首都医科大学学报 ›› 2023, Vol. 44 ›› Issue (3): 407-412.doi: 10.3969/j.issn.1006-7795.2023.03.008

• 内分泌研究与临床实践 • 上一篇    下一篇

Graves眼病患者血浆细胞因子浓度与临床活动度的相关性分析

谢荣荣1,史婷婷2,信中2,曹曦1,杨金奎1,2*   

  1. 1. 北京市糖尿病研究所/北京市糖尿病防治办公室,北京  100730; 2. 首都医科大学附属北京同仁医院内分泌科,北京 102600
  • 收稿日期:2023-03-01 出版日期:2023-06-21 发布日期:2023-06-08
  • 通讯作者: 杨金奎 E-mail:jkyang@ccmu.edu.cn
  • 基金资助:
    北京市医管局“培育计划”项目(PX2021006), 首都医科大学校培育基金(PYZ21090),首都医科大学附属北京同仁医院青年人才院内种子基金项目(2020-YJJ-ZZL-012) 

Analysis of the correlation between levels of cytokines and the clinical active severity in patients with Graves ophthalmopathy

Xie Rongrong1,Shi Tingting2, Xin Zhong2, Cao Xi1, Yang Jinkui1,2*   

  1. 1. Beijing Diabetes Research Institute/Diabetes Prevention and Control Office of Beijing Municipality, Beijing 100730, China; 2. Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 102600, China
  • Received:2023-03-01 Online:2023-06-21 Published:2023-06-08
  • Supported by:
    This study was supported by Beijing Municipal Administration of Hospitals Incubating Program (PX2021006), Foundation of Capital Medical University (PYZ21090),the Priming Scientific Research Foundation for the Junior Researcher in Beijing Tongren Hospital, Capital Medical University (2020-YJJ-ZZL-012). 

摘要: 目的  Graves眼病(Graves' ophthalmopathy,GO) 是一种器官特异性自身免疫疾病,是成人最常见的眼眶疾病之一,其导致的眼部损害给患者带来了沉重的身心负担。GO的发病机制包括炎症细胞(淋巴细胞、浆细胞、肥大细胞和巨噬细胞)增多,分泌多种细胞因子导致炎症反应。在本研究中,测定活动期及非活动期GO患者血浆12种细胞因子的浓度,探讨其与疾病临床活动度的相关性。方法  选取2021年1月-2023月1月在首都医科大学附属北京同仁医院内分泌科诊断为GO患者27例,并按照其临床活动性评分(Clinical Activity Score,CAS)将其划分为活动期组(CAS≥3)14例及非活动期组(CAS<3)13例。采用多重微球流式免疫荧光发光法检测血浆12项细胞因子 [包括白细胞介素(interleukin, IL)-1β、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-17、IL-12P70,干扰素(interferon, IFN)-α、IFN-γ、肿瘤坏死因子(tumor necrosis factor, TNF)-α] 浓度,同时收集所有研究对象的性别、年龄、肝肾功能、甲状腺功能及抗体等临床指标。结果  与非活动期组相比,活动期GO患者的IL-1、IL-4、IL-5、IL-8、IL-10、IL-17、TNF-α及IFN-γ浓度明显升高,差异均有统计学意义(P<0.05)。 Spearman相关性分析显示IL-1、IL-4、IL-5、IL-8、IL-10、IL-17、TNF-α及IFN-γ与CAS评分呈现显著正相关。单因素Logistic回归分析显示IL-1、IL-4、IL-5和IL-17升高会增加活动期风险。结论  (1)活动期GO患者IL-1、IL-4、IL-5、IL-8、IL-10、IL-17、TNF-α及IFN-γ浓度明显高于非活动期组,提示这些细胞因子可能参与了GO的免疫反应。(2)单因素回归分析显示,IL-1、IL-4、IL-5和IL-17升高会增加活动期风险,推测这4种细胞因子有望作为评判GO病情活动性的指标。

关键词: Graves眼病, 活动期病变, 非活动期病变, 细胞因子, 白细胞介素, 临床活动度评分

Abstract: Objective To explore the correlation between plasma levels of 12 cytokines and the clinical activity of the disease in patients with Graves' ophthalmopathy (GO) in active and inactive phases. Methods A total of 27 patients with GO were enrolled, who were diagnosed in the  Department of Endocrinology,  Beijing Tongren Hospital, Capital Medical University from January 2021 to January 2023. According to their Clinical Activity Score (CAS), the patients were divided into active phase group (14 cases, CAS ≥ 3) and inactive phase group (13 cases, CAS<3)  The levels of 12 cytokines in plasma were measured by multiple microsphere flow immunofluorescence luminescence method, including interleukin (IL)-1β IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, IL-12P70, interferon (IFN)-α, IFN-γ, and tumor necrosis factor (TNF)-α. The clinical characteristics such as gender, age, liver and kidney function, thyroid function, and antibody of all the subjects were collected. Results The levels of IL-1, IL-4, IL-5, IL-8, IL-10, IL-17,  IFN-γ and TNF-α  in active GO patients were significantly higher than those in inactive GO patients. Levels of TNF-α and IFN-γ were significantly increased in active GO patients, with statistically significant difference (P<0.05). Spearman correlation analysis showed that IL-1, IL-4, IL-5, IL-8, IL-10, IL-17, TNF-α and IFN-γ were significantly positively correlated with CAS score (P< 0.05). The univariate logistic regression showed that the elevated levels of IL-1, IL-4, IL-5 and IL-17 increase the risk of active phase. Conclusion The levels of IL-1, IL-4, IL-5, IL-8, IL-10 and IL-17 in active GO patients are significantly higher than those in inactive patients, suggesting that these cytokines may participate in the immune response of the disease. Elevated levels of IL-1, IL-4, IL-5 and IL-17 increase the risk of active phase, indicating a potential of these four cytokines as indicators for judging the activity of GO disease.

Key words: Graves' ophthalmopathy, active phase, inactive phase, cytokines, interleukin, clinical activity scoreGraves

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