重症肌无力患者血清Th1/Th2/Th17细胞因子的变化及意义

目的：分析重症肌无力（MG）患者血清CD4^＋ T细胞主要细胞因子的水平,探讨不同亚型CD4^＋ T细胞分泌的细胞因子在MG发病机制中的作用。方法：用ELISA测定93例MG患者和34名健康对照者血清中各项细胞因子（IL-2、IL-12、IFN-γ、TNF-α、IL-4、IL-10、IL-13和IL-17）的水平,分组行统计学分析。结果：与健康对照组相比,MG患者Th1细胞相关各细胞因子（IL-2、IL-12、IFN-γ及TNF-α）均明显升高,差异有统计学意义（P〈0.05）;Th2细胞相关的细胞因子IL-4、IL-10差异无统计学意义（P〉0.05）,仅IL-13水平升高;Th17细胞的细胞因子IL-17水平差异无统计学意义（P〉0.05）。MG眼肌型与全身型患者血清中各细胞因子水平的差异无统计学意义（P〉0.05）,在不同病程的MG患者中差异也无统计学意义（P〉0.05）。结论：Th1细胞因子在MG发病机制中发挥重要作用,而Th2细胞及其细胞因子在MG机制中的角色各异。

The Change and Relevant Significance of Th1/Th2/Th17 Cytokines in Myasthenia Gravis

Aim：To analyze the levels of cytokines of CD4^＋ T cells in sera of patients with myasthenia gravis （MG）,and explore the roles of cytokines secreted from different subtypes of CD4^＋ T cells in MG pathogenesis. Methods：The cytokines（IL-2,IL-12,IFN-γ,TNF-α,IL-4,IL-10,IL-13 and IL-17） of sera taken from 93 patients with MG and 34 healthy controls were measured by enzyme-linked immunosorbent assay.Data were analyzed by unpaired t-test in case of Gaussian distribution,while the nonparametric test was applied in case of abnormal distribution.Results：Compared with healthy controls,the cytokines associated with Thl cells（IL- 2,IL-12,IFN-γand TNF-α） were all fairly increased.For the cytokines secreted by Th2 cells,IL-4 and IL- 10 were similar to the controls while IL-13 was increased.The IL-17 secreted by Th17 cells was comparable with the controls.The cytokoines of ocular MG and generalized MG patients were comparable,and so were patients with different course of disease.Conclusion：Thl cytokines play important roles in pathogenesis of MG,while Th2 cytokines have complex and contrasting roles.