摘要目的 探讨产生IL-17的CD4+T细胞(Th17)在SLE患者组织中的定位,以及与狼疮活动的关系.方法 共聚焦显微镜、免疫荧光双标技术、免疫组化和HE染色,分析Th17细胞业群在4例活动期SLE患者和2例正常人外周血单一核细胞中、皮损组织和肺组织中的定位.流式细胞仪检测50例SLE患者和15例正常人对照外周血Th17的比例,RT-PCR检测相关细胞因子基因表达,用ELISA检测血清中IL-17的分泌水平.结果 在活动期狼疮患者外周血单一核细胞中可见有Th17细胞,其IL-17的荧光强度为(127.6±20.5),明显高于正常人IL-17荧光强度,其值为(40.6±11.1),P＜0.001.在活动期SLE患者受损的皮肤组织和肺组织中可见有Th17细胞的浸润,而正常人皮肤未见有Th17细胞的浸润.活动期SLE患者外周血中Th17比例明显增加,且与SLE活动指数(SLEDAI)呈正相关.相关细胞因子IL-17A和IL-17F mRNA表达明显增加,血清中的不IL-17水平分泌增加,活动期SLE患者中Th17增加与血管炎的发病呈正相关,经过治疗后Th17随病情缓减而减少.结论 Th17细胞亚群在活动期SLE患者体内扩增,其扩增与SLE活动密切相关,可能参与SLE 血管炎的发生.

abstractsobjective To investigate the tissue localization of CD4+T cells producing IL-17,namely Th17 cells.in patients with systemic lupus erythematosus (SLE),as well as its relationship with the activity of lupus.Methods By using H&E staining.double-label immunofluorescence.immunohistochemistry and confocal microscopy.the localization of Th17 cells was carried out in peripheral blood mononuclear cells (PBMCs).affected tissue of skin and lung obtained from 4 patients with active SLE and 2 normal human controls.Flow cytometry.reverse transcription PCR.ELISA were used to detect the proportion of Th17 cells in PBMCs,the mRNA expression of interleukin-17(IL-17)A and IL-17 F,and serum level of interleukin 17,respectively,in 50 consecutive adult patients with SLE and 15 normal human controls.Results Th17 cells were detected in PBMCs of patients with active SLE.and the fuorescence intensity of IL-17 was significantly higher in patients with active SLE than in normal human controls(127.6±20.5 vs 40.6±11.1,P＜0.001).Infiltrates of Th17 cells were noted in both skin and lung tissues of patients with active SLE.but not in those of normal human controls.The proportion of Th17 cells in PBMCs was increased in patients with active SLE.and the proportion positively correlated with SLE disease activity index(SLEDAI) (r=0.725,P＜0.01).Further more.a significant increase was observed in the mRNA expression of IL-17 A and IL-17 F and serum level of IL-17 in patients with active SLE compared with normal human controls.The amount of Th17 cells was positively correlated with the development of vasculitis.and it experienced a decrease with the remission of SLE.Conclusions A proliferation of Th17 cells is noted in patients with active SLE.which seems to closely correlated with the activity of SLE and may take part in the development of vasculitis in SLE.