系统性红斑狼疮患者外周血白细胞介素-17与辅助T细胞17的检测及其意义

目的 研究系统性红斑狼疮(SLE)患者外周血白细胞介素(IL)-17蛋白和mRNA水平、辅助T细胞(Th17)细胞表达比例,探讨其临床意义.方法 用酶联免疫吸附试验检测SLE患者及对照者血浆中IL-17的蛋白水平;采用实时荧光定量反转录-聚合酶链式反应(RT-PCR)检测2组外周血中IL-17 mRNA表达水平;运用流式细胞术检测SLE患者外周血单个核细胞(PBMCs)中Th17细胞比例,进一步分析IL-17/Th17细胞与SLE临床实验室指标的相关性.计量资料组间比较采用t检验,相关性分析采用Spearman秩和相关分析.结果 SLE组患者血浆IL-17含量明显高于健康对照组,SLE组患者外周血IL-17 mRNA表达水平(28.3±11.7)×10-5]高于对照组(9.8±2.2)×10-5](P均＜0.01).SLE患者PBMCs中Th17细胞比例(2.5±1.5)%及IL-17荧光强度(1937±1022)显著高于对照组(1.5±0.7)%,(1245±413)],且SLE活动期患者Th17细胞百分比高于非活动组,SLE肾病组Th17细胞比例较无肾病组明显升高(P均＜0.05).SLE患者血浆IL-17水平、Th17细胞数与SLE疾病活动性指数(SLEDAI)呈正相关(r=0.681,P＜0.01;r=0.426,P=0.034).结论 SLE患者体内IL-17蛋白分泌及基因表达水平存在明显异常,外周血Th17细胞比例亦显著升高,且与疾病活动性有明显相关,提示IL-17/Th17细胞可能在SLE发病中起着重要作用.

Expression and clinical significance of interleukin-17 and Th17 cells in the peripheral blood of patients with systemic lupus erythematosus

Objective To determine the protein and mRNA levels ofinterleukin-17 (IL-17) and the proportion of Th17 cells in the peripheral blood of patients with systemic lupus erythematosus (SLE) and their clinical significance is analyzed. Methods Twenty-five hospitalized SLE patients were recruited and twentytwo healthy volunteers were enrolled as normal controls. Plasma protein and mRNA of IL-17 in the peripheral blood were measured by enzyme-linked immunosorbent assay and real time-PCR respectively. Flow cytometric assay was used to analyze the percentage of Th17 cells in SLE patients. The relationship between IL-17/Th17 cells and clinical or laboratory parameters of SLE patients was explored. Students' t-test and Spearman's correlation was used to evaluate the relationship between mRNA level and inflammatory parameters. Results The plasma concentration and mRNA level of IL-17 was significantly elevated in SLE patients as compared to the normal controls (P＜0.05). The percentage of Th17 cells in patients with SLE was higher than that of normal controls and was significantly increased in more active SLE patients and SLE with nephritis than less active SLE and SLE without nephritis (P＜0.05). Both plasma levels of IL-17 and the proportion of Th17 cells were positively correlated with SLEDAI (r=0.681, P＜0.01; r=0.426, P=0.034). Conclusion Plasma IL-17 protein and mRNA expression level and the percentage of Th17 cells in SLE patients are all significantly elevated and the close relationship between IL-17/Th17 cells and disease activity suggests that IL-17/Th17 may play an important role in the pathogenesis of SLE.