香烟烟雾提取物致Th17/Treg的失衡在慢性阻塞性肺疾病发生发展中的作用与意义  

The role and significance of the imbalance of Th17/Treg caused by cigarette smoke extract in development of COPD

作　　者：刘晓君[1] 吴世满[1] 康彩云[1] 刘娟[1] 

机构地区：[1]山西医科大学第一医院呼吸科,太原030001

出　　处：《中华临床医师杂志（电子版）》2014年第11期61-66,共6页Chinese Journal of Clinicians(Electronic Edition)

基　　金：山西省回国留学人员科技资助项目[晋人函字(2008)56号]

摘　　要：目的观察慢性阻塞性肺疾病(COPD)患者外周血中Th17细胞、Treg细胞占CD4+T细胞的比例及香烟烟雾提取物(CSE)对其的影响,探讨CSE对Th17细胞、Treg细胞的影响及Th17/Treg的平衡关系在COPD发生发展中的作用。方法随机收集慢性阻塞性肺疾病急性加重期(AECOPD)患者20例(A组),COPD稳定期患者20例(B组),吸烟肺功能正常者20例(C组),不吸烟肺功能正常者20例(D组)。抽取空腹静脉血制备单个核细胞悬液(PBMC),将每个试验对象的PBMC分为空白对照组和CSE干预组,采用流式细胞术检测所有试验对象对照组和干预组CD4+Th17细胞及CD4+Treg细胞各占CD4+T细胞的比例;ELISA法检测各组血浆中IL-17的浓度。结果 Th17/CD4+T细胞百分比对照组A组(5.33±0.66)高于B组(2.99±0.50)、C组(2.09±0.68)、D组(1.19±0.48)(P<0.001),CSE干预组较对照组升高(P<0.001);Treg/CD4+T细胞百分比对照组C组(5.88±0.52)高于D组(3.35±0.30)、B组(2.25±0.30)、A组(1.58±0.39)(P<0.001),CSE干预组较对照组升高(P<0.001);CD4+Th17细胞百分比对照组与CSE干预组差值A、B组高于C、D组(P<0.001),A组与B组之间差异无统计学意义(P=0.866),C组与D组之间差异无统计学意义(P=0.793);CD4+Treg细胞百分比对照组与CSE干预组差值C、D组高于B组、A组(P<0.001),C组与D组之间差异无统计学意义(P=0.756);外周血IL-17水平A组(145.22±5.50)高于B组(94.99±3.19)、C组(59.77±5.09)、D组(50.84±5.85)(P<0.001);COPD组血浆中IL-17的水平与外周血Th17细胞比例呈正相关(rA=0.524,rB=0.462);与FEV1/FVC值呈负相关(rA=-0.456,rB=-0.567);与FEV1/预计值%呈负相关(rA=-0.503,rB=-0.445)。结论 Th17与Treg比例的失衡可能是COPD的其中一个重要的发病机制;外周血IL-17水平与FEV1/FVC值、FEV1/预计值%呈负相关。Objective To determine Th17 cells, Treg cells accounted for the proportion of CD4＋T cells in Peripheral blood of patients with chronic obstructive pulmonary disease（COPD） and the effects of cigarette smoke extract（CSE）. To investigate the effect of CSE on Th17 cells, Treg cells and the role of the balance between Th17/Treg occur in the development COPD. Methods Choose 20 patients with AECOPD, 20 patients with stable COPD, 20 smokers with normal lung function, 20 non-smokers with normal lung function randomly. Collecting fasting venous blood to prepare peripheral blood mononuclear cell suspension（PBMC）, the PBMC of every experiment object subject were divided into control group and intervention group of CSE. The percentage of Th17 cells and Treg cells in CD4＋ T cells was determined by flow cytometry; IL-17 level of each group was detected by ELISA method in plasma. Results The percentage of CD4＋ Th17 cells of the control group A was higher than control group B, C, D（P〈0.001）, it in CSE intervention group was increased than in the control group（P〈0.001）; The percentage of CD4＋Treg cells of the control group C was higher than control group A, B, D（P〈0.001）, it in CSE intervention group was increased than in the control group（P0.001）; In terms of the difference of the percentage of CD4＋ Th17 cells between the intervention group CSE and the control group, group A, B were higher than C, D group（P〈0.001）, there was no statistically significant difference between group A and group B（P=0.866）, the same to group C and D（P=0.793）; In terms of the difference of the percentage of CD4＋ Treg cells between the intervention group CSE and the control group, group C, D were higher than group C and higher than group D（P〈0.001）, there was no statistically significant difference between group C and group D（P=0.756）; The levels of IL-17 in plasma in group A was higher than group B, C, D, there was statistically significant difference among the four groups; The levels

关 键 词：肺疾病 慢性阻塞性 白细胞介素17 TH17细胞 TREG细胞 香烟烟 雾提取物 

分 类 号：R563.9[医药卫生—呼吸系统]