摘要目的 探讨特应性皮炎(atopic dermatitis,AD)患者外周血白介素17蛋白和mRNA水平及辅助性T细胞17(Th17)表达及其意义.方法 用酶联免疫吸附测定法(ELISA)检测63例AD患者及30例正常人对照血浆中IL-17蛋白水平.实时荧光定量RT-PCR检测两组外周血中IL-17 mRNA表达水平.流式细胞仪检测AD患者和对照者外周血单一核细胞中Th17细胞的比例.分析外周血Th17细胞比例和IL-17水平与AD患者病情严重度的相关性.结果 急性期AD患者外周血中Th17细胞比例为1.83％±0.47％,明显高于正常人对照组(0.85％±0.45％,t=4.128,P＜ 0.01)和慢性期组(1.12％±0.69％,t=2.439,P＜0.05).AD组外周血中血浆IL-17水平为98.37 ng/L,高于正常人组63.75 ng/L,U=168,P＜0.05.AD组外周血IL- 17mRNA表达水平高于正常人对照组.AD患者外周血Th17细胞比例和血IL-17蛋白水平与湿疹面积及严重度指数(EASI)积分均呈显著正相关(r=0.681,P＜ 0.01；r=0.427,P＜ 0.05).结论急性期AD患者外周血Th17细胞比例显著升高,IL-17蛋白分泌及基因表达水平存在异常,与病情严重度明显相关,提示IL-17和Th17细胞可能在AD发病中起作用.

abstractsObjective To determine the protein and mRNA expression levels of interleukin-17 (IL-17) and proportions of Th17 cells in peripheral blood of patients with atopic dermatitis (AD),and to analyze their clinical significance.Methods Venous blood samples were obtained from 63 patients with AD and 30 normal human controls.Enzyme linked immunosorbent assay was performed to measure the plasma level of IL-17 protein,real time fluorescence reverse transcription (RT)-PCR to detect the mRNA expression level of IL-17 in peripheral blood,flow cytometry to determine the percentage of Th17 cells in peripheral blood mononuclear cells (PBMCs).Spearman's rank correlation analysis was performed to assess the relationship of peripheral blood Th17 cell percentage and IL-17 levels with disease severity in patients with AD.Results The percentage of Th17 cells in PBMCs was 1.83％ ± 0.47％ in patients with acute AD,significantly higher than that in normal human controls (0.85％ ± 0.45％,t =4.128,P ＜ 0.01 ) and in patients with chronic AD ( 1.12％ ± 0.69％,t =2.439,P ＜ 0.05).There was a significant increase in the plasma level (98.37 vs.63.75 ng/L,U =168,P ＜ 0.05) and mRNA expression level of IL-17 in peripheral blood in patients with AD compared with normal controls.Both the Th17 cell percentage and plasma IL-17 level were positively correlated with eczema area and severity index (EASI) score in patients with AD (r =0.681,P ＜ 0.01;r =0.427,P ＜ 0.05).Conclusions There is an elevated proportion of Th17 cells and an abnormal expression of IL-17 protein and mRNA in peripheral blood from patients with acute AD,which are positively correlated with disease severity,implicating the possible roles of IL-17 and Th17 cells in the pathogenesis of AD.