白细胞介素23受体、白细胞介素17A在炎症性肠病患者中的表达及临床意义

目的：通过检测白细胞介素23受体（1L-23R）及白细胞介素17A（IL-17A）在炎症性肠病（IBD）患者肠黏膜及血清中的表达水平，探讨其在IBD发病过程中的作用及意义。方法：收集32例克罗恩病（CD）患者、29例溃疡性结肠炎（UC）患者及27例对照者的内镜肠黏膜活检标本，采用荧光定量PCR技术检测肠黏膜内IL-23R、IL-17AmRNA的表达情况，免疫组化技术分析IL-23R、IL-17A在肠黏膜中的原位表达。结果：与健康对照组相比，CD及UC患者肠黏膜组织内IL-23RmRNA表达显著增高（P〈0．05），CD及UC组间的表达量差异无统计学意义（P〉0．05）。CD及UC患者肠黏膜组织内IL-17AmRNA表达显著增高（P〈0．05），CD组肠黏膜组织内IL．17AmRNA表达显著高于uc组（P〈0．05）。免疫组化分析显示IL-23R阳性细胞在CD与uc肠黏膜固有层内有较多表达，较正常黏膜内的肠上皮细胞相比，CD及UC患者肠黏膜IL-23R蛋白表达量最著增高（P〈0．05），UC及CD组间的表达量差异无统计学意义（P〉0．05）。IL-17A阳性细胞在CD与UC肠黏膜固有层内有较多表达，较正常黏膜内的肠上皮细胞相比，CD及UC患者肠黏膜IL-17A蛋白表达量最著增高（P〈0．05）。结论：IL．23R及IL-17A在IBD患者肠黏膜中表达显著增高，提示IL-23R及IL-17A表达异常与IBD的发生发展密切相关，有可能成为IBD治疗的新靶点。

The Expression of Interleukin-23 Receptor and Interleukin-17a in Patients with Inflammatory Bowel Disease and its Clinical Significance

Objective： To investigate the function and significance of interleukin-23 receptor （IL-23R） and interleukin-17a （IL-17A） in the pathogenesis of inflammatory bowel disease （IBD） by detecting the expression in the intestinal mucosal of patients with IBD. Methods： Intestinal or colonic mucosal biopsies of 32 patients with Crohn＇s disease （CD）, 29 patients with ulcerative colitis （UC） and 27 healthy controls were chosen. The expression of IL-23R and IL-17A was detected by real-time PCR and the situ expression of IL-23R and IL-17A in intestinal mucosa was analyzed with immunohistoehemistry. Results： Compared with that in healthy controls, the expression of IL-23R at mRNA level in inflamed mucosa of CD and UC patients increased significantly （P〈0.05）, and there was no statis- tic difference between CD and UC groups （P〉0.05）; The expression of IL-17A at mRNA level in inflamed mucosa of CD and UC patients increased significantly （P〈0.05）, and there was the statistic difference between CD and UC groups （P〈0.05）. The immunobisto- chemistry results indicated that more IL-23R and IL-17A positive ceils were in the intestinal or colonic mucosa of UC and CD patient, and the expression of IL-23R and IL-17A in normal lamina mucosa was low. The expression of IL-23K and IL-17A protein in the intesti- nal or colonic mucosa of CD and UC patients increased significantly （P〈0.05）. Conclusion： The expression oflL-23R and IL-I7A in the intestinal mucosa of IBD patients increased significantly, which suggested that abnormal IL-23R and IL-17A expression may had closely relation with the pathogenesis of IBD. IL-23R and IL-17A may be a new target for the IBD treatment.