Th 细胞因子IL-17、IFN-γ、IL-4 在狼疮性肾炎中的表达及意义

目的:探讨T辅助细胞(Th)相关细胞因子在狼疮性肾炎发病中的免疫机制作用。方法:64例系统性红斑狼疮患者和28例健康体检者作为对照,采用酶联免疫吸附测定法(ELISA法)检测所有受试者血清IL-17、IFN-γ、IL-4水平,并对其与SLEDAI、SDI、24小时尿蛋白量相关性进行研究。结果:狼疮性肾炎组血清IL-17水平显著高于狼疮无肾炎组和健康对照组(P<0.001),狼疮性肾炎组血清IFN-γ水平显著高于狼疮无肾炎组(P<0.05)和健康对照组(P<0.01),血清IL-4水平在狼疮性肾炎组、狼疮无肾炎组均显著高于健康对照组(P<0.01)。狼疮性肾炎组IFN-γ/IL-4比值显著高于狼疮无肾炎组(P<0.01)和健康对照组(P<0.05);狼疮无肾炎组IFN-γ/IL-4比值显著低于健康对照组(P<0.01)。SLE患者血清IFN-γ表达水平与SLEDAI积分呈正相关(r=0.402,P<0.05),血清IL-17、IL-4表达水平与SLEDAI、SDI、抗ds-DNA抗体、C3、24小时尿蛋白量均无相关性。结论:狼疮性肾炎患者外周血中IL-17、IFN-γ、IL-4等促炎细胞因子均有不同程度升高促起炎症发生及组织损伤,参与了狼疮性肾炎的免疫发病过程。

Role of Peripheral Blood Th Cells Relevant Cytokines in Patients with Lupus Nephritis

Objective: To investigate the effect and the clinical significance of Th cells in the pathogenesis of patients with lupus nephritis(LN).Methods:64 systemic lupus erythematosus patients and 28 healthy controls were enrolled.The concentrations of serum IL-17,IFN-γ,IL-4 were measured by enzyme-linked immunosorbent assay(ELISA).Results: 1.The expression of IL-17 in LN Group exhibited a significant increase compared with that in SLE Group and healthy controls(P<0.001).2.The levels of IFN-γ in LN Group were higher than those in SLE Group and in healthy controls(P<0.05,P<0.01,respectively).3.The levels of IL-4 in SLE Group,LN Group were higher than those in healthy controls(P<0.01).4.Th1/Th2(IFN-γ/IL-4) ratio in LN Group increased significantly than that in SLE Group(P<0.01) and HC group(P<0.05);Th1/Th2(IFN-γ/IL-4) ratio decreased in SLE Group compared with that in HC group(P<0.01).5.The levels of IFN-γ were positively correlated with SLEDAI scores in SLE patients(P<0.05).Conclusions: The significantly elevated serum IL-17,IFN-γ,IL-4 levels in lupus nephritis,suggesting that Th17/ Th1/ Th2 functional imbalance may be involved in the pathogenesis of renal damage in SLE patients.