摘要
目的 探讨慢性重型乙型肝炎患者外周血中骨桥蛋白（OPN）和白细胞介素-17 （IL-17）的表达及临床意义.方法 于2009-2010年期间收集浙江大学医学院附属第一医院传染科住院的乙型肝炎引起的慢加急性肝功能衰竭（ACLF）患者20例,其中男11例,女9例,年龄37 ～ 65岁,中位数为39岁.并收集同期健康体检者40名作为对照组,其中男20名,女20名,年龄25 ～ 55岁,中位数35岁.采用ELISA法检测血浆中OPN及血清中IL-17的水平.并应用刀豆球蛋白A（ConA）诱导的小鼠暴发性肝炎模型,分析外周血及肝脏中OPN和IL-17的水平随时间的变化.分离人外周血单个核细胞（PBMC）,在ConA刺激的基础上,添加肿瘤坏死因子（TNF）-α或anti-TNF-α培养后,收集细胞培养上清,检测OPN和IL-17的水平.采用SPSS统计软件进行统计学处理,两组间比较采用t检验,OPN与IL-17之间关系采用Pearson相关性分析.结果 慢性重型乙型肝炎组IL-17和骨桥蛋白的水平[ （42.4±12.9） pg/ml和（1460.1±523.1） ng/ml]高于健康对照组[（10.6±4.8）pg/ml和（472.8 ±67.5） ng/ml],差异有统计学意义（t=2.387和3.570,P均＜0.05）.小鼠肝炎模型中,ConA注射后6h,外周血中的OPN即达到高峰,在12 h后OPN水平回落；而IL-17在24h内逐渐升高.注射后6h,肝脏组织中的OPN水平有一小的下降后逐渐升高并在12 h达到高峰；IL-17在ConA注射后6h达到高峰.慢性重型乙肝患者中骨桥蛋白与IL-17水平呈正相关（R2 =0.582,P=0.026）,TNF-a增加淋巴细胞对骨桥蛋白的分泌（P＜0.05）.结论 重型肝炎发生与骨桥蛋白和IL-17的表达水平有关,骨桥蛋白与IL-17水平呈正相关.TNF-α能促进淋巴细胞产生骨桥蛋白.
Objective To analyze the expression of osteopontin （OPN） and interleukin-17 （IL-17）and study the roles in the pathogenesis of chronic severe hepatitis B.Methods Twenty patients of acute on chronic liver failure were collected from the infection disease in-patients department of the First Affiliated Hospital of Medical College,Zhejiang University from 2009 to 2010,and 40 health controls were from medical examination center during the same period.Meanwhile,Balb/C mice were used for ConA injection to induce fulminant hepatitis and the plasma,serum and liver tissue of mice were collected.OPN and IL-17concentrations were measured using ELISA kits.PBMC were separated and cultured with anti-TNF-α or TNF-α.Supernatants were collected for analysis of OPN and IL-17.Differences between groups were evaluated by using a Student＇s t test and the relationship between IL-17 and OPN were evaluated by Pearson correlation.Results In chronic severe hepatitis B group,levels of OPN and IL-17 were markedly higher than those of healthy control,respectively.（42.4 ± 12.9 vs 10.6 ±4.8 pg/ml; 1460.1 ±523.1 vs 472.8 ±67.5 ng/ml） （ t =2.387,3.570,P 〈 0.05）.The level of OPN in blood and liver reached peak at 6 hours at 12 hours after ConA injection,respectively.The level of IL-17 in blood and liver was significantly increased after ConA injection.IL-17 were positive correlated with OPN levels （R2 =0.582,P =0.026）.TNF-α can increase the level of OPN secreted by lymphocytes.Conclusions OPN and IL-17 levels in peripheral blood of hepatitis B patients are closely related to the hepatitis B degree.TNF-α can increase the level of OPN secreted by lymphocytes.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2012年第2期141-144,共4页
Chinese Journal of Laboratory Medicine
基金
基金项目：教育部留学回国人员启动经费资助项目
新世纪优秀人才支持计划资助项目（NCET-09-0686）
钱江人才资助项目（2010R10061）
