Th17细胞在系统性红斑狼疮免疫炎症反应中的作用机制研究

目的从Th17/Treg、IL-17及RORγt mRNA表达3方面进行研究,探讨Th17细胞在SLE免疫炎症反应中的作用机制。方法研究对象为26例活动期SLE患者、16例非活动期SLE患者和20例正常对照,采用细胞内染色流式细胞术检测Th17/Treg,ELISA法检测IL-17及RT-PCR法检测RORγt mRNA表达,并探讨它们与SLE疾病活动性的关系。结果活动期SLE患者组Th17/Treg、IL-17及RORγt mRNA表达水平显著高于非活动期及正常对照组;非活动期SLE患者组RORγt mRNA表达显著高于正常对照组,但两组间Th17/Treg、IL-17水平无显著差异。SLE患者Th17/Treg、IL-17及RORγt mRNA表达水平均与和SLEDAI呈正相关。结论 SLE患者存在着Th17细胞高表达现象,阻断Th17细胞分化的上游或下游均可能减轻SLE的免疫炎症反应而达到治疗SLE的目的。     

Th17细胞及IL-17与系统性红斑狼疮

系统性红斑狼疮（SLE）是多种因素相互作用引起的自身免疫性疾病,其发病机制复杂。Th17细胞是最近发现的CD4^＋效应T细胞的新亚群。初始T细胞在TGF—B和IL-6的共同作用下分化发育成为Th17细胞,后者可以分泌IL-17、IL-21、IL-22等多种细胞因子。其中IL-17在多种自身免疫疾病（比如类风湿关节炎和Crohn’s病）中起关键作用,但在SLE中的作用尚不清晰。     

Th17及Th17型细胞因子与炎症性肠病

Th17细胞已被划分为一个不同于Th1、Th2和Treg的新的T细胞亚群,以分泌IL-17为主要特征。Th17在防御胞外细菌感染、介导慢性炎症和自身免疫性疾病的发病机制中发挥重要作用。炎症性肠病属于自身免疫性疾病的一种,免疫调节紊乱是其发病的关键因素。免疫学和基因学的发现表明Th17及Th17效应因子在炎症性肠病发病机理中起重要作用。对Th17的进一步深入研究可以加深我们对相关疾病发病机制的认识并指导临床治疗。     

Expression of lncRNA NEAT1 in peripheral blood mononuclear cells of patients with systemic lupus erythematosus and its correlation with Th1/Th2 balance

Objective: This study explored and analyzed the expression of LncRNA NEAT1 in peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE) and its correlation with Th1/Th2 balance. Methods: We chose 97 SLE patients admitted in our hospital from Jun. 2016 to Feb. 2019 as SLE group, and randomly selected 50 healthy volunteers that underwent physical examination in our hospital during the same period as control group. We detected the expression of LncRNA NEAT1 in PBMCs of the two groups of subjects by qRT-PCR, the degree of Th1 and Th2 cells in both groups by flow cytometry, and the expression of TFN-γ and IL-4 in both groups by ELISA. Results: The relative expression of LncRNA NEAT1 in PBMCs of SLE group was higher than that of control group (P<0.05). The proportion of Th1 and the ratio of Th1/Th2 cells in PBMCs were markedly lower in the SLE group than the control group (P<0.05), while the proportion of Th2 was higher in the SLE group than the control group (P<0.05). IFN-γ level in SLE group was much lower than the control group (P<0.05), while IL-4 level was evidently higher in the SLE group than in controls (P<0.05). The expression of LncRNA NEAT1 in PBMCs of SLE group was notably negatively correlated with Th1 proportion and Th1/Th2 ratio (P<0.05), while positively correlated with Th2 proportion (P<0.05). Conclusion: LncRNA NEAT1 in PBMCs of SLE patients is abnormally highly expressed, and this expression is negatively correlated with Th1/Th2 balance. These two factors may interact and jointly affect the occurrence and progression of SLE.     

Selected angiogenic cytokines in systemic lupus erythematosus patients

The objective of this study was to determine the serum concentration of angiogenic factors (vascular endothelial growth factor, VEGF; transforming growth factor beta, TGF-β1; hepatic growth factor, HGF; basic fibroblast growth factor, bFGF; tumor necrosis factor alpha, TNF-α; soluble vascular endothelial growth factor receptor 1, sVEGF-R1; soluble vascular endothelial growth factor receptor 2, sVEGF-R2), the relationships among them and to assess the relation of their levels with the applied therapy in 48 females with systemic lupus erythematosus (SLE; 37 long-term treated +11 newly diagnosed). The control group consisted of 24 healthy women. A statistically significant increase of sVEGF-R2 and significant decrease of sVEGF-R1 were observed in the subgroup of newly diagnosed SLE patients as compared to the control subjects. No significant differences were found between serum angiogenic factors in the long-term treated subgroup and the control, the long-term treated subgroup and the newly diagnosed SLE patients after a 3-month treatment, and the subgroup of newly diagnosed SLE patients before therapy and after a 3-month treatment. The significant decrease in the serum of sVEGF-R2 was revealed in the subgroup treated for a long-time as compared to the subgroup of newly diagnosed untreated SLE patients. The analysis of relationships between serum concentration of sVEGF-R1 and other cytokines levels revealed positive correlation with concentration of VEGF and TNF-α in the total group of patients. In the newly diagnosed untreated subgroup, a strong positive correlation between concentration of sVEGF-R1 and bFGF was observed. Furthermore, a moderate positive correlation between concentration of sVEGF-R1 and the level of VEGF was revealed in the long-term treated patients. The association between sVEGF-R2 and HGF was also noted in this subgroup. The obtained data suggest the necessity of further investigations to determine the importance of angiogenic factors in pathogenesis and therapy of SLE.     

Dietary factors regulate cytokines in murine models of systemic lupus erythematosus

Cytokines play the active roles in the pathogenesis of systemic lupus erythematosus (SLE) and contribute significantly to the immune imbalance in this disease. Conservative therapeutic approaches, such as dietary modifications have been shown to have some beneficial impact on the disease activity of the SLE. Over the past years, accumulating evidences have supported a major role for specific dietary factors, including calorie restriction, n−3/n−6 fatty acids, vitamin A, vitamin D, vitamin E, phytoestrogens or herbal medicine in the regulation of cytokines involved in SLE development. Although there are many reviews that discuss the issue of nutrition and immunity, there are relatively few articles that focus on the regulation of cytokines by dietary factors. This concise review will summarize those animal studies that investigated not only the outcome of autoantibody production and proteinuria, but also cytokines production. However, the field of dietary factors in the immunomodulation of SLE is still in its infancy. More clinical studies are needed to confirm the preliminary results and advance the knowledge in this field. Lifestyle modification and adjustments in diet are important and encouraged to be suggested as an adjuvant therapy for SLE.     

Hydroxychloroquine decreases Th17-related cytokines in systemic lupus erythematosus and rheumatoid arthritis patients

OBJECTIVES:

Hydroxychloroquine is an antimalarial agent that has been used in systemic lupus erythematosus and rheumatoid arthritis treatment for many years. Recently, novel mechanisms of action have been proposed, thereby broadening the therapeutic perspective of this medication. The purpose of this study was to evaluate the immunomodulatory activity of hydroxychloroquine in T helper 17 (Th17) cytokines in healthy individuals and patients.

METHODS:

Eighteen female patients with systemic lupus erythematosus (mean age 39.0±12.9 years) and 13 female patients with rheumatoid arthritis (mean age 51.5±7.7 years) were recruited from Universidade Federal de Pernambuco-Brazil. The patients were included after fulfilling four classification criteria for systemic lupus erythematosus or rheumatoid arthritis from the American College of Rheumatology. After being stimulated with phorbol 12-myristate 13-acetate and ionomycin in the absence or presence of different concentrations of hydroxychloroquine, the interleukin 6, 17 and 22 levels were quantified with an enzyme-linked immunosorbent assay in culture supernatants of peripheral blood mononuclear cells from healthy individuals and patients.

RESULTS:

We demonstrated that in peripheral blood mononuclear cells from healthy volunteers and in systemic lupus erythematosus and rheumatoid arthritis patients, there was a significant reduction in the IL-6, IL-17 and IL-22 supernatant levels after adding hydroxychloroquine.

CONCLUSIONS

Our in vitro results demonstrated that hydroxychloroquine inhibits IL-6, IL-17 and IL-22 production and contributes to a better understanding of the mechanism of action of this medication.     

炎性细胞因子在系统性红斑狼疮中的作用

系统性红斑狼疮是一个全身性自身免疫病，常伴多器官受累，许多炎性细胞因子参与了系统性红斑狼疮的发病与发展，该病的活动性及器官损伤程度与不同的细胞因子相关。     

Interleukin-17 in systemic lupus erythematosus: A comprehensive review

Abstract

Systemic lupus erythematosus (SLE) is a complicated autoimmune disease of multifactorial pathoaetiology. One of the most serious manifestations is lupus nephritis. The pathogenesis of SLE has not been well elucidated, but it has been reported that interleukin-17 (IL-17) and Th17 cells play important roles in the pathogenesis of SLE. IL-17A, a member of IL-17 family, amplifies the immune response by inducing the local production of chemokines and cytokines, recruiting neutrophils and monocytes, augmenting the production of autoantibodies, and aggravating the inflammation and damage of target organs such as the kidney in SLE. In recent years, several IL-17A pathway inhibitors have advanced into clinical trials, including the anti-IL-17A monoclonal antibody and the anti-17RA monoclonal antibody. Several agents have shown great success in Phase II trials in multiple autoimmune diseases such as psoriasis, rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis, and non-infectious uveitis, which has sparked the urgent need of anti-IL-17A as innovative therapeutic option in controlling disease activity of moderate-to-severe SLE. Here, we review and summarize current progress in IL-17A and SLE from in vitro studies, human expression studies, and animal models, providing novel insight into its therapeutic potential.     

Ets-1在系统性红斑狼疮中的研究进展

系统性红斑狼疮(SCE)是一种典型的系统性自身免疫性疾病,其发病机制尚未明确,其中T、B细胞功能异常起着重要作用.转录因子Ets-1作为SLE的易感基因之一在淋巴细胞分化与细胞因子调节上起重要作用.Ets-1除影响B细胞分化和功能外,对T细胞的生存、增殖、发育和功能起重要作用.虽然Ets-1在SLE发病中的确切机制仍尚未明确,但越来越多的研究表明Ets-1在SLE的发生发展中起着重要作用.     

茯苓多糖对系统性红斑狼疮患者Th17/Treg平衡的影响

目的:研究茯苓多糖对系统性红斑狼疮(SLE)患者外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡的免疫调节作用。方法:选取45例SLE患者和35例健康对照者,应用磁珠分选法分离外周血CD4~+ T细胞,流式细胞术检测CD4~+ T细胞中Th17和Treg细胞的比例。用茯苓多糖分别处理健康对照者及患者的CD4~+ T细胞,MTT法检测细胞活力以测定茯苓多糖毒性,ELISA检测细胞中白细胞介素17(IL-17)、IL-6、IL-10及转化生长因子β(TGF-β)的含量,RT-q PCR和Western blot法分别测定维甲酸相关孤儿受体γt(RORγt)与叉头框蛋白P3(Foxp3)的mRNA和蛋白表达水平。结果:与健康对照组相比,SLE患者的Th17细胞比例显著升高,Treg细胞比例明显降低(P0.05)。用100μg/L的茯苓多糖处理SLE患者CD4~+ T细胞,与空白对照组相比,IL-17和IL-6的含量显著降低,IL-10和TGF-β的含量明显上升(P0.05);RORγt的mRNA和蛋白表达显著下降,同时Foxp3的表达在mRNA和蛋白水平上明显增加(P0.05);并且Th17/Treg的比值降低(P0.05)。结论:茯苓多糖可以通过升高Treg并降低Th17细胞的比例,对SLE起到一定的治疗作用。     

催乳素与系统性红斑狼疮Th1/Th2型细胞因子分泌异常

系统性红斑狼疮(SLE)是多种因素相互作用引起的自身免疫性疾病,其发病机制复杂。近年来,随着对神经内分泌免疫网络的研究和认识日渐增多加深,发现催乳素(PRL)与多种自身免疫性疾病相关,如SLE、类风湿性关节炎、干燥综合征等,其中与SLE的关系最引人注目,但具体作用机制还未明确。PRL作为一个自分泌/旁分泌的细胞因子,在细胞因子网络中起着重要的作用,影响其他细胞因子的产生。分别从SLE与Th1/Th2型细胞因子分泌异常、PRL与Th1/Th2细胞因子分泌异常、SLE与PRL的关系等作简要的分析非常重要。     

系统性红斑狼疮消化系统损害

系统性红斑狼疮是一种累及全身多系统、多器官的自身免疫性疾病,临床表现多种多样。近年来国内外系统性红斑狼疮之消化系统损害亦逐渐引起临床医师的关注,相关报道日益增多。本文综述系统性红斑狼疮消化系统损害的发生率、原因和机制,以及多种临床表现和治疗。     

狼疮肾炎中Th17细胞相关细胞因子的变化

目的:探讨狼疮肾炎(Lupus nephritis,LN)血浆中Th17细胞相关的细胞因子(Interleukin,IL)-17、IL-6、IL-23、IL-27和转化生长因子β(Transforming growthfactor-beta,TGF-β)水平的变化。方法:实验组分为系统性红斑狼疮(Systemic lupus erythe-matosus,SLE)有活动性肾脏病变组的患者23例,无肾脏病变组的SLE患者20例;健康对照组20例。采用酶联免疫吸附法测定血浆中IL-17、IL-6、IL-23、IL-27和TGF-β水平,分析它们的相关性。结果:SLE患者与健康对照组比较血浆中IL-17、IL-6、IL-23和IL-27的浓度都明显升高,TGF-β的血浆浓度则明显降低,而且实验组与健康对照组之间的差异具有统计学意义(P<0.05)。SLE有活动性肾脏病变和SLE无肾脏病变组之间比较,有活动性肾脏病变组IL-6升高更明显,TGF-β的血浆浓度降低更明显,且有统计学差异(P<0.05)。而IL-17、IL-23和IL-27在实验组之间则无明显的差异。IL-17与IL-6、IL-23和IL-27之间呈正相关,与TGF-β之间则呈负相关。结论:IL-17及其相关的细胞因子在SLE表达异常,但IL-17的表达与SLE肾脏病变无相关性。     

系统性红斑狼疮患者外周血Th1细胞自噬相关标记物的表达

目的:探讨系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者外周血Th1细胞自噬相关标记物的表达情况及意义.方法:应用流式细胞术检测68例SLE患者及23例正常人外周血Th1细胞自噬相关标记物的表达水平,并分析其与补体C3 、SLEDAI评分和血清Anti-dsDNA水平的相关性.结果:SLE患者Th1细胞自噬标记物Beclin-1和Phospho-mTOR的水平均低于正常人,而LC3的水平高于正常人(均P＜0.05);活动期SLE患者Phospho-mTOR水平低于非活动期患者(P＜0.05).SLE患者Th1细胞Phospho-mTOR水平与SLEDAI评分呈负相关,与血清C3水平呈正相关,与血清Anti-dsDNA水平呈负相关(均P＜0.05).外周血Th1细胞Phospho-mTOR和补体C3水平变化在判断SLE患者疾病活动情况时敏感性高于血清Anti-dsDNA,但特异性不如血清Anti-dsDNA.结论:SLE患者外周血Th1细胞存在自噬异常现象,且自噬相关标记物Phos-pho-mTOR的表达与病情活动度相关,有望成为评价SLE活动度的指标之一.     

IL-17: A new actor in IFN-driven systemic autoimmune diseases

Systemic autoimmune diseases such as systemic lupus erythematosus are type I IFN-driven diseases with exaggerated B-cell responses and autoantibody production. Th17 cells, a T-helper-cell subset with high inflammatory capacity, was initially discovered and characterized in the context of experimental autoimmune encephalomyelitis - an animal model of multiple sclerosis. There is now emerging evidence that Th17 cells, and more generally IL-17 and IL-17-producing cells, may play a role in the pathogenesis of type I IFN-driven systemic autoimmune diseases such as lupus. Here, we review the different studies suggesting a role for IL-17 and IL-17-producing cells in systemic autoimmune diseases, both in humans and in animal models, and we consider the possible mechanisms by which these cells may contribute to disease. We also discuss the hypothesis that type I IFN and IL-17 act in concert to sustain and amplify autoimmune and inflammatory responses, making them a dangerous combination involved in the pathogenesis of systemic autoimmune diseases.     

系统性红斑狼疮的分子遗传学研究

系统性红斑狼疮（systemiclupuserythematosus,SLE）是一种复合性多基因的自身免疫性疾病。遗传因素在SLE易感性方面起重要的作用。该文介绍目前已知几个与SLE的易感性有关的遗传基因。通过对这些基因研究,有利于阐明SLE的发病机制,进一步为SLE的预防、诊断和治疗提供重要的依据。     

Current and novel therapeutics in the treatment of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a complex autoimmune disease with significant clinical heterogeneity. Recent advances in our understanding of the genetic, molecular, and cellular bases of autoimmune diseases and especially SLE have led to the application of novel and targeted treatments. Although many treatment modalities are effective in lupus-prone mice, the situation is more complex in human subjects. This article reviews the general approach to the therapy of SLE, focusing on current approved therapies and novel approaches that might be used in the future.