白介素35在支气管哮喘中的作用机制

支气管哮喘(简称哮喘)是由多种细胞和细胞因子参与的慢性呼吸道炎症性疾病,发病机制可能与Th1/Th2细胞因子失衡、CD4+ CD25+T细胞(调节性T细胞,简称Tregs)及Th17/IL-17等异常有关.白介素35是一种新发现的细胞因子,其与Tregs及Th17/IL-17等免疫调节功能密切相关,通过多种途径参与哮喘的发病和调节,有望成为哮喘的治疗新靶点.本文对此相关研究作一综述.     

Th2／Th17细胞群与支气管哮喘机制研究

支气管哮喘（简称哮喘）是一种由多种细胞（如嗜酸粒细胞、肥大细胞、T淋巴细胞、中性粒细胞和气道上皮细胞等）和细胞组分参与的气道慢性炎症性疾病。经典的Th1／Th2细胞失衡被认为是过敏性哮喘的主要发病机制,Th17／IL-17轴被证实与重症哮喘、激素抵抗型哮喘、以中性粒细胞浸润为主的哮喘有关。近年来研究发现,机体内存在一种不同于目前已知的Thl、Th2、Thl7、Th9等的新型CD4＋T细胞,被称为Th2／Th17双表型记忆性CD4＋T细胞群（简称Th2／Th17细胞群）。在哮喘发病机制的探讨中发现,Th2／Th17细胞群既能分泌Th2表型细胞因子IL-4、IL-5、IL-13,也可以分泌Th17型细胞因子IL-17、IL-8、IL-22等;且在不同的微环境下发生不一样的生物学效应,这显示了Th2／Th17细胞群可能在哮喘发生发展（特别是重症哮喘）及各亚型相互转化过程中起着决定性作用。现就Th2／Th17细胞群的生物学功能及其与哮喘的相关性进行如下综述。     

T细胞在哮喘免疫调节中的作用

哮喘是由T细胞、嗜酸粒细胞、肥大细胞等多种炎症细胞参与的气道慢性炎症性疾病,气道慢性炎症导致气道高反应性（AHR）的形成.其中Th2细胞通过分泌IL-4、IL-5、IL-9、IL-13等多种细胞因子在哮喘发病中起主要作用,而Th1分泌的IFN-γ抑制Th2的功能,近年来研究发现CD4^＋T细胞还包括多种具有调节功能的细胞群体并参与哮喘的免疫调节.另外,NKT细胞和CD8^＋T细胞在哮喘免疫调节中亦具有一定的作用.     

白介素23受体在支气管哮喘小鼠脾源性CD4^＋T细胞中的表达及意义

-23R）的表达及在哮喘发病中的作用。方法建立急性哮喘小鼠模型,免疫磁珠分离小鼠脾源性CD4^＋T细胞,培养24h后,检测CD4^＋T细胞表面IL-23R的表达、Th17细胞的阳性率及细胞培养上清液中的IL-17水平。结果哮喘小鼠脾脏CD4^＋T细胞表面IL-23R的表达明显高于正常组（P〈0．01）;哮喘小鼠脾脏CD4^＋T细胞中Th17细胞的阳性率明显高于正常组（P〈0．01）;哮喘小鼠脾脏CD4^＋T细胞分泌IL-17浓度明显高于正常组（P〈O．01）;小鼠脾脏CD4^＋T细胞表面IL-23R的表达与Th17细胞的阳性率和IL-17的浓度呈正相关。结论IL-23R在急性哮喘的发病机制中可能起重要作用。     

白介素-13和哮喘发病的研究进展

支气管哮喘（简称哮喘）是一种严重威胁人类健康的慢性呼吸道疾病。在世界范围内,过敏性哮喘的发病率和病死率逐年上升。研究表明,哮喘的发病是由于Th2型细胞过度释放细胞因子后诱导IgE产生,导致肥大细胞和嗜酸粒细胞脱颗粒,引起气道速发性过敏反应和以嗜酸粒细胞、肥大细胞、T细胞等多种炎症细胞参与的慢性气道炎症。白介素-13（IL-13）是一种由CD4^＋、Th2型细胞分泌的多效性细胞因子,介导变态反应的发生,与哮喘的发生有密切的关联。     

Th17细胞及其相关疾病的研究进展

Th17细胞是一类独立于Th1、Th2的CD4^＋T细胞亚群,在其分化过程中需要白细胞介素（IL）-6和转化生长因子-β、转录因子ROR-γt及STAT3等参与,分泌IL-17、IL-22、IL-6等多种细胞因子,并参与多种炎症反应、自身免疫性疾病的发生发展,本文旨在阐述Th17细胞及其相关疾病的研究进展作一综述。     

Th17细胞及其在相关肝病中的作用

Th17细胞是一种不同于Th1细胞和Th2细胞的新型CD4＋T细胞亚群。Th17细胞分化需要转化生长因子β和白细胞介素（IL）-6、转录因子孤儿核受体（ROR）γt等参与,分泌IL-17A、IL-17F、IL-21、IL-22、IL-6、肿瘤坏死因子（TNF）α等多种细胞因子,参与自身免疫性肝病、急性肝损伤、慢性乙型肝炎、乙型肝炎肝纤维化、肝癌和肝移植术后急性排斥反应的发生发展。本文旨在对Th17细胞与肝脏疾病的研究进展作一综述。     

Th17细胞与肝脏疾病

辅助性T细胞（Th细胞）根据产生细胞因子和生物学功能分为Th1和Th2细胞。最近研究发现了一种与Th1和Th2细胞亚群不同的活化CD4^＋T细胞亚群-Th17细胞。TGF-8与IL-6或IL-21的协同作用,诱导Th17细胞分化。IL-12家族的IL-23在促进IL-17分泌、增强Th17细胞效应功能方面发挥重要作用,而RORγt是其特异性转录因子。分化成熟的Th17细胞可以分泌IL-17A、IL-17F、IL-21、IL-22、IL-6、TNF—α等多种细胞因子,在介导炎性反应（防御病原菌感染）、自身免疫性疾病、肿瘤、移植排斥反应等过程中发挥重要作用。Th17细胞也为研究肝脏疾病的发病机制及防治策略提供了新思路和方向。     

T细胞在哮喘免疫调节中的作用

哮喘是由T细胞、嗜酸粒细胞、肥大细胞等多种炎症细胞参与的气道慢性炎症性疾病,气道慢性炎症导致气道高反应性(AHR)的形成。其中Th2细胞通过分泌IL-4、IL-5、IL-9、IL-13等多种细胞因子在哮喘发病中起主要作用,而Th1分泌的IFN-γ抑制Th2的功能,近年来研究发现CD4+T细胞还包括多种具有调节功能的细胞群体并参与哮喘的免疫调节。另外,NKT细胞和CD8+T细胞在哮喘免疫调节中亦具有一定的作用。1Th1/Th2与哮喘1986年,Mossmann等[1]发现小鼠CD4+T存在Th1和Th2两个亚群,Th1产生白介素-2(IL-2)、干扰素(IFN)γ和β,不产生IL-4和IL…     

溃疡性结肠炎患者外周血Th17/Treg免疫平衡的研究

目的研究溃疡性结肠炎（UC）患者外周血Th17细胞（CD4＋IL-17＋T细胞）与Treg细胞（CD4^＋CD25^＋T细胞）数量以及相关细胞因子的表达水平,分析Th17／Treg细胞免疫平衡在UC发病机制中的作用。方法收集UC患者（UC组）和健康体检者（对照组）的外周肝素抗凝静脉血,分离纯化T淋巴细胞。分别以PE-CD4与FTTC—CD25单抗,PE-CD4与FITC—IL-17的单抗作双色流式细胞术,分析溃疡性结肠炎患者外周血Th17、Treg细胞的百分率,ELISA法检测血清中相关细胞因子IL-17和TGF—β1的水平。结果与对照组比较,溃疡性结肠炎患者外周血Th17细胞百分率升高,Treg细胞的百分率显著下降,Th17／Treg比值升高（P〈0．05）,血清中细胞因子IL-17升高、TGF-β1降低,并且IL-17／TGF-β1比值升高。结论溃疡性结肠炎患者外周血存在细胞免疫功能失调;Th17／Treg细胞数量与免疫平衡状态发生改变,T淋巴细胞耐受机制的破坏可能与溃疡性结肠炎的发病机制有关。     

Effects and Mechanism of Arsenic Trioxide on Reversing the Asthma Pathologies Including Th17-IL-17 Axis in a Mouse Model

In traditional Chinese medicine, arsenous compounds, including arsenic trioxide (ATO), are often used to treat many diseases, which are safe and effective. Recently, studies have indicated that Th17- IL-17 involved in the pathogenesis and development of asthma. The goal of this study was to investigate the effect and mechanism of ATO on asthma, especially the Th17- IL-17 axis.We used oval bumin (OVA)-immunized mice as a model for asthma and treated mice with ATO or dexamethasone. The mice were then monitored airway responsiveness, airway inflammation, mucus production, IL-17 levels in BALF and the positive rate of Th17 cells. In vitro, CD4+ T cells from splenic cell suspensions were separated and purified. We measured the expression of IL-17 and caspase-12 protein in purified CD4+ T cells, and detected IL-17 levels in CD4+ T lymphocyte culture solution with or without ATO. Moreover, apoptosis, mitochondrial membrane potential, cytosolic calcium were analyzed. We found that ATO could reduce airway responsiveness, airway inflammation, mucus hyperplasia, the expression of IL-17 in BALF and the positive rate of Th17 cells at a level comparable to treatment with DXM. In vitro data suggested that ATO can induce CD4+ T cells apoptosis, cause mitochondrial dysfunction, Ca2+ overload and promote caspase-12 activation. Our study suggested that ATO had potential medical value for the treatment of human asthma..     

白介素23受体在支气管哮喘小鼠脾源性CD4+T细胞中的表达及意义

目的 探讨急性支气管哮喘(简称哮喘)小鼠CD4+T细胞表面白介素23受体(IL-23R)的表达及在哮喘发病中的作用.方法 建立急性哮喘小鼠模型,免疫磁珠分离小鼠脾源性CD4+T细胞,培养24 h后,检测CD4+T细胞表面IL-23R的表达、Th17细胞的阳性率及细胞培养上清液中的IL-17水平.结果 哮喘小鼠脾脏CD4+T细胞表面IL-23R的表达明显高于正常组(P＜0.01);哮喘小鼠脾脏CD4+T细胞中Th17细胞的阳性率明显高于正常组(P＜0.01);哮喘小鼠脾脏CD4+T细胞分泌IL-17浓度明显高于正常组(P＜0.01);小鼠脾脏CD4+T细胞表面IL-23R的表达与Th17细胞的阳性率和IL-17的浓度呈正相关.结论 IL-23R在急性哮喘的发病机制中可能起重要作用.     

Skewed distribution of Th17 lymphocytes in patients with Wegener's granulomatosis in remission

OBJECTIVE: The recently characterized interleukin-17 (IL-17)-producing T helper cell lineage (Th17), rather than the Th1 lineage, is involved in several autoimmune diseases. The possible role of Th17 cells in Wegener's granulomatosis (WG) has not yet been elucidated. We undertook this study to assess the distribution of Th1/Th2/Th17 cells and to investigate the presence of Th17 cells specific for the WG autoantigen proteinase 3 (PR3) in WG. METHODS: Peripheral blood from patients with WG in remission (n = 26) and healthy controls (n = 10) was stimulated in vitro with PR3 or with the control stimuli staphylococcal enterotoxin B (SEB), tetanus toxoid (TT), or phorbol myristate acetate/calcium ionophore, together with anti-CD28 and anti-CD49d. The frequencies of the various CD4+ T cell phenotypes responsive to stimuli were determined by 7-color flow cytometric detection of CD3, CD8, an early activation marker (CD69), and intracellular cytokines (IL-2, interferon-gamma [IFNgamma], IL-17, and IL-4). RESULTS: The percentage of CD69+,CD4+ T cells in patients with WG in remission was significantly decreased in response to PR3 and tended to be lower in response to other stimuli compared with the percentage in healthy controls. The percentages of Th17 cells (IL-4-,IL-17+,IFNgamma-) and Th2 cells (IL-4+,IL-17-,IFNgamma-) within the activated CD69+,CD4+ T cell population were significantly increased in patients with WG in remission, while no difference was found in Th1 cells (IL-4-,IL-17-,IFNgamma+) compared with the percentage in healthy controls. Increased percentages of Th17 cells in response to TT and SEB were found both in antineutrophil cytoplasmic antibody (ANCA)-positive and in ANCA-negative patients, while an increased frequency of PR3-specific Th17 cells was restricted to ANCA-positive patients. CONCLUSION: A skewed Th17 response found in ANCA-positive WG patients following stimulation with the autoantigen PR3 suggests that IL-17 is involved in disease pathogenesis and could constitute a new therapeutic target.     

类风湿关节炎患者外周血Th17细胞的检测及意义

目的 探讨Th17细胞在类风湿关节炎(RA)患者外周血中的水平及意义.方法 分离RA患者和健康者外周血单个核细胞(PBMC),免疫磁珠阴选CD4~+T细胞,用或不用非特异性刺激剂(A-CD3、A-CD28),然后加佛波酯/离子霉素(PMA/Ion),经固定,透膜处理进行细胞内染色,流式细胞术(FCM)检测CD4~+T细胞内白细胞介素(IL)-17~+/干扰素(IFN)-γ~+、IL-17~+/IL-6~+水平.分组:①健康对照组;②RA病情稳定组;③RA病情活动组.结果 免疫磁珠阴选CD4~+T细胞纯度>90%.RA病情活动组IL-17表达水平(1.54±0.41)显著高于RA病情稳定组(0.70±0.21,P<0.01),二者又显著高于健康对照组(0.42±0.12,P<0.01).用A-CD3、A-CD28、IL-23刺激后,CD4~+T细胞IL-17胞内表达水平较无刺激组显著增加(P<0.05).CD4~+T细胞IFN-γ表达水平呈现与IL-17表达相似的特点,而RA患者与健康对照组IL-6表达水平差异无统计学意义.RA患者IL-17胞内表达水平与IFN-γ、IL-6无显著相关.结论 RA患者外周血CD4~+T细胞中存在异常增高的Th17细胞,且其水平与病情活动相关,有望作为判断RA患者病情活动的指标之一.     

T-cell cytokine profiles are altered in childhood asthma exacerbation

Background and objective:   Stable asthma is characterized by the production of Th2 cytokines, although Th1 cytokines may play a key role in aspects such as airway hyper-responsiveness. This study explored cytokine profiles associated with asthma exacerbation.
Methods:   Intracellular T-cell cytokine production was measured in 16 children with acute severe asthma (emergency department), after convalescence (6 weeks, n  = 13), with stable disease (after 6 months, n  = 7) and in 14 age-matched hospital controls. Flow cytometry was used to identify CD4+ and CD8+ cells and to quantify intracellular T-cell production of the cytokines interferon (IFN)-γ, IL-4 and IL-13. Cytokine production was compared using analysis of variance and random-effects generalized linear models and associations were examined using Pearson's correlation.
Results:   Cytokine production was evident in CD4+ and CD8+ cells, and compared with asthmatic children, non-asthmatics had a higher percentage of IFN-γ+CD4+ cells ( P  = 0.01). The percentage of CD8+IFN-γ+ cells was increased in the convalescent phase compared with acute ( P  = 0.009) and stable asthma ( P  = 0.004). IL-4+ cells were not significantly altered. IL-13 levels were higher in acute disease than in stable asthma ( P  = 0.009 in CD4+ cells) and IFN-γ/IL-13 ratios indicated a Th2 profile during exacerbation ( P  = 0.005 in CD4+ cells).
Conclusions:   IL-13, rather than IL-4, may play a pro-inflammatory role during acute severe asthma, whereas IFN-γ responses were associated with recovery from acute severe asthma. These results suggest that altered T-cell cytokine profiles may contribute to the pathogenesis of and recovery from asthma exacerbations.     

Increased levels of circulating Th17 cells in quiescent versus active Crohn's disease

Background and aimsTh17 cells, a subset of CD4 + T cells that produce interleukin (IL)-17A, IL-17F, IL-21, IL-22, IL-26, and the chemokine CCL20 are critically involved in the mucosal inflammation observed in Crohn's disease (CD). However, their role as mediators of inflammation in CD has been questioned by a recent clinical trial in which anti-IL-17A (secukinumab) treatment was ineffective. Besides being pro-inflammatory, Th17-related cytokines mediate mucosal protective functions. We aimed to investigate the role of Th17 cells in CD inflammation.MethodsBlood samples from 26 patients with active CD and 10 healthy controls (HC) were analyzed for levels of IL-17A-, IL-21- and IL-22-producing CD45RO+CD4 + T cells using multicolor flow cytometry. Samples were analyzed before and during adalimumab treatment to compare intra-individual changes during active and quiescent disease.ResultsCD patients had statistically significantly higher levels of IL-17-A-, IL-21- and IL-22-producing CD45RO+CD4 + T cells in both active and quiescent disease compared with HC. Baseline levels of IL-21 and IL-22 producing CD45RO+CD4 + T cells correlated inversely with mucosal inflammation estimated by fecal calprotectin. Patients who responded to adalimumab treatment demonstrated a 2- to 3-fold increase in levels of IL-17A- and IL-21-producing CD45RO+CD4 + T cells in quiescent disease compared with active disease.ConclusionOur data support the involvement of Th17 cells and IL-21- and IL-22-producing CD45RO+CD4 + T cells in CD. Because patients had higher levels in quiescent disease compared with active CD, we question whether Th17 cells are promoters of inflammation. Instead, Th17 cells may counterbalance inflammation and maintain gut homeostasis.     

参麦注射液对支气管哮喘患者外周血Th17/Treg细胞的影响

目的 探讨参麦注射液对支气管哮喘(简称哮喘)患者外周血Th17/Treg细胞的影响及其意义.方法 选取山西医科大学第一医院呼吸科急性发作期、缓解期哮喘患者各25例,选取山西医科大学第一医院体检中心肺功能正常、激发或者舒张试验阴性的健康人25例作为对照组,分别使用1640培养液及参麦注射液进行干预处理.抽取晨起空腹静脉血5 ml,运用流式细胞仪对各组外周血Th17细胞、Treg细胞分别占CD4+的比例及Th17/Trcg细胞的比值进行比较,同时检测血清中IL-10因子的水平.结果 ①各组间干预前CD4+ Th17细胞/CD4+T细胞、CD4+ Th17细胞/CD4+ Treg细胞的比值,急性发作期组(3.05±1.27、1.49±1.78)高于缓解期组(2.38±0.93、0.61±0.24)及对照组(1.19±0.39、0.30±1.14),差异有统计学意义(P＜0.05),缓解期高于对照组,差异有统计学意义(P＜0.05);CD4+Treg细胞/CD4+T细胞的比值,对照组(5.20±3.26)高于缓解期组(3.99±0.90)及急性发作期组(2.76±0.93),差异有统计学意义,(P＜0.05),缓解期组高于急性发作期组,差异有统计学意义(P ＜0.05).血清中IL-10因子的水平,对照组(5,28±1.31)高于缓解期组(4.46±0.83)及急性发作期组(3.90±0.64),差异有统计学意义(P＜0.05),缓解期组高于急性发作期组,差异有统计学意义(P ＜0.05).②同一组间CD4+ Th17细胞/CD4+T细胞、CD4+Th17细胞/CD4+ Treg细胞的比值,干预前高于干预后,差异有统计学意义(P＜0.05).CD4+ Treg细胞/CD4+T细胞的比值,干预后高于干预前,差异有统计学意义(P＜0.05).血清中IL-10因子水平,干预后高于干预前,差异有统计学意义(P ＜0.05).结论 哮喘患者外周血中存在Th17/Treg细胞失衡,参麦注射液可以改善哮喘患者的Th17/Treg细胞失衡.     

Crucial role of the interleukin-6/interleukin-17 cytokine axis in the induction of arthritis by glucose-6-phosphate isomerase

OBJECTIVE: To clarify the glucose-6-phosphate isomerase (GPI)-specific CD4+ T cell lineage involved in GPI-induced arthritis and to investigate their pathologic and regulatory roles in the induction of the disease. METHODS: DBA/1 mice were immunized with GPI to induce arthritis. CD4+ T cells and antigen-presenting cells were cocultured with GPI, and cytokines in the supernatant were analyzed by enzyme-linked immunosorbent assay. Anti-interferon-gamma (anti-IFNgamma) monoclonal antibody (mAb), anti-interleukin-17 (anti-IL-17) mAb, or the murine IL-6 receptor (IL-6R) mAb MR16-1 was injected at different time points, and arthritis development was monitored visually. After MR16-1 was injected, percentages of Th1, Th2, Th17, and Treg cells were analyzed by flow cytometry, and CD4+ T cell proliferation was analyzed using carboxyfluorescein diacetate succinimidyl ester. RESULTS: GPI-specific CD4+ T cells were found to be differentiated to Th1 and Th17 cells, but not Th2 cells. Administration of anti-IL-17 mAb on day 7 significantly ameliorated arthritis (P < 0.01), whereas administration of anti-IFNgamma mAb exacerbated arthritis. Neither anti-IL-17 mAb nor anti-IFNgamma mAb administration on day 14 ameliorated arthritis. Administration of MR16-1 on day 0 or day 3 protected against arthritis induction, and MR16-1 administration on day 8 significantly ameliorated existing arthritis (P < 0.05). After administration of MR16-1, there was marked suppression of Th17 differentiation, without an increase in Th1, Th2, or Treg cells, and CD4+ T cell proliferation was also suppressed. CONCLUSION: IL-6 and Th17 play an essential role in GPI-induced arthritis. Since it has previously been shown that treatment with a humanized anti-IL-6R mAb has excellent effects in patients with rheumatoid arthritis (RA), we propose that the IL-6/IL-17 axis might also be involved in the generation of RA, especially in the early effector phase.