胃肠病学和肝病学杂志

目的探讨炎症因子肿瘤坏死因子-α(tumor necrosis factors-α,TNF-α)、白介素-6(IL-6)和白介素-4(IL-4)在溃疡性结肠炎(ulcerative colitis,UC)中的表达水平及临床意义。方法利用葡聚糖硫酸钠盐(dextran sodium sulfate,DSS)诱导C57BL/6小鼠,构建UC小鼠模型,病理学鉴定结肠炎症组织及正常组织,并采用实时荧光定量PCR(RT-PCR)方法检测不同炎症组织中TNF-α、IL-6和IL-4的mRNA水平。临床上,采用酶联免疫吸附试验(ELISA)方法检测62例UC患者及26名正常对照者血清中TNF-α、IL-6和IL-4的水平,分析炎症因子与结肠炎病变的相关性。结果 UC动物模型中,结肠炎症组织TNF-α、IL-6的mRNA表达水平明显高于正常组织(P<0.05),而IL-4 mRNA表达水平明显低于正常组织(P<0.01)。UC活动期患者血清TNF-α、IL-6水平明显高于正常对照组和UC缓解组(P<0.05),且与结肠炎严重程度呈正相关;而IL-4水平明显低于对照组和UC缓解组(P<0.05),且与UC严重程度呈负相关。结论促炎因子TNF-α、IL-6和抑炎因子IL-4的表达失衡与UC的病情进展相关,对UC的诊断和临床评估具有重要意义。

Objective To investigate the clinical significance of cytokines-TNF-α,IL-6 and IL-4 in ulcerative colitis( UC). Methods UC mouse model was induced by DSS and identified in pathology. The mRNA expression of TNF-α,IL-6 and IL-4 in colitis and normal tissues were detected by real-time PCR. The serum TNF-α,IL-6 and IL-4 of 62 UC patients and 26 healthy controls were measured by ELISA,and the correlation of cytokines with colitis severity was analyzed. Results In UC model,the mRNA expressions of TNF-α,IL-6 in colitis tissues were higher than that in normal tissues( P < 0. 05),while the mRNA expression of cytokine IL-4 in colitis tissues was lower than that in normal tissues( P < 0. 01). Moreover,the serum TNF-α and IL-6 in active UC patients were higher than that in healthy controls and remission UC patients( P < 0. 05),they were positively related with UC severity. However,the serum IL-4 in active UC patients was lower than that in healthy controls and remission UC patients( P < 0. 05),it was negatively related with UC severity. Conclusion The imbalance of pro-inflammatory and anti-inflammatory cytokines are correlated with colitis severity,which is very important for diagnosis and clinical appraisal of UC.