哮喘患儿外周血RORC mRNA、IL-17水平及其与气道重塑的关系研究

目的：研究Th17细胞上游调控基因维甲酸相关孤儿核受体C （RORC）mRNA及主要效应分子IL-17在支气管哮喘患儿外周血单个核细胞中的表达变化，并探讨其与哮喘气道重塑的关系。方法收集2010年9月至2012年8月中山大学孙逸仙纪念医院儿科就诊的中重度持续哮喘儿童45例，其中哮喘急性发作期25例，临床缓解期20例，以20名健康儿童为对照组。采用荧光实时定量PCR技术和双抗体夹心ELISA法分别检测PBMC中 RORC mRNA和IL-17的表达；选取其中14例病程较长的临床缓解期患儿，采用高分辨螺旋CT进行胸部检测及支气管壁测量，并与同期IL-17水平进行相关分析。结果哮喘儿童急性发作期外周血PBMC 表达RORC mRNA、IL-17水平均显著高于缓解组和正常对照组；缓解期患儿IL-17水平比对照组明显增高（P＜0．05），而RORC mRNA表达水平与对照组比较差异无统计学意义（P＞0．05）。中重度哮喘患儿气道壁厚度、气道壁面积均明显增加，且与IL-17水平呈正相关（r 分别为0．78、0．77，P＜0．05）。结论转录因子RORC及IL-17参与儿童哮喘发病，其中IL-17水平升高与儿童哮喘气道重塑密切相关。

Relationship between level of RORC mRNA and IL-17 in peripheral blood mononuclear cells and air-way remodeling in asthmatic children

Objective To study the relationship between level of RORC mRNA,IL-1 7 in peripheral blood mononuclear cells （PBMC）and airway remodeling in asthmatic children.Methods Blood samples were taken from 45 children with moderate-severe persistent asthma,including 25 children in acute attack stage,20 children in remission stage,and 20 healthy children as control.The expression of RORC mRNA was detected by quantitative RT-PCR and IL-1 7 by ELISA.Chest examination was performed with resolution high computed tomography （HRCT）.Result The expression of RORC mRNA and IL-1 7 in PBMC in asthmatic children was higher in attack stage than in remission stage and control group.There was no significant difference in the ex-pression of RORC mRNA between asthmatic children in remission stage and healthy individuals （P〉0.05）. The IL-1 7 level,however,was found to be higher in remission stage than in healthy controls,it also tended to be positively correlated with the thickness of the small airway wall （P〈0.05）.Conclusion Both RORC mR-NA and IL-1 7 participate in the onset of asthma.The increase of IL-1 7 level may play a potential role in the airway remodeling of asthma.