CAJ | 학술논문

目的探讨白细胞介素(IL)-17在重型再生障碍性贫血(SAA)患者发病机制中的作用.方法收集2012年10月至2013年10月天津医科大学总医院血液科诊断明确的SAA患者40例(初治组25例、缓解组15例)及10名健康对照的外周血标本,采用流式液相多重蛋白定量技术检测血清IL-17水平,分析其与T细胞亚群(CD4 +/CD8+比值)、树突细胞(DC)亚群[髓样树突细胞(mDC)/淋系树突细胞(pDC)比值]、调节性T细胞(Treg)及血常规表达的相关性.结果 SAA初治组IL-17水平为(17.07±15.18) ng/L,明显高于恢复组[(7.09 ±3.84) ng/L,P＜0.01]和对照组[(3.53±2.08) ng/L,P＜0.01];SAA恢复组IL-17水平亦明显高于对照组(P＜0.05).初治组CD4+/CD8+比值为0.32±0.08明显低于恢复组(1.11±0.31,P＜0.01)及对照组(1.07±0.26,P＜0.01);初治组mDC/pDC比值为3.16±0.55明显高于恢复组(1.60 ±0.43,P＜0.01)及对照组(1.43±0.38,P＜0.01);初治组Treg占外周血单个核细胞比例(CD4+ CD25+ CD127dim/PBL)为0.80％±0.31％明显低于恢复组(1.78％±0.69％,P＜0.01)及对照组(2.23％±0.66％,P＜0.01).初治组IL-17水平与CD4+/CD8+比值及CD4+ CD25+ CD127dim/PBL均呈负相关(r=-0.421,P ＜0.05;r=-0.650,P＜0.01),与mDC/pDC比值呈正相关(r=0.414,P＜0.05),与白细胞水平呈负相关(r=-0.689,P＜0.01);恢复组IL-17水平与白细胞水平呈负相关(r=-0.640,P＜0.05).结论 SAA患者血清IL-17升高,并与SAA免疫功能状态及病情严重程度相关.
목적 탐토백세포개소(IL)-17재중형재생장애성빈혈(SAA)환자발병궤제중적작용.방법 수집2012년10월지2013년10월천진의과대학총의원혈액과진단명학적SAA환자40례(초치조25례、완해조15례)급10명건강대조적외주혈표본,채용류식액상다중단백정량기술검측혈청IL-17수평,분석기여T세포아군(CD4 +/CD8+비치)、수돌세포(DC)아군[수양수돌세포(mDC)/림계수돌세포(pDC)비치]、조절성T세포(Treg)급혈상규표체적상관성.결과 SAA초치조IL-17수평위(17.07±15.18) ng/L,명현고우회복조[(7.09 ±3.84) ng/L,P＜0.01]화대조조[(3.53±2.08) ng/L,P＜0.01];SAA회복조IL-17수평역명현고우대조조(P＜0.05).초치조CD4+/CD8+비치위0.32±0.08명현저우회복조(1.11±0.31,P＜0.01)급대조조(1.07±0.26,P＜0.01);초치조mDC/pDC비치위3.16±0.55명현고우회복조(1.60 ±0.43,P＜0.01)급대조조(1.43±0.38,P＜0.01);초치조Treg점외주혈단개핵세포비례(CD4+ CD25+ CD127dim/PBL)위0.80％±0.31％명현저우회복조(1.78％±0.69％,P＜0.01)급대조조(2.23％±0.66％,P＜0.01).초치조IL-17수평여CD4+/CD8+비치급CD4+ CD25+ CD127dim/PBL균정부상관(r=-0.421,P ＜0.05;r=-0.650,P＜0.01),여mDC/pDC비치정정상관(r=0.414,P＜0.05),여백세포수평정부상관(r=-0.689,P＜0.01);회복조IL-17수평여백세포수평정부상관(r=-0.640,P＜0.05).결론 SAA환자혈청IL-17승고,병여SAA면역공능상태급병정엄중정도상관.
Objective To explore the role of interleukin-17 (IL-17) in the pathogenesis of severe aplastic anemia (SAA).Methods Peripheral blood samples were obtained from 40 SAA patients (25 untreated,15 recovery) and 10 normal controls from October 2012 to October 2013.The level of IL-17in peripheral blood was measured with cytometric bead array (CBA).The correlations between IL-17 and T cells subset (CD4 +/CD8 +),dendritic cells (DC) subset (mDC/pDC),regulatory T cells (Treg) and hemogram were analyzed.Results The serum level of IL-17 in untreated patients was higher than that in recovery patients and normal controls ((17.07 ± 15.18) vs (7.09 ±3.84) and (3.53 ±2.08) ng/L,both P ＜ 0.01).Also significant differences existed between the latter two groups (P ＜ 0.05).The ratio of CD4 +/CD8 + was (0.32 ± 0.08) in untreated patients and it was lower than that in recovery patients (1.11 ±0.31,P ＜ 0.01) and normal controls (1.07 ± 0.26,P ＜ 0.01).The ratio of mDC/pDC was (3.16 ±0.55) in untreated patients was higher than that in recovery patients (1.60 ±0.43,P ＜0.01)and normal controls (1.43 ± 0.38,P ＜ 0.01).The percentage of Tregs in peripheral blood lymphocyte (CD4 +CD25 + CD127dim/PBL) was 0.80％ ± 0.31％ in untreated patients and it was lower than that in recovery patients (1.78％ ±0.69％,P ＜ 0.01) and normal controls (2.23％ ± 0.66％,P ＜ 0.01).The serum level of IL-17 in untreated SAA patients was related positively with mDC/pDC ratio (r =0.414,P ＜ 0.05)and negatively with CD4 +/CD8 + ratio (r =-0.421,P ＜ 0.05) and CD4 + CD25 + CD127dim/PBL (r =-0.650,P ＜ 0.01).And significant negative correlations existed between serum IL-17 and white blood cells in untreated patients (r =-0.689,P ＜ 0.01) and recovery patients (r =-0.640,P ＜ 0.05).Conclusion The elevated serum level of IL-17 in SAA is related with the immunological status and disease severity.