皮质类固醇激素对系统性红斑狼疮患者Th细胞因子平衡的影响

目的 :探讨皮质类固醇激素治疗对系统性红斑狼疮 (SLE)患者Th1 Th2细胞因子平衡的影响。方法 :对5 8例SLE患者 ,于皮质类固醇激素治疗前后采用ELISA法检测其血清中Th1,Th2细胞因子水平 ,比较其差异。结果 :皮质类固醇激素治疗前SLE患者体内Th1,Th2类细胞因子水平均显著高于正常人 (P <0 .0 5 ) ;在治疗后SLE患者体内上述细胞因子水平均较治疗前降低 (P <0 .0 5 ) ,但Th1类细胞因子较Th2类细胞因子降低更为显著 (P <0 .0 5 )。结论 :SLE患者经皮质类固醇激素治疗后 ,体内Th细胞因子平衡向Th2偏移 ,这可能为皮质类固醇激素治疗SLE患者机制之一。

Effect of corticosteroids on the balance of Th cytokines in patients with systemic lupus erythematosus

Objective To investigate the levels of Th cell derived cytokines and the effect of corticosteroids on the balance of Th1/Th2 cytokines in patients with systemic lupus erythematosus (SLE). Methods Fifty eight SLE patients were treated with corticosteroids. Their IFN γ, IL 4 and IL 10 levels were detected by ELISA before and after the treatment with corticosteroids respectively;and the SLEDAI scores of the patients were compared before and after the treatment. Results Before the treatment, the serum levels of IFN γ, IL 4 and IL 10 were higher than those of the healthy controls (P<0.05). After the treatment with corticosteroids, the elevated levels of IFN γ, IL 4 and IL 10 in the SLE patients were all significantly reduced than those before the treatment(P<0.05). At the same time, the SLEDAI scores were significantly lower than those before the treatment (P<0.01). The serum level of IFN γ was significantly decreased in the patients with SLE compared with the healthy controls (P<0.05).By contrast, the levels of IL 4 and IL 10 of the patients with SLE were significantly increased compared with the healthy controls (P<0.05). Conclusion Corticosteroids may induce a shift from the Th1 to Th2 profile of cytokine secretion. This may be one aspect of the mechanisms for corticosteroids treatment.