支气管哮喘患者外周血Th17 与Th9 细胞的变化及临床意义

目的:探讨Th17、Th9 细胞水平在支气管哮喘患者中的表达及其临床意义。方法:选取67 例哮喘患者为研究对象,30 例健康体检者为对照组,根据全球哮喘防治倡议(GINA)将哮喘患者分为间歇与轻度持续组20 例,中度持续组25 例和重度持续组22 例。收集患者临床资料,完成哮喘控制测试(ACT)评分、肺功能和呼出气一氧化氮(FeNO)值测定,流式细胞仪检测外周血PBMC 中CD3+ CD8- IL-17+ 、CD3+ CD8- IL-9+细胞水平。结果:与健康对照组相比,哮喘患者Th17、Th9 细胞水平均明显升高(P<0.05);中重度哮喘患者Th17 及Th9 细胞水平显著高于间歇与轻度哮喘组(P<0.05),而间歇与轻度哮喘组患者与健康对照组比较,差异无统计学意义(P>0.05)。哮喘患者外周血Th17 及Th9 细胞的表达均与FeNO 值正相关(r 值依次为0.501、0.438;P<0.05),与ACT 评分、肺功能FEV1、FEV1/ FVC 及PEF 负相关(r 值依次为-0.441、-0.362;-0.307、-0.377;-0.419、-0.411;-0.428、-0.24;P<0.05),同时Th17 与Th9 细胞在哮喘患者外周血中的表达率正相关(r 值为0.443,P<0.05)。结论:Th17、Th9 细胞在哮喘患者中高表达,具有协同致炎作用,且与症状严重程度相关,提示Th17 及Th9 细胞对哮喘患者病情评估有潜在的参考价值。

Changes and clinical significance of Th17 and Th9 cells in patients with asthma

Objective:To explore the expression of Th17 and Th9 cells and their clinical significance in patients with asthma.Methods:67 patients with asthma and 30 healthy subjects were enrolled in this study,according to GINA,the asthmatic patients were classified intermittent to mild persistent asthma(n = 20),moderate persistent asthma(n = 25)and severe persistent asthma(n =22). The characteristics of patients,Asthma control test(ACT) scores,pulmonary function and fractional exhaled nitric oxide(FeNO)were evaluated,the levels of CD3+ CD8- IL-17+ ,CD3+ CD8- IL-9+ were determined by flow cytometric analysis.Results:The levels of Th17,Th9 cells were significantly higher in asthma patients compared with control group(P<0.05);moderate to severe persistent group showed a significant increase of Th17 and Th9 proportion compared with intermittent to mild persistent group,while there were no signif-icance between intermittent to mild persistent asthma and control group(P>0.05).The expression of Th17 and Th9 cells were positively correlated with FeNO(r =0.503,0.438;P<0.05) while negatively correlated with ACT,FEV1,FEV1/ FVC and PEF in the asthmatic patients(r=-0.441,-0.362;-0.307,-0.377;-0.419,-0.411;-0.428,-0.324;P<0.05). There were positive correlation between the expression of Th17 and Th9 cells(r = 0.443;P <0.05).Conclusion:Th17 and Th9 cells highly increased in the patients with asthma have synergy inflammatory effect,which were associated with symptom severity.These results indicate that Th17 and Th9 cells may have a potential value to assess severity of asthma.