中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2012年
9期
655-658
,共4页
黄慧%陆志伟%姜纯国%刘佳%徐作军
黃慧%陸誌偉%薑純國%劉佳%徐作軍
황혜%륙지위%강순국%류가%서작군
结节病,肺%糖皮质激素类%T淋巴细胞,辅助诱导%视黄酸相关孤独受体γt
結節病,肺%糖皮質激素類%T淋巴細胞,輔助誘導%視黃痠相關孤獨受體γt
결절병,폐%당피질격소류%T림파세포,보조유도%시황산상관고독수체γt
Sarcoidosis,lung%Glucocorticoids%T lymphocyte,helper cell%RORγt
目的 研究Th17在活动期结节病患者外周血和BALF中的表达特征及其特异性核转录因子mRNA水平在糖皮质激素治疗前后的变化,探讨Th17细胞在结节病免疫病理机制中的作用.方法 选择2010年7-9月在北京协和医院呼吸内科门诊经病理确诊、根据结节病诊疗建议的原则需要接受系统性糖皮质激素治疗、用药4～6周后治疗有效的活动期肺结节病患者10例(男1例,女9例)为研究组,招募性别、年龄匹配的10名健康志愿者为对照组；年龄为40 ～ 60岁,平均(52 ±8)岁.以CD4+ IL-17A+标记Th17细胞,通过流式细胞分析比较研究组治疗前和对照组外周血中Th17细胞的水平,以及研究组治疗前外周血和BALF中Th17细胞的水平.通过实时PCR的方法比较研究组治疗前后外周血中Th17细胞特异性核转录因子视黄酸相关孤独受体γt(RORγt)mRNA的表达水平.结果 (1)流式细胞分析结果:研究组治疗前外周血中 Th17细胞的比例为(1.61±1.09)％,高于对照组外周血的(0.51±0.43)％(t=3.02,P=0.014),低于同一患者BALF中的(3.05±1.87)％(t=-2.94,P=0.001).(2)实时PCR检测结果:研究组治疗前外周血中的RORγt的mRNA表达水平为(0.952±0.367),治疗后其表达水平为(0.168±0.272),RORγt mRNA表达水平有下凋趋势,但差异无统计学意义(t=1.76,P=0.057).结论 Th 17细胞可能参与结节病的发病,且可能参与糖皮质激素的治疗反应过程；抑制驱使Th17转化的细胞因子有可能成为结节病的治疗靶点.
目的 研究Th17在活動期結節病患者外週血和BALF中的錶達特徵及其特異性覈轉錄因子mRNA水平在糖皮質激素治療前後的變化,探討Th17細胞在結節病免疫病理機製中的作用.方法 選擇2010年7-9月在北京協和醫院呼吸內科門診經病理確診、根據結節病診療建議的原則需要接受繫統性糖皮質激素治療、用藥4～6週後治療有效的活動期肺結節病患者10例(男1例,女9例)為研究組,招募性彆、年齡匹配的10名健康誌願者為對照組；年齡為40 ～ 60歲,平均(52 ±8)歲.以CD4+ IL-17A+標記Th17細胞,通過流式細胞分析比較研究組治療前和對照組外週血中Th17細胞的水平,以及研究組治療前外週血和BALF中Th17細胞的水平.通過實時PCR的方法比較研究組治療前後外週血中Th17細胞特異性覈轉錄因子視黃痠相關孤獨受體γt(RORγt)mRNA的錶達水平.結果 (1)流式細胞分析結果:研究組治療前外週血中 Th17細胞的比例為(1.61±1.09)％,高于對照組外週血的(0.51±0.43)％(t=3.02,P=0.014),低于同一患者BALF中的(3.05±1.87)％(t=-2.94,P=0.001).(2)實時PCR檢測結果:研究組治療前外週血中的RORγt的mRNA錶達水平為(0.952±0.367),治療後其錶達水平為(0.168±0.272),RORγt mRNA錶達水平有下凋趨勢,但差異無統計學意義(t=1.76,P=0.057).結論 Th 17細胞可能參與結節病的髮病,且可能參與糖皮質激素的治療反應過程；抑製驅使Th17轉化的細胞因子有可能成為結節病的治療靶點.
목적 연구Th17재활동기결절병환자외주혈화BALF중적표체특정급기특이성핵전록인자mRNA수평재당피질격소치료전후적변화,탐토Th17세포재결절병면역병리궤제중적작용.방법 선택2010년7-9월재북경협화의원호흡내과문진경병리학진、근거결절병진료건의적원칙수요접수계통성당피질격소치료、용약4～6주후치료유효적활동기폐결절병환자10례(남1례,녀9례)위연구조,초모성별、년령필배적10명건강지원자위대조조；년령위40 ～ 60세,평균(52 ±8)세.이CD4+ IL-17A+표기Th17세포,통과류식세포분석비교연구조치료전화대조조외주혈중Th17세포적수평,이급연구조치료전외주혈화BALF중Th17세포적수평.통과실시PCR적방법비교연구조치료전후외주혈중Th17세포특이성핵전록인자시황산상관고독수체γt(RORγt)mRNA적표체수평.결과 (1)류식세포분석결과:연구조치료전외주혈중 Th17세포적비례위(1.61±1.09)％,고우대조조외주혈적(0.51±0.43)％(t=3.02,P=0.014),저우동일환자BALF중적(3.05±1.87)％(t=-2.94,P=0.001).(2)실시PCR검측결과:연구조치료전외주혈중적RORγt적mRNA표체수평위(0.952±0.367),치료후기표체수평위(0.168±0.272),RORγt mRNA표체수평유하조추세,단차이무통계학의의(t=1.76,P=0.057).결론 Th 17세포가능삼여결절병적발병,차가능삼여당피질격소적치료반응과정；억제구사Th17전화적세포인자유가능성위결절병적치료파점.
Objective To describe the characteristic of Th17 cells in peripheral blood (PB) and bronchoalveolar lavage fluid (BALF) from patients with sarcoidosis,and to investigate the effect of glucocorticoid therapy on the expression of RORγt mRNA,and therefore to explore the role of Th17 cells in the immunopathogenesis of pulmonary sarcoidosis.Methods Ten patients with active pulmonary sarcoidosis who were prescribed with prednisone according to the guidelines were defined as the study group.All of them had positive pathological results and had definite response to corticosteroids. Ten healthy controls were recruited from volunteers with similar sex distribution and age. The proportion of CD4+ IL-17A + T cells in peripheral blood mononuclear cells (PBMC) and BALF were calculated by flow cytometry. The mRNA expression of RORc in PBMC was measured by Real-time PCR.Results The mean age was (52 ± 8) years in both the study group and the controls,and there were 9 females and 1 male in both groups.The proportion of CD4+ IL-17A + T cells was higher in the PB of sarcoidosis patients compared to that of the controls [(1.61±1.09)％ vs (0.51 ±0.43)％,t=3.02,P=0.014].For the same patients,the proportion of CD4+ IL-17A +T cells was higher in the BALF compared to that in the PB [ (3.05 ± 1.87)％ vs (1.61 ±1.09 )％,t =2.94,P =0.001 ].After 4 to 6 week therapy with glucocorticoids,all the 10 patients showed definite response. The level of RORc mRNA in the PB did not decrease significantly after treatment [ (0.952 ±0.367) vs (0.168 ±0.272),t =1.76,P =0.057],although a trend was noted.Conclusions Th17 cells was probably involved in the immunopathogenesis of sarcoidosis, and glucocorticoids might modulate the disturbance of Th17 cells in pulmonary sarcoidosis.
