元智昊, 闫红, 李玉堂, 林辉, 郭春文. 多发伤患者免疫功能抑制相关机制的研究[J]. 解放军医学院学报, 2016, 37(8): 842-844. DOI: 10.3969/j.issn.2095-5227.2016.08.007
引用本文: 元智昊, 闫红, 李玉堂, 林辉, 郭春文. 多发伤患者免疫功能抑制相关机制的研究[J]. 解放军医学院学报, 2016, 37(8): 842-844. DOI: 10.3969/j.issn.2095-5227.2016.08.007
YUAN Zhihao, YAN Hong, LI Yutang, LIN Hui, GUO Chunwen. Mechanisms of immunosuppression in patients with multiple trauma[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2016, 37(8): 842-844. DOI: 10.3969/j.issn.2095-5227.2016.08.007
Citation: YUAN Zhihao, YAN Hong, LI Yutang, LIN Hui, GUO Chunwen. Mechanisms of immunosuppression in patients with multiple trauma[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2016, 37(8): 842-844. DOI: 10.3969/j.issn.2095-5227.2016.08.007

多发伤患者免疫功能抑制相关机制的研究

Mechanisms of immunosuppression in patients with multiple trauma

  • 摘要: 目的 探讨多发伤患者免疫功能抑制相关机制。 方法 收集我院2014年1月- 2015年1月55例多发性创伤患者作为研究组,30例接受体检的正常人作为对照组。患者入院治疗1周后,抽取肘静脉血。采用速率散射免疫比浊法测定对照组和研究组血清中补体系统活化产物C3a、C4a、C5a和C5b-9水平;采用流式细胞术检测对照组和研究组外周血中间充质干细胞(mesenchymal stem cell,MSC)和调节性T细胞(regutatory T cell,Treg)含量;采用酶联免疫法(ELISA)检测对照组和研究组血清中IFN-γ、TGF-β和IL-10水平。 结果 研究组血清C3a、C4a和C5b-9分别为(0.65±0.16) g/L,(0.18±0.06) g/L,(10.87±1.78) ng/L,对照组为(1.25±0.31) g/L,(0.32±0.18) g/L,(26.38±2.28) ng/L,差异有统计学意义(P< 0.05);研究组C5a(185.56±3.45)μg/ml,对照组(131.58±12.15)μg/ml,差异有统计学意义(P< 0.05)。研究组外周血中MSC (3.98±0.25)%,Treg细胞含量(4.46±0.35)%,对照组为(2.58±0.12)%、(3.12±0.23)%,差异有统计学意义(P< 0.05);研究组血清IFN-γ、TGF-β和IL-10分别为(15.27±0.75) ng/ml、(10.08±0.65) ng/ml、(12.45±0.38) ng/ml,对照组为(8.74±0.51) ng/ml、(5.29±0.47) ng/ml、(7.96±0.52) ng/ml,差异有统计学意义(P< 0.05)。 结论 多发性创伤患者血清中C3a、C4a和C5b-9显著降低,补体系统的活性降低,患者处于免疫抑制状态,外周血中含有大量MSC和Treg细胞,血清中含有大量的免疫抑制因子如IFN-γ、TGF-β和IL-10,可显著抑制创伤后免疫反应。

     

    Abstract: Objective To investigate the mechanisms of immunosuppression in patients with multiple trauma. Methods From January 2014 to January 2015, 55 patients with multiple trauma were enrolled as research group, and 30 healthy individuals as control group. One week after hospitalization, the blood sample was collected and stored for analysis. The serum level of C3a, C4a, C5a and C5b-9 (the active products of complement system) of patients in control group and research group were measured by rate scattering immune turbidimetry, the amount of mesenchymal stem cells and Tregs in periphery blood were detected by flow cytometry, and the serum IFN-γ, TGF-β and IL-10 level were tested by ELISA. Results The C3a, C4a and C5b-9 levels of the research group were significantly lower than those of control group (0.65±0.16) g/L vs (1.25±0.31) g/L, (0.18±0.06) g/L vs (0.32±0.18) g/L, (10.87±1.78) ng/L vs (26.38±2.28) ng/L, P< 0.05, while the C5a level in serum in research group was significantly higher than that of control group (185.56±3.45)μg/mL vs (131.58±12.15)μg/mL, P< 0.05. The results of flow cytometry indicated that the amount of MSC and Tregs of the research group were higher than those of the control group (3.98±0.25)% vs (2.58±0.12)%, (4.46±0.35)% vs (3.12±0.23)%, P< 0.05. The levels of IFN-γ, TGF-β and IL-10 in research group were significantly higher than those of control group (15.27±0.75) ng/ml vs (8.74±0.51) ng/ml, (10.08±0.65) ng/ml vs (5.29±0.47) ng/ml, (12.45±0.38) ng/ml vs (7.96±0.52) ng/ml, P< 0.05. Conclusion Patients with multiple trauma has a low serum level of complement gystem active products such as C3a, C4a and C5b-9. The low activity of complement system results in a state of immunosuppression, the periphery blood of the patients contains large amount of immunosuppressive cells such as MSC and Tregs, and the serum level of immuno-suppressors such as IFN-γ, TGF-β and IL-10 increases obviously leading to obvious immune suppression after trauma.

     

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