Content and Clinical Significance of IL-15and IL-21in Serum of Patients with Thyroid-Associated Ophthalmopathy
|Keywords||thyroid related ophthalmopathy IL-15 IL-21 cytokines|
ObjectiveThyroid associated ophthalmopathy (TAO) is one of the most common disease in orbital diseases,incidence rates for the first in the orbital disease in adults, most closely associated with thyroid disease, belong to autoimmune diseases, its specific pathogenesis is not clear. In the process of the TAO, its characteristics is the extraocular muscle (EM) and orbital fat (OF) in the lymphocyte infiltration, extraocular muscle enlargement and orbital fat volume increase, ultimately lead to the orbital connective tissue structure change, clinical manifestations of exophthalmos. Many scholars generally think that TAO patients exist in a variety of disorders and abnormal expression of cytokines balance. In recent years, with the deepening of the research on cytokines, diagnosis and treatment in patients with TAO tend to be diversified, interleukins (IL) refers to a group of secreted by a variety of cell types, and used in a variety of cells, between cells can adjust the role of cytokines, and blood cell growth factor belong to cytokines, In information transmission, immune cell activation, T cell and B cell activation, proliferation and differentiation of mediated interleukins has an irreplaceable role. Now about IL-15and IL-21in expression levels in serum in patients with TAO, less coverage at home and abroad. This study put forward by the reference Mourits TAO Clinical activity score(CAS) standards, divided the patients into two groups:atypical activity and activity, according to activity in patients with severe degree classification is divided into invasive and non invasive, Respectively from peripheral blood in patients with IL-15and IL-21, Measuring the content change, solution added experimental basis for clinical treatment, and play a guiding role.Materials and MethodsCollected in June2011to April2012in our hospital endocrinology diagnostic information for patients with TAO and serum samples from76cases,35cases of male, female41cases; Aged22to69(38.1+11.2). Treatment, all patients were no other related and both have signed informed consent form. Inclusion criteria:accord with the standard of diagnosis of the TAO, all not line of glucocorticoid and immunosuppressants, any relevant local radiation therapy. Another collection of normal physical examination in our hospital outpatient medical center over the same serum specimens from35cases, there were no any hyperthyroidism and TuYanZheng shape, as control group,18cases of male, female17cases, aged23-63(35.2+10.5). TAO patients and normal control group were no statistical significance of age and sex ratio, comparable. TAO patients and normal control group medical, dawn on an empty stomach blood5ml, centrifugal supernatant, after put in PC tube-20℃, samples at once. Detection methods for the double antibody sandwich enzyme-linked immunosorbent (ELISA), and in strict accordance with the kit required specification, and calculate the density of IL-15and IL-21.Statistical analysisUsing SPSS17.0software for statistical analysis, measurement data with the average standard deviation of plus or minus (x+s); Comparing multiple samples of mean using single factor analysis of variance (One-Way ANOVA); Multiple sample mean differences between every two of mean comparison, according to the f test (Homogen city-of-variance), such as the population variance together with the LSD method is adopted, such as the population variance is to select Tamhane ’T2method. (P<0.05) showed significant difference, P<0.01, said there is a very significant difference.Results1.TAO activity of patients with serum IL-15and21levels of IL-higher than TAO activity group and normal control group, the difference was very significant (P <0.01); TAO the activity of serum IL-15and i1-6in patients with21levels higher than normal control group, the difference was statistically significant (P<0.05).2.Non invasive TAO patients serum IL-15and IL-21compared with normal control group no significant difference; And invasive TAO patients serum IL-15and IL-21levels higher than normal control group and non invasive group, the difference was very significant (P<0.01).3.6-10group and11-15grouping patients serum IL-15and21levels of IL-compared with0-5group,6-10grouping patients serum IL-15and the content of L-21, respectively is0-5group6times and almost13times;11-15grouping patients serum IL-15and the content of IL-21, respectively is0-5groups of nearly7and13times; Differences were very significant. So think IL-15and21the expression level of IL-as eye score increased significantly increases, TAO patients serum IL-15and i1-6levels in patients with TAO21aggravating gradually rise.ConclusionTAO patients serum IL-15and IL-21changes involved in the progress of TAO, the two levels in patients with TAO progress, increase gradually to rise. IL-15and IL-21is expected as the TAO of the clinical diagnosis, condition serious degree evaluation and guide the important indicator of a therapeutic intervention, TAO and become the evaluation of clinical curative effect and prognosis of important indicators.