初发SLE病人Th1/Th2及调控因子IL-18基因研究

目的：探讨未经药物治疗初发狼疮病人Th1/Th2细胞亚群分布及其调控细胞因子、细胞因子受体基因表达的差异，试图揭示系统性红斑狼疮发病的免疫紊乱机理。方法：运用三色荧光标记法流式细胞术检测42例未经药物治疗初发狼疮病人细胞亚群分布，并以10例正常人作对照；ABI7700 real-time PCR法同时检测 38例未经药物治疗初发狼疮病人和 28例正常人IL-18及其受体mRNA表达水平的差异。结果：①初发狼疮病人Th1较正常人明显减低（P<0．05），但Th1/Th2无显著性改变。②与正常组相比，SLE组病人IL-18 mRNA及其受体表达较正常人明显降低（P<0．05）；③面部红斑组病人Th1/Th2较正常人明显降低（P<0．05）；④关节炎组SLE病人较无关节炎病人IL-18表达降低。结论SLE是一种以Th1细胞下降，Th2细胞相对占优势的免疫介导的自身免疫性疾病，源于诱导向Th1细胞分化的IL-18及其受体减少和细胞因子间失衡所致。

Studying on Th1/Th2 and their regulatory cytokines in SLE patients

Abstract Objective:To analyze Th1/Th2 balance of peripheral Th cells and its inducing cytokines and cytokine receptors in recent onsetSLE patients to make clear the cause of the immunological imbalance in SLE patients. Methods: The intracellular cytokine detection methodwith flow cytometry was used to quantitates Th1/Th2 cells in recent-onset SLE patient(n=42) and the control(n=10) .At the same time,using ABI 7700 real time PCR to detect IL-18, IL-18R mRNA expression in SLE patoemts(n=38/42) and the control(n=28). Results:There were no difference in the Th1/Th2 ratio between SLE patients and the control (P>0.05). However,Th1 was decreased significantly inthe SLE patient group than that in the normal control (P<0.05) .IL-18 and their according receptor IL-18R significantly decreased in SLEgroup than that in the control(Pall < 0.05). SLE patients with malar rash group has the significantly lower Th1/Th2 ratio. Conclusion: SLE isa relative Th2 predominance disease due to the Th1 decreased and the IL-18 and IL-18R mRNA expression decreased too. SLE patient with ma-lar Th1/Th2 ratio rash maybe the special subtype of the SLE,for they have the different Th distribution and IL-18,IL-18R expression.