摘要
目的探讨不同胰岛素水平对脓毒症患者的体外单核细胞分泌和抗原递呈功能的影响。方法分离10例脓毒症(sepsis)患者外周血单核细胞进行体外培养。根据培养液中胰岛素浓度的不同分为5组:A组(不含胰岛素)、B组(胰岛素浓度为10μU／ml)、C组(100μU／ml)、D组 (1000μU／ml)和E组(5000μU／ml)。在不同培养液中培养24 h,观察单核细胞内毒素刺激后的分泌细胞因子(TNF-α、IL-6、IL-10)和抗原递呈功能(HLA-DR表达)的变化。结果单核细胞经过24 h 的培养,内毒素刺激后分泌TNF-α和IL-6的能力在较低胰岛素浓度时均无明显变化。当培养液中胰岛素浓度增加到1000μU／ml时,单核细胞分泌TNF-α和IL-6的能力均显著下降(A组与D组比较, P<0．05)。在各胰岛素浓度下,单核细胞分泌IL-10和表面抗原HLA-DR的表达均无明显变化。结论胰岛素能抑制内毒素刺激后脓毒症患者单核细胞分泌IL-6、TNF-α等炎性细胞因子的能力。提示外源性给予胰岛素对脓毒症患者有潜在的抗炎作用。
Objective To observe the in vitro cytokines production and expression of human leukocyte antigen DR （HLA-DR） in monocytes in human septics. Methods Monocytes were isolated from 10 septic patients to observe the secretion function of TNF-α, IL-6 and IL-10 and HLA-DR expression in monocytes. Monocytes were isolated and incubated with different concentration of insulin ： group A （ no insulin）, group B （ 10μU/ml） ,group C （ 100μU/ml） ,group D （ 1000 μU/ml） and group E （5000μU/ ml）, for 24 hours at 37℃. The levels of TNF-α, IL-6 and IL-10 in the supernatants were tested by ELISA. The antigen presenting function represented by HLA-DR expression was detected by flow cytometry analysis. Results With lower insulin concentration of culture media, secretion of TNF-α and IL-6 did not change in monocytes after excitation by LPS. When the insulin concentration elevated to 1000μU/ml, monocyte excretion of TNF-α and IL-6 was on significant depression （ group D vs. group A, P 〈 0. 05）. Along with upgraded insulin concentration in culture media, the expression of HLA-DR and the secretion of IL-10 in monocyte was not changed. Conclusion Insulin has the ability to suppress synthesis of TNF-α and IL-6 in monocytes in human sepsis, and hence benefits the treatment of sepsis and septic shock.
出处
《中华普通外科杂志》
CSCD
北大核心
2006年第3期218-220,共3页
Chinese Journal of General Surgery
基金
军队"十五"重点科研基金资助项目(01Z011)
