特发性肺纤维化患者肺泡灌洗液及血清中前列腺素E2和白细胞介素12、13水平变化的意义

目的　探讨特发性肺纤维化 (IPF)患者肺泡灌洗液及血清中前列腺素E2 (PGE2 )和白细胞介素 12、13(IL 12、IL 13)水平变化的意义。方法　用放射免疫法及酶联免疫吸附法 ,检测 30例IPF患者 (IPF组 )血清及支气管肺泡灌洗液 (BALF)中PGE2 和IL 12、IL 13的水平 ;健康非吸烟的自愿献血者 30名 ,为血清对照组 ,检测其血清PGE2 和IL 12、IL 13的水平 ;以胸痛为主诉进行BALF检查证实为健康者 9名 ,作为BALF对照组 ,检测其BALF中PGE2 和IL 12、IL 13的水平。结果　IPF组患者BALF中PGE2 为 (5 91± 88)ng/L、IL 12为 (1 34± 0 2 5 )ng/L、IL 13为 (38± 5 )ng/L ,对照组BALF中PGE2 、IL 12、IL 13分别为 (2 38± 7)、(2 2 9± 0 2 6 )、(2 0± 4 )ng/L ,两组相比差异有显著意义 (P值均 <0 0 1) ;血清IL 13水平的变化与BLAF一致 ,但IPF组患者血清PGE2 为 (2 35± 13)ng/L、IL 12为 (2 35± 0 14 )ng/L ,与血清对照组相比差异无显著性 (P >0 0 5 )。结论　IPF患者BALF中PGE2 水平升高 ,可能与IL 13的增高和IL 12水平的下降有关 ,并在IPF的发生、发展中起重要的作用。肺纤维化患者PGE2水平增高主要发生在肺的局部 ,而并非全身性的。

Change of prostaglandin E2 and interleukin-12,interleukin-13 in the bronchoalveolar lavage fluid and the serum of the patients with idiopathic pulmonary fibrosis

OBJECTIVE: To detect the levels of prostaglandin E2 (PGE2) and interleukin-12 (IL-12), IL-13 in the bronchoalveolar lavage fluid (BALF) and the serum of patients with idiopathic pulmonary fibrosis (IPF) and to investigate the significance of their change in the pathogenesis of IPF. METHODS: Radioimmunoassay (RIA) and enzyme-linked immunoadsorbent assay (ELISA) were used to detect the levels of PGE2 and IL-12, IL-13 in the BALF and the serum of patients with IPF. RESULTS: In the BALF of patients with IPF, the levels of PGE2 (591 +/- 88) ng/L and IL-13 (38 +/- 5) ng/L were higher than that of the control group (P < 0.01), and the level of IL-12 (1.34 +/- 0.25) ng/L was lower than that of control group. In the patients with IPF, the change of IL-13 in the serum was consistent with the change in the BALF. But the levels of PGE2 (235 +/- 13) ng/L and IL-12 (2.35 +/- 0.14) ng/L in the serum showed no significant difference between the patients with IPF and the control group. CONCLUSIONS: In the patients with IPF the increase of PGE2 may be correlated with the increase of IL-13 and the decrease of IL-12. It suggests that disequilibrium of Th1/Th2 plays an important role in the development of IPF. The increase of PGE2 in IPF is a local event rather than a systemic effect.