支气管哮喘患者脂肪因子chemerin、omentin与Th17、Th9细胞的相关性研究

发布时间：2018-07-10 15:48

本文选题：哮喘 + 趋化素　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的:检测支气管哮喘患者循环血chemerin、omentin水平及Th17、Th9细胞的百分比,分析Th17和Th9细胞与Fe NO值的关系,并探讨二者在介导哮喘炎症病理中的相互关系。分析脂肪因子与Th17、Th9细胞的相关性,探讨脂肪因子chemerin和omentin在哮喘发病机制中可能介导的免疫和炎症调节作用。方法:收集支气管哮喘患者76例,根据GINA指南将入组患者分为间歇与轻度持续组28例,中度持续组26例和重度持续组22例,另外选取20例健康志愿者为对照组。收集患者临床资料,完成肺功能FEV1(%predicted)、FVC(%predicted)、FEV1/FVC(%)、PEF(%predicted)及Fe NO值的测定,FCM检测外周血PBMC中Th17和Th9细胞百分比,Elisa检测血浆脂肪因子chemerin和omentin浓度,并进行相关性分析。结果:1.哮喘各组肺功能FEV1(%predicted)、FVC(%predicted)、FEV1/FVC(%)水平均无统计学差异(p0.05),中(81.55±18.81)、重度(75.53±26.09)持续组PEF(%predicted)较间歇与轻度持续组(87.66±26.41)明显降低,差异有统计学意义(p0.05)。随病情严重程度加重,Fe NO值依次升高。2.随哮喘病情严重程度加重,Th17和Th9细胞比例升高。中(1.24±0.53%)、重度(1.69±0.52%)持续哮喘组Th17细胞比例明显高于间歇与轻度持续组(0.72±0.31%)和健康对照组(0.53+0.17%)(p0.05)。间歇与轻度(0.74±0.40%)、中度(1.04±0.33%)及重度(2.11±0.44%)持续哮喘组Th9细胞百分比较健康对照组(0.51±0.36%)显著升高(p0.05)。3.重度持续哮喘组(0.45±0.36 ng/ml)血浆chemerin浓度较健康对照组(0.18±0.06 ng/ml)明显升高(p0.05),而间歇与轻度(0.24±0.15 ng/ml)、中度(0.30±0.19 ng/ml)持续组与健康对照组(0.18±0.06 ng/ml)之间比较,差异无统计学意义(p0.05)。中(4.07±2.91 ng/ml)、重度(3.72±2.82 ng/ml)持续哮喘组患者omentin浓度与健康对照组相比(9.74±4.87 ng/ml)明显降低(p0.01),但间歇与轻度持续组(6.62±4.04 ng/ml)与健康对照组(9.74±4.87 ng/ml)无显著统计学差别。Chemerin与omentin范围在哮喘各亚组之间比较均无明显差别(p0.05)。4.哮喘患者外周血PBMC中Th17与Th9细胞表达均与Fe NO值正相关(r=0.43,p0.01;r=0.53,p0.01),同时二者在哮喘患者外周血中的表达率正相关(r=0.864,p0.01)。5.哮喘患者血浆chemerin浓度与外周血PBMC中Th17、Th9细胞比例均呈明显正相关(r=0.62,p0.01;r=0.71,p0.01);相反,血浆omentin水平与外周血PBMC中Th17、Th9细胞比例均显著负相关(r=-0.50,p0.01;r=-0.66,p0.01)。结论:1.支气管哮喘患者血浆中chemerin浓度升高,omentin浓度下降,提示chemerin和omentin与哮喘的发生发展有关;2.Th17、Th9细胞在哮喘患者中高表达,且与Fe NO值正相关,表明Th17和Th9细胞与T细胞促成的系统性炎症及维持气道炎症相关;3.哮喘患者外周血PBMC中Th17与Th9细胞比例正相关,提示Th17和Th9细胞在介导哮喘炎症病理进程中可能发挥协同致炎作用;4.哮喘患者血浆chemerin含量与Th17、Th9细胞比例呈正相关,而omentin含量与Th17、Th9细胞比例呈负相关,脂肪因子chemerin和omentin可能参与介导哮喘的炎症应答和免疫调节作用。
[Abstract]:Objective: to detect the level of chemerinomentin and the percentage of Th17 Th9 cells in bronchial asthma patients, to analyze the relationship between Th17 and Th9 cells and Fe no, and to explore the relationship between Th17 and Th9 cells in the pathogenesis of asthma inflammation. To analyze the relationship between fat factor and Th17 Th 9 cells and to explore the role of fat factor chemerin and omentin in the regulation of immune and inflammation in the pathogenesis of asthma. Methods: 76 patients with bronchial asthma were divided into intermittent and mild persistent group (n = 28), moderate persistent group (n = 26) and severe persistent group (n = 22) according to Gina guidelines, and 20 healthy volunteers were selected as control group. The clinical data of the patients were collected and the FEV1 (predicted) FVC (%) FEV1 / FVC (%) and FeNO value were measured. The percentage of Th17 and Th9 cells in peripheral blood PBMCs were detected by FCM-ELISA to detect the concentration of plasma fat factor chemerin and omentin, and the correlation analysis was carried out. The result is 1: 1. There was no significant difference in FEV1 (predicted) and FEV1 / FVC (%) levels between asthmatic groups (p0.05), moderate (81.55 卤18.81), severe (75.53 卤26.09) persistent group (75.53 卤26.09) and intermittent group (87.66 卤26.41), the difference was statistically significant (p0.05). The no value of Fe increased with the severity of the disease. The proportion of Th17 and Th9 cells increased with the severity of asthma. The percentage of Th17 cells in moderate (1.24 卤0.53%) and severe (1.69 卤0.52%) groups was significantly higher than that in intermittent and mild persistent groups (0.72 卤0.31%) and healthy controls (0.53 0.17%, p0.05). The percentage of Th9 cells in intermittent and mild (0.74 卤0.40%), moderate (1.04 卤0.33%) and severe (2.11 卤0.44%) groups was significantly higher than that in healthy controls (0.51 卤0.36%) (p0.05). The concentration of plasma chemerin in severe asthma group (0.45 卤0.36 ng/ml) was significantly higher than that in healthy control group (0.18 卤0.06 ng/ml) (p0.05), but there was no significant difference between intermittent group and mild group (0.24 卤0.15 ng/ml), moderate group (0.30 卤0.19 ng/ml) and healthy control group (0.18 卤0.06 ng/ml) (p0.05). The concentration of omentin in moderate (4.07 卤2.91 ng/ml) and severe (3.72 卤2.82 ng/ml) patients with persistent asthma was significantly lower than that in healthy controls (9.74 卤4.87 ng/ml) (p0.01), but there was no significant difference between intermittent group and mild group (6.62 卤4.04 ng/ml) and healthy control group (9.74 卤4.87 ng/ml). There was no significant difference between the two groups (p0.05). The expression of Th17 and Th9 cells in peripheral blood PBMC of asthmatic patients were positively correlated with Fe no value (r = 0.43p 0.01), and the expression rate of Th17 and Th9 cells in peripheral blood of asthmatic patients was positively correlated with that of peripheral blood (r = 0.864p 0.01) .5.The expression of Th17 and Th9 cells in peripheral blood of asthmatic patients was positively correlated with Fe no. In asthmatic patients, there was a significant positive correlation between the concentration of chemerin and the proportion of Th17hTh9 cells in peripheral blood PBMCs (r 0.62%, P 0.01), but there was a significant negative correlation between the level of plasma omentin and the proportion of Th17P Th9 cells in peripheral blood PBMCs (r-0.50p0.01p0.01r-0.66p0.01). Conclusion 1. The increase of plasma chemerin concentration in patients with bronchial asthma indicates that chemerin and omentin are related to the occurrence and development of asthma. 2. Th17T9 cells are highly expressed in asthmatic patients, and positively correlated with Fe no. Th17 and Th9 cells are associated with T cell-induced systemic inflammation and maintenance of airway inflammation. The proportion of Th17 and Th9 cells in peripheral blood PBMC of asthmatic patients was positively correlated, suggesting that Th17 and Th9 cells may play a synergistic role in the pathogenesis of asthma inflammation. There was a positive correlation between plasma chemerin content and Th17 Th9 cell ratio in asthmatic patients, but a negative correlation between omentin content and Th17 Th 9 cell ratio. Chemerin and omentin may be involved in mediating the inflammatory response and immune regulation of asthma.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R562.25

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