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目的探讨在良性前列腺增生(BPH)患者中辅助性T细胞(Th)17和Th1/Th2/Th17相关细胞因子的表达及意义。方法收集2013至2014年住院手术且有完整病历资料的80例行尿道前列腺电切术(TURP)的BPH患者的术前外周血及术中前列腺组织标本,根据病理学检查是否合并组织学炎症分为单纯组和炎症组。另选取20例健康男性作为对照组。采用流式微球技术检测血浆Th17细胞相关细胞因子(IL-17、IL-23)、Th1细胞相关细胞因子(IFN-γ、IL-2)和Th2细胞相关细胞因子(IL-4、IL-6)的水平;流式细胞术检测外周血单个核细胞(PBMC)中Th17细胞的比例;免疫组化法检测IL-17蛋白在前列腺组织中的表达。结果 (1)80例TURP切除的前列腺组织标本中,有60例(75%)患者前列腺组织中存在组织学炎症,依据组织学炎症情况分为BPH轻度(n=31)、中度(n=18)和重度炎症组(n=11);另20例不存在组织学炎症(单纯组)。(2)BPH炎症各亚组患者血浆IL-17含量明显高于对照组和单纯组患者(P均<0.05),但轻、中、重度炎症亚组间比较无统计学差异(P均>0.05)。其他细胞因子(IL-23、IFN-γ、IL-6、IL-4、IL-2)含量在不同组别之间比较水平相近(P均>0.05)。(3)流式细胞术检测结果,BPH炎症各亚组PBMC中Th17细胞百分比均较单纯组有升高的倾向,但差异无统计学意义(P均>0.05)。(4)在前列腺组织中,BPH轻、中、重炎症组IL-17蛋白表达水平分别高于对照组和BPH单纯组(P均<0.05),IL-17蛋白表达水平与BPH的组织学炎症程度呈正相关(r=0.501,P=0.014)。结论 Th1和Th2细胞对BPH的影响可能不大;而Th17细胞存在升高趋势,其相关细胞因子IL-17在血浆中的含量和前列腺组织中的表达水平明显增高。推测Th17可能经前列腺组织中的炎症因子作用迁移至前列腺组织中而促进前列腺增生。
Objective To investigate the expression and significance of T helper 17 and Th1 / Th2 / Th17 related cytokines in patients with benign prostatic hyperplasia (BPH). Methods Preoperative peripheral blood and prostate tissue samples were collected from 80 BPH patients undergoing urethral prostatectomy (TURP) during hospitalization from 2013 to 2014 with complete medical records. Tissue inflammation scores Simple group and inflammation group. Another 20 healthy men as the control group. Flow cytometry was used to detect the levels of Th17-related cytokines (IL-17, IL-23), Th1-related cytokines (IFN-γ, IL-2) and Th2 related cytokines ). The proportion of Th17 cells in peripheral blood mononuclear cells (PBMCs) was detected by flow cytometry. The expression of IL-17 protein in prostate tissues was detected by immunohistochemistry. Results (1) Histological inflammation was found in prostate tissue of 60 cases (75%) of 80 cases of TURP resected prostate tissue. According to histological inflammation, they were divided into mild (n = 31), moderate = 18) and severe inflammation group (n = 11). The other 20 cases had no histological inflammation (simple group). (2) The levels of plasma IL-17 in each subgroup of BPH patients were significantly higher than those in control group and simple group (all P <0.05), but there was no significant difference among mild, moderate and severe subgroups of inflammation (P> 0.05 ). The levels of other cytokines (IL-23, IFN-γ, IL-6, IL-4 and IL-2) in different groups were similar (all P> 0.05). (3) Flow cytometry results showed that the percentages of Th17 cells in PBMC of each subgroup of BPH inflammation were higher than that of the simple group, but the difference was not statistically significant (all P> 0.05). (4) In the prostatic tissue, the expression of IL-17 in BPH mild, moderate and severe inflammation group were higher than those in control group and BPH simple group (P <0.05), IL-17 protein expression and histological inflammation of BPH The degree was positively correlated (r = 0.501, P = 0.014). Conclusions Th1 and Th2 cells may not have a significant effect on BPH. However, Th17 cells have an increasing trend, and the content of IL-17 in plasma and the expression level in prostate tissue are significantly increased. It is hypothesized that Th17 may migrate into prostate tissue through the action of inflammatory factors in prostate tissue to promote benign prostatic hyperplasia.