辅助性T细胞Th17与1型糖尿病发病的关系

目的阐明1型糖尿病患者自身免疫反应与辅助性Th17T细胞的关系及其机制。方法选取2009年1月至2010年12月在武汉大学中南医院内分泌科诊治的门诊和住院1型糖尿病患者39例1型糖尿病组，男21例，女18例，平均年龄（31±13）岁]，另选择同期在武汉大学中南医院体检的健康志愿者36名健康对照组，男19名，女17名，平均年龄（29±12）岁]和内分泌科收治的住院2型糖尿病患者40例2型糖尿病组，男28例，女12例，平均年龄（36±8）岁]。采用流式细胞仪检测外周血Th17辅助性T细胞比例，应用荧光实时定量聚合酶链反应检测外周血单核细胞RORγt基因表达，运用酶联免疫吸附法检测血浆白细胞介素．17A和B细胞活化因子水平。采用t检验进行组间数据比较。结果1型糖尿病组Th17辅助性T细胞含量（4．2±0．8）％VS（1．8±0．6）％，t=8．338，P=0．005]、血浆白细胞介素-17A水平（2．42±0．24）VS（1．37±0．37）ng／L，t=5．601，P=0．021]、RORγt mRNA表达（5．0±1．3VS1．4±1．0，t=38．959，P=0．000）、B细胞活化因子水平（91±5）VS（66±8）ng／L，t=6．211，P：0．015]显著高于健康对照组。偏相关分析显示，在1型糖尿病组中，B细胞活化因子与白细胞介素-17A水平呈显著正相关（r=0．623，P=0．000）。多元逐步回归分析显示，Th17辅助性T细胞与1型糖尿病患者空腹C肽水平呈显著负相关（r=-0．069，P=0．011）。结论Th17辅助性T细胞分泌的白细胞介素-17A可能通过促进B细胞活化因子的分泌影响B细胞的存活，参与1型糖尿病的发生。

Relationship between Th17 cells and type 1 diabetes mellitus

Objective To assess the role of Th17 cells in the development of type 1 diabetes mellitus (TIDM).Methods Thirty-nine T1DM patients (T1DM group,21 males,18 females,mean age (31 ± 13) years),40 type 2 diabetes mellitus (T2DM) patients(T2DM group,28 males,12 females,mean age (36 ± 8) years) and 36 healthy volunteers (control group,19 males,17 females,mean age (29 ± 12) years) admitted to our hospital during January 2009 and December 2010 were enrolled in this study.Plasma levels of interleukin-17A (IL-17A) and B cell activating factor were measured by enzymelinked immunosorbent assay ( ELISA ) and the frequency of Th17 cells in peripheral blood mononuclear cells was tested by flow cytometry.The expressions of RORγt gene was measured by real-time quantitative polymerase chain reaction.t test was used for data analysis.Results In comparison with the control group,Th17 cells ((4.2±0.8)％ vs (1.8±0.6)％,t =8.338,P=0.005),IL-17A level ((2.42±0.24) vs ( 1.37 ± 0.37) ng/L,t =5.601,P =0.021 ),RORγt mRNA expression (5.0 ± 1.3 vs 1.4 ± 1.0,t =38.959,P =0.000),and B cell activating factor ( (91 ± 5 ) vs (66 ± 8) ng/L,t =6.211,P =0.015 ) of the TI DM group were increased.Partial two-tailed correlation analysis showed that there was a positive correlation between IL-17A and B cell activating factor in the Tl DM group (r =0.623,P =0.000).Stepwise linear regression analysis indicated that Th17 cells was negatively correlated with fasting C-peptide ( r =-0.069,P =0.0 1 1 ).Conclusion Th17 cells might play a role in the development of T1DM through stimulating B cell activating factor.