稳定期慢性阻塞性肺疾病患者肺泡灌洗液中IL⁃8、IL⁃17水平的相关性研究
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江苏省社会发展项目(BE2017745)


Concentrations of IL⁃8 and IL⁃17 in bronchoalveolar lavage fluid of patients with stable chronic obstructive pulmonary disease and their correlations with clinical indicators
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    摘要:

    目的:研究稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者肺泡灌洗液中白介素(interleukin,IL)-8和IL-17的表达水平,探究其与临床指标之间的关系。方法:收集2017年11月1日—2018年5月30日来自东南大学附属中大医院呼吸科就诊肺结节患者,其中稳定期COPD患者72例,吸烟但肺功能正常者17例,不吸烟正常对照者20例。记录患者的病史、吸烟史,同时进行COPD评估测试呼吸问卷(COPD assessment test,CAT)和呼吸困难指数评分(modified Medical Research Council,mMRC)等评价,通过CT评估患者的肺气肿水平。常规进行支气管镜检查并留取肺泡灌洗液,采用酶联免疫吸附法测定IL-8、IL-17的浓度。结果:IL-8、IL-17在COPD患者中的表达水平明显高于吸烟者(P < 0.01)和正常对照者(P < 0.01);在全部受试者和COPD患者中,IL-8、IL-17两者间的表达水平均呈现明显的相关性(r=0.929,P < 0.001;r=0.865,P < 0.001);IL-8、IL-17的表达水平与第1秒用力呼气流量占预计值的百分比(forced expiratory volume in one second,FEV1)、用力呼气中期流速(maximum midexpiratory flow,MMEF)呈负相关,与CAT、mMRC等指标存在正相关;在肺气肿较轻的COPD患者中,IL-8、IL-17与肺气肿指数正相关(r=0.559,P < 0.001;r=0.627,P < 0.001);而在较重的COPD患者中未发现这种关联。结论:稳定期COPD患者肺泡灌洗液中IL-8、IL-17水平明显升高,与患者疾病的严重程度平行;与反映患者症状水平的CAT、mMRC评分正相关,并与FEV1、MMEF等指标负相关;在肺气肿明显的患者中,IL-8、IL-17和肺气肿指数不相关。

    Abstract:

    Objective:This study aims to investigate the concentrations of interleukin(IL)-8 and IL-17 in bronchoalveolar lavage fluid of patients with stable chronic obstructive pulmonary disease(COPD),and analyze their correlations with clinical parameters. Methods:We recruited 109 patients with lung peripheral nodules who visited the Zhongda Hospital Affiliated to Southeast University between Dec.1st 2017 and May 30th 2018,including 79 patients with stable COPD,17 smokers with normal lung function,and 20 healthy non-smokers. Smoking history inquiry,COPD assessment test(CAT),modified Medical Research Council(mMRC)dyspnea index score were collected while spirometry,chest computed tomography and bronchoscopy were performed in all subjects. The levels of IL-8 and IL-17 in BALF were analyzed by enzyme linked immunosorbent assay(ELISA). Results:The levels of IL-8 and IL-17 in the patients with stable COPD were significantly higher than those of the smokers and the healthy non-smokers(P < 0.01). The concentration of IL-8 was correlated with IL-17 in all subjects(r=0.929,P < 0.001)and in the COPD patients(r=0.865,P < 0.001). The levels of IL-8 and IL-17 were negatively correlated with forced expiratory volume in one second(FEV1)and maximum midexpiratory flow(MMEF),while positively correlated with CAT and mMRC. The correlations of IL-8 and IL-17 with emphysema index were significant in the COPD patients with mild emphysema(r=0.559,P < 0.001;r=0.627,P < 0.001),however with no indication among COPD patients with severe emphysema. Conclusion: In stable COPD patients,the levels of IL-8 and IL-17 in bronchoalveolar lavage fluid are increased significantly and correlated with the disease severity. IL-8 and IL-17 have correlation with clinical indicators such as CAT,mMRC,FEV1 and MMEF. The correlations of IL-8 and IL-17 with emphysema index are not significant in COPD patients with mild emphysema.

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丁 明,袁 成,李 萍,黄 静,朱晓莉.稳定期慢性阻塞性肺疾病患者肺泡灌洗液中IL⁃8、IL⁃17水平的相关性研究[J].南京医科大学学报(自然科学版),2019,(6):884-889

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  • 收稿日期:2018-12-15
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  • 在线发布日期: 2019-07-01
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