【摘要】：目的檢測(cè)CD4+CD25+Foxp3+Treg細(xì)胞及細(xì)胞因子IL-10、IL-17、IL-23在慢性蕁麻疹患者外周血中的表達(dá)水平,探討CD4+CD25+Foxp3+Treg細(xì)胞、Th17細(xì)胞、IL-17/IL-23炎癥軸、IL-10之間的關(guān)系及在慢性蕁麻疹發(fā)病中的免疫學(xué)機(jī)制。方法對(duì)50例來(lái)自于青島大學(xué)附屬醫(yī)院黃島院區(qū)皮膚科門診的慢性蕁麻疹患者組收集病史資料,抽取外周血,對(duì)40例來(lái)自于青島大學(xué)附屬醫(yī)院黃島院區(qū)健康查體中心的健康對(duì)照組收集基本臨床信息并抽取外周血。采用流式細(xì)胞術(shù)檢測(cè)外周血中CD4+CD25+Foxp3+Treg細(xì)胞的表達(dá)水平,采用酶聯(lián)免疫吸附試驗(yàn)(ELISA法)檢測(cè)血清中IL-10、IL-17、IL-23的表達(dá)水平。對(duì)兩組所測(cè)數(shù)據(jù)進(jìn)行整理及統(tǒng)計(jì)學(xué)分析,設(shè)P0.05,差異有統(tǒng)計(jì)學(xué)意義。所得數(shù)據(jù)兩組間定量資料的比較采用t檢驗(yàn)、組內(nèi)定量資料之間的相關(guān)性分析采用Pearson相關(guān)分析。結(jié)果(1)慢性蕁麻疹患者外周血中CD4+CD25+Foxp3+Treg細(xì)胞水平(1.59±0.50)%明顯低于健康對(duì)照組(3.24±0.77)%,差異有統(tǒng)計(jì)學(xué)意義(P0.05),且病程長(zhǎng)者外周血Treg細(xì)胞水平(1.18±0.33)%低于病程較短者(1.79±0.29)%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)慢性蕁麻疹患者血清中IL-10水平(199.09±149.99)pg/ml略高于健康對(duì)照組(162.79±134.44)pg/ml,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(3)慢性蕁麻疹患者血清中IL-17水平(294.09±76.97)pg/ml明顯高于健康對(duì)照組(104.71±43.58)pg/ml,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)慢性蕁麻疹患者血清中IL-23水平(2189.13±612.49)pg/ml明顯高于健康對(duì)照組(962.20±383.92)pg/ml,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(5)慢性蕁麻疹患者血清中IL-17水平與IL-23水平呈正相關(guān)(r=0.439,P0.05)。(6)慢性蕁麻疹患者外周血中CD4+CD25+Foxp3+Treg細(xì)胞水平與IL-10水平無(wú)明顯相關(guān)性(r=-0.263,P0.05)。(7)慢性蕁麻疹患者外周血中CD4+CD25+Foxp3+Treg細(xì)胞水平與IL-17水平無(wú)明顯相關(guān)性(r=0.264,P0.05)。結(jié)論慢性蕁麻疹患者外周血中CD4+CD25+Foxp3+Treg細(xì)胞比例及IL-17、IL-23水平存在明顯異常,提示CD4+CD25+Foxp3+Treg細(xì)胞和IL-17、IL-23參與了慢性蕁麻疹的發(fā)病,推測(cè)慢性蕁麻疹的發(fā)生可能與自身免疫有關(guān),需要進(jìn)一步研究。意義通過(guò)該課題的研究,可以為慢性蕁麻疹的預(yù)防及治療提供實(shí)驗(yàn)室依據(jù),也可以為其它過(guò)敏性皮膚病的研究及治療提供新的思路和方法。
[Abstract]:Objective to detect the expression of CD4 CD25 Foxp3 Treg cells and cytokines IL-10,IL-17,IL-23 in peripheral blood of patients with chronic urticaria and to explore the inflammatory axis of CD4 CD25 Foxp3 Treg cells, Th17 cells and IL-17/IL-23. The relationship between IL-10 and the immunological mechanism in the pathogenesis of chronic urticaria. Methods 50 patients with chronic urticaria from the Department of Dermatology, Huangdao Hospital, Qingdao University, were collected and their peripheral blood was drawn. The basic clinical information and peripheral blood were collected from 40 healthy controls from Huangdao District Health examination Center of affiliated Hospital of Qingdao University. The expression of CD4 CD25 Foxp3 Treg cells in peripheral blood was detected by flow cytometry and the expression of IL-10,IL-17,IL-23 in serum was detected by enzyme linked immunosorbent assay (ELISA). The data of the two groups were collected and statistically analyzed, and the difference was statistically significant (P 0.05). T test was used to compare the quantitative data between the two groups, and Pearson correlation analysis was used to analyze the correlation between the quantitative data of the two groups. Results (1) the level of CD4 CD25 Foxp3 Treg cells in peripheral blood of patients with chronic urticaria (1.59 鹵0.50)% was significantly lower than that of healthy controls (3.24 鹵0.77)%, the difference was statistically significant (P0.05). The level of Treg cells in peripheral blood of elderly patients with disease course (1.18 鹵0.33)% was lower than that of those with shorter course (1.79 鹵0.29)%. The serum IL-10 level of patients with chronic urticaria (199.09 鹵149.99) pg/ml was slightly higher than that of healthy controls (162.79 鹵134.44) pg/ml, (P0.05). (2). There was no significant difference (P0.05). (3) in serum IL-17 level between patients with chronic urticaria (294.09 鹵76.97) pg/ml and healthy control group (104.71 鹵43.58 pg/ml,). The serum IL-23 level of patients with chronic urticaria (2189.13 鹵612.49) pg/ml was significantly higher than that of healthy controls (962.20 鹵383.92) pg/ml, (P0.05). (4). There was a positive correlation between serum IL-17 level and IL-23 level in patients with chronic urticaria (P0.05). (5). P0.05). (6) there was no significant correlation between CD4 CD25 Foxp3 Treg cell level and IL-10 level in peripheral blood of patients with chronic urticaria (r = 0.263, P < 0.05). There was no significant correlation between CD4 CD25 Foxp3 Treg cell level and IL-17 level in peripheral blood of patients with chronic urticaria (P 0.05). Conclusion the proportion of CD4 CD25 Foxp3 Treg cells and the level of IL-17,IL-23 in peripheral blood of patients with chronic urticaria are obviously abnormal, which suggests that CD4 CD25 Foxp3 Treg cells and IL-17,IL-23 are involved in the pathogenesis of chronic urticaria. It is speculated that the occurrence of chronic urticaria may be related to autoimmunity, which needs further study. The purpose of this study is to provide laboratory basis for the prevention and treatment of chronic urticaria, and to provide new ideas and methods for the study and treatment of other allergic dermatosis.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R758.24

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