黄芪注射液对慢性阻塞性肺疾病患者外周血Th17/Treg细胞平衡的影响及意义

目的探讨黄芪注射液干预前后慢性阻塞性肺疾病(COPD)患者外周血Th17细胞、Treg细胞占CD4+T细胞的比例及白介素-10(IL-10)的表达水平,及黄芪注射液对其的作用。方法收集COPD急性加重期(A组)、稳定期(B组)、肺功能正常吸烟者(C组)及肺功能正常非吸烟者(D组)各20例,分别抽取患者空腹静脉血制备单个核细胞悬液(PBMC),分为空白组和黄芪组,应用流式细胞术检测各组黄芪注射液干预前后Th17细胞、Treg细胞占CD4+T细胞的比例及IL-10的表达水平。结果CD4+Th17细胞的比例:空白组均高于黄芪组(P0.05),空白组:A组(2.87±0.90)%高于B组(2.07±0.76)%、C组(1.20±0.42)%、D组(1.02±0.30)%,B组高于C、D组,C组和D组相比差异无统计学意义(P0.05);黄芪组:A组(1.51±0.93)%高于B组(0.94±0.65)%、C组(0.75±0.45)%、D组(0.68±0.37)%(P0.05),B、C、D组组间两两比较差异无统计学意义(P0.05);CD4+Treg细胞的比例:黄芪组均高于空白组(P0.05),在黄芪组,D组(8.04±2.65)%高于A组(4.76±1.43)%、B组(5.89±1.93)%、C组(6.50±2.2)%(P0.05),B组和C组相比差异无统计学意义,C组高于A组(P0.05);在空白组,D组(6.29±3.24)%高于A组(2.42±1.45)%、B组(4.13±1.83)%、C组(4.41±2.67)%(P0.05),B组和C组相比差异无统计学意义,C组高于A组(P0.05);外周血IL-10水平:黄芪组均高于空白组(P0.05),黄芪组:D组(7.25±1.32)%高于A组(4.76±1.31)%、B组(6.32±1.75)%、C组(6.02±1.39)%(P0.05),B组和C组相比差异无统计学意义,C组高于A组(P0.05);空白组:D组(5.21±1.07)%高于A组(2.96±1.25)%、B组(4.00±0.81)%、C组(4.31±0.90)%(P0.05),B组和C组相比差异无统计学意义,C组高于A组(P0.05);Th17/Treg细胞的比值:空白组均高于黄芪组(P0.05),黄芪组:A组(0.34±0.21)%均高于B组(0.17±0.13)%、C组(0.14±0.10)%、D组(0.11±0.07)%(P0.05);空白组,A组(4.27±7.77)%均高于B(0.60±0.33)%、C(0.31±0.19)%、D组(0.21±0.13)%(P0.05)。结论 Th17/Treg比值升高,平衡失调,可能是COPD发病的免疫机制;黄芪注射液在一定程度上能调节Th17/Treg比例失衡,对COPD的治疗可能有一定的疗效。

Effect and significance of Astragalus injection on the balance of Th17/Treg cell in the peripheral blood of the patients with chronic obstructive pulmonary disease

Objective To investigate the percentage of Th17 cells,Treg cells in CD4+T cells and the expression level of interleukin-l0 (IL-10) in the peripheral blood of the patients with chronic obstructive pulmonary disease (COPD) before and after the interference of Astragalus Injection,to explore the effect of Astragalus Injection on them.Methods The study selected randomly 20 AECOPD patients (group A),20 stable COPD patients (group B),20 smokers of normal lung function (group C) and 20 non-smokers of normal lung function (group D) to collect the peripheral venous blood of them to prepare the peripheral blood mononuclear cell suspension (PBMC),then divided the PBMC of all subjects into blank group and Astragalus group,the ratio of CD4+ Th17 cells,CD4+ Treg cells and the expression level of IL-t0 before and after the intervention of Astragalus injection were detected by flow cytometry.Results The ratio of CD4+ Th 17 cells:the blank groups were higher than Astragalus groups (P＜0.05),group A (2.87± 0.90)％ was highest among the four groupsin blank groups (P＜0.05),group B (2.07± 0.76) ％ was higher than group C (l.20 ± 0.42) ％ and group D (1.02±0.30)％ (P＜0.05),the result had no statistically significant difference between group C and group D (P＞0.05);group A (1.51 ±0.93)％ was highest among the four groups in Astragalus groups (P＜0.05),the result had no statistically significant difference among the group B(0.94±0.65)％,group C(0.75±0.45) ％ and group D(0.68±0.37)％ (P＞0.05);the ratio of CD4+ Treg cells:Astragalus groups were higher than blank groups (P＜ 0.05),group D (8.04± 2.65) ％ was highest among the four groups in Astragalus groups (P＜0.05),the result had no statistically significant difference between group B (5.89± 1.93)％ and group C (6.50±2.26)％ (P＞0.05),group C was higher than group A(4.76±1.43)％ (P＜0.05);group D(6.29± 3.24) ％ was highest among the four groups in blank groups(P＜0.05),the result had no statistically significant difference between group B (4.13 ± 1.83) ％ and group C (4.41 ± 2.67) ％ (P＞ 0.05),group C was higher than group A (2.42± 1.45)％ (P＜0.05).The level of IL-10:Astragalus groups were higher than blank groups (P＜0.05),group D(7.25± 1.32)％ was highest among the four groups in Astragalus groups (P＜0.05),the result had no statistically significant difference between group B (6.32± 1.75) ％ and group C (6.02± 1.39) ％ (P ＞0.05),group C was higher than group A(4.76±1.31)％ (P＜0.05);group D(5.21±1.07)％ was highest among the four groups in blank groups(P＜0.05),the result had no statistically significant difference between group B(4.00±0.81)％ and group C(4.31±0.90)％ (P＞0.05),group C was higher than group A (2.96±1.25) ％ (P＜0.05).The ratio of Th17/Treg cells:the blank groups were higher than Astragalus groups (P＜ 0.05),group A was highest among the four groups in Astragalus groups and blank groups (P＜ 0.05).Conclusions The immune mechanism of COPD pathogenesis may be the ratio of Th17/Treg increased and Th17/Treg balance diaordered;to a certain extent,Astragalus injection can regulate the imbalance of Th17/Treg cells,and may have certain curative effect for the treatment of COPD.