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目的建立免疫性肝损伤模型,探讨Tim-3及Th17细胞在免疫性肝损伤发病过程中的动态变化及意义。方法 60只Wistar雄性大鼠随机分为急性组(10只)、中间组(10只)、慢性组(30只)和对照组(10只)。用刀豆蛋白A建模,在第0、2、4、6、8周时对慢性组大鼠实施体外心间取血1.5 ml,分离血清后于-20℃备用。8周建模成功后取完整肝脏并计算肝脏指数;生化分析法测血清中ALT、AST、TP及ALB的动态变化;ELISA法测血清中细胞因子Tim-3、IL-17、IL-6及IL-23的动态表达;HE染色观察肝脏的病理变化;免疫组化法检测肝脏中Tim-3和IL-17蛋白的表达。结果与对照组相比,急性组、中间组及慢性组的ALT及AST均显著升高(P<0.05),ALB显著下降(P<0.05)。中间组HE染色偶见假小叶,而慢性组发现有明显的炎性细胞和肝脏损伤,镜下假小叶较多见。在慢性组的不同阶段中,IL-17的动态表达是先升高,4周后开始降低(P<0.05);Tim-3的动态表达则是先降低,4周以后开始升高(P<0.05)。结论 Tim-3及Th17细胞参与了免疫性肝损伤的发病机制,其表达水平的变化可以在一定程度上反应病情的严重程度。
Objective To establish a model of immune liver injury and explore the dynamic changes of Tim-3 and Th17 cells during the pathogenesis of immune-induced liver injury. Methods Sixty Wistar male rats were randomly divided into acute group (n = 10), middle group (n = 10), chronic group (n = 30) and control group (n = 10). Using concanavalin A model, 1.5 ml of extracorporeal blood was drawn from the chronic group at 0, 2, 4, 6 and 8 weeks, and the serum was separated and stored at -20 ° C. Serum levels of ALT, AST, TP and ALB were measured by biochemical analysis. The levels of cytokines Tim-3, IL-17, IL-6 and IL- 23 in the liver. The pathological changes of the liver were observed by HE staining. The expressions of Tim-3 and IL-17 in the liver were detected by immunohistochemistry. Results Compared with the control group, the levels of ALT and AST in acute group, intermediate group and chronic group were significantly increased (P <0.05) and ALB significantly decreased (P <0.05). The middle group of HE staining occasional false lobules, and chronic group found obvious inflammatory cells and liver damage, under the microscope pseudarthrosis more common. The dynamic expression of IL-17 in the chronic group increased first and then decreased after 4 weeks (P <0.05). The dynamic expression of Tim-3 decreased first and then increased after 4 weeks (P < 0.05). Conclusion Tim-3 and Th17 cells are involved in the pathogenesis of immune-induced liver injury. The changes of their expression levels may reflect the severity of the disease.