摘要
目的测定狼疮肾炎（LN）患者血清白细胞介素-18（IL-18）的水平以及外周血单个核细胞（PBMC）内干扰素（IFN）-γ／IL-4的表达情况，探讨LN患者体内Th1/Th2型细胞的平衡情况以及IL-18与Th1/Th2型免疫反应的相关性。方法酶联免疫吸附试验（ELISA）方法检测血清IL-18的表达：佛波酯（PMA）和离子霉素联合刺激培养，流式细胞术从单个核细胞水平检测细胞内IFN-γ/IL-4的表达情况。结果LN患者血清IL-18的水平显著高于对照组（P=0．000）；Th1型（IFN—γ^＋）细胞百分率明显高于对照组（P=0．009），Th1/Th2型细胞的比率（IFN-γ／IL-4^＋）明显增高（P=0．005）；Th1/Th2型细胞比率与尿蛋白定量（24h）呈明显正相关；Th1型细胞百分率与血清IL-18的水平呈明显的正相关。结论LN患者血清IL-18水平升高，并与Th1/Th2型免疫反应失衡有关，IL-18可以促进LN患者体内Th1型免疫反应增强。从而加重蛋白尿的发展。削弱Th1型免疫反应重建Th1/Th2型免疫反应的平衡，理论上可能会阻止狼疮肾炎的发病。
Objective To investigate the serum level of interleukin （IL）-18 and the IFN-γ^＋/IL-4^＋ cell ratio in the peripheral blood mononuclear cells （PBMCs）. The phenotypic distribution of Th1/Th2 type cells and the correlation between Th1/Th2 and serum IL-18 in lupus nephritis （LN） was evaluated. Methods Serum level of IL-18 was measured with ELISA method. Flow cytometry （FCM） was used to determine IFN-γ^＋/IL-4^＋ cells ratio in PBMCs which were stimulated by phorbol myristate acetate（PMA） and ionomycin beforehand. Resuits Serum level of IL-18 in LN patients was （146±101）pg/ml significantly higher than that of normal controls [（48±45） pg/ml, P=0.000]. A predominance of IFN-γ^＋ cells with higher Th1/Th2 type （IFN-γ^＋/IL-4^＋） cells ratio was seen in LN patients compared to normal controls. The percentage of Th 1 cells （IFN-γ^＋ cells） in LN patients was （32±14） significantly higher than that of normal controls （19±5, P=-0.009）. Th1/Th2 type （IFN-γ^＋/IL-4^＋） cells ratio of LN patients was （25±19） significantly higher than that of normal controls （9±4, P=- 0.005）. Significant correlation was found between Th1/Th2 type （IFN-γ^＋/IL-4^＋） cells ratio and 24 hours urine protein （r=-0.7640, P=0.004）. Significant correlation was also found between Thl type （IFN-γ^＋） cells and serum IL-18 levels in LN （r=0.577, P=0.024）. Conclusion LN patients have higher serum IL-18 than controls, and the serum IL-18 is correlated with the imbalance of Th1/Th2. IL-18 may play a role in the pathogenesis of LN by promoting cytokine imbalance towards Thl type immune response. The increasement of Thl type immune response may aggravate the development of albuminuria. So impairing the Thl immune response and reconstructing Th1/Th2 balance may theoretically prevent the development of disease.
出处
《中华风湿病学杂志》
CAS
CSCD
2007年第3期158-161,共4页
Chinese Journal of Rheumatology
基金
上海市教委特色学科基金资助项目（风湿病学）（T0203）
