Th17及Th2细胞在博莱霉素致小鼠肺纤维化中的表达及相互关系

目的探讨T辅助细胞17(Th17)及Ⅱ型辅助性T细胞(Th2)在肺纤维化(PF)形成中的表达及相互关系。方法将20只雌性BALB/c小鼠随机分为两组各10只,其中博来霉素(BLM)组每日注射BLM建立PF模型,对照组注射PBS,两组均连续注射4周。采用HE、Masson染色观察两组肺部病理改变,进行PF评分;样本碱水解法检测肺组织中的羟脯氨酸(HYP)含量;RT-PCR技术检测肺组织中的IL-6 mRNA表达,ELISA法检测外周血中的IL-17A、IL-6,流式细胞计数检测外周血、肺组织中的Th17及Th2细胞水平;并分析上述指标间的相关性。结果与对照组比较,BLM组肺HYP、PF评分、IL-17A、IL-6、Th17、Th2细胞均明显升高(P均<0.01)。外周血Th17、Th2细胞、IL-17A及IL-6分别与PF评分、肺HYP含量密切相关,肺组织中的Th17、Th2细胞及IL-6 mRNA分别与PF评分、肺HYP含量密切相关,Th17细胞分别与Th2细胞、IL-6及IL-17A密切相关,Th2细胞分别与IL-17A、IL-6密切相关(P均<0.01)。结论 Th17、Th2细胞与PF病变密切相关,两者可能均参与PF的发病过程,且有协同效应;IL-6可能为影响Th17、Th2细胞相互作用的关键因子。     

肝癌患者外周血Th17/Treg细胞和相关细胞因子的表达及IL-17对肝癌细胞侵袭的影响

目的探讨肝癌患者体内辅助性T细胞(Th)17/调节性T细胞(Treg)比例和相关细胞因子的表达水平及白细胞介素(IL)-17影响肝癌细胞侵袭的机制。方法选取在该院就诊的40例肝癌患者为观察组,同期在医院进行体检的40例健康人为对照组。采用流式细胞术检测两组人群外周血Th17和Treg细胞比例,酶联免疫吸附(ELISA)法检测两组外周血中IL-17、IL-10、IL-6和转化生长因子(TGF)-β的表达水平。在人肝癌细胞系SMMC7721中瞬时转染IL-17 siRNA及阴性对照,并采用实时荧光定量PCR(qRT-PCR)、ELISA及免疫印迹(Western blot)法检测沉默后IL-17 mRNA及蛋白水平的表达变化,然后采用Transwell法检测侵袭变化,qRT-PCR和Western印迹检测MMP-2、MMP-9表达水平。结果与对照组比较,观察组外周血中Th17细胞和Treg细胞上升,Th17/Treg比例下降(P<0.05);观察组外周血中IL-17、IL-10、IL-6和TGF-β表达水平均高于对照组(P<0.05)。与阴性对照比较,SMMC7721转染IL-17 siRNA后,IL-17表达水平显著下降(P<0.05),干扰IL-17后SMMC7721细胞侵袭能力显著下降(P<0.05),MMP-2和MMP-9表达水平明显降低(P<0.05)。结论 Th17/Treg在肝癌患者外周血中存在失衡现象,IL-17、IL-10、IL-6和TGF-β等细胞因子在肝癌患者外周血中高表达,沉默IL-17可抑制肝癌细胞侵袭并抑制MMP-2和MMP-9表达,IL-17可能通过调控MMP-2和MMP-9参与调节肝癌细胞的侵袭。     

Th17细胞及IL-17蛋白在食管鳞癌患者外周血、肿瘤组织中的表达及意义

目的观察Th17细胞及其特异性分泌的IL-17蛋白在食管鳞癌患者外周血、肿瘤组织中的表达变化,并探讨其临床意义。方法收集23例食管鳞癌患者(食管癌组)、17例健康志愿者(对照组)外周血,采用流式细胞术检测外周血中Th17细胞的水平。取食管癌组患者食管鳞癌组织及相应的癌旁组织,采用Western blot法检测IL-17。结果食管鳞癌患者外周血Th17细胞占CD4+T细胞的比例为6.5%±2.9%,显著高于对照组的1.9%±1.6%(P<0.05),Th17占CD4+T细胞比例在食管癌Ⅰ+Ⅱ期者为4.9%±2.2%,Ⅲ+Ⅳ期者为8.3%±2.5%(P<0.05),与肿瘤TNM分期有关。食管鳞癌组织与癌旁组织中IL-17的相对表达量分别为0.61±0.29、0.43±0.25,两者相比,P<0.05。结论 Th17细胞及在食管鳞癌患者外周血中的表达明显上调,其特异性分泌的IL-17在食管鳞癌组织中的表达高于癌旁组织,Th17细胞可能与食管鳞癌的发病有关。     

老年慢性阻塞性肺疾病患者外周血HIF-1α、IL-18、Th17和Treg的表达及与肺功能的关系

目的探讨慢性阻塞性肺疾病(COPD)老年患者外周血中低氧诱导因子(HIF)-1α、白细胞介素(IL)-18、辅助性T细胞(Th)17和调节性T淋巴细胞(Treg)的表达情况及与肺功能的关系。方法随机选取COPD稳定期,且吸烟≥20年的老年(≥60岁)患者24例作为观察组,另选取门诊体检肺功能健康且吸烟≥20年的老年人20例作为对照组,肺功能正常且不吸烟的老年人30例作为健康组。采用酶联免疫法(ELISA法)检测所有老人外周血血清中HIF-1α和IL-18的水平进行,采用流式细胞术对所有老人外周血中Th17和Treg的表达进行检测。结果三组血清中HIF-1α和IL-18的水平存在显著差异(P0.05),观察组对照组健康组;三组外周血中Th17和Treg细胞的表达率(%)存在显著差异(P0.05),观察组对照组健康组;观察组和对照组外周血Th17/Treg比值显著高于健康组(P0.05),而观察组和对照组间无显著差异(P0.05);血清HIF-1α、IL-18,Th17和Treg与吸烟量呈正相关(P0.05),HIF-1α、IL-18、Th17、Treg和Th17/Treg与FEV1/预计值和FEV1/FVC均呈负相关(P0.05)。结论 COPD且吸烟的老年患者外周血中HIF-1α、IL-18、Th17和Treg水平均上升,HIF-1α、IL-18、Th17和Treg可能参与了COPD持续性炎症反应的形成,吸烟可能导致并促进炎症反应加重。     

Th17/Treg细胞在炎性关节病的免疫调节作用

炎性关节病包括一大类以外周关节炎为主要表现的风湿性疾病,如类风湿关节炎（rheumatoid arthritis,RA）、脊柱关节病（spondyloarthropathy,SpA）及其相关的关节炎,如强直性脊柱炎（ankylosingspondylitis,AS）、银屑病关节炎（psoriaticarthritis,PsA）和炎症性肠病关节炎等。免疫细胞在他们的发病过程中起了重要作用。近年又发现了一种以分泌IL-17为主的辅助性T细胞17（Thelpcell 17,Th17）,其介导炎症反应。调节性T细胞（regulatory T cells,Treg）是一类具有免疫抑制作用的T细胞亚群。Th17与Treg细胞在分化过程中是密切相关的,多种细胞因子参与了他们的发育分化过程,Th17/Treg细胞的平衡对维持正常免疫应答、防止自身免疫性疾病具有重要意义。     

系统性红斑狼疮患者体内Th17、Th1细胞及其相关因子的表达及意义

目的 研究系统性红斑狼疮（SLE）患者血浆IL-17、干扰素（IFN）-γ水平及外周血辅助性T细胞（Th）17和Th1细胞表达比例,探讨其临床意义.方法 用酶联免疫吸附法检测SLE患者及对照组血浆中IL-17、IFN-γ浓度;运用流式细胞术检测SLE患者外周血单个核细胞（PBMCs）中Th17、Th1细胞表达比例.进一步分析Th17/Th1细胞及其相关因子与SLE临床实验室指标的相关性.结果 SLE患者PBMCs中Th17细胞比例显著高于对照组,且SLE活动期患者Th17细胞百分比高于非活动期患者（P〈0.05）,而SLE患者Th1细胞比例与对照组无差异（P〉0.05）.SLE患者血浆IL-17水平、Th17细胞数与SLE疾病活动性指数呈正相关.结论 SLE患者体内IL-17水平、Th17细胞比例显著升高,且与疾病活动性明显相关,提示IL-17/Th17细胞在SLE发病机制中可能发挥重要作用.     

通肺平喘汤联合布地奈德对老年支气管哮喘患者外周血Th17/Treg表达的影响

目的探讨通肺平喘汤联合布地奈德对老年支气管哮喘患者外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)表达的影响。方法选取150例老年支气管哮喘患者为研究对象,随机分为2组。对照组75例,采用布地奈德治疗;研究组75例,采用通肺平喘汤联合布地奈德治疗。比较治疗前、后两组Th17、Treg表达、肺功能〔用力肺活量(FVC)、1 s用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)及不良反应,并评价两组临床疗效。结果与治疗前相比,治疗后两组Th17降低,Treg、FVC、FEV1、FEV1/FVC升高,且研究组上述观察指标均优于对照组(P<0.05);研究组总有效率为90.67%(68/75),明显高于对照组〔73.33%(55/75),P<0.05〕;两组不良反应发生率相比差异无统计学意义(P>0.05)。结论采用通肺平喘汤联合布地奈德治疗老年支气管哮喘,可显著提高临床疗效,降低外周血Th17的表达,增强Treg表达,促进肺功能恢复。     

宫颈癌患者外周血Th17细胞水平变化及意义

目的探讨辅助性T17(Th17)细胞与宫颈癌发生、发展的关系。方法采用流式细胞术检测61例宫颈癌患者(宫颈癌组)和38例健康查体者(正常对照组)外周血中Th17细胞水平,分析宫颈癌患者外周血Th17水平变化与临床病理参数的关系。结果宫颈癌组和正常对照组外周血Th17细胞分别为4.67%±0.79%(2.8%～6.8%)、3.25%±0.68%(1.9%～4.8%),两组比较P<0.000 1;宫颈癌患者外周血Th17细胞水平与肿瘤直径、脉管癌栓、淋巴结肿大、远处转移、宫颈癌FIGO(2000)分期有关,并随FIGO(2000)分期增高而增加(P均<0.05)。结论 Th17细胞可能通过分泌IL-17直接或间接参与宫颈癌细胞的增殖、侵袭和远处转移。     

Th17/Treg失衡与炎症性肠病的关系

炎症性肠病(inflammatory bowel disease.IBD)的病因和发病机制尚未完全明确,肠道黏膜免疫系统异常反应所导致的炎症过程在发病中起重要作用.辅助性T细胞17(T helper 17 cells,Th17)可介导慢性炎症和自身免疫性疾病的发生,调节性T细胞(regulatory T cell,Treg)有抑制自身免疫的功能,二者存在相互转化的关系.有研究表明Th17/Treg转化平衡是维持肠道免疫稳态的重要因素,这可能是导致人类IBD的原因之一.最近研究表明TGF-β,IL-6和维甲酸(retinoic acid,RA)可能是调控二者平衡关系的重要因素.肠道菌群(intestinal flora)与IBD的发生发展关系密切,益生菌(probiotics)对IBD的治疗作用成为研究的热点.深化对Th17/Treg转化调控关系的研究是当前重要的研究课题.     

Th17与Foxp3~+Treg在胃癌患者外周血中的表达

目的:研究胃癌患者外周血CD4+CD25+Foxp3+调节性T细胞(Treg)及Th17细胞表达的临床意义.方法:收集胃癌患者(n=77)与健康志愿者(n=20)外周血并分离获取PBMC;流式细胞术分析CD4+CD25+Foxp3+Treg表达;PMA+Ionomycin联合刺激后,流式细胞术检测CD4+IL-17+Th17表达;结合临床资料分析Treg及Th17表达的临床意义.结果:胃癌组患者外周血Th17和Treg表达均显著高于正常组(P<0.05).进一步临床分析发现,胃癌患者外周血中Treg细胞表达水平与胃癌临床分期、肿瘤浸润深度及淋巴结转移有关;未见Th17与胃癌临床分期、浸润深度及淋巴结转移相关.结论:尽管两群Th细胞在胃癌患者体内显著升高,但仅Treg与肿瘤进展相关,Th17的作用尚需进一步探讨.     

Assessment of Th17/Treg cells and Th cytokines in an improved immune thrombocytopenia mouse model

Objectives: The improved passive immune thrombocytopenia (ITP) mouse model has been extensively utilized for the study of ITP. However, how closely this model matches the human inflammation state and immune background is unclear. Our study aimed to explore the profile of Th cytokines and Th17/Treg cells in the model.

Methods: We induced the ITP mouse model by dose-escalation injection of MWReg30. The serum levels of cytokines (IFN-γ, IL-2, IL-4, IL-10, IL-17A, and TGF-β1) were measured by enzyme-linked immunosorbent assay and the frequency of Th17 and Treg cells was measured by flow cytometry. The mRNA expression of Foxp3 and RORrt was measured by real-time PCR.

Results: The serum levels of cytokines IFN-γ, TGF-β1, IL-4, and IL-10 were significantly lower in ITP mice. The secretion of serum proinflammatory cytokines IL-2 and IL-17A and the percentage of Th17 cells showed no statistically significant increase. In ITP mice the frequency of Treg cells and mRNA expression of Foxp3 was significantly lower in splenocytes.

Conclusion: Our data suggest that the improved passive ITP mouse model does not mimic the autoimmune inflammatory process of human ITP. Compared with human ITP, this model has a similar change in frequency of Treg cells, which may directly or indirectly result from antibody-mediated platelet destruction due to attenuated release of TGF-β.     

扩张型心肌病患者Treg/Th17的检测及意义

目的:探讨扩张型心肌病(DCM)患者外周血中Treg/Th17的水平及意义.方法:采用流式细胞术和ELISA法检测30例DCM患者和30例健康对照组Treg/Th17的水平.结果:DCM患者较正常组,外周血Treg细胞比例明显降低,而Th17细胞比例明显增高.Treg细胞相关细胞因子(TGF-β1和IL-10)的血浆水平明显降低,而Th17相关细胞因子(IL-17,IL-6,IL-23)水平明显增加.结论:DCM患者体内Treg细胞与Th17细胞平衡发生负向偏倚.     

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。     

类风湿关节炎患者外周血Th17细胞/调节性T细胞变化及其临床意义

目的 通过检测类风湿关节炎(RA)患者外周血,Th17细胞和调节性T细胞的变化,探讨其在RA发病机制中的作用及其临床意义.方法 采用流式细胞术(FCM)检测57例RA患者和32名健康对照者外周血单个核细胞(PBMCs)中IL-17+CD4+T细胞(Th17细胞)与Foxp3+CD25+CD4+T细胞(调节性T细胞)占CD4+T细胞的百分比,分析其与RA临床及实验室指标的关系.统计学处理采用t检验和方差分析,相关分析采用Pearson直线相关分析.结果 RA组Th17细胞占CD4+T细胞的百分率较健康对照组明显升高[(4.2±2.2)%和(2.3±1.4)%,P=0.000],调节性T细胞降低[(3.9±1.6)%和(7.0±2.2)%,P=0.000],Th17细胞/涮节性T细胞比值显著升高(1.15±0.62和O.34±0.17,P=0.000).RA早期组与非早期组外周血Thl7细胞、调节性T细胞及,Th17调节性T细胞比值比较,差异无统计学意义(P均>0.05).相关性分析显示RA患者Th17细胞及Th17细胞/调节性T细胞比值与关节压痛数、患者疼痛模拟视觉评分(VAS)、RA28关节疾病活动评分(DAS)28评分等病情活动指标呈正相关(P均<0.05),而调节性T细胞与上述病情活动指标无明显相关性(P均>0.05).单因素回归分析显示Th17细胞、Th17细胞/调节性T细胞比值、DAS28评分及病程对RA患者骨侵蚀有显著影响(P均<0.05).经抗风湿药物治疗后,RA患者Th17细胞阙节性T细胞比值降低.结论 RA患者Th17细胞明显增多,调节性T细胞减少,Th17细胞/调节性T细胞比例明显增高.可能是RA发病的重要原因,通过抗风湿药物治疗可调节Th17细胞/调节性T细胞亚群平衡.

Abstract：

Objective To analyze the level of Th17 and Treg cells in the peripheral blood of patients with rheumatoid arthritis(RA),and to investigate its role in the pathogenesis of RA and the clinical significance.Methods Flow cytometry(FCM)was used to analyze the ratio of interleukin(IL)-17+CD4+T (Thl7)cells and Foxp3+CD25+CD4+T(Treg)cells in CD4+T cells from the peripheral blood of 57 RA patients and 32 normal controls.T-test and Chi-square test were used for inter-group comparison and Pearson's linear analysis was used for correlation analysis.Resuits Compared with normal controls.the level of both IL-17+CD4+T cells and the ratio of Th17/Treg in RA patients increased significantly.while the level of Foxp3+CD4+CD25+T cells decreased markedly[(4.2±2.2)%vs(2.3±1.4)%,P=0.000;1.15±0.62 I)5 0.34±0.17,P=0.000;(3.9±1.6)%vs(7.0±2.2)%,P=0.000].Compared with early RA(persistent for 2 years or less)patients,the levels of Th17,Treg and the ratio of Th17/Treg in chronic RA(duration for more than 2 years)patients didn't markedly changed(P>0.05).The level of Th17 cells and the ratio of Th17/Treg was directlycorrelated with disease activity parameter (including tender ioint counts,visual analog seale of patients,disease activitv score in 28 joints,etc).Regression analysis discovered that risk factors of bone erosion were the level of Th17 cells,the ratio of Th17/Treg,disease activity score in 28 joints and disease duration.Antirheumatic drugs could decreascthe ratio of Th 17/Treg.Conclusions Treg cells is decreased in RA patients while Th7 cells is increased in patients with RA.Th17/Treg ratio goes up significantly as well.Change of T celt subsets,especially Th17 and Treg cells are important for the pathogenesis of RA.Th17 and Treg cells could aggrevate disease activity and bone destruction throughout the whole disease process.Anti-rheumatic medications is effective by regulating Th17/Treg subset balance.     

Th17、Treg细胞及其细胞因子变化在特发性肺动脉高压患者中的监测作用

目的分析特发性肺动脉高压(IPAH)患者外周血Th17、Treg细胞及其细胞因子的变化,探讨其在IPAH中的作用。方法以2013年3月-2015年9月本院收治的特发性肺动脉高压患者28例为研究对象,以同期收治的慢性支气管炎患者54例为对照(其中慢性支气管炎合并肺动脉高压者24例,单纯慢性支气管炎患者30例),测定各组外周血Th17和Treg细胞比例和细胞因子。结果 IPAH组和(慢支+PAH)组外周血Th17细胞比例均高于慢支组,而IPAH组和(慢支+PAH)组外周血Th17细胞比例差异无统计学意义;IPAH组和(慢支+PAH)组外周血Treg细胞比例低于慢支组,IPAH组低于(慢支+PAH)组(P0.05);IPAH组和(慢支+PAH)组外周血IL-17水平均高于慢支组,IPAH组高于(慢支+PAH)组(P0.05);IPAH组和(慢支+PAH)组外周血IL-10水平均低于慢支组,IPAH组低于(慢支+PAH)组(P0.05)。IPAH组外周血IL-17水平与肺动脉压力呈正相关(P0.01);IL-10水平与肺动脉压力呈负相关(P0.01)。结论Th17/Treg失衡及其细胞因子变化在特发性肺动脉高压的发生发展中起着重要作用。     

肝衰竭前期大鼠模型的建立及辅助性T淋巴细胞17/调节性T淋巴细胞失衡的研究

目的研究肝衰竭前期大鼠模型建立的方法以及地塞米松和胸腺肽干预前后辅助性T淋巴细胞(Th)17、调节性T淋巴细胞(Treg)和Th17/Treg的变化。方法 64只大鼠随机分为四氯化碳(CCl4)组和脂多糖(LPS)联合D-氨基半乳糖(D-Gal N)组,分别建立肝衰竭前期大鼠模型。通过观察大鼠活动,肝功能以及全血Th17、Treg的变化,评价成模效果。并用地塞米松和胸腺肽进行干预,观察干预效果。计量资料组间比较采用t检验,组内比较采用配对t检验。结果造模组血清ALT、AST、TBil水平显著升高,与对照组相比差异均有统计学意义(CCl4组:t值分别为-3.95、-3.60、-3.57,P值分别为0.006、0.009、0.009;D-Gal N联合LPS组:t值分别为-10.56、-9.63、-11.82,P值均0.001)。造模后大鼠外周血Th17均上升、Treg均下降,Th17/Treg失衡。造模组大鼠肝组织病理符合肝衰竭前期改变。地塞米松干预后大鼠Th17下降(CCl4组:0.830±0.224 vs 0.580±0.105,t=3.25,P=0.014;D-Gal N联合LPS组:1.301±0.163 vs 0.921±0.141,t=4.12,P=0.004)、Treg上升(CCl4组:0.317±0.076 vs 0.385±0.083,t=-11.13,P0.001;D-Gal N联合LPS组:0.351±0.110 vs 0.570±0.119,t=-4.06,P=0.005)、Th17/Treg再平衡(CCl4组:2.201±0.556 vs 1.511±0.534,t=3.56,P=0.09;D-Gal N联合LPS组:3.699±0.976 vs 1.619±0.423,t=3.82,P=0.07),胸腺肽干预后Th17上升(CCl4组:1.161±0.219 vs 1.270±0.230,t=-5.74,P=0.001;D-Gal N联合LPS组:0.451±0.095 vs 0.929±0.130,t=-8.61,P0.001)、Treg下降(CCl4组:0.643±0.100 vs 0.615±0.092,t=2.66,P=0.032;D-Gal N联合LPS组:0.200±0.085 vs 0.161±0.095,t=3.15,P=0.016)、Th17/Treg失衡加剧(CCl4组:1.799±0.625 vs 2.071±0.587,t=-6.47,P0.001;D-Gal N联合LPS组:2.244±0.634 vs 5.770±1.455,t=-11.72,P0.001)。结论 CCl4和LPS联合D-Gal N两种方法均可成功建立肝衰竭前期大鼠模型,均未出现死亡,肝组织学及血清生化学变化符合肝衰竭前期改变。地塞米松干预后Th17/Treg失衡改善,胸腺肽干预后动物模型Th17/Treg失衡加剧。     

Th17/Treg水平对脑卒中并发肺部感染的临床分析

目的探讨Th17/Treg水平对脑卒中并发肺部感染的临床特征。 方法回顾性分析2018年10月至2020年10月我院收治的86例脑卒中患者,分析脑卒中患者并发肺部感染情况,对比脑卒中并发肺部感染和未并发感染患者临床资料,采用Logistic回归分析影响脑卒中并发肺部感染的因素。 结果脑卒中患者肺部感染发生率为17.44%;脑卒中肺部感染患者卒中类型、外周血Th17、Treg、Th17/Treg与肺部未感染患者比较,差异有统计学意义(P<0.05);Logistic多因素回归分析显示Th17/Treg、Treg、侵入性操作、出血性脑卒中均是影响脑卒中并发肺部感染的独立危险因素(OR＝2.790,2.214,2.266,1.754);Th17、Treg、Th17/Treg预测脑卒中并发肺部感染的最佳截断点分别为5.21%、2.20%、2.03,灵敏度分别为69.23%、80.77%、84.62%,特异度分别为84.31%、77.45%、79.41%,AUC分别为0.819、0.834、0.844。 结论脑卒中并发肺部感染患者外周血Th17/Treg平衡向Th17偏移,且Th17/Treg、Treg、侵入性操作、出血性脑卒中均是影响脑卒中并发肺部感染的危险因素,Th17、Treg、Th17/Treg均可作为预测脑卒中并发肺部感染的临床意义。     

Clinical significance of changes in the Th17/Treg ratio in autoimmune liver disease

AIM To investigate the levels, ratios, and clinical significance of T helper 17(Th17) cells and regulatory T(Treg) cells in the peripheral blood of patients with autoimmune liver disease(AILD). METHODS F o r t y-t w o A I L D p a t i e n t s w e r e i n c l u d e d i n t h e experimental group(group E), and 11 healthy subjects were recruited as the control group(group C). Flow cytometry was performed to determine the percentages of Th17 and Treg cells in peripheral blood lymphocytes. Furthermore, a range of biochemical indices was measured simultaneously in the blood of group E patients. RESULTS The percentage of Th17 cells and the Th17/Treg ratio were higher in group E than in group C(P 0.01), whereas the percentage of Tregs was lower in the group E patients(P 0.05). Patients in group E who were admitted with AILD in the active stage showed significantly higher Th17 percentages and Th17/Treg ratios than those measured in patients with AILD in remission(P 0.05). In addition, among patients with AILD in the active stage, individuals that remained unhealed after hospitalization showed significantly higher baseline values of the Th17 percentage and the Th17/Treg ratio than those detected in patients who improved after treatment(P 0.05). The results suggested that imbalance in the Th17/Treg ratio plays an important role in the pathogenesis and development of AILD.CONCLUSION A high Th17/Treg ratio appears to predict poor shortterm prognosis in patients with AILD in the active stage.     

Effects of erdosteine on inflammation and fibrosis in rats with pulmonary fibrosis induced by bleomycin

We aimed to investigate the levels of some chemokines, inflammatory cell counts in bronchoalveolar lavage (BAL) fluid, histopathological changes in lung tissue, to determine the effect of erdosteine on acute inflammatory changes and fibrosis in a rat fibrosis model induced by bleomycine (BLM). Forty-five Wistar male rats were taken into the study. On day 0, intratracheal saline to control group (group 1, n= 15), intratracheal BLM 7.5 U/kg to BLM (group 2, n= 15) and erdosteine group (group 3, n= 15) was administered. In group 3, oral erdosteine (10 mg/kg/day) was applied two days before BLM. On day 0, 14, and 29th five rats in each groups were sacrificed, BAL fluid was performed. Malonyldialdehyde (MDA), macrophage inflammatory protein (MIP)-1alpha, MIP-2 levels in BAL fluid, hydroxyproline levels in lung tissue were measured. Histopathological examination was performed. When BLM group compared to erdosteine group, the levels of MDA, MIP-1alpha, MIP-2, and neutrophil counts, the hydroxyproline (OH-P) level of lung tissue were decreased in erdosteine group on acute inflammatory phase (day 14) (p< 0.001, p= 0.017, p= 0.009, p< 0.001, p= 0.009, respectively), and late fibrosis phase (day 29) except BAL MIP-2 (p= 0.022, p= 0.025, p= 0.01, p< 0.001, respectively). Fibrosis level was significantly lower in erdosteine group than BLM group on day 29 (p= 0.01). We conclude that erdosteine may prevent the acute lung inflammation and fibrosis by suppressing the accumulation of neutrophils, inhibition of lipid peroxydation, chemokine production, and release.