Th17/Treg细胞失衡与溃疡性结肠炎患者疾病活动度及炎症程度的关系
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摘要
目的研究Th17/Treg细胞失衡与溃疡性结肠炎(UC)患者疾病活动度及炎症程度的关系。方法选择从2017年1月～2018年5月在云南省老年病医院(以下简称"我院")诊治的UC患者93例进行研究,UC活动期者56例为活动期组,UC缓解期者37例为缓解期组。根据改良Mayo评分将活动期组划分亚组:轻度组19例、中度组24例、重度组13例。另选取同期在我院进行健康体检的40名志愿者作为对照组。检测并比较各组Th17/Treg、C反应蛋白(CRP)、白细胞介素(IL)-10及IL-17水平,分析患者Th17、Treg细胞与疾病活动度及炎症程度的关系。结果活动期组及缓解期组的Th17细胞比例及Th17/Treg水平较对照组高,且活动期组较缓解期组高(P <0.05),活动期组的Treg细胞比例较对照组低(P <0.05)。重度组的Th17/Treg水平较轻度组和中度组高,且Th17细胞比例较轻度组高(P <0.05),Treg细胞比例较轻度组和中度组低(P <0.05)。活动期组及缓解期组的CRP及IL-17水平较对照组高,且活动期组较缓解期组高(P <0.05)。活动期组及缓解期组的IL-10水平较对照组低(P <0.05)。重度组的CRP及IL-17水平较轻度组高,IL-10水平较轻度组低(P <0.05),重度组的CRP水平较中度组高,且中度组较轻度组高(P <0.05)。Pearson相关性分析结果,Th17细胞及Th17/Treg与疾病活动度、CRP及IL-17均呈正相关,与IL-10呈负相关(P <0.05)。Treg细胞与疾病活动度、CRP及IL-17均呈负相关,与IL-10呈正相关(P <0.05)。结论 UC患者机体中Th17/Treg细胞失衡与其疾病活动度及炎症程度之间存在密切关系,临床上应尽可能地确保患者的Th17/Treg细胞平衡,从而有利于其病情防控。
Objective To study the relationship between the imbalance of Th17/Treg cells and the degree of disease activity and inflammation in patients with ulcerative colitis(UC). Methods Ninety-three patients with UC from January2017 to May 2018 admitted to Yunnan Geriatric Hospital("our hospital" for short) were selected and studied. Among the patients, 56 cases in UC active period were as the active period group, 37 cases in remission period were as the remission period group. The active stage group was divided into subgroups according to the modified Mayo scoring:19 cases in the mild group, 24 cases in the moderate group, and 13 cases in the severe group. Another 40 healthy volunteers undergoing physical examination in the same period were selected as the control group. The levels of Th17/Treg, C-reactive protein(CRP), interleukin(IL)-10, IL-17 were detected and compared. Th17, Treg cells in each group were measured and the relationship between Th17, Treg cells and disease activity and inflammation was analyzed. Results The proportion of Th17 cells and the level of Th17/Treg in the active period group and the remission period group were significantly higher than the control group, and those in the active period group were significantly higher than the remission period group(P < 0.05), and the proportion of Treg cells in the active period group was significantly lower than the control group(P < 0.05). Th17/Treg level in the severe group was significantly higher than the mild group and moderate group, and the proportion of Th17 cells was significantly higher than the mild group(P < 0.05). The proportion of Treg cells in the severe group was significantly lower than the mild group and moderate group(P < 0.05). The CRP and IL-17 in the active period group and the remission period group were significantly higher than the control group, and the CRP and IL-17 in the active period group were significantly higher than the remission period group(P < 0.05). The IL-10 in active period group and remission period group was significantly lower than the control group(P < 0.05). The CRP and IL-17 in the severe group were significantly higher than the mild group(P < 0.05).The CRP in the severe group was significantly higher than the mild group, and the CRP in the severe group was significantly higher than the mild group(P < 0.05). According to Pearson correlation analysis method, the Th17 cells and Th17/Treg were positively correlated with disease activity and IL-17, and was negatively correlated with IL-10(P <0.05). The Treg cells was negatively correlated with disease activity, CRP, IL-17 and positively correlated with IL-10(P < 0.05). Conclusion There is a close relationship between the imbalance of Th17/Treg cells and the degree of disease activity and inflammation in the patients with UC. The balance of Th17/Treg cells in patients with UC should be ensured as much as possible in clinic, which is beneficial to the prevention and control of the disease.
Objective To study the relationship between the imbalance of Th17/Treg cells and the degree of disease activity and inflammation in patients with ulcerative colitis(UC). Methods Ninety-three patients with UC from January2017 to May 2018 admitted to Yunnan Geriatric Hospital("our hospital" for short) were selected and studied. Among the patients, 56 cases in UC active period were as the active period group, 37 cases in remission period were as the remission period group. The active stage group was divided into subgroups according to the modified Mayo scoring:19 cases in the mild group, 24 cases in the moderate group, and 13 cases in the severe group. Another 40 healthy volunteers undergoing physical examination in the same period were selected as the control group. The levels of Th17/Treg, C-reactive protein(CRP), interleukin(IL)-10, IL-17 were detected and compared. Th17, Treg cells in each group were measured and the relationship between Th17, Treg cells and disease activity and inflammation was analyzed. Results The proportion of Th17 cells and the level of Th17/Treg in the active period group and the remission period group were significantly higher than the control group, and those in the active period group were significantly higher than the remission period group(P < 0.05), and the proportion of Treg cells in the active period group was significantly lower than the control group(P < 0.05). Th17/Treg level in the severe group was significantly higher than the mild group and moderate group, and the proportion of Th17 cells was significantly higher than the mild group(P < 0.05). The proportion of Treg cells in the severe group was significantly lower than the mild group and moderate group(P < 0.05). The CRP and IL-17 in the active period group and the remission period group were significantly higher than the control group, and the CRP and IL-17 in the active period group were significantly higher than the remission period group(P < 0.05). The IL-10 in active period group and remission period group was significantly lower than the control group(P < 0.05). The CRP and IL-17 in the severe group were significantly higher than the mild group(P < 0.05).The CRP in the severe group was significantly higher than the mild group, and the CRP in the severe group was significantly higher than the mild group(P < 0.05). According to Pearson correlation analysis method, the Th17 cells and Th17/Treg were positively correlated with disease activity and IL-17, and was negatively correlated with IL-10(P <0.05). The Treg cells was negatively correlated with disease activity, CRP, IL-17 and positively correlated with IL-10(P < 0.05). Conclusion There is a close relationship between the imbalance of Th17/Treg cells and the degree of disease activity and inflammation in the patients with UC. The balance of Th17/Treg cells in patients with UC should be ensured as much as possible in clinic, which is beneficial to the prevention and control of the disease.
引文
[1]徐再玲,施骅,刘俊伟,等.ω-3多不饱和脂肪酸辅助治疗溃疡性结肠炎的疗效及其机制研究[J].中华全科医学,2018,16(4):561-563.
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[8]李丹丹,袁星星,杨磊,等.解毒化瘀汤对活动期溃疡性结肠炎Th17/Treg细胞及其细胞因子的影响[J].中国中医急症,2018,27(1):16-19.
[9]李黎.美沙拉嗪联合灌肠治疗溃疡性结肠炎的效果探讨[J].中外医学研究,2017,15(36):63-65.
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[11]张瑜鸿,苗新普.溃疡性结肠炎患者血清IDO水平与调节性T细胞的关系研究[J].国际检验医学杂志,2018,39(1):21-24.
[12]郝永彪,张晓燕.祛疡清热汤治疗湿热蕴结型溃疡性结肠炎的临床疗效观察及对Treg/Th17的调节作用研究[J].四川中医,2018,36(6):114-117.
[13]厉启芳,刘善军,景德怀,等.基于临床疗效及Th1/Th2、Th17/Treg炎性平衡变化探讨痛泻要方治疗溃疡性结肠炎的机制[J].辽宁中医杂志,2018,45(8):1569-1572.
[14]尚瑞,吴军,郑雪皎,等.外周血Th17、Treg细胞水平在溃疡性结肠炎和克罗恩病中的比较研究[J].胃肠病学和肝病学杂志,2017,26(5):559-561.
[15]陈孝国,王荣芋,施培华,等.Th17、Treg细胞及其相关细胞因子对溃疡性结肠炎发病的影响[J].皖南医学院学报,2018,37(4):325-327.
[16]马海芹,赵小静,张红杰.血清炎性活动指标、Th17/Treg细胞在溃疡性结肠炎患者中的改变及其临床意义[J].胃肠病学和肝病学杂志,2018,27(8):885-890.
[17]张博,熊壮,姜鑫,等.自拟扶正平溃汤联合针灸治疗慢性溃疡性结肠炎的疗效及对肠道菌群失调和Th17/Treg细胞免疫平衡的影响[J].现代中西医结合杂志,2018,27(11):1164-1167.
[18]葛卫力,江建军,朱敏,等.Th17、IL-17在长程持续性心房颤动中的作用机制[J].中国现代医学杂志,2018,28(17):77-80.
[19]刘端勇,徐荣,黄敏芳,等.树突状细胞在溃疡性结肠炎发病中的价值与途径分析[J].世界中西医结合杂志,2016,11(4):576-578.
[20]庞艳华,吴东方,马亚会,等.白细胞介素-6在溃疡性结肠炎模型小鼠Th17/Treg细胞失衡中的作用[J].胃肠病学和肝病学杂志,2018,27(5):488-491.
[2]陈冲,颜玉,王艳凤,等.布拉氏酵母菌对溃疡性结肠炎模型大鼠Treg/Th17免疫平衡的调节作用[J].黑龙江医药科学,2017,40(6):59-60.
[3]郝莉莉,刘小溪.健脾利湿汤治疗轻中度溃疡性结肠炎的疗效及其对调节T细胞功能影响的机制研究[J].天津中医药,2018,35(5):344-348.
[4]李昕,陈明锴,金锦莲,等.益生菌治疗溃疡性结肠炎的临床疗效及其机制研究[J].现代生物医学进展,2016,16(27):5361-5363.
[5]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见[J].中华内科杂志,2012,51(10):818-831.
[6]王程玉林,孙军刚,耿煜,等.Treg/Th17平衡轴在溃疡性结肠炎发病中的意义及流式细胞术检测进展[J].免疫学杂志,2015,31(6):541-544.
[7]刘志威,王学群,李甜甜,等.溃疡性结肠炎患者肠道菌群变化的临床意义[J].胃肠病学和肝病学杂志,2016,25(5):554-556.
[8]李丹丹,袁星星,杨磊,等.解毒化瘀汤对活动期溃疡性结肠炎Th17/Treg细胞及其细胞因子的影响[J].中国中医急症,2018,27(1):16-19.
[9]李黎.美沙拉嗪联合灌肠治疗溃疡性结肠炎的效果探讨[J].中外医学研究,2017,15(36):63-65.
[10]李静,陈卫刚.肠道菌群治疗溃疡性结肠炎的研究进展[J].实用医学杂志,2017,33(24):4189-4192.
[11]张瑜鸿,苗新普.溃疡性结肠炎患者血清IDO水平与调节性T细胞的关系研究[J].国际检验医学杂志,2018,39(1):21-24.
[12]郝永彪,张晓燕.祛疡清热汤治疗湿热蕴结型溃疡性结肠炎的临床疗效观察及对Treg/Th17的调节作用研究[J].四川中医,2018,36(6):114-117.
[13]厉启芳,刘善军,景德怀,等.基于临床疗效及Th1/Th2、Th17/Treg炎性平衡变化探讨痛泻要方治疗溃疡性结肠炎的机制[J].辽宁中医杂志,2018,45(8):1569-1572.
[14]尚瑞,吴军,郑雪皎,等.外周血Th17、Treg细胞水平在溃疡性结肠炎和克罗恩病中的比较研究[J].胃肠病学和肝病学杂志,2017,26(5):559-561.
[15]陈孝国,王荣芋,施培华,等.Th17、Treg细胞及其相关细胞因子对溃疡性结肠炎发病的影响[J].皖南医学院学报,2018,37(4):325-327.
[16]马海芹,赵小静,张红杰.血清炎性活动指标、Th17/Treg细胞在溃疡性结肠炎患者中的改变及其临床意义[J].胃肠病学和肝病学杂志,2018,27(8):885-890.
[17]张博,熊壮,姜鑫,等.自拟扶正平溃汤联合针灸治疗慢性溃疡性结肠炎的疗效及对肠道菌群失调和Th17/Treg细胞免疫平衡的影响[J].现代中西医结合杂志,2018,27(11):1164-1167.
[18]葛卫力,江建军,朱敏,等.Th17、IL-17在长程持续性心房颤动中的作用机制[J].中国现代医学杂志,2018,28(17):77-80.
[19]刘端勇,徐荣,黄敏芳,等.树突状细胞在溃疡性结肠炎发病中的价值与途径分析[J].世界中西医结合杂志,2016,11(4):576-578.
[20]庞艳华,吴东方,马亚会,等.白细胞介素-6在溃疡性结肠炎模型小鼠Th17/Treg细胞失衡中的作用[J].胃肠病学和肝病学杂志,2018,27(5):488-491.