子宫内膜异位症患者辅助性T细胞亚群免疫状态的研究

目的　探讨辅助性T细胞 (Th)亚群在子宫内膜异位症 (内异症 )发病中的作用。方法　采用酶联免疫吸附法检测 30例内异症患者 (内异症组 )及 2 0例非内异症患者 (对照 1组 )血清及腹腔液中白细胞介素 (IL) 2、6的水平 ;用免疫组化技术分别检测IL 2、IL 6在内异症组患者异位内膜组织和 10例子宫肌瘤患者 (对照 2组 )的正常子宫内膜组织中的表达。结果　内异症组患者血清及腹腔液中位数IL 6水平分别为 5 3、2 1ng/L ,对照 1组患者血清及腹腔液中位数IL 6水平分别为 2 5、0 9ng/L ,两组妇女血清和腹腔液中IL 6水平分别比较 ,差异均有统计学意义 (P <0 0 5 ) ;内异症组Ⅲ～Ⅳ期患者血清及腹腔液中位数IL 6水平分别为 13 6、4 1ng/L ,Ⅰ～Ⅱ期患者血清及腹腔液中位数IL 6水平分别为 3 7、1 6ng/L ,Ⅲ～Ⅳ期患者与Ⅰ～Ⅱ期患者血清及腹腔液中位数IL 6水平比较 ,差异均有统计学意义 (P <0 0 5 ) ;内异症组IL 2 /IL 6比值在血清及腹腔液中分别为 0 7、1 1,均分别低于对照组的 0 8、6 2 ,差异也有统计学意义 (P <0 0 5 )。内异症组患者腹腔液与血清IL 6水平呈正相关 (r =0 74 5 ,P <0 0 1) ,血清及腹腔液中IL 6水平与IL 2 /IL 6比值均呈负相关 (r =- 0 4 0 6 ,P <0 0 5 ;r =- 0 4 80 ,P <0 0 5 )

Study on the changes of T-lymphocyte subsets in the patients with endometriosis

OBJECTIVE: To investigate the function of T-lymphocyte subsets in patients with endometriosis. METHODS: The levels of interleukin-2 (IL-2) and interleukin-6 (IL-6) in the serum, and peritoneal fluid of 30 cases with endometriosis were detected using enzyme linked immunoabsorbent assay and compared with those of 20 non-endometriosis cases. The expression of IL-2 and IL-6 in ectopic endometrial tissue from the patients with endometriosis and the endometrial tissues of 10 normal women was investigated by immunohistochemistry method. RESULTS: Significantly elevated levels of IL-6 (cytokines of T help cell 2) were found in the serum and peritoneal fluid of patients with endometriosis (Median: 5.3 ng/L, 2.1 ng/L, P < 0.05) compared with that of non-endometriosis patients median: 2.5 ng/L, 0.9 ng/L). The level of IL-6 in the serum and peritoneal fluid of endometriosis patients in early stages (stages I, II) was 3.7 ng/L, 1.6 ng/L, significantly lower than those in advanced stages (stages III, IV) (13.6 ng/L, 4.1 ng/L) (P < 0.05). The ratio of IL-2/IL-6 in the serum and peritoneal fluid in patients with endometriosis (0.7, 1.1) was significantly lower than those in the control non-endometriosis group (0.8, 6.2, P < 0.05). The levels of IL-6 detected in the peritoneal fluid of patients with endometriosis had a positive correlation with those in the serum (r = 0.745, P < 0.01). The levels of IL-6 in serum and peritoneal fluid in the patients with endometriosis had a negative correlation with the IL-2/IL-6 ratios in the serum and peritoneal fluid respectively (r = -0.406, r = -0.480, P < 0.05). IL-2 and IL-6 were expressed in the interstitial cells of ectopic endometrial tissue, with an expression rate of 56.7%, and 60.0% respectively. There was significant difference in the expression of IL-2 and IL-6 between the ectopic endometrial tissue and normal endometrial tissue. CONCLUSIONS: The levels of IL-6 in the serum and peritoneal fluid of patients with endometriosis are increased, implying that IL-6 might play a role in the pathophysiology of endometriosis. The ratio of IL-2/IL-6 in the serum and peritoneal fluid was decreased in patients with endometriosis compared with the control group, suggesting shift of Th1 cell toward Th2 cell in patients with endometriosis. Stronger expression of IL-2 and IL-6 in the ectopic endometrial tissues may contribute to the disturbed immune regulation in patients with endometriosis.