Graves眼病患者糖皮质激素治疗前后血清细胞因子的变化  

Changes of cytokines in patients with Graves'ophthalmopathy before and after treatment with glucocorticoid

作　　者：史婷婷[1] 谢荣荣 信中[1] 刘薇[1] 苏志燕[1] 杨金奎[1,2] Shi Tingting;Xie Rongrong;Xin Zhong;Liu Wei;Su Zhiyan;Yang Jinkui(Department of Endocrinology,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China;Beijing diabetes Research Institute,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院内分泌科,北京100176 [2]北京市糖尿病研究所,北京100730

出　　处：《首都医科大学学报》2024年第3期399-405,共7页Journal of Capital Medical University

基　　金：国家自然科学基金项目(82200937);北京市医管局“培育计划”项目(PX2021006);首都医科大学附属北京同仁医院青年人才院内种子基金项目(2020-YJJ-ZZL-012)。

摘　　要：目的对活动期Graves眼病(Graves'ophthalmopathy,GO)患者糖皮质激素治疗前后的血清细胞因子进行检测,探讨其水平变化与治疗的相关性。方法选取活动期GO患者28例[临床活动性评分(clinical activity score,CAS)≥3分],入组患者均经过糖皮质激素周脉冲治疗,激素总剂量为4.5 g。检测治疗前后患者血清34项细胞因子浓度,同时收集所有研究对象的性别、年龄、肝肾功能、治疗前后的甲状腺功能及抗体等临床指标。结果活动期GO患者经过糖皮质激素治疗后血清细胞因子包括白细胞介素(interleukin,IL)(IL-1α、IL-1β、IL-1Rα、IL-2Rα、IL-6、IL-8、IL-18、IL-12p40及IL-16)浓度显著下调,细胞因子皮肤T细胞吸引趋化因子(cutaneous T cell attraction chemokines,CTACK)、单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)、巨噬细胞游走抑制因子(macrophage migration inhibitory factor,MIF)、基质细胞衍生因子-1α(stromal cell-derived factor 1α,SDF-1α)、血浆碱性成纤维细胞生长因子(basic fibrobast growth factor,basic-FGF)、粒细胞集落刺激因子(granulocyte colony-stimulating factor,G-CSF)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及干扰素-γ(interferon-γ,IFN-γ)浓度显著下调,而IL-9显著上调,治疗前后两组差异有统计学意义(P<0.05)。结论糖皮质激素治疗活动期GO患者后血清IL-1α、IL-1β、IL-1Rα、IL-2Rα、IL-6、IL-8、IL-18、IL-12p40及IL-16浓度显著下调,细胞因子CTACK、MCP-1、MIF、SDF-1α、basic-FGF、G-CSF、TNF-α及IFN-γ的浓度显著下调,提示这些细胞因子与糖皮质激素治疗GO的疗效有相关性。Objective To explore the correlation between the changes of serum cytokine in active Graves'ophthalmopathy(GO)patients before and after glucocorticoid therapy and efficacy of glucocorticoid therapy.Methods Twenty-eight patients diagnosed with GO in the Department of Endocrinology,Beijing Tongren Hospital,Capital Medical University from January 2021 to January 2024 were selected.All patients were diagnosis as active GO patients(CAS≥3).Patients received regular weekly glucocorticoid weekly pulse therapy with a total dose of 4.5 g.The concentrations of 34 cytokines in serum were examined.Meanwhile,clinical indicators such as gender,age,liver and kidney function,thyroid function before and after treatment,and antibodies of all subjects were collected.Results The levels of interleukins(IL)(IL-1α,IL-1β,IL-1Rα,IL-2Rα,IL-6,IL-8,IL-18,IL-12p40 and IL-16)and cytokines including cutaneous T cell attraction chemokines(CTACK),monocyte chemoattractant protein-1(MCP-1),macrophage migration inhibitory factor(MIF),stromal cell-derived factor 1α(SDF-1α),basic fibroblast growth factor(basic-FGF),granulocyte colony-stimulating Factor(G-CSF),tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)in active GO patients after glucocorticoid treatment were significantly decreased compared with before treatment(P<0.05).Conclusion The levels of interleukins(IL-1α,IL-1β,IL-1Rα,IL-2Rα,IL-6,IL-8,IL-18,IL-12p40 and IL-16)and cytokines including CTACK,MCP-1,MIF,SDF-1α,basic-FGF、G-CSF,TNF-αand IFN-γin active GO patients decreased significantly after glucocorticoid therapy,suggesting that these cytokines may be involved in the efficacy of glucocorticoid therapy for GO.

关 键 词：GRAVES眼病 活动期病变 糖皮质激素 细胞因子 白细胞介素 

分 类 号：R58[医药卫生—内分泌]