GVHD患者外周血Th17/Treg细胞相关的细胞因子检测与临床意义

本研究旨在探讨急性移植物抗宿主病(aGVHD)、慢性GVHD(cGVHD)患者外周血中Th17/Treg细胞相关的细胞因子的水平与临床意义。外周血样品采集自造血干细胞移植术后患者和健康人,其中aGVHD组10例、cGVHD组13例、无GVHD组16例,健康人20名。采用酶联免疫吸附方法(ELISA)检测各组外周血血浆中细胞因子IFN-γ、IL-4、IL-6、IL-10、TGF-β1、IL-17、IL-23的表达水平。结果表明:a/cGVHD组IFN-γ、IL-4、IL-6、IL-17及IL-23水平显著高于无GVHD组和健康人(p<0.05),而IL-10、TGF-β1水平显著低于无GVHD组和健康人(p<0.05)。aGVHD和cGVHD组患者治疗有效后,外周血中IL-6、IL-17及IL-23水平较治疗前明显降低;IL-10、TGF-β1水平明显升高,而IFN-γ、IL-4无明显变化。各组患者血浆中TGF-β1与IL-6、TGF-β1与IL-17、TGF-β1与IL-23水平呈负相关(r分别等于-0.36、-0.51和-0.44,p均<0.05),IL-6与IL-17、IL-6与IL-23、IL-17与IL-23水平呈正相关(r分别等于0.62、0.71和0.93,p均<0.05)。结论:Th17/Treg细胞相关的细胞因子可能在aGVHD和cGVHD的发生、发展中具有重要作用,对它们的研究有助于寻找治疗a/cGVHD的新靶点。

Detection of Th17/Treg Cell-Associated Cytokines in Peripheral Blood of Patients with Graft-Versus-Host Disease and Its Clinical Significance

To investigate the peripheral levels and clinical significance of Th17/Treg cell-associated cytokines in patients with acute graft versus host disease（aGVHD） or chronic GVHD（cGVHD）,blood samples were collected from 39 hematopoietic stem-cell transplantation patients and 20 healthy donors.The patients included 10 patients with aGVHD,13 patients with cGVHD and 16 patients without evidence of GVHD.Th17/Treg cell-associated cytokines such as IFNγ,IL-4,IL-6,IL-10,TGF-β1,IL-17 and IL-23 were detected by ELISA.The results showed that the plasma levels of IFN-γ,IL-4,IL-6,IL-17 and IL-23 significantly increased in patients with aGVHD or cGVHD,compared with the patients without clinical signs of GVHD and the healthy donors（p〈0.05）,while IL-10 and TGF-β1 were obviously lower than that of them（p〈0.05）.After aGVHD and cGVHD patients were treated effectively,the plasma levels of IL-6,IL-17 and IL-23 were significantly decreased,and IL-10,TGF-β1 were significantly increased,while the levels of IFN-γ and IL-4 did not markedly change.The TGF-β1 level were negatively correlated with IL-6（r=-0.36,p〈0.05）,IL-17（r=-0.51,p〈0.05） and IL-23（r=-0.44,p〈0.05） respectively,while there were positive correlations between IL-6 and IL-17（r=0.62,p〈0.05）,IL-6 and IL-23（r=0.71,p〈0.05）,IL-17 and IL-23（r=0.93,p〈0.05）.It is concluded that Th17/Treg cell-associated cytokines may play an important role in the development of a/cGVHD,which helps to find novel targets for developing new strategies of GVHD treatment.