【摘要】 目的检测慢性阻塞性肺疾病(COPD)患者外周血Th17细胞、Treg细胞分别占CD4+T细胞比例及全反式维A酸(ATRA)对其影响,探讨ATRA对COPD患者外周血Th17细胞、Treg细胞、Th17/Treg的影响及其对COPD的意义。方法收集COPD急性加重期患者23例(A组),COPD缓解期患者23例(B组),肺功能正常健康吸烟者23例(C组),肺功能正常健康非吸烟者23例(D组);分别抽取试验对象外周静脉血制备单个核细胞悬液(PBMC),分为空白对照组和ATRA干预组,应用流式细胞术检测所有对象ATRA干预前后Th17细胞、Treg细胞分别占CD4+T细胞的比例。结果 CD4+Th17细胞占外周血CD4+细胞比例:空白对照组均高于ATRA干预组(P<0.05),空白对照组中,A组[(6.95±2.33)%]高于B组[(5.21±1.37)%]、C组[(4.15±1.23)%]、D组[(2.84±1.21)%](P<0.05),B组高于C、D组(P<0.05),C组高于D组(P<0.05);ATRA干预组中,A组[(4.66±1.86)%]高于B组[(2.77±1.10)%]、C组[(3.10±1.28)%]、D组[(1.68±0.80)%](P<0.05),B组和C组相比差异无统计学意义(P>0.05),二者均高于D组(P<0.05);CD4+Treg细胞占外周血CD4+细胞比例:各ARTA干预组均高于空白对照组(P<0.05),空白对照组中,C组[(4.64±1.36)%]高于A组[(2.50±1.21)%]、B组[(3.46±1.29)%]、D组[(3.55±1.59)%](P<0.05),B组和D组相比差异无统计学意义(P>0.05),二者均高于A组(P<0.05),ATRA干预组中,C组[(6.28±1.44)%]高于A组[(3.26±1.44)%]、B组[(4.53±1.54)%]、D组[(4.45±1.94)%](P<0.05),B组和D组相比差异无统计学意义(P>0.05),二者均高于A组(P<0.05)。结论 Th17和Treg的失衡可能和COPD的发病机制相关,且Th17和Treg比例失衡程度和患者病情严重程度相关,ATRA在一定程度上能纠正Th17和Treg失衡。更多还原

【Abstract】 Objective To detect the proportion of Th17 cells and Treg cells in CD4+ T cells in the peripheral blood of the patients with chronic obstructive pulmonary disease(COPD) respectively and to survey the influence on them by all trans retinoic acid(ATRA), meanwhile to explore the influence and significance of the balance of Th17/Treg affected by ARTA in the peripheral blood of the patients with COPD. Methods To collect 23 patients with AECOPD, 23 patients with COPD ease period, 23 healthy smokers, 23 healthy non-smokers, to collect peripheral venous blood of every experiment object to prepare the peripheral blood mononuclear cell suspension(PBMC), and to divide them into blank group and ATRA intervention group, to detect the proportion of Th17 cells and Treg cells in CD4+ cells of all experiment objects of every group by the flow cytometry. Results The proportion of CD4+ Th17 cells and Treg cells in peripheral blood CD4+ cells: the blank groups were higher than ATRA intervention groups(P<0.05), in blank groups, group A(6.95±2.33)% was higher than group B(5.21±1.37)%, C(4.15±1.23)%, D(2.84±1.21)%(P<0.05), group B was higher than group C, D(P<0.05), group C was higher than group D(P<0.05); In ATRA intervention groups, group A(4.66±1.86)% was higher than group B(2.77±1.10)%, C(3.10±1.28)%, D(1.68±0.80)%(P<0.05), between group C and group B, the result was no statistically significant difference(P>0.05), and both of them were higher than group D(P<0.05); the proportion of CD4+ Treg cells accounted for peripheral blood CD4+ cells: artal intervention group was higher than blank group(P<0.05), in blank groups, group C(4.64±1.36)% was higher than group A(2.50±1.21)%, B(3.46±1.29)%, D(3.55±1.59)%(P<0.05), compared to group B and D, the difference was not statistically significant(P>0.05), but both of them were higher than group A(P<0.05), in ATRA intervention groups, group C(6.28±1.44)% was higher than group A(3.26±1.44)%, B(4.53±1.54)%, D(4.45±1.94)%(P<0.05), compared to group B and D, the result had no statistically significant difference(P>0.05), and both were higher than group A(P<0.05).Conclusions The imbalance of Th17 and Treg may be associated with the pathogenesis of COPD, and the variation of the imbalance of Th17 and Treg may be associated with the severity of COPD. ATRA can correct the imbalance of Th17 and Treg to some extent.更多还原