CAJ | 학술논문

目的：探讨调节性T细胞（Treg）、辅助T细胞（Th）在慢性阻塞性肺疾病（COPD）患者肺功能降低中的作用。方法采用肺功能仪观察COPD患者肺功能变化，采用酶联免疫吸附法检测血清γ－干扰素（ IFN）、白介素（ IL）－4、IL－17变化，采用流式细胞术检测外周血Treg表达。结果与正常组比较，COPD患者肺功能参数降低，6 min 步行距离缩短，血清 IL－4、外周血 CD4＋CD25＋FOXP3＋Treg降低，而血清 IFN－γ、IL－17升高（ P＜0．05或P＜0．01）。相关分析结果显示，COPD患者Treg与IL－17呈负相关，IL－17、IFN－γ与IL－4呈负相关；Treg与 IL－4呈正相关，IFN－γ与Th1／Th2、IL－17呈正相关；最大呼气流量（ PEF）与IL－17呈负相关，FEV1／FVC与IFN－γ、Th1／Th2呈负相关；FEV1与IL－4、Treg呈正相关，FEV1／FVC与Treg 呈正相关（P＜0．05或P＜0．01）。结论 COPD 患者Treg表达降低，免疫抑制功能明显下降，失去对炎性细胞的抑制作用，引起Th1／Th2失衡或Th17细胞过表达，导致COPD发生和肺功能降低。
목적：탐토조절성T세포（Treg）、보조T세포（Th）재만성조새성폐질병（COPD）환자폐공능강저중적작용。방법채용폐공능의관찰COPD환자폐공능변화，채용매련면역흡부법검측혈청γ－간우소（ IFN）、백개소（ IL）－4、IL－17변화，채용류식세포술검측외주혈Treg표체。결과여정상조비교，COPD환자폐공능삼수강저，6 min 보행거리축단，혈청 IL－4、외주혈 CD4＋CD25＋FOXP3＋Treg강저，이혈청 IFN－γ、IL－17승고（ P＜0．05혹P＜0．01）。상관분석결과현시，COPD환자Treg여IL－17정부상관，IL－17、IFN－γ여IL－4정부상관；Treg여 IL－4정정상관，IFN－γ여Th1／Th2、IL－17정정상관；최대호기류량（ PEF）여IL－17정부상관，FEV1／FVC여IFN－γ、Th1／Th2정부상관；FEV1여IL－4、Treg정정상관，FEV1／FVC여Treg 정정상관（P＜0．05혹P＜0．01）。결론 COPD 환자Treg표체강저，면역억제공능명현하강，실거대염성세포적억제작용，인기Th1／Th2실형혹Th17세포과표체，도치COPD발생화폐공능강저。
Objective To investigate the mechanism of regulatory T cells (Treg),Helper T cell (Th) in patients of chronic obstruc-tive pulmonary disease ( COPD ) with reduced lung function .Methods Pulmonary function was detected by spirometer in patients with COPD .γ-interferon ( IFN-γ) ,interleukin ( IL)-4 and IL-17 in serum were detected by enzyme-linked immunosorbent assay .Treg of peripheral blood was detected by flow cytometry .Results Compared with those of normal group ,lung function parameters ,6 minutes walking distance , the levels of IL-4 and CD4+CD25+FOXP3+Treg were decreased ,while the expression of IFN-γ,IL-17 in serum were increased in COPD pa-tients(P<0.05 or P<0.01).Treg was negatively correlated with IL-17,and IL-17,IFN-γwere negatively correlated with IL-4.Treg was posi-tively correlated with IL-4, and IFN-γ, Th1/Th2 were positively correlated with IL-17.Pulmonary function parameters , such as PEF and FEV1/FVC,were negatively correlated with IFN-γ,Th1/Th2 and IL-17.FEV1 was positively correlated with IL-4,Treg( P<0.01 or P<0. 05).Conclusions The expression of Treg is decreased significantly in COPD patients ,and immune suppression is decreased .Treg can loss the function of inhibition to inflammatory cells which could cause imbalance of Th 1/Th2 or over-expression of Th17 cells,and result to COPD and reduce pulmonary function .