IL-23/Th17轴在变应性哮喘中的研究进展

变应性哮喘是一种由辅助性T细胞（T helper cell,Th cell）调节的慢性炎症性疾病。Th1/Th2的失衡一直被认为是变应性哮喘的发病机制,Th2细胞及其分泌的细胞因子白介素4（interleukin 4,IL-4）、IL-5以及IL-13在变应性哮喘特异性症状的发病中发挥重要作用。最近研究发现Th17细胞及其分泌的IL-17参与变应性哮喘的发展过程,IL-23在Th17细胞维持生存和功能成熟中发挥重要作用,并参与抗原诱导的气道炎症反应。该文对目前IL-23/Th17轴在变应性气道炎症反应中的研究进展作一综述。     

IL-23和IL-17在结核病中的研究进展

近年来结核病的发病率越来越高,随着对结核病免疫机制的进一步研究,发现了Th17、IL-23、IL-17在结核免疫保护中起着重要作用。对这免疫途径的研究有利于进一步阐明结核病的免疫机制和指导临床诊疗。     

TH17细胞相关细胞因子IL-17和IL-23在系统性红斑狼疮中的表达及其意义

目的:探究SLE的发病机制,通过测定SLE患者及正常人外周血浆中的IL-17以及IL-23的表达水平,研究SLE患者体内的IL-17以及IL-23水平是否异常,并探讨其在SLE疾病中的作用.通过研究有望为SLE患者的治疗在细胞因子方面提供方向.方法:SLE组33例;健康对照组20例.采用酶联免疫吸附试验测定血浆中IL-17、IL-23的水平,收集整理SLE患者的临床资料及实验室数据.按照SLE患者疾病活动度、有无狼疮肾炎和抗ds-DNA阳性与否以及补体水平进行分组.结果:活动期SLE患者血浆中的IL-17以及IL-23水平明显高于对照组(P＜0.01),与SLE非活动组相比,也有明显差异,其具有统计学意义(P＜0.01),但非活动组与正常对照组间无统计学意义.狼疮肾炎组和非狼疮肾炎组患者血浆中的IL-17和IL-23水平均高于正常对照组(P＜0.01),但IL-17和IL-23的水平在肾炎组和非肾炎组间无明显统计学差异.抗ds-DNA抗体阳性组与阴性组间IL-17和IL-23水平也无明显统计学差异.补体C3、C4水平高值组与正常组间IL-17和IL-23水平也无明显统计学差异.结论:IL-17和IL-23表达水平在SLE患者活动期血浆中表达有明显增高,提示IL-17和IL-23可能参与了SLE疾病的发生发展过程,可能与疾病的活动度有密切的关系.是否有肾脏损害以及抗ds-DNA抗体阳性与否、补体水平的高低与否可能对SLE患者血浆中IL-17和IL-23的表达水平影响较小.通过此研究我们可以在SLE的细胞因子治疗方面有进一步突破,进一步明确SLE的发病机制,为SLE患者带来更大的福音.     

血清IL-17 与IL-23 在支气管哮喘患者中的表达水平及其相关性

目的:探讨IL-17与IL-23在支气管哮喘患者血清中的表达水平及其相关性。方法:选择2010年2月~2015年9月在我院进行诊治的支气管哮喘患者98例,其中包括56例为缓解期组,42例为急性发作期组,对照组为20例体检健康者,观察三组的血清IL-17、IL-23水平及肺功能指标的差异,并分析其相关性。结果:与对照组相比,缓解期组和急性发作期组血清IL-17、IL-23水平均明显升高(P0.05),急性发作期组血清IL-17、IL-23水平均显著高于缓解期组(P0.05);急性发作期组患者的PEF%、FEV1%、V50%、V25%均明显低于缓解期组,差异有统计学意义(P0.05);哮喘患者血清IL-17水平与IL-23水平呈正相关(r=0.685,P=0.000),血清IL-17与FEV1负相关(r=-0.592,P=0.000)、与PEF负相关(r=-0.515,P=0.000),IL-23与FEV1负相关(r=-0.598,P=0.000),与PEF负相关(r=-0.532,P=0.000)。结论:血清IL-17和IL-23的高表达可能参与了支气管哮喘的形成,并能影响疾病的进程,两者表达水平密切相关。     

退变腰椎间盘中IL-17表达的变化及其意义

目的:研究退变的椎间盘组织中IL-17表达的变化及其与椎间盘退变严重程度之间的关系。方法:收集退变椎间盘标本23例,正常椎间盘标本12例,通过免疫组织化学染色、免疫荧光染色、实时-定量PCR(RT-PCR)和酶联免疫吸附实验(ELISA)从细胞、蛋白和基因水平检测椎间盘组织中IL-17和孤独受体(retinoid-related orphan receptor,RORγt)的表达。结果:免疫组化染色显示退变椎间盘组织中IL-17阳性细胞比例较对照组明显增高,有统计学差异(P<0.05);免疫荧光染色显示退变椎间盘组织中Th17细胞含量明显增多(P<0.05);退变的椎间盘组织中IL-17和RORγt m RNA的相对表达量较对照组增加,有统计学差异(P<0.001),且两者之间呈显著正相关(r=0.6919,P<0.001);退变的椎间盘组织中IL-17的含量较对照组明显增加(P<0.01),且与椎间盘退变的严重程度呈正显著相关(r=0.4714,P<0.01)。结论:IL-17含量增加参与了腰椎间盘退变的病理过程,并且可能对椎间盘退变起促进作用。     

靶定IL-17 治疗类风湿关节炎研究进展

IL-17作为前炎症因子参与类风湿关节炎,系统性红斑狼疮等自身免疫性疾病的病理过程。它主要由CD4+T细胞的一个亚群--Th17细胞分泌释放。目前,IL-17在类风湿关节炎的病理过程中的作用引起了医学界广泛的关注,抗IL-17A抗体已经生产并进入临床实验,用于治疗类风湿关节炎、银屑病关节炎等疾病。但其在类风湿关节炎病理过程中的作用尚需进一步研究,其有效性亦尚需进一步探讨。本文主要针对IL-17家族的各个亚型的表达、调控、生物学作用及与类风湿关节炎发病的关系进行阐述,为类风湿关节炎的治疗提供新的思路。     

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。     

Th17细胞的分化、调节及其主要细胞因子和功能

近几年来以分泌白介素17(interleukin 17,IL-17)为特征的辅助性T细胞Th17(T help cell 17,Th17)细胞被认为是有区别于Th1(T help cell 1,Th1)、Th2(T help cell 2,Th2)新型的细胞亚群,它的发现改变了以往人们只将Th细胞分为Th1、Th2的传统分类认识。Th17细胞参与了自身免疫疾病、肿瘤的发生及机体各种炎症的发病机制,其分泌的细胞因子在生物学功能中发挥了极其重要的作用。同时Th17细胞的活化需要各种转化生长因子、IL-6(interleukin 6,IL-6)、IL-23(interleukin 23,IL-23)等细胞因子的参与,活化的Th17细胞同时再进一步的促进各种细胞因子的分泌,以通过分泌IL-17、IL-21(interleukin 21,IL-21)、IL-22(interleukin22,IL-22)、IL-26(interleukin 26,IL-26)、肿瘤坏死因子(tumor necrosis factor,TNF)α等细胞因子导致机体炎症等各种疾病的发生。     

辅助性T细胞17在免疫相关性全血细胞减少症中的免疫调节功能研究

免疫相关性全血细胞减少(immune-related pancytopenia,IRP)是临床多个学科易见的疾病,也是困扰临床医师的一大难题。近年来关于辅助性T细胞17(T helper 17,Th17)对IRP发病作用的研究更是热点。通过检测免疫相关性全血细胞减少症患者骨髓中Th17细胞数量及功能变化,探讨Th17细胞在IRP中的免疫调节作用。研究发现,IRP患者(IL-23R)+CD4+/CD4+细胞比率及其骨髓上清液IL-6、IL-17、IL-23水平增高,提示IL-23介导的Th17细胞分化亢进可能是IRP发病原因之一。免疫干预治疗可以显著降低Th17细胞比率及IL-23R,抑制Th17细胞分化亢进可能是治疗IRP的一个靶点。     

IL-21/IL-21R信号在TNBS诱导小鼠炎症性肠病病变形成中的作用研究

探讨IL-21/IL21R信号在炎症性肠病病变形成中对肠固有层辅助T细胞应答的调控机制。利用IL-21R基因敲除小鼠(IL-21R KO),建立TNBS诱导的炎症性肠病动物模型。监测小鼠体重及生存率;HE染色观察小鼠肠组织形态结构及炎症反应情况;分离和提取肠固有层淋巴细胞(lamina propria lymphocyte,LPL),应用流式细胞仪检测Th1、Th2、Th17、Treg细胞比例和绝对数;ELISA法检测LPL培养上清中的细胞因子(IFN-γ、IL-4、IL-17A、IL-10)的分泌。结果显示:与WT小鼠相比,IL-21R KO小鼠体重下降更快,生存率明显降低;HE染色显示IL-21R KO小鼠肠管上皮损伤严重、隐窝大面积消失、大量炎性细胞浸润,并侵犯到黏膜肌层;IL-21R KO小鼠肠固有层Th1细胞应答显著增强,相反Th2、Th17和Treg应答明显抑制。因此,IL-21/IL-21R信号通过调节小鼠肠固有层Th细胞应答,在TNBS诱导的肠炎病变形成中发挥重要的保护性作用。     

TGF-β is necessary for induction of IL-23R and Th17 differentiation by IL-6 and IL-23

TGF-β and IL-6 induce Th17 differentiation, and IL-23 is required for expansion and maintenance of Th17 cells. Recently, it was shown that IL-6 up-regulates IL-23R mRNA in naive CD4⁺ T cells and therefore IL-6 and IL-23 synergistically promote Th17 differentiation. However, the molecular mechanism whereby IL-6 and IL-23 induce Th17 differentiation and the relevance to TGF-β remain unknown. Here, we found that IL-6 up-regulated IL-23R mRNA expression, and IL-6 and IL-23 synergistically augmented its protein expression. The combination induced Th17 differentiation, and TGF-β1 further enhanced it. IL-6 augmented endogenous TGF-β1 mRNA expression, whereas the amount of TGF-β produced was not enough to induce Th17 differentiation by IL-6 alone. However, unexpectedly, the up-regulation of IL-23R and induction of Th17 differentiation by IL-6 and IL-23 were almost completely inhibited by anti-TGF-β. These results suggest that the induction of IL-23R and Th17 differentiation by IL-6 and IL-23 is mediated through endogenously produced TGF-β.     

Potential role of myeloid cell/eosinophil-derived IL-17 in LPS-induced endotoxin shock

IL-17RA is a shared receptor subunit for several cytokines of the IL-17 family, including IL-17A, IL-17C, IL-17E (also called IL-25) and IL-17F. It has been shown that mice deficient in IL-17RA are more susceptible to sepsis than wild-type mice, suggesting that IL-17RA is important for host defense against sepsis. However, it is unclear which ligands for IL-17RA, such as IL-17A, IL-17C, IL-17E/IL-25 and/or IL-17F, are involved in the pathogenesis of sepsis. Therefore, we examined IL-17A, IL-17E/IL-25 and IL-17F for possible involvement in LPS-induced endotoxin shock. IL-17A-deficient mice, but not IL-25- or IL-17F-deficient mice, were resistant to LPS-induced endotoxin shock, as compared with wild-type mice. Nevertheless, studies using IL-6-deficient, IL-21Rα-deficient and Rag-2-deficient mice, revealed that neither IL-6 and IL-21, both of which are important for Th17 cell differentiation, nor Th17 cells were essential for the development of LPS-induced endotoxin shock, suggesting that IL-17A-producing cells other than Th17 cells were important in the setting. In this connection, IL-17A was produced by macrophages, DCs and eosinophils after LPS injection. Taken together, these findings indicate that IL-17A, but not IL-17F or IL-25, is crucial for LPS-induced endotoxin shock. In addition, macrophages, DCs and eosinophils, but not Th17 cells or γδ T cells, may be sources of IL-17A during LPS-induced endotoxin shock.     

The prevalence of Th17 cells in patients with gastric cancer

Th17 cells have emerged as an important mediator in inflammatory and autoimmune diseases. However, recent studies suggest a potential impact of Th17 cells on tumor. The current study was designed to investigate the possible involvement of Th17 cells in gastric cancer. Compared with healthy volunteers, patients with gastric cancer had a higher proportion of Th17 cells in peripheral blood. Notably, the increased prevalence of Th17 cells was associated with clinical stage. In addition, increased populations of Th17 cells were present in tumor-draining lymph nodes with advanced disease. Furthermore, the mRNA expression levels of Th17-related factors (IL-17, IL-23p19, and RORC) in tumor tissues and the serum concentrations of IL-17 and IL-23 cytokines were significantly increased in patients with advanced gastric cancer. The results indicate that Th17 cells may contribute to gastric cancer pathogenesis.     

Development of experimental cerebral malaria is independent of IL-23 and IL-17

Cerebral malaria (CM) is the most severe complication of Plasmodium infection. Although inappropriate immune responses to Plasmodium falciparum are reported as the major causes of CM, the precise mechanisms for development remain unclear. IL-23 and IL-17 have critical roles in the onset of autoimmunity and inflammatory diseases triggered by microbial infections. Thus, we investigated the influence of IL-23 and IL-17 on experimental CM (ECM) using Plasmodium berghei ANKA infection of C57BL/6 mice. Both IL-23 deficient mice and wild-type (WT) mice developed ECM. IL-17 deficient mice also developed ECM, while IL-17 producing cells other than CD4⁺ T cells (Th17) were increased in WT mice that developed ECM. In conclusion, this study showed that IL-23 and IL-17 are not involved in ECM development.     

Antigen-specific IL-23/17 pathway activation by murine semi-mature DC-like cells

We analyzed the phenotype and function of bone marrow-derived dendritic cells (DCs) induced in vitro without using any serum during the late stage of cultivation. These ‘serum-free’ DCs (SF-DCs) possessed the ability to induce T cell proliferation as well as antibody responses, indicating that they were functional DCs. Surprisingly, the SF-DCs akin to semi-mature DCs in terms of both phenotypic and functional characteristics. The SF-DCs did not produce IL-12 but produced large amounts of IL-23 following lipopolysaccharide stimulation. The antigen-specific production of IL-17 by CD4⁺ T cells co-cultured with OVA-loaded SF-DCs was significantly higher than that with OVA-loaded conventional DCs. These results suggest that SF-DCs tend to produce IL-23 and can consequently induce the IL-17 producing CD4⁺ T cells. The semi-mature DC-like cells reported here will be useful vehicles for DC immunization and might contribute to studies on the possible involvement of semi-mature DCs in Th17 cell differentiation.     

Cyclosporin A inhibits the production of IL-17 by memory Th17 cells from healthy individuals and patients with rheumatoid arthritis

Recent evidence from several studies indicated that IL-17-producing Th17 cells can represent the key effector cells in the induction and development of autoimmune disorders. Cyclosporine A (CsA) is a commonly used immunosuppressant to treat lots of autoimmune diseases including rheumatoid arthritis (RA). Here, we demonstrated that PBMCs and purified CD4⁺ T cells from healthy individuals and patients with RA could be induced to produce large amounts of IL-17 after stimulation with anti-CD3 plus anti-CD28 mAbs. Phenotypic analysis indicated that the majority of IL-17-producing cells were Th17 cells with memory phenotype. The addition of CsA into cell cultures significantly inhibited the IL-17 production by Th17 cells at protein and at mRNA levels. Compared to the PBMCs from normal individuals, PBMCs from the patients with RA produced higher levels of IL-17 that was also significantly inhibited by CsA both at protein and at mRNA levels. The mechanism might be the effect of CsA on the T cells activation because the expression of CD69 and CD25 molecules on T cells was markedly reduced in the presence of CsA. Taken together, these results demonstrated that CsA suppressed the IL-17 production and inhibited the Th17 cells differentiation from both healthy individuals and patients with RA.     

IL-17在肿瘤发生发展中的作用

Th17作为新发现的一类Th细胞亚群,其分泌的IL-17在肿瘤的发生与发展过程中有着重要的作用。大量文献报道IL-17在肿瘤发生发展过程中发挥双刃剑的作用,一方面,IL-17可以通过促进血管生成和肿瘤细胞的迁移促进肿瘤的生长。另一方面,IL-17亦可促进细胞毒性T细胞的免疫应答抑制肿瘤的生长。     

Th17细胞及白细胞介素-17在肝移植急性排斥反应中的意义

目的探讨Th17细胞及相关因子白细胞介素-17（IL-17）在肝移植急性排斥反应中的变化及意义。方法收集2011年1月至2012年12月大连医科大学附属第二医院肝移植手术患者28例,根据移植肝组织穿刺活检病理诊断结果将肝移植的28例患者分为急性排异反应组6例和无排斥反应稳定组22例,15名健康体检者作为对照组。急性排斥组及稳定组在移植术后3 d和7 d,行肝穿刺活检病理检查;同时检测受检者外周血Th17细胞,受检者血清中IL-17水平。结果移植肝穿刺活检病理诊断显示急性排斥组随着移植时间延长,排斥反应逐渐增强。肝组织出现典型的细胞免疫性病理损伤,术后7 d肝脏汇管区、肝实质、小静脉壁、胆管上皮内及小叶间胆管被大量的淋巴细胞及嗜中性粒细胞包绕及浸润,胆管上皮细胞内空泡形成、上皮细胞凋亡。病理改变明显比术后3 d严重;急性排斥组患者术后3 d和7 d外周血Th17细胞比例及血清中IL-17含量较稳定组和对照组均明显增多（P〈0.05）,且Th17细胞及IL-17在术后急性排斥期7 d值均明显高于3 d（P〈0.05）。结论 Th17细胞及IL-17在肝移植急性排斥反应的发生、发展中可能起着促进作用,外周血Th17细胞及IL-17的检测有可能成为肝移植急性排斥反应的早期诊断指标。