摘要目的 探讨结节病患者外周血中IL-35蛋白和基因的表达水平及其临床意义.方法 采用横断面对照研究方法回顾性分析2016年1月至2017年3月北京协和医院就诊的98例结节病患者外周血标本,其中男32例,女66例,年龄27～72岁,平均(51±9)岁.同期98名健康体检者作为对照组,其中男41名,女57名,年龄29～ 69岁,平均(49±10)岁.采用酶联免疫吸附法检测两组血浆IL-35水平,分析其与患者肺功能、BALF、主要的实验室及影像学检查等临床参数之间的关系.使用实时荧光定量PCR检测两组外周血单核细胞IL-35亚基EBI3、p35及调节性T细胞(Treg细胞)转录因子Foxp3 mRNA的表达水平,分析其相关性.结果 结节病患者血浆中IL-35为(44±12)ng/L,明显低于对照组[(55±12) ng/L,P＜0.001],外周血单核细胞(PBMC)中EBI3和Foxp3 mRNA的表达(1.54±0.74,0.92±0.36)与对照组(2.12 ±0.61,1.10 ±0.27)比较明显减低(均P＜0.05).相关性分析结果表明,结节病患者血浆中IL-35水平与DLCO占预测值％呈正相关(r=0.76,P＜0.0m),与其他临床参数比较未发现明显相关性;EBI3与Foxp3 mRNA的相对表达量呈正相关(r=0.786,P＜0.001).结论 IL-35可能参与了结节病的炎症过程,在其发病过程中具有重要作用.

abstractsObjective To investigate the expression of interleukin (IL)-35 protein and gene in peripheral blood of patients with sarcoidosis and its clinical significance.Methods Peripheral blood samples from 98 patients with sarcoidosis and 98 healthy volunteers were collected at Peking Union Medical College Hospital between January 2016 and March 2017.The plasma levels of IL-35 were detected by enzyme-linked immunosorbent assays (ELISA),and the relationship between IL-35 and the clinical characteristics was analyzed.Real-time quantitative PCR was used to detect the expression levels of IL-35 subunit EBI3,p35 and T regulatory cell transcription factor Foxp3 mRNA in peripheral blood mononuclear cells,and their correlations were analyzed.Results The plasma levels of IL-35 in patients with sarcoidosis (44 ± 12) ng/L was significantly lower than that in the normal control group (55 ± 12) ng/L (P ＜ 0.001).There was a positive correlation between the plasma levels of IL-35 and DLCO％ predicted values (r =0.76,P ＜0.001),but it showed no significantly correlation with other clinical parameters.The expression of EBI3 and Foxp3 mRNA in peripheral blood mononuclear cells of patients with sarcoidosis (1.54 ± 0.74,0.92 ± 0.36) were significantly lower than those in the normal control group respectively (2.12 ± 0.61,1.10 ± 0.27,all P ＜ 0.05).There was a significant positive correlation between the expression of EBI3 and Foxp3 mRNA in the sarcoidosis group (r =0.786,P ＜ 0.001).Conclusion IL-35 may be involved in the inflammatory process of sarcoidosis and play an important role in the pathogenesis of the disease.