CAJ | 학술논문

目的阐明1型糖尿病患者自身免疫反应与辅助性Th17 T细胞的关系及其机制.方法选取2009年1月至2010年12月在武汉大学中南医院内分泌科诊治的门诊和住院1型糖尿病患者39例[1 型糖尿病组,男21例,女18例,平均年龄(31±13)岁],另选择同期在武汉大学中南医院体检的健康志愿者36名[健康对照组,男19名,女17名,平均年龄(29±12)岁]和内分泌科收治的住院2型糖尿病患者40例[2型糖尿病组,男28例,女12例,平均年龄(36±8)岁].采用流式细胞仪检测外周血Th17辅助性T细胞比例,应用荧光实时定量聚合酶链反应检测外周血单核细胞RORγt基因表达,运用酶联免疫吸附法检测血浆白细胞介素-17A和B细胞活化因子水平.采用t检验进行组间数据比较.结果 1型糖尿病组Th17辅助性T细胞含量[(4.2±0.8)％vs(1.8±0.6)％,t=8.338,P=0.005]、血浆白细胞介素-17A水平[(2.42±0.24) vs( 1.37±0.37) ng/L,t=5.601,P=0.021]、RORγt mRNA表达(5.0±1.3 vs 1.4±1.0,t=38.959,P=0.000)、B细胞活化因子水平[(91 ±5) vs(66±8)ng/L,t=6.211,P=0.015]显著高于健康对照组.偏相关分析显示,在1型糖尿病组中,B细胞活化因子与白细胞介素-17A水平呈显著正相关(r=0.623,P=0.000).多元逐步回归分析显示,Th17辅助性T细胞与1型糖尿病患者空腹C肽水平呈显著负相关(r=-0.069,P =0.011).结论 Th17辅助性T细胞分泌的白细胞介素-17A可能通过促进B细胞活化因子的分泌影响B细胞的存活,参与1型糖尿病的发生.
목적 천명1형당뇨병환자자신면역반응여보조성Th17 T세포적관계급기궤제.방법 선취2009년1월지2010년12월재무한대학중남의원내분비과진치적문진화주원1형당뇨병환자39례[1 형당뇨병조,남21례,녀18례,평균년령(31±13)세],령선택동기재무한대학중남의원체검적건강지원자36명[건강대조조,남19명,녀17명,평균년령(29±12)세]화내분비과수치적주원2형당뇨병환자40례[2형당뇨병조,남28례,녀12례,평균년령(36±8)세].채용류식세포의검측외주혈Th17보조성T세포비례,응용형광실시정량취합매련반응검측외주혈단핵세포RORγt기인표체,운용매련면역흡부법검측혈장백세포개소-17A화B세포활화인자수평.채용t검험진행조간수거비교.결과 1형당뇨병조Th17보조성T세포함량[(4.2±0.8)％vs(1.8±0.6)％,t=8.338,P=0.005]、혈장백세포개소-17A수평[(2.42±0.24) vs( 1.37±0.37) ng/L,t=5.601,P=0.021]、RORγt mRNA표체(5.0±1.3 vs 1.4±1.0,t=38.959,P=0.000)、B세포활화인자수평[(91 ±5) vs(66±8)ng/L,t=6.211,P=0.015]현저고우건강대조조.편상관분석현시,재1형당뇨병조중,B세포활화인자여백세포개소-17A수평정현저정상관(r=0.623,P=0.000).다원축보회귀분석현시,Th17보조성T세포여1형당뇨병환자공복C태수평정현저부상관(r=-0.069,P =0.011).결론 Th17보조성T세포분비적백세포개소-17A가능통과촉진B세포활화인자적분비영향B세포적존활,삼여1형당뇨병적발생.
Objective To assess the role of Th17 cells in the development of type 1 diabetes mellitus (TIDM).Methods Thirty-nine T1DM patients (T1DM group,21 males,18 females,mean age (31 ± 13) years),40 type 2 diabetes mellitus (T2DM) patients(T2DM group,28 males,12 females,mean age (36 ± 8) years) and 36 healthy volunteers (control group,19 males,17 females,mean age (29 ± 12) years) admitted to our hospital during January 2009 and December 2010 were enrolled in this study.Plasma levels of interleukin-17A (IL-17A) and B cell activating factor were measured by enzymelinked immunosorbent assay ( ELISA ) and the frequency of Th17 cells in peripheral blood mononuclear cells was tested by flow cytometry.The expressions of RORγt gene was measured by real-time quantitative polymerase chain reaction.t test was used for data analysis.Results In comparison with the control group,Th17 cells ((4.2±0.8)％ vs (1.8±0.6)％,t =8.338,P=0.005),IL-17A level ((2.42±0.24) vs ( 1.37 ± 0.37) ng/L,t =5.601,P =0.021 ),RORγt mRNA expression (5.0 ± 1.3 vs 1.4 ± 1.0,t =38.959,P =0.000),and B cell activating factor ( (91 ± 5 ) vs (66 ± 8) ng/L,t =6.211,P =0.015 ) of the TI DM group were increased.Partial two-tailed correlation analysis showed that there was a positive correlation between IL-17A and B cell activating factor in the Tl DM group (r =0.623,P =0.000).Stepwise linear regression analysis indicated that Th17 cells was negatively correlated with fasting C-peptide ( r =-0.069,P =0.0 1 1 ).Conclusion Th17 cells might play a role in the development of T1DM through stimulating B cell activating factor.