糖皮质激素对葡萄膜炎患者外周血Th1和Th2细胞因子的影响

目的探讨糖皮质激素治疗前后葡萄膜炎患者外周血单核细胞（PBMC）培养上清液Th1/Th2细胞因子的变化。方法应用酶联免疫吸附试验检测治疗前后葡萄膜炎患者PBMC上清液干扰素（IFN-γ）、白介素（IL）-2、IL-4和IL-10水平的变化,30例健康人作为正常对照。结果急性葡萄膜炎患者PBMC上清液IFN-γ、IL-2、IL-4和IL-10水平与IFN-γ/IL-4、IFN-γ/IL-10比值明显高于恢复期患者和正常对照者（P=0.000）。糖皮质激素治疗后,IFN-γ和IL-2水平、IFN-γ/IL-4和IFN-γ/IL-10比值降低（P=0.000）,IL-10水平升高（P=0.000）。治疗前不同类型葡萄膜炎组仅IFN-γ和IL-10水平差异有统计学意义（P〈0.01）,治疗后IL-2、IL-4、IL-10和IFN-γ/IL-10比值差异有统计学意义（P〈0.05）。治疗前后前葡萄膜炎和Vogt-小柳原田病患者除IL-4外,其余细胞因子及比值差异均有统计学意义（P〈0.05）;Behcet病患者除IL-4和IL-10外,其余细胞因子及比值差异均有统计学意义（P〈0.01）。治疗前后葡萄膜炎患者IFN-γ与IL-2水平间及IL-4与IL-10水平间呈正相关（P=0.000）。结论急性葡萄膜炎患者PBMC中Th1细胞因子显著升高并占优势,表明Th1/Th2细胞因子不平衡性与葡萄膜炎的发病有关。

Effects of corticosteroids on Th1/Th2 cytokines in peripheral blood mononuclear cells in the patients with uveitis

Objective The aim of present study was to investigate the effects of corticosteroids on Th1/Th2 cytokines level in cultured supernatant of peripheral blood mononuclear cells （PBMC） in the patients with uveitis.MethodsThe levels of Th1 cytokines （IFN-γ,IL-2） and Th2 cytokines （IL-4,IL-10） in PBMC supernatant of 65 cases with uveitis and 30 healthy subjects（control group） were detected by enzyme linked immunosorbent assay before and after treatment of corticosteroids.ResultsThe levels of IFN-γ,IL-2,IL-4,IL-10 in supernatants of PBMC as well as IFN-γ/IL-4 and IFN-γ/IL-10 ratios were significantly different among pre-,post-treatment and control groups （F=13.643-87.307,P=0.000;F=19.824/12.388,P=0.000）.After treatment,the levels of IFN-γ and IL-2 were decreased significantly （t=16.937/21.211,P=0.000）,but that of IL-10 was increased （t=4.213,P=0.000）,and the IL-4 level was insignificantly changed （t=1.453,P=0.151） in comparison with before treatment.The difference in IFN-γ and IL-10 were significant in different types of uveitis （F=5.561/9.985,P=0.00）.After treatment,the difference of IL-2,IL-4,IL-10 and IFN-γ/IL-10 ratio were significant（F=3.860-11.759,P〈0.05）,and the difference of the IFN-γ and the IFN-γ/IL-4 ratio were not significant among the different types of uveitis（F=0.037/0.324,P〉0.05）.No obvious difference in IL-4 level between anterior uveitis and Vogt-Koyanagi-Harada disease before and after treatment （t=0.338/1.291,P=0.738/0.212）,and the difference in other cytokines were significant （t=2.162-18.280,P〈0.05）.There was insignificant difference in IL-4 and IL-10 between pre-and post-treatment in Behcet patients （t=0.717/1.385,P〉0.05）,but significant difference was found in other cytokines（t=4.528-11.298,P〈0.001）.IFN-γ and IL-2 or IL-4 and IL-10 level showed a positive correlation before and after treatment （r=0.68/0.55,r=0.90/0.86,P=0.000）.ConclusionThe Th1 cytokines polarization plays an important role in acute uveitis.The ba