皮质类固醇激素对系统性红斑狼疮患者Th细胞因子平衡的影响

目的：探讨皮质类固醇激素治疗对系统性红斑狼疮（SLE）患者Th1/Th2细胞因子平衡的影响。方法：对58例SLE患者，于皮质类固醇激素治疗前后采用ELISA法检测其血清中Th1,Th2细胞因子水平，比较其差异。结果：皮质类固醇激素治疗前SLE患者体内Th1,Th2类细胞因子水平均显著高于正常人（P＜0.05）；在治疗后SLE患 本内上述细胞因子水平均较治疗前降低（P＜0.05），但Th1类细胞因子较Th2类细胞因子降低更为显著（P＜0.05）。结论：SLE患者经皮质类固醇激素治疗后，体内Th细胞因子平衡向Th2偏移，这可能为皮质类固醇激素治疗SLE患者机制之一。

Effect of corticosteroids on the balance of Th cytokines in patients with systemic lupus erythematosus]

OBJECTIVE: To investigate the levels of Th cell-derived cytokines and the effect of corticosteroids on the balance of Th1/Th2 cytokines in patients with systemic lupus erythematosus (SLE). METHODS: Fifty-eight SLE patients were treated with corticosteroids. Their IFN-gamma, IL-4 and IL-10 levels were detected by ELISA before and after the treatment with corticosteroids respectively; and the SLEDAI scores of the patients were compared before and after the treatment. RESULTS: Before the treatment, the serum levels of IFN-gamma, IL-4 and IL-10 were higher than those of the healthy controls (P < 0.05). After the treatment with corticosteroids, the elevated levels of IFN-gamma, IL-4 and IL-10 in the SLE patients were all significantly reduced than those before the treatment (P < 0.05). At the same time, the SLEDAI scores were significantly lower than those before the treatment (P < 0.01). The serum level of IFN-gamma was significantly decreased in the patients with SLE compared with the healthy controls (P < 0.05). By contrast, the levels of IL-4 and IL-10 of the patients with SLE were significantly increased compared with the healthy controls (P < 0.05). CONCLUSION: Corticosteroids may induce a shift from the Th1 to Th2 profile of cytokine secretion. This may be one aspect of the mechanisms for corticosteroids treatment.