CAJ | 학술논문

目的：通过观察 COPD 患者 IL-33在抗凝血浆蛋白表达水平变化和淋巴细胞中mRNA 表达水平变化及其相关性，探讨 IL-33在 COPD 发病机制中的作用，从而为 COPD 的病情判断和干预治疗提供理论依据。方法选取2012年2月至2014年6月上海市第八人民医院收治的COPD 患者232例作为研究对象，其中116例为 COPD 急性加重期，剩余116例为 COPD 稳定期患者，另选择同期85例正常健康人作为对照组，抽取3组受试者的外周血标本，分离淋巴细胞，抽提总 RNA，用荧光定量 PCR 方法检测标本中 IL-33mRNA 表达量；同时分离，采用双抗体 ELISA法测定抗凝血浆中 IL-33的蛋白水平。结果相对于116例稳定期 COPD 患者，116例急性加重期COPD 患者 IL-33mRNA 的表达水平显著上升（P<0.01），抗凝血浆 IL-33蛋白含量也上升；经抗感染等积极有效治疗后均获得缓解。同样方法复测 IL-33mRNA 表达量显著下降，抗凝血浆 IL-33蛋白含量无明显差异。结论 IL-33作为 TH2型细胞因子，与蛋白表达水平相比，mRNA 表达水平更灵敏，在 COPD 患者急性加重期其表达显著增加，经过治疗获得缓解，表达又开始下调，这表明 IL-33参与 COPD 的发病，尤其在急性加重期起重要作用。
목적：통과관찰 COPD 환자 IL-33재항응혈장단백표체수평변화화림파세포중mRNA 표체수평변화급기상관성，탐토 IL-33재 COPD 발병궤제중적작용，종이위 COPD 적병정판단화간예치료제공이론의거。방법선취2012년2월지2014년6월상해시제팔인민의원수치적COPD 환자232례작위연구대상，기중116례위 COPD 급성가중기，잉여116례위 COPD 은정기환자，령선택동기85례정상건강인작위대조조，추취3조수시자적외주혈표본，분리림파세포，추제총 RNA，용형광정량 PCR 방법검측표본중 IL-33mRNA 표체량；동시분리，채용쌍항체 ELISA법측정항응혈장중 IL-33적단백수평。결과상대우116례은정기 COPD 환자，116례급성가중기COPD 환자 IL-33mRNA 적표체수평현저상승（P<0.01），항응혈장 IL-33단백함량야상승；경항감염등적겁유효치료후균획득완해。동양방법복측 IL-33mRNA 표체량현저하강，항응혈장 IL-33단백함량무명현차이。결론 IL-33작위 TH2형세포인자，여단백표체수평상비，mRNA 표체수평경령민，재 COPD 환자급성가중기기표체현저증가，경과치료획득완해，표체우개시하조，저표명 IL-33삼여 COPD 적발병，우기재급성가중기기중요작용。
Objective By observing the plasma level and mRNA changes of Interleukin-33(IL-33)in patient swith chronic obstructive pulmonary disease(COPD)at acute exacerbation phase and stable phase,to investigate the role of IL-33 in the pathogenesis of COPD to offer evidence for the judgement of COPD illness state and treatment. Methods The expression of IL-33 mRNA was tested by RT-QPCR in lymphocyte samples in paired 116 COPD patients at acute exacerbation phase and stable phase. The plasma levels of IL-33 were determined in 116COPD patients at acute exacerbation phase and stable phase by sandwich enzyme-linked immunosorbent assay (sandwich-ELISA). Results Compared with 116 cases of stable COPD patients,the IL-33mRNA expression levels is significantly increased (P<0.01)and the anticoagulant plasma IL-33 content of 116 cases of acute COPD patients are also increased;The situation is in remission after active treatment such as anti-infection. Use the same way to retest the samples, the level of IL -33mRNA expression was significantly decreased,but the plasma IL-33 content shows no significant difference.Over the same period, we collected 85 cases of healthy people as control group. Conclusion As a TH2-type cytokine, the expression level of IL-33 mRNA is more sensitive compared with the plasma level at acute exacerbation phase and stable phase of COPD patients,and the results also shows that the mRNA expression level is significantly decreased.Dynamic monitoring of the indicator (IL-33) has a certain significance to diagnosis and prognosis the acute COPD patients.