中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2013年
7期
668-673
,共6页
谈旭华%孙松%朱婷婷%任天丽%武志峰%王柯
談旭華%孫鬆%硃婷婷%任天麗%武誌峰%王柯
담욱화%손송%주정정%임천려%무지봉%왕가
干眼%细胞免疫%辅助T细胞17%细胞因子%白细胞介素-17%白细胞介素-22%泪液%外周血单核细胞%酶联免疫吸附试验
榦眼%細胞免疫%輔助T細胞17%細胞因子%白細胞介素-17%白細胞介素-22%淚液%外週血單覈細胞%酶聯免疫吸附試驗
간안%세포면역%보조T세포17%세포인자%백세포개소-17%백세포개소-22%루액%외주혈단핵세포%매련면역흡부시험
Dry eye disease%Cell-mediated immunity%T helper cell 17%Cytokine%Interleukin-17%Interleukin-22%Tear%Peripheral blood mononuclear cell%Enzyme-linked immunosorbent assay
背景 辅助T细胞17(Th17)是一种新发现的CD4+T细胞亚群,动物研究显示,Th17细胞及其效应因子白细胞介素-17(IL-17)在干眼的发病和发展过程中发挥重要作用,但其发病机制还需进一步证实.目的 检测干眼患者泪液及外周血单核细胞(PBMCs)培养上清液中IL-17和IL-22的表达水平,探讨其与干眼临床症状及体征的相关关系. 方法 收集在无锡第二医院眼科确诊的Sj(o)gren综合征(SS)、非Sj(o)gren综合征(NSS)患者各20例,并纳入同期医院内职工和学生健康志愿者20人为正常对照组,3个组间患者年龄、性别比均匹配.所有患者行干眼症状调查量表评分、泪膜破裂时间(BUT)、泪液分泌试验Ⅰ(SⅠt)、角膜荧光素染色检查.收集所有受检者外周血3 ml,采用酶联免疫吸附(ELISA)法检测各组受检者PBMC培养上清液及泪液中IL-17、IL-22的质量浓度并进行比较,并与干眼临床症状和体征进行相关分析. 结果 NSS组、SS组及正常对照组干眼症状调查量表评分依次降低,SS组、NSS组及正常对照组BUT值依次延长,SⅠt值依次增大,角膜荧光素染色评分明显降低,3个组间上述指标的总体比较差异均有统计学意义(症状评分:H=40.81,P＜0.01；BUT:H=40.15,P＜0.01；S Ⅰ t:H=50.07,P＜0.01；角膜荧光素染色评分:H=40.52,P＜0.01).SS组、NSS组及正常对照组PBMCs培养上清液中IL-17质量浓度分别为(964.92±124.83)、(718.85±115.89)、(341.95±85.08) ng/L；泪液中IL-17质量浓度分别为(440.69±126.09)、(364.33±126.85)、(61.16±11.60) ng/L,SS组、NSS组患者PBMCs中和泪液中IL-17质量浓度明显高于正常对照组,3个组间总体比较差异均有统计学意义(F=162.95,P＜0.01；F=75.27,P＜0.01).SS组、NSS组及正常对照组PBMCs培养上清液中IL-22质量浓度分别为(98.77±11.27)、(79.65±11.01)、(32.78±9.34) ng/L,泪液中分别为(22.22±8.96)、(14.92±4.35)、(10.47±2.67) ng/L,表明SS组、NSS组患者PBMCs中和泪液中IL-22质量浓度明显高于正常对照组,3个组间总体比较差异均有统计学意义(F=206.27,P＜0.01；F=19.87,P＜0.01).干眼患者PBMCs培养上清液及泪液中IL-17、IL-22水平与角膜荧光素染色评分、SⅠt有明显关联,但与干眼症状量表评分、BUT均无相关性.结论 干眼患者PBMCs及泪液中IL-17、IL-22的质量浓度明显升高,进一步提示Th17在干眼免疫机制中发挥重要作用.
揹景 輔助T細胞17(Th17)是一種新髮現的CD4+T細胞亞群,動物研究顯示,Th17細胞及其效應因子白細胞介素-17(IL-17)在榦眼的髮病和髮展過程中髮揮重要作用,但其髮病機製還需進一步證實.目的 檢測榦眼患者淚液及外週血單覈細胞(PBMCs)培養上清液中IL-17和IL-22的錶達水平,探討其與榦眼臨床癥狀及體徵的相關關繫. 方法 收集在無錫第二醫院眼科確診的Sj(o)gren綜閤徵(SS)、非Sj(o)gren綜閤徵(NSS)患者各20例,併納入同期醫院內職工和學生健康誌願者20人為正常對照組,3箇組間患者年齡、性彆比均匹配.所有患者行榦眼癥狀調查量錶評分、淚膜破裂時間(BUT)、淚液分泌試驗Ⅰ(SⅠt)、角膜熒光素染色檢查.收集所有受檢者外週血3 ml,採用酶聯免疫吸附(ELISA)法檢測各組受檢者PBMC培養上清液及淚液中IL-17、IL-22的質量濃度併進行比較,併與榦眼臨床癥狀和體徵進行相關分析. 結果 NSS組、SS組及正常對照組榦眼癥狀調查量錶評分依次降低,SS組、NSS組及正常對照組BUT值依次延長,SⅠt值依次增大,角膜熒光素染色評分明顯降低,3箇組間上述指標的總體比較差異均有統計學意義(癥狀評分:H=40.81,P＜0.01；BUT:H=40.15,P＜0.01；S Ⅰ t:H=50.07,P＜0.01；角膜熒光素染色評分:H=40.52,P＜0.01).SS組、NSS組及正常對照組PBMCs培養上清液中IL-17質量濃度分彆為(964.92±124.83)、(718.85±115.89)、(341.95±85.08) ng/L；淚液中IL-17質量濃度分彆為(440.69±126.09)、(364.33±126.85)、(61.16±11.60) ng/L,SS組、NSS組患者PBMCs中和淚液中IL-17質量濃度明顯高于正常對照組,3箇組間總體比較差異均有統計學意義(F=162.95,P＜0.01；F=75.27,P＜0.01).SS組、NSS組及正常對照組PBMCs培養上清液中IL-22質量濃度分彆為(98.77±11.27)、(79.65±11.01)、(32.78±9.34) ng/L,淚液中分彆為(22.22±8.96)、(14.92±4.35)、(10.47±2.67) ng/L,錶明SS組、NSS組患者PBMCs中和淚液中IL-22質量濃度明顯高于正常對照組,3箇組間總體比較差異均有統計學意義(F=206.27,P＜0.01；F=19.87,P＜0.01).榦眼患者PBMCs培養上清液及淚液中IL-17、IL-22水平與角膜熒光素染色評分、SⅠt有明顯關聯,但與榦眼癥狀量錶評分、BUT均無相關性.結論 榦眼患者PBMCs及淚液中IL-17、IL-22的質量濃度明顯升高,進一步提示Th17在榦眼免疫機製中髮揮重要作用.
배경 보조T세포17(Th17)시일충신발현적CD4+T세포아군,동물연구현시,Th17세포급기효응인자백세포개소-17(IL-17)재간안적발병화발전과정중발휘중요작용,단기발병궤제환수진일보증실.목적 검측간안환자루액급외주혈단핵세포(PBMCs)배양상청액중IL-17화IL-22적표체수평,탐토기여간안림상증상급체정적상관관계. 방법 수집재무석제이의원안과학진적Sj(o)gren종합정(SS)、비Sj(o)gren종합정(NSS)환자각20례,병납입동기의원내직공화학생건강지원자20인위정상대조조,3개조간환자년령、성별비균필배.소유환자행간안증상조사량표평분、루막파렬시간(BUT)、루액분비시험Ⅰ(SⅠt)、각막형광소염색검사.수집소유수검자외주혈3 ml,채용매련면역흡부(ELISA)법검측각조수검자PBMC배양상청액급루액중IL-17、IL-22적질량농도병진행비교,병여간안림상증상화체정진행상관분석. 결과 NSS조、SS조급정상대조조간안증상조사량표평분의차강저,SS조、NSS조급정상대조조BUT치의차연장,SⅠt치의차증대,각막형광소염색평분명현강저,3개조간상술지표적총체비교차이균유통계학의의(증상평분:H=40.81,P＜0.01；BUT:H=40.15,P＜0.01；S Ⅰ t:H=50.07,P＜0.01；각막형광소염색평분:H=40.52,P＜0.01).SS조、NSS조급정상대조조PBMCs배양상청액중IL-17질량농도분별위(964.92±124.83)、(718.85±115.89)、(341.95±85.08) ng/L；루액중IL-17질량농도분별위(440.69±126.09)、(364.33±126.85)、(61.16±11.60) ng/L,SS조、NSS조환자PBMCs중화루액중IL-17질량농도명현고우정상대조조,3개조간총체비교차이균유통계학의의(F=162.95,P＜0.01；F=75.27,P＜0.01).SS조、NSS조급정상대조조PBMCs배양상청액중IL-22질량농도분별위(98.77±11.27)、(79.65±11.01)、(32.78±9.34) ng/L,루액중분별위(22.22±8.96)、(14.92±4.35)、(10.47±2.67) ng/L,표명SS조、NSS조환자PBMCs중화루액중IL-22질량농도명현고우정상대조조,3개조간총체비교차이균유통계학의의(F=206.27,P＜0.01；F=19.87,P＜0.01).간안환자PBMCs배양상청액급루액중IL-17、IL-22수평여각막형광소염색평분、SⅠt유명현관련,단여간안증상량표평분、BUT균무상관성.결론 간안환자PBMCs급루액중IL-17、IL-22적질량농도명현승고,진일보제시Th17재간안면역궤제중발휘중요작용.
Background T helper cell 17 (Th17),a newly discovered subset of CD4+ T cells,have been found to play an important role in dry eye disease in animal model.Further investigation should be done on the immunopathogenesis of Th17 cells in dry eye patients.Objective This study was to analyze the expression status of interleukin-17 (IL-17) and IL-22 in tear and supernatant of peripheral blood mononuclear cells (PBMCs) of dry eye patients and their correlation with clinical symptom and sign.Methods Twenty Sj(o)gren syndrome (SS)patients,twenty non-Sj(o)gren syndrome (NSS) patients were included in Wuxi Second Hospital from 2010 to 2011,and twenty healthy volunteers were recruited at the same period.All of subjects understood the purpose and procedure of research and written informed consent was obtained form each subject initial of this study.Dry eye symptom questionnairs were self-answered and multiple dry eye disease-related clinical tests,including the breakup time of tear film (BUT),Schirmer Ⅰ test (S Ⅰ t) and corneal fluorescein staining were performed.The periphery blood of 3 ml and tear were collected in all the subjects,and IL-17 and IL-22 levels in supernatant of PBMCs and tear were detected by enzyme-linked immunosorbent assay (ELISA).The correlations between levels of IL-17 and IL-22 with BUT,S Ⅰ t,corneal fluorescein staining and dry eye scores were analyzed.Results The dry eye scores reduced,BUT prolonged,S Ⅰ t increased and corneal fluorescein dye decreased from SS group,NSS group to normal control group,with significant differences among the three groups (dry eye scores:H =40.81,P＜0.01 ; BUT:H =40.15,P＜0.01 ;S Ⅰ t..H=50.07,P＜0.01 ;corneal dye scores:H=40.52,P＜0.01).The concentration of IL-17 in the supernatant of PBMCs in the SS patients,NSS patients and normal controls were (964.92±124.83)ng/L,(718.85± 115.89)ng/L and (341.95±85.08) ng/L,showing a statistically significant difference among them (F=162.95,P＜0.01).The levels of IL-17 in the tear were (440.69±126.09) ng/L,(364.33±126.85) ng/L and (61.16±11.60) ng/L in the SS group,NSS group and normal control group respectively,exhibiting an elevated level in the SS group and NSS group compared with the control group (F=75.27,P＜0.01).In addition,the levels of IL-22 in the supernatant of PBMCs in the SS patients,NSS patients and normal controls were (98.77± 11.27) ng/L,(79.65 ± 11.01) ng/L and (32.78±9.34) ng/L,and those in the tear were (22.22 ± 8.96) ng/L,(14.92 ±4.35) ng/L and (10.47 ± 2.67) ng/L,with significant differences among the three groups (F =206.27,P＜0.01 ;F =19.87,P＜0.01).The significant correlations were found between the IL-17 and IL-22 concentration in the supernatant of PBMCs and tear with corneal fluorescein staining scores and S Ⅰ t.Conclusions The contents of IL-17 and IL-22 in PBMCs and tear upregulate in the SS and NSS patients,indicating that Th17 plays a key role in the immunity mechanism of dry eye.
