外阴阴道念珠菌病患者血清及分泌物HMGB1、IL-17、IL-23表达水平及临床意义

摘要/Abstract

摘要： 目的探讨外阴阴道念珠菌病（vulvovaginal candidiasis，VVC）患者血清及阴道分泌物中高迁移率族蛋白1（high mobility group box-1，HMGB1）、白细胞介-17（interleukin-17，IL-17）和白细胞介-23（interleukin-23，IL-23）的表达水平及其临床意义。方法选取我院就诊的轻中、重度VVC患者及复发性外阴阴道念珠菌病（recurrent vulvovaginal candidiasis，RVVC）患者为观察组，同期的正常体检者为对照组，采用酶联免疫吸附试验（enzyme linked immunosorbent assay，ELISA）检测血清及阴道分泌物中HMGB1、IL-17和IL-23水平，并分析各指标之间及其与VVC临床症状严重程度间的相关性。结果本研究共纳入VVC患者105例，其中轻中度VVC组51例、重度VVC组21例、RVVC组33例；对照组39例。血清中，重度VVC组及RVVC组患者HMGB1水平均较对照组高（t=2.971，P=0.008；t=2.365，P=0.005），轻中度及重度VVC组IL-17水平均高于对照组（t=2.370，P=0.024；t=2.987，P=0.008），轻中度及重度VVC组、RVVC组IL-23水平均高于对照组（t=2.948，P=0.008；t=2.955，P=0.008；t=2.940，P=0.009）；分泌物中，轻中度及重度VVC组、RVVC组IL-17水平均高于对照组（t=2.273，P=0.029；t=2.097，P=0.049；t=2.075，P=0.046），仅轻中度VVC组IL-23水平高于对照组（r=2.624，P=0.017）。对HMGB1、IL-17进行相关性分析发现，外周血中，HMGB1水平与IL-17、IL-23表达成正相关（r=0.328，P<0.001，r=0.172，P=0.04），IL-23水平与IL-17表达成正相关（r=0.689，P<0.001）；分泌物中，IL-23水平与IL-17表达成正相关（r=0.268，P=0.001）；对HMGB1、IL-17、IL-23表达水平与VVC疾病严重程度的相关性分析发现，外周血中，HMGB1水平与疾病严重度成正相关（r=0.286，P=0.001）；分泌物中，IL-17水平与疾病严重度成正相关（r=0.273，P=0.001）。结论 VVC患者体内HMGB1、IL-17、IL-23水平上调，且与VVC的严重程度具有相关性，HMGB1、IL-17、IL-23可能参与VVC的发病。

关键词: 外阴阴道念珠菌病, 高迁移率族蛋白1, 白细胞介素-17, 白细胞介素-23

Abstract: Objective To investigate the expression and clinical significance of IL-17,IL-23,HMGB1 in vulvovaginal candidiasis. Method Various vulvovaginal candidiasis patients in our hospital were selected as the observation groups,and healthy volunteers were selected as the control group. ELISA was used to detect the expression of HMGB1,IL-17 and IL-23 in serum and vaginal discharge secretion of all subjects,and the relationship between the expression of these indexes and the clinical parameters of VVC was analyzed.Result In this study, 105 VVC patients were divided into mild and moderate VVC group (51 cases), severe VVC group (21 cases) and recurrent vulvovaginal candidiasis(RVVC) group (33 cases). 39 cases with normal physical examination results were selected as control group. In peripheral blood, the levels of HMGB1 in severe VVC group and RVVC group were higher than that in normal group (t=2.971, P=0.008; t=2.365, P=0.005). The levels of IL-17 in mild to moderate and severe VVC group were higher than that in control group (t=2.370, P=0.024; t=2.987, P=0.008), and the levels of IL-23 in mild, moderate and severe VVC group and RVVC group were higher than that in control group (t=2.948, P=0.008; t=2.955, P=0.008; t=2.940, P=0.009); In the vaginal discharge, the levels of IL-17, mild, moderate and severe VVC group and RVVC group were higher than those in control group (t=2.273, P=0.029; t=2.097, P=0.049; t=2.075, P=0.046), the levels of IL-23 in mild to severe VVC group were significantly higher than that in control group (r=2.624, P=0.017). From a correlation analysis between HMGB1, IL-17, IL-23 and clinical parameters of VVC, in peripheral blood, the level of HMGB1 was positively correlated with the expression of IL-17 (r=0.328, P<0.001; r=0.172, P<0.004), and the level of IL-23 was positively correlated with the expression of IL-17 (r=0.689, P<0.001), There was a positive correlation between IL-23 level and IL-17 expression in the vaginal discharge (r=0.268, P<0.001). in peripheral blood, the level of HMGB1 was positively correlated with severity of disease (r=0.286, P=0.001). In the vaginal discharge, the level of IL-17 was positively correlated with the severity of the disease (r=0.273, P=0.001). Conclusion Levels of HMGB1, IL-17 and IL-23 were significantly higher in VVC patients,and they were closely related to disease severity. These indexes may play an important role in the pathogenesis of VVC.

Key words: vulvovaginal candidiasis, HMGB1, IL-17, IL-23

中图分类号:

R519.3

高爱莉, 代歆悦, 李华平, 王焕丽, 马少吟, 陈教全, 朱慧兰. 外阴阴道念珠菌病患者血清及分泌物HMGB1、IL-17、IL-23表达水平及临床意义[J]. 中国真菌学杂志, 2021, 16(5): 314-318,325.

GAO Aili, DAI Xinyue, LI Huaping, WANG Huanli, MA Shaoyin, CHENG Jiaoquan, ZHU Huilan. The levels of HMGBl,IL-17 and IL-23 in patients with vulvovaginal candidiasis and its clinical significance[J]. Chinese Journal of Mycology, 2021, 16(5): 314-318,325.

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