特发性肺纤维化患者免疫球蛋白A、TGF-β1、IL-6和IL-17水平变化的意义
|
摘要
目的分析特发性肺纤维化(IPF)患者血清中免疫球蛋白A(IgA)、转化生长因子β(TGF-β1),白介素6(IL-6)和白介素17(IL-17)表达水平,研究其在IPF患者的诊断及对病情评估中的应用价值。方法选择石家庄市第二医院、河北省中医院、河北医科大学第四医院进行治疗的IPF的38例患者为病例组,选择30例因胸痛等原因进行相关检查为健康就诊者30例为对照组,分析2组研究对象血清中IgA、TGF-β1、IL-6和IL-17水平,并测定肺功能和6 min步行试验相关指标。结果病例组患者血清IgA、TGF-β1、IL-6和IL-17水平均明显高于对照组(P<0.01);病例组患者FVC、FEV1、 FEV1/FVC和步行距离明显低于对照组,而血氧饱和度下降分数明显高于对照组,差异均有统计学意义(P<0.01),病例组血清IgA、TGF-β1、IL-6和IL-17水平与FVC、FEV1和步行距离水平均呈现明显的负相关性,和血氧饱和度下降分数呈明显的正相关性(P<0.01)。结论血清IgA、TGF-β1、IL-6和IL-17水平与IPF患者发病及肺功能等情况具有一定的相关性,可能成为判断IPF病情的诊断指标。
Objective To observe the expression levels of IgA,TGF-β1,IL-6 and IL-17 in serum of patients with idiopathic pulmonary fibrosis(IPF),and to explore its diagnosis in diagnosis and evaluation of disease severity.Methods A total 38 patients with IPF were enrolled as case group, and the other 30 healthy subjects who received relevant examinations due to chest pain were enrolled as control group.The serum levels of IgA, TGF-β1,IL-6 and IL-17 were detected,moreover the lung function and 6-minute walking test examination were observed and compared between the two groups.Results The serum levels of IgA, TGF-β1,IL-6 and IL-17 in case group were significant higher than those in control group(P<0.01). The levels of FVC,FEV1,FEV1/FVC and walking distance in case group were significantly lower than those in control group,however, the decrease scores of oxyhemoglobin saturation in case group were significantly higher than those in control group(P<0.01).Moreover the serum levels of IgA, TGF-β1,IL-6 and IL-17 in case group were closely negatively correlated with FVC, FEV1,FEV1/FVC and walking distance,however,which were positively correlated with the decrease scores of oxyhemoglobin saturation(P<0.01).Conclusion The serum levels IgA, TGF-β1,IL-6 and IL-17 are correlated with pathogenesis of patients with IPF at certain extent,which may become the diagnostic indicator for evaluating IPF severity.
Objective To observe the expression levels of IgA,TGF-β1,IL-6 and IL-17 in serum of patients with idiopathic pulmonary fibrosis(IPF),and to explore its diagnosis in diagnosis and evaluation of disease severity.Methods A total 38 patients with IPF were enrolled as case group, and the other 30 healthy subjects who received relevant examinations due to chest pain were enrolled as control group.The serum levels of IgA, TGF-β1,IL-6 and IL-17 were detected,moreover the lung function and 6-minute walking test examination were observed and compared between the two groups.Results The serum levels of IgA, TGF-β1,IL-6 and IL-17 in case group were significant higher than those in control group(P<0.01). The levels of FVC,FEV1,FEV1/FVC and walking distance in case group were significantly lower than those in control group,however, the decrease scores of oxyhemoglobin saturation in case group were significantly higher than those in control group(P<0.01).Moreover the serum levels of IgA, TGF-β1,IL-6 and IL-17 in case group were closely negatively correlated with FVC, FEV1,FEV1/FVC and walking distance,however,which were positively correlated with the decrease scores of oxyhemoglobin saturation(P<0.01).Conclusion The serum levels IgA, TGF-β1,IL-6 and IL-17 are correlated with pathogenesis of patients with IPF at certain extent,which may become the diagnostic indicator for evaluating IPF severity.
引文
1 Serrano-Mollar A,Gay-Jordi G,Guillamat-Prats R,et al.Safety and Tolerability of Alveolar Type Ⅱ Cell Transplantation in Idiopathic Pulmonary Fibrosis.Chest,2016,150:533-543.
2 Canestaro WJ,Forrester SH,Raghu G,et al.Drug Treatment of Idiopathic Pulmonary Fibrosis:Systematic Review and Network Meta-Analysis.Chest,2016,149:756-766.
3 Fortuna G,Marinkovich MP.Linear immunoglobulin A bullous dermato- sis.Clinics in Dermatology,2016,170:338-338.
4 顾盼,罗本芳,易祥华,等.特发性肺纤维化和特发性非特异性间质性肺炎中细胞因子的表达及分析.中华结核和呼吸杂志,2014,37:664-670.
5 Aleyd E,Heineke MH,Van EM.The era of the immunoglobulin A Fc receptor FcαRI; its function and potential as target in disease.Immunological Reviews,2015,268:123-138.
6 Ten Klooster L,Nossent GD,Kwakkel-Van.Erp JM,et al.Ten-Year survival in Patients with idiopathic pulmonary fibrosis after lung gran SPlantation.Lung,2015,193:919-926.
7 Klooster LT,Moorsel CHMV,Erp KV,et al.Immunoglobulin A in serum:an old acquaintance as a new prognostic biomarker in idiopathic pulmonary fibrosis.Clinical & Experimental Immunology,2015,181:357-361.
8 中华医学会呼吸病学分会.特发性肺(间质)纤维化诊断和治疗指南(草案).中华内科杂志,2002,25:498-500.
9 Nalysnyk L,Cid-Ruzafa J,Rotella P,et al.Incidence and prevalenceof idiopathic pulmonary fibrosis:review of the literature.EurRespir Rev,2012,21:355-361.
10 崔社怀. 特发性肺间质纤维化的回顾和展望.中华肺部疾病杂志:电子版,2010,3:4-5.
11 Eng NF,Garlapati S,Gerdts V,et al.PCEP enhances IgA mucosal immune responses in mice following different immunization routes with influenza virus antigens.Journal of Immune Based Therapies & Vaccines,2010,8:1-11.
12 Brandtzaeg P,Johansen FE.Mucosal B.Cells:phenotypic characteristics,transcriptional regulation,and homing properties.Immunological Reviews,2005,206:32-63.
13 Raghu G,Collard HR,Egan JJ,et al.An Official ATS/ERS/JRS/ALAT statement:idiopathic pulmonary fibrosis:evidence-based guidelines for diagnosis and management.Am J Respir Crit Care Med,2011,183:788-824.
14 沈成龙,何宋兵,赵华,等.辅助性T细胞17相关细胞因子与结肠癌的研究进展.医学研究生学报,2013,26:402-406.
15 Semik-Orzech A1,Barczyk A,Pierzchala W.The role of interleukin 17 cytokine family in inducing allergic inflammation in the pulmonary tract.Pneumonol Alergol Pol,2006,74:409-413.
16 张慧琴,刘学军.IL-17和IL-6在大鼠肺纤维化过程中的动态表达及意义.中国医药导报,2012,9:24-25,28.
17 章琳,杨渭临.沙利度胺对老年特发性肺纤维化患者BALF中IL-6、TNF-α、TGF-β1表达的影响.西安交通大学学报(医学版),2012,33:622-625.
18 Alhamad EH.The six-minute walk test in patients with pulmonary sarcoidosis.Ann Thorac Med,2009,4:60-64.
19 边绿斐,周毅,陈金寅,等.六分钟步行试验在特发性肺纤维化中的应用价值.现代实用医学,2011,23:888-890.
20 郭治,李娜,陈媛媛,等.6分钟步行试验在评价特发性肺纤维化病死率中的作用.国际呼吸杂志,2018,38:270-275.
2 Canestaro WJ,Forrester SH,Raghu G,et al.Drug Treatment of Idiopathic Pulmonary Fibrosis:Systematic Review and Network Meta-Analysis.Chest,2016,149:756-766.
3 Fortuna G,Marinkovich MP.Linear immunoglobulin A bullous dermato- sis.Clinics in Dermatology,2016,170:338-338.
4 顾盼,罗本芳,易祥华,等.特发性肺纤维化和特发性非特异性间质性肺炎中细胞因子的表达及分析.中华结核和呼吸杂志,2014,37:664-670.
5 Aleyd E,Heineke MH,Van EM.The era of the immunoglobulin A Fc receptor FcαRI; its function and potential as target in disease.Immunological Reviews,2015,268:123-138.
6 Ten Klooster L,Nossent GD,Kwakkel-Van.Erp JM,et al.Ten-Year survival in Patients with idiopathic pulmonary fibrosis after lung gran SPlantation.Lung,2015,193:919-926.
7 Klooster LT,Moorsel CHMV,Erp KV,et al.Immunoglobulin A in serum:an old acquaintance as a new prognostic biomarker in idiopathic pulmonary fibrosis.Clinical & Experimental Immunology,2015,181:357-361.
8 中华医学会呼吸病学分会.特发性肺(间质)纤维化诊断和治疗指南(草案).中华内科杂志,2002,25:498-500.
9 Nalysnyk L,Cid-Ruzafa J,Rotella P,et al.Incidence and prevalenceof idiopathic pulmonary fibrosis:review of the literature.EurRespir Rev,2012,21:355-361.
10 崔社怀. 特发性肺间质纤维化的回顾和展望.中华肺部疾病杂志:电子版,2010,3:4-5.
11 Eng NF,Garlapati S,Gerdts V,et al.PCEP enhances IgA mucosal immune responses in mice following different immunization routes with influenza virus antigens.Journal of Immune Based Therapies & Vaccines,2010,8:1-11.
12 Brandtzaeg P,Johansen FE.Mucosal B.Cells:phenotypic characteristics,transcriptional regulation,and homing properties.Immunological Reviews,2005,206:32-63.
13 Raghu G,Collard HR,Egan JJ,et al.An Official ATS/ERS/JRS/ALAT statement:idiopathic pulmonary fibrosis:evidence-based guidelines for diagnosis and management.Am J Respir Crit Care Med,2011,183:788-824.
14 沈成龙,何宋兵,赵华,等.辅助性T细胞17相关细胞因子与结肠癌的研究进展.医学研究生学报,2013,26:402-406.
15 Semik-Orzech A1,Barczyk A,Pierzchala W.The role of interleukin 17 cytokine family in inducing allergic inflammation in the pulmonary tract.Pneumonol Alergol Pol,2006,74:409-413.
16 张慧琴,刘学军.IL-17和IL-6在大鼠肺纤维化过程中的动态表达及意义.中国医药导报,2012,9:24-25,28.
17 章琳,杨渭临.沙利度胺对老年特发性肺纤维化患者BALF中IL-6、TNF-α、TGF-β1表达的影响.西安交通大学学报(医学版),2012,33:622-625.
18 Alhamad EH.The six-minute walk test in patients with pulmonary sarcoidosis.Ann Thorac Med,2009,4:60-64.
19 边绿斐,周毅,陈金寅,等.六分钟步行试验在特发性肺纤维化中的应用价值.现代实用医学,2011,23:888-890.
20 郭治,李娜,陈媛媛,等.6分钟步行试验在评价特发性肺纤维化病死率中的作用.国际呼吸杂志,2018,38:270-275.