1)占预计值百分比、用力肺活量(FVC)占预计值百分比、FEV1/FVC呈负相关(r分别为-0.902、-0.905、-0.474、-0.935、-0.869、-0.491,P值均<0.05),调节性T细胞与FEV1占预计值百分比、FVC占预计值百分比、FEV1/FVC呈正相关(r分别为0.747、0.716、0.274,P值均<0.05)。结论COPD中树突状细胞成熟障碍,且存在Th17/调节性T细胞失衡,倾向Th17介导的促炎性反应,可能参与了COPD的发病机制。ObjectiveTo explore the role of lung dendritic cells (DCs) and Th17/regulatory T cells (Treg) pathway in the pathogenesis of chronic obstructive pulmonary disease(COPD). MethodsCOPD patients who received lobectomy from Sep. 2015 to Mar. 2016 in our hospital were enrolled and classified into non-smoking non-COPD group, smoking without COPD group and COPD group. The expression of CD80, chemokine recepter-6 (CCR6), interleukin-17A (IL-17A) and fork-head transcription factor P3 (FoxP3) were detected by immunohistochemistry (IHC) in lung tissue. Mature DCs (mDCs), immature DCs (imDCs), Th17 cells and Treg cells in lung tissue were detected by flow cytometry (FCM) and the correlation between Th17/Treg cells with lung function was analyzed. Results(1) The expression of CD80 and FoxP3 in COPD group was decreased, while the expression of CCR6 and IL-17A was increased (P<0.05). (2) The percentage of mDCs and Treg in lung tissue of COPD group was significantly decreased. In contrast, the proportion of imDCs and Th17 cells in COPD group was significantly increased (P<0.05). (3) The imbalance of Th17/Treg ratio in lung tissue was seen in patients with COPD, suggesting the potential mechanism of Th17 cell-mediated proinflammatory response. (4) The percentage of Th17 cells and Th17/Treg ratio in COPD patients was negatively correlated with forced expiratory volume in the first second (FEV1) as a percentage of predicted value (FEV1% pred), forced vital capacity(FVC) as a percentage of predicted value (FVC% pred), FEV1/FVC. On the other hand, the percentage of Treg cells was positively correlated with FEV1% pred, FVC% pred, FEV1/FVC. ConclusionsThe data in this study demonstrate the maturation disorder of dendritic cells in lung tissue of COPD patients. The imbalance of Th17/Treg ratio suggests that Th17 cell-mediated proinflammatory response may be involved in the pathogenesis of COPD.

关 键 词：肺疾病 慢性阻塞性 树突细胞 辅助性T细胞17 T淋巴细胞 调节性 

分 类 号：R563.9[医药卫生—呼吸系统]