支气管哮喘患者外周血Th17/Treg及相关细胞因子的表达及临床意义  

Expression and clinical significance of Th17/Treg and related cytokines in peripheral blood of patients with bronchial asthma

作　　者：舒姣洁 刘思伯[1] 刘国梁[1] 周恒杰[1] 葛冬 SHU Jiao-jie;LIU Si-bo;LIU Guo-liang;ZHOU Heng-jie;GE Dong(The First Department of Critical Care Medicine,Dalian Municipal Central Hospital,Liaoning Province,Dalian 116033,China)

机构地区：[1]大连市中心医院重症医学一科,辽宁大连116033

出　　处：《中国当代医药》2019年第8期18-21,共4页China Modern Medicine

基　　金：辽宁省大连市医学研究课题(WSJ/KJC-01-JL-01)

摘　　要：目的探讨支气管哮喘患者外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)及相关细胞因子的表达情况及临床意义。方法收集2016年10月～2017年10月我院收治的84例急性发作的支气管哮喘患者作为哮喘组,另选取50例健康体检者作为对照组。采用流式细胞术检测外周血Th17细胞、Treg细胞水平,酶联免疫吸附试验(ELISA)检测血白细胞介素17(IL-17)、白细胞介素10(IL-10)、转化生长因子β1(TGF-β1)表达水平,并测量肺功能指标。分析患者各指标与肺功能指标的相关性。结果哮喘组急性期的外周血Th17细胞、Th17/Treg、血浆IL-17水平高于对照组及缓解期,哮喘组缓解期以上各指标高于对照组,差异均有统计学意义(P<0.05)。哮喘组急性期的IL-10、TGF-β1、Treg细胞以及肺功能指标低于对照组及缓解期,而缓解期的IL-10、TGF-β1、Treg细胞低于对照组,差异均有统计学意义(P<0.05);哮喘组患者急性期的外周血Th17细胞、血浆IL-17水平与肺功能指标均成负相关(P<0.05);而Treg细胞、IL-10、TGF-β1与肺功能指标均成正相关(P<0.05)。结论支气管哮喘患者体内存在外周血Th17/Treg平衡紊乱,其效应细胞因子分泌出现异常。外周血Th17/Treg变化可反应哮喘患者体内炎症水平,有助于对哮喘机制进行进一步研究,为临床诊疗提供新策略。Objective To investigate the expression and clinical significance of helper T cell 17 (Th17)/regulatory T cell (Treg) and related cytokines in peripheral blood of patients with bronchial asthma. Methods A total of 84 patients with acute bronchial asthma admitted in our hospital from October 2016 to October 2017 were enrolled as asthma group. Another 50 healthy people were selected as control group at the same time. The levels of Th17 cells and Treg cells were detected by flow cytometry, the expression levels of serum interleukin-17 (IL-17), interleukin-10 (IL-10) and transforming growth factor-β1 (TGF-β1) were detected by enzyme-linked immunosorbent assay (ELISA), and pulmonary function index was also measured. The correlations between levels of Th17 cells, Treg cells, IL-17, IL-10, TGF-β1 and pulmonary function index in patients with bronchial asthma were analyzed. Results The levels of Th17 cells, Th17/Treg and IL-17 in asthma group in acute stage were statistically higher than those in remission stage and control group, and the above indexes in the remission stage were higher than those in the control group (P<0.05). The levels of IL-10, TGF-β1, Treg and the indexes pulmonary function in asthma group in acute stage were statistically lower than those in control group and remission stage, and those in the asthma group in remission stage were lower than those in the control group (P<0.05). The levels of Th17 cells and IL-17 were negatively correlated with pulmonary function in asthma group in acute stage, and Treg cells, IL-10 and TGF-β1 were positively correlated with lung function indexes (P<0.05). Conclusion There is a balance disorder of Th17/Treg in peripheral blood in patients with bronchial asthma, and the secretion of related cytokines is abnormal. The change of Th17/Treg in peripheral blood can reflect the level of inflammation in patients with bronchial asthma, which is helpful to further study the mechanism of asthma and provide a new strategy for clinical diagnosis and treatment.

关 键 词：支气管哮喘 辅助性T细胞17 调节性T细胞 细胞因子 

分 类 号：R392[医药卫生—免疫学]