白细胞介素27在舌下脱敏治疗调控变应性鼻炎患者Th17/Treg平衡中的作用
|
摘要
目的探讨白细胞介素27(IL-27)在舌下脱敏特异性免疫治疗(SLIT)调控变应性鼻炎(AR)患者Th17/调节性T细胞(Treg)细胞平衡过程中的作用。方法选取60例就诊于该院耳鼻喉科门诊并确诊为AR的患者,用随机数字表法随机分为对照组和SLIT组。对照组接受常规药物治疗,SLIT组在此基础上联合舌下脱敏治疗,比较两组患者治疗前和治疗6个月后AR症状评分、药物积分、外周血AR特异性IgE(sIgE)、特异性IgG4(sIgG4)、IL-27水平,以及Th17和Treg细胞比例。结果与对照组患者相比,SLIT治疗组患者药物积分和sIgG4水平较低,差异有统计学意义(P<0.05)。与治疗前相比,两组患者Th17/CD4+T的比例均下降,而Treg/CD4+T的比例升高,差异有统计学意义(P<0.01)。与对照组相比,SLIT组治疗后Th17/CD4+T进一步下降,而Treg/CD4+T的比例进一步升高,差异有统计学意义(P<0.05)。治疗后对照组IL-27水平升高至(23.18±2.72)pg/mL,SLIT组升高至(26.33±3.69)pg/mL,与治疗前比较差异有统计学意义(P<0.01);治疗后SLIT组血清IL-27水平高于对照组,差异有统计学意义(P<0.05)。相关性分析显示治疗前IL-27与Th17/CD4+T比例呈负相关(r=-0.723,P=0.015)。结论 SLIT在调控AR患者Th17/Treg失衡过程中需要IL-27的参与,IL-27与抑制AR患者Th17反应有关。
Objective To investigate the role of interleukin-27(IL-27)for regulating Th17/Treg balance in sublingual desensitization specific immunotherapy(SLIT)in the patients with allergic rhinitis(AR).Methods A total of 60 patients who were diagnosed with AR in the otolaryngology clinic of our hospital were selected and divided into the control group and SLIT group by the random number table method.The control group received the routine medication treatment,while the SLIT group were given sublingual desensitization therapy on this basis.Then the AR symptom scores,medication score,peripheral AR specific IgE(sIgE),sIgG4,IL-27,Th17 and Treg were compared between before treatment and after 6-months of treatment.Results The medication treatment scores and sIgG4 level in the SLIT group were lower compared with those in the control group(P<0.05).Compared with before treatment,the ration of Th17/CD4+T in the two groups was decreased,while the Treg/CD4+T ration was increased,the difference was statistically significant(P<0.01).Compared with the control group,the Th17/CD4+T after SLIT treatment was further decreased,while the ration of Treg/CD4+T was further increased,and the difference was statistically significant(P<0.05).After treatment,the IL-27 level in the control group was increased to(23.18±2.72)pg/mL,and the SLIT group was increased to(26.33±3.69)pg/mL,the difference was statistically significant compared with those before treatment(P<0.01).The IL-27 level after treatment in the SLIT group was higher than that in the control group,the difference was statistically significant(P<0.05).The correlation analysis showed that the IL-27 was negatively correlated to the Th17/CD4+T(r=-0.723,P=0.015).Conclusion SLIT IL-27 requires the involvement of in the regulating of Th17/Treg balance in AR patients IL-27 is associated with inhibition of Th17 response in AR patients.
Objective To investigate the role of interleukin-27(IL-27)for regulating Th17/Treg balance in sublingual desensitization specific immunotherapy(SLIT)in the patients with allergic rhinitis(AR).Methods A total of 60 patients who were diagnosed with AR in the otolaryngology clinic of our hospital were selected and divided into the control group and SLIT group by the random number table method.The control group received the routine medication treatment,while the SLIT group were given sublingual desensitization therapy on this basis.Then the AR symptom scores,medication score,peripheral AR specific IgE(sIgE),sIgG4,IL-27,Th17 and Treg were compared between before treatment and after 6-months of treatment.Results The medication treatment scores and sIgG4 level in the SLIT group were lower compared with those in the control group(P<0.05).Compared with before treatment,the ration of Th17/CD4+T in the two groups was decreased,while the Treg/CD4+T ration was increased,the difference was statistically significant(P<0.01).Compared with the control group,the Th17/CD4+T after SLIT treatment was further decreased,while the ration of Treg/CD4+T was further increased,and the difference was statistically significant(P<0.05).After treatment,the IL-27 level in the control group was increased to(23.18±2.72)pg/mL,and the SLIT group was increased to(26.33±3.69)pg/mL,the difference was statistically significant compared with those before treatment(P<0.01).The IL-27 level after treatment in the SLIT group was higher than that in the control group,the difference was statistically significant(P<0.05).The correlation analysis showed that the IL-27 was negatively correlated to the Th17/CD4+T(r=-0.723,P=0.015).Conclusion SLIT IL-27 requires the involvement of in the regulating of Th17/Treg balance in AR patients IL-27 is associated with inhibition of Th17 response in AR patients.
引文
[1]文春秀,谢小娟,甘金梅,等.粉尘螨滴剂通过改善机体免疫功能治疗过敏性鼻炎[J].中国免疫学杂志,2016,32(2):244-246.
[2] KiM S H,KIM S H,CHUNG S J,et al.Changes in basophil activation during immunotherapy with house dust mite and mugwort in patients with allergic rhinitis[J].Asia Pac Allergy,2018,8(1):e6.
[3] LEE J H,KIM S C,CHOI H,et al.A retrospective study of clinical response predictors in subcutaneous allergen immunotherapy with house dust mites for allergic rhinitis[J].Allergy Asthma Immunol Res,2018,10(1):18-24.
[4]桂晓钟,陈涌,赵军,等.变应性鼻炎皮下注射和舌下含服特异性免疫治疗依从性对比[J].中国耳鼻咽喉头颈外科,2010,17(12):631-633.
[5]田媛,刘慧峰,王效军,等.舌下脱敏治疗对变应性鼻炎患者Th17/Treg免疫平衡的影响[J].中国耳鼻咽喉头颈外科,2016,23(6):341-344.
[6] WEI P,HU G H,KANG H Y,et al.An aryl hydrocarbon receptor ligand acts on dendritic cells and T cells to suppress the Th17response in allergic rhinitis patients[J].Lab Invest,2014,94(5):528-535.
[7] BOZEK A,KOLODZIEJCZYK K,KOZLOWSKA R,et al.Evidence of the efficacy and safety of house dust mite subcutaneous immunotherapy in elderly allergic rhinitis patients:a randomized,double-blind placebo-controlled trial[J].Clin Transl Allergy,2017(7):43.
[8]朱亮,陆纪红,谢青,等.皮下免疫和舌下免疫治疗尘螨变应性鼻炎的安全性及依从性分析[J].中华耳鼻咽喉头颈外科杂志,2010,45(6):444-449.
[9] Berker M,Frank L J,Gessner A L,et al.Allergies-A T cells perspective in the era beyond the TH1/TH2paradigm[J].Clin Immunol,2017(174):73-83.
[10]谭倩,刘志丹,李晓燕,等.Th17/Treg细胞失衡在变应性鼻炎中的作用研究进展[J].中国免疫学杂志,2017,33(4):638-640.
[11]GU Z W,WANG Y X,CAO Z W.Neutralization of interleukin-17suppresses allergic rhinitis symptoms by downregulating Th2and Th17responses and upregulating the Treg response[J].Oncotarget,2017,8(14):22361-22369.
[12]NI K,ZHAO L,WU J,et al.Th17/Treg balance in children with obstructive sleep apnea syndrome and the relationship with allergic rhinitis[J].Int J Pediatr Otorhinolaryngol,2015,79(9):1448-1454.
[13]NIEMINEN K,VALOVIRTA E,SAVOLAINEN J.Clinical outcome and IL-17,IL-23,IL-27and FOXP3expression in peripheral blood mononuclear cells of pollen-allergic children during sublingual immunotherapy[J].Pediatr Allergy Immunol,2010,21(1Pt 2):e174-184.
[14]SHEN Y,YUAN X D,HU D,et al.Association between interleukin-27gene polymorphisms and susceptibility to allergic rhinitis[J].Hum Immunol,2014,75(9):991-995.
[15]黄雪琨,杨钦泰,陈玉莲,等.变应性鼻炎患者外周血中IL-27和Treg细胞的相关性分析[J].中国组织化学与细胞化学杂志,2013,22(5):391-395.
[16]QIU S L,DUAN M C,LIANG Y,et al.Cigarette smoke induction of interleukin-27/WSX-1regulates the differentiation of Th1and Th17cells in a smoking mouse model of emphysema[J].Front Immunol,2016(7):553.
[2] KiM S H,KIM S H,CHUNG S J,et al.Changes in basophil activation during immunotherapy with house dust mite and mugwort in patients with allergic rhinitis[J].Asia Pac Allergy,2018,8(1):e6.
[3] LEE J H,KIM S C,CHOI H,et al.A retrospective study of clinical response predictors in subcutaneous allergen immunotherapy with house dust mites for allergic rhinitis[J].Allergy Asthma Immunol Res,2018,10(1):18-24.
[4]桂晓钟,陈涌,赵军,等.变应性鼻炎皮下注射和舌下含服特异性免疫治疗依从性对比[J].中国耳鼻咽喉头颈外科,2010,17(12):631-633.
[5]田媛,刘慧峰,王效军,等.舌下脱敏治疗对变应性鼻炎患者Th17/Treg免疫平衡的影响[J].中国耳鼻咽喉头颈外科,2016,23(6):341-344.
[6] WEI P,HU G H,KANG H Y,et al.An aryl hydrocarbon receptor ligand acts on dendritic cells and T cells to suppress the Th17response in allergic rhinitis patients[J].Lab Invest,2014,94(5):528-535.
[7] BOZEK A,KOLODZIEJCZYK K,KOZLOWSKA R,et al.Evidence of the efficacy and safety of house dust mite subcutaneous immunotherapy in elderly allergic rhinitis patients:a randomized,double-blind placebo-controlled trial[J].Clin Transl Allergy,2017(7):43.
[8]朱亮,陆纪红,谢青,等.皮下免疫和舌下免疫治疗尘螨变应性鼻炎的安全性及依从性分析[J].中华耳鼻咽喉头颈外科杂志,2010,45(6):444-449.
[9] Berker M,Frank L J,Gessner A L,et al.Allergies-A T cells perspective in the era beyond the TH1/TH2paradigm[J].Clin Immunol,2017(174):73-83.
[10]谭倩,刘志丹,李晓燕,等.Th17/Treg细胞失衡在变应性鼻炎中的作用研究进展[J].中国免疫学杂志,2017,33(4):638-640.
[11]GU Z W,WANG Y X,CAO Z W.Neutralization of interleukin-17suppresses allergic rhinitis symptoms by downregulating Th2and Th17responses and upregulating the Treg response[J].Oncotarget,2017,8(14):22361-22369.
[12]NI K,ZHAO L,WU J,et al.Th17/Treg balance in children with obstructive sleep apnea syndrome and the relationship with allergic rhinitis[J].Int J Pediatr Otorhinolaryngol,2015,79(9):1448-1454.
[13]NIEMINEN K,VALOVIRTA E,SAVOLAINEN J.Clinical outcome and IL-17,IL-23,IL-27and FOXP3expression in peripheral blood mononuclear cells of pollen-allergic children during sublingual immunotherapy[J].Pediatr Allergy Immunol,2010,21(1Pt 2):e174-184.
[14]SHEN Y,YUAN X D,HU D,et al.Association between interleukin-27gene polymorphisms and susceptibility to allergic rhinitis[J].Hum Immunol,2014,75(9):991-995.
[15]黄雪琨,杨钦泰,陈玉莲,等.变应性鼻炎患者外周血中IL-27和Treg细胞的相关性分析[J].中国组织化学与细胞化学杂志,2013,22(5):391-395.
[16]QIU S L,DUAN M C,LIANG Y,et al.Cigarette smoke induction of interleukin-27/WSX-1regulates the differentiation of Th1and Th17cells in a smoking mouse model of emphysema[J].Front Immunol,2016(7):553.