辅助性T细胞亚群分化在Ⅲ型前列腺炎免疫发病机制中的作用

目的 探讨前列腺液(EPS)中CD+4T细胞亚群辅助性T细胞(Th细胞)分化在Ⅲ型前列腺炎免疫发病机制中的作用. 方法门诊诊断前列腺炎患者76例,年龄18～47岁,平均32岁.患者均有慢性前列腺炎典型临床症状,病程均＞3个月.按美国国立卫生院分类方法分为ⅢA型组(47例)、ⅢB型组(29例).其中ⅢA型组根据炎症程度又分为ⅢAl组(轻度炎症26例)和ⅢA2组(重度炎症21例).另设健康对照组(16例),年龄19～45岁,平均31岁.采用双抗体夹心酶联免疫法检测EPS中Th1类细胞因子(IFN-γ)、Th2类细胞因子(IL-4)水平及Th1/Th2比值(IFN-γ/IL-4),比较各组问差异.结果 ⅢA、ⅢB组IFN-γ水平(134.78±43.67),(109.82±30.09)pg/m1]与对照组(60.63±15.16)pg/m1]比较,差异有统计学意义(P＜0.05),ⅢA组较ⅢB组升高更明显(P＜0.05);ⅢA组IL-4水平(51.99±20.59)pg/m1]与对照组(53.88±17.92)pg/m1]比较差异无统计学意义P＞0.05),ⅢB组IL-4水平(76.40±17.99)pg/m1]明显上调(P＜0.05);ⅢA组IFN-γ/IL-4水平(2.94±1.12)明显高于对照组(1.20±0.48,P＜0.05),Ⅲ B组(1.49±0.48)无明显改变(P＞0.05).与对照组比较,Ⅲ A1组IL-4水平(63.03±18.86)pg/m1]无明显变化(P＞0.05),而ⅢA2组水平(30.20±13.16)pg/m1]显著下调(P＜0.05);ⅢA1组和m A2组IFN-γ水平均明显上调(127.65±36.57),(143.49±50.76)pg/m1],P＜0.05),但2组间差异无统计学意义(P＞0.05);ⅢA2组IFN-γ/IL-4明显高于ⅢA1组(3.67±0.82 vs 2.34±0.97,P＜0.05).结论 ⅢA型前列腺炎Th1细胞分化占优势,Th1/Th2平衡向Th1漂移,以细胞免疫反应为主;Th细胞分化也参与了ⅢB型前列腺炎的发病,但Th1/Th2处于相对平衡状态.Th1的优势分化可能是导致前列腺局部炎症发展的原因之一.

Differentiation of helper T lymphocyte in type Ⅲ prostatitis

Objective To investigate the differentiation of CD4+T helper cell in expressed prostatic secretions(EPS)in type Ⅲ prostatitis. Methods Seventy-six patients were studied,aged from 18 to 47(average 31.8).All patients presented with typical clinical symptoms for over 3 months.Cases were classified as type Ⅲ A(47 cases),type Ⅲ B(29 cases)and control group(16 cases)according to NIH classification system.Type Ⅲ A was also divided into group Ⅲ A1 with 26 cases(mild inflammation)and group Ⅲ A2 with 21 cases(severe inflammation).Th1 cytokine IFN-γ,Th2 cytokines IL-4 in EPS were detected by double antibody sandwich ELISA,and IFN-γ/IL-4 was determined.Results Compared with group control,IFN-γ in group Ⅲ A and Ⅲ B were significantly up regulated (134.78±43.67 pg/ml,109.82±30.09 pg/ml,P＜0.05),while IFN-γ level in group Ⅲ A was higher than in group Ⅲ B(P＜0.05).IL-4 in groupⅢ A was not changed(51.99±20.59 pg/ml,P＞0.05).IL-4 in group ⅢB was higher(76.40±17.99 pg/ml,P＜0.05).IFN-γ/IL-4 in group ⅢA was elevated significantly(2.94±1.12,P＜0.05),while IFN-γ/IL-4 in group ⅢB was not changed(1.49±0.48,P＞0.05).IFN-γ/IL-4 in group Ⅲ A2 was higher than in groupⅢA1 significantly(3.67±0.82vs 2.34±0.97,P＜0.05). Conclusions Th1 eell differentiation took the dominance in type Ⅲ A prostatitis.Th1/Th2 equilibrium was shifted to Th1.It is probably one of the pathogenies that Th1 dominant differentiation leads to local inflammation in prostate of type Ⅲ A prostatitis.