白介素-17A对鼻息肉局部使用糖皮质激素的影响  

Influence of IL-17A on Glucocorticoid Efficacy in Patients with Nasal Polyps

作　　者：钟伟[1] 冯琨[1] 金雪玲[1] 刘丹[1] 罗庆[1] 

机构地区：[1]南昌大学第一附属医院耳鼻咽喉头颈外科,南昌330006

出　　处：《实用临床医学（江西）》2014年第10期82-84,94,共4页Practical Clinical Medicine

基　　金：江西省自然基金自由申请项目(20142BAB205036);江西省教育厅青年科学基金项目(GJJ12155)

摘　　要：目的探讨鼻息肉中白介素-17A(IL-17A)对局部使用糖皮质激素疗效的影响。方法选取行手术的鼻息肉患者20例(手术组,术中取息肉组织),与正常下鼻甲黏膜(对照1组,n=10)行IL-17A免疫组织化学检查;另选门诊30例鼻息肉患者(激素组,予糖皮质激素局部喷鼻治疗1个月)和无鼻部症状10例患者(对照2组),采用酶联免疫吸附剂测定(ELISA)激素组治疗前后和对照2组IL-17A,同时比较激素组疗效。结果 IL-17A的免疫组织化学结果在鼻息肉黏膜中主要表达于上皮细胞及黏膜下细胞,手术组和对照1组的阳性表达率分别为0.49±0.20、0.28±0.19,2组比较差异有统计学意义(t=-2.803,P=0.009);激素组治疗前后IL-17A的ELISA检测结果差异无统计学意义(t=1.648,P=0.11),其中低IL-17A组(IL-17A<33.80 pg·m L-1,n=18)治疗效果较高IL-17A组(IL-17A>33.80 pg·m L-1,n=12)更好(P<0.05)。结论在鼻息肉患者中,高表达IL-17A会导致局部糖皮质激素治疗效果变差,IL-17A与激素治疗不敏感有一定的关联。Objective To investigate the influence of interleukin-17A（IL-17A） on glucocorticoid efficacy in patients with nasal polyps（NPs）. Methos The expression of IL-17 A was detected by immunohistochemistry in polyp tissues from 20 patients undergoing surgery for NPs（surgery group） and normal inferior turbinate mucosa from 10 subjects without NPs（control group 1）. In addition, the levels of IL-17 A expression were determined by ELISA in polyp tissues from 30 NPs outpatients receiving glucocorticoid nasal spray treatment for 1 month（glucocorticoid group） and 10 subjects without nasal symptoms（control group 2）. Results Immunohistochemistry showed that IL-17 A was mainly expressed in epithelial cells and submucosal cells. The positive expression rate of IL-17 A in surgery group was significantly higher than that in control group 1（0.49±0.20 vs 0.28±0.19, t=-2.803, P=0.009）. No changes in IL-17 A expression were found after treatment in glucocorticoid group（t =1.648, P =0.11）.Furthermore,glucocorticoid treatment for patients with IL-17 A level 33.80 pg·m L-1（ n =18） is more effective than that for patients with IL-17 A level 33.80 pg·m L-1（n =12）（P〈0.05）.Conclusions NPs patients with high IL-17 A expression have less response to treatment with local glucocorticoid. There is a relation between the expression of IL-17 A and the insensitivity to glucocorticoid treatment.

关 键 词：鼻息肉 激素不敏感性 IL-17A 

分 类 号：R765.2[医药卫生—耳鼻咽喉科]