目的 观察成人支气管哮喘患者急性发作期外周血白细胞介素27(IL-27)表达变化,并探讨其临床意义.方法 选择支气管哮喘急性发作期患者20例作为哮喘组、体检健康者12例作为对照组.采集两组外周静脉血,提取血清及单个核细胞.用流式细胞术检测表达IL-27的树突状细胞比例;实时荧光定量PCR技术检测外周血单个核细胞IL-27亚基(p28、EBI3)及Th1、Th2细胞特异性转录因子(T-bet、GATA3)mRNA表达;酶联免疫吸附试验检测血清中IL-27、Th1细胞因子γ干扰素(IFN-γ)、Th2型细胞因子白细胞介素4(IL-4)水平,并与IL-27做相关分析.结果 哮喘组外周血IL-27阳性树突状细胞比例较对照组低(P<0.05).与对照组比较,哮喘组外周血p28、EBI3、T-bet mRNA表达及T-bet/GATA3低(P均<0.05),两组GATA3 mRNA表达比较差异无统计学意义(P>0.05).与对照组比较,哮喘组血清IL-27、IFN-γ水平低(P均<0.05),血清IL-4水平高(P<0.05).哮喘组血清IL-27水平与IFN-γ呈正相关(r=0.693,P<0.01),与IL-4无相关性(r=0.259,P>0.05).结论 成人支气管哮喘患者急性发作期外周血中I L-27呈低表达,其可能通过作用于T h 1细胞参与哮喘的发生发展.%Objective To investigate the expression changes and clinical significance of interlukin-27 (IL-27)in the peripheral blood of adult patients with acute exacerbation of asthma. Methods Twenty adult patients with acute exacerba-tion of asthma were collected as the asthmatic group,while 12 healthy controls from medical examination center were select-ed as the control group. Heparinized venous blood was collected from the two groups,and then peripheral blood mononucle-ar cells (PBMCs)were separated from the blood. The proportion of IL-27 + dendritic cells (DCs)was evaluated by flow cytometry. The mRNA expression levels of IL-27 subunits (p28,EBI3),Th1 and Th2 specific transcription factors (T-bet,GATA3)in the PBMCs were detected by quantitative real-time PCR (qPCR). The levels of serum IL-27,Th1 specif-ic cytokine interferon-gamma (IFN-γ),Th2 specific cytokine interleukin 4 (IL-4),and the correlations between them were examined by ELISA. Results Asthmatic patients showed down-regulated proportion of IL-27 + DCs as compared with the controls (P < 0. 05). Compared with the control group,the mRNA expression levels of p28,EBI3,T-bet,and the magnitude of T-bet expression versus GATA3 (T-bet/ GATA3)decreased in the asthmatic group (all P < 0. 05),while GATA3 mRNA expression was not statistically different between the two groups (P > 0. 05). Compared with the control group,the levels of serum IL-27 and IFN-γ significantly decreased,while the IL-4 level increased in the asthmatic group (all P < 0. 05). Moreover,in the asthmatic group,the level of serum IL-27 was positively correlated with IFN-γ (r =0. 693,P < 0. 001),but was not related with IL-4 (r = 0. 259,P > 0. 05). Conclusion The IL-27 is low expressed in the peripheral blood of adult patients with acute exacerbation of asthma,which suggests that IL-27 could contribute to the pathogenesis of asthma by regulating Th1 cells.
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