中重度哮喘患儿白细胞介素-17及中性粒细胞炎症反应关系.docVIP

中重度哮喘患儿白细胞介素-17及中性粒细胞炎症反应关系 　 作者：李静 檀卫平 吴葆菁 蓝丹 李文益 麦贤弟 范玲玲 【摘要】 【目的】 探讨白细胞介素-17(IL-17)在中重度儿童哮喘发病、气道中性粒细胞炎症反应中的作用。【方法】 中重度持续哮喘发作期儿童45例，其中中度持续组(20例)与重度持续组(25例);以健康儿童20例为对照组。以酶联免疫吸附法(ELISA)检测两组患儿外周血单个核细胞(PBMC)在CD3和CD28单克隆抗体刺激下分泌的IL-17水平，检测诱导痰中性粒细胞数量;对以上病例进行联合治疗3个月后随访，达到临床缓解的病例20例纳入哮喘缓解组，复查其IL-17水平。比较不同病情间IL-17的表达水平，了解IL-17与儿童哮喘临床病情、气道炎症反应的关系。【结果】 哮喘患儿PBMC表达IL-17水平显著高于正常对照组(2 685 ± 1 081) pg/mL，其中哮喘发作组 (5 355 ± 813) pg/mL显著高于哮喘缓解组(4 504 ± 687) pg/mL (P均 lt; 0.05);重度持续组患儿PBMC表达IL-17水平(5 830 ± 807) pg/mL显著高于中度持续组(4 962 ± 751) pg/mL (P lt; 0.05);急性发作期哮喘患儿IL-17水平(5 355 ± 813) pg/mL与诱导痰中性粒细胞比例(Xmin = 0， Xmax = 98.8， M = 44.73)%、血中性粒细胞比例(51.72 ± 13.43) %成正相关(r = 0.820、0.736， P lt; 0.001)。【结论】 中重度哮喘患儿外周血单个核细胞IL-17表达水平升高，并与哮喘临床病情、气道炎症反应密切相关。 【关键词】 哮喘; IL-17; 中性粒细胞 　　Abstract： 【Objective】 To investigate the effect of interleukin-17 (IL-17) on the pathogenesis of moderate to severe children asthma and on the airway neutrophil inflammation reaction. 【Methods】 Forty-five patients (20 patients with moderate persistent asthma， 25 patients with severe persistent asthma)， as well as 20 normal control subjects， were included in this study. ELISA was used to measure IL-17 concentration in peripheral blood mononuclear cells (PBMC) from 65 children. PBMC were stimulated by anti-CD3 monoclonal antibody (OKT3) (0.2 mg/L) and anti-CD28 monoclonal antibody (anti-CD28) (1 mg/L). The sputum specimens were assayed for cellular differential count. Then the asthmatic children received combined treatment for 3 months， 20 cases were relieved， their IL-17 concentration in PBMC were measured again. The correlation between the IL-17 levels and the percentage of eosinophil， neutrophil in the induced sputum was analyzed. IL-17 levels were compared between moderate persistent group and severe persistent group， between the acute group and the remission group. The relationship between IL-17 and the disease severity and airway inflammation was analyzed. 【Results】 The IL-17 levels of asthmatic grou