变应性鼻炎患者特异性免疫治疗前后TGF-β、IL-10和IL-17的变化及和症状关系的研究

目的:研究变应性鼻炎(AR)患者特异性免疫治疗过程中血清TGF-β、IL-10和IL-17的变化情况及其与患者症状的相互关系。方法:应用酶联免疫吸附法测定48例AR患者血清TGF-β、IL-10和IL-17水平在特异性免疫治疗前及免疫治疗1、2年后的变化,对鼻部症状计分。并取35例健康者血清作为对照组。结果:①AR患者免疫治疗前血清TGF-β和IL-10水平均低于对照组(P<0.05)。免疫治疗2年后的血清TGF-β和IL-10水平均低于免疫治疗1年后,但高于免疫治疗前(均P<0.05);同时免疫治疗2年后低于对照组,两者差异有统计学意义(P<0.05)。②AR患者免疫治疗前血清IL-17水平高于对照组(P<0.05)。通过免疫治疗,IL-17水平逐渐下降,但治疗2年后仍高于对照组(P<0.05)。③AR患者治疗前与免疫治疗2年后血清中IL-10和TGF-β的水平分别与症状评分存在负相关,IL-17则与症状评分存在正相关(均P<0.05);AR患者免疫治疗1年后血清中IL-10、TGF-β及IL-17与症状评分均没有相关性(均P>0.05)。结论:在免疫治疗过程中,患者血清中IL-10、TGF-β呈波动性变化,先升高后降低,但始终高于免疫治疗前,而IL-17则呈持续性下降。IL-10、TGF-β及IL-17水平变化在免疫治疗2年后才与症状相关,提示特异性免疫治疗2年后,IL-10、TGF-β及IL-17可作为效果评估指标。

Role of TGF-beta, IL-10 and IL-17 in allergic rhinitis patients with specific immunotherapy

Objective:To detect the level of TGF-β,IL-10 and IL-17 in the allergic rhinitis(AR) patients pre-and post-specific immunotherapy(SIT).Method:The level of TGF-β,IL-10 and IL-17 in serum of 48 AR patients were detected by enzyme-linked immunosorbent assay before SIT,and the nasal symptom score(NSS) was evaluated in the first and second year after SIT.At the same time,35 healthy persons were made as normal.Result:① The level of TGF-β and IL-10 in serum of AR patients were lower than that of normal group(P<0.05).The level of TGF-β and IL-10 in AR patients taken SIT for two years was lower than that of patients with one year SIT(P<0.05),but it was higher than that of patients pre-immunotherapy(P<0.05).However,The level of TGF-β and IL-10 in the group that taken SIT for two years was still lower than that of normal group(P<0.05).② The level of IL-17 in serum of AR patients pre-immunotherapy was higher than that of normal group(P<0.05).The level of IL-17 continuously declined after taking SIT,However it was higher than that of normal group two years later(P<0.05).③ In AR patients pre-immunotherapy and post-immunotherapy for 2 years,the level of IL-10 and TGF-β showed negative correlation with NSS respectively,the level of IL-17 was positive related to NSS respectively(P<0.05).But the level of IL-10,TGF-β and IL-17 showed no correlation with NSS respectively(P>0.05) when SIT was taken for one year.Conclusion:IL-10 and TGF-βwere fluctuated in AR patients taking SIT,which arised first and then dropped.but the level of IL-10 and TGF-βwas higher than that of pre-immunotherapy.However,the level of IL-17 continuously declined in the whole process.It showed that the level change of IL-10,TGF-βand IL-17 correlate with patients’symptom only two years after SIT,so the level change of IL-10、TGF-βand IL-17 can be used as an index for evaluating the treatment effectiveness of SIT at that time.