摘要
目的探讨Th细胞各亚群在腹泻型肠易激综合征（IBS）患者中的变化，揭示IBS患者黏膜免疫激活的具体免疫学机制。方法按照罗马Ⅲ标准收集腹泻型IBS患者27例，部分肠黏膜病理学表现为非特异性炎症，归为IBS—A组共13例，无明显病理学改变者归为IBS组共14例。另将痔疮患者设为对照组16例。采用细胞内细胞因子染色和四色荧光抗体流式细胞术检测各组肠黏膜和外周血中Th1／Th2／Th17比例，Western印迹检测肠黏膜白细胞介素（IL）4、IL-12、IL-17的表达，酶联免疫吸附试验检测外周血IL-4、IL-12、IL-17水平。结果（1）IBS-A组患者肠黏膜Th17比例[M（QR）]明显高于对照组，差异有统计学意义[3．60（4．05）比1．25（3．70），P=0．045]，而Th1、Th2比例无明显改变；IBS—A组患者肠黏膜和外周血中IL-4、IL-12、IL-17表达以及外周血中Th1、Th2、Th17比例与对照组比较，差异均无统计学意义（均P〉0．05）。（2）IBS组患者肠黏膜和外周血中Th1、Th2和Th17的比例以及IL4、IL-12和IL-17的表达，与对照组比较差异亦均无统计学意义（均P〉0．05）。结论腹泻型IBS患者部分存在肠黏膜非特性炎症，提示肠黏膜存在免疫激活，该免疫状态表现为Th细胞向Th17偏移。
Objective To analyze the change of Th1/Th2/Th17 in colonic mucosa and peripheral blood in diarrhea-predominant IBS （D-IBS） to uncover the underlying mechanism for the activation of mucosal immune system. Methods Colonic biopsy specimens and peripheral blood were obtained from patients with D-IBS （n = 27） and controls （n = 16）. Two different groups were classified on the basis of histological assessment of biopsy specimens from D-IBS patients. One group （14 of 27 ） had normal conventional histology （IBS）, while another group （13 of 27） had nonspecific microscopic inflammation （IBS-A）. Flow cytometric detection of intracellular IFN-γ/IL-4/IL-17 cytokine production was employed to investigate Th1, Th2 and Th17 cells in colonic lamina propria and peripheral blood. Western blot was used to determine the expressions of IL-12, IL-4 and IL-17 in colonic mucosa. The levels of IL-12, IL-4 and IL- 17 in peripheral blood were detected by ELISA. Results In colonic mucosa, the proportion of 33117 increased in IBS-A group as compared with controls [ 3.60 （4. 05 ） vs 1.25 （ 3.70 ）, P = 0. 045 ], but not in IBS group. No difference could be observed in the frequencies of Th1 and Th2 in colonic mucosa and peripheral blood. The levels of IL-12, IL-4 and IL-17 in TBS and IBS-A showed no difference in either colonic mucosa or peripheral blood. Conclusion Subgroup of D-IBS showed abnormal conventional histology, implicating the activation of mucosal immune system in pathogenesis. The shift of Th1/Th2/Th17 balance in colonic mucosa showed the enhanced Th17 activity.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2009年第30期2120-2123,共4页
National Medical Journal of China
基金
国家自然科学基金（30770986）
