中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2012年
12期
1118-1121
,共4页
邹文军%武志峰%项晓丽%孙松%张洁
鄒文軍%武誌峰%項曉麗%孫鬆%張潔
추문군%무지봉%항효려%손송%장길
急性前葡萄膜炎%人类白细胞抗原-B27%流式细胞术%辅助性T淋巴细胞亚群%免疫反应
急性前葡萄膜炎%人類白細胞抗原-B27%流式細胞術%輔助性T淋巴細胞亞群%免疫反應
급성전포도막염%인류백세포항원-B27%류식세포술%보조성T림파세포아군%면역반응
Acute anterior uveitis%Human leucocyte antigen-B27%Flow cytometry%T-helper cell subset%Immune response
背景 人类白细胞抗原-B27(HLA-B27)阳性急性葡萄膜炎是非感染性葡萄膜炎常见的类型之一,Thl7细胞是在人类自身免疫性疾病中发挥重要作用的细胞因子,而Th17细胞与HLA-B27阳性急性前葡萄膜炎的关系鲜见报道. 目的 研究HLA-B27相关性急性前葡萄膜炎患者外周血中辅助性T淋巴细胞亚群(Th1、Th2、Th17)的表达及意义.方法 采用前瞻性队列研究设计.收集2011年1-10月于无锡第二医院眼科就诊的HLA-B27阳性急性前葡萄膜炎患者22例,并收集性别和年龄匹配的健康体检者16名作为正常对照组.采用流式细胞术检测受检者外周血中Th1、Th2、Th17细胞的表达比例,采用免疫比浊法检测患者外周血中C反应蛋白(CRP)质量分数,并对患者的病情程度进行评分,采用Spearman秩相关分析法对患者外周血中Th1、Th2、Th17细胞比例与病情严重程度评分或CRP质量分数的关系进行统计分析. 结果 HLA-B27阳性急性前葡萄膜炎患者外周血中γ干扰素(IFN-γ)+CD4+ Th1细胞比例、CD4+白细胞介素-17(IL-17)+Th17细胞比例均明显高于正常对照组,差异均有统计学意义[(23.11±9.69)％vs.(16.00±4.26)％,P=0.041；(3.96±2.92)％ vs.(1.68±0.60)％,P=0.002],而CD4+ IL-4+Th2细胞比例与正常对照组相比差异无统计学意义[(0.33±0.36)％vs.(0.56±0.34)％,P=0.122].患者外周血Th1细胞比例与患者病情严重程度评分及CRP质量分数均无明显相关性(r=0.197,P=0.500；r=0.253,P=0.383)；Th2细胞比例与患者病情严重程度评分及CRP质量分数均无明显相关性(r=0.068,P=0.817；r=0.439,P=0.116)；Th17细胞比例与患者病情严重程度评分呈明显正相关(r=0.805,P=0.001),与患者CRP质量分数无显著相关性(r=0.226,P=0.436).结论 HLA-B27阳性急性前葡萄膜炎患者外周血中CD4+T细胞内IFN-γ和IL-17细胞呈高表达,且Th17细胞比例与患者病情的严重程度有关,提示Th1细胞和Th17细胞共同参与了急性前葡萄膜炎的发病过程,可能以Th17细胞发挥作用为主.
揹景 人類白細胞抗原-B27(HLA-B27)暘性急性葡萄膜炎是非感染性葡萄膜炎常見的類型之一,Thl7細胞是在人類自身免疫性疾病中髮揮重要作用的細胞因子,而Th17細胞與HLA-B27暘性急性前葡萄膜炎的關繫鮮見報道. 目的 研究HLA-B27相關性急性前葡萄膜炎患者外週血中輔助性T淋巴細胞亞群(Th1、Th2、Th17)的錶達及意義.方法 採用前瞻性隊列研究設計.收集2011年1-10月于無錫第二醫院眼科就診的HLA-B27暘性急性前葡萄膜炎患者22例,併收集性彆和年齡匹配的健康體檢者16名作為正常對照組.採用流式細胞術檢測受檢者外週血中Th1、Th2、Th17細胞的錶達比例,採用免疫比濁法檢測患者外週血中C反應蛋白(CRP)質量分數,併對患者的病情程度進行評分,採用Spearman秩相關分析法對患者外週血中Th1、Th2、Th17細胞比例與病情嚴重程度評分或CRP質量分數的關繫進行統計分析. 結果 HLA-B27暘性急性前葡萄膜炎患者外週血中γ榦擾素(IFN-γ)+CD4+ Th1細胞比例、CD4+白細胞介素-17(IL-17)+Th17細胞比例均明顯高于正常對照組,差異均有統計學意義[(23.11±9.69)％vs.(16.00±4.26)％,P=0.041；(3.96±2.92)％ vs.(1.68±0.60)％,P=0.002],而CD4+ IL-4+Th2細胞比例與正常對照組相比差異無統計學意義[(0.33±0.36)％vs.(0.56±0.34)％,P=0.122].患者外週血Th1細胞比例與患者病情嚴重程度評分及CRP質量分數均無明顯相關性(r=0.197,P=0.500；r=0.253,P=0.383)；Th2細胞比例與患者病情嚴重程度評分及CRP質量分數均無明顯相關性(r=0.068,P=0.817；r=0.439,P=0.116)；Th17細胞比例與患者病情嚴重程度評分呈明顯正相關(r=0.805,P=0.001),與患者CRP質量分數無顯著相關性(r=0.226,P=0.436).結論 HLA-B27暘性急性前葡萄膜炎患者外週血中CD4+T細胞內IFN-γ和IL-17細胞呈高錶達,且Th17細胞比例與患者病情的嚴重程度有關,提示Th1細胞和Th17細胞共同參與瞭急性前葡萄膜炎的髮病過程,可能以Th17細胞髮揮作用為主.
배경 인류백세포항원-B27(HLA-B27)양성급성포도막염시비감염성포도막염상견적류형지일,Thl7세포시재인류자신면역성질병중발휘중요작용적세포인자,이Th17세포여HLA-B27양성급성전포도막염적관계선견보도. 목적 연구HLA-B27상관성급성전포도막염환자외주혈중보조성T림파세포아군(Th1、Th2、Th17)적표체급의의.방법 채용전첨성대렬연구설계.수집2011년1-10월우무석제이의원안과취진적HLA-B27양성급성전포도막염환자22례,병수집성별화년령필배적건강체검자16명작위정상대조조.채용류식세포술검측수검자외주혈중Th1、Th2、Th17세포적표체비례,채용면역비탁법검측환자외주혈중C반응단백(CRP)질량분수,병대환자적병정정도진행평분,채용Spearman질상관분석법대환자외주혈중Th1、Th2、Th17세포비례여병정엄중정도평분혹CRP질량분수적관계진행통계분석. 결과 HLA-B27양성급성전포도막염환자외주혈중γ간우소(IFN-γ)+CD4+ Th1세포비례、CD4+백세포개소-17(IL-17)+Th17세포비례균명현고우정상대조조,차이균유통계학의의[(23.11±9.69)％vs.(16.00±4.26)％,P=0.041；(3.96±2.92)％ vs.(1.68±0.60)％,P=0.002],이CD4+ IL-4+Th2세포비례여정상대조조상비차이무통계학의의[(0.33±0.36)％vs.(0.56±0.34)％,P=0.122].환자외주혈Th1세포비례여환자병정엄중정도평분급CRP질량분수균무명현상관성(r=0.197,P=0.500；r=0.253,P=0.383)；Th2세포비례여환자병정엄중정도평분급CRP질량분수균무명현상관성(r=0.068,P=0.817；r=0.439,P=0.116)；Th17세포비례여환자병정엄중정도평분정명현정상관(r=0.805,P=0.001),여환자CRP질량분수무현저상관성(r=0.226,P=0.436).결론 HLA-B27양성급성전포도막염환자외주혈중CD4+T세포내IFN-γ화IL-17세포정고표체,차Th17세포비례여환자병정적엄중정도유관,제시Th1세포화Th17세포공동삼여료급성전포도막염적발병과정,가능이Th17세포발휘작용위주.
Background Human leucocyte antigen (HLA)-B27-associated uveitis is one of the most common causes of non-infectious uveitis.T helper 17 (Th17) cells play an important role in human autoimmune diseases,but the pathology research on the production of Th17 cells in acute anterior uveitis patients positive for HLA-B27 was rarely reported.Objective The aim of this study was to investigate the expression and significance of the peripheral blood T helper cell subsets (Th1,Th2,Th17) in acute anterior uveitis patients positive for HLA-B27.Methods This study meets the criteria of the Helsinki Declaration.Informed consent was obtained from all the participants.A prospective cohort design was used in this study.Twenty-two patients with acute anterior uveitis positive for HLA-B27 were enrolled from Affiliated Second Hospital of Nanjing Medical University,and 16 normal healthy subjects with matched gender and age were enrolled as controls.The expression of interferon-γ (IFN-γ),interleukin-4 (IL-4) and IL-17 on lymphocytes (CD4+) in blood were assessed by flow cytometry,and immunoturbidimetry was used to detect the C reactive protein (CRP) level in blood.The degree of the severity of disease was evaluated by clinical scoring.The correlations between the percentage of IFN-γ+Th1,IL-4+Th2,or IL-17+Th17 with clinical factors and CRP were analyzed.Results The percentages of IFN-γ+Th1 and IL-17+Th17 in the peripheral blood were (23.11 ±9.69) ％ and (3.96±2.92) ％ in the patient group,showing a significant increase in comparison with (16.00±4.26)％ and (1.68±0.60) ％ in the control group (P=0.041,P=0.002).However,the IL-4+Th2 level was not significantly different between the patient group (0.33％ ±0.36％) and the control group (0.56％ ±0.34％) (P=0.122).No significant correlations were found between the percentage of IFN-γ+ Th1 with disease severity and CRP (r =0.197,P =0.500 ; r =0.253,P =0.383),between the percentage of IL-4+ Th2 with disease severity and CRP (r =0.068,P =0.817 ; r =0.439,P =0.116) as well as between the percentage of IL-17 + Th17 with CRP (r =0.226,P =0.436).However,a positive correlation was seen between the percentage of IL-17+ Th17 with disease severity (r =0.805,P =0.001).Conclusions IFN-γ and IL-17 in human CD4+T cells are significantly elevated in the blood of HLA-B27-related acute anterior uveitis patients.Disease severity is associated with the percentage of IL-17 +Th17,suggesting that Th1 cells together with Th17 cells participate in the pathogenesis of the disease and Th17 cells might play a dominant role in the disease.
