| ObjectiveDacryoadenitis is a common clinical disease in ophthalmology，and previous studies found that the occurrence of the disease might be related to infection, some granulomatous lesions, benign lymph epithelial lesions and other factors. In recent years, the increasing trend of the dacryoadenitis had been found that had the immune response characteristics in clinic. At the same time, some studies had shown that its pathological feature was the infiltration of T lymphocyte with great quantities in lachrymal. Many studies of about the disease considered that this kind of dacryoadenitis might belong to IgG4-related diseases.A variety of studies about autoimmune diseases considered that the imbalance of Thl/Th2was the main cause of the disease. At the same time, because of its independent regulating function in differentiation and development, Th17cells become the new element in the pathogenesis of autoimmune disease.Immunological researches showed that the occurrence of the dacryoadenitis was related to the abnormal immune response between lymphocytes and the lachrymal gland associated autoantigen. A variety of inflammatory cytokines and chemokines had been involved. Meanwhile, γ-interferon (γ-IFN), interleukin-4(IL-4) and IL-17had been recognized respectively as the characteristic cytokine of Th1, Th2and Th17.In the study, the level of interleukin4(IL-4), IL-17and γ-interferon (γ-IFN) in serum were measured with the method of enzyme-linked immunosorbent assay (ELISA) in31patients with dacryoadenitis, in inflammation period and inflammation remission period. And at the same time, we compared the results with32cases of IL-4, IL-17, and γ-IFN levels in normal human serum. We observed the contents and significances of IL-4, IL-17and γ-IFN with patients in inflammation period and remission period.Materials and Methods1Data and samplesA total of31dacryoadenitis patients with their data and blood samples in inflammation and remission stage were collected in our hospital from October2012to July2013, including12male and19female. The age of patients was from18years old to61years old, and the average age was42.8years old. The total of blood samples was62. Another32normal serum samples were collected in the same period in our hospital examination, without lacrimal gland inflammation or other autoimmune diseases, as the normal control group. The normal control group included17males and15females, aged22to63years, and the mean age was40.3years old.The inclusion criteria of immune response related dacryoadenitis: there were the redness and swelling of unilateral and bilateral sides lachrymal area repeatedly, and the illness history was more than3month, recurrence of at least1or more times, without treatment of glucocorticoid, immunosuppressants, and other related local radiation therapy.Exclusion criteria: without other eye diseases, autoimmune diseases, infections diseases and other malignant tumors, etc. The Institutional Review Board of Zhengzhou University had approved this research program. Ethics committee for examination and approval; All of the patients had signed informed consent. 2blood specimen collection and detecting methodsThere were2ml blood samples collected from patients with dacryoadenitis in the morning, then, after centrifugation the upper serum was carefully collected, placed in the EP tubes, stored at-80degrees in refrigerator. The serum of normal control group was from check-up center in our hospital.The concentrations of IL-4, IL-17, and γ-IFN in serum were detected by a double antibody sandwich enzyme-linked immunosorbent assay (ELISA) method, according to the reagent instructions. The wavelength was set to450nm in Automatic Microplate Reader (American Thermo Scientific company Multiskan MS), which sequentially measured the absorbance A value of each well, draw standard curve, and then the concentration of IL-4, IL-17, γ-IFN was calculated.3Statistical analysisSAS v9.1statistical software was used to analyze all the data. x_±s was used to express the levels of IL-4, IL-17, γ-IFN in serum. T test of normality and homogeneity of variance was carried on all the data in each group. Inflammation period mean and inflammation remission mean values were compared by paired T test data itself, comparison between normal control group mean and inflammation mean by two independent samples T test, and the comparison between normal control group mean and inflammation remission mean by two independent samples t test. α=0.05was the significance level.Results1Serum concentration of IL-4, IL-17and γ-IFN in normal control group, inflammation stage and inflammation remission stage in patients with dacryoadenitisSerum level of IL-4in normal control group was604.84~1293.06ng l-1, the average was826.09±137.40ng l-1; serum level of IL-17was108.88~164.36ng l-1, the average was133.42±17.53ng l-1; serum level of γ-IFN was166~191.52ng l-1, the average was191.86±17.82ng l-1. Serum level of IL-4in inflammation patients was945.96~1594.28ng l-1, the average was1151.56±178.43ng l-1; serum level of IL-17was178.42~300.5ng l-1, the average was220.68±37.07ng l-1; serum level of γ-IFN was371.56~432.08ng l-1, the average was400.28±15.57ng l-1.Serum level of IL-4in inflammation remission patients was604.06~987.33ng l-1, the average was890.47±194.68ng l-1; serum level of IL-17was106.6~156.78ng l-1, the average was126.65±15.30ng l-1; serum level of γ-IFN was175.86~241.04ng l-1, the average was203.82±19.63ng l-1.2Comparison serum IL-4, IL-17and γ-IFN among normal control group，inflammation stage and remission stage in patients with dacryoadenitisThere were significant differences(P <0.05) in serum IL-4, IL-17and γ-IFN between normal control group and dacryoadenitis inflammation period, there were not significant differences between normal control group and dacryoadenitis inflammation remission (P>0.05); there were significance differences between inflammation and inflammation remission in patients with dacryoadenitis (P <0.05).ConclusionIL-4, IL-17and γ-IFN can be considered as monitoring serology indexes of dacryoadenitis activity. Th1and Th17Th2cells which were represented by IL-4, IL-17and γ-IFN may participate in the inflammation process of lacrimal gland, and can be detected the changes in the serum. It was proved that the disease was associated with systemic immunity,and may be involved in cellular immunity and humoral immunity. |
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