南方医科大学学报

南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (12): 1712-.

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炎性细胞因子在溃疡性结肠炎患者中的表达及其对预后的影响

林安娜，李雨晴，钟慕晓，刘江，代倩，朱薇，张亚历   

  • 出版日期:2016-12-20 发布日期:2016-12-20

Expressions of inflammatory cytokines in intestinal mucosa and their prognostic value in patients with ulcerative colitis

  • Online:2016-12-20 Published:2016-12-20

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摘要： 目的探讨细胞因子IL-17、IL-23、IL-22、IL-11在溃疡性结肠炎（UC）患者肠道黏膜中的表达及临床意义。方法选取2008 年1月~2015年1月于南方医院消化科就诊的活动期UC患者40例，缓解期UC患者15例，健康对照组15例，运用免疫组织化学 法检测上述70例入选者肠黏膜活检组织中IL-17、IL-23、IL-22、IL-11的表达与分布。进一步收集40例经规范化治疗并且定期 随访的活动期UC患者，根据规范化治疗2月后内镜下黏膜愈合情况分为黏膜愈合良好组和预后欠佳组，比较上述细胞因子在 两组间治疗前肠道黏膜中的表达。结果活动期UC患者肠黏膜组织IL-17、IL-23、IL-22、IL-11的表达均明显高于缓解UC组和 健康对照组（分别为0.0727±0.0037 vs 0.0354±0.0243 vs 0.0330±0.0045；0.1407±0.0068 vs 0.0865±0.0051 vs 0.0442±0.0137； 0.0522±0.0045 vs 0.0259±0.0063 vs 0.0115±0.0061；0.0479±0.0022 vs 0.0365±0.0024 vs 0.0232±0.0009）（P<0.05）。IL-17、IL-23、 IL-22 在肠黏膜中表达水平随疾病活动度增加而增加（分别为：0.0545±0.0072 vs 0.0786±0.0051 vs 0.0847±0.0197；0.1112± 0.0046 vs 0.1480±0.0089 vs 0.1644±0.0190；0.0307±0.0063 vs 0.0548±0.0071 vs 0.0719±0.0056）（P<0.05）。IL-17、IL-23、IL-22、 IL-11 表达水平，与内镜下活动度分级均呈正相关（P<0.05），其中IL-17、IL-22 表达水平，与病理组织学分级亦呈正相关（P< 0.05）。此外，各炎性细胞因子相互之间的表达水平均呈正相关。IL-17 高表达组的黏膜愈合欠佳率（66.67%）较低表达组 （25.00%）的显著增高（P<0.05）。结论IL-17、IL-23、IL-22、IL-11在溃疡性结肠炎的发病发展中均发挥一定作用，可一定程度上 评估患者病情的严重程度，IL-17的表达水平可能对短期治疗后黏膜愈合的预后预测有一定参考价值。

Abstract: Objective To detect the expressions of IL-17, IL-23, IL – 22 and IL – 11 in the intestinal mucosa of patients with ulcerative colitis (UC) and analyze their prognostic values. Methods Forty patients with active UC, 15 with UC in remission and 15 healthy subjects were examined for the expressions and distribution of IL-17, IL-23, IL-22, and IL-11 in the colorectal mucosausing immunohistochemistry. We further collected the data from 40 patients with routine therapy and regular follow-up and compared the expressions of those cytokines according to the condition of mucosal healing. Results The expressions of cytokines in patients with active UC were significantly higher than those in patients with remittent UC and healthy control subjects (IL-17: 0.0727±0.0037 vs 0.0354±0.0243 vs 0.0330±0.0045; IL-23: 0.1407±0.0068 vs 0.0865±0.0051 vs 0.0442± 0.0137; IL-22: 0.0522±0.0045 vs 0.0259±0.0063 vs 0.0115±0.0061; IL-11: 0.0479±0.0022 vs 0.0365±0.0024 vs 0.0232±0.0009, P<0.05). The expression levels of IL-17, IL-23, and IL-22 increased significantly with the increase of the disease activity (IL-17: 0.0545± 0.0072 vs 0.0786± 0.0051 vs 0.0847±0.0197; IL-23: 0.1112±0.0046 vs 0.1480±0.0089 vs 0.1644±0.0190; IL-22: 0.0307±0.0063 vs 0.0548± 0.0071 vs 0.0719±0.0056, P<0.05). In patients with active UC, the expression levels of the 4 cytokines in the intestinal mucosa were positively correlated with the endoscopic activity grade (P<0.05), and IL-17 and IL-22 expression levels were also positively correlated with the histological grade (P<0.05). All the 4 cytokines were positively intercorrelated. The patients with low IL-17 expression (25.00% ) showed a significantly lower rate of poor mucosal healing than those with high IL-17 expressions (25% vs 67%, P<0.05). Conclusion The cytokines IL-17, IL-23, IL-22, and IL-11 all participate in the pathogenesis of UC and may serve as indicators for evaluating the inflammatory activity. The expression level of IL-17 can be a valuable indicator for predicting mucosal healing in UC patients after a short-term treatment.