| Objective: Idiopathic pulmonary fibrosis (IPF) is a progressive and usually fatal lung disease characterized by alveolar epithelial injury, fibroblast proliferation and exuberant extracellular matrix remodeling, which result in irreversible distortion of the lung's architecture. Usual interstitial pneumonia (UIP) is the main histopathological pattern of IPF.The middle-aged and old persons are likely to suffer from the disease. The accurate morbidity is unknown. It was reported about ten for one hundrand million. And the mechanism of the disease is unknown as well. Prognosis is poor and it is reported that median survival is less than four years. About 55 percent of patients can live for more than five years.Only 29% of paitent with IPF live about ten years after their diagnosis. The present study aims to determine the change of serum levels of cytokines, such as TGF-β1, IL-4 and IL-12 in patients with IPF before and after treatment for 3 months and explore the relationship between such change and IPF. We hope the experiment may provide us with some possible measures for monitoring the change of the condition of IPF, evaluating the effect of treatment.It may help us determine the treament. Method: The case group involved twenty patients with IPF who were selected in out-patient clinic in the second hospital of Hebei Medical University from 3, 2005 to 10, 2006. Among the 20 patients, 9 were male and 11 were female. The median age was 56 years(range from 46 to 65 years). The diagnosis of IPF was in accordance with the international consensus statement defining the diagnosis and treatment of IPF from the American Thoracic Society in 2000. We excluded patients with infection, heart failure, cancer, thromboembolism, uncontrolled diabetes, peptic ulcer, severe osteoporosis, tuberculosis. And we also excluded patients with severe cardiac, hepatic, renal disease, pregnancy(or its pursuance), mental disease. The control group involved twenty healthy people (10 male and 10 female). The median age was 56 years(range from 43 to 63 years).The patients of case group had been treated with delta prenovis for three months. Four ml blood samples from healthy controls and patients before and after treatment were collected and separated. Serum levels of TGF-β1, IL-4 and IL-12 were measured by ELISA according to directions in the test kit.All the statistical analysis was deal with the SPSS13.0 software. All data were shown as mean±SD. Comparisons of measurement data were performed using the t-test and the analysis of variance. Comparisons of enumeration data were performed using the chi-square test. Statistical significance was defined as P <0.05.Results:1 The serum TGF-β1 levels were increased in the patients with IPF before treatment(107.78士21.91ng/ml ), compared with the control subjects(26.32士12.66ng/ml), and there were statistical significances (P<0.05). The serum IL-4 levels(10.75士2.26ng/ml) were augment compared with the healthy control subjects(3.65士1.39ng/ml), and there were statistical significances (P<0.05). The serum IL-12 levels(2.68士0.66g/ml) were decreased compared with the healthy control subjects(7.58士1.85ng/ml), and there were statistical significances (P<0.05).2 The serum TGF-β1 levels in the patients with IPF after treatment(87.78士16.31ng/ml) were decreased compared with those before treatment(107.78士21.91ng/ml), and there were statistical significances(P<0.05). The serum IL-4 levels in the patients with IPF after treatment(8.78士1.74ng/ml) were decreased compared with those before treatment(10.75士2.26ng/ml), and there were statistical significances (P <0.05). The serum IL-12 levels in the patients with IPF after treatment(6.23士1.57ng/ml) were increased compared with those before treatment(2.68士0.66ng/ml), and there were statistical significances(P<0.05).Conclusions:1 The serum levels of TGF-β1 and IL-4 in patients with IPF significantly increase compared with the normal group,on contrary, The serum level of IL-12 in patients with IPF significantly decrease compared with the normal group. It shows that the serum levels of TGF-β1 , IL-4 and IL-12 may help us diagnose IPF. 2 After traement, the serum levels of TGF-β1 and IL-4 in patients with IPF significantly decrease, at the same time, the serum level of IL-12 in patients with IPF significantly increase.3 The study may show that the treament may affect the level of TGF-β1 , IL-4 and IL-12 in patients with IPF, may adjust the unbalanced Th1/Th2. But the accurate result must be confirmed by more experiments. |
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