CAJ | 학술논문

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。目的：觀察慢性阻塞性肺疾病（COPD）患者外週血中Th17細胞、Treg細胞佔CD4+T細胞的比例及香煙煙霧提取物（CSE）對其的影響，探討CSE對Th17細胞、Treg細胞的影響及Th17/Treg的平衡關繫在COPD髮生髮展中的作用。方法隨機收集慢性阻塞性肺疾病急性加重期（AECOPD）患者20例（A組），COPD穩定期患者20例（B組），吸煙肺功能正常者20例（C組），不吸煙肺功能正常者20例（D組）。抽取空腹靜脈血製備單箇覈細胞懸液（PBMC），將每箇試驗對象的PBMC分為空白對照組和CSE榦預組，採用流式細胞術檢測所有試驗對象對照組和榦預組CD4+Th17細胞及CD4+Treg細胞各佔CD4+T細胞的比例；ELISA法檢測各組血漿中IL-17的濃度。結果 Th17/CD4+T細胞百分比對照組A組（5.33±0.66）高于B組（2.99±0.50）、C組（2.09±0.68）、D組（1.19±0.48）（P＜0.001），CSE榦預組較對照組升高（P＜0.001）； Treg/CD4+T細胞百分比對照組C組（5.88±0.52）高于D組（3.35±0.30）、B組（2.25±0.30）、A組（1.58±0.39）（P＜0.001），CSE榦預組較對照組升高（P＜0.001）；CD4+ Th17細胞百分比對照組與CSE榦預組差值A、B組高于C、D組（P＜0.001），A組與B組之間差異無統計學意義（P＝0.866），C組與D組之間差異無統計學意義（P＝0.793）；CD4+Treg細胞百分比對照組與CSE榦預組差值C、D組高于B組、A組（P＜0.001）， C組與D組之間差異無統計學意義（P＝0.756）；外週血IL-17水平A組（145.22±5.50）高于B組（94.99±3.19）、C組（59.77±5.09）、D組（50.84±5.85）（P＜0.001）；COPD組血漿中IL-17的水平與外週血Th17細胞比例呈正相關（rA＝0.524，rB＝0.462）；與FEV1/FVC值呈負相關（rA＝-0.456， rB＝-0.567）；與FEV1/預計值%呈負相關（rA＝-0.503，rB＝-0.445）。結論 Th17與Treg比例的失衡可能是COPD的其中一箇重要的髮病機製；外週血IL-17水平與FEV1/FVC值、FEV1/預計值%呈負相關。
목적：관찰만성조새성폐질병（COPD）환자외주혈중Th17세포、Treg세포점CD4+T세포적비례급향연연무제취물（CSE）대기적영향，탐토CSE대Th17세포、Treg세포적영향급Th17/Treg적평형관계재COPD발생발전중적작용。방법수궤수집만성조새성폐질병급성가중기（AECOPD）환자20례（A조），COPD은정기환자20례（B조），흡연폐공능정상자20례（C조），불흡연폐공능정상자20례（D조）。추취공복정맥혈제비단개핵세포현액（PBMC），장매개시험대상적PBMC분위공백대조조화CSE간예조，채용류식세포술검측소유시험대상대조조화간예조CD4+Th17세포급CD4+Treg세포각점CD4+T세포적비례；ELISA법검측각조혈장중IL-17적농도。결과 Th17/CD4+T세포백분비대조조A조（5.33±0.66）고우B조（2.99±0.50）、C조（2.09±0.68）、D조（1.19±0.48）（P＜0.001），CSE간예조교대조조승고（P＜0.001）； Treg/CD4+T세포백분비대조조C조（5.88±0.52）고우D조（3.35±0.30）、B조（2.25±0.30）、A조（1.58±0.39）（P＜0.001），CSE간예조교대조조승고（P＜0.001）；CD4+ Th17세포백분비대조조여CSE간예조차치A、B조고우C、D조（P＜0.001），A조여B조지간차이무통계학의의（P＝0.866），C조여D조지간차이무통계학의의（P＝0.793）；CD4+Treg세포백분비대조조여CSE간예조차치C、D조고우B조、A조（P＜0.001）， C조여D조지간차이무통계학의의（P＝0.756）；외주혈IL-17수평A조（145.22±5.50）고우B조（94.99±3.19）、C조（59.77±5.09）、D조（50.84±5.85）（P＜0.001）；COPD조혈장중IL-17적수평여외주혈Th17세포비례정정상관（rA＝0.524，rB＝0.462）；여FEV1/FVC치정부상관（rA＝-0.456， rB＝-0.567）；여FEV1/예계치%정부상관（rA＝-0.503，rB＝-0.445）。결론 Th17여Treg비례적실형가능시COPD적기중일개중요적발병궤제；외주혈IL-17수평여FEV1/FVC치、FEV1/예계치%정부상관。
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(P<0.001);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 of IL-17 in plasma were positively correlated with the percentage of Th17 in CD4+ T cells in patients with chronic obstructive pulmonary disease(rA=0.524, rB=0.462);and were negatively correlated with FEV 1/FVC(%) (rA=-0.456, rB=-0.567) and FEV1(pred%) (rA=-0.503, rB=-0.445) separately. Conclusion Imbalance of the proportion of Th17 and Treg may be one of the important pathogenesis of COPD; IL-17 levels in peripheral blood are negatively correlated with FEV1/FVC(%) and FEV1(pred%) separately.