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目的探讨IL-18、总IgE、Th1和Th2类细胞因子在哮喘、慢性阻塞性肺病(COPD)发病时血清水平的变化及其相关性。方法随机收集哮喘急性发作期患者50例(哮喘组),老年COPD急性加重期患者80例(COPD组),健康者50例(对照组)血清,采用双抗体夹心酶联免疫吸附试验检测血清IL-18、总IgE、IL-8、IL-4、IFN-γ水平。结果COPD组急性期IL-18、IL-8、IL-4、IFN-γ水平分别高于对照组1.8、25.2、116、150.8倍。哮喘组IL-18、IL-8、IL-4分别高于对照组29.9、3.4、5.2倍。哮喘组血清总IgE水平高于对照组223.2倍,而COPD组血清总IgE水平与对照组相比无显著性差异。COPD血清中IL-18与IL-8、IFN-γ,IL-8与IL-4呈正相关;哮喘组IL-18与IL-8、IL-4、总IgE,IL-4与总IgE呈正相关。结论高血清IL-18提示细胞因子参与哮喘及COPD的发病过程。哮喘发作时IL-18与总IgE正相关,而在COPD急性加重期无相关性,表明COPD和哮喘是两类有不同发生机制的气道炎症。
Objective To investigate the changes of serum levels of IL-18, total IgE, Th1 and Th2 cytokines in the pathogenesis of asthma and chronic obstructive pulmonary disease (COPD) and their correlation. Methods Fifty patients with acute exacerbation of asthma (asthma group), 80 patients with acute exacerbation of COPD (COPD group) and 50 healthy controls (control group) were collected randomly. Serum IL-6 levels were measured by double antibody sandwich enzyme-linked immunosorbent assay -18, total IgE, IL-8, IL-4, IFN-γ levels. Results The levels of IL-18, IL-8, IL-4 and IFN-γ in COPD group were significantly higher than those in control group at 1.8, 25.2, 116 and 150.8 times respectively. The levels of IL-18, IL-8 and IL-4 in asthma group were 29.9, 3.4 and 5.2 times higher than those in control group respectively. The serum total IgE level in asthma group was 223.2 times higher than that in control group, while there was no significant difference in total serum IgE level between COPD group and control group. IL-18 and IL-8, IL-4, total IgE, IL-4 and total IgE in COPD serum were positively correlated with IL-8, IFN-γ, IL-8 and IL- . Conclusion High serum IL-18 suggests that cytokines are involved in the pathogenesis of asthma and COPD. There was a positive correlation between IL-18 and total IgE during asthma attacks, but no correlation between COPD and acute exacerbations, indicating that COPD and asthma are two types of airway inflammation with different mechanisms.